Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and ...Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.展开更多
Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of pre...Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of preconception care. Therefore, the aim of this study was to establish the provision of preconception care by midwives, nurses and doctors at Ndola Teaching Hospital in Zambia. Methods: A concurrent embedded mixed methodology utilising a descriptive explorative study design, where 107 respondents were randomly selected using the lottery technique for quantitative part and two focused group discussions for qualitative part of the study was used. A self-administered questionnaire was used to collect quantitative data and a focus group discussion guide was used for the focus group discussions. Statistical Package of Social Sciences version 26 with significance set at 0.05 and at 95% confidence level and thematic analysis were used for data analysis. Results: 75% of the respondents in this study were not providing preconception care and only 25% of respondents were providing preconception care;however, this was provided randomly because there were no guidelines to follow. Among the respondents, 81.3% had medium knowledge, 70.1% had good practices and 92.5% had positive attitudes towards preconception care. Further analysis showed that the association between preconception care and knowledge, practices and attitudes was not statistically significant (p = values 0.336;0.344;1.000 respectively). Multivariate logistic regression revealed that participants with high knowledge were five times more likely to provide preconception care (OR = 5.00, CI = 0.42 - 59.7, P = 0.203). Generally, all the participants acknowledged that preconception care was an important package that could prevent maternal and child morbidities and mortalities. Conclusions: The study revealed that most of the respondents were not providing preconception care. Provision of preconception was done by a small fraction of the respondents and it was done in an unorderly manner due to lack of set standards and guidelines. Despite medium levels of knowledge and generally good practices and positive attitudes towards preconception care, its random provision indicates a need for established standards to enhance maternal and child health outcomes.展开更多
Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabo...Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.展开更多
Introduction: Measles is a viral disease that is a major public health problem in both developed and developing countries. It is a contagious disease resulting from infection with the measles virus and is still respon...Introduction: Measles is a viral disease that is a major public health problem in both developed and developing countries. It is a contagious disease resulting from infection with the measles virus and is still responsible for more than 100,000 deaths per year. Although vaccination is one of the most successful and cost-effective public health interventions to reduce mortality and morbidity, approximately 1.4 million children worldwide die from vaccine-preventable diseases each year. In Zambia, MCV2 was 66% below WHO recommended target of 95%. This study therefore assessed the acceptability of second dose measles vaccination services among caretakers/mothers with children less than two years of age in Livingstone, Zambia. Methods: The study used analytical cross-sectional study design. A logistic regression analysis was performed to identify factors associated with acceptability of the second dose of measles vaccine. A semi structured questionnaire was administered to collect data on socio demographic characteristics and factors related to acceptability of the second dose of measles vaccine. SPSS version 26.0 was used for descriptive and inferential analysis at 5% level of significance. Results: There was no statistically significant difference in acceptability of the second dose of measles vaccine by gender, marital status, type of employment, income level, socio-cultural and traditional beliefs, and education level. However, there was a statistically significant difference in acceptability of the second dose of measles vaccine by knowledge level of second dose of measles vaccine. A Chi square test result indicated that second dose acceptability was higher with less children than that of respondents with many children (χ2(5) = 15.3, p and knowledge levels (χ2(2) = 14.8, p Changes in knowledge level from medium to high reduced the odds of second dose measles vaccine acceptability. Furthermore, this study showed that acceptance of the second measles vaccination increased from mothers/caretakers with low knowledge (3.6%) to medium knowledge (13.3%) and finally high knowledge (83.1%). Conclusion: Tailored messaging to increase knowledge among mothers and caregivers on the importance of the second dose of measles vaccine is critical in improving acceptability. Therefore, the researchers recommend that the health providers should continue to raise awareness associated with the low acceptability of the second dose of measles vaccine and improve on child preventable diseases such as measles.展开更多
Family resilience is not the sum of the individual psychological resilience of each of the family members,but the family itself as a unit of resilience research.The representative models of family stress tolerance the...Family resilience is not the sum of the individual psychological resilience of each of the family members,but the family itself as a unit of resilience research.The representative models of family stress tolerance theory mainly include Mc Cubbin's series of family stress tolerance models and Walsh's family stress tolerance framework,which are widely used in the practice of family therapy.In the future,empirical studies on family resilience should be strengthened,measurement tools with high reliability and validity should be established,and the combination of family resilience theory and community-based practice should be promoted.展开更多
Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perce...Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.展开更多
Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the...Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the lip and are sucked or chewed. The Zambian government, in the 2019 country report, gave an estimated figure of 4.5% of females aged 15 years and above in 2017 used smokeless tobacco and by 31st December, 2018, there was an increase of smokeless tobacco users to 6.8% women of the same age group. This study aimed to explore the extent of smokeless tobacco use among women in Kasama district-Zambia. Methodology: An analytical cross-sectional quantitative study design was used to collect data using the modified structured interview schedule, adopted from Medicine for Global Health. Simple random sampling method using rotary technique was used to select 430 respondents after meeting the inclusion criteria. Informed consent to participate in the study was obtained. Data was analysed using version 26.0 of the Statistical Package for Social Sciences. Appropriate parametric or non-parametric statistical tests (Chi-squared or Fisher’s exact test) were adopted in testing for associations between variables. Univariable and multivariable binary logistic regression analysis were employed in identifying smokeless tobacco use among women using an investigator-led stepwise approach, guided by various fit statistics and the likelihood ratio test. All statistical analyses adopted a 5% significance level at 95% confidence interval. Results: The results showed that most of the respondents were aged between 18 and 25 years (45.6%), (53.7%) lived in urban settlements and the majority (80%) were unemployed. The majority of respondents (83.5%) had a friend/relative who used smokeless tobacco and over half (53.5%) thought smokeless tobacco was beneficial to them. The commonly mentioned benefits of smokeless tobacco included body warmth (13.6%) and vaginal tightening (7.9%). The results revealed that most of the respondents attained a secondary level of education (38.4%). According to the study, smokeless tobacco use among women of Kasama-Zambia was significantly associated with the following;age (p Conclusion: Based on these findings, the study recommends that efforts should be channeled towards the dissemination of information on the impacts of smokeless tobacco use in order to overcome cultural beliefs attached to smokeless tobacco use.展开更多
Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay...Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay in seeking early diagnosis and treatment of cervical cancer among women in Malawi. The study was exploratory and utilized qualitative data collection and analysis method. In-depth interviews were conducted using a semi-structured interview guide on a purposive sample of 24 women who were diagnosed of cervical cancer at the gynaecological wards of Zomba and Queen Elizabeth Central Hospitals in Malawi between July and September, 2011. Thematic content analysis was used to analyze the qualitative data. Two major themes (individual and health facility) emerged from the participants’ narratives as factors that contributed to their delay in seeking early diagnosis and treatment. The individual factors included;limited knowledge on symptoms and signs and limited financial resources. The health facilities factors included;limited accessibility and unavailability of cancer screening facilities in the health centres. Results show that there is a need to strengthen the screening of cervical cancer among women in the country. In addition, there is a need to create community awareness on the signs and symptoms of cervical cancer and the merits of seeking early diagnosis and treatment.展开更多
Ghanaian governments have made some social interventions in order to reduce risks associated with pregnancy and child delivery. However, most pregnant women do not seek maternal care. Previous studies have examined fa...Ghanaian governments have made some social interventions in order to reduce risks associated with pregnancy and child delivery. However, most pregnant women do not seek maternal care. Previous studies have examined factors contributing to maternal care services utilization in Ghana using national data which limit such study applicability in some areas with specific background characteristics. These studies have mostly limited it to rural areas where the utilization is very low. This study seeks to bridge the gaps identified by exploring the factors which influence maternal care utilization in urban and rural communities in the Brong Ahafo Region of Ghana. The Chi-Square test of association and the logistic regression models are used to analyze data obtained from the 2014 Ghana Demographic and Health Survey (DHS). The data analyses were carried out using R and STATA softwares. The results revealed that women with at least 5 children were less likely (OR = 0.374, 95% CI: 0.173 - 0.796) to utilize antenatal care compared to those who had less than five live births. Educated women are three times likely (95% CI: 1.929 - 5.257) to deliver at a health facility compared to uneducated women. Women from the rich wealth quintile were nearly 16.9 times more likely (95% CI: 4.816 - 107.124) to deliver in a health facility compared to those from the poor wealth quintile. On the other hand, residing in rural communities makes it less likely (OR = 0.569, 95% CI: 0.350 - 0.913) for women to receive postnatal care within 2 months of delivery compared to living in urban communities. This study has demonstrated that maternal educational level plays a crucial role in maternal health care service utilization in the region. Therefore, government policies and programs aimed at providing more educational opportunities for girls in the region should be reinforced.展开更多
