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- ItemDescribe the Knowledge and Attitude on the Use of International Guidelines for Management of Patients with Heart Failure Among Nurses at the Uganda Heart Institute, Mulago Hospital.(2024-03-25) Atifa MunandaBackground and aim: Heart failure is a raising public health issue globally. In Uganda HF affects more than 15 % Ugandans annually, and results to increased hospital length of stay, frequent re-hospitalizations, increase hospital costs and premature deaths among those affected. The aim of study is to describe the knowledge and attitude on the use of international guidelines for managing HF among nurses at the Uganda Heart Institute. Methods: The study employed descriptive cross-Sectional study design of quantitative approach of data collection. The research was conducted on 72 nurses who have worked for more than six months in Uganda heart institute. The questionnaire consisted of 30 questions that assessed knowledge and attitude of nurses on the use of international guidelines. The study questionnaire was conducted on the month of June 2023 to July 2023. Results: A total of 72 nurses participated in this study. Average age was 36.7 years with minimum age 27 and maximum age 58 years. 67% of the respondents were below 40 years. Overall, 46.9% of the respondents had good knowledge about management of heart failure using international guidelines. Among the 72 respondents 48(66.7%) had positive attitude towards heart failure management (M = 3.8, SD= 3.3), male had nearly equal attitude compared to female (70.0% vs. 68.7%), participants who had an experience of more than 20 years had a better attitude compared to all categories of experience. Discussions and conclusion: participants had a good knowledge compared to the results from other studies. The knowledge was associated with knowledge years of experience and some forms of specialization. The results showed good attitude which was similar to other studies. Increasing awareness on the use of international guidelines might further improve knowledge.
- ItemEffect of Clinical Coaching on the Health Workers’ Knowledge, Attitudes, and Practice Towards the Use of the Patient Health Questionnare-9 Tool in HIV Care at Atiak HCIV in Amuru District, Northern Uganda(2024-04-10) Douglas Tonny OtimAbstract Background: Worldwide depression is a concern, especially in people living with HIV. In low- and middle-income countries, its identification continues to be difficult in lower-level healthcare facilities. Specific assessment tools for depression such as Patient Health Questionnare-9 (PHQ-9) are accessible tools that can be implemented to support and improve detection in clinical settings. Health workers in lower-level facilities are not trained to use the PHQ-9 tool, and yet they are in a better position to screen and improve depression detection. Addressing healthcare workers' knowledge, attitudes, and practices using a clinical coaching strategy can increase the efficacy of the PHQ-9 tool. This study aimed to analyze the effect of clinical coaching on the knowledge, attitude, and practices of health workers towards the use of the PHQ-9 assessment tool in an HCIV in Northern Uganda. Method: A one-group pretest-posttest cross-sectional study that employed consecutive sampling was used among 34 health workers. A 5-hour clinical coaching interventions were implemented, and a structured self-administered questionnaire was used to collect data pre- and post-interventions. Descriptive statistics and the significance of the observed difference were assessed with SPSS version 22. Result: There was a significant difference before (M=70.8, SD=3.3) and after (M=90.6, SD=2.6) the coaching intervention on knowledge, t(33) =11.4, p= <0.001, a significant improvement in the scores for before (M= 3.32, SD=0.42) and after (M=3.58, SD=0.31) clinical coaching intervention in attitude; t(9) = -4.77, p = 0.001, and a significant improvement in the optimal practice scores from the baseline (58.8%) and after clinical coaching intervention (85.3%), p = 0.023. Conclusion: Generally there was a noticeable improvement in the knowledge, attitude, and practices of health workers regarding the use of the PHQ-9 tool after clinical coaching intervention. Keywords: Knowledge, attitude, practices, clinical coaching, PHQ-9, and depression screening.
