Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study.

Background: Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods: We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings: Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion: To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.

Erratum: Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria.

[This corrects the article DOI: 10.3332/ecancer.2023.1615.].

Social capital for carers of patients with advanced organ failure: a qualitative exploration of stakeholders' perspectives.

BACKGROUND: Carers of patients with advanced organ failure (AOF) experience a tremendous caregiving burden. Social capital utilizes the internal strength of a community to support its members and may provide carers with comprehensive support. This study aimed to identify the different sources of social capital that can support carers of patients with AOF from the perspectives of stakeholders. METHOD: A descriptive qualitative study was conducted in community settings from April 2021 to May 2022. Stakeholders from medical social work departments, self-help groups, and non-governmental organizations were recruited, while some community members were invited through online media platforms. Individual semi-structured interviews were conducted using an interview guide. Interview transcripts were analyzed using a qualitative description approach. In total, 98 stakeholders, including 25 carers, 25 patients, 24 professionals, and 24 community members, were recruited using purposive and snowball sampling. RESULTS: Six categories about social capital for carers emerged, namely, carer attributes, the community, social care services, healthcare services, information, and policies. While the attributes of carers and their relationships with care recipients had a significant influence on caregiving, support from different groups in the community, such as neighbors and employers, was valued. Good communication of information about caregiving and social services was emphasized as being helpful by carers and other stakeholders. While carers presented a need for various healthcare and social care services, several features of these services, including their person-centeredness and proactive reach, were deemed useful. At the societal level, policies and research on comprehensive supportive services are warranted. The different sources of social capital constitute a multi-layer support system in the community. CONCLUSION: Carers can utilize personal attributes, interpersonal relationships, community resources, and societal contexts to enhance their caregiving. While this system can serve as a framework for building carer-friendly communities, interventions may be required to strengthen some aspects of social capital.

Knowledge, attitude and perception of cesarean section among pregnant women attending antenatal clinic at Babcock University Teaching Hospital, Ilishan-Remo, Ogun State.

Background: While the rate of Cesarean Section (CS) has been increasing in developed countries, the same cannot be said about developing countries, especially Nigeria. Despite the various indications of CS that may arise, the CS rate in Nigeria has remained as low as 2.7% as against the 15% acceptable upper limit according to the World Health Organization. The level of knowledge, perception, and attitude toward CS among pregnant women have been found to significantly influence the women's decision to utilize this life-saving means. Hence, the researchers conducted this study among pregnant women attending the antenatal clinic at Babcock University Teaching Hospital (BUTH), Ogun State, to assess their level of knowledge, perception and attitude toward CS.Methodology: A descriptive cross-sectional design was utilized. A questionnaire designed by the researchers was used to collect data from 200 respondents, and the data were analyzed with Statistical Package for the Social Sciences version 25. Results were reported with frequencies, mean scores and percentages.Results: Findings of the study showed that 78.5% had a high level of knowledge of CS, 67.5% had a good perception of CS, and 93% had a positive attitude toward CS. Around average (52.5%) considered CS a safe procedure, and 78.5% would agree to have CS if medically indicated. The majority (76.5%) believed that opting for a CS could save the life of the mother or the child.Discussion: In conclusion, the findings of this study show that although majority of the respondents had good knowledge and perception of CS, and were willing to accept CS when medically indicated, around one-third had poor perception of CS and around two-tenths would not agree to have it if medically indicated. Hence, nurses and other stakeholders are thus encouraged to always include CS lessons in antenatal teachings to ensure that every woman is knowledgeable enough to accept CS, especially when medically indicated.

Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria.

Background: Maternal health is the mother's state of well-being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State. Materials and Methods: This study is a cross-sectional survey. One hundred and eighty-eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self-designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product-moment correlation at 0.05 level of significance. Result: From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women. Conclusions: Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.

Key lifestyles and interim health outcomes for effective interventions in general populations: A network analysis of a large international observational study.