Objective:This study aimed to examine the referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state of Nigeria.Materials and Methods:A ...Objective:This study aimed to examine the referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state of Nigeria.Materials and Methods:A concurrent embedded descriptive mixed method consisting of both quantitative and qualitative methods was adopted for the study.Participants(104)were recruited using multistage sampling and 8 participants using purposive sampling techniques for quantitative and qualitative aspects of the study,respectively.The three-phase delay model directed the study.A self-developed structured questionnaire and an in-depth interview guide were used to elicit quantitative and qualitative responses from the participants.Quantitative instrument was tested for reliability,while the qualitative instrument went through the rigors of qualitative data.Results:Findings revealed low level of referral and counter-referral practices as only 19(18.27%)and 30(28.85%),respectively,of care providers referred patients above 10 times in a year.The study also revealed inadequate human and material resources for referrals and counter-referrals.The mean on barriers to referral was 2.90,which was above the cutoff of mean of 2.50,which indicates that the barriers are militating against referral and counter-referral in obstetric emergencies.Conclusions:Low levels of referral and counter-referral practices are identified with inadequate resources among others posing as barriers.Therefore,provision of standard operational procedures/protocols in every health-care facility as well as provision of adequate material and skilled human resources among others is recommended to enhance referral and counter-referral network in obstetric emergencies.There is also a need for teamwork and synergy among all stakeholders in the referral chain.展开更多
Knowledge on individual’s HIV/AIDS status provides a tool to reduce or avoid HIV transmission, spread and mortalities due to HIV-related illness. However, most people still do not know their HIV status because they a...Knowledge on individual’s HIV/AIDS status provides a tool to reduce or avoid HIV transmission, spread and mortalities due to HIV-related illness. However, most people still do not know their HIV status because they are not willing to test for HIV/AIDS due to various reasons. Hence the aim of this paper is to investigate the effects of various risk factors that are likely to influence decision to ever test for HIV/AIDS. The data used in this paper were obtained from the Ghana Demographic and Health Survey (n = 1828 observations and 32 risk factors). We applied the Chi-Square test statistic and the logistic regression model to the data in order to study the effects of these risk factors on one’s decision to ever test for HIV. STATA version 14.1 and R version 3.5.2 were used to carry out the statistical analyses. Generally, the results show that education, especially higher education significantly (OR = 0.53, 95% = 0.230, 0.837) increases the likelihood to ever test for HIV. Also, the younger the age groups the higher the effect and significance in the likelihood to ever test for HIV. We found that HIV-TB co-infection (OR = 0.53, 95% = 0.165, 0.893), use of condom anytime one has sex (OR = 0.31, 95% = 0.054, 0.573), wealth index (OR = 0.46, 95% = 0.137, 0.791), awareness of HIV transmission during child-delivery, number of partners significantly affect HIV testing. Those with many partners are less likely (OR = -0.26, 95% = -0.504, -0.007) to ever test for HIV and those who know that healthy person may have HIV are more likely (OR = 0.41, 95% = 0.137, 0.679) to ever test for HIV. Age is the common significant risk factor of ever tested for HIV across the 10 regions in Ghana. Resources should be allocated for more education on these significant risk factors in order to help in the fight against HIV-Health related issues.展开更多
This cross-sectional study was aimed to determine the incidence and the significant risk factors to neonatal jaundice in FMC, Jalingo. Four hundred and thirty three neonates admitted to special baby care unit (SBCU) F...This cross-sectional study was aimed to determine the incidence and the significant risk factors to neonatal jaundice in FMC, Jalingo. Four hundred and thirty three neonates admitted to special baby care unit (SBCU) FMC, Jalingo with their mothers were surveyed. Data were collected through a data extraction format looking on the medical records of the neonates (from 1st January, 2021 to 31st August, 2021) and interviewing the mothers. Data were transferred to an Excel data sheet and results were summarized by frequencies and percentages (categorical variables). Logistic regression analysis was used to determine the strength of the risk factors to neonatal jaundice while the significance was tested at p-value ≤ 0.05. The findings revealed that the incidence of neonatal jaundice in FMC Jalingo was 40.18% while the significant risk factors were age group 41 - 50 years (I = 15.01%, OR: 2.970 at 95% CI: 1.566 - 5.634, p = 0.000), spontaneous vaginal delivery (I = 18.01%, OR: 1.382 at 95% CI: 0.940 - 2.033, p = 0.000), premature rupture of membrane (I = 24.94%, OR at: 2.252 at 95% CI: 1.520 - 3.337, p = 0.000), hypertension in pregnancy (I = 21.02%, OR: 1.831 at 95% CI: 1.240 - 2.703, p = 0.002). Others were breech fetal presentation (I = 23.33%, OR: 2.689 at 95% CI: 1.809 - 3.995, p = 0.000), birth asphyxia (I = 22.40%, OR: 3.469 at 95% CI: 2.3105.210, p = 0.000), significant bruising (I = 22.86%, OR: 1.705 at 95% CI: 1.157 - 2.513, p = 0.007), neonatal sepsis (I = 21.02%, OR: 1.688 at 95% CI: 1.145 - 2.488, p = 0.008) and congenital hemolytic anemia (I = 21.71%, OR: 1.723 at 95% CI: 1.169 - 2.540, p = 0.006). Therefore, the need for all concerned to ensure the incidence is reduced and the risk factors identified early and tackled.展开更多
