Medicine and Health Sciences Commons^™

Gender Based Violence And Health Effects, Tazeen Saeed Ali

School of Nursing & Midwifery

Gender Based Violence (GBV) violates the basic human right of a person’s physical, sexual and emotional integrity and health ([i]) such that globally, one out of every three women is subject to some form of violence, ranging from verbal and physical abuse to emotional blackmailing and psychological torture eventually leading to futile despair and hopelessness. The ironical perception of gender equality in our society is the root cause of gender based violence, with women being more afflicted by such a form of gender discrimination than men. [i]. Ali TS, Krantz G, Gul R, Asad N, Johansson E, …

Introducing Icm’S President – Author Of Editorial December, 2019, Rafat Jan, Franka Cadee

Journal of Asian Midwives (JAM)

No abstract provided.

Caesarean Section Rates In South Asian Cities: Can Midwifery Help Stem The Rise?, Sulochana Dhakal Rai, Amudha Poobalan, Rafat Jan, Malin Bogren, Juliet Wood, Ganesh Dangal, Pramod Regmi, Edwin Van Teijlingen, Keshar Bahadur Dhakal, Sahib Jan Badar, Farhana Shahid

Journal of Asian Midwives (JAM)

Introduction: Caesarean section (CS) is a life-saving surgical intervention for delivering a baby when complications arisein childbirth. World Health Organization recommends a rate of CS from 10% to 15%. However, CS rates increased steadily in recent decades and have almost doubled from 12.1% in 2000 to 21.1% in 2015. Therefore, this has become a global public health problem. The main purpose of the scoping review article is to give an overview and analysis of the rising CS use in four South Asian countries: Bangladesh, India, Nepal and Pakistan.
Methods: A scoping review was carried-out using several bibliographic electronic databases (MEDLINE, …

Can Cmws Sustain Quality Services And High Coverage As Private Providers In Chitral? A Three-Year Prospective Qualitative Study, Rafat Jan, Arusa Lakhani, Salma Rattani, Laila Lalji, Kiran Mubeen, Mehtab Q. Jaffer

Journal of Asian Midwives (JAM)

Background: The maternal and neonatal mortality ratesof Chitral district of Pakistan are among the highest in the country. One of the factors that found to havepositive impact on maternal and newborn health indicators is the availability ofquality skill birth attendance because the majority of the poor women cannot access facility-based maternity care. Therefore, in 2006, the Government of Pakistan (GOP) has initiated a program to train and deploy Community Midwives (CMWs) to support safe pregnancies and births. The Aga Khan Health Service’ Pakistan, initiated the Chitral Child Survival Program (CCSP) in partnership with the National Maternal Neonatal and Child Health …

Psychosocial Factors Of Deliberate Self-Harm In Afghanistan: A Hospital Based, Matched Case-Control Study, Akbar Paiman, Murad M. Khan Dr., Tazeen S. Ali, Nargis Asad, Iqbal Azam Syed

Department of Psychiatry

Background: Deliberate self-harm is not only a major global public health problem but also an important index of psychological distress and a risk factor for suicide.
Aims: We aimed to determine the psychosocial risk factors for deliberate self-harm in patients aged ≥ 16 years presenting to tertiary care hospitals in Kabul, Afghanistan.
Methods: A matched case-control study was conducted from February 2015 to May 2015. We recruited 185 cases (patients with deliberate self-harm) and 555 age- and sex-matched controls (patients with general medical conditions) from 4 tertiary care hospitals in Kabul. We developed a questionnaire to record the sociodemographic characteristics …

Falls Prevention Among Older Adults At A Nursing Home In A Northern Suburban Of Perth In Western Australia, Horatius Musembi, Deborah Sundin

School of Nursing & Midwifery, East Africa

The objective was to identify factors leading to falls and determine the role of nurses and carers play in falls prevention. A retrospective audit of the performance of nurses and carers regarding falls prevention among older adults was used. Residents who had a fall during July 2015 (n=25) were identified using purposeful sampling. Data for this study were collected from the files of these residents. Data analysis was done by using the Fisher exact test which was appropriate for the collected data. Residents aged 85-89 years had the most falls (32%); however, one resident who fell five times in the …

This Disease Is “Not For Hospital”: Myths And Misconceptions About Cancers In Northern Nigeria, Ahmed Sarki, Babangida L. Roni

