Nursing Commons^™

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 …

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 …

Improving Nursing Documentation Via Reducing The Written Work Load, Anaiz Ahmed Khowaja, Nasreen Rafiq

School of Nursing & Midwifery

With the growth in the health care industry around the world and introduction to new technologies in the system, the uses of traditional methods in nursing practices are reducing. These modern work practices are meant to reduce human effort without compromising on the quality. Where as dealing with documentation whereas always has been a major challenge in providing the better health care. The project thus outlines the improving nursing documentation via reducing the written work load to increase work efficiency.

Structured On-The-Job Training To Improve Retention Of Newborn Resuscitation Skills: A National Cohort Helping Babies Breathe Study In Tanzania, Mary Drake, Dunstan R. Bishanga, Akwila Temu, Mustafa Njozi, Erica Thomas, Victor Mponzi, Lauren Arlington, Georgina Msemo, Mary Azayo, Allan Kairuki, Amunga R. Meda, Kahabi Isangula, Brett D. Nelson

School of Nursing & Midwifery, East Africa

Background: Newborn resuscitation is a life-saving intervention for birth asphyxia, a leading cause of neonatal mortality. Improving provider newborn resuscitation skills is critical for delivering quality care, but the retention of these skills has been a challenge. Tanzania implemented a national newborn resuscitation using the Helping Babies Breathe (HBB) training program to help address this problem. Our objective was to evaluate the effectiveness of two training approaches to newborn resuscitation skills retention implemented across 16 regions of Tanzania.

Methods: An initial training approach implemented included verbal instructions for participating providers to replicate the training back at their service delivery site …

Patterns And Outcomes Of Paediatric Trauma At A Tertiary Teaching Hospital In Kenya, Anthony Ndung'u, Jared Sun, Joan Musau, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction: Trauma continues to be a major cause of morbidity and mortality especially in the paediatric population of low- and middle-income countries such as Kenya. The aim of this study was to establish the profile and outcomes of admitted paediatric trauma cases at the Aga Khan University Hospital, Nairobi.

Methods: This retrospective, descriptive study involved a 12-month chart review (January 2016–December 2016). A total of 218 records were identified of which 144 were reviewed.

Results: Most injuries were amongst boys (65.3%) and the very young (mean age 6), occurred in private residences (42.4% homes, 25.7% residential institutions), were typically caused …

Turnover Propensity Among Nurses In Pakistan: Overview And Management, Anaiz Ahmed Khowaja, Nasreen Rafiq, Fazal Rabi, Nazia Merchant, Neelam Rafiq, Sanam Zulfiqar

School of Nursing & Midwifery

Human resource management is an important stake of health care systems. Today, the increase in the burden of diseases has increased the demands of health care professionals in particular Nurses who are the key assets to these agencies. Unfortunately, there is a huge difference between the numbers of nurses between developed and developing countries. Various databases were used to identify this gap, rationales behind its existence and recommendations to improve it.

Nurse-Identified Patient Care And Health Services Research Priorities In The United Arab Emirates: A Delphi Study, Nabeel Al-Yateem, Muna Al-Tamimi, Maria Brenner, Hanan Al Tawil, Alaa Ahmad, Sharon Brownie, Shameran Slewa-Younan

School of Nursing & Midwifery, East Africa

Background: The need for improved research on ill health has been recognized internationally and locally in the United Arab Emirates (UAE). The UAE Nursing and Midwifery Council recently committed to enhancing the status and contributions of nursing in healthcare research across the UAE by establishing a National Committee for Research Development. This study using a Delphi method to identify research priorities from the perspective of nurses delivering frontline healthcare.

Methods: A two-phase Delphi design was implemented with 1032 nurses participating in phase one of the study and 1339 in phase two.

Results: The most important priority was patient safety and …

Growing Evidence For The Impact Of Air Pollution On Depression, Naureen Akber Ali, Adeel Khoja

School of Nursing & Midwifery

No abstract provided.

Tanzanian Mothers’ Cultural Beliefs And Misinformation Regarding The Reasons For Their Cesarean Sections, Victor Mathias, Eleanor Holroyd, Grace Edwards

School of Nursing & Midwifery, East Africa

Background: In Tanzania, cesarean section (CS) rates have been steadily increasing, yet little is known about mothers’ understanding of the medical rationale for their CSs.

Aim: To identify mothers’ cultural understandings of the rationale for their CSs.

Methods: Design: A qualitative descriptive design was employed.

Setting: A government hospital in the western region in Tanzania.

Participants: A total of 117 mothers were interviewed using convenience sampling post CS.

Findings: Forty percent of the mothers were younger than 18 years, with more than 50% having had five or more live babies. Among multigravida women, 40.2% had had one or more previous …

Missed Nursing Care In Newborn Units: A Cross-Sectional Direct Observational Study, David Gathara, George Serem, Georgina A. V. Murphy, Alfred Obengo, Edna Tallam, Debra Jackson, Sharon Brownie, Mike English

School of Nursing & Midwifery, East Africa

Background: Improved hospital care is needed to reduce newborn mortality in low/middle-income countries (LMIC). Nurses are essential to the delivery of safe and effective care, but nurse shortages and high patient workloads may result in missed care. We aimed to examine nursing care delivered to sick newborns and identify missed care using direct observational methods.