Optimum care for patients with a terminal illness is dependent on understanding their values,beliefs,and preferences on end-of-life issues and providing service that meets their preferences.As the only way to explore ...Optimum care for patients with a terminal illness is dependent on understanding their values,beliefs,and preferences on end-of-life issues and providing service that meets their preferences.As the only way to explore patients’living wills,advance care planning(ACP)is an important means to honor patient autonomy and respect their human rights and dignity.ACP has been recognized as a key indicator for quality palliative care and endorsed into national health systems by many high-income countries;however,it is little known in China's Mainland.China is now facing a growing aging and terminally ill population with many unmet needs for end-of-life care;therefore,it is imperative to implement ACP in China.In this review,we clarify the relevant concept and suitable population for ACP,describe the current situation of implementation in high-income countries,and provide better suggestions for the future development of ACP in the mainland of China.展开更多
This paper presents the theoretical background of using auricular therapy(AT)for managing chemotherapy-induced nausea and vomiting(CINV)from the perspectives of traditional zang-fu organs and meridian theory.The zang-...This paper presents the theoretical background of using auricular therapy(AT)for managing chemotherapy-induced nausea and vomiting(CINV)from the perspectives of traditional zang-fu organs and meridian theory.The zang-fu organs of stomach,spleen and liver play a crucial role in regulating the gastrointestinal functions.The chemotherapeutic agents can significantly impede the gastrointestinal functions and subsequently contribute to various gastrointestinal symptoms including nausea and vomiting.Dysfunctions of the stomach,spleen and liver can correspond to specific auricular acupoints,while by stimulating those acupoints,the chaotic Qi movement can be reversed to its normal status,and the hyperactivities of the gastrointestinal system can also be alleviated to reduce the CINV symptoms.Clinical studies based on such theory have well supported the effects of AT on CINV.However,relationships between the traditional theory and the modern medicine understanding of the CINV mechanisms remain unknown and should be further explored in future research.展开更多
Objective:To explore the concept of radiation dermatitis wet healing through a literature review and provide references for future treatment of patients with radiation skin injury.Methods:Related ar ticles selected fr...Objective:To explore the concept of radiation dermatitis wet healing through a literature review and provide references for future treatment of patients with radiation skin injury.Methods:Related ar ticles selected from China National Knowledge Infrastructure(CNKI),Wanfang Database,Pub Med,Web of Science,Medline,and EBSCO were analyzed with Rodger’s concept analysis.Results:We identified the application status of wet healing in domestic and foreign literature,defined explicit attributes of the procedure,and clarified concepts related to wet healing of radiation skin injury to provide a reference for the management of radiation dermatitis with wet healing.Conclusions:Treatment of radiation dermatitis with wet healing is a unique procedure.Analyzing this concept can contribute to its development in the future and can offer a theoretical basis for treatment of patients with radiation skin injury.展开更多
Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care ...Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.展开更多
文摘Caesarean section remains one of the most common obstetric and major operations performed on women during pregnancy and has contributed to improving maternal and foetal health. Consequently, significant mortality and morbidity from pregnancy and labour-related causes can be eliminated by a timely caesarean section. The acceptance of the life-saving procedure remains unsatisfactory in most sub-Saharan nations. The study aimed to assess the acceptability of caesarean section and associated factors among pregnant women seeking antenatal care at Women and Newborn Hospital-University Teaching Hospitals in Lusaka Zambia. The study utilised a quantitative cross-sectional analytical study design involving 420 pregnant women selected using systematic random sampling at Women and Newborn Hospital-University Teaching Hospitals Lusaka Zambia. Data was obtained using an Interview schedule and analysed using R software version 4.3.2. Chi-square, Fisher’s exact test, Wilcoxon rank sum test and binary logistic regression for statistical analysis at a 5% level of significance. The study found that the acceptability of Caesarean section as a mode of delivery was low (29%) among respondents at Women and Newborn Hospital-University Teaching Hospitals. This was influenced by marital status (P = 0.002), socioeconomic status (P = 0.050), parity (P = 0.004), gestation age (P = 0.008), previous history of caesarean section (P = 0.003), knowledge (P < 0.001), attitude (P < 0.001), and sociocultural beliefs (P = 0.045). Low acceptability of Caesarean section delivery is common among women at Women and Newborn Hospital-University Teaching Hospitals, despite its potential benefits for maternal and neonatal health. Socio-demographic and maternal characteristics, knowledge, attitude, perception, and socio-cultural beliefs play a major role in determining acceptability. Therefore, efforts to enhance acceptability should focus on improving knowledge, enhancing positive perceptions and attitudes, and allaying negative socio-cultural beliefs towards caesarean section.
