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Determinants of foot self-care practices among diabetic patients attending diabetic clinic at a referral hospital, Meru county - Kenya
(2019-09) Wanja, Laurenzia; Mwenda, Catherine; Mbugua, Ruth G.; Njau, Stanley
Foot self-care practices are regarded as fundamental in prevention of diabetic foot ulcers[2].Globally, it is estimated that the prevalent cases of persons living with type 2 diabetes mellitus (DM) were more than 500 million [17]. Patients with type 2 DM suffer diabetic foot ulcer (DFU), one of the DM complication most costly to treat and with huge impact on global health [3]. The purpose of the study was to assess the determinants of foot self-care practices among patients with type 2 Diabetes Mellitus. This research was a descriptive cross sectional, conducted among 133 type 2 DM clients who were selected using systematic random sampling technique. Data was collected using an interviewer administered semi-structured questionnaire. Analysis of data was done using SPSS version 21. Socio-demographic characteristics such as age of the respondents (p=0.003), level of education (p=0.006 and monthly income (p=0.014) significantly influenced foot self-care practices. 51.2% of the respondents demonstrated low level foot self-care practice while48.8% demonstrated high level foot care practice. 61% were found to have low knowledge level while 39% had high level of knowledge on foot self-care. Low level of knowledge on foot care influenced the practice of foot self-care among the type 2 DM patients attending out-patient diabetic clinic at a referral hospital in Meru County. There was a significant association between knowledge and practice of foot self-care practice (p=<0.001). Those with high level of knowledge were 4.3 times more likely to have high level of foot self-care practice.
Knowledge, perception and uptake of prostate cancer screening: Cross sectional study at a Level III Hospital in Kenya
(Scientific & Academic Publishing, 2018) Wachira, Beth W.; Meng’anyi, Lucy W.; Mbugua, Ruth G.
Objective: The aim of the study was to assess the Knowledge, Perception and Uptake of Prostate Cancer Screening among men attending Mathare North Health Centre. Methods: This was a Descriptive cross-sectional facility based study. The study was conducted at Mathare Health Centre in Nairobi County in Kenya among men aged 30 years and above attending the facility outpatient department. Quantitative data was collected using a structured interview based questionnaire. Data was analysed by use of Statistical Package for Social Scientists (SPSS) version 22. Results: Eighty percent (80%) of the respondents were aware of prostate cancer existence with the mass media being the major source of the information. Knowledge on various domains was low as 87% of the respondents were not aware of the symptoms of prostate cancer, 52% did not know that the disease is preventable while 71% did not know the disease is curable. Sixty four percent (64%) of the respondents were not aware of existence of prostate cancer screening services, 63% of the respondents perceived themselves as not being at risk of developing the disease while 8.8% of the respondents perceived themselves as being susceptible to prostate cancer in the future. The respondents (62.2%) held fatalistic beliefs towards prostate cancer. Only 1.3% of the respondents had undergone screening which was done more than three years preceding the study. Conclusion: The level of awareness of prostate cancer was high while knowledge on the various domains was low. There was low perception of self-vulnerability and existence of fatalistic beliefs. Consistent with the low level of knowledge, low perception of self- vulnerability, the uptake of prostate cancer was extremely low. There is need to Scale up health education to the community regarding prostate cancer to enhance knowledge, eliminate negative beliefs and increase the uptake of screening.
Utilization of the nursing process among nurses working at a level 5 hospital, Kenya
(Scientific & Academic Publishing, 2019) Mwangi, Catherine; Meng’anyi, Lucy W.; Mbugua, Ruth G.
Background: The nursing process is a valuable tool that has revolutionized nursing practice for better patient outcome. Utilization of nursing process (NP) is however usually compromised by various internal and external factors. Objective: The aim of this study was to assess Knowledge, Attitude, Practices and Hospital factors affecting the utilization of nursing process among nurses in Thika Level 5 Hospital. Methods: A descriptive cross sectional study was conducted in the month of September 2017 where 69 respondents were randomly sampled from nurses in medical, surgical and paediatric units. Data on knowledge and attitude was collected using a self-administered questionnaire and Key Informant Interview guide of the ward in-charges. Data on practice of NP was collected using a checklist where in patient files were sampled. Results: Majority (78.3%) of the respondents reported they have a knowledge gap in NP, 81.2% felt NP is time consuming, 29% felt that NP contributes to patients’ wellness at times and 3% felt it does not contribute to patients’ wellness. Half (50%) of the unit in-charges reported that half of the nurses had a positive attitude towards utilizing NP. Most (72.5%) of the respondents reported the facility inadequately supports the implementation of the NP. From the in-patient files; incomplete or missing information, in regards to patient episodic assessment, and nursing care plans was revealed. Discussion: A knowledge gap in relation to utilization of NP and a negative attitude were noted. The practice on NP was wanting as most of the files did not have complete care plans and this therefore indicates that there might be a compromise in patient care. Respondents echoed that practice of NP was a challenge as a result of shortage of staff, lack of supplies as they are overworked and the NP paper work meant there was no time for patient care. Conclusions and Recommendation: The facility management needs to employ more nurses, provide material resources and ensure continuous education, workshops, seminars or updates on NP to support and enhance the implementation of NP.