School of Nursing & Midwifery, East Africa

Cancers are one of the major chronic diseases in Nigeria, with over 100,000 new cases and 70,000 cancer deaths recorded annually. Notwithstanding the public health significance of cancers in Nigeria, there is a dearth of evidence relating to cancers in the country, with most of the few available studies conducted in the Southern regions. This paper aimed to highlight some longstanding myths and misconceptions about cancers in the Northern Nigerian region. We consulted key stakeholders including individuals, local leaders, traditional medicine practitioners, and healthcare professionals. The most common myths and misconceptions about cancers in Northern Nigeria include the following: people …

Resilience And Quality Of Life (Qol) Of Head And Neck Cancer And Brain Tumour Survivors In Pakistan: An Analytical Cross-Sectional Study Protocol, Nida Zahid, Wardah Khalid, Khabir Ahmad, Shireen Shehzad, Iqbal Azam Syed, Nargis Asad, Adnan Jabbar, Mumtaz J Khan, Ather Enam

Department of Surgery

Background: Cancer is a devastating disease and has detrimental effects on the quality of life (QoL) of cancer survivors and interferes with their treatment compliance. The aim of the study is to assess resilience and QoL among cancer survivors and to evaluate the important factors affecting their resilience and QoL, with respect to the Pakistani cultural context.
Method and Analysis: A cross-sectional study will be conducted at a tertiary care hospital in Karachi, Pakistan. A minimum sample size of 250 head and neck cancers and 250 brain tumour survivors with 10% inflation for non-response rate will be required. The SD …

Enhancing Patient Well-Being: Apply Positive Psychology In Nursing Practice, Farida Bibi Mughal

School of Nursing & Midwifery

Objective: Positive psychology is the emerging concept in the medical field and has shown the positive effects on one’s well-being. This paper highlights the application of PERMA model in nursing practice.
Method: The model applied in the clinical area to access improvement in patient’s well-being. The concept of positive psychology’s applicability is discussed with the real life examples.
Result: The PERMA model when applied yields a positive impact on patient’s health and overall well-being.
Conclusion: The learning outcomes of this research will help the people in health care to understand the relationship between positive psychology and nursing practices for the …

Perception Of Nursing Students Regarding Blended Learning Implementation At University Of Lahore, Pakistan, Muhammad Afzal, Tazeen Saeed Ali, Syed Amir Gilani

School of Nursing & Midwifery

Background and objectives: Blended learning (BL) is positive development in education. This method provoke the learner’s critical thinking and given different ways for implementation of their knowledge in real life. There are several advantages of blended learning to the faculty, students and institutions as well.
Methods: The Cross-sectional study design was used to collect data from nursing students. The study was carried out at Lahore School of Nursing, The University of Lahore, Pakistan. All nursing undergraduates students enrolled at elective practicum blended learning course at Lahore School of Nursing, The University of Lahore, Pakistan academic year 2016-2017 were included in …

Knowledge And Practices Among Nurses Regarding Patients’ Care Following Cardiac Catheterization At A Tertiary Care Hospital In Karachi, Pakistan, Adnan Yaqoob, Rubina Barolia, Ahmed Noor, Afshan Nazar

School of Nursing & Midwifery

Aims: The purpose of this study was to assess the knowledge and practices among nurses regarding patient care, following cardiac catheterization, at a tertiary care hospital in Karachi, Pakistan.
Background: Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality, globally. Nurses are the largest body of health care professionals who attempt to reduce the burden of cardiovascular diseases. Design: This study employed a descriptive analytical cross-sectional study design to answer the research questions.
Methodology: The data were collected from 70 participants using two instruments. Knowledge was assessed through a 50-multiple-choice questions-based questionnaire, whereas, to assess the practices, an …

Sociodemographic Factors Associated With Mothers’ Experiences Of Psychosocial Care And Communication By Midwives During Childbirth In Nairobi, Kenya, Jane Kabo, Eleanor Holroyd, Grace Edwards, Ahmed Sarki

School of Nursing & Midwifery, East Africa

Purpose: To clarify sociodemographic and socioeconomic factors associated with mothers’ experiences of psychosocial care and communication by midwives during childbirth in Nairobi, Kenya.

Design: A descriptive cross-sectional study conducted in a government national referral hospital. Respondents were 109 systematically sampled mothers who delivered in the study hospital. Mothers’ experiences of intrapartum care were assessed using three subscales from the Experience of Psychosocial Care and Communication during Childbirth Questionnaire (effective communication; emotional support; and respect, care and dignity). Simple and multivariable logistic regression analyses were used to assess associations between sociodemographic factors, socioeconomic factors and mothers’ experiences of intrapartum care.