文摘Background: The goal of preconception care is to improve the outcome of a mother’s pregnancy and childbirth. Nevertheless, in most developing nations;Zambia included, there are still issues with implementation of preconception care. Therefore, the aim of this study was to establish the provision of preconception care by midwives, nurses and doctors at Ndola Teaching Hospital in Zambia. Methods: A concurrent embedded mixed methodology utilising a descriptive explorative study design, where 107 respondents were randomly selected using the lottery technique for quantitative part and two focused group discussions for qualitative part of the study was used. A self-administered questionnaire was used to collect quantitative data and a focus group discussion guide was used for the focus group discussions. Statistical Package of Social Sciences version 26 with significance set at 0.05 and at 95% confidence level and thematic analysis were used for data analysis. Results: 75% of the respondents in this study were not providing preconception care and only 25% of respondents were providing preconception care;however, this was provided randomly because there were no guidelines to follow. Among the respondents, 81.3% had medium knowledge, 70.1% had good practices and 92.5% had positive attitudes towards preconception care. Further analysis showed that the association between preconception care and knowledge, practices and attitudes was not statistically significant (p = values 0.336;0.344;1.000 respectively). Multivariate logistic regression revealed that participants with high knowledge were five times more likely to provide preconception care (OR = 5.00, CI = 0.42 - 59.7, P = 0.203). Generally, all the participants acknowledged that preconception care was an important package that could prevent maternal and child morbidities and mortalities. Conclusions: The study revealed that most of the respondents were not providing preconception care. Provision of preconception was done by a small fraction of the respondents and it was done in an unorderly manner due to lack of set standards and guidelines. Despite medium levels of knowledge and generally good practices and positive attitudes towards preconception care, its random provision indicates a need for established standards to enhance maternal and child health outcomes.
文摘Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.
文摘Introduction: Measles is a viral disease that is a major public health problem in both developed and developing countries. It is a contagious disease resulting from infection with the measles virus and is still responsible for more than 100,000 deaths per year. Although vaccination is one of the most successful and cost-effective public health interventions to reduce mortality and morbidity, approximately 1.4 million children worldwide die from vaccine-preventable diseases each year. In Zambia, MCV2 was 66% below WHO recommended target of 95%. This study therefore assessed the acceptability of second dose measles vaccination services among caretakers/mothers with children less than two years of age in Livingstone, Zambia. Methods: The study used analytical cross-sectional study design. A logistic regression analysis was performed to identify factors associated with acceptability of the second dose of measles vaccine. A semi structured questionnaire was administered to collect data on socio demographic characteristics and factors related to acceptability of the second dose of measles vaccine. SPSS version 26.0 was used for descriptive and inferential analysis at 5% level of significance. Results: There was no statistically significant difference in acceptability of the second dose of measles vaccine by gender, marital status, type of employment, income level, socio-cultural and traditional beliefs, and education level. However, there was a statistically significant difference in acceptability of the second dose of measles vaccine by knowledge level of second dose of measles vaccine. A Chi square test result indicated that second dose acceptability was higher with less children than that of respondents with many children (χ2(5) = 15.3, p and knowledge levels (χ2(2) = 14.8, p Changes in knowledge level from medium to high reduced the odds of second dose measles vaccine acceptability. Furthermore, this study showed that acceptance of the second measles vaccination increased from mothers/caretakers with low knowledge (3.6%) to medium knowledge (13.3%) and finally high knowledge (83.1%). Conclusion: Tailored messaging to increase knowledge among mothers and caregivers on the importance of the second dose of measles vaccine is critical in improving acceptability. Therefore, the researchers recommend that the health providers should continue to raise awareness associated with the low acceptability of the second dose of measles vaccine and improve on child preventable diseases such as measles.
基金supported by Scientific research fund project of Binzhou Medical University(No.20SKNY13)Binzhou 2023 social science planning project(No.23-SKGH-189)innovation program of university students(No.202210440071)。
文摘Family resilience is not the sum of the individual psychological resilience of each of the family members,but the family itself as a unit of resilience research.The representative models of family stress tolerance theory mainly include Mc Cubbin's series of family stress tolerance models and Walsh's family stress tolerance framework,which are widely used in the practice of family therapy.In the future,empirical studies on family resilience should be strengthened,measurement tools with high reliability and validity should be established,and the combination of family resilience theory and community-based practice should be promoted.
文摘Sexual and reproductive health (SRH) is among the fundamental packages of health care, which all clients seeking health care should receive. However, it is unclear how healthcare providers, in particular, nurses perceive the issue of people with mental problems having sexual health needs. The aim of this study was to explore perceptions of nurses at Ndola Teaching Hospital towards sexual health needs of people with mental health problems. A general descriptive qualitative study design was utilized and data were collected using three focus group discussions (FGDs) that were recorded and later transcribed verbatim. Purposive sampling was used to select 21 nurses who participated in the study. Nine were male, while 12 were female. Each FGD comprised seven participants. Thematic analysis was used to analyze the data, and six major themes: 1) physiological interplay among different body systems, 2) disease process and effects of psychotropic, 3) participant differences in age, gender, educational level, and cultural backgrounds, 4) staff shortages in mental health units, 5) deficient record keeping, and 6) Social stereotypes and labelling theories emerged. Despite acknowledging the existence of sexual activity among people with mental health problems;participants had both positive and negative perceptions. It is, therefore, recommended that interventions aimed at strengthening implementation of SRH guidelines among nurses caring for people with mental health problems should be put in place.
