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Support Care Cancer ; 28(3): 1295-1304, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31240464


PURPOSE: In resource-limited settings, family caregivers (FCGs) of adult cancer patients (ACPs) function in a context marred by high patient symptom burden, limited cancer care services and support and high caregiving burden. Despite this predicament, little is known about the quality of life (QoL) of FCGs in these settings. The study aimed to explore the determinants of QoL among FCGs of ACPs in Uganda. METHODS: A cross-sectional design was used to collect data from 284 FCGs of ACPs. The study questionnaire was composed of the Katz Index, Family Pain Questionnaire, modified Chronic Pain Self-efficacy Scale and the Caregiver Quality of Life-Index-Cancer. RESULTS: The mean age of FCGs was 36 ± 13.8 years. Most ACPs had stage 3 or 4 cancer (56%), severe pain (66.2%), reported moderate pain relief (51.1%) and were on chemotherapy (60.9%). The overall QoL of FCGs (70.2 ± 20.3) was moderate and 46.8% had low QoL. Most FCGs had high positive adaptation or financial concerns (55.3%) and low QoL in terms of burden (50.7%), disruptiveness (53.5%) and support (56.7%). The main determinants of overall QoL were FCGs' knowledge and self-eficacy for cancer pain management. The determinants of burden, disruptiveness, support and positive adaptations and financial concerns are reported. CONCLUSION: The key determinants of the QoL of FCGs were knowledge and self-efficacy for cancer pain management. In Uganda and similar settings, interventions to build FCGs capacity in cancer-related pain and other symptom management may help to enhance the QoL of FCGs and the ACPs.

Cuidadores , Neoplasias/terapia , Áreas de Pobreza , Qualidade de Vida , Adulto , Cuidadores/economia , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Estudos Transversais , Feminino , Recursos em Saúde/economia , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/economia , Neoplasias/epidemiologia , Manejo da Dor/economia , Manejo da Dor/psicologia , Manejo da Dor/estatística & dados numéricos , Cuidados Paliativos/economia , Cuidados Paliativos/métodos , Cuidados Paliativos/psicologia , Cuidados Paliativos/estatística & dados numéricos , Autoeficácia , Inquéritos e Questionários , Uganda/epidemiologia , Adulto Jovem
J Cancer Educ ; 34(6): 1150-1159, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30187440


Cancer-related pain is prevalent and has debilitating effects on patients and their family. The effects of cancer pain can be curtailed if the family members caring for the patient receive essential support to enhance their capabilities for cancer pain management. Little has been done to study the available support to family caregivers (FCGs) towards pain management in adult cancer patients (ACPs) living in resource-limited countries where the burden of cancer is on the rise. This study evaluated the influence of an education intervention delivered in the home setting on FCGs' knowledge and self-efficacy (SE) for pain management in ACPs. One-group pre-/post-test design was used in a sample of 54 FCGs who had been caring for ACPs suffering from pain for at least 1 month. Data were collected using the Family Pain Questionnaire and Caregiver Pain Management SE Scale. The FCGs' mean knowledge score post-intervention (26.69 ± 10) was higher than the baseline (45 ± 12.9), and the difference was statistically significant (t = 10.382, p = 0.000, CI = 17.12-25.43). Additionally, the FCGs' mean SE score post-intervention (1003.30 ± 191) was higher than the baseline (648.3 ± 273.4), and the difference was statistically significant (t = - 8.52, p = 0.000, CI = - 438.6-- 271.4). The home-based education intervention significantly and positively influenced the FCGs' knowledge and SE for pain management while at home. Cancer pain management educational interventions delivered at home should be considered as one of the strategies for enhancing cancer care in resource limited settings.

Dor do Câncer/terapia , Cuidadores/educação , Família/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Recursos em Saúde/economia , Neoplasias/complicações , Manejo da Dor/métodos , Adolescente , Adulto , Dor do Câncer/etiologia , Cuidadores/psicologia , Feminino , Recursos em Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/psicologia , Áreas de Pobreza , Autoeficácia , Inquéritos e Questionários , Adulto Jovem
Support Care Cancer ; 27(6): 2265-2274, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30327878


Adult cancer patients (ACPs) in resource-limited settings disproportionately suffer from inadequate pain control despite advancements in pain management. Family caregivers (FCGs) can support optimal pain control for ACPs in these settings if they are knowledgeable and confident about the needed care. However, the status of FCGs' knowledge and self-efficacy (SE) for pain management in developing countries is not well established. PURPOSE: To assess the FCGs' knowledge and SE levels for pain management among ACPs while at home in a resource-limited setting. METHODS: Using a questionnaire that comprised a Family Pain Questionnaire and Chronic Pain Self-efficacy Scale, data were collected from 284 FCGs of ACPs receiving care from two cancer care centres. RESULTS: The FCGs had moderate knowledge (mean = 41.70 ± 14.1) and SE (mean = 795.95 ± 301.3) levels for pain management at home for ACPs. Majority of the FCGs had low knowledge (52.1%), but expressed higher SE (52.5%). Poor self-rated health among FCGs was significantly associated with low knowledge levels (OR = 1.75; 95% CI 1.024-2.978, p = 0.041). SE was significantly associated with perceiving a low impact of caregiving on health (OR = 1.55; 95% CI 1.074-2.239, p = 0.019), hours of caregiving per week (OR = 0.52; 95% CI 0.315-0.854; p = 0.01) and receiving organisational support (OR = 0.388; 95% CI 0.222-0.679; p = 0.001). CONCLUSION: The results show a need for deliberate interventions to enhance FCG knowledge and SE for pain management at home as one of the ways of improving cancer pain management in resource-limited settings.

