Structure and process factors that influence patients' perception of inpatient psychiatric nursing care at Mathari Hospital, Nairobi.

To explore structure and process factors which influence patients' perception of quality inpatient psychiatric nursing care at Mathari hospital. This was a cross-sectional study of 236 inpatients selected by stratified random sampling. Competence to give consent was determined by a minimum score of 24 on Mini Mental State Examination. Patients were interviewed using a semi-structured questionnaire. Differences in proportions of variables were determined by calculating confidence interval and summary chi-squared statistics. P-values of < or =0.05 were considered significant. Majority of patients (87%) were aged 20-49 years with 43% having stayed in the ward for over a month. Structure factors related to patients' perception of care included physical environment, being happy with the way the ward looked was significantly related to satisfaction with care (chi(2) = 5.506, P = 0002). Process factors significantly related to patients' satisfaction with care included nurses providing patients with information on prescribed medicines (chi(2) = 10.50, P = 00012). Satisfaction with care was positively related to ability to recommend someone for admission in the same ward (chi(2) = 20.2, P = 00001). Structure and process factors identified as influencing patients' perception of care were physical environment and nurses' qualities that fit within the characteristics of Peplau's Interpersonal Relations Theory.

The Pap smear for detection of bacterial vaginosis.

OBJECTIVE: To assess validity of Pap smears in diagnosing bacterial vaginosis. METHOD: A prospective diagnostic accuracy study with 533 women in Mombasa, Kenya. Diagnosis of bacterial vaginosis using clinical observations scored with simplified Amsel's criteria and Bethesda system for Pap smears was compared with a reference standard (Nugent criteria for gram stains). Both laboratory tests were interpreted blindly. RESULT: Bacterial vaginosis prevalence was 36.7% (191/521) with Nugent criteria. Pap smear sensitivity and specificity were 59.4% (111/187) and 83.3% (270/324), with corresponding figures for simplified Amsel's criteria of 44.8% (81/181) and 84.8% (263/310). For Pap smear and simplified Amsel's criteria, positive predictive values were 67.3 and 63.3%, and negative predictive values 78.0% and 72.5%. CONCLUSION: In diagnosing bacterial vaginosis, Pap smears have moderate sensitivity (though higher than simplified Amsel's criteria). Specificity of Pap smears is adequate. Including bacterial vaginosis assessment as a standard component of Pap smears warrants consideration.

Knowledge, attitudes and practices on the acquired immune deficiency syndrome (AIDS) among health workers in (Nyeri) a district in Kenya.

OBJECTIVE: To assess the level of knowledge, Attitudes and practices of health workers toward HIV/AIDS. METHOD: The study was a cross-sectional KAP study of HIV/AIDS among 263 health workers in a district in Kenya. A self administered questionnaire was completed by the health workers under the supervision of the investigators. The subjects were randomly selected and proportionately allocated to nurses, clinical officers and laboratory technologists. RESULTS: The study revealed that as significant proportion of the study subjects had high knowledge on the history and transmission of HIV/AIDS (over 85%). There was expressed fear a proportion of (46%) health workers in the handling of AIDS patients. Though a sizeable proportion was knowledgeable of the recommended procedures in relation to aseptic technique in routine clinical procedures (over 75%). Lack of sufficient supplies and logistics hindered the conformity to the guidelines. CONCLUSION: An integrated and comprehensive educational; programme and periodic feedback is recommended.

Relationship between nurses opinion on nursing care for HIV infected/AIDS patients and socio-economic factors in Nyeri District; Kenya

The main objective of the study was to relate the attitudes of nursing staff towards HIV positive and AIDS patients to the nurses' age; sex; religious affiliation and marital status. 211 nurses were randomly selected for the study form all health centres and the only District hospital in Nyeri; Kenya. Information was collected using a self-administered questionnaire; with the help and/or supervision of the investigators. There was statistically significant relationship between marital status of the nurses and the need to keep the HIV status of the patient confidential. 69 of the nurses said that it was not necessary to observe confidentiality for a number of reasons. Out of the 31 of those who said taht confidentiality was necessary; 83 were married. Nurses' expressed fear of contracting AIDS through casual contact did not have a significant relationship with christian denomination to which they were affiliated. 32 of the nurses said that one could get AIDS through casual contact. Other parameters are presented and discussed in this paper. It is evident that nurses need to be more enlightened on AIDS facts in order to improve on the quality of nursing care for HIV/AIDS patients