Open Access Systematic Review Article

Cesarean Section Rates and Indications in Turkey: A Systematic Review and Meta-Analysis

Ayşe Şenoğlu, Melike Öztürk, Zekiye Karaçam

Asian Journal of Research in Nursing and Health, Page 31-57

Background: The World Health Organization reports that acceptable cesarean section delivery rate would be 10%-15%. High cesarean rates in Turkey constitutes a risk to mother and baby health.

Aims: The aim of this study was to determine total and primary cesarean section rates and indications based on the results of studies conducted in Turkey.

Study Design: The aim of this study was to determine total and primary cesarean section rates and indications based on the results of studies conducted in Turkey.

Place and Duration of Study: The study was carried out over the period January 1-31, 2020 by means of a search of Turkish and English literature indexes.

Methodology: The study was carried out over the period January 1-31, 2020 by means of a search of Turkish and English literature indexes. The searching was carried out in the PubMed, Medline, EBSCO, Web of Science, Google Scholar, National Thesis Center, Dergipark, Ulakbim. The data extracted were combined through meta-analysis.

Results: Data from 31 cross-sectional studies and a total of 479.440 women were included in this systematic review and meta-analysis. It was determined that 177.484 of the women had undergone a cesarean delivery. The meta-analysis indicated that the estimated total cesarean rate was 43% (CI: 0.39-0.47; P< .001) while the primary cesarean rate was 26% CI: 0.12-0.47; P= .028). It was found that cesarean rates at the training/research hospitals (42%; CI: 0.39-0.45; P< .001) and university hospitals (69%; CI: 0.60-0.76; P< .001) were higher than at the state hospitals (29%; CI: 0.23-0.37; P< .001).It was seen that the estimated rates for the most common indications of cesarean births were, previous cesarean sections 46% (CI: 0.43-0.50; P= .051) and fetal distress 19% (CI: 0.15-0.23; P< .001).

Conclusion: The results of the study showed that cesarean rates are generally quite high, particularly at the training/research and university hospitals and that indications are varied.

Open Access Original Research Article

“Awareness and Use of Insecticide-Treated Bed Nets (ITNs) among Students in the Second Cycle Institutions in the Tamale Metropolis of Northern Region” Ghana

Asumah Mubarick Nungbaso, Florence Assibi Ziba, Ruth Nimota Nukpezah, Abubakari Abdulai, Mahama Ayisha Evelyn, Musah Zakiyya, Mahmud Mohammed Yussif

Asian Journal of Research in Nursing and Health, Page 1-12

Introduction: Insecticide-treated nets (ITNs) are a type of personal protection that has been shown to reduce severe illness and death caused by malaria in endemic areas. Effective malaria prevention  reduces  mortality and morbidity rates associated with malaria. The use of ITNs have been shown as one of the effective and simplest way of preventing malaria among the general population. Yet, the awareness and utisation of ITNs are not encouraging in most African countries including Ghana. This study aimed at assessing students' level of awareness and use of insecticide-treated bed nets in the Tamale Metropolis of Ghana's Northern Region.

Methods: A school-based cross-sectional study design was used. The participants were 368 in total from six different schools within the Metropolis. The study participants were recruited using multistage sampling techniques. Data were collected with a pretested questionnaire and the data were analyzed with SPSS version 24. Descriptive and binary logistic regression models were used. The results were presented in the form of frequencies, percentages, and tables.

Results: The study revealed a high level of knowledge (92.1%), possession of ITN (74.2%), 87.0% knew the use of ITNs to prevent malaria. Majority (69.8%) of respondents use ITNs, out of those who use ITNs, only 14.4% indicated sleeping under ITN throughout the year while 85.6% use ITNs during the season of mosquitoes. Students who had a good understanding of the purpose of ITNs were 1.39 times more likely to use ITNs (AOR=1.39, 95% CI=0.25-7.56, P= .002) and students who did not own ITNs were 0.3% less likely to use ITNs (AOR=0.003, 95% CI=0.007-0.014, P>.001).

Conclusion: The study reported high awareness about ITNs and ownership. The usage of ITN all year round however was low. The success of ITNs usage in second cycle institutions is dependent on the government’s ability to provide adequate infrastructure to allow for some space to enable the students to tie their Nets.  The students of the second cycle institutions should be educated more on ITNs usage and its benefits.