Background: The interconnected nature of lifestyles and interim health outcomes implies the presence of the central lifestyle, central interim health outcome and bridge lifestyle, which are yet to be determined. Modifying these factors holds immense potential for substantial positive changes across all aspects of health and lifestyles. We aimed to identify these factors from a pool of 18 lifestyle factors and 13 interim health outcomes while investigating potential gender and occupation differences. Methods: An international cross-sectional study was conducted in 30 countries across six World Health Organization regions from July 2020 to August 2021, with 16 512 adults self-reporting changes in 18 lifestyle factors and 13 interim health outcomes since the pandemic. Results: Three networks were computed and tested. The central variables decided by the expected influence centrality were consumption of fruits and vegetables (centrality = 0.98) jointly with less sugary drinks (centrality = 0.93) in the lifestyles network; and quality of life (centrality = 1.00) co-dominant (centrality = 1.00) with less emotional distress in the interim health outcomes network. The overall amount of exercise had the highest bridge expected influence centrality in the bridge network (centrality = 0.51). No significant differences were found in the network global strength or the centrality of the aforementioned key variables within each network between males and females or health workers and non-health workers (all P-values >0.05 after Holm-Bonferroni correction). Conclusions: Consumption of fruits and vegetables, sugary drinks, quality of life, emotional distress, and the overall amount of exercise are key intervention components for improving overall lifestyle, overall health and overall health via lifestyle in the general population, respectively. Although modifications are needed for all aspects of lifestyle and interim health outcomes, a larger allocation of resources and more intensive interventions were recommended for these key variables to produce the most cost-effective improvements in lifestyles and health, regardless of gender or occupation.

'Research is the last thing on our minds, we are in crisis': Experiences of Lagos state nurses towards research and scholarly endeavours.

AIM: To explore the experiences of Nigerian nurses in research and scholarly endeavours. DESIGN: Descriptive phenomenological qualitative study design. METHOD: In-depth interviews were conducted among 30 nurses until data saturation was reached. Data were analysed using the thematic analysis method, and consolidated criteria for reporting qualitative research guidelines (COREQ) were adhered to in reporting this study. RESULTS: Three themes emerged: (1) challenges of nurses with research; (2) the state of nursing research in Lagos state; (3) strategies to improve the state of nursing research in Lagos state. Some challenges nurses in Lagos State encounter with research include heavy workload and nursing shortage due to brain drain, faulty research foundation, lack of continuing education in research and the stressful nature of conducting research in Lagos. CONCLUSION: As research is essential in addressing healthcare challenges, policymakers are encouraged to employ more nurses to reduce the workload and provide time for research activities. Training and continuing education in research can be incorporated into professional development programmes. Lagos State will benefit from nursing research units in the hospitals, and a coordinating centre for the units should be provided with adequate funding. Support could be obtained from the Institute of Nursing Research Nigeria in establishing these structures. Hospital management should embrace and welcome research output from nurses and ensure such results are implemented to improve patients' care. Nurses who excel in research might be recognised with awards and other incentives to inspire their peers.

Global impacts of COVID-19 on lifestyles and health and preparation preferences: An international survey of 30 countries.

Background: The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. Methods: We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels. Results: 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. Conclusions: Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics.

eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study.

Background: Electronic health (eHealth) literacy may play an important role in individuals' engagement with online mental health-related information. Aim: To examine associations between eHealth literacy and psychological outcomes among Nigerians during the Coronavirus disease-2019 (COVID-19) pandemic. Methods: This was a cross-sectional study among Nigerians conducted using the 'COVID-19's impAct on feaR and hEalth (CARE) questionnaire. The exposure: eHealth literacy, was assessed using the eHealth literacy scale, and psychological outcomes were assessed using the PHQ-4 scale, which measured anxiety and depression; and the fear scale to measure fear of COVID-19. We fitted logistic regression models to assess the association of eHealth literacy with anxiety, depression, and fear, adjusting for covariates. We included interaction terms to assess for age, gender, and regional differences. We also assessed participants' endorsement of strategies for future pandemic preparedness. Results: This study involved 590 participants, of which 56% were female, and 38% were 30 years or older. About 83% reported high eHealth literacy, and 55% reported anxiety or depression. High eHealth literacy was associated with a 66% lower likelihood of anxiety (adjusted odds ratio aOR, 0·34; 95% confidence interval, 0·20-0·54) and depression (aOR: 0·34; 95% CI, 0·21-0·56). There were age, gender, and regional differences in the associations between eHealth literacy and psychological outcomes. eHealth-related strategies such as medicine delivery, receiving health information through text messaging, and online courses were highlighted as important for future pandemic preparedness. Conclusion: Considering that mental health and psychological care services are severely lacking in Nigeria, digital health information sources present an opportunity to improve access and delivery of mental health services. The different associations of e-health literacy with psychological well-being between age, gender, and geographic region highlight the urgent need for targeted interventions for vulnerable populations. Policymakers must prioritize digitally backed interventions, such as medicine delivery and health information dissemination through text messaging, to address these disparities and promote equitable mental well-being.

