OpenUCT :: Browsing by Department "Division of Nursing and Midwifery"

Browsing by Department "Division of Nursing and Midwifery"

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Open Access
A questionnaire for assessing breastfeeding intentions and practices in Nigeria: validity, reliability and translation
(2017) Emmanuel, Andy; Clow, Sheila E
BACKGROUND: Validating a questionnaire/instrument (whether developed or adapted) before proceeding to the field for data collection is important. This article presents the modification of an Irish questionnaire for a Nigerian setting. The validation process and reliability testing of this questionnaire (which was used in assessing previous breastfeeding practices and breastfeeding intentions of pregnant women in English and Hausa languages) were also presented. METHOD: Five experts in the field of breastfeeding and infant feeding voluntarily and independently evaluated the instrument. The experts evaluated the various items of the questionnaire based on relevance, clarity, simplicity and ambiguity on a Likert scale of 4. The analysis was performed to determine the content validity index (CVI).Two language experts performed the translation and back-translation. Ten pregnant women completed questionnaires which were evaluated for internal consistency. Two other pregnant women completed the questionnaire twice at an interval of two weeks to test the reliability. SPSS version 21 was used to calculate the coefficient of reliability. RESULTS: The content validity index was high (0.94 for relevance, clarity and ambiguity and 0.96 for simplicity). The analysis suggested that four of the seventy one items should be removed. Cronbach's Alpha was 0.81, while the reliability coefficient was 0.76. The emerged validated questionnaire was translated from English to Hausa, then, back-translated into English and compared for accuracy. CONCLUSION: The final instrument is reliable and valid for data collection on breastfeeding in Nigeria among English and Hausa speakers. Therefore, the instrument is recommended for use in assessing breastfeeding intention and practices in Nigeria.
Open Access
An exploration into nephrology nurses' lived experiences of caring for dying patients with end stage kidney disease following withdrawal of dialysis
(2019) Bidii, Dempto Boniface; Fouche, Nicki A
The aim of this study sets out to better understand nephrology nurses’ lived experiences of dying and deaths of patients with ESKD following withdrawal of dialysis. A qualitative research design using an interpretative phenomenological approach was used to explore the experiences of a purposive heterogeneous sample of eight nephrology nurses who were working in private dialysis units. Information was gathered by phenomenological conversations and feed-back sessions. Colaizzi’s phenomenological method was employed to formulate four main themes: 1. Emotional trauma 2. Detachment 3. Loss of altruistic values in nursing 4. being-with-death For the participants in this study, emotional trauma was the most significant. The participants experienced a sense of powerlessness which caused emotions of hopelessness and anger and subsequently a sense of premature mourning and detachment. This state of hopelessness proved to be an obstacle in patient care, resulting in the altruistic values of nursing to be no longer applied. The participants’ ontological confrontation of being-with-death was evident, as they came to terms with the reality of their own death. Recommendations are offered to address the educational aspects of death and dying for nephrology nurses. This study endorses the need for further research into patients with ESKD ‘end-of-life’ which can influence how healthcare professionals should treat these patients during this phase.