Open Access Original Research Article

Effect of Self-Learning Module (SLM) on Knowledge Regarding Legal Aspects of Nursing Care among Nurses

Premalatha Paulsamy, Shadia Hamoud Alshahrani, Krishnaraju Venkatesan, Pranave Sethuraj, MD. Zaheen Hassan Ansari

Asian Journal of Research in Nursing and Health, Page 13-17

Every nurse must demonstrate safe and appropriate clinical practise in order to practise nursing care within legal regulations. It is essential to have up to date knowledge on legal implications of nursing care, to practice safe care. This study was performed to assess the effect of self-learning module (SLM) on knowledge regarding legal aspects of nursing care among nurses working in primary health centres(PHC).The Quantitative approach with one group, pre and post test design was used in this study. Fifty nurses working in primary health centres were selected using convenient sampling technique. A self – learning module (SLM) developed which refers to an independent learning material generated systematically by researchers on legal elements of patient care, such as admission and discharge procedures, protecting confidentiality, informed consent, common laws, and torts relating to patient care. The results show that the increase in knowledge level was significant at p = 0.001 in the post test. The gender (p =0.05) and academic qualification and previous knowledge on legal aspects of patient care was significant at p = 0.01 level.

Open Access Original Research Article

Socioeconomic and Lifestyle Factors as Risks for Suicidality in Nigeria

Zulkiflu Musa Argungu, Murtala Hassan Hassan, Ahmed Sai’du

Asian Journal of Research in Nursing and Health, Page 18-30

Aims: Suicidal behavior is seen in the context of a variety of mental disorders and while many believe that, in general, first episode psychosis is a particularly high-risk period for suicide, no general agreement regarding higher prevalence of suicide in first episode psychosis is achievable. The aim of this study was to evaluate the associated factors of suicidal ideation (SI) and attempt (SA) among Nigerian adults.

Method: The data were collected from Federal Medical Center Birnin Kebbi and the Ministry of Health and Welfare in Kebbi State, a nationally representative sample recruited using a multi-stage clustered probability design.

Results: Female, previously married status, lower education, and lower-income were associated with SI and SA. In particular, the effect of age on SI presented a reverse pattern based on gender; there was a positive association for men and a negative association for women.

Conclusions: This study suggested that low education, low incomes, marital status and age were predominantly associated with the prevalence of SI and SA in women than men. While the lower prevalence of SI was observed in men who engaged in physical activity.

Open Access Original Research Article

Assessment of Quality of Care for Children with Sickle Cell Disease in the South Tongu District of Ghana: Nurses’ Perspective

Raphael Edem Kudzo Korkortsi

Asian Journal of Research in Nursing and Health, Page 58-74

Sickle cell disease (SCD) is a genetic disorder of erythrocytes with frequent episodes of vaso-occlusive crisis and complex morbidities. Studies identify gaps in quality of care for children with SCD including poor knowledge of providers and inadequate logistics. South Tongu district of Ghana records increasing incidence of SCD children’s morbidities and prolonged hospitalizations.

Aims: The study sought to examine the quality of nursing care for children with SCD in South Tongu district and identify opportunities for improvement. The study was conducted in the two hospitals of the South Tongu district of Ghana.

Study Design: A descriptive cross-sectional survey was employed to examine nurses’ knowledge of comprehensive care and their perspectives on quality of structures, processes and outcomes of care for SCD children.

Methodology: Convenient sampling method was used to obtain data from 74 nurses using structured questionnaires based on Donabedian model.

Results: Results showed a mean score of 10.25 out of 20 (51%) indicating inadequate knowledge of comprehensive care. Nurses’ perception regarding quality of service structures for SCD children obtained the worst evaluations (mean=41.50); mostly in the aspects of service logistics and supplies, and access to emergency vehicles (ambulance). The process dimension had the best evaluation (mean=58.68), followed by outcome (mean=43.17). Communication problems within the nursing team and interpersonal relationships with SCD children/families were major challenges affecting quality care in the process and outcome domains. A weak positive relationship (p=0.188) was found between the process and outcome measures.

Conclusion: The study suggests continuous education and training of nurses on comprehensive care for children with SCD and strengthening of all the dimensions of quality care, particularly the structure.

Open Access Original Research Article

Assessing Intravenous Medication Administration among Nurses in the Emergency Department of the Komfo Anokye Teaching Hospital

Henrietta Delecter Ntow, Albert Opoku, Awube Menlah, Abena Agyekum Poku

Asian Journal of Research in Nursing and Health, Page 75-96

Introduction: Patient safety is a major concept in the provision of health care and a significant factor in the maintenance of quality health care services. Medication errors are among one of patients’ safety issues which needs to be dealt with because of consequences it poses to the patient. Intravenous medications administrations have high incidence of error but there is limited evidence of associated factors or error severity.

