Open Access Original Research Article

Knowledge and Practice on Safe Handling of Anticancer Drugs among Hospital Staff in Sri Lanka

Rasintha Sandakalum, Sachith Abeysundara

Asian Journal of Research in Nursing and Health, Page 1-10

Aims: Anticancer drugs are useful to treat cancers but can also harm healthy cells. Hospital oncology staff is exposed to these types of drugs due to lack of knowledge regarding proper handling. The aim of this study was to evaluate knowledge, practice, and challenges on safe handling of anticancer drugs among hospital oncology staff at hospitals in Sri Lanka.

Study design: A cross-sectional study was conducted.

Place: This survey-based study has been performed with the help of the hospital staffs employees from Teaching Hospitals from Kandy and Karapitiya, and National Cancer Institute from Maharagama, Sri Lanka.

Methodology: A self-administered questionnaire, containing standard methods to measure knowledge, practice, and challenges for safe handling of anticancer drugs, was used to collect data from 203 participants (17 Pharmacists and 186 Nurses).

Results: Out of 203 participants, 191 (94%) had adequate knowledge; 52 (25.62%) had special training on safe handling of anticancer drugs. 175 (86%) participants were poor on preparation practices and 199 (98%) participants were poor for cleaning practices from the total sample. There was no significant association between knowledge and practices regarding proper handling, protection, and preparation of anticancer drugs.

Conclusion: Although pharmacists and nurses had adequate knowledge on safe handling of anticancer drugs, the standard level of safe handling practices, the knowledge on handling of anticancer drugs was not always applied within the standard level of safe handling practices. Therefore, proper trainings, guidelines, procedures, and Personal Protective Equipment are essential for enhancing safe handling practices.

Open Access Original Research Article

Lived Experiences of Women Who Terminated Pregnancy in Adolescence

William Mooketsi Baratedi, Botshelo Rachel Sebola

Asian Journal of Research in Nursing and Health, Page 11-19

Introduction: Termination of pregnancy is an event flooded with personal and social conflicts. There are individual, relationship, community, and societal factors regarding termination of pregnancy in adolescence that need consideration.

Background: Teenage pregnancy is a public health crisis in the world. It is a major contributor to maternal and child morbidity and mortality rates. Termination of pregnancy was introduced as a safety measure to solve the problem of unwanted pregnancies and maternal deaths caused by backstreet terminations.

Aim: The aim of the study was to explore the lived experiences of women, who had a terminated pregnancy in adolescence, using the socio-ecological model.

Methods: Interpretive phenomenology analysis was used to explore the lived experiences of women who terminated a pregnancy in adolescence. Individual audio-recorded  interviews were conducted with 11 participants, who terminated a pregnancy in Adolescentsadolescence.

Findings: Interpretive analysis yielded three themes, namely: failure to protect one’s unborn baby, the burden of secrecy, and failure to form lasting relationships. The findings show the lasting negative effects of terminating a pregnancy in adolescence.

Conclusion and policy recommendation: The qualitative study confirmed that women who terminated pregnancy in adolescence face a lot of challenges in adulthood. The study further confirmed that women do not forgive themselves for having had a termination of pregnancy in adolescence. Health-care policymakers need to hear the voices of women who terminated a pregnancy in adolescence, to enable them to develop relevant and appropriate policies that answer the needs of women who have a termination of pregnancy in adolescence.

Open Access Original Research Article

Evaluating the Effectiveness of Cultural Competence Intervention in Improving Quality of Maternal Care Service among Women in Marakwet, Kenya

Solomon Kemoi Cheboi, Kenneth Kibaara Rucha, Anastasiah Nyamilu Kimeu, Peter Kithuka

Asian Journal of Research in Nursing and Health, Page 29-43

Background: variances amongst the cultures of health care services providers and consumers are recognized as a fundamental obstacle for dignified quality maternal care. Few studies have exploited context specific innovations such as cultural competence to reduce health disparities for priority populations. Data in this field may provide clarity and pathways for its operationalization in achieving respectable and equitable quality health care.

Methods:  This was a cluster randomized trial in Marakwet, Kenya. The study aimed at evaluating the effects of cultural competence intervention in improving quality of maternal care service. Data  was collected through a client exit complemented by mystery client before and after the intervention. The sample size was 758 respondents proportional distributed per cluster and sample consecutively.  Statistical Package for Social Science (SPSS) was used to analyze the data. The effect of the interventions was measured using standard mean difference and t-test. 