Satisfaction and perceived impact of virtual learning during COVID-19 lockdown: A case study of an online nursing research conference.

AIM: This study aimed to assess nurses' satisfaction and perceptions of the impact of virtual learning. DESIGN: A descriptive cross-sectional survey. METHOD: 236 nurses attending an online conference from several parts of Nigeria participated in the study. Analysed data were summarized and presented in tables and graphs, while linear regression was used to measure the associations. RESULTS: Most of the respondents perceived the programme as highly impactful. All three domains: learner-content interaction (p = 0.020), learner-instructor interaction (p = 0.000) and learner-learner interaction (p = 0.000), were found to be statistically significantly associated with the perceived impact of the programme, and thus statistically significant predictors of the effects of online learning (p = 0.02), (F = 5.471). Conclusively, the Interaction of learners with learning content, lecturers and other learners was seen as determinants of an effective and impactful online education. It is recommended that nursing training institutions embrace online learning either as the leading platform or as an adjunct to a face-to-face method.

Experiences of community tuberculosis volunteers in Ibadan north local government: A qualitative study.

BACKGROUND: Although several efforts have gone into combating tuberculosis (TB) in Nigeria, the country remains one of the worst hit with TB globally. Community Tuberculosis Care (CTBC) which refers to community TB efforts taken beyond the confines of the hospital facilities, has been suggested as a means to reach TB cases not reported or diagnosed. However, CTBC is in the formative stage in Nigeria, and the experiences of Community Tuberculosis Volunteers (CTVs) remain unclear. Hence, the study was conducted to explore the experiences of CTVs in Ibadan North Local Government. METHODS: A qualitative descriptive design with focus group discussion was adopted. CTVs in the Ibadan-north Local Government were recruited, and data were collected using a semi-structured interview guide. The discussions were audio-recorded. Qualitative content analysis method was used for data analysis. RESULTS: All the CTVs (10) in the local government were interviewed. Four themes emerged which include: CTVs' activities, the need of the patient living with TB, success stories, and challenges faced by CTVs. CTBC activities by the CTVs include case finding, awareness rallies, community education. The needs of the patient living with TB include finances, love, attention and support. Challenges encountered by them include myths, poor family and governmental support. CONCLUSION: CTBC was progressing well in this community as the CTVs have many success stories to share. However, the CTVs needed more support from the government in terms of finances, free and adequate drug supply, and assistance with media advert.

Awareness of Nigerian Mothers on the Risk Factors, Prevention and Management of Seizures in Newborns.

Objectives: The study aimed to assess the awareness of mothers on the risk factors, prevention, and management of seizures in newborns. Materials & Methods: This descriptive cross-sectional study was conducted on 359 mothers using simple random sampling. The data were collected using questionnaires that included general awareness, awareness of the causes, risk factors, prevention, and management. The data collected were analyzed using frequencies and percentages. Null hypotheses were tested using chi-square at 0.05 level of significance. Results: Two hundred seventy-four mothers (76.3%) had high awareness of seizures in newborns, thirty-four (9.5%) had average awareness, and fifty-one (14.2%) had low awareness. Two hundred seventy-three mothers (76%) had high awareness of the risk factors, and eighty-six (24%) had low awareness, meaning that although some respondents had misconceptions, awareness of the risk factors and causes was good. Two hundred twenty-three (62.1%) respondents had high awareness of preventing seizures in newborns, while 136 (37.9%) had low awareness. The awareness of respondents on managing seizures in newborns is positive, as 291 (81.1%) had high awareness of managing seizures in newborns, while sixty-eight (18.9%) had low awareness. There was a significant relationship between age (p =0.000), marital status (p=0.018), level of education (p =0.000), and awareness of risk factors of seizures in the newborn. Conclusion: A high awareness of neonatal seizures was found among mothers because of their high educational level, although some still had some misconceptions. Improving maternal neonatal seizure awareness and appropriate educational interventions to correct misconceptions are needed.