文摘Background: Smokeless tobacco is defined as a product that contains tobacco, is not smoked or burned at the time of use, and commonly consumed orally or nasally. These products can be placed in the mouth, cheek or the lip and are sucked or chewed. The Zambian government, in the 2019 country report, gave an estimated figure of 4.5% of females aged 15 years and above in 2017 used smokeless tobacco and by 31st December, 2018, there was an increase of smokeless tobacco users to 6.8% women of the same age group. This study aimed to explore the extent of smokeless tobacco use among women in Kasama district-Zambia. Methodology: An analytical cross-sectional quantitative study design was used to collect data using the modified structured interview schedule, adopted from Medicine for Global Health. Simple random sampling method using rotary technique was used to select 430 respondents after meeting the inclusion criteria. Informed consent to participate in the study was obtained. Data was analysed using version 26.0 of the Statistical Package for Social Sciences. Appropriate parametric or non-parametric statistical tests (Chi-squared or Fisher’s exact test) were adopted in testing for associations between variables. Univariable and multivariable binary logistic regression analysis were employed in identifying smokeless tobacco use among women using an investigator-led stepwise approach, guided by various fit statistics and the likelihood ratio test. All statistical analyses adopted a 5% significance level at 95% confidence interval. Results: The results showed that most of the respondents were aged between 18 and 25 years (45.6%), (53.7%) lived in urban settlements and the majority (80%) were unemployed. The majority of respondents (83.5%) had a friend/relative who used smokeless tobacco and over half (53.5%) thought smokeless tobacco was beneficial to them. The commonly mentioned benefits of smokeless tobacco included body warmth (13.6%) and vaginal tightening (7.9%). The results revealed that most of the respondents attained a secondary level of education (38.4%). According to the study, smokeless tobacco use among women of Kasama-Zambia was significantly associated with the following;age (p Conclusion: Based on these findings, the study recommends that efforts should be channeled towards the dissemination of information on the impacts of smokeless tobacco use in order to overcome cultural beliefs attached to smokeless tobacco use.
文摘Cervical cancer is a curable disease if diagnosed early. However, many women in Malawi seek treatment when the disease has reached inoperable stage. This study was conducted to explore factors that contribute to delay in seeking early diagnosis and treatment of cervical cancer among women in Malawi. The study was exploratory and utilized qualitative data collection and analysis method. In-depth interviews were conducted using a semi-structured interview guide on a purposive sample of 24 women who were diagnosed of cervical cancer at the gynaecological wards of Zomba and Queen Elizabeth Central Hospitals in Malawi between July and September, 2011. Thematic content analysis was used to analyze the qualitative data. Two major themes (individual and health facility) emerged from the participants’ narratives as factors that contributed to their delay in seeking early diagnosis and treatment. The individual factors included;limited knowledge on symptoms and signs and limited financial resources. The health facilities factors included;limited accessibility and unavailability of cancer screening facilities in the health centres. Results show that there is a need to strengthen the screening of cervical cancer among women in the country. In addition, there is a need to create community awareness on the signs and symptoms of cervical cancer and the merits of seeking early diagnosis and treatment.
文摘Ghanaian governments have made some social interventions in order to reduce risks associated with pregnancy and child delivery. However, most pregnant women do not seek maternal care. Previous studies have examined factors contributing to maternal care services utilization in Ghana using national data which limit such study applicability in some areas with specific background characteristics. These studies have mostly limited it to rural areas where the utilization is very low. This study seeks to bridge the gaps identified by exploring the factors which influence maternal care utilization in urban and rural communities in the Brong Ahafo Region of Ghana. The Chi-Square test of association and the logistic regression models are used to analyze data obtained from the 2014 Ghana Demographic and Health Survey (DHS). The data analyses were carried out using R and STATA softwares. The results revealed that women with at least 5 children were less likely (OR = 0.374, 95% CI: 0.173 - 0.796) to utilize antenatal care compared to those who had less than five live births. Educated women are three times likely (95% CI: 1.929 - 5.257) to deliver at a health facility compared to uneducated women. Women from the rich wealth quintile were nearly 16.9 times more likely (95% CI: 4.816 - 107.124) to deliver in a health facility compared to those from the poor wealth quintile. On the other hand, residing in rural communities makes it less likely (OR = 0.569, 95% CI: 0.350 - 0.913) for women to receive postnatal care within 2 months of delivery compared to living in urban communities. This study has demonstrated that maternal educational level plays a crucial role in maternal health care service utilization in the region. Therefore, government policies and programs aimed at providing more educational opportunities for girls in the region should be reinforced.
