Microbiology and Nursing Research

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    Prevalence, Effect and Management of Cancer Pain at Garissa, Kenya
    (IOSR Journal of Nursing and Health Science, 2018-12-25) Affey, Fatuma; Mwenda, Catherine; Too, Wesley; Elmi, Mohamed
    High prevalence, negative effect and suboptimal cancer pain management has been reported from resource-limited countries such as Kenya. Precisely, trends of cancer cases are on the increase at Garissa County in Kenya, yet no data exist on the prevalence, effect and management of cancer pain. This study was to examine the prevalence, effect and cancer pain management of adult patients at Garisssa County Referral Hospital. A descriptive cross sectional survey was employed and 94 cancer patients from both outpatient on follow up care and inpatient were recruited to participate. MBPI (Modified Brief Pain Inventory) and ECOG (Eastern Cooperative Oncology Group) tools were used for data collection. Pain Management Index was calculated and significant levels were set at P<0.05 for all tests. Mean age of participants was 50years, composed of 42(44.7%) male and 52 (55.3%) female. Cancers of Breast and prostate were most prevalent with (25%) female and (14%) male respectively. Prevalence of cancer pain was 78% with majority reporting moderate to severe pain and undertreatment with PIM of (p-value < 0.05). Participants accounting 76.9% male and 66.7% female reported cancer pain interference with ability to walk and 91% male and 70% female reported that pain interfered with their mood. Male participants reported to experience more psychological, physical and social pain than female participants. A total of 81.9% (77) participants incorrectly utilised WHO analgesic ladders, 65% (61) and 77.6% (73) considered alternative therapy of Quran and Somali herbs respectively for pain management. This study found a high prevalence of cancer pain with negative impact and suboptimal cancer pain management.
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    'XANNUN’ NURSING CARE MODEL FOR CANCER PAIN MANAGEMENT AMONG ADULT PATIENTS AT GARISSA COUNTY REFERRAL HOSPITAL (GCRH), KENYA
    (2019) Affey, Fatuma
    Nursing care models allows concept application of not only the physical treatment of pain but also synthesis the significance of social-cultural practices, psychological and spiritual pain relief. Cancer pain has high prevalence and negative impact on the quality of life of patients at Garissa County due to limited access to healthcare facilities and unique pastoral lifestyle of the community. This necessitated the development of ‗Xannun‘ model of nursing care for holistic pain management that is clinically proficient and culturally competent. Phase one of the utilised triangulation method approach to recruit 94 cancer patients, 84 clinical nurses and 15 key informants, while phase two was the actual development and testing of Xannun nursing care model. Various sampling procedures that included random, purposive and snowball and recruit participants voluntarily was done. Modified Brief Pain Inventory (MBPI) tool combined with focus group discussion and Eastern Cooperative Oncology Group (ECOG) performance status was used to obtain data from participants. The sample population was 188 participants. Cancer patients had a mean age of 51years, with prevalence of pain at 78 % (73) that ranged from moderate to severe. A total of 78 % (66) of clinical nurses had no tool for pain assessment, 83.2 % (70) of them did not know how to utilise WHO analgesic ladder. Majority of patients 82 % (78) were on incorrect WHO analgesic ladder with negative PMI (p-value < 0.05) of under treatment. Majority of patients considered alternative treatment for cancer pain such as Quran recitation and Somali herbs accounting for 65% (61) and 77.6% (73) respectively. Almost all KI 93% (14) indicated the inadequate availability of pain medication. Phase two, Delphi survey to gain expert opinion was used. Experts‘ opinion of 80% of respondents agreed that the ‗Xannun‘ nursing model captured the challenges of cancer pain management and 60% of them predicted that the model could be utilised. However, 100% of the experts suggested that the model will bring a positive change, though 90% of them upheld that there will be potential challenges of implementing such a model. This study found high prevalence of cancer pain, suboptimal pain care, Knowledge deficit among nurses and inaccessibility of pain medication associated with the dynamic of a nomadic lifestyle. Thus, this study recommends the implementation of ―Xannun‖ Nursing Care model at GCRH, for a better approach of cancer pain management.