Manejo de la hemorragia posparto por parte de las matronas en centros sanitarios del estado de Ekiti: estudio cualitativo exploratorio / Management of postpartum hemorrhage by midwives in healthcare facilities in Ekiti state: An exploratory qualitative study

Objetivos: La mortalidad materna continúa planteando un desafío crítico en la práctica obstétrica, siendo la hemorragia posparto (HPP) una de las principales causas. El objetivo de este estudio fue explorar las experiencias vividas de matronas en relación con el manejo de la HPP. Métodos: El estudio empleó un enfoque fenomenológico cualitativo. Los participantes fueron seleccionados utilizando la técnica de muestreo intencional, reclutándose un total de 15 participantes para el estudio. La recopilación de datos se realizó utilizando una entrevista guiada semiestructurada para entrevistas en profundidad. Las entrevistas fueron grabadas en audio, y el análisis de datos se realizó mediante análisis temático. Resultados: Dos temas emergieron del análisis: 1) prácticas de manejo adoptadas contra la HPP y 2) protocolo hospitalario para el manejo de la HPP. Las principales prácticas de manejo adoptadas por las matronas fueron el uso de uterotónicos, especialmente la oxitocina junto con otras prácticas de manejo como el uso de prendas antichoque, estimulación de las contracciones por frotamiento del útero, evaluación de la causa del sangrado y sutura de laceraciones. También se dedujo que los diferentes centros sanitarios tienen su propia política para el manejo de la HPP. Las barreras que afectan el manejo efectivo de la HPP incluyen la falta de personal, la falta de disponibilidad de instalaciones y equipos adecuados, las restricciones de las enfermeras/parteras en el manejo de la HPP, la política hospitalaria desfavorable y la falta de comunicación entre el equipo de atención sanitaria. Conclusión: Las experiencias de los participantes sugieren que están algo satisfechos con el manejo de la HPP en sus centros. Sin embargo, deben abordarse las barreras como la falta de personal, la falta de disponibilidad de equipos, la mala comunicación entre los equipos...(AU)

Objectives: Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum hemorrhage (PPH). Methods: The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis. Results: Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum hemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team. Conclusion: The participants’ experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives’ experiences in PPH management.(AU)

Knowledge and acceptability of cervical cancer screening among female undergraduates in Babcock University Ilishan-Remo, Ogun State, Nigeria.

Background: Cervical cancer (CC) is currently the fourth most common cancer among women. There are several factors which have, in recent times, posed a threat to the recognition and acceptance of CC screening in Nigeria. This study was undertaken to assess the predictors of knowledge of female undergraduates at Babcock University, Ogun State, Nigeria, on CC screening and the level of acceptance readiness. Method: This study was a descriptive cross-sectional survey of 345 female undergraduates at Babcock University, Ogun State, Nigeria, using a self-administered structured questionnaire. Data collected were analysed using the Statistical Package for the Social Sciences (SPSS) version 23 software. Hypotheses were tested using Pearson product-moment correlation at p < 0.05 level of significance. Results: This study revealed that majority of the respondents have a substantial awareness and knowledge of CC screening (68.4%). The study suggested that health talk and level of exposure might be responsible for the good knowledge. While 47.5% were ready to undergo CC screening, 76.2% were ready to undergo the screening if a health professional performed the procedure, and 66.1% will tell their family members to go for screening. However, 49.9% reported not having the correct information on CC screening. A significant correlation was found between knowledge and acceptability of CC screening among the students (r = -0.366, p ˂ 0.05). Also, this study suggested that the age of female undergraduates is correlated with acceptance of CC screening (r = -0.221, p ˂ 0.05). Conclusion: As the acceptability of CC screening was high, CC screening facilities could be made available for the students. Similarly, educational interventions to improve awareness of CC screening among this population are warranted, as over one-third reported they did not have the correct information on CC screening.

Coping Experiences of Nigerian Women during Pregnancy and Labour: A Qualitative Study.