Results: The results showed that intervention improved quality of delivery rooms settings. The means of two groups were indifferent pre-intervention (749) = -0.380, p = 0.704 but significant thereafter t (756) = -5.214, p < 0.001. The intervention effect size was (F (1, 756) = 10.142, p = .001, ηp2 = 0.036). The score of trust in provider was insignificant before t (692) = -957, p = 0.339 but significant later t (690) = -6.137, p = 0.001.  The mean of the intervention improved to 4.26±0.698 from 4.05±0.727. The effect size was significant (F (1, 756) = 6.395, p = 0.012, ηp2 = .018).

Conclusion: people first care intervention prompt facility and providers to make concerted efforts in provision of quality maternity services.   Additionally, the concept of cultural competence prioritizes patients’ needs for reengineering people centered services and provide ambiance for enhanced patient-provider relationship.

Open Access Original Research Article

Developing a Game-Based Intervention to Promote HPV Vaccination among Adolescents

Angela Chia-Chen Chen, Lihong Ou, Abigail M. Beaman, Ashish Amresh

Asian Journal of Research in Nursing and Health, Page 44-58

Aims: To develop a developmentally and gender appropriate game-based intervention to promote Human Papillomavirus (HPV) vaccination in adolescents.

Study Design:  Qualitative interview.

Place and Duration of Study: Participants were recruited from communities in Arizona, United States in 2019.

Methodology: Sample: eight parent-child dyads representing different adolescent’s gender (4 boys, 4 girls aged 11-14) and racial/ethnic groups in the U.S. were recruited through purposive sampling. After receiving consents and assents, we conducted semi-structured interviews (60-90 minutes each) with each dyad at a quiet and private room. Each dyad received $50 for their time and effort. The interview questions consisted of two parts: (a) questions related to game design, functioning, and feasibility of implementation; (b) questions related to theoretical constructs of the Health Belief Model and the Theory of Planned Behavior. The interviews were audio recorded with permission, transcribed into textual data, and analyzed using NVivo 12. We organized data and developed themes based on the theories and game design/development categories. Three researchers reviewed the results and discussed the discrepancies until reaching a consensus.

Results: Our findings suggested that the most common motivating factors for adolescents’ HPV vaccination were vaccine effectiveness, benefits, convenience, affordable cost, provider’s recommendation, and reminder for the 2nd shot. Recommendations for the game content and design: (1) Content: information about HPV and vaccine (e.g., consequences if infected, side effects of the vaccine), who, when and where to receive the vaccine. (2) Game design: 15 minutes or shorter, fighting/action storyline, option to choose characters/avatars, reward mechanism, and delivered by portable device (e.g., tablet).

Conclusion: Our findings inform a game-based intervention that incorporates key concepts of HPV and vaccine, and desired game features for adolescents and their parents. The long-term goal is to promote HPV vaccination in adolescents to prevent cancers.

Open Access Review Article

Occupational Stress: Main Theoretical Models with Particular Relevance to the Nursing Profession

Antigoni Fountouki, Dimitrios Theofanidis

Asian Journal of Research in Nursing and Health, Page 20-28

Aims: The main aim of this critical review is to cite, analyze and evaluate the core theoretical models on occupational stress with particular reference to the nursing profession.

Methodology: A systematic search was undertaken which yielded 84 articles that were finally reduced to 39. Furthermore, the results were elaborated upon further to form a concise table on theoretical models for occupational stress in the nursing profession. The nine theoretical models were elaborated further in chronological date order.

Results: there are 8 main theoretical models that explore emotional exhaustion as characterized by a marked lack of physical energy, and a feeling that there are no further reserves or resources from which to renew his energy. In general, the individual feels that he or she is no longer in the mood required to make an emotional investment in his or her work and is further suffering from the demands of his or her clients and/or the wider working environment. Perhaps the most unpleasant thing is that he cannot foresee a solution to such problems and loses perspective on what the next day may hold.

Conclusions: Emotional exhaustion and depersonalization are the two stages that preceded professional incapacitation and a worker's sense of diminished personal achievements where hope is lacking. Therefore, active measures need to be taken by management and other coworkers who might identify such a problem in order to take steps to protect and ease the stress so that much needed staff can be retained. The recent Covid-19 pandemic has dictated that nursing staff retention is a critical issue on a global scale.