Objectives: The objective was to evaluate which elements such as nurses' knowledge, training needs, behaviour, and attitude could prevent medication errors in the emergency department during the administration of intravenous (IV) medications.

Methodology: The study used quantitative descriptive design. One hundred and thirty-nine (139) nurses were selected using a simple random sampling method. Open and closed ended structured questionnaires were used as the data collection tool and analysed with Stata Version 15.1 (IBM) Program. Descriptive and Inferential Statistics were employed to analyse the data.

Results and Finding: The results from the study indicated that more than half (65%) of the respondents had adequate knowledge on IV medication administration. Also less than half (19.4%) of the respondents had correct answers on the calculation and dosing of IV medications. The majority (55%) of respondents have poor attitude and poor behaviour (53%) towards IV drug administration. Training on IV medication administration was significant on the behaviour of nurses.

Conclusion: Training should be maximized on calculation and dosing skills of nurses. There should be regular update on the knowledge of nurses on IV medication administration to improve the safety of patients. Standardised reporting systems should be available in the facility so that errors will be captured and audited to reduce the incidence of errors.

Open Access Original Research Article

Ghanaian Nurse Practitioners' Experiences in Negotiating Antibiotic Prescription Stewardship for Upper Respiratory Tract Infections

Abubakari Yussif, Kennedy Asuo-Tannor, Ruth Nimota Nukpezah

Asian Journal of Research in Nursing and Health, Page 97-108

Background: Antibiotic misuse and antimicrobial resistance (AMR) are becoming increasingly serious global health concerns, It necessitates urgent multisectoral action. Although many countries have established antibiotic guidelines, little has been done to investigate nurse practitioners' experiences in negotiating antibiotic prescription stewardship for upper respiratory tract infections.

Aim: To explore Nurse Practitioners' experiences in negotiating antibiotic prescription stewardship for upper respiratory tract infections.

Methods: A semi-structured interview guide was used in this qualitative study. In-depth, face-to-face interviews were held between June 15 and July 22, 2021, with a Purposively sampled 10 nurse practitioners from the Tamale Metropolis. Interviews were recorded on a dictaphone. The recorded interviews were transcribed verbatim and the data were subsequently analyzed using a thematic approach.

Results: Nurse Practitioners' experiences in negotiating antibiotic prescription stewardship for upper respiratory tract infections were classified into five themes: “Antibiotic prescription Governance”, “Professional Practice”, “Reliance on abilities and skills”, “Outcomes of Antibiotic prescriptions” and “Expectations”

Conclusion: A better understanding of the nurse practitioners antimicrobial stewardship for Upper respiratory tract infections is needed to inform antimicrobial prescription behaviour and prevent improper antibiotic administration among the nurse practitioners.

Open Access Review Article

Motivators and Barriers to the Pursuit of Advanced Nursing Education in Nigeria

Oluwaseun Tosin Aina, Aina Daniel Olagoke, Olumide Abraham Ajayi

Asian Journal of Research in Nursing and Health, Page 109-115

Introduction:  Nursing is a profession that keeps evolving in order to improve care for persons, families and communities as a whole. Education is an important tool of training and retraining these professionals in order to make them keep up with the pace of practice and consequently improve outcome of the healthcare system. Thus, a need to understudy advanced nursing education motivators and barriers in Nigeria.

Study Aim: This study was aimed at finding motivators and barriers to the pursuit of advanced nursing education in a teaching hospital in Nigeria. 

Methodology: This is a descriptive correlation study conducted to identify factors that promote and deter nurses from the pursuit of advanced nursing education in Nigeria. The population was made up of nurses from a teaching hospital in Nigeria.  Stratified random sampling technique was used to select 180 elements from the population. Data was analysed using Statistical Package for Social Sciences version 18(SPSS 18).

Results: Findings showed that majority of nurses were interested in advanced nursing education. However, the tuition fees for such education was high. The findings also showed that job security, increased salary, and promotion were motivators for the pursuit of advanced nursing          education.

Conclusion: The study concluded that job incentives, job security, increased salary, and promotion are motivators for the pursuit of advanced nursing education while cost of tuition, work life balance and family commitment are barriers to the pursuit of advanced nursing education. The study therefore recommended that policy makers should make efforts to provide adequate job incentives for nurses and reduce the cost of tuition for advance nursing education to an affordable level.