Background: Pregnancy and labour are defining moments in the lives of women. While these are joyful moments for many, some physical and psychological issues have been reported during labour and pregnancy. This study was conducted to explore the coping experiences of Nigerian women during pregnancy and labour. Methods: This is an exploratory qualitative study using the content analysis. The study was conducted from November 2021 to January 2022 in Ekiti State and Federal Capital Territory, Nigeria. In-depth interviews were conducted with 30 women selected using the purposive sampling technique. Data collection was stopped when we reached data saturation. Data were analyzed through content analysis using the NVIVO software version 12. Results: Two themes emerged from the study including coping strategies during pregnancy and trying to endure labour pain. The theme, coping strategies utilized during pregnancy, included obtaining the relatives' experiences, seeking information, religious practices, and engaging in exercise. The theme, trying to endure labour pain, consisted of exercising for pain relief, relying on God, Positive imagination, giving psychological support, and behaving according to the accepted cultural beliefs. Conclusion: Findings suggested that women utilized many non-pharmacological methods for coping. Interventions to support women during pregnancy and labour should consider these strategies during planning and implementation.

Management of postpartum hemorrhage by midwives in selected healthcare facilities in Ekiti State: An exploratory qualitative study.

OBJECTIVES: Maternal mortality continues to pose a critical challenge in obstetric practice, with postpartum haemorrhage as one of the major causes. This study aimed to explore the lived experiences of midwives regarding the management of postpartum haemorrhage (PPH). METHODS: The study employed a qualitative phenomenological approach. Participants were selected using purposive sampling technique, and 15 participants were recruited for the study. Data collection was done using a semi-structured interview guide for in-depth interviews. The interviews were audio-recorded, and data analysis was done using thematic analysis. RESULTS: Two themes emerged from the analysis, including 1) management practices adopted against PPH and 2) hospital protocol for the management of PPH. The major management practices adopted by the midwives were using uterotonics, especially oxytocin, and other management practices such as anti-shock garments, stimulation of contractions by rubbing the uterus, and assessment of the cause of bleeding and suturing of lacerations. It was also deduced that different healthcare facilities had policies for managing postpartum haemorrhage. Barriers affecting the effective management of PPH were understaffing, unavailability of suitable facilities and equipment, restrictions on nurses/midwives in managing PPH, unfavourable hospital policy and lack of communication among the healthcare team. CONCLUSION: The participants' experiences suggest they are somewhat satisfied with PPH management in their facilities. However, barriers such as understaffing, unavailability of equipment, poor communication among healthcare teams and restrictions on nurses in PPH management should be addressed to improve midwives' experiences in PPH management.

Effect of mHealth interventions on psychological issues experienced by women undergoing chemotherapy for breast cancer: A systematic review and meta-analysis.

BACKGROUND: A range of psychological issues often accompany breast cancer chemotherapy. Due to their ubiquity, mobile phones have been used to deliver supportive interventions addressing these issues. However, we currently lack sufficient evidence to guide the design of such interventions. AIM: To analyse and synthesise available evidence on the effectiveness of mobile-phone-based (mHealth) interventions in alleviating the psychological issues experienced by women receiving chemotherapy for breast cancer. METHODS: A systematic literature search was conducted from 14 relevant databases. Revman 5.4 was used to pool the quantitative results from comparable studies for statistical meta-analysis. For clinically heterogeneous studies where statistical pooling of results was not possible, a narrative summary was used to present the findings. RESULTS: The review included nine RCTs which covered 1457 patients. The meta-analysis results indicated a significant improvement in the quality of life (standardised mean difference [SMD] = 0.32, 95% confidence interval [CI] [0.07, 0.58], p = .01, I2  = 17%). No significant effects were found for anxiety (SMD = -0.01, 95% CI [-0.26, 0.25], p = .96, I2  = 53%) and depression (SMD = 0.02, 95% CI [-0.17, 0.20], p = .87, I2  = 0%). Individual studies suggest reduced symptom prevalence (p = .033, d = 0.27), symptom distress (p = .004, d = 0.34), symptom interference (p = .02, d = 0.51), supportive care needs (p < .05, d = 2.43); improved self-efficacy (p = .03, d = 0.53), self-esteem (p < .001, d = 0.87) and emotional functioning (p = .008, d = 0.30). The methodological quality ranged from low to moderate. CONCLUSION: mHealth interventions might help address certain psychological issues experienced by this population, although the evidence is still being gathered and not yet conclusive. More rigorous trials are warranted to confirm the suitable duration while addressing the methodological flaws found in previous studies. PROSPERO REGISTRATION NUMBER: CRD42021224307.