Nurse factors influencing compliance with CDC guidelines for catheter associated urinary tract infection prevention in a referral hospital in Kenya
(Scientific & Academic Publishing, 2019) Methu, C. W.; Mwenda, C. M.; Mbugua, Ruth G.
Urinary tract infections are the most frequently occurring health-care associated infections. 75% of these infections are linked with utilization of an indwelling urinary catheter. However, 40% of urinary tract infections are preventable. The researcher sought to assess nurse related factors influencing compliance with Centre for Disease Control (CDC) guidelines for CAUTI prevention among nurses working at Embu level 5 hospital. The study was carried out in 2017. Methods: A descriptive cross-sectional study was conducted among nurses working at Embu level 5 hospital between 107 participants were selected using systematic random sampling. Data collection tools included a self-administered structured questionnaire, and an interview schedule for key informants and an observation checklist. Data analysis was done using SPSS version 21 and thematic analysis. Findings: Compliance among the nurses was found to be low (46.7%). However, most respondents had adequate knowledge of the guidelines on CAUTI prevention (overall knowledge score of 71%). A majority (60.2%) of the respondents also had a positive attitude towards CAUTI prevention. There was no significant association between nurse related factors (knowledge & attitude) and nurse’ compliance (all p >0.05). However, some of the key informants felt that inadequate knowledge on CAUTI prevention guidelines was a factor hindering nurse’ compliance. Conclusion & Recommendation: The nurses’ level of compliance with CAUTI guidelines was poor. The null hypothesis (H0) was accepted (p > 0.05) which implies that nurses’ knowledge and attitude do not influence their compliance with CAUTI guidelines. Further studies should be carried out on other factors, for example institutional factors that might influence nurse’ compliance with guidelines for CAUTI prevention.
Uptake of prostate cancer screening and associated intra-personal factors among men aged 40-69 years: A cross-sectional study in a rural community in Kenya
(2020) Mbugua, Ruth G.; Oluchina, Sherry; Karanja, Simon; Cheboi, Solomon
INTRODUCTIONProstate Cancer (PC) is mostly asymptomatic despite mortality rate highly dependent on early diagnosis and treatment which might have been hindered by existing barriers. By the year 2018, PC ranked second globally among the most diagnosed cancers in males attributing to 13.5% of deaths. Disparities existed regarding the mortality rates of PC with a slight predominance in blacks compared to other races. The level of PC screening in Kenya like any other Sub-Sahara African country was terribly low [2-,10]. A community-based study carried out in a rural area reported only 2.4% of the participants had been screened, while in the capital city of Kenya (Nairobi City County), only 4.1% of the respondents had ever been screened.OBJECTIVEThe aim of the study was to determine the intra- personal factors influencing uptake of prostate cancer screening among men aged 40-69 years in Kiambu County, Kenya.METHODOLOGYIn April 2019, the study adopted a descriptive cross-sectional survey design in Kiambu County. A total of 576 men aged between 40-69 years except those already diagnosed with prostate cancer from the Community units within Gatundu North and Kiambu Sub- counties were recruited. Data was collected through an interviewer-administered questionnaire. It was coded, cleaned and analyzed using Statistical Package of Social Sciences (SPSS) version 22. Bivariate analysis with Pearson’s chi -square test was used to compare the proportions. A Pvalue of <0.05 was considered statistically significant at 95% Confidence Interval. The significant variables were then subjected to Multi-variate logistics regression for further analysis of the association with uptake of screening of Prostate Cancer. Participant’s autonomy andanonymity was maintained, and any information shared by them was confidential.RESULTSThe level of screening was low. Only 5% of the respondents had ever been screened for prostate cancer. Socio-demographic factors were not associated with prostate cancer screening but Socio-economic factors made an impact. Owning 1-3 acres of land was significantly associated with screening. Respondents who owned 1-3 acres were 15 times more likely to take up screening in comparison with those having less than 1 acre of land. [OR =15.672 CI 95% (1.256- 195.47) P=0.033]. CONCLUSIONThe level of prostate cancer screening was low. Socio- economic factors were found to influence uptake of prostate cancer screening. Socio-economic factors when designing prostate cancer prevention programs need to be emphasized. Prostate Cancer screening remained a controversial issue due to the documented risk of over diagnosis and harm associated with biopsy and treatment in developed countries.RECOMMENATIONSAn early diagnosis of Prostate cancer will give an opportunity for treatment. Preventive Services Task Force report recommends the screening of men for PC among those considered at risk within the age of 40-69 years through shared a decision-making process.