- ItemEffect of the Educational Intervention on the Attitude and Practice of Finalist Student Nurses Towards the Care of the Hospitalised Elderly in Uganda(2024-04-09) Margaret A. WandabwaBackground to the study: Ugandan hospitals like most countries worldwide have a challenge with caring for elderly patients yet elderly population is increasing. Most of the patients admitted to hospitals are the elderly, (65 years and above) and majority are admitted with chronic conditions and are at high risk for functional decline (Brauwer, Corrette, Boland, Verschuren, & Hoore, 2017). Seventeen percent of those admitted while independently mobile end up either requiring assistance to walk on discharge or with detrimental effects of hospitalization (Inderpal, 2016). Many of these patients are discharged with activities of daily living function worse than the baseline function indicating lack of attendance to activities of daily living (Edemekong, Bomgaars, Sukumaran, & Levy, 2020). Nurses are reported to have negative attitude towards care of the elderly and therefore not correctly providing care to this category of patients. Objectives: The study aimed at determining the effect of the educational intervention on the attitude and practice of the finalist student nurses towards care of the hospitalised elderly in Uganda and compared their attitude and practice towards the care of the elderly with the basic information. Methodology A quansi experimental design, using pretest and posttest single group method was used to determine the attitude and practice of the finalist student nurses towards care of the elderly in relation to activities of daily living. A sample size of seventy participants was selected through simple random sampling. The intervention involved training the finalist student nurses in the use of the Katz tool for assessing activities of daily living. Quantitative data was collected using self-administered questionnaires before and after the intervention. Data was analyzed in SPSS package Version 26.0 at both descriptive and inferential levels. Results All the selected participants participated. They had some information on the care of the elderly 42 (60%) and most of them received it from the clinical area. All had ever nursed elderly patients. The attitude towards care of the elderly in relation to activities of daily living improved from negative to positive for most participants. They were positive that it was vital to correctly assess the patient’s ADLS to determine the functional status and identify areas for intervention. They appreciated the Katz tool as a useful tool for the assessment. After the intervention there was a significant change in the attitude towards the care of the elderly from 2.37 to 5.11 with p <0.001. They strongly agreed that nurses must have positive attitude to be able to provide correct care to these patients. They appreciated the Katz tool as a useful tool for assessing the pts ADLS. Conclusions and recommendations The study results revealed that care of the elderly is a very important area of nursing care and that it requires positive attitude and skills for quality of care. The participants had some information on the care of the elderly which most of them acquired from the clinical area. They realised the importance of positive attitude towards care of the elderly and that negative attitude affects care provision and patient recovery. The study recommends that nurse leaders and policymakers address care of the elderly as a specialty and to formalize training of nurses in the care of the elderly. They should advocate training of care providers emphasizing on positive attitude for them to be able to provide quality care to elderly. They should device effective ways of providing quality care like developing tools that can guide care providers to identify areas of care.
- ItemA Criterion - Based Audit of Postnatal services Given to Mothers and Newborns Within 24 Hours of Birth in the General Hospital in Western Uganda(Uganda Christian University, 2023-09-12) AGNES AGWANGAbstract Background: Postnatal care is a key global intervention and a major safe motherhood initiative recommended for reducing maternal and neonatal mortality globally. Criterion-based audit helps measure the quality of postnatal care reliably and checks adherence to World Health Organization criteria and standards. This study assessed the quality of postnatal care services offered to mothers and their babies within 24 hours using a baseline Criterion-based audit at the general hospital. Methods: Mixed methods used on a facility Criterion-based audit with descriptive cross-sectional and explorative study design. Study population comprised of quarterly recorded and reviewed maternal postnatal files. A questionnaire and key informant interview guide were used. A systematic sampling technique was used for selecting files while key informants were selected purposively. Data was analyzed using SPSS version 20. Qualitative data was transcribed using related concepts to form themes and sub themes. Results: 248 files reviewed. Assessment of the mothers and their babies within one hour after birth almost met the WHO standards in all the parameters except after birth pains and incision site for cesarean mothers. Within 6 hours, assessments fell far below the WHO criteria and standards, including records of potentially life-threatening conditions and information shared upon discharge. No mental health information was shared upon discharge. Immediate care of the newborn almost met the WHO criteria and standards except for stimulation of the baby, use of ambu bag and mask, and use of resuscitation drugs. Six hours and subsequently the standards were not met (head circumference, temperature, bladder and bowel function, color of the eyes, cord checked and skin color), including records of potentially life-threatening conditions. Information on discharge was shared except delayed bath and continuity of prescribed treatment. Factors associated with quality of postnatal care included lack of guidelines, understaffing, inadequate sundries and equipment. Conclusion and recommendations: Assessment of the mothers and their babies after six hours of birth did not meet the WHO criteria and standards. Criterion-Based Audit of postnatal services in this study revealed that attention was given in improving the quality of postnatal care than it did before through, adopting WHO guidelines for postnatal care, improving the staffing levels and their general welfare. Criterion-based Audits can be used in other maternity departments like antenatal clinic and labour ward to assess quality of care.
- ItemThe Effect of Intergrating the Pain Assessment Scale to the Nurses Knowledge,Attitude,and Practice Towards Post Operative Pain Management on the Surgical Wards(Uganda Christian University, 2023-09-19) Betty Nabiwande Musisi