Javanese Women's Experiences during the First Pregnancy.

Background: Women experience physical, hormonal, and psychological changes during pregnancy. Similarly, some traditions are prevalent among Javanese women, which could affect their pregnancy. The experiences of first-time pregnant women in this area remain unclear. This study aimed to explore the lived experiences of women during their first pregnancy. Materials and Methods: The qualitative study with a phenomenological approach was conducted in Kesambon village in Malang Regency, Indonesia. Eight women in their third trimester were selected purposively. Data were gathered using semi-structured interviews and subsequently open-coded using the NVivo-12 software manufactured by the QS International. Results: The participants were married primigravida women aged 17 to 22 years. Four themes emerged as follows: pregnancy is a positive experience, pregnant women are not independent, belief in pregnancy-related myths and traditions, and pregnancy-related information seeking. Conclusions: During the first pregnancy, pregnant women believed and practiced Javanese traditions regarding pregnancy. Although they were happy, they were still dependent and lacked the motivation to seek pregnancy-related information. Hence, midwives should provide them with adequate pregnancy-related information while addressing harmful myths and misconceptions. This should culminate in a successful pregnancy.

Awareness and practice of breast self-examination among female staff at Babcock University, Nigeria.

Background: Despite the ever-growing breast cancer awareness campaigns in Nigeria, the practice of breast self-examination (BSE) continues to vary widely among women. We aimed to assess breast cancer awareness and practice of BSE among female staff at Babcock University, Ogun State, Nigeria. Methods: The cross-sectional descriptive design was adopted for this study. Data were collected using a structured questionnaire administered to 160 respondents. Data analysis was done using Statistical Package for Social Sciences version 23. Results: Although the majority of the respondents were highly aware of breast cancer (78.12%) and had good knowledge about BSE (96.9%), their practice of BSE was low. Only 11.3% always examine their breasts in the mirror by raising their hands over their head, looking at their breasts and examining it in a circular motion; 56% rarely looked for puckering, colour changes and dimpling of the skin when examining their breasts in the mirror, although 53.8% sometimes squeezed their nipples and looked for discharge when they examined their breasts. Conclusion: Knowledge and positive opinions toward preventive strategies for breast cancer should not be interpreted as readiness for practice. Educational intervention programs emphasising the importance of early detection in managing breast cancer should be reinforced to birth the desirable change.

Perceived feasibility and usefulness of mHealth interventions for psychoeducational support among Nigerian women receiving chemotherapy for breast cancer: a focus group study.

BACKGROUND: Women diagnosed with breast cancer (BC) receiving chemotherapy have reported various side effects, which adversely affect their psychological state. Evidence suggests that psychoeducational interventions (PEIs) delivered through mobile phones might effectively provide psychoeducational support for this population. However, there is a lack of evidence on Nigerian women's perception of mobile health (mHealth) PEI, which prompted this study. METHOD: A qualitative study was conducted among women with BC who had completed chemotherapy at two tertiary hospitals in Nigeria. Face-to-face focus group discussions were conducted at the oncology clinics. Data were collected using focus groups until data saturation was reached. Data were analyzed using thematic analysis. RESULTS: In total, 32 women were recruited, with seven focus group discussions conducted. The participants were between 22 and 75 years old and mostly diagnosed with Stage III BC. Four main themes emerged from the data analysis, including experiences of BC diagnosis and treatment phase, patients' needs during chemotherapy, coping with chemotherapy, and perception of mHealth intervention for psychoeducational support. BC diagnosis was devastating, and psychological disturbances were experienced while receiving chemotherapy, but the participants indicated that mHealth intervention was acceptable as it could provide psychological and informational support. The suggested contents include information on chemotherapy, how to deal with the fear of chemotherapy, nutritious diet locally available, and information on exercise. CONCLUSION: This study has shown that the participants perceived a mHealth PEI is feasible and acceptable in providing psychoeducational support for Nigerian women diagnosed with BC receiving chemotherapy. It is hoped that the unmet needs of this population will be addressed while receiving chemotherapy.