Findings: …

Case-Based Insights: Arab Muslim Mothers’ Experiences Of Managing A Child Newly Diagnosed With Type 1 Diabetes Mellitus, Rachel Cathrine Rossiter, Jennifer Louise Cooper, Suhad Issa Marjei, Sharon Brownie

School of Nursing & Midwifery, East Africa

Mothers frequently fulfill the role of primary caregiver for children diagnosed with type 1 diabetes mellitus (T1DM). A T1DM diagnosis has a significant impact on the child and the wider family unit. The objective is to develop understanding of mothers’ experiences caring for children diagnosed with T1DM in the cultural context of the Middle East to facilitate enhanced health service provision and support. This study used a qualitative design. Data were collected in individual semistructured interviews. Participants were mothers of Arabic descent and Muslim belief who had a child diagnosed with T1DM within the last 12 months. All mothers were …

Reasons For Delay In Seeking Treatment Among Women With Obstetric Fistula In Tanzania: A Qualitative Study, Mary Lyimo, Idda H. Mosha

School of Nursing & Midwifery, East Africa

Background: Obstetric fistula is among the serious and distressing maternal morbidities in Tanzania. Obstetric fistula is a childbirth-related injury caused by prolonged and obstructed labor which has a devastating impact on affected women and their families. The aim of this study was to explore reasons why women with obstetric fistula admitted to the Comprehensive Community- Based Rehabilitation in Tanzania (CCBRT) hospital delayed seeking fistula treatment.

Methods: This exploratory study incorporated qualitative approach. In-depth interviews were used to collect data from 18 women with obstetric fistula admitted to CCBRT hospital. The interviews were conducted in Kiswahili and lasted for 40–45 min. …

Quality Of Life Of Road Traffic Injury Survivors Aged 15-44 Years Suffered From Moderate And Severe Head Injuries In Karachi, Pakistan, S A. Abbasi, Tazeen Saeed Ali, Shafquat Rozi, Uzma Rahim Khan, Rashid Jooma

Community Health Sciences

Background: Most of Road traffic injuries are predicted to be the third leading contributor to the global burden of disease by 2020 and patients end up into head injuries which leave devastating impacts on individual and society. Quality of Life After Brain Injury (QOLIBRI) is a specific tool that measures quality of life in head injury patients.
Methods: This was a cross sectional study among 300 patients aged 15-45 years, attended emergency department of the Aga khan University Hospital. Structured questionnaire included demography, injury details, QOLIBRI, GOSE and WHO Disability Assessment Scale (WHODAS 12 items). Severity of injury was determined …

Mortality And Functional Outcomes After A Spontaneous Subarachnoid Haemorrhage: A Retrospective Multicentre Cross-Sectional Study In Kenya, Peter Waweru, Samwel Gatimu

School of Nursing & Midwifery, East Africa

Introduction: Despite a reduction in poor outcomes in recent decades, spontaneous subarachnoid haemorrhage (SAH) remains associated with severe disability and high mortality rates. The exact extent of these outcomes is however unknown in Africa. This study aimed to determine the mortality and functional outcomes of patients with SAH in Kenya.

Methods: We conducted a retrospective multicentre cross-sectional study involving patients admitted with SAH to three referral hospitals in Nairobi. All patients with a confirmed (primary) discharge diagnosis of first-time SAH between January 2009 and November 2017 were included (n = 158). Patients who had prior head trauma or cerebrovascular disease …

Asian Midwifery In 2019, Rafat Jan, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

No abstract provided.

Cultural Assessment: A Study Of Midwives’ Knowledge, Attitude And Self-Reported Practice In Uganda, Mercy Muwema, Karen Drake, Pamela Friesen, Grace Edwards

Journal of Asian Midwives (JAM)

Background: Cultural assessment is critical due to the increased movement and resettlement of people across the globe, and diverse cultural groups in Uganda. This is putting the health care delivery systems serving the communities under pressure to recognize the different attitudes of people towards health and to develop care systems that are effective in meeting diverse needs. However, despite the importance of cultural assessment in nursing literature, little is known about the cultural assessment competence of Ugandan midwives. This study assessed the knowledge, attitude, and practice of midwives in this assessment process.

Methods: A descriptive correlational design was used to …

Examining Clinical Indications For Cesarean Section In A University Hospital In Karachi, Pakistan, Zehra Kanji, Shannon D. Simonovich, Nida Najmi, Jessica Bishop-Royse

Journal of Asian Midwives (JAM)

Background and objectives: Current research reports that Pakistan exceeds the recommended percent of deliveries via cesarean sections, including both emergent and non-emergent. In order to better understand the high rate of cesarean sections in Pakistan we examined the medical and non-medical indications of these surgeries at a private university hospital in Karachi.