文摘Objective:This study aimed to examine the referral and counter-referral practices in obstetric emergencies among health-care providers in selected health facilities in Plateau state of Nigeria.Materials and Methods:A concurrent embedded descriptive mixed method consisting of both quantitative and qualitative methods was adopted for the study.Participants(104)were recruited using multistage sampling and 8 participants using purposive sampling techniques for quantitative and qualitative aspects of the study,respectively.The three-phase delay model directed the study.A self-developed structured questionnaire and an in-depth interview guide were used to elicit quantitative and qualitative responses from the participants.Quantitative instrument was tested for reliability,while the qualitative instrument went through the rigors of qualitative data.Results:Findings revealed low level of referral and counter-referral practices as only 19(18.27%)and 30(28.85%),respectively,of care providers referred patients above 10 times in a year.The study also revealed inadequate human and material resources for referrals and counter-referrals.The mean on barriers to referral was 2.90,which was above the cutoff of mean of 2.50,which indicates that the barriers are militating against referral and counter-referral in obstetric emergencies.Conclusions:Low levels of referral and counter-referral practices are identified with inadequate resources among others posing as barriers.Therefore,provision of standard operational procedures/protocols in every health-care facility as well as provision of adequate material and skilled human resources among others is recommended to enhance referral and counter-referral network in obstetric emergencies.There is also a need for teamwork and synergy among all stakeholders in the referral chain.
文摘Knowledge on individual’s HIV/AIDS status provides a tool to reduce or avoid HIV transmission, spread and mortalities due to HIV-related illness. However, most people still do not know their HIV status because they are not willing to test for HIV/AIDS due to various reasons. Hence the aim of this paper is to investigate the effects of various risk factors that are likely to influence decision to ever test for HIV/AIDS. The data used in this paper were obtained from the Ghana Demographic and Health Survey (n = 1828 observations and 32 risk factors). We applied the Chi-Square test statistic and the logistic regression model to the data in order to study the effects of these risk factors on one’s decision to ever test for HIV. STATA version 14.1 and R version 3.5.2 were used to carry out the statistical analyses. Generally, the results show that education, especially higher education significantly (OR = 0.53, 95% = 0.230, 0.837) increases the likelihood to ever test for HIV. Also, the younger the age groups the higher the effect and significance in the likelihood to ever test for HIV. We found that HIV-TB co-infection (OR = 0.53, 95% = 0.165, 0.893), use of condom anytime one has sex (OR = 0.31, 95% = 0.054, 0.573), wealth index (OR = 0.46, 95% = 0.137, 0.791), awareness of HIV transmission during child-delivery, number of partners significantly affect HIV testing. Those with many partners are less likely (OR = -0.26, 95% = -0.504, -0.007) to ever test for HIV and those who know that healthy person may have HIV are more likely (OR = 0.41, 95% = 0.137, 0.679) to ever test for HIV. Age is the common significant risk factor of ever tested for HIV across the 10 regions in Ghana. Resources should be allocated for more education on these significant risk factors in order to help in the fight against HIV-Health related issues.
文摘This cross-sectional study was aimed to determine the incidence and the significant risk factors to neonatal jaundice in FMC, Jalingo. Four hundred and thirty three neonates admitted to special baby care unit (SBCU) FMC, Jalingo with their mothers were surveyed. Data were collected through a data extraction format looking on the medical records of the neonates (from 1st January, 2021 to 31st August, 2021) and interviewing the mothers. Data were transferred to an Excel data sheet and results were summarized by frequencies and percentages (categorical variables). Logistic regression analysis was used to determine the strength of the risk factors to neonatal jaundice while the significance was tested at p-value ≤ 0.05. The findings revealed that the incidence of neonatal jaundice in FMC Jalingo was 40.18% while the significant risk factors were age group 41 - 50 years (I = 15.01%, OR: 2.970 at 95% CI: 1.566 - 5.634, p = 0.000), spontaneous vaginal delivery (I = 18.01%, OR: 1.382 at 95% CI: 0.940 - 2.033, p = 0.000), premature rupture of membrane (I = 24.94%, OR at: 2.252 at 95% CI: 1.520 - 3.337, p = 0.000), hypertension in pregnancy (I = 21.02%, OR: 1.831 at 95% CI: 1.240 - 2.703, p = 0.002). Others were breech fetal presentation (I = 23.33%, OR: 2.689 at 95% CI: 1.809 - 3.995, p = 0.000), birth asphyxia (I = 22.40%, OR: 3.469 at 95% CI: 2.3105.210, p = 0.000), significant bruising (I = 22.86%, OR: 1.705 at 95% CI: 1.157 - 2.513, p = 0.007), neonatal sepsis (I = 21.02%, OR: 1.688 at 95% CI: 1.145 - 2.488, p = 0.008) and congenital hemolytic anemia (I = 21.71%, OR: 1.723 at 95% CI: 1.169 - 2.540, p = 0.006). Therefore, the need for all concerned to ensure the incidence is reduced and the risk factors identified early and tackled.
