OBJECTIVE: This research aimed to understand the perceived barriers to reporting postpartum hemorrhage care experienced by women and healthcare workers in Birnin Kebbi, North west-Nigeria.
METHODS: Qualitative case research was employed in this study with face-to-face interviews among ten postnatal women who experienced bleeding and six healthcare workers. Data were collected from September to November 2021. The interviews were all audio-taped, transcribed verbatim, and analyzed using thematic analysis. NVivo Pro Version 12 was applied to organize further and manage the data.
RESULTS: Six themes were developed: (1) knowledge deficit, (2) poor attitudes, behaviors, and performances, (3) low socioeconomic status, (4) lack of healthcare personnel, (5) cultural norms, and (6) lack of access to healthcare facilities.
CONCLUSION: The study findings might serve as input for healthcare policymakers and healthcare workers to improve health and reduce maternal mortality. Enhancing knowledge and awareness about reporting process is necessary to improve reporting for postpartum hemorrhage care among women. Training and continuous professional development of health care workers are also highly suggested to enhance the quality of care.
OBJECTIVE: This study was conducted to identify lipohypertrophy prevalence and to establish the association between the presence of lipohypertrophy and its associated risk factors, including years on injection, total injection in a day, total insulin unit per day, often change needle, insulin injection site and move to a different area.
METHODS: This cross-sectional study included 128 patients with type 2 diabetes mellitus who received insulin therapy in an outpatient diabetic clinic. Questionnaires on socio-demographic and lipohypertrophy-associated risk factors were distributed among patients, and lipohypertrophy-assessment was done using a checklist. Descriptive statistics and Pearson Chi-square were used for statistical analysis.
RESULTS: The prevalence of lipohypertrophy was 51.6% (95% CI: 42.6, 60.5). Swelling on fatty tissue (46.1%) exhibited the highest percentage of lipohypertrophy features during the assessment. Pearson Chi-Square revealed a significant relationship between the presence of LH and BMI categories (χ2 = 10.059, df = 3, p = 0.018), duration of injection (χ2 = 15.001, df = 3, p = 0.002), frequency of needle replacement (χ2 = 9.525, df = 3, p = 0.023) and rotation of injection site (χ2 = 5.914, df = 1, p = 0.015).
CONCLUSION: The high prevalence of lipohypertrophy indicates a need for a prevention strategy. Thus, nurses should play an important role in educating patients regarding the proper administration of insulin injections and performing a routine lipohypertrophy assessment and health education on the correct method of insulin injection.
OBJECTIVE: This study aimed to assess the effectiveness of the NPWT program in improving the management of chronic wound healing.
DESIGN: Systematic review and meta-analysis was used.
DATA SOURCES: The search strategy ranged from 2016 to 2021 in PubMed, CINAHL, ProQuest, and ScienceDirect.
REVIEW METHODS: Risk of bias was done based on the Risk of Bias 2.0 guideline using RevMan 5.4.1, and meta-analysis was done using Jeffreys's Amazing Statistics Program (JASP) software version 0.16.3. Critical appraisal of the included articles was done according to Joanna Briggs Institute's (JBI) appraisal checklist.
RESULTS: A total of 15 articles were included, with 3,599 patients with chronic wounds. There was no publication bias in this study seen from the results of the Egger's test value of 0.447 (p >0.05), symmetrical funnel plot, and fail-safe N of 137. However, heterogeneity among studies was present, with I2 value of 66.7%, Q = 41.663 (p <0.001); thus, Random Effect (RE) model was used. The RE model showed a significant positive effect of the NPWT on chronic wound healing, with z = 3.014, p = 0.003, 95% CI 0.085 to 0.400. The observed effects include decreased rate of surgical site infection, controlled inflammation, edema, and exudate, as well as increased tissue with varying forest plot size, as demonstrated by the small effect size (ES = 0.24, 95% CI -0.26 to 0.79, p <0.05).
CONCLUSION: The analysis results show that the standard low pressure of 80-125 mmHg could improve microcirculation and accelerate the healing process of chronic wounds. Therefore, applying the NPWT program could be an alternative to nursing interventions. However, it should be carried out by competent wound nurses who carry out procedure steps, implement general patient care, and give tips on overcoming device problems and evaluation.
PROSPERO REGISTRATION NUMBER: CRD42022348457.
OBJECTIVE: This study was conducted to explore the experiences of school health teams in Malaysia who provide unmarried adolescents with sexual health information either during school health visits or at health clinics, with a particular interest in the strategies they use to educate these young people.
METHODS: This qualitative study used semi-structured interview data from twenty participants from four multidisciplinary school health teams. The participants included staff nurses, medical officers, and family medicine specialists. The transcripts were analysed for common themes.
RESULTS: Four main themes were identified: discourse on risk, being selective, using scare tactics and maintaining own honour. The findings indicate that the interactions between school health teams and unmarried adolescents were not always 'adolescent friendly'. The school health teams tended to use discourses of 'risk' or scare tactics to encourage abstinence in the adolescents they advised. Staff were also selective about the information they gave, prioritising notions of 'maintaining honour' over 'safer sex' messages.
