Ability and Preparedness of Family Physicians to Recognise and Treat Adolescent Mental Health Disorders in Nigeria and Ghana.

Background: Management of mental health disorders has not been fully integrated into primary care despite been advocated by the World Health Organisation (WHO) and the World Organisation of Family Doctors (WONCA). This study therefore seeks to assess the ability and preparedness of Family Physicians to recognise and treat mental health disorders in adolescents. Methodology: A descriptive cross-sectional study of 233 randomly selected Physicians Practicing in Family Medicine Clinics in Nigeria and Ghana was conducted using a semi structured self-administered questionnaire that was developed by the researchers and validated with a Cronbach's alpha coefficient of .85. Data analysis was done with the Statistical Package for Social Sciences™ (IBM Corp, Armonk, NY, USA) version 22.0. Results: Respondents had a mean age of 43 ± 8 years, were mostly males 130 (55.79%), practised in Nigeria 168 (72.10%) and have been in practice for over 10 years 149 (63.95%). Majority of respondents 153 (65.67%) received at least one Medical Education sessions in mental health in the preceding 12 months of the study. Out of these, 146 (95.42%) said the sessions enhanced their knowledge of mental health, and 121 (79.08%) said the sessions enhanced their abilities and preparedness to attend to patients with mental disorders. Barriers included stigmatisation 156 (66.95%), poor facilities 136 (58.37%), non-conducive environment 135 (57.94%) and non-cooperation from patients 133 (57.08%). Conclusion: This study showed that a lot of family physicians in Ghana and Nigeria are able and prepared to manage adolescent mental health disorders. They however cited stigmatisation, poor facilities and non-conducive environment as barriers to management of adolescent mental health disorders in primary care. Considering the severity of the disorder, there is a need to increase the training of Family Physicians in the management of adolescent mental health.

Common adolescent mental health disorders seen in Family Medicine Clinics in Ghana and Nigeria.

BACKGROUND: Mental health disorders among adolescents is on the rise globally. Patients seldom present to mental health physicians, for fear of stigmatization, and due to the dearth of mental health physicians. They are mostly picked during consultations with Family Physicians. This study seeks to identify the common mental health disorders seen by family Physicians in Family Medicine Clinics in Nigeria and Ghana. METHODS: A descriptive cross-sectional study involving 302 Physicians practicing in Family Medicine Clinics in Nigeria and Ghana, who were randomly selected for the study. Data were collected using self-administered semi-structured questionnaire, and were entered into excel spreadsheet before analysing with IBM-SPSS version 22. Descriptive statistics using frequencies and percentages was used to describe variables. RESULTS: Of the 302 Physicians recruited for the study, only 233 completed the study, in which 168 (72.1%) practiced in Nigeria and 65 (27.9%) in Ghana. They were mostly in urban communities (77.3%) and tertiary health facilities (65.2%). Over 90% of Family Medicine practitioners attended to adolescents with mental health issues with over 70% of them seeing at least 2 adolescents with mental health issues every year. The burden of mental health disorder was 16% and the common mental health disorders seen were depression (59.2%), Bipolar Affective Disorder (55.8%), Epilepsy (51.9%) and Substance Abuse Disorder (44.2%). CONCLUSION: Family Physicians in Nigeria and Ghana attend to a good number of adolescents with mental health disorders in their clinics. There is the need for Family Physicians to have specialized training and retraining to be able to recognize and treat adolescent mental health disorders. This will help to reduce stigmatization and improve the management of the disease thus, reducing the burden.

Being the nurse for my child at home: A qualitative analysis of parental recognition, appraisal, and reactions to childhood cancer in Ghana.

Parental involvement in childhood cancer care is of utmost importance, but the understanding of parental recognition, appraisal, and reactions to childhood cancer in settings such as Ghana is limited. We conducted an empirical phenomenological study to explore these aspects among Ghanaian parents. Twenty parents were purposively sampled to participate in semi-structured interviews between June and September 2022. All interviews were transcribed and analysed using an inductive thematic approach. We found that parents recognised symptoms through personal observation and their child's self-report, often perceiving them as non-severe. Emotional reactions upon receiving their child's cancer diagnosis included psychological distress, fear, doubts, and confusion. Enduring emotions experienced by parents were fears of disease recurrence and impending death of their child. Parents assumed the role of nurses at home, monitoring therapy effects, managing pain and symptoms, and dressing wounds. In conclusion, parents in Ghana play a crucial role in the recognition, diagnosis, and treatment pathways of childhood cancer. To enhance their ability to recognise symptoms and take timely actions, it is recommended to implement media programs and health education initiatives targeting parents.

Corrigendum to "A rapid review of the use of face mask in preventing the spread of COVID-19" [International Journal of Nursing Studies Advances 3 (2021) 100013].

[This corrects the article DOI: 10.1016/j.ijnsa.2020.100013.].

A rapid review of the use of face mask in preventing the spread of COVID-19.