文摘Optimum care for patients with a terminal illness is dependent on understanding their values,beliefs,and preferences on end-of-life issues and providing service that meets their preferences.As the only way to explore patients’living wills,advance care planning(ACP)is an important means to honor patient autonomy and respect their human rights and dignity.ACP has been recognized as a key indicator for quality palliative care and endorsed into national health systems by many high-income countries;however,it is little known in China's Mainland.China is now facing a growing aging and terminally ill population with many unmet needs for end-of-life care;therefore,it is imperative to implement ACP in China.In this review,we clarify the relevant concept and suitable population for ACP,describe the current situation of implementation in high-income countries,and provide better suggestions for the future development of ACP in the mainland of China.
基金This paper is part of the work contained within the PhD thesis of Dr Jing-Yu Tan.Figures that are presented in this paper are derived and modified from the original thesis.Contents,presentation,styles of in-text citations and referencing list of the original chapter in the thesis have been partially modified and reorganised to fit the journal requirementThis work was supported by The Hong Kong Polytechnic University School of Nursing PhD scholarship.
文摘This paper presents the theoretical background of using auricular therapy(AT)for managing chemotherapy-induced nausea and vomiting(CINV)from the perspectives of traditional zang-fu organs and meridian theory.The zang-fu organs of stomach,spleen and liver play a crucial role in regulating the gastrointestinal functions.The chemotherapeutic agents can significantly impede the gastrointestinal functions and subsequently contribute to various gastrointestinal symptoms including nausea and vomiting.Dysfunctions of the stomach,spleen and liver can correspond to specific auricular acupoints,while by stimulating those acupoints,the chaotic Qi movement can be reversed to its normal status,and the hyperactivities of the gastrointestinal system can also be alleviated to reduce the CINV symptoms.Clinical studies based on such theory have well supported the effects of AT on CINV.However,relationships between the traditional theory and the modern medicine understanding of the CINV mechanisms remain unknown and should be further explored in future research.
文摘Objective:To explore the concept of radiation dermatitis wet healing through a literature review and provide references for future treatment of patients with radiation skin injury.Methods:Related ar ticles selected from China National Knowledge Infrastructure(CNKI),Wanfang Database,Pub Med,Web of Science,Medline,and EBSCO were analyzed with Rodger’s concept analysis.Results:We identified the application status of wet healing in domestic and foreign literature,defined explicit attributes of the procedure,and clarified concepts related to wet healing of radiation skin injury to provide a reference for the management of radiation dermatitis with wet healing.Conclusions:Treatment of radiation dermatitis with wet healing is a unique procedure.Analyzing this concept can contribute to its development in the future and can offer a theoretical basis for treatment of patients with radiation skin injury.
文摘Background: Termination of pregnancy (TOP) in Zambia is guided by the Termination of Pregnancy (TOP) Act of 1972 and as amended in 1994 of the laws of Zambia. However, despite provision of Comprehensive abortion care services with the liberal law, statistics at Kanyama First Level Hospital in relation to unsafe illegal abortions are alarming. This study sought to understand the Awareness on the TOP Act of the laws of Zambia among women of reproductive age 15 - 49 years at Kanyama First Level Hospital in Lusaka District. Purpose of the Study: To assess awareness on the TOP Act among women of reproductive age at Kanyama First Level Hospital in Lusaka, Zambia. Methodology: A convergent parallel mixed method design was conducted using both survey and in-depth interviews among women of reproductive age at Kanyama First Level Hospital in Lusaka District. The study surveyed 370 randomly sampled women aged 15 to 49 years old while the in-depth interviews included eight women purposively sampled from the survey population. Survey data was analyzed using descriptive and inferential statistics while qualitative data thematic analysis was used. Results: The study found that 37% of the participants were aware of the TOP Act while 63.8% viewed legalization of abortion for any reason as wrong. The study results also showed that widowed women were 8 times more likely to be aware of the TOP Act compared to single women (AOR: 8.262;95% CI: 1.105, 61.778). Women in business were significantly more likely to be aware of the TOP Act compared to those who reported having no occupation. (AOR: 2.61;95% CI: 1.246, 5.499). Limited access to information, the social stigma attached to abortion, health care providers’ attitudes, cultural norms, values and religious beliefs, restrictive legal requirements, and absence of a supportive network were some of the barriers affecting awareness and utilization of available safe abortion care services. Conclusions: The research findings concluded that a significant lack of awareness among women of reproductive age regarding the Termination of Pregnancy (TOP) Act. The majority of respondents held the view that abortion should only be legalized for medical reasons. Furthermore, there was a notable gap in knowledge concerning the penal code’s provisions on abortion.