CONCLUSION: This study revealed how school health teams perceived sexual health education to be about moral issues and social attitudes. Influenced by both culture and religion, the sexual health services provided were underpinned by a 'moral' approach and promoted abstinence. However, most of the nurses in this study held the belief that sexual health knowledge acts as an encouragement for sexual activity. Thus, as part of school health teams, nurses need to embrace evidence that improved sexual health education may delay sexual initiation and prevent unintended pregnancy and HIV/STDs.
OBJECTIVE: To review and determine the effectiveness of PCE for dyslipidemia management compared with usual care. The primary outcome chosen was cholesterol level. Other measures, such as psychosocial or cognitive, behavioral, and other relevant outcomes, were also extracted. Additionally, underlying theories and other contributing factors that may have led to the success of the intervention were also reviewed and discussed.
METHODS: We conducted searches in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Google Scholar from inception until April 2021. All studies involving randomized controlled trials were included. Study quality was assessed using the Critical Appraisal Skills Program (CASP) checklist specifically for randomized controlled trials.
RESULTS: The search identified 8,847 records. Of these, 20 studies were eligible for inclusion. Interventions using a PCE approach were largely successful. Contributing factors extracted from the included studies were underlying theories, instant reward system, dietary education, collaborative care, duration of intervention with systematic follow-ups, social support, adherence assessment method, and usage of e-health.
CONCLUSIONS: PCE is successful in achieving the desired outcomes in dyslipidemia management. Future studies may incorporate the elements of PCE to improve the management of dyslipidemia in hospital or community settings where appropriate.
OBJECTIVE: This paper aims to elaborate on the process of developing, validating, and examining the Diabetic Care Self-Management Mobile Health Application (Diabetic Care).
METHODS: There are two phases conducted. The first phase is the process of developing and validating Diabetic Care. Intervention Mapping (IM) Framework was used to guide the process of developing Diabetic Care, while in assessing validity, guidance from Kassam-Adams et al. was used. A team of experts was appointed to validate the mobile app developed. Next, the usability of Diabetic Care was conducted among ten conveniently chosen patients with diabetes in a governmental primary care clinic.
RESULTS: The process of developing Diabetic Care was clearly explained. The Diabetic Care app showed a good I-CVI score (1.00) and general CVI score (1.00) after the expert team assessed. During the trial, two drawbacks were identified and explored to find solutions.
CONCLUSION: The Diabetic Care app is proven appropriate to be employed in the study. Even though there were two drawbacks encountered, however, possible solutions were able to be explored in addressing the issues. Further research should be conducted to examine the effectiveness of this mobile app in modifying foot care behavior and dietary behavior. Hence, it will assist in the translation of advanced technology in nursing care.
OBJECTIVE: This study aimed to explore the caregivers' beliefs on children with acute lymphoblastic leukemia caregiving experiences in order to promote their well-being.
METHODS: Caregivers from thirteen families of children with acute lymphoblastic leukemia participated in this phenomenological study. NVivo 12 was used for the thematic analysis of the data. Consolidated criteria for reporting qualitative research (COREQ) were used in this study.
RESULTS: Overall, five main themes for caregivers' beliefs were identified from their responses: 1) dietary intake with emphasis on its importance in aiding recovery and its potential influence on cancer complications, 2) childcare which emphasized the need to be strong and self-sacrifice, 3) treatment which reflected the use of home or natural remedies and caregivers' negative perception towards chemotherapy, 4) causes of cancer believed to be linked to early childcare choices on food, beverage, and stress imposed on the child, and 5) source of beliefs that included doctors, online platforms, personal encounters and information on food labels.
CONCLUSION: Caregivers' beliefs are varied and nuanced, formed in a multicultural social background of Malaysia. These findings provide knowledge for future supportive cancer care for patients, their caregivers, and the treatment outcome in the Malaysian context. Nurses, who play an essential role between healthcare professionals and patients and/or their caregivers, can be empowered to provide psychological support, early detection of psychological distress, and exploration of caregiver beliefs, given that the number of clinical psychologists in Malaysia is lacking, and there is greater preference for care to be provided by doctors or nurses.
DATA SOURCES: None.
STUDY SELECTION: Current literature describing the conduct, reporting, and appraisal of systematic reviews and meta-analyses.
DATA EXTRACTION: Best practices for conducting, reporting, and appraising systematic review were summarized.
DATA SYNTHESIS: A systematic review is a review of a clearly formulated question that uses systematic and explicit methods to identify, select, and critically appraise relevant original research, and to collect and analyze data from the studies that are included in the review. Critical appraisal methods address both the credibility (quality of conduct) and rate the confidence in the quality of summarized evidence from a systematic review. The A Measurement Tool to Assess Systematic Reviews-2 tool is a widely used practical tool to appraise the conduct of a systematic review. Confidence in estimates of effect is determined by assessing for risk of bias, inconsistency of results, imprecision, indirectness of evidence, and publication bias.
CONCLUSIONS: Systematic reviews are transparent and reproducible summaries of research and conclusions drawn from them are only as credible and reliable as their development process and the studies which form the systematic review. Applying evidence from a systematic review to patient care considers whether the results can be directly applied, whether all important outcomes have been considered, and if the benefits are worth potential harms and costs.