Methods: A cross-sectional study using directobservational methods for 216 newborns admitted in six health facilities in Nairobi, Kenya, was used to determine which tasks were completed. We report the frequency of tasks done and develop a nursing care index (NCI), an unweighted summary score of …

Acquiring Knowledge About The Use Of A Newly Developed Electronic Fetal Heart Rate Monitor: A Qualitative Study Among Birth Attendants In Tanzania, Sara Rivenes Lafontan, Johanne Sundby, Hussein Kidanto, Columba Mbekenga, Hege L. Ersdal

School of Nursing & Midwifery, East Africa

In an effort to reduce newborn mortality, a newly developed strap-on electronic fetal heart rate monitor was introduced at several health facilities in Tanzania in 2015. Training sessions were organized to teach staff how to use the device in clinical settings. This study explores skilled birth attendants’ perceptions and experiences acquiring and transferring knowledge about the use of the monitor, also called Moyo. Knowledge about this learning process is crucial to further improve training programs and ensure correct, long-term use. Five Focus group discussions (FGDs) were carried out with doctors and nurse-midwives, who were using the monitor in the labor …

The Politics Of Abortion And Maternal Health: A Discussion Paper, Ihsan Ullah, Ayaz Ayub, Edwin Van Teijlingen

Journal of Asian Midwives (JAM)

Abortion should be legally allowed for women because it can save mothers from childbirth-related complications and death. Legal abortion is one of the safest methods to terminate a pregnancy when there is a risk to the mother’s health by childbirth or severe deformity of the fetus or it is unwanted. Unfortunately, approximately half of all abortions worldwide mostly in nations where abortion is severely restricted and are performed in dangerous settings. These risky abortions are a significant contributor to maternal morbidity and disability. Limiting a woman's access to an abortion does not stop abortion; rather, it just encourages more risky …

Routine Episiotomies Without Consent, Komal Abdul Rahim, Nasreen Rafiq

School of Nursing & Midwifery

No abstract provided.

Effect Of Psychological Distress On The Emerging Cause Of Infertility, Faiza Kausar

Journal of Asian Midwives (JAM)

Background: Infertility is a growing issue of the recent era, and it represents significant crises for most couples. Psychological distress has often been suggested as a cause of unexplained infertility. Male infertility accounts for 40% of all infertility problems, while female infertility accounts for 40% of all infertility problems; others are unexplained. Previous studies have indicated that stress and depression negatively impact various infertility parameters in both partners. To determine the relationship between infertility and psychological distress and the level of different types of stress among infertile couples, and to relate the significant stressors responsible for worsening infertility or …

Labor Companionship: A Concept Of Doula Care, Arisha Amin, Rabab Vadivala

Journal of Asian Midwives (JAM)

A labor companion is a person who offers consistent individualized support to laboring women. Doula care is defined as the care which an individual provides of physical, social, and emotional support during pregnancy, labor, birth, and the postnatal period (1). Doulas help women ease their anxiety, and pain and address their concerns with comfort, care, and respect. Doulas help in cherishing a mother and child bonding helps in initiate breastfeeding and provide an emotional bond throughout the birthing time. It helps in reducing cesarean sections, and high-risk pregnancies and minimizes infant and maternal mortalities. The purpose of the study is …

Nursing & Midwifery: The Key To The Rapid And Cost Effective Expansion Of High Quality Universal Healthcare, Nigel Crisp, Sharon Brownie, Charlotte Refsum

School of Nursing & Midwifery, East Africa

Nurses and midwives play a central role in all health systems. They support people in every aspect of their health and wellbeing – from health promotion to chronic disease management and specialist services. Together they make up half of the professional health workforce globally and account for about 90 percent of the contacts between patients and health professionals. This report argues that countries that invest in and develop their nursing and midwifery workforce can achieve a rapid, cost-effective expansion of high-quality UHC. This will also help to realize the World Health Assembly (WHA) target of 1 billion more people benefiting …

Nursing And #Metoo, Nasreen Rafiq, Shyrose Sultan, Afsheen Hirani, Samreen Verasiya, Zainish Hajani, Neelam Rafiq

School of Nursing & Midwifery

The year 2018 revealed a number of sexual harassment stories into public conversation as part of the #MeToo movement. The campaign has relatively spread across all professions and work industries. Today, the society is already hypersensitive towards sexual talks, and the campaigns such as #MeeToo make it even more difficult to overlook these stories; it has challenged the demarcation of important and superfluous accusations which gives rise to various ethical dilemmas. Therefore, the #MeToo movement becomes significant to evaluate both sides of a coin, and assess a situation from various ethical paradigms in order to reach an ethically acceptable solution.

The Intersection Of School Corporal Punishment And Associated Factors: Baseline Results From A Randomized Controlled Trial In Pakistan, Hussain Maqbool Ahmed Khuwaja, Rozina Karmaliani Professor, Judith Mcfarlane, Rozina Somani, Saleema Gulzar, Tazