Medicine and Health Sciences Commons^™

Parents’ Emotional And Psychological Perspective Of Caring Children With Oncological Disorders: A Descriptive Qualitative Study, Ambreen Navroz Ali Salyani

Theses & Dissertations

Background: Childhood cancer has a profound effect on the emotional and psychological well-being of parents, yet often their own psychological health is overlooked as the primary focus while treating the child. These parents silently suffer from psychological distress while caring for their children. They use their own coping strategies to overcome the situation. However, limited studies have been carried out in low- and middle-income countries (LMIC) regarding parents’ emotional and psychological perspectives of caring their children with oncological disorder.
Purpose: The objective of this study was to explore the psychological perspectives that parents of children with cancer diagnosis, treatment, social …

Mothers’ Perspectives On The Use Of Social Media For Receiving Professional Support In Enhancing Their Lactation Self-Efficacy: A Qualitative Descriptive Exploratory Study, Mehtab Lalwani

Theses & Dissertations

Background: Inadequate breastfeeding support and low exclusive breastfeeding rates in Pakistan underpin the need for effective strategies to enhance lactation self-efficacy among mothers. Social media has emerged as a promising professional support and information dissemination avenue. However, concerns about the accuracy of online advice highlight the importance of investigating mothers' perspectives regarding utilizing social media for professional breastfeeding support.
Purpose: This study aims to investigate how mothers perceive social media for receiving professional breastfeeding support, to enhance their lactation self-efficacy.
Methodology: This exploratory-descriptive qualitative study utilized in-depth semi-structured interviews with 12 breastfeeding mothers, purposively recruited from a tertiary care hospital …

Family Needs Of Patients Admitted To Intensive Care Units At A Tertiary Care Hospital, Karachi, Pakistan An Analytical Cross-Sectional Study, Tariq Ali

Theses & Dissertations

Background: The admission of patients to the ICU is a distressing emergency. Family members of ICU patients suffer from anxiety and depression compounded by disrupted routines and role conflicts. Nurses often prioritise patient care over family support, while the family goes ignored. The family members staying in hospital have different physical and psychological needs. Family members frequently bear the responsibility of making critical decisions for the patients. The unmet important family needs add to their stress and anxiety.
Purpose: This study aimed to assess the self-perceived importance of family needs in the ICU using the CCFNI Scale and identifying socio-demographic …

Perceptions Of Intensive Care Nurses And Physicians Regarding Interprofessional Collaboration In Intensive Care Unit Of A Tertiary Care Hospital In Karachi: An Exploratory Qualitative Study, Waheed Ullah

Theses & Dissertations

Background: Interprofessional Collaboration (IPC) is crucial in healthcare, particularly in intensive care units (ICUs). Effective Interprofessional Collaboration between physicians and nurses in patient care can reduce hospital stays, improve the quality of care, and enhance the health outcomes of patients. It has been determined that Interprofessional Collaboration (IPC) is a key policy method foming healthcare personnel and patient safety challenges and improving the healthcare organization.
Purpose: This study aims to explore the perceptions of ICU nurses and physicians regarding IPC in a tertiary care hospital in Karachi, Pakistan. It also investigates the factors that facilitate and limit IPC, thereby impacting …

Association Between Patient Safety Culture And Missed Nursing Care Among Nurses At A Tertiary Care Teaching Hospital In Karachi, Pakistan, Zaifullah Khan

Theses & Dissertations

Background: This study seeks to investigate the relationship between Patient Safety Culture (PSC) and Missed Nursing Care (MNC) in a tertiary care teaching hospital in Karachi, Pakistan. It stands out for its focus on healthcare setting in a developing country, addressing a significant gap in existing literature.
Purpose: The aim is to assess PSC, determine the prevalence of MNC among nurses, investigate their correlation, and examine the impact of demographic factors, including identifying the most frequent missed nursing care and their underlying reasons, providing valuable insights for healthcare systems in developing countries.
Methods: A cross-sectional analytical approach was adopted, involving …

A Mixed Methodological Approach To Study The Feasibility Of An End-Of-Life Care Pathway, Noureen Azizullah Mistry

Theses & Dissertations

Background: The growing significance of end-of-life care in response to the increasing prevalence of chronic illnesses and aging populations has prompted recognition of the need for patient-centred care. Care pathways are employed worldwide to offer comprehensive end-of-life care to patients in various healthcare settings. In Pakistan, there is a recognised need to evaluate the feasibility of introducing an end-of-life care pathway.
Objectives: This study aimed to (a) determine the feasibility of using an end-of-life care pathway for hospital-based and home-based palliative care patients, and (b) explore the experiences and opinions of registered nurses piloting the pathway.
Methods: An explanatory sequential …

Exploring Experiences Of Alarm Response And Alarm Fatigue Among Nurses Working In The Icu Of A Tertiary Care Hospital In Karachi, Pakistan: A Qualitative Study, Shenila Shamsuddin

Theses & Dissertations

Background: Alarm fatigue is a significant concern within the healthcare sector, marked by the excessive exposure of healthcare practitioners to clinical alarms. This prolonged exposure can result in desensitization and delay nurse’s responsiveness to vital warnings. The occurrence of inaccurate alarms intensifies desensitization, undermining confidence in alarm systems and potentially leading nurses to ignore alarms. Alarm fatigue is a prevalent issue of worldwide significance, which calls for more investigation to effectively tackle these issues and enhance understanding of alarm systems to get the best possible treatment results. However, there is a lack of study undertaken in Pakistan about the investigation …

Qualitative Research Exploring Perceptions About Umbilical Cord Care Practices Among Mothers/Caregivers Of Neonates Admitted At A Children Hospital Managed Through A Public-Private Partnership, Ruqia Yasmeen

Theses & Dissertations

Background: Newborns in LMICs face high mortality rates. Multiple factors contribute to these moralities. Among these are unhygienic conditions, and infection of the umbilical cord stump. Unhealthy cultural practices, lack of awareness, myths, and socioeconomic status are key barriers to newborn care. In Pakistan, nearly 300,000 newborns die annually, highlighting the need for improved newborn care.
Objectives: This study is aimed to explore the perceptions and knowledge of mothers/caregivers about umbilical cord care.
Methodology: The qualitative descriptive exploratory design was employed to explore mothers' and caregivers' understanding of cord care through in-depth interviews. Fifteen interviews were conducted at a children's …

Assessment Of Preoperative Anxiety, Its Contributing Factors, And Impact On Immediate Postoperative Outcomes Among Cardiac Surgery Patients - A Cross-Sectional Study, Naveen Nizar Ali

Theses & Dissertations

Background: Preoperative anxiety is characterized by an intense sensation of fear, apprehension, and nervousness. In the domain of cardiac surgery, the assessment and management of preoperative anxiety is of paramount importance, as it plays a pivotal role in shaping the patient's surgical experience and immediate postoperative outcomes. While the etiology of preoperative anxiety is multifaceted, the influence of sociodemographic factors in this context is of paramount importance. However, limited studies have been conducted in developing countries regarding this phenomenon.
Purpose: The study aimed to identify the frequency of preoperative anxiety, its contributing factors, and its impact on immediate postoperative outcomes …

Exploring The Patients’ And Family Members’ Perspectives On Home-Based Palliative Care, Nadia Sultan Ali

Theses & Dissertations

Background: Home health care is considered as a partial substitute for institutional long-term care, because patients and families with known poor prognoses prefer to stay home with their loved ones and people mostly cannot bear the cost of care at the hospital. Therefore, the importance of home-based palliative care is raised via a shared and coordinated model for saving lives through care.
Purpose: To explore patients' and family members' perspectives and experiences of receiving home-based palliative care services.
Method: This was a qualitative exploratory study conducted in Karachi, targeting patients and family members receiving home-based palliative care services. The data …

Prevalence Of Depression In Patients With Cardiovascular Diseases, Faryal Ghafoor

Theses & Dissertations

Background: Approximately 17.3 million individuals across the globe lose their lives to cardiovascular diseases (CVD), with a majority of these cases occurring in low-to-middle-income countries. The incidence of cardiovascular disease in Pakistan is 918 cases per 100,000 individuals. Depression frequently impacts the health, expenses, and prognosis of patients with cardiovascular disease.
Purpose: This study aimed to determine the prevalence of depression among CVD patients at Aga Khan University Hospital, Karachi, and explore the influence of co-morbidities, marital status, age, and educational background on one's status, regarding depression.
Method: A quantitative descriptive cross-sectional study was conducted at the Aga Khan University …

Comparison Of Physical Activity Levels Among School-Age Adolescents In The Rural And Urban Areas Of District Swat Kpk, Pakistan- An Analytical Cross-Sectional Study, Imran Uddin

Theses & Dissertations

Background: Obesity and overweight represent significant global public health concerns. Young adolescents are in particular increasingly experiencing obesity and overweight due to their sedentary lifestyles, excessive electronic media use, and lack of physical activity (PA). This trend is linked to the development of non-communicable diseases in later life. Moreover, data regarding the lack of PA is available in Pakistan, but a gap exists in the comparative analysis of physical activity levels between rural and urban adolescents. Rural and urban areas exhibit distinctions in both geographical settings and technological advancements, potentially influencing the PA levels of their respective inhabitants.
Purpose: The …

Factors Hindering The Care Of Geriatric Patients Admitted In A Tertiary Care Hospital In Karachi, Pakistan, Muhammad Shoaib

Theses & Dissertations

Background: Older adult’s patient care presents multiple challenges to nurses due to their growing numbers worldwide. According to WHO in 2020 the number of older adults aged 60 and above is one billion and by 2050 this population will be doubled. The current geriatric population of Pakistan is above eight million and is estimated to reach twenty-seven million by 2050. This increasing trend of the geriatric population poses a greater challenge to the compromised healthcare systems in Pakistan, healthcare workers especially nurses struggle hard due to limited resources, lack of knowledge regarding geriatric, and the frailty of older patients, to …

The Experiences Of Nurses Regarding Practice Change In Maintaining Nine Months Clabsi-Free Medical Intensive Care Unit: A Qualitative Study At A Tertiary Care Hospital, Karachi, Pakistan, Safia Islamuddin

Theses & Dissertations

Background: CLABSI’s are serious healthcare-associated infections resulting from central venous catheters which are predominantly used in ICUs. Nurses, as frontline caregivers, play a critical role in preventing CLABSIs. Their views often highlight the importance of strict protocols, vigilance, and teamwork to minimize CLABSI risks, enhancing patient safety. Studies in low-middle countries like, Pakistan till yet have focused on investigation CLABSI incidents, knowledge of it and associated factors. From a unit with a long-term record of being free from CLABSIs can offer valuable insights into identifying best practices, replicating them, and understanding the obstacles involved in achieving a CLABSI-free environment.
Objectives: …

Blood Culture Versus Antibiotic Use For Neonatal Inpatients In 61 Hospitals Implementing With The Nest360 Alliance In Kenya, Malawi, Nigeria, And Tanzania: A Cross-Sectional Study, Sarah Murless-Collins, Kondwani Kawaza, Nahya Salim, Elizabeth Molyneux, Msandeni Chiume, Jalemba Aluvaala Aluvaala, William Macharia, Veronica Chinyere Ezeaka, Opeyemi Odedere, Donat Shamba

Paediatrics and Child Health, East Africa

Background: Thirty million small and sick newborns worldwide require inpatient care each year. Many receive antibiotics for clinically diagnosed infections without blood cultures, the current ‘gold standard’ for neonatal infection detection. Low neonatal blood culture use hampers appropriate antibiotic use, fuelling antimicrobial resistance (AMR) which threatens newborn survival. This study analysed the gap between blood culture use and antibiotic prescribing in hospitals implementing with Newborn Essential Solutions and Technologies (NEST360) in Kenya, Malawi, Nigeria, and Tanzania.

Methods: Inpatient data from every newborn admission record (July 2019–August 2022) were included to describe hospital-level blood culture use and antibiotic prescription. Health Facility …

Access To Pediatric Neurology Training And Services Worldwide:A Survey By The International Child Neurology Association, Jo M Wilmshurst, Coriene Catsman- Berrevoets, Donald L. Gilbert, Lakshmi Nagarajan, Pauline Samia, Esra Serdaroglu Serdaroglu, Chahnez Triki, Jorge Vidaurre, Biju Hameed

Paediatrics and Child Health, East Africa

Pediatric neurology is the medical subspecialty responsible for diagnosing and managing diseases and disorders of the nervous system in childhood and adolescence. In many, but not all, regions of the world, the discipline of pediatric neurology is recognized as a specialty or subspecialty of either neurology or pediatrics. Significant knowledge and competencies in this area are necessary to be effective in clinical practice. The need for this is driven by the high burden of disease from neurologic conditions in children and the effect on their families. As the first part of a multistaged project under the auspices of the International …

Can Machine Learning Methods Be Used For Identification Of At-Risk Neonates In Low-Resource Settings? A Prospective Cohort Study, Babar S. Hasan, Zahra Hoodbhoy, Amna Khan, Mariana Nogueira, Bart Bijnens, Devyani Chowdhury

Department of Paediatrics and Child Health

Introduction: Timely identification of at-risk neonates (ARNs) in the community is essential to reduce mortality in low-resource settings. Tools such as American Academy of Pediatrics pulse oximetry (POx) and WHO Young Infants Clinical Signs (WHOS) have high specificity but low sensitivity to identify ARNs. Our aim was assessing the value of POx and WHOS independently, in combination and with machine learning (ML) from clinical features, to detect ARNs in a low/middle-income country.
Methods: This prospective cohort study was conducted in a periurban community in Pakistan. Eligible live births were screened using WHOS and POx along with clinical information regarding pregnancy …

Experiences Of Indigenous Women With Maternal Nutrition In Climate Change (Cold Weather) In Rural Bajaur, Khyber Pakhtunkhwa, Pakistan: Implications For Maternal-Infant Health, Ihsan Ullah

Theses & Dissertations

Background: Pakistan is one of the countries that is most susceptible to the effects of climate change. The country’s Northern regions have experienced several extreme cold weather events, including floods, heavy snowfall, and heavy rains, in recent years, significantly impacting maternal and infant health. Indigenous child-bearing age women in the northern rural areas are the most vulnerable populations experiencing food insecurity, disruptive food systems, increasing food prices, and disrupting food production due to climate change exacerbation.
Aim of the study: The study aimed to explore the experiences of indigenous women with maternal nutrition in harsh winter caused by climate change …

World Allergy Organization (Wao) Diagnosis And Rationale For Action Against Cow's Milk Allergy (Dracma) Guidelines Update – X – Breastfeeding A Baby With Cow's Milk Allergy, Vicki Mcwilliam, Merryn Netting, Evelyn Volders, Debra Palmer, Ignacio Ansotegui, Stefania Arasi, Amal H. Assa'ad, Sami L. Bahna, Antonio Bognanni, Rose Kamenwa

Paediatrics and Child Health, East Africa

Cow’s milk allergy is rare in exclusively breastfed infants. To support the continuation of breastfeeding an infant after diagnosis with a cow’s milk allergy, it is critical to examine the evidence for and against any form of cow’s milk elimination diet for lactating mothers. In this narrative review, we highlight the lack of high-quality evidence, hence subsequent controversy, regarding whether the minuscule quantities of cow’s milk proteins detectable in human milk cause infant cow’s milk allergy symptoms. Current clinical practice recommendations advise a 2–4 week trial of maternal cow’s milk dietary elimination for: a) IgE-mediated cow’s milk allergy only if …

Nursing Faculty Perspective On Simulation Based Education: A Qualitative Exploratory Study At Public And Private Nursing Schools In Karachi, Pakistan, Saira Mehboob Ali Lalani

Theses & Dissertations

Background: Simulation-based education (SBE) provide novice and proficient student nurses a platform to learn and practice skills in a simulated environment, to become safe and competent nurses. This pedagogy is especially beneficial for those studying healthcare-related domains, as it permits students to gain hands-on expertise that is much more real and facilitating than the traditional methods of teaching. The role of nursing faculty is crucial in this process. Purpose The purpose of this study was to investigate the perceptions of nursing faculty members regarding SBE, as well as the facilitators and barriers of SBE.
Research Methods: An exploratory qualitative research …

Stress And Its Associated Factors In Mothers With Preterm Infants In A Private Tertiary Care Hospital Of Karachi, Pakistan, Salima Akbar

Theses & Dissertations

Background: Preterm births are the leading cause of death worldwide. Preterm births not only have devastating effects on the new born, but they also have psychological effects on the mothers. Identifying stress related to preterm births, and the factors associated with the stress among mothers with preterm infants is of great importance, for providing sound care to the newborns and their mothers. This study aimed to assess the level of stress and the factors associated with increased level of stress among mothers with preterm infants, in a tertiary care hospital in Karachi, Pakistan.
Purpose: The study aimed to answer the …

Experiences Of Sexual And Reproductive Health Among Women Undergoing Haemodialysis In Pakistan: A Descriptive Phenomenological Study, Misbah Zafar

Theses & Dissertations

Background: Sexual and reproductive health is an essential component of a woman’s life that includes respectful and satisfying sexual relationships without coercion and violence, as well as couples' decisions about whether and when to have children. Reproductive-age women undergoing haemodialysis experience numerous sexual and reproductive health challenges as a consequence of their physical and psychological health conditions, negatively impacting their overall well-being. However, they are reluctant to seek assistance from healthcare professionals despite having many sexual and reproductive health issues. Concerning this, it was necessary to explore in-depth, the phenomenon of lived experiences of sexual and reproductive health among reproductive-age …

The Knowledge, Experiences, And Barriers Associated With Male Involvement In Family Planning At Lal Qila, District Dir (Lower), Kpk, Pakistan: A Descriptive Exploratory Study, Jalal Khan

Theses & Dissertations

Background: Pakistan is one of the world’s most populous countries with a high growth rate. The overgrowth in population negatively affects the country’s socioeconomic progress in many aspects, like education, housing, employment, and health. Family Planning (FP) is the best way to reduce the fertility rate and control population overgrowth through contraception. FP positively impacts the mother's health and the productive results of every pregnancy.
Purpose: This study aims to explore the knowledge, experiences, and barriers associated with male involvement in family planning.
Method: A qualitative exploratory design was used with a purposive sampling technique to explore the perceptions of …

Concept Of Health-Related Quality Of Life Among People With Heart Failure In Karachi, Pakistan, Anny Ashiq Ali

Theses & Dissertations

Background: Non-communicable diseases (NCDs), including cardiovascular diseases, are a leading cause of global mortality. The mortality rate for cardiovascular diseases is on the rise, with 80 % to 86 % of fatalities, particularly in low- and middle-income countries, including Pakistan. Among NCDs, heart failure (HF) is a condition for which there is no cure, and patients rely on supportive treatments to maintain their quality of life. HF not only affects physical well-being but also has far-reaching consequences on the emotional, social, and cognitive aspects of life. In the context of Pakistan, where unique healthcare, sociocultural, and economic factors prevail, the …

Nurses’ Perceptions Regarding The Use Of The Nursing Process; A Descriptive Qualitative Study At Hayatabad Medical Complex, Peshawar, Pakistan, Kashif Khan

Theses & Dissertations

Background: The Nursing Process (NP) is a comprehensive approach to care, integrating nursing intuition, goal-oriented tasks, patient-centered care, critical thinking, and evidence-based practice (EBP). It aims to enhance patient outcomes and well-being by identifying, treating, and preventing health problems. Widely acknowledged as a valuable instrument in healthcare, it emphasizes the crucial function of nursing. This study fills the gap in the literature by exploring nurses' perspectives on the utilization of the NP in Pakistan.
Purpose: The study aimed to explore nurses' perceptions regarding the use of the nursing process and to identify the barriers and facilitators to its implementation in …

Antimicrobial Resistance And Rational Prescription Practices: Knowledge, Perceptions And Confidence Of Health Profession Interns In Uganda, Shamim Nabidda, Rogers Ssennyonjo, Joseph Atwaru, Andrew Marvin Kanyike, Shiellah Baryayaka, Kennedy Pangholi, Jonans Tusiimire

School of Nursing & Midwifery, East Africa

Background

Antimicrobial resistance (AMR) is significantly driven by misuse and overuse of antibiotics. Graduate health profession interns often prescribe antimicrobials under minimum supervision.

Objectives

This study explored the knowledge, perceptions and confidence of health profession interns in Uganda regarding AMR and rational prescription practices.

Methods

This was a cross-sectional survey employing quantitative techniques carried out between October and November 2022 at six tertiary hospitals in Uganda. Health profession interns including doctors, nurses, midwives and pharmacists were recruited as study participants. Data were collected using online Kobo toolbox software. Data analysis was performed using STATA (StataCorp) version 16. Bivariate analysis and …

Differences In Symptom Severity And Quality Of Life Among Patients With Cancer Using Conventional Therapies With/Without Herbal Medicines In Uganda: A Cross-Sectional Study, John Baptist Asiimwe, Prakash B. Nagendrappa, Alfred Jatho, Maud M. Kamatenesi, Esther C. Atukunda

School of Nursing & Midwifery, East Africa

Objective:

Patients with cancer experience numerous symptoms related to cancer and treatment side effects that reduce their quality of life (QOL). Although herbal medicine (HM) is used to manage such symptoms by patients in sub-Saharan Africa, data on patients perceived clinical outcomes are limited. We compared differences in QOL and symptom severity between patients with cancer using HM plus conventional therapies (i.e., chemotherapy, hormonal therapy, radiotherapy, surgery) and those using conventional therapies alone.

Methods:

This cross-sectional study included patients with cancer aged >18 years who were consecutively sampled and completed a researcher-administered questionnaire between December 2022 and January 2023. Specifically, …

Burnout And Its Impact On Nurses And Doctors, Zahra Tharani, Abeer Musaddique, Syeda Humera Qutb

School of Nursing & Midwifery

No abstract provided.

Seeds Of Trust Ripe As Luscious Fruits: Faculty Mentorship Forum At Aga Khan University Medical College, Rehana Rehman, Rahila Ali, Saira Khalid, Tazeen Saeed Ali

Department of Biological & Biomedical Sciences

Background & objective: Faculty members require mentoring in all stages of their professional development. Aga Khan University (AKU) has initiated mentorship programs for students and faculty at AKU Medical College (AKU- MC) and AKU School of Nursing and Midwifery (AKU-SONAM). This study aimed to explore perceptions of mentors, mentees, administrators (chairs, co-chairs, founder members and coordinators of the mentoring program) and leadership and further investigate the strengths and challenges faced by 'Faculty Mentorship Program' at AKU- MC.
Methods: We conducted a qualitative exploratory study from February till December 2021 after approval from AKU using purposive criterion sampling. Mentors, mentees, administrators …

Stop-Bang Questionnaire For Screening Obstructive Sleep Apnea Syndrome Among Hypertensive Patients In Kenya, Salim Abdallah, Jasmit Shah, Jumaa Bwika, Sayed Karar

Internal Medicine, East Africa

Introduction: Obstructive sleep apnea (OSA) is a type of breathing problem during sleep caused by the blockage of the upper airway, which can cause cessation of airflow. There is limited research on the prevalence of OSA in hypertensive patients in sub-Saharan Africa (SSA). The study aimed to describe the prevalence and clinical characteristics of OSA among hypertensive patients at a tertiary hospital in Nairobi, Kenya.

Methods: This cross-sectional study was conducted at the Aga Khan University Hospital in Nairobi, Kenya. Two hundred and fifty-one hypertensive patients were screened for OSA risk using the STOP-Bang questionnaire (SBQ). Patients with a SBQ …