Open Access
Beyond the feeding relationship: mothers' descriptions of interaction within the mother-child dyad
(2009) Barbard, Penelope Jane; Coetzee, Minette; Mayers, Pat
The mother-child relationship is a key determinant of child health. Current evidence acknowledges that impaired mother-child interaction affects social, emotional, cognitive and behavioural development in infants. Disrupted interaction within the mother-child dyad can be caused by a variety of factors including prolonged separation, illness, abusive relationships, maternal stress and other psychosocial disturbances. Post-Partum Depression (PPD), in particular, compromises mother-child interaction. Despite the fact that recent studies have demonstrated that the prevalence of PPD in low-income communities is approximately three times that found in first world countries, mother-child interaction is seldom evaluated and facilitated in primary care. Physical growth is often the only measure of infant health and development. The objectives of this qualitative study were to explore the mother's description of mother-child interaction; the importance that the mother ascribes to this interaction; and the mother's perception of the factors which facilitated interaction within the mother-child dyad. First-time mothers were purposively sampled and semi-structured interviews were conducted. After general inductive analysis of the verbatim transcriptions of the interviews, five main themes emerged. These were: (2)"What I expected" which described expectations around the birth and the impact on mother-child interaction, (2) "Isn't one supposed to feel ... ?" explored the mothers concerns regarding interaction, emotions and adaptation, (3) "Connecting with my baby" described a process of physical connectedness which enhanced emotional connectedness, (4)"We reflect each other's feelings " illustrated how feelings are echoed between mother and baby and empathy developed, and (5) "That helped/hindered our interaction " described factors which eased the fluency of mother-child interaction. These findings are discussed in relation to neuro-scientific developmental theories; namely Porges' Polyvagal Theory of subconscious adaptation for social behaviour and security strategies, and The Mirror Neuron Theory which describes mechanisms of imitation and the development of empathy. Factors which enhanced mother-child interaction are discussed within the context of a changing society. The findings suggest the potential value of including the facilitation of mother-child interaction in the practice of health professionals, particularly midwives and other workers in maternal and child health. This may include training in non-directive counselling of mothers, the recognition of disengaged mother-child interaction, and relationship facilitation. This study emphasizes the importance of mother-child interaction and that health professionals need to be aware of the potential for maternal mental health problems after birth, and the long-term consequences of poor mother-child interaction on infant health.
Open Access
Carinus Nursing College : an historical study of nursing education and management using the general systems approach, 1947-1987
(1992) Goodchild-Brown, Beatrix; Thompson, Rosalie A E; Human, P
The purpose of this dissertation is to research aspects of the historical development of Nursing Education and Nursing Management at the Carinus Nursing College from 1949 to 1987; to determine and explain how the College has adapted and coped with historical change and to determine whether proposals for the future can be made. Research has been done by applying the general systems theory and by using the standard methods of historical analysis. Data has been collected by means of oral history, literature search and documentation. The variables isolated are the College as a system; the government or influential super systems; resources such as financial, personnel and students and material inputs; and throughput or processing the work in the output, which leads to the professional nurse. The models used are Bucheles' organizational system, Sharma's flow chart pattern, Mintzberg's parts of organizational systems, and power flows and as shown in Emery, Feibleman and Friends relations and rules of interaction in systems thinking. Parsons' "imperatives of maintenance of a system" as well as Alvin Toffler's "second and third wave phenomena as responses to change" were two further models that were used. By using Robert Buchele's model, the work is divided into four parts: - i) the College as a system ii) the super systems iii) the resources iv) the throughput or processing. A further design that emerged was that two eras could be distinguished, within which three historical phases: - Early, Middle and Late are developed.
Open Access
The childbirth experiences of adolescent mothers in the Western Cape
(2016) Füzy, Elizabeth; Clow, Sheila; Fouché, Nicola
Objective: The objective of this study was to explore the lived childbirth experiences of middle adolescent mothers between 14 and 16 years of age. Methodology: A qualitative design was followed, using Husserl's phenomenological approach. Information was gathered by semi-structured conversations. Identified themes and sub-themes (Colaizzi's steps) were presented to participants for authentication during follow-up conversations. Study Setting: Two hospitals in the Cape Town Metropolitan area, Western Cape, South Africa. Participants: Six adolescent girls between the ages of 14 and 16 years of age who had normal vaginal births of healthy, term infants. Findings: An over-arching theme of preservation of personhood was identified. Themes and sub-themes were derived according to three Husserlian phenomenological concepts. Within these concepts three essential themes emerged from the conversations: i) essences: physically underdeveloped and emotionally unprepared for childbirth, ii) intentionality and consciousness: an unsettled state of mind during childbirth, and iii) life-world: feeling physically and emotionally overwhelmed by the experience. Conclusion: The participants highly valued the presence of a support person; they indicated that their mothers were their first choice. Friendly, helpful, respectful and non-judgmental care from nurses and midwives were associated with more positive birth experiences while humiliation, victimisation and rudeness were associated with negative birth experiences. Implications for adolescent-friendly practice: A condensed form of antenatal education is needed together with adolescent-friendly health care services to ensure better preparedness and experiences. Shared-decision making regarding certain aspects of childbirth is necessary. Continuous labour support is an important coping strategy and pain management is vital. Additional training is needed to address midwives' attitudes. Quality assessment tools are needed to address the mistreatment of maternity patients in health care facilities.
Open Access
Community health workers & professional nurses : a descriptive study of their relationship in two Western Cape communities
(2000) Doherty, Tanya; Coetzee, Minette
Bibliography: leaves 151-160.
Open Access
The costs and benefits of nurse migration to their families in Maseru, Lesotho
(2008) Ntlale, Matsola Evelyn; Duma, Sinegugu
Health professionals including nurses from developing countries are currently leaving their native countries at an alarming rate to work in other countries, especially developed countries. As such developing countries are faced with the depletion of skilled human resource and Lesotho is no exception in this regard. These nurses are leaving their families, however, the impact of nurse migration is not known on the families left behind. The purpose of this study was to explore and describe the experiences of family members of migrating nurses with regard to the costs and benefits on their lives.
Open Access
A critical analysis of the concept 'care' in the practice and discourse of nursing
(1999) Haegert, Sandy; Shutte, Augustine; Kyriacos, Una
This research sought to answer the question: " What meanings has the nursing profession given to the concept 'caring'"? This was achieved by means of a three-fold approach: interpretive phenomenology combined with linguistic analysis [Wittgenstein's as interpreted by Bowden], and, a conceptual philosophical framework. Narratives, from registered nurses working in hospices and oncology/haematology units, were obtained and analyzed through juxtaposing them with selected theorists, and each other, to construct 'family resemblances' and 'layers of understanding'. Their meanings, obtained by requesting them to draw on memories of being cared-for or caring, resulted in descriptive understandings of their use of the concept 'care'; and, to a relational ethic enabling the construal of a normative ethic: one allegedly embedded in the practice and experience of these practitioners. The findings show it is not possible to give a simple definition to explain the concept 'caring'. The meanings, contained in the collected narratives, reveal strong 'family resemblances' in their usage of the term, verifying the Wittgensteinian observation: that no single meaning, no singular essence captures every cultural, individualized use of the term. The findings pointed to these 'meanings' being 'private' but not in the sense of being 'false'. Within the research one becomes aware that the term 'care' is not an ethical notion. To be ethical care is dependent upon context and responsible attitudes and actions. The discourses comprise the personal 'passion', an ethical ideal, held by most respondents; but, their ideal was not always the caring they were enabled to give. Institutionalized care whether hospice or not fell below the ideal because of socio-economic constraints and concerns. The original thesis question was from O'Malley: "[W]hether in encounter man himself makes his own meaning or is made by the meaning made of and for him ...". This research led to the assertion that the reality of the practice setting shapes the 'public' meaning of caring these practitioners act upon, but, they shape their own 'private' meanings and implement it on a micro level. It is at the macro-level of care/caring that there should also be concern. Although not true of all respondents, a possible reason for this less-than-ideal-type caring is the possibility that in institutions there are nurses who for some reason(s) fail to 'grow' - to develop in a fully integrated way that includes the freedom to exercise one's spirituality and to become morally caring not merely on a micro [one-to-one] basis but on a macro level [whole unit basis].
Open Access
Critical care nurses' experience of the sudden unexpected death of a patient : a phenomenological study
(2003) Turner, Roseanne Elizabeth; Mayers, Pat; Oskowitz, beverley
Bibliography: leaves 115-129.
Open Access
The critical care nursing workforce in Western Cape hospitals - a descriptive survey
(Health and Medical Publishing Group, 2006) Gillespie, R.S.; Kyriacos, U.; Mayers, P.M.
Background: A global shortage of registered nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical care nurses (CCNs) especially are in great demand and short supply. Purpose: The purpose of this study was to quantify the nursing workforce and compare it with requirements of critical care units (CCUs) in hospitals of the Western Cape province as at 1 January 2005, and to quantify potential recruits from nursing education institutions. Design: A descriptive survey conducted on site in CCUs of the private and public sector hospitals of the Western Cape, using a structured questionnaire. Results: Data were obtained from questionnaires (96.5% return rate) from 77 of the 80 CCUs surveyed in 35 hospitals (12 public; 23 private). Intensive care units (ICUs) and high-care units (HCUs) were classified in the questionnaire. Findings revealed: 39 adult ICUs (12; 27), 2 paediatric ICUs (public), 14 neonatal ICUs (4; 10), 13 adult HCUs (11, 2), 1 paediatric HCU (public), 3 neonatal HCUs (public) and 5 high-dependency units (HDUs) for adults (public), with 720 functional unit beds in total (359; 361). A registered nurse/ventilated patient ratio of 1:1 was used in 5.26% of public sector units but in all private sector units. Of the 768 nurses of all categories in public sector units 118 (15.4%) were trained CCNs and 289 were RNs (37.6%). In private sector units 204 (38.1%) of 535 nurses were trained CCNs and 204 (38.1%) were RNs. According to a consensus-driven method developed in Australia to measure the required number of ICU nurses, the Western Cape has a deficit of 72% and 80%RNs respectively in public and private sector CCUs, amounting to an actual total shortage of 2 711 RNs. Data from 7 educational institutions revealed that during 2004, 300 undergraduate nurses and 80 postgraduate CCNs graduated. Conclusion: The current supply of nurses does not meet the needs of CCUs in the Western Cape, and the number of educators and clinical mentors is inadequate.
Open Access
A description of final year nursing students' ability to recognize abnormal vital signs recordings and clinical decision-making process
(2014) Leonard, Martha Maria; Kyriacos, Una
The aim of this study was to determine whether final year nursing students can recognize and respond to abnormal vital sign recordings, and to analyse their clinical decision-making processes.
Open Access
A description of the self-perceived roles of registered nurses in student health services in selected tertiary institutions in South Africa
(2006) Adams, Bridget; Mayers, Pat
Includes bibliographical references.
Open Access
A descriptive survey of renal unit practitioners' knowledge, attitude and practice relative to use and effects of unfractionated heparin in selected adult chronic haemodialysis centres in the Cape Town metropole
(2014) Ockhuis, Debra; Kyriacos, Una
Background: Chronic haemodialysis treatment of 3-4 hours' duration two or three times a week is the most common renal replacement therapy for adult patients diagnosed with stage 5 end-stage kidney failure. During the procedure 200-250 ml/minute of the patient's blood volume is extracorporeal and patency of the circuit is maintained by an anticoagulant, for example, unfractionated heparin (UFH). Incorrect dosage or time of administration of UFH can have serious adverse effects if not fatal consequences for patients. It is important to perform base-line clotting studies before the initial administration and subsequent doses of UFH. There is a paucity of published information on renal unit practitioners' knowledge, attitude and practice (KAP) concerning the administration of UFH globally and no published South African studies were located. Aim: To describe renal unit practitioners' self-reported KAP regarding use and effects of UFH in purposively selected adult chronic haemodialysis centres in the Cape Town Metropole. Secondly, to determine whether there is an association between KAP regarding the use and effects of unfractionated heparin and selected variables (category of renal unit practitioner, years of experience, duration of orientation to the adult chronic haemodialysis unit and in-service education on the pharmacology of UFH).
Open Access
A descriptive survey of the nursing workforce in critical care unit in hospitals of the Western Cape Province
(2006) Gillespie, Rencia S; Kyriacos, Una; Mayers, Pat
A global shortage of Registered Nurses (RNs) has been reported internationally, and confirmed in South Africa by the National Audit of Critical Care services. Critical Care Nurses (CCNs) especially are in great demand and short supply. This has affected the quality of patient care. The purpose of this study was to perform a workforce analysis and needs assessment of critical care nursing services in the Western Cape Province as at 1 January 2005. The study design is a descriptive survey conducted on site in the critical care units of the private and public sector hospitals of the Western Cape, using a structured questionnaire, with a 96.5% return rate. Findings showed that the 35 hospitals surveyed in the public and private healthcare sectors had 80 functional critical care units including Intensive Care Units and High Care Units for adults, children and neonates, and High Dependency Units for adults. Factors that contribute to the demand for critical care nurses include the number of critical care beds, patient admissions, severity of illness, available facilities, medical, nursing and support staff. Compared to internationally accepted norms, the Western Cape units have a deficit of 74% of Registered Nurses (RNs) in the public sector hospitals, and a deficit of 82% in the private sector. This equates to an actual shortage of 3010 RNs for both sectors. If all categories of nursing staff are included in the calculation, the public sector meets 49% of its requirements and the private sector 24%. Half of the private sector and 28.9% of the public sector Registered Nurses are Critical Care Nurses. Few measures appear to be taken to recruit and retain nursing staff. The number of students being trained at both the undergraduate (300 during 2004) and the postgraduate (80 CCNs during 2004) level at the educational institutions, in conjunction with the hospitals, is inadequate. Clinical training institutions are available, but the numbers of educators and clinical mentors are inadequate to train the number of nurses required to meet the demand.
Open Access
The development and validation of a modified Situation-Background-Assessment-recommendation (SBAR) communication tool for reporting early signs of deterioration in patients
(2015) Burger, Debora; Kyriacos, Una; Jordan, Sue E
Background: Errors in communication are prevalent in healthcare and affect patient safety and cause unnecessary patient deaths. Reporting early signs of physiological or clinical deterioration could improve patient safety and prevent 'failure to rescue' or unexpected intensive care admissions, cardiac arrest or death. The structured Situation-Background-Assessment-Recommendation (SBAR) communication tool enables nurses to provide doctors with pertinent information about a deteriorating patient in a logical order, based on a complete assessment. In addition, nurses have increased confidence in their findings and are better able to initiate a call and to convince a doctor to provide orders promptly or see a patient. Aim: The aim of this sub-study of a randomized controlled trial was to develop and validate a modified SBAR communication tool incorporating components of a local MEWS vital signs observations chart. Methods: The modified SBAR communication tool was developed following a review of available published examples and validated by employing a mixed methods approach: 1) cognitive interviews (n=3 nurses, 2 doctors), 2) determining the index of content validity with nurses (n=5), physicians (n=5) and surgeons (n=8) and 3) inter-rater reliability testing, with calculation of kappa values (n=2 nurses). Results: Cognitive interviews prompted more changes to the modified SBAR communication tool than determined by the content validity index. For cognitive interviews, there were 15/42 (35.71 %) modifications: 11 items were added (26.19 %) and three removed, (7.14 %) resulting in 49 items whereas for content validity index there were 4/49 (8.16%) modifications, 5/49 (10.20%) items removed and one item added (2.04%). Four of 49 items (8.16%) rated as relevant by <70% of nurses and doctors were revised or deleted. No additional modifications were needed following review by surgeons, as all items were rated as relevant by the pre-determined ≥70% of experts. Inter-rater reliability of the SBAR tool was established by two nurses who were mostly in substantial to full agreement on 37/45 items on the modified tool. The exceptions were: 'Calling from' (Cohen's Kappa-0.05) and 'this is a change from' (Cohen's Kappa-0.07), representing agreement below the level of chance. However, the high percentage agreement and nature of the questions suggest that the questions are sound. Percentage agreement amongst participants for these items was 91 % (95% confidence interval (CI): 71 to 99 ) and 86% (95% CI: 65 to 97 ) respectively. Deciding whether a doctor should see the patient now (Cohen's Kappa 0.09) or in the next 30 minutes, achieved fair agreement (Cohen's Kappa 0.20). This reflects a difference in clinical judgement as the decision when to call for assistance depended on the individual nurse's clinical judgement. IRR was not possible to test on 4/45 items, as those items required a response by the person being summoned. Overall, nine of 42 items were removed, 12 were added and 19 substantially modified, leaving 45 items. Conclusion: The modified SBAR communication tool was valid and reliable for use in a local context in conjunction with the Cape Town Modified Early Warning Score (MEWS) vital EWS) vital signs chart.
Open Access
Development and validation of a questionnaire on nurses' knowledge and recognition of early signs of clinical deterioration
(2018) Berning, Briony; Kyriacos, Una
Introduction: There is evidence-based concern that nurses on general wards do not recognise signs of physiological and clinical deterioration and delay calling for more skilled assistance for review of a patient showing signs of deterioration. Aim: The development and validation of a questionnaire to assess factors influencing general ward nurses’ ability to recognise and respond to patient deterioration; nurses’ knowledge of physiological and clinical parameters associated with patient deterioration; and nurses’ self-reported clinical reasoning ability. Methodology: A mixed methods sequential 4-phase study design was employed: 1) an indepth literature review to identify and develop content domains and item statements for a prototype questionnaire; 2) determining the index of content validity (CVI) (n=5 expert registered professional nurses) of all item statements; 3) conducting cognitive interviews (n=3 expert registered professional nurses) to explore face validity and the quality of the revised prototype questionnaire; and 4) assessing stability of the final validated questionnaire through test-retest reliability testing (n=30 nurses: Registered Professional Nurses with four years of training, Enrolled Nurses with two years of training, Enrolled Nursing Auxiliaries with one year of training) two weeks apart. Results: The CVI exceeded the pre-set proportion of ≥70% agreement for 56/65 (86.2%) item statements scoring 3 (relevant only needing minor editing) or 4 (extremely relevant); removal of 3/65 (4.6%) items from the prototype questionnaire. Cognitive interviews then resulted in amendment of 30/78 (38.5%) item statements; removal of 2/78 (2.6%) from the revised prototype questionnaire. The weighted kappa statistic for level of agreement beyond chance for nurse respondents’ test-retest data was fair (0.21-0.4) for 18/47 (38.3%) items, moderate (0.41-0.6) for 12/47 (25.5%) items and substantial (0.61-0.8) for 13/47 (27.7%) items. Registered Professional Nurses’ responses between time 1 and time 2 were more consistent than for Enrolled Nurses and Nursing Auxiliaries. Conclusion and recommendations: The researcher-developed questionnaire was validated by registered professional nurses, but there is concern about its stability, tested on three categories of nurses. The questionnaire should be reassessed for content and face validity using a sample inclusive of all categories for nurses who take and interpret patients’ vital signs in an attempt to improve the reliability of the questionnaire.
Open Access
The development, validation and testing of a vital signs monitoring tool for early identification of deterioration in adult surgical patients
(2011) Kyriacos, Una; Jelsma, Jennifer
Patients often exhibit premonitory abnormalities in vital signs before an adverse clinical outcome. Patient survival may depend on the decisions of nurses to call for assistance. There is a paucity of published early warning scores (EWS) literature for general ward use from South Africa. In a public hospital in South Africa, the study aimed to develop, validate and test the impact of implementation of a modified early warning scoring (MEWS) system vital signs chart and training programme designed to improve hospital nurses’ performance in early identification of postoperative clinical and physiological deterioration in adult patients.
Open Access
Early warning scoring systems versus standard observations charts for wards in South Africa: a cluster randomized controlled trial
(BioMed Central, 2015-03-20) Kyriacos, Una; Jelsma, Jennifer; James, Michael; Jordan, Sue
Background: On South African public hospital wards, observation charts do not incorporate early warning scoring (EWS) systems to inform nurses when to summon assistance. The aim of this trial was to test the impact of a new chart incorporating a modified EWS (MEWS) system and a linked training program on nurses’ responses to clinical deterioration (primary outcome). Secondary outcomes were: numbers of patients with vital signs recordings in the first eight postoperative hours; number of times each vital sign was recorded; and nurses’ knowledge. Methods/design: A pragmatic, parallel-group, cluster randomized, controlled clinical trial of intervention versus standard care was conducted in three intervention and three control adult surgical wards in an 867-bed public hospital in Cape Town, between March and July 2010; thereafter the MEWS chart was withdrawn. A total of 50 out of 122 nurses in full-time employment participated. From 1,427 case notes, 114 were selected by randomization for assessment. The MEWS chart was implemented in intervention wards. Control wards delivered standard care, without training. Case notes were reviewed two weeks after the trial’s completion. Knowledge was assessed in both trial arms by blinded independent marking of written tests before and after training of nurses in intervention wards. Analyses were undertaken with IBM SPSS software on an intention-to-treat basis. Results: Patients in trial arms were similar. Introduction of the MEWS was not associated with statistically significant changes in responses to clinical deterioration (50 of 57 received no assistance versus 55 of 57, odds ratio (OR): 0.26, 95% confidence interval (CI): 0.05 to 1.31), despite improvement in nurses’ knowledge in intervention wards. More patients in intervention than control wards had recordings of respiratory rate (27 of 57 versus 2 of 57, OR: 24.75, 95% CI: 5.5 to 111.3) and recordings of all seven parameters (5 of 57 versus 0 of 57 patients, risk estimate: 1.10, 95% CI: 1.01 to 1.2). Conclusions: A MEWS chart and training program enhanced recording of respiratory rate and of all parameters, and nurses’ knowledge, but not nurses’ responses to patients who triggered the MEWS reporting algorithm. Trial registration: This trial was registered with the Pan African Clinical Trials Registry (identifier: PACTR201309000626545) on 9 September 2013.
Open Access
Effects of a psychosocial intervention on the quality of life or primary caregivers of women with breast cancer in Abuja, Nigeria
(2017) Gabriel, Israel Olatunji; Mayers, Pat
Studies have shown that limited attention has been paid to the psychosocial wellbeing of caregivers of patients undergoing care and treatment for breast cancer in Nigeria. There are no interventions in place to cater for their needs despite, the psychological problems faced by this group of people. This study investigated the effectiveness of a psychosocial intervention in term of impact on the quality of life (QOL) of primary caregivers of women with breast cancer in Abuja, Nigeria. Using a quasiexperimental design, sample of 108 participants assigned to the intervention and control groups, the study made use of the Zarit Burden Interview (ZBI) and Caregiver Quality of Life Index-Cancer (CQOLC) to measure caregiver burden and QOL respectively. The hypothesis for the study was that the primary caregivers of women with breast cancer who receive a psychosocial intervention programme will report improved QOL compared with caregivers who do not attend a psychosocial intervention programme. The study established that there were a negative linear relationship between caregiver burden and QOL (R = -0.45, p < 0.001) as a basis for intervention, and also that 29% variance of QOL could be explained by caregiver burden. The intervention results showed that at baseline 51.9% participants reported moderate to severe burden and 48.1% reported severe burden. These figures reduced to 22.3% and 12.6% for moderate to severe and severe burden respectively at 6 weeks after intervention, and further reduced to 18.6% and 4.9% respectively at 12 weeks after intervention. Comparing the QOL of the intervention and control groups, the results showed a significant difference on the score at baseline, 6 and 12 weeks. However, looking at performance of the intervention group, there was no significant different at baseline and 6 weeks (t=0.83, p < 0.05), and baseline and 12 weeks (t=1.65, p < 0.05). With reference to the caregiver burden of the intervention and control groups, it was found that a significant difference existed at baseline (t=9.33, p < 0.001). In respect of the impact of the intervention on caregiver burden of the intervention group, results showed a significant difference between baseline and 6 weeks (t=30.34, p < 0.001) and between baseline and 12 weeks (t = 36.80, p < 0.001) after intervention. The study concluded that the psycho-education intervention significantly affected caregiver burden but did not affect caregivers' QOL. Therefore, there is a need for a psycho-education intervention for caregivers of patients with breast cancer, in order to reduce the burden and help them cope with the work of caregiving. Appropriate supportive interventions should be made available to support the close family members of patients with breast cancer in order to reduce caregiver burden. Relevant stakeholders in the healthcare sector especially in palliative care should promote awareness of carer needs. The provision of intervention programmes for caregivers requires further research to develop contextually specific programmes and services which will improve the QOL of caregivers.
Open Access
Effects of decreasing maternal separation of under 6-month old infants directly before and after surgery on allostatic load and outcomes : a randomised control trail [i.e. trial]
(2014) Ssenyonga, Lydia V N; Coetzee, Minette; Bergman, Nils
The current understanding is that infants below six months old do not show separation anxiety (Bretherton, 1985). The objective of the study was to measure the evidence of stress using heart rate variability and impedance cardiograph as indicators of autonomic nervous system activation in order to determine whether decreasing maternal separation of under 6-month-old infants directly before and after surgery decreases their stress experience. The hypothesis was a mother’s presence makes a difference to the autonomic response to stress in infants under six months old undergoing elective hernia surgery.