Methods: A retrospective analysis of patient medical record data was conducted from January 1st, 2018 to March 31st, 2018. The data collected was analyzed using SPSS 25.

Results: The total number of deliveries during the period was n= 1,211, out of which n=602 (49.70%) were CS. The top …

Male Involvement In Family Planning Among Squatter Settlement Residents Of Karachi, Fahmida Khowaja, Mehak Pervaiz, Naushaba Khatoon

Journal of Asian Midwives (JAM)

Background: Worldwide, the Contraceptive Prevalence Rate (CPR) increased from 54.8% to 63.3%. However, Pakistan’s current CPR is estimated to be 35%. Men can play an important role in increasing CPR by providing support to their partners, yet their role has been overlooked in targeted reproductive health strategies. The aim of this study was to assess the awareness and practices of married men regarding Family Planning (FP).
Material and Method: This cross-sectional study was conducted among 419 married men, residing in an urban squatter settlement of Karachi. Participants were selected through non-probability convenience sampling and a structured questionnaire was used to …

Higher Education In Midwifery In Pakistan: A Proposed Framework, Rafat Jan, Arusa Lakhani, Karyn Kaufman

Journal of Asian Midwives (JAM)

Access to a skilled professional midwife is the right of each woman. Research evidence shows that midwives prepared to international standards decrease rates of morbidity and mortality and promote health of both mothers and infants. At present, in Pakistan, there are several midwifery cadres, with different formal education levels, who provide maternal and child health services. There are currently three types of diploma programs each serving a different cadre. Until 2012, there was no opportunity to obtain higher education in midwifery in the country. This absence contributed to non-acceptance and invisibility of midwifery as a profession. As a result, midwives …

Perceptions And Experiences Of Skilled Birth Attendants On Using A Newly Developed Strap-On Electronic Fetal Heart Rate Monitor In Tanzania, Sara Rivenes Lafontan, Hussein Kidanto, Hege L. Ersdal, Columba Mbekenga, Johanne Sundby

School of Nursing & Midwifery, East Africa

Background: Regular fetal heart rate monitoring during labor can drastically reduce fresh stillbirths and neonatal mortality through early detection and management of fetal distress. Fetal monitoring in low-resource settings is often inadequate. An electronic strap-on fetal heart rate monitor called Moyo was introduced in Tanzania to improve intrapartum fetal heart rate monitoring. There is limited knowledge about how skilled birth attendants in low-resource settings perceive using new technology in routine labor care. This study aimed to explore the attitude and perceptions of skilled birth attendants using Moyo in Dar es Salaam, Tanzania.

Methods: A qualitative design was used to collect …

Factors That Influence Transition To Advanced Roles By Rn To Bsn Nurses, In Three Selected Hospitals Of Central-Uganda, John Baptist Asiimwe, Mercy Muwema, Karen B. Drake

School of Nursing & Midwifery, East Africa

Background

Despite the global rise in the number of nurses upgrading from Registered Nursing (RN) to a Bachelor of Science in Nursing (BSN), studies have indicated that successful role transition is difficult once the nurses return to their previous workplaces. Guided by the Transitional Theory, this study investigates the factors that influence the transition from basic to advanced roles among RN to BSN nurses in Uganda, Africa.

Methods

This study employed a descriptive correlational design. Using convenience sampling, fifty-one (51) RN to BSN nurses completed the semi-structured questionnaires.

Results

All the study participants (100%) described themselves as having transitioned from …

Silence In Violence: A Curse Or A Goodwill, Afsheen Hirani, Nasreen Rafiq, Shyrose Sultan, Zainish Hajani, Samreen Siraj

School of Nursing & Midwifery

Healthcare professionals face dilemmas regarding maintaining and breaching confidentiality while dealing with victims of sexual violence. The sensitivity of the cases of violence and the aim to prevent harm generates ambiguity for sound ethical and legal decision making. In Pakistan, maintaining silence is often preferred over breaking the silence. Thus, it is essential to view the risks and benefits of the conflicting positions keeping in mind the diverse perspectives and the bigger picture. Organizations, community and government can plan different strategies to put an end to this obscene game of “silence in violence”.

Developing A Rubric To Assess Critical Thinking In A Multidisciplinary Context In Higher Education, Sadia Muzaffar Bhutta, Sahreen Chauhan, Syeda Kauser Ali, Raisa B. Gul, Shanaz Hussein Cassum, Tashmin Khamis

School of Nursing & Midwifery

Critical thinking (CT) is a generic attribute that is greatly valued across academic disciplines in higher education, and around the globe. It is also defined as one of the graduate attributes of higher education for the sample private university where this research was conducted, as it is perceived that CT helps the graduate to become ‘engaged citizens’ in the twenty-first century. Despite the well-documented importance of CT, its assessment remains a challenge. This study addresses this challenge through the systematic development and field-testing of a rubric for assessing critical thinking in a multidisciplinary context in higher education. A multidisciplinary group …

My Husband Will Love Me More If I Give Birth To More Children: Rural Women’S Perceptions And Beliefs On Family Planning Services Utilization In A Low Resource Setting, Agnes Msoka, Eunice Pallangyo, Sharon Brownie, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

Introduction: Responsibility for family planning in low resource settings is almost solely delegated to women, with very low male involvement. This study investigated rural Tanzanian women’s perceptions and cultural beliefs of the barriers to family planning services utilization.

Methods: This study used a qualitative descriptive approach drawing on four group discussions with 20 purposively selected married women with two or more children. The study followed COREQ guidelines for reporting qualitative studies. Data were collected from participants at four health facilities in Bagamoyo and Kisarawe districts in Pwani, Tanzania.

Results: Participants’ occupations included housewives, small-scale farmers, and entrepreneurs. Most women were …

Students’ Perspectives Regarding Clinical Preceptors (Cps) In The Baccalaureate Undergraduate Nursing Programme In Karachi, Pakistan, Amina Aijaz Khowaja Ap, Jacqueline Maria Dias

School of Nursing & Midwifery

Introduction: Clinical practice is considered an integral part of nursing education. It is in the clinical area that the students integrate the theory learnt in the classroom into practice. An enabling clinical environment with the assistance of a clinical preceptor (CP) ensuresthat student nurses become independent practitioners and competent in their roles and responsibilities.
Design : A comprehensive study was undertaken to explore the emerging role of CPs in Pakistan. This research has been reported in the literature. This paper will deal exclusively with the perceptions of nursing students when working with CPs in the four-year undergraduate baccalaureate program at …

Factors Associated With Postoperative Pain Among Patients After Cardiac Surgery In The Tertiary Care Teaching Hospital Of Karachi, Pakistan, Sineer Micah, Rubina Barolia, Yasmin Parpio, Santosh Kumar, Hasanat Sharif

School of Nursing & Midwifery

Background: Pain is the subjective feeling of an individual, which affects the overall recovery of patients after cardiac surgery. Postoperative pain is the most inadequately managed symptom of cardiac surgery. Subsequently, there are many factors that can either hinder or facilitate pain management, including patients' beliefs, cultural values, physiological features, hospital policies, and healthcare providers' knowledge and beliefs. The purpose of this research was to identify factors associated with postoperative pain and its management, after cardiac surgery, among patients in a tertiary care hospital in Karachi, Pakistan.
Methods: Quantitative correlational study design was employed to attain the study purpose. Data …

Exploring Lived Experiences Of Married Pakistani Women Post-Mastectomy, Laila Hussain, Zeenatkhanu Kanji, Sharifa Bashir Lalani, Shabnam Moledina, Abida K. Sattar

School of Nursing & Midwifery

Objective: This qualitative descriptive exploratory study aimed to explore the lived experiences of married Pakistani women, 2 years post-mastectomy.
Methods: Twelve participants were recruited through purposive sampling from outpatient oncology clinic from a tertiary care hospital in Pakistan. Interviews were audio-taped and transcribed, and then themes and sub-themes were identified.
Results: Women verbalized a range of their experiences throughout the span from diagnosis to mastectomy. One over arching theme, quality of life and four main themes and their subthemes emerged from the data. Following are the themes; from history to diagnosis, worries, coping strategies, and recommendations.
Conclusions: The study findings …

A Race Inside The Body: Decision Of The Fate Of Newborn, Shyrose Sultan, Samreen Siraj, Zainish Zafarullah Hajani, Afsheen Hirani, Nasreen Rafiq

School of Nursing & Midwifery

Sex-selective abortion is the killing of a girl fetus merely due to its gender. It has become an emerging problem in developing countries mainly due to lack of resources and cultural stereotypes. Illegal abortions have increased and are jeopardizing not only the gender ratio but also the health of the mother by exposing them to complications and violating their rights. The aim of this paper is to evaluate a case scenario based on many ethical dilemmas and questions that arise form it. The paper presents the problem in light of major ethical principles and theories by counteracting each argument with …