Microbiology and Nursing Research
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Item Influence of Cultural Competence Training among Health Care Workers on Patient Satisfaction and Health Outcomes in Diverse Communities(Asian Journal of Research in Nursing and Health, 2024-10-30) Musembi Mary; Affey, FatumaThis study aimed at exploring impact of cultural competence training on enhancing patients satisfaction and improving health outcomes within such communities. Study Design: Analytical-cross sectional study design approach was applied in this study, both qualitative and quantitative methods were utilized to collect data. Relationship between cultural competence training and its effects on patient satisfaction and health outcomes was examined as well as mechanisms through which cultural competence training influences healthcare delivery in diverse settings was explored. Place and Duration of Study: The study was conducted in Kiambu Level 5 Hospital in Kiambu County, Kenya. This region hosts a mixed population with varying cultures, and it is a level 5 hospital with high referrals of various cases from different parts of the county. The area provided conducive environment for this study since it borders Nairobi and its populationItem 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, MohamedHigh 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.Item 'XANNUN’ NURSING CARE MODEL FOR CANCER PAIN MANAGEMENT AMONG ADULT PATIENTS AT GARISSA COUNTY REFERRAL HOSPITAL (GCRH), KENYA(2019) Affey, FatumaNursing 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.Item Levels of Compliance to Proposed Hemodialysis Treatment Standards by Nurses at Kenyatta National Hospital, Kenya(International Journal of Nursing Science, 2017) Kereu, Dominic Riang’a; Ogoncho, Isaac Machuki; Halake, Dabo; Amunga, RhodaCompliance with treatment standards helps to improve health outcomes and prevent complications. This study sought to determine the level of compliance to hemodialysis treatment standards among nurses in the renal unit at Kenyatta National Hospital, Kenya. Methods: A cross sectional descriptive study was carried out involving nurses working in the renal unit. A self administered structured questionnaire and an observational checklist was used to collect information on nursing care during hemodialysis treatment. Results: 48 nurses were recruited. A majority of the respondents 26 (54%) were below the age of 40 years and were predominantly females. Most of the respondents 44 (92%) had specialized nephrology training. A significant association (p=0.018) was reported between nephrology training and compliance to the proposed hemodialysis treatment standards. Most of the respondents 42(87%) had a moderate level of compliance to the proposed hemodialysis treatment standards being implemented at the renal unit. Conclusion: The level of compliance to hemodialysis treatment standards by nurses working in the renal unit at Kenyatta National Hospital was moderate.Item Case Management of Substance Induced Psychosis Using Peplau’s Theory of Interpersonal Relations(2017) Ogoncho, Isaac Machuki; Sanga, Philip; Halake, Dabo GalgaloSubstance induced psychosis is a form of psychosis that develops from the use of alcohol or other drugs. The symptoms for this form of psychosis can resolve within days or weeks though tendencies of relapsing occur with persistent use of the drugs. The purpose of this article was to examine Peplau’s theory of interpersonal relations as a framework to assist nurses in understanding and managing patients with substance induced psychosis. The theory involves a therapeutic process that is collaboratively undertaken by both the nurse and the patient towards resolving an identified health problem. The nurse-patient relationship evolves through three phases of orientation, working and termination. The nurse may function as a stranger, leader, teacher, resource person, surrogate and counsellor in helping the patient adopt a healthier behaviour. The nurse-patient relationship allows the patient to freely express their emotions, feelings and thoughts about a given health problem. This enhances understanding of the health problem and guides nurses to helping the patients meet their individual needs. Nursing practice should focus on strengthening interpersonal relationships with patients to improve health outcomes.Item Unveiling the hidden battle: Impact of Charlson comorbidities index on critical illness rate and mortality among hospitalized COVID-19 patients, comparing vaccinated and unvaccinated individuals in Kenya: A retrospective study(African Journal of Medical and Health Sciences, 2024-01) Isinta, M. Elijah; Kitagwa, W.; Halake, Dabo G; Wang, YouxinFatal outcomes were observed in hospitalized COVID-19 patients, particularly among those who were unvaccinated and had comorbidities. Robust research is needed to validate these findings in both vaccinated and unvaccinated groups. The study, involving 1792 COVID-19 patients, explored the links between comorbidities and fatal outcomes. This single-center retrospective cohort study employed Cox proportional hazard regression to analyze the impact of comorbidities on COVID-19 fatalities, adjusting for age, sex, smoking and vaccination status. Males experienced severe illness (75%) or mortality (76.8%). Notably, most people admitted to the ICU were over 31 years old (96.2%), with individuals over 60 years old facing the highest fatality rate (61.6%). The proportion of ICU admissions increased with the Charlson Comorbidities Index (CCI), with CCI 1-3 at 51.0% and CCI >4 at 52.6%. Mortality linked to CCI was 55.4% for CCI 1-3 and 52.6% for CCI >4. The risk of ICU admission and mortality both increased with higher CCIs. Common comorbidities such as obesity, cardiovascular diseases, diabetes, chronic liver disease, chronic pulmonary obstructive disease, cancer/malignancy, chronic kidney disease and hypertension predicted critical illness and mortality among COVID-19 patients. The area under the receiver operating characteristic curve (AUC-ROC) for predicting critical illness was 0.90 (95% CI: 0.89-0.93), and for mortality, it was 0.90 (95% CI: 0.88-0.91). Additional factors, such as HIV and rheumatoid arthritis, independently predicted critical illness and mortality. The risk of critical illness and mortality showed an increase with the Charlson Comorbidities Index, both among vaccinated and unvaccinated individualsItem The Role of Mobile Health in Supporting Cancer Prevention, Detection, Treatment and Palliative Care in Low and Middle Income Countries: A Scoping Review(Public Health Research, 2017) Halake, Dabo Galgalo; Ogoncho, Isaac MachukiCancer is one of the non-communicable diseases with high morbidity and mortality rates, particularly in low-and-middle income countries. Increasing cancer burden is attributable to lifestyle risk factors, poor health system infrastructures, rapid population growth and ageing. These challenges are predicted to persist for years to come; thus the cancer burden is feared to become a major public health crisis hence need for innovative approaches to manage it. Though the widespread use of mobile health technologies in low and middle income countries can potentially address these challenges, evidence on mobile health use has not been fully explored. This study aim to examine the existing published and unpublished literature on the use of mobile technology-based interventions designed to support cancer prevention, detection, treatment and palliation in LMICs. The study adapted a scoping review approach using Arksey & O’Malley (2005) methodological framework. Six electronic databases; Medline, EMBASE, PsycINFO, PubMed, Web of Science and WHO Global Health Library were systematically searched for relevant studies between 1990 to 2014. The search also included additional sources from trial registers, Google, Google Scholar and reference lists. The search yielded 523 articles of which 16 were reviewed, one of these being an ongoing trial. The key findings revealed that mHealth technologies had significantly contributed to the positive outcomes in the cancer care in various contexts with all mobile technology-based features used showing improvement in care delivery. The cell phones were the common mobile device used (46.6% of the studies) followed by Smartphone (26.6%), while SMS was a commonly used mHealth feature. Mobile health interventions predominantly targeted cancer screening and diagnosis in the continuum of care, with less focus on treatment and palliation support. In conclusion, mobile health interventions have a high potential to transform cancer services in low resource settings. However, there is a paucity of evidence on mobile health interventions for cancer care. Most of the reviewed studies were descriptive, hence the need for robust studies with multidimensional focus, including control of risk factors, treatment compliance and palliative care.Item Patients’ Perceptions of Caring and Uncaring Nursing Encounters in Inpatient Rehabilitation Settings(Africa Journal of Nursing and Midwifery, 2019) Cheruiyot, Joan C.; Brysiewicz, PetraThis study explores and describes caring and uncaring nursing encounters from the perspective of the patients admitted to inpatient rehabilitation settings in South Africa. The researchers used an exploratory descriptive design. A semi-structured interview guide was used to collect data through individual interviews with 17 rehabilitation patients. Content analysis allowed for the analysis of textual data. Five categories of nursing encounters emerged from the analysis: noticing and acting, and being there for you emerged as categories of caring nursing encounters, and being ignored, being a burden, and deliberate punishment emerged as categories of uncaring nursing encounters. Caring nursing encounters make patients feel important and that they are not alone on the rehabilitation journey, while uncaring nursing encounters make the patients feel unimportant and troublesome to the nurses. Caring nursing encounters give nurses an opportunity to notice and acknowledge the existence of vulnerability in the patients and encourage them to be present at that moment, leading to empowerment. Uncaring nursing encounters result in patients feeling devalued and depersonalized, leading to discouragement. It is recommended that nurses strive to develop personal relationships that promote successful nursing encounters. Further, nurses must strive to minimize the patients’ feelings of guilt and suffering, and to make use of tools, for example the self-perceived scale, to measure this. Nurses must also perform role plays on how to handle difficult patients such as confused, demanding and rude patients in the rehabilitation settings.Item Knowledge of Staff Nurses on Management of Deconditioning in Older Adults: A Cross- Sectional Study(Journal of Natural Sciences Research, 2013) Cheruiyot, Joan; Laoingco, Jose Reinhard C.; Kamau, Simon MachariaA significant issue facing today’s acute care nurse is the ability to respond to the rising number of older adults admitted to the hospital, while simultaneously preventing complications of hospitalization, specifically de conditioning.Item Nurses’ perceptions of caring and uncaring nursing encounters in inpatient rehabilitation settings in South Africa: A qualitative descriptive study(International Journal of Africa Nursing Sciences, 2019) Cheruiyot, Joan Chebet; Brysiewicz, PetraBackground: Nursing encounters are face-to-face meetings and interactions occurring between the nurse and the patient and they can be experienced as being caring or uncaring. Caring nursing encounters are those that promote positive care experiences to the patient leading to satisfaction with care, and an improvement in their well-being. Uncaring nursing encounters promote negative care experiences, leading to patients’ dissatisfaction with care and a decrease in patients’ wellness. Purpose: This study describes nurses’ perceptions of caring and uncaring nursing encounters in inpatient rehabilitation settings. Methods: This study utilized an exploratory and descriptive qualitative approach using manifest content analysis. Participants were purposively sampled and a semi-structured interview guide used to collect data through individual interviews. Data redundancy was reached after interviewing 21 participants. This is part of a larger case study aimed at developing guidelines to facilitate caring encounters in inpatient rehabilitation settings. Results: Caring nursing encounters were “keeping their hope alive” and “going the extra mile,” while uncaring nursing encounters were “frustration with patients,” “being inadequate,” and “ignoring the patient.” Conclusion: Caring nursing encounters promoted positive patient care experiences, easing their rehabilitation journey, while uncaring nursing encounters elicited strong negative emotions, giving patients feelings of being denied compassionate care. Recommendation: Nurses must constantly encourage the rehabilitation patient to stay positive in the rehabilitation journey and empower them to self-manage their conditions. Nurses must strive to strike a balance in caring by building trust with rehabilitation patients and encourage them to air their grievances regarding uncaring nursing encounters as they happen