Cuidadores/psicologia , Neoplasias/reabilitação , Manejo da Dor/métodos , Adulto , Estudos Transversais , Feminino , Humanos , Conhecimento , Masculino , Autoeficácia , Inquéritos e Questionários
Midwifery ; 28(3): 374-9, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-21601966


OBJECTIVE: across Africa the prevalence of postpartum depression is a major health problem affecting mothers, their infants and families. The purpose of this study was to explore the factors associated with postpartum depressive symptoms (PDS) among women living in a rural Ugandan district. DESIGN: descriptive correlation design. SETTING: Young-Child's Clinic of a public hospital, providing postpartum care services to approximately 450 women and their babies per month in a rural district of Uganda. PARTICIPANTS: 202 postpartum women who have lived in the rural district both during pregnancy and postpartum period following birth of the current infant of age ≤12 weeks. MEASUREMENTS: PDS were measured using the Edinburgh Postnatal Depression Scale (EPDS). FINDINGS: participants' mean age and number of children were 24±4.33 years and 2.85±1.26 children, respectively. Majority of participants were married (61%), delivered the current infant by normal vaginal delivery (91%) at a health facility (86%) and experienced no complications (80%). The mean EPDS score for the sample was 9.5±0.18 and 43% of the participants were found to have PDS (scores ≥10). Statistically significant relationships were found between PDS and factors such as number of female sexual partners the husband has (r=0. 28, p≤0.01); current problems in marriage (r=0.22, p≤0.01), participant's parity (r=-0.24, p≤0.05), infant's ability to breast feed (r=0.28, p≤0.05) and husband support during the postpartum period (r=0. 20, p≤0.05). CONCLUSION: male partners of postpartum women are a major source of factors associated with PDS in rural areas. IMPLICATION FOR PRACTICE: midwifery practitioners in rural settings should emphasise psychosocial assessment and male involvement in postpartum care to increase opportunities of identifying mothers at risk of PDS and implementation of interventions targeting men.

Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Tocologia/métodos , Mães/estatística & dados numéricos , Relações Enfermeiro-Paciente , População Rural/estatística & dados numéricos , Adulto , Atitude Frente a Saúde , Área Programática de Saúde , Feminino , Humanos , Recém-Nascido , Acontecimentos que Mudam a Vida , Relações Mãe-Filho , Mães/psicologia , Papel do Profissional de Enfermagem , Avaliação em Enfermagem/estatística & dados numéricos , Gravidez , Prevalência , Fatores de Risco , Apoio Social , Fatores Socioeconômicos , Uganda/epidemiologia , Adulto Jovem
J Contin Educ Nurs ; 43(2): 90-6, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21985072


BACKGROUND: The quality of nursing care in developing countries is poor, and attempts to improve it through continuing education programs are under way. Nurses' orientation toward lifelong learning has not been explored, despite its potential effect on the success of such programs. METHODS: The Jefferson Scale of Physician Lifelong Learning (JSPLL) was used to measure orientation toward lifelong learning among 200 nurses at Uganda's national hospital. RESULTS: Most participants had fair orientation (52%) toward lifelong learning (JSPLL mean score = 36.8 [SD = 7.2]) and rated their skills in self-directed learning as good or excellent (44%). Reported barriers to lifelong learning included patient workload, lack of mentors, lack of library resources, and lack of computer skills. Nurses' orientation toward lifelong learning was significantly associated with professional experience (p ≤ .05), age (p ≤ .05), and education level (p ≤ .01). CONCLUSION: In Uganda, nurses' orientation toward lifelong learning remains low, and this has implications for successful implementation of continuing education programs for nurses.

Atitude do Pessoal de Saúde , Educação Continuada em Enfermagem , Recursos Humanos de Enfermagem no Hospital/educação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Uganda
Int J Qual Health Care ; 23(5): 516-23, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21775313


OBJECTIVE: To identify factors associated with general satisfaction among clients attending outpatient clinics in a referral hospital in Uganda. DESIGN: Cross-sectional exit survey of patients and care-givers in selected outpatient clinics. SETTING: Seven outpatients' clinics at Mulago National Referral and Teaching Hospital. MAIN OUTCOME MEASURES: Mean score of clients' general satisfaction with health-care services. RESULTS: Overall the clients' general satisfaction was suboptimal. Average satisfaction was higher among clients with a primary or secondary education compared with none, those attending HIV treatment and research clinic compared with general outpatient clients, and returning relative to new clients. Conversely, satisfaction was lower among clients incurring costs of at least $1.5 during the visit, and those reporting longer waiting time (>2 h). Client's perceived technical competence of provider, accessibility, convenience and availability of services especially prescribed drugs were the strongest predictor of general satisfaction. CONCLUSIONS: This study highlights the important findings about outpatient services at Mulago hospital. The sub-optimal satisfaction scores for outpatient care strongly suggest that more could be done to assure that services provided are more patient centered. Significant factors including category of clinic visited, waiting time, costs incurred, accessibility of services and perceived providers' technical competence at this hospital should be explored by the Makerere University College of Health Sciences and Mulago hospital for potential improvements in quality of the health service delivered.

Acesso aos Serviços de Saúde/normas , Ambulatório Hospitalar/normas , Satisfação do Paciente , Relações Profissional-Paciente , Adolescente , Adulto , Fatores Etários , Agendamento de Consultas , Estudos Transversais , Escolaridade , Feminino , Infecções por HIV/psicologia , Infecções por HIV/terapia , Gastos em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Medicamentos sob Prescrição/provisão & distribução , Uganda , Adulto Jovem