INTRODUCTION: The original use of face masks was to help protect surgical wounds from staff-generated nasal and oral bacteria. Currently governments across the world have instituted the mandatory use of masks and other face coverings so that face masks now find much broader usage in situations where close contact of people is frequent and inevitable, particularly inside public transport facilities, shopping malls and workplaces in response to the COVID-19. OBJECTIVE: We conducted a rapid review to investigate the impact face mask use has had in controlling transmission of respiratory viral infections. METHOD: A rapid review was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Five electronic databases (CINAHL, Embase, Medline, PsycINFO and Global Health) were searched from database inception to date, using pre-defined search terms. We included all studies of any design and used descriptive analysis to report summary statistics of search results. Data were extracted including sample characteristics, study design, respiratory virus being controlled, type of face masks used and their effectiveness. RESULTS: 58 out of 84 studies met the inclusion criteria, of which 13 were classified as systematic reviews and 45 were quantitative studies (comprising randomised controlled trials, retrospective cohort studies, case control, cross-sectional, surveys, observational and descriptive studies). N = 27 studies were conducted amongst healthcare workers wearing face masks, n = 19 studies among the general population, n = 9 studies among healthcare workers the general population and patients wearing masks, and n = 3 among only patients. Face masks use have shown a great potential for preventing respiratory virus transmission including COVID-19. CONCLUSION: Regardless of the type, setting, or who wears the face mask, it serves primarily a dual preventive purpose; protecting oneself from getting viral infection and protecting others. Therefore, if everyone wears a face mask in public, it offers a double barrier against COVID-19 transmission.

Extension for Community Healthcare Outcomes-Palliative Care in Africa Program: Improving Access to Quality Palliative Care.

PURPOSE: There is limited access to quality palliative care (PC) for patients with advanced cancer in sub-Saharan Africa. Our aim was to describe the development of the Project Extension for Community Healthcare Outcomes-Palliative Care in Africa (ECHO-PACA) program and describe a preliminary evaluation of attitudes and knowledge of participants regarding the ability of the program to deliver quality PC. METHODS: An interdisciplinary team at the MD Anderson Cancer Center, guided by experts in PC in sub-Saharan Africa, adapted a standardized curriculum based on PC needs in the region. Participants were then recruited, and monthly telementoring sessions were held for 16 months. The monthly telementoring sessions consisted of case presentations, discussions, and didactic lectures. Program participants came from 14 clinics and teaching hospitals in Ghana, Kenya, Nigeria, South Africa, and Zambia. Participants were surveyed at the beginning, midpoint, and end of the 16-month program to evaluate changes in attitudes and knowledge of PC. RESULTS: The median number of participants per session was 30. Thirty-three (83%) of 40 initial participants completed the feedback survey. Health care providers' self-reported confidence in providing PC increased with participation in the Project ECHO-PACA clinic. There was significant improvement in the participants' attitudes and knowledge, especially in titrating opioids for pain control (P = .042), appropriate use of non-opioid analgesics (P = .012), and identifying and addressing communication issues related to end-of-life care (P = .014). CONCLUSION: Project ECHO-PACA was a successful approach for disseminating knowledge about PC. The participants were adherent to ECHO PACA clinics and the completion of feedback surveys. Future studies should evaluate the impact of Project ECHO-PACA on changes in provider practice as well as patient outcomes.

Malaria chemoprophylaxis: cross-sectional study of use among air travellers departing from Accra, Ghana.

Background: Malaria is the most common life-threatening infectious disease among travellers and chemoprophylaxis is recommended. The overall effectiveness, medication types and cost of malaria chemoprophylaxis in Accra are not well documented. This study investigated the use of chemoprophylaxis for malaria prevention in air travellers departing from Kotoka International Airport (KIA) in Accra, Ghana. Materials and methods: A cross-sectional study was conducted in the departure lounge of the KIA between February and May 2012. A total of 424 respondents voluntarily completed a semi-structured questionnaire, which included socio-demographic characteristics, duration of stay, nationality, country of permanent residence, chemoprophylaxis used, number of doses missed, cost and side effects experienced, and cost of treatment. Results: The mean age of respondents was 37 ± 0.84 years with a male:female ratio of 1.2:1.The mean duration of stay in Ghana was 47.9 days [SD 56.8] and 73.5% had made one trip to the country in the preceding year. Of the respondents, 50.7% were from Europe, 24.1% from North America and 17.5% from Africa. The most popular malaria prevention method used was prophylactics (37%) with atovaquone/proguanil used most frequently (34.9%), followed by mefloquine (11.6%) and doxycycline (7.8%). Compliance was high: 73.8% of respondents did not miss a single dose. The most commonly reported side effects were dreams, abdominal discomfort and headaches. Malaria incidence was 7.1% with 80% of them receiving treatment in a hospital or clinic; incurring a cost of up to $30 to treat a person. Conclusions: Most air travellers from Accr a take atovaquone/pr oguanil. Malaria incidence was low and most travellers were compliant with their chemoprophylaxis with very few side effects. The cost of chemoprophylaxis is low and is thus recommended for all travellers to Accra, Ghana.

A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

PURPOSE: To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. FINDINGS: A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. CONCLUSIONS: A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying.