Philosophiae Doctor - PhD (Nursing)

Permanent URI for this collection

https://hdl.handle.net/10566/12323

Browse

Now showing 1 - 20 of 57

The development of a good clinical practice training model for use in South African clinical trials
(University of the Western Cape, 2005) Raphesu, Nomusa Joyce; Kortenbout, Elma; Dept. of Nursing; Faculty of Community and Health Sciences
Medicines for human use worldwide are generated in part through the conduct of clinical trials. This is done to ensure safety and efficacy. The involvement of human subjects in drug trials has raised concerns for the protection of human rights. As a consequence of the medical misadventures, the Declaration of Helsinki was formulated in 1964 and revised up to 2002. Today, the International Conference of Harmonization of Good Clinical Practice of 1996 guidelines are used worldwide (including South Africa) in the conduct of clinical trials. This study took place in South Africa. The objectives of the study were to first develop an instrument to be used in identifying the current good clinical practice knowledge and training needs of clinical researchers; secondly identify the knowledge level and training needs using the designed instrument and thirdly, based on the findings, develop a Good Clinical Practice training model so as to facilitate the achievement of quality standards for the conduct of clinical trials in South Africa.
Facilitating care: The experiences of informal carers during the transition of elderly dependants from hospital to home- a grounded theory study
(University of the Western Cape, 2006) Jeggels, June Deanna; Mpofu, R.M.B; Dept. of Nursing; Faculty of Community and Health Sciences
Major changes have occurred in South Africa over the past twelve years. The delivery of health care changed significantly. Community Health Centres (CHCs) became the main service delivery sites within districts. Due to socio-economic changes in the country, the care of dependants, particularly children and the aged, became problematic to families where most of the adult members have to work to secure an income. A focused literature search indicates that informal carers are ill prepared for their task, that there is a need to include these carers in the discharge planning of the dependants and that the carers need to be supported within their families and communities. The aim of this study was to explore the experiences of informal carers during the transition of their elderly dependants from hospital to home, within the home and across different social groupings in the metropolitan area of Cape Town, South Africa. In addition, the involvement of informal carers in the rehabilitation of the elderly was explored.
The development of a model for continuing professional development for professional nurses in South Africa
(University of the Western Cape, 2009) Arunachallam, Sathasivan; Nikodem, C.; Dept. of Nursing; Faculty of Community and Health Sciences
Comparative analysis of the CPD systems internationally and nationally revealed that CPD is mandatory for some whilst for other countries it is compulsory, but not mandatory for licensing purposes. Licensing occurs on a yearly basis, but CPD recognition is accredited over a time period with expiry deadlines and minimum requirements. A portfolio was a common method of recording and proof of evidence for CPD, and a continuous theme was that CPD is needed to ensure competency. The Nursing Act 33 of 2005 makes provision for CPD for nurses but to date the South African Nursing Council has not yet decided on a model of CPD for implementation for SA nurses.
A model to enhance the empowerment of professional nurses to promote the recovery of people who have been diagnosed with depression
(University of the Western Cape, 2010) Pearce, Shelltunyan; Kortenbout, W.
The purpose of this research study is to develop and describe a model to enhance the empowerment professional nurses to promote the recovery of people who have been diagnosed with depression. Depression is a prevalent psychiatric disorder that despite its increase worldwide, often goes undetected or inadequately treated. The biomedical model's reductionist and dualistic approach proves to be inadequate for nursing practice to address depression and calls for the examination of a multifaceted holistic approach. A multifaceted holistic approach views disease as having multiple causes that are amenable to multiple therapeutic interventions. Despite research evidence about the effectiveness of such an approach, an in-dept literature search did not reveal the availability of such a model to enhance the empowerment of professional nurses to promote the recovery of people who have been diagnosed with depression. The research question that emerged was: • How can professional nurses in the Western Cape be empowered to promote the recovery of people who have been diagnosed with depression? The assumption is that this question was necessary to address. To realise the purpose of this research study, the following objectives were formulated: • To explore and describe the self reported attributes needed by professional nurses to promote the recovery of people who have been diagnosed with depression. • To explore and describe how these self reported attributes can be facilitated in the work environment. • To propose a model to enhance the empowerment of professional nurses to promote the recovery of people who have been diagnosed with depression. • To develop guidelines for the operationalisation of the model. The theoretical framework for this research study was adopted from the Critical Social Theory. The research design and method used was qualitative, explorative, descriptive and contextual in nature. The research was done in two phases. In phase one the researcher did semi- structured interviews with a purposive and convenient sample of fourteen (14) professional nurses who were working in the Cape Town Metropolitan area and the West Coast.
Evaluating the effectiveness of the regional collaboration on the common teaching platform for undergraduate nursing in the Western Cape
(University of the Western Cape, 2010) Daniels, Felicity; Khanyile, T.D.
South Africa’s transition from apartheid to democracy necessitated transformation within all sectors to ensure their appropriateness for the new democratic era. In line with the national transformation agenda and the transformation and restructuring of the higher education sector, the Minister of Education in 2002 announced that the University of the Western Cape (UWC) and the Cape Peninsula University of Technology (CPUT) would be the only enrolling institutions for undergraduate nursing education in the Western Cape. This decision meant that the University of Stellenbosch and the University Cape Town would no longer enrol undergraduate nurses, but would combine their strengths in a collaborative manner with UWC to train nurses for the region. The Cape Higher Education Consortium (CHEC), however, proposed the establishment of a Common Teaching Platform (CTP) for undergraduate nursing education in the region, requiring collaboration between all higher education institutions in the Western Cape. The Common Teaching Platform came into effect in 2005. The purpose of the study was to evaluate the effectiveness of the regional collaboration on the Common Teaching Platform for B Cur Nursing in the Western Cape. An evaluation research design using qualitative methods was adopted for the study. Stufflebeam’s decision-oriented evaluation model, which caters for the evaluation of the context, input, process and product components of programmes, was used to guide the research process. Semi-structured, in-depth interviews, focus group discussions and a record review were used to collect data from the Chief Executive Officers of CHEC; Deputy Vice-Chancellors of the participating universities; Deans of the Health Science Faculties; Heads of Departments, Lecturers and Students of the Nursing Departments of the participating universities. The study adopted an inductive approach to data analysis. The inductive analysis procedure described by Thomas (2003) was adapted and used. The results evinced a general lack of application of the basic tenets of change management and a systems approach to the planning and implementation of the Common Teaching Platform. Transformation of nursing education in the Western Cape, according to the results, was in line with the national transformation agenda. Participants, however, felt that people were not yet ready to collaborate and needed enough time to accept the change, given that transformation was relatively new in the country. A critical finding was that important stakeholders were excluded from the planning phase, which led to challenges during the implementation of the Common Teaching Platform. The results further highlighted that a top-down approach was adopted. Numerous challenges with regards to the implementation of the Common Teaching Platform, including inter alia, poor communication, lack of commitment to the collaboration process, lack of adequate resources and challenges with the delivery of the curriculum, were shared by all the participants. Despite all these challenges the results showed that the student throughput rates were not compromised, and that the number of reported complaints from lecturers and students decreased over the years. On the whole, however, participants felt that the goals of the collaboration were not met due to the unresolved challenges which included inadequate resources, lack of sharing of resources and expertise across institutions, lack of commitment to participation on the CTP and failure to produce sufficient graduates to address the nurse shortage in the province.
Developing a framework for a district-based information management system for mental health care in the Western Cape
(University of Western Cape, 2013) Bimerew, Million S; Adejumo, Oluyinka; Korpela, Mikko
A review of the literature has shown that there is a lack of mental health information on which to base planning of mental health services and decisions concerning programme development for mental health services. Several studies have indicated that the use of an evidence-based health information system (HIS) reduces inappropriate clinical practices and promotes the quality of health care services. This study was aimed at developing a framework for a district-based mental health information management system, utilising the experiences of health care providers and caregivers about a district mental health information system (DMHIS). Activity Theory was used as the philosophical foundation of the information system for the study. A qualitative approach was employed using semi-structured individual interviews, Focus Group Discussions (FGDs), systematic review and document analysis. The intervention research design and development model of Rothman and Thomas (1994) was used to guide the study, which was conducted in the Cape Town Metropole area of the Western Cape. A purposive, convenient sampling method was employed to select study participants. Ethical clearance for the study was obtained from the University of the Western Cape, and permission to use the health facilities from the Department of Health. The data collection process involved 62 individual interview participants, from mental health nurses to district health managers, health information clerks, and patient caregivers/families and persons with stable mental conditions. Thirteen caregivers took part in the FGDs. Document review was conducted at three community mental health centres. The data were analysed manually using content analysis. Core findings of the interviews were lack of standardized information collection tools and contents for mental health, information infrastructure, capacity building, and resources. Information processing in terms of collection, compiling, analysing, feedback, access and sharing information were the major problems. Results from document analysis identified inconsistencies and inaccuracies of information recording and processing, which in turn affected the quality of information for decision making. Results from the systematic review identified five functional elements: organizational structure; information infrastructure; capacity building; inputs, process, output and feedback; and community and stakeholders’ participation in the design and implementation of a mental health information system (MHIS). The study has contributed a framework for a DMHIS based on the findings of the empirical and systematic review. It is recommended that there is a need to establish a HIS committee at district health facility level for effective implementation of the framework and quality information processing. There is a need to ensure that staffs have adequate knowledge and skills required for effective implementation of an information system. It is recommended that higher education institutions include a course on HISs in their curriculum. It is suggested that the South African Mental Health Policy be reviewed to include an MHIS and ensure involvement of the community and stakeholders in this system as well as adequate budget allocation.
The development of a model of emotional support for undergraduate nursing students working in mental health care settings
(University of Western Cape, 2013) Martin, Penelope Dawnette; Daniels, Felicity
The mental health care environment is a stressful environment because of the environment, perceived unpreparedness of students and the emotional demands placed on the students which are inherent in the nature of the work. The use of the self as a therapeutic tool also presents challenges for students. Whilst researchers have identified supportive interventions and strategies to address students support needs in mental health care settings, these interventions/strategies focus on meeting clinical learning objectives with the assumption that if the student learning needs are met, they will feel emotionally supported. Literature and experience indicates that it is imperative that in this field of study, students should be prepared to cope emotionally with the demands of mental health work. The aim of this research was to develop a model of emotional support for student nurses working in mental health care settings. A theory-generating design based on a qualitative, explorative and descriptive research approach was used to achieve the aim of the study. Purposive sampling was employed to select participants namely: students, educators and clinical staff who met the eligibility criteria. A sample of 40 students, nine educators and nine clinical staff who worked in the four psychiatric hospitals and community mental health clinics in the Western Cape participated in the study. Data collection was by means of focus group interviews (students) and indepth individual interviews (educators and clinical staff). Data was analysed by means of Tesch’s method of content analysis. The model was developed by means of the four steps of the theory generation process. Step one was concept development which consisted of two sub-steps namely concept identification and concept definition. A total of 22 concepts were identified which was further synthesised into six main concepts. The main concepts which were used to develop the model were: positive self-concept; positive work environment; academic and professional development; effective communication; formal and informal supportive interventions and collaboration between the Higher Education Institution and the mental health care setting. Step two of the theory generating process was model development. These main concepts were placed in relation with each other which formed an emotional support model for students working in mental health care settings. Step three was model description. The model was described using the three phases of interpersonal communication namely orientation phase, working phase and the termination phase. A visual application of the model which depicts the main concepts, the process and the context was shown. Step four dealt with the development of the guidelines for the implementation of the emotional support model. A critical reflection of the model was done using five criteria for model evaluation according to Chinn & Kramer. Trustworthiness of the data was ensured by means of applying Guba’ model of truth value, applicability, consistency and neutrality. Reflexivity was used by the researcher to further enhance trustworthiness. Permission to conduct the study was obtained from the relevant authorities. The ethical principles of respect for human dignity, beneficence and justice were applied throughout the study. Limitations were identified and ecommendations for nursing practice, education concluded the study.
The development of an implementation framework for service-learning in the undergraduate nursing programme in the Western Cape
(University of the Western Cape, 2014) Julie, Hester; Adejumo, Oluyinka
In this doctoral thesis, I explored how the national guidelines for higher education to institutionalise service-learning as a particular type of community engagement were implemented in South African higher education institutions. Whilst the particular School of Nursing where the study was conducted was cognisant of the national policy imperative on service-learning as stipulated in the guidelines of the Higher Education Quality Committee (HEQC), operationalisation within the academic programmes had not been addressed. An intervention study was thus undertaken to develop a service-learning implementation framework for the School of Nursing using the multi-phased design and development model of Rothman and Thomas (1994). The factors that influenced the implementation of the HEQC’s service-learning policy guidelines in the nursing programmes were explored during the first phase: problem analysis and project planning. During this phase, the research focused on the readiness of the school to institutionalise service-learning at organisational and individual level because service-learning scholars advocate a systems approach to service-learning institutionalisation. At organisational level, the research question investigated whether the higher education institution had created an enabling environment for the school to institutionalise service-learning successfully in the academic. The factors that were associated with readiness at organisational (school) level were those cited as critical success factors for service-learning institutionalisation by Furco (2002) or better known in South African terminology as service-learning good practice indicators. Individual readiness was determined in terms of service-learning scholarship and willingness to participate in service-learning -capacitating activities.
Development of neonatal nursing care clinical competency-based assessment tool for Nurse-midwife technicians in CHAM nursing colleges, Malawi
(University of the Western Cape, 2015) Phuma, Ellemes Everret; Van Wyk, Brian; Adejumo, Oluyinka
Literature has shown that Malawi is experiencing a shortage of qualified healthcare providers, with the greatest burden on maternal and neonatal health. The majority of health service providers are Nurse-Midwife Technicians (NMT), contributing to 87% of the nursing and midwifery workforce. However, research has shown that the NMTs lack the ability to transfer skills into different clinical settings. It was not known what competencies were taught in Christian Health Association of Malawi colleges to equip the NMTs with clinical competence in neonatal nursing practice and how the clinical teachers assisted these NMTs to acquire the competencies. Furthermore, there was no documentation on the availability of a clinical competency-based assessment tool to validate the NMTs’ achievement of clinical competence in neonatal nursing. The purpose of this study was to develop a neonatal nursing care clinical competency-based assessment tool to validate NMTs’ achievement of clinical competence in CHAM nursing colleges. The competency, outcomes and performance assessment (COPA) model and the skills acquisition model were the conceptual frameworks used as the foundation of the study. The study adopted a sequential mixed method approach in which both qualitative and quantitative methods were utilized. Data collection was conducted using focus group discussions, document review and cross-sectional survey. The design and development model developed by Reeves (2006) and steps to development of assessment tools identified by the Department of Training and Workforce Development (2012) guided the study and development of the competency-based assessment tool. The study was conducted in eight CHAM nursing colleges. The researcher employed purposive, convenient and proportional stratified sampling to select the participants. Ethics clearance was obtained from the University of Western Cape and the National Health Sciences Ethical Research Committee in Malawi, prior to data collection. The data collection involved 31 midwifery clinical teachers and 140 third year students for the FGD and 48 midwifery clinical teachers and 195 third year students for the cross section survey. Document analysis was conducted at all the eight nursing colleges. The qualitative data was analysed using content analysis with Atlas.ti 7 and the quantitative data was analysed using descriptive analysis with SPSS 22. The research findings showed that the NMTs were taught basic nursing skills to enable them provide basic care to the health newborn baby. However, there were inadequate clinical assessments done to validate the NMT’s achievement of clinical competence in this setting. In addition, the clinical teachers used skills checklists to evaluate the NMTs clinical performance on specific procedures. The outcome of this study was the establishment of neonatal nursing clinical competencies, and development of a neonatal nursing care clinical competency-based assessment tool for the validation of NMT’s achievement of clinical competence. The tool provides a framework for neonatal nursing clinical teaching and assessments as well as tracking of the NMT’s clinical performance in this setting. It is recommended that training institutions should reinforce mechanisms to track the students’ clinical experience and performance assessments using this tool to ensure quality student outcomes. Furthermore, the clinical teachers should be oriented on the use of the developed assessment tool for familiarisation; thereby enhancing consistency and objectivity in the students’ performance assessments.
Developing a model for integration of core competencies related to HIV and AIDS into undergraduate nursing curriculum at the University of the Western Cape
(University of the Western Cape, 2015) Modeste, Regis Rugira Marie; Adejumo, Oluyinka
The HIV epidemic is in its third decade, and there is still neither a cure nor an effective vaccine in sight. Although the number of new HIV infections and AIDS-related deaths has decreased since the early 2000s, the number of people living with HIV remains high. Sub- Saharan Africa carries the burden of the epidemic, and South Africa has the highest number of people living with HIV globally. In South Africa HIV and AIDS is one of the health priorities, and nurses’ role in the fight against HIV infection is crucial, as nurses form the bulk of health care professionals in the country. The South African Government has increased its efforts in the fight against HIV infection, with the introduction of various policies and guidelines. For these policies to be implemented effectively and able to fight the HIV epidemic successfully, nurses’ training needs to provide adequate preparation for nurses to attend to people living with HIV and AIDS upon graduation. The literature highlights various shortfalls in nurses’ training related to HIV and AIDS care and management; in-service training has been the main training model so far, with limited emphasis on pre-service training. The purpose of this study was to develop a model for integration of HIV and AIDS nursing competencies into the undergraduate nursing programme at the University of the Western Cape. The study’s objectives include identification of HIV and AIDS-related core competencies for a nurse in South Africa, then integration of the identified competencies into the undergraduate nursing programme, supported by the Competency, Outcome, Performance, Assessment framework, within a constructivist paradigm. Applying the intervention research: design and development approach, the study was conducted in three phases. Data collection was carried out using nominal group technique, interviews, systematic research synthesis as well as workshops, and data were analysed qualitatively. The 112 participants included nurse educators, people living with HIV and AIDS, registered nurses in clinical practice, recent graduates, South African Nursing Council representatives, lecturers that teach in the nursing programme as well as nurse experts on HIV and AIDS in South Africa, with 12.8% of them participating in more than one phase of the study. Three competency categories covering seven core competencies were identified, namely: foundation (knowledge); supporting pillars (ethics, policies, interdisciplinary approach, personal and professional development); and performance (health education, holistic safe practice). Furthermore, four structural requirements were identified, namely teaching and learning strategies, learning opportunities, service readiness and staff development, forming the HIV and AIDS nursing core competency framework. Vertical and horizontal integration of the core competencies was completed, highlighting how they can be integrated into the undergraduate nursing programme, and this was validated by experts through a workshop. The integration model which was developed is flexible, allowing further adoption into any other undergraduate nursing programme, and provides the potential to assist in the systematic integration of HIV and AIDS into the nursing curriculum. This would enhance new nurse raduates’ competencies in the provision of HIV and AIDS-related care and management upon graduation.
Development of a framework for health care professionals to lead youth victims of violence towards wellness in the Genadendal community of the Western Cape
(University of the Western Cape, 2015) Ahanonu, Ezihe Loretta; Jooste, Karien; Waggie, Firdouza
The Wellness Leadership White Paper states that leadership is needed in a supportive environment with the purpose of guiding clients to lasting wellness. Wellness can be defined as an active process that enables an individual to become aware of all aspects of the self and to make choices in terms of a more healthy existence by means of balancing and integrating various life dimensions. Health care professionals are leaders who play an important role in creating an environment that contributes to wellness. Their leadership is, therefore, viewed as a wellness strategy. Leadership has been identified as an essential role of health care professionals with a responsibility to attend to the needs of their clients, such as youth victims of violence, with the aim of leading them towards wellness. The Provincial Nursing Strategy of the Western Cape in South Africa emphasises the need for health care professionals to demonstrate their leadership capacity in practice. In the communities of the Western Cape Province of South Africa, many youth victims of violence report for treatment at the health care facilities; it places a high burden on the health care system. Even though health care professionals provide treatment to this group of youth, it is not clear how health care professionals lead them towards wellness after an incidence of violence. The purpose of this study was to develop a conceptual framework that can be implemented by health care professionals to gain a better understanding about the important role they play in leading youth victims of violence towards wellness in a rural community in the Western Cape Province of South Africa. This research study applied a qualitative, exploratory, descriptive and contextual design. The study population who were selected by means of a purposive sampling technique consisted of youth attending a high school and who had been victims of violence and of health care professionals (professional nurses, medical doctors and social workers) working at the health care facilities in the community where the study was conducted. The study was conducted in four phases. Phase 1 of the study focused on the exploration and description of the expectations of the youth victims of violence about how health care professionals should lead them towards wellness. Focus group discussions (FGDs) were conducted at a high school at the study site. Phase 2 explored and described the experiences of health care professionals who were supporting youth victims of violence at the health care facilities in the community of study. The execution of this phase comprised of unstructured individual interviews. The total number of the FGDs and unstructured individual interviews conducted in this study was determined by data saturation. Data analysis of the data collected involved transcription of the voice recordings of the all the interviews and writing up of field notes. The steps of Tesch’s coding technique were used at the end of Phases 1 and 2. To ensure trustworthiness of the collected data, Guba and Lincoln’s strategies of credibility, transferability, dependability, confirmability and authenticity were applied. Phase 3 of this study entailed the development of a conceptual framework for health care professionals to lead youth victims of violence towards wellness. It was based on the findings from Phases 1 and 2 of the study; Phase 4 of the study involved peer debriefing and validation of the developed conceptual framework. In Phase 1 of the study, a total of nine (n = 9) FGDs were conducted among fifty eight (n = 58) youth participants between the ages of 15 and 19 years. Each group consisted of 6 to 8 participants and the interviews did not last more than an hour per session. The data analysis in this phase showed that the youth victims of violence did have expectations from the health care professionals in guiding them towards wellness. They shared their interpretation of the term wellness and were also quite aware of the challenges in their community. Four categories emerged from the data in Phase 1: Category 1 - Dimensions of wellness as it related to healthy body, mind, spirit and positive interactions: The findings of this category revealed that youth participants described wellness as a holistic concept that comprised healthy living, self-care and a healthy personality and mind (emotional, psychological) as well as spiritual well-being. They did not necessarily consider wellness as the absence of sickness or illness, Category 2 - Common problems among youth in the context of the community: They articulated that drug abuse, teenage pregnancy and violent behaviour were important issues of concern to them in their community. Category 3 – Building a sound and trusting relationship: They expressed their need for health care professionals to have a positive attitude towards them, to be respectful and to provide them with accurate information, as well as confidential and supportive services. Category 4 - Guidance of youth to wellness: The youth also proposed strategies that they believe could be used by the health care professionals while guiding them towards wellness. These strategies were: Provision of information / health education, school and community outreach programmes, provision of counselling services and role modelling. For the second phase, seven (n = 7) health care professionals were interviewed. Two (n = 2) were professional nurses, three (n = 3) medical doctors and two (n = 2) social workers. The findings of the individual interviews indicated that the health care professionals recognised the fact that wellness is very important. However, they felt that guiding youth victims of violence toward wellness was a challenging process. Three categories emerged from the data in Phase 2: Category 1 - Different points of view about the concept of wellness: The health care professionals described wellness as the holistic wellbeing of a person, an absence of illness or disease and living a healthy lifestyle. Category 2 - Barriers to leading youth victims of violence towards wellness: The health care professionals reported challenges while attempting to lead youth victims of violence towards wellness which included low socioeconomic status of families, unsupervised youth, violent behaviour, drug and substance abuse, a lack of resources in the community, negative staff attitudes, inadequate physical infrastructure and human resources as well as the absence of a process of guiding youth victims to wellness. Category 3 - Guidance to leading youth victims to wellness: The health care workers proposed strategies for guiding youth victims towards wellness. Those strategies included the provision of support in the form of counselling services, use of support groups, family and community support; recreational activities, dedicated staff to work with youth victims of violence and a multidisciplinary team approach. The findings from the first two phases were triangulated during the third phase of this study with the purpose of developing a conceptual framework. The survey list of Dickoff, James and Wiedenbach formed the foundation of the reasoning map for the development of the framework. The unique contribution of this study is the development of an original, participative leadership framework that provides health care professionals with information for leading youth victims of violence towards wellness in a rural community in the Western Cape. This study was conducted in a single rural community of the Western Cape Province of South Africa. Despite this limitation, the framework could be evaluated for use in similar settings. Finally, guidelines to implement the framework and recommendations for improving community health care practice, nursing education and nursing research were suggested based on the findings from the study.
An empowerment programme for women on breast self-examination towards the prevention of breast cancer in Iddo Local Government, Oyo State, South-west Nigeria
(University of the Western Cape, 2015) Hanson, Victoria Funmilayo; Van Wyk, Brian
Cancer is a major public health concern in both developed and developing countries; it accounts for 13% of all deaths globally, of which 70% occur in middle- and low-income countries. In Nigeria, over 10 000 cancer deaths and 250 000 new cases of cancer are recorded yearly. Breast cancer is the second most common cancer worldwide, after lung cancer. It is the most common type of cancer diagnosed in women and the most common cause of death worldwide. Late detection and diagnosis of breast cancer leads to high mortality rate. In Nigeria certain cultural taboos are associated with breast cancer, which lead to poor information dissemination to women in rural communities. Breast self-examination (BSE) provides an inexpensive method for early detection of breast tumours. Knowledge and awareness about Breast Self-Examination are critical to promote consistent practices when the people concerned are empowered with the needed information to acquire the knowledge and skills which will inform practice of any health issue. In Nigeria it was reported that the number of women at risk of breast cancer increased progressively from 24.5 million in 1990 to about 40 million in 2010. This number is projected to rise to over 50 million by 2020, should the trend continue unabated. The current study explored the understandings of breast cancer and prevention, with particular emphasis on BSE practice among rural women, and developed an empowerment programme to promote uptake of this practice in a rural community in a south-western state of Nigeria. The study was framed in the Health Belief Model and Kieffer’s empowerment process. Participatory action research was used as study design and approach; and utilized both qualitative and qualitative methods. The sample for quantitative phase comprised 345 women aged 20 to 60 years, selected from 5 communities using a cross-sectional procedure. Data gathering instrument was a questionnaire. Summative statistics were calculated using the SPSS program. The sample for qualitative phase comprised of 95 women who were selected from the respondents to the quantitative phase. The data was collected through focus group discussion. The qualitative data was subjected to thematic analysis. Three themes that emerged for qualitative analysis which are: knowledge/awareness of BSE, practice and appeal for intervention, and misconception and fear. The survey results showed that a large proportion of the respondents (75.1% and 76.5%) had low levels of knowledge about BSE and did not practice BSE. Also, about 77% of the respondents expressed one form of barrier or another to BSE practice. However, despite these inadequacies, 87% of the respondents were ready and willing to improve their health if empowered with the right information and motivation. The empowerment program informed by the quantitative and qualitative phases and the stages of change with the full participation of the women. The program consisted of hands-on physical demonstrations, BSE pamphlets, and mnemonic songs were identified media of disseminating knowledge and practice of BSE. These media became the platforms for the empowerment programme developed for the women. A day was also set aside, just as is done for immunisation, for BSE practice and other women’s health issues to promote the prevention of breast cancer in the community. The “Physical demonstration” intervention resulted in an increase in the correct BSE practice from 23.5% at the beginning of the study, to 85.3% post the intervention. The “other intervention” resulted in 80% to 94.7% of participating women being able to practice correct physical step-by-step performance of BSE. The participatory approach contribute to a high levels of participation by women in Iddo local Government which led to the increase in the correct Breast Self–Examination as stated above.
Development of an Employee Assistance Programme (EAP) for midwives dealing with maternal death cases in the Ashanti Region, Ghana
(University of the Western Cape, 2016) Dartey, Anita Fafa; Phetlhu, Deliwe Rene
Globally, Employee Assistance Programme (EAP) has become the most effective workplace programme used to assist employees in the identification and resolution of performance and behavioural related problems. Employees, irrespective of the sector of employment are seen as the most valuable assets of any organization and therefore their wellness is as important as the organization itself. Employees' personal or work related problems may adversely affect their health as well as their productivity, thereby impeding the growth of an organization. It is for this reason that the EAP has increasingly become an important tool in addressing employees’ personal and work related challenges. Midwives as employees are prone to challenges such as maternal deaths at the workplace. They are more likely to undergo stressful situations for failing to meet the general goal of their profession, which, among others, include provision of adequate care for pregnant women until they safely deliver. These stressful conditions have negative effects on midwives' health, behaviour and productivity. However, there is no literature that has looked at how midwives in the Ashanti Region of Ghana are affected by maternal deaths and their coping mechanisms employed to address the effects of maternal deaths. Literature revealed that there is hardly any known work-related assistance programme designed to support Ghanaian midwives when faced with work-related challenges likely to affect their work-output. Hence, this study developed an appropriate EAP for midwives dealing with maternal deaths in Ghana based on the exploration and description of the effects of maternal death, coping mechanisms used and their experiences with the facility-based maternal death review (MDR). In order to meet the general aim of the study, a qualitative research approach, with a combination of exploratory, descriptive and contextual designs was used. Purposive sampling was employed to select participants; ward and unit managers (supervisors) (18) and midwives who met the inclusion criteria (39). A total of 57 participants were used in the study. Data were collected through semi-structured individual interviews and focus group discussions, as well as field notes. Thematic Content Analysis was used to manage data through transcribing, organizing, development of category and coding of data. Final data management was done with qualitative computer data analysis package (Atlas ti version 7.1.7). The full understanding of the effects of maternal deaths on midwives and the mechanisms of coping employed to address effects afforded the development of an EAP to support midwives dealing with maternal deaths. Five main themes emerged from the analysis of collected data, namely effect of death as a unique experience, multi-dimensional effects of MD on Midwives' personal life, effects of MD on the midwives’ associated environment, mechanisms of coping employed by Midwives and Perceived MDR process (Phase 1). Phase 2 considered the development of Employee Assistance Programme (EAP) for midwives dealing with maternal deaths in Ashanti Region of Ghana. The steps of developing occupational health service at the workplace by Acutt Hattingh and Bergh (2011) were applied to develop the EAP. Ethical practices pertaining to the study of human subjects as specified by the Research Ethics Committee of the University of the Western Cape and research guidelines of Ministry of Health- Ghana Health Service were observed. It is recommended that, all hospitals in Ashanti Region institute the EAP programme to assist midwives cope with challenges associated with maternal death.
Practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution in the Western Cape
(University of the Western Cape, 2016) Linda, Ntombizodwa Sarah Beauty; Phetlhu, D.R.; Klopper, H.C.
Literature attest that holistic approach to care is the best way to ensure that all human needs, including spiritual needs are taken care of. As such holistic approach to care accepts the notion of "wholeness" nature of the patient. However, in practice patient's holistic needs, which are essential for optimum health, are not routinely addressed when practicing nursing. This implies that regardless of the nurses doing their best to attend to patient's health needs, patients still do not achieve their required optimum health. Furthermore, in the face of good nursing education programmes, attempts to meet the patient's care needs as advocated, a gap still exists in rendering nursing services that truly promote health in a holistic manner. Confusion regarding the scope and holistic nature of nursing, relates not only to nursing organisations having failed to define nursing with clarity concerning the spiritual dimension of care; but they have also not succeeded in implementing nursing that is truly holistic. In this study, it is argued that where spiritual care aspects in nursing remain at the periphery, holistic nursing cannot be truly attained. According to Burkhardt and Hogan promoting one's spirituality within a nursing paradigm can be one way to promote and optimise health, particularly in response to illness. In view of the existing gap between teaching-learning of spiritual care and espoused theory of holistic nursing, a need to develop a theory that would guide and assist nurse educators and nursing students in the teaching and learning of spiritual care was imperative. The aim of this research was to generate a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution by answeringthe research question "how can a practice theory for teaching-learning of spiritual care in the undergraduate nursing programme at a higher education institution in the Western Cape be generated? Ethical procedures were applied in accordance to stipulations of the University Research Ethics Committee. The credibility of the study was ensured by application of Guba's model of trustworthiness for qualitative data.
Development of a health education programme for self-management of Type 2 diabetes in Edo State, Nigeria
(University of the Western Cape, 2016) Afemikhe, Juliana Ayafegbeh; Chipps, Jennifer; Kooste, K.
Diabetes is a chronic, metabolic disease that requires lifelong medical management, health education and self-management. According to a World Health Organisation report, there is a global increase in the prevalence of diabetes and even more so in the low-and middle-income countries, specifically Nigeria, which has the highest number of people with diabetes in the African region of the World Health Organisation. As a global issue, the positive health outcomes of diabetes are tied to health education and self-management of the disease and using the health resources of nations. However, in the context of limited resources in Nigeria, there is a need for improvement of health education in self-management of Type 2 diabetes. Health education that is provided in some Nigerian health facilities is reported to be unstructured, without patients’ active participation, not tailored to the needs and the interests of the patients and limited collaboration between multi-disciplinary professionals. In this context, the aim of the study was to develop a structured health education programme for self-management of patients with Type 2 diabetes, to facilitate the quality of the lives of these patients .An adapted intervention mapping framework provided a structured process for development of an evidenced based programme. A mixed method approach was followed. In the first phase of the study an exploratory descriptive qualitative research design was followed. A purposive sampling approach was used in selecting (i) participants, who were patients with Type 2 diabetes and (ii) health-care professionals working in two health-care institutions in Benin City, Edo State, Nigeria. In phase 1, Step1 of the research was a situation analysis, which consisted of conducting 30 semi-structured interviews with patients; observation of nurses providing health education; and five focus group discussions with health-care professionals (nurses, dieticians and social workers). Qualitative data analysis was accomplished through using Tesch’s (1990) steps of analysis to identify themes and categories. The situation analysis revealed, firstly, that there was a lack in the knowledge and self-management of Type 2 diabetes among patients. Secondly, that the health-care professionals acknowledged their collective role in health education and were burdened with the patients who were non-adherent to self-management. The result also revealed the necessity to change from a traditional teaching method to a structured educational process that is patient-centred. The second phase of the research was the stage of developing the educational programme through collaboration with the stakeholders (health-care professionals and patients with Type 2 diabetes) using the findings from the data-analysis of the first phase supported with literature. In phase 2, Step 2 was to develop matrices from the data analysis in Phase 1 for the programme. Step 3 added theory-based intervention methods and practical applications to the preliminary program and in Step 4 the programme was described. This was followed in Step 5 by preparing health-care professionals for offering the programme to patients and implementing and evaluating the programme. The evaluation of the programme was by means of a quantitative pilot study in which a pre-post-test in a quasi-experiment was conducted with 28 patients and qualitative interviews after the program and post intervention interviews with the participants. The evaluation showed that the program was effective in meeting its objectives. In Step 6 a plan for the adoption, implementation, sustainability and evaluation of future implementations was developed.
A model of community engagement in the prevention of maternal health complications in rural communities of Cross River State, Nigeria
(University of the Western cape, 2016) Nsemo, Alberta David; Chipps, Jennifer
Pregnancy-related poor maternal health and maternal death remain major problems in most Nigerian states including Cross River State. The acute impact of these problems is borne more heavily by rural communities where the majority of births take place at home unassisted or assisted by unskilled persons. These problems are due to a mixture of problem recognition and decision-making during obstetric emergencies leading to delayed actions. Every pregnancy faces risk, and prenatal screening cannot detect which pregnancy will develop complications. If the goal of reducing maternal morbidity/mortality is to be achieved, increasing the number of women receiving care from a skilled provider (doctor/nurse/midwife) during pregnancy, delivery, and post-delivery and prompt adequate care for obstetric complications has been identified as the single most important intervention. One of the strategies identified in many countries is engaging and working with individuals, families, and communities as partners to improve the quality of maternal healthcare. This strategy is thought to remove the barriers that dissuade women from using the services that are available, empowering the community members to increase their influence and control of maternal health, promote ownership and sustenance, as well as increase access to skilled care. The aim of the study: The overall aim of this PhD study was to develop a model of community engagement to facilitate the prevention of maternal health complications in the rural areas of Cross River State, Nigeria. To develop this model, the study specifically sought to: 1. Understand the current situation in Cross River State by exploring the knowledge gap of women of child-bearing age (pregnant and new mothers) regarding obstetric danger signs, birth preparedness and complication readiness, delivery practices of women, the action of family/community members, and the role of community-based maternal health initiatives, if any, in emergencies, as well as explore participants’ opinions on actions to be taken by the community to promote the utilisation of orthodox healthcare facilities by rural women of Cross River State (Phase 1). 2. Engage community members through a participatory approach (Photovoice) to highlight problems regarding pregnancy and birth practices, identify possible solutions, and make recommendations on communities’ roles in the prevention of maternal health complications (Phase 2). The older women of the study communities were also engaged to verify and validate the findings from phases 1 & 2 analyses. 3. Develop a model of community engagement to improve maternal health literacy by increasing knowledge on early detection of obstetric complications, birth preparedness, complication readiness, and improved access to skilled birth attendance (Phase 3). Methods: The study was conducted using a qualitative descriptive research approach that combined qualitative semi-structured interviews and focus group discussions within the Photovoice participatory approach. Purposive sampling was employed to select 20 participants, 10 each from the Idundu (Community A) and Anyanganse (Community B) rural communities of Akpabuyo Local Government Area of Cross River State, Nigeria. The participants comprised pregnant women and new mothers (babies aged 12 months and younger) who met the eligibility criteria. Data collection was by means of semi-structured interviews (Phase1), focused group discussions and Photovoice (Phase 2). Trustworthiness of the data was ensured by means of applying Guba’s model of credibility, transferability, and authenticity. The ethical principles of respect for human dignity, beneficence, confidentiality, and justice were applied throughout the study. The Citizenship Healthcare and Socio-Ecological Logic models were used to direct the study. Permission was obtained from participants for all the phases of the study while approval for the study was obtained from the Senate Higher Degrees Committee of the University of the Western Cape and the Cross River State Ministry of Health Ethical Committee. Data was analysed using Tesch’s method of content analysis. Based on the findings of Phases 1 & 2 of the study, themes emerged that were then validated by the older women in the study communities. The model was then developed by means of the four steps of the theory generation process. Step one was concept development that consisted of the identification, definition, validation, classification, and verification of the main and related concepts. Step two was model development consisting of the sub-steps, namely model guidelines and definitions. The communities’ stakeholders were engaged at this phase to verify and validate the concepts, as well as contribute to the drafting of the model guidelines and the definitions. Step three was a model description whereby the structure, definition, relation statements, and the process of the model were described. A visual application of the model that depicts the main concepts, the process, and the context was shown. Step four dealt with the development of guidelines for the operation of the model. A critical reflection of the model was done using Chinn and Kramer’s five criteria for model evaluation. Results: The study revealed that Idundu and Anyanganse’s rural women have limited knowledge of obstetric danger signs and very few of them acknowledged the importance of hospital delivery. They also exhibited poor understanding of what birth preparedness and complication readiness entailed. There was a high preference for traditional birth attendant care during pregnancy and delivery with their reasons being belief and trust in traditional birth attendants, a long standing tradition to deliver with them, assumptions that orthodox healthcare is expensive, poor attitude of healthcare providers towards women, unavailability of 24-hour services in healthcare facilities, fear of hospital procedures and operations, communal living in traditional birth attendant’s homes, spirituality in traditional birth attendant services, and the consideration of proximity to service points. These factors exacerbated the delays in seeking care and in referrals for skilled care in phases of emergency. The study also revealed that in the study communities, heavy household chores carried out by pregnant women is culturally accepted and seen as exercise to ease labour, there is lack of proper information regarding maternal and child health issues, men are sole decision-makers, they are ignorant of availability of free treatment in health centres, there is an ignorance regarding care of the new-born, and a lack of community structures to support women’s health. Based on the above findings, the women made the following suggestions towards finding a solution: improving maternal health literacy, increasing spirituality in service delivery, involving of husbands in antenatal care for proper information on maternal health issues, accessing community support through the use of community structures (town announcers, women groups, churches, etc.) with the purpose of emphasising facility delivery, constitution of influential groups to monitor the activities of pregnant women to ensure utilisation of skilled attendants, access to healthcare through free services and availability of providers, trust of health services, and traditional birth attendant training/traditional birth attendant facility collaboration. A total of eight concepts were identified from the concluding statements of steps 1 & 2, and used to develop the Maternal Health-Community Engagement Model (MH-CEM). These were: maternal health literacy, spirituality in healthcare, integrated traditional birth attendants’ role (value, training, and traditional birth attendants/hospital collaboration), trust in health services (by addressing previous experiences, attitude, and fear), improving access to healthcare, culturally acceptable care, husbands’ involvement in women’s health issues, and community support. These concepts formed the core components for the Maternal Health-Community Engagement Model which was developed as the main recommendation to address the core concepts. Central to this Model was the Community Engagement Group (CEG) which was established during the process of engaging the community stakeholders in validating the concepts and drawing up of the guidelines for the Model development. Conclusions and Recommendations: It is believed that the activities of the Community Engagement Group may bring about improved maternal health literacy, a process for working with traditional birth attendants through training and re-orienting them to be promoters of facility delivery when appropriate, and a model for involving husbands, and indeed the entire community, in maternal health issues. Limitations were identified and recommendations for nursing practice, education, and research concluded the study.
Quality of service analysis towards development of a model for primary-level maternity care in Ibadan, Nigeria
(University of the Western Cape, 2016) Aluko, Joel Ojo; Rhoda, Anthea; Marie Modeste, Regis Rugira
The unacceptable high rate of maternal and neonatal deaths in Nigeria has been persistently unabated. Therefore, the present quality of maternal care evident by the magnitude of severe maternal/neonatal morbidity and mortality in this region makes designing of a model that will serve as a framework for provision of quality maternity care to women and their new-born a worthwhile study. The global report of deaths related to pregnancy and childbirth documented 600,000 maternal deaths annually. Developing countries, including Nigeria, have the highest burden of maternal and neonatal deaths resulting from complications related to pregnancy and childbirth. There has been no improvement in Nigeria as far as maternal and neonatal deaths are concerned. In Nigeria, the maternal mortality ratio in 2008 was recorded as 545/100,000 live births, and 576/100,000 live births in 2013. Women and children from low socioeconomic background are the vulnerable groups. The peculiarity of their vulnerability predisposes them to finding quicker and cheaper avenues to seek health care. The Primary Health Care (PHC) maternity facilities are to serve this large population of women and their babies at grassroots level. Few studies have been done to measure quality of antenatal and delivery care separately at higher level of care with resultant subjective findings and conclusions. Each of these aspects of maternity is a part of the whole and not the whole. Currently, there is gross dearth of literature regarding quality of maternity services at the disposal of the vulnerable women, who are likely to utilize the PHC facilities. The measurement of the quality of the existing maternity services at primary level is imperative for designing a more effective model capable of improving quality of services at this level. This study sought to develop a quality service improvement model for primary level-based maternity following rigorous analysis of the quality of its structure, the process and the outcome as proposed by Donabedian. The specific objectives of the study were to describe the status of infrastructures, equipment, instruments, medications; investigate the degree to which the services rendered are timely, appropriate, satisfactory and consistent with current professional knowledge; investigate the degree to which services rendered in the facilities are satisfactory to the women and uphold their basic reproductive rights; measure clients’ return rates for maternity-related services in the facilities; and to develop a validated model to guide provision of quality maternity care in PHC facilities. Using a theory-generating approach, the study was conducted in two distinct phases. The first phase focused on analysis of the existing maternity services at PHC level, while the second phase concentrate on model development. The first phase, which is an embedded mixed-methods approach, utilized validated clients’ questionnaire, health workers’ questionnaire, observation checklist, focused group discussions, and in-depth interviews for data collection. A multistage sampling method was used for sample size selection. Five local government areas (LGAs) in Ibadan were selected purposively. Similarly, all the facilities that offer maternity care in each LGA were purposively selected. Postnatal women, health workers in each facility, medical officers of health (MOHs) and heads of facilities were the participants in the study. A total of 755 postnatal women who participated in the surveys were recruited from the sample frames (attendance registers) using systematic random sampling. A validated structured questionnaire was utilized to elicit information on their experiences with their chosen places of antenatal and childbirth care from pregnancy to puerperium. Similarly, the 130 health workers who participated in the surveys were recruited from the sample frames (duty rosters) using systematic random sampling. A validated structured questionnaire was utilized to elicit information on their competences, attitudes and the midwifery practice in their respective facilities. In addition to the quantitative surveys, focus group discussions (FGDs) and in-depth interviews (IDIs) were conducted for some postnatal women and four MOHs/heads of group of facilities. The participants for the FGDs and the IDIs were conveniently and purposively selected, respectively. FGD guide and IDI guide were used to guide the interviewers. The study was approved by the Faculty Board Research and Ethics Committees, the Senate Research Committee of University of the Western Cape and Oyo State Research Ethical Review Committee in Nigeria. Informed consent was obtained from each study participant. Autonomy, anonymity, and confidentiality of information provided by the participants were ensured. Nobody was coerced to participate in the study. The data collected with the aid of observation checklist and questionnaire from the selected PHC, health workers and client (postnatal women) were analyzed using descriptive statistics (frequency/percentage distributions); while association between variables of interest and difference in mean values were done using chi-square and t-test statistics, respectively. The second phase of the study focused on model development, and was done in line with a theory- generating research process in the literature supported by McKenna & Slevin, (2008) and Chinn& Kramer (2014). The developed model was tested for its appropriateness, adequacy, accuracy and whether it represents reality, for it to be assumed effective in achieving the goal if applied in midwifery practice at primary level.Client-participants were between 15 and 44 years; their mean age ± standard deviation was 28 ±5.3. The health workers were between 20 and 58 years; mean age ± standard deviation being 41 ±10. Out of the 730 client-participants, 92.1 % were married. None of the women had access to preconception counselling in any health facility. A total of 92.6 % of the women received prenatal care under the existing traditional model of antenatal care (ANC), out of which 22.6 %registered for ANC in two different facilities for various reasons. Although there was gross shortage of manpower in all the facilities, the percentage of nurses/midwives was fewer than that of the community health extension workers (CHEWs) and health assistants (HAs), while only one medical doctor was employed to cover all the different types of facilities in each local government area . There was a questionable staff level of competence reported in the study. Evidence of training in life-saving skill (LSS), post-abortion care (PAC) and safe motherhood was rare among the health worker participants. Among health workers who had witnessed vaginal laceration and those who claimed to have performed episiotomy on women, 30.2% and 32.6 % would depend on other health workers for repair of the vaginal traumas, respectively. Partograph was not in use for management of progress of labour by any health worker in any of the facilities. Both quantitative and qualitative data analysis showed evidences of abuse of women’s rights to timely, quality and respectful maternity care and risky practices by the health workers. The conditions of the buildings used for PHC centres and the beds were not satisfactory. There was gross inadequacy of essential and basic items needed to provide standard and quality care across all the facilities, while significant proportion of the available equipment/instruments were obsolete, dirty, rusty and faulty. The infection prevention and control practices were sub- standard. Inadequate funding by respective local government authorities was implicated for the poor conditions of infrastructures, equipment/instruments, staff recruitments and consequent shortage of manpower. Low level of patients’ satisfaction, evidenced by verbal expression, percentage difference between antenatal registration and childbirth record, immunization clinic visits and childbirth record in each facility, was reported. Therefore, fixing the deplorable and/or non-commodious building infrastructures to meet the required standard, provision of facilities and items needed for quality care and infection prevention, recruitment of skilled qualified health professionals, establishing a new Primary Health Board in the state to provide efficient funding and effective monitoring systems were recommended, based on the findings of the study. Lastly, the implementation of the newly developed model is strongly recommended in order to improve women’s and new-born’s health.
The development of a framework to align theory and practice to improve midwifery education in the Western Cape
(University of the Western Cape, 2017) Phiri, Wendy Augusta; Daniels, Felicity
Midwives play a critical role in the care of pregnant women from the first antenatal visit, through to the delivery and the postpartum period. The education of midwives has however become a concern, not only in South Africa but in many countries for a multitude of reasons. Evidence suggests that South Africa is devoted to reducing the maternal mortality rates as reflected in the Negotiated Service Delivery Agreement, signed in 2010, which identifies reductions in maternal and child/neonatal mortality rates as key strategic outcomes for the South African Health sector. However, by 2015 the set Millennium Development goals, specifically goal 4 (to reduce child mortality) and 5 (to improve maternal health) were not met and were replaced by Sustainable Development Goals, specifically goal 3 (to ensure healthy lives and promote wellbeing for all at all stages). This lag in meeting the indicators for improving the health of the population is associated in some respects to the education and training of health professionals.
A human resource strategy to facilitate competencies of assistant nurse managers in the public health facilities in the Western Cape
(University of the Western Cape, 2017) Makie, Vatiswa Veronica; Jooste, K.
The health workforce provides the most important input to any health system. There are estimated to be 59.2 million full-time paid health workers worldwide. The workforce has a strong comprehensive impact on the performance of the health system. Competent nurse managers are needed, particularly in countries such as South Africa, which places nurses at the epicentre of the health delivery system. During the implementation of the Occupational Specific Dispensation in 2007, the post of Assistant Director of Nursing was amended to Assistant Nurse Manager on a higher managerial level and newly appointed ANMs were expected to be competent. A generic human resources strategy was initiated in 2010 because of complaints about the competencies of nurse managers in the South African public health sector. This attempt excluded assistant nurse managers. The aim of this study was to develop a human resources strategy for facilitating the competencies of ANMs at the public health facilities in the Western Cape.
The development of a community-based model for promotion of cervical cancer prevention for Yoruba women in Ibadan Nigeria
(University of the Western Cape, 2017) Olanlesi-Aliu, Adedoyin Deborah; Martin, P.D.
Cervical cancer is the fourth most common cancer among women worldwide. The global disparities in cervical cancer incidence and mortality between wealthy and poor countries are likely related to lack of prevention and detection efforts. There is an exponential increase in cervical cancer deaths in Ibadan. Literature suggests that the increase of cervical cancer deaths is most likely a result of a lack of awareness and knowledge of cervical cancer, lack of outreach programmes and the unavailability of prevention services at community level. Community-based interventions have been identified as being most suitable for the promotion of cervical cancer prevention among women of low socio-economic status, a group that forms the greater part of Nigeria's population. The aim of this research study was to develop a community-based model for preventing cervical cancer in Yoruba women in Ibadan, Nigeria. A multi-method research approach, using both quantitative and qualitative methodologies was used. This study was conducted in 3 phases. Phase 1 was a descriptive survey during which data was collected using a multistage technique to select 480 community members to explore their knowledge, practice, beliefs and attitudes towards cervical cancer. Data collection was by means of a semistructured interviewer administered questionnaire (community members), yielding a response rate of 95% (n= 452). Phase 2 was an exploratory, descriptive design during which data was collected from twenty (20) health workers and four (4) policy makers to explore the barriers to cervical cancer prevention services and ways to promote cervical cancer prevention services using semi-structured interview (health workers), and key informant interviews (policy makers). Quantitative data collected was analyzed using descriptive and inferential statistics such as Chi-square and correlation to test the significance of association between variables.

Browse

Browsing by Issue Date

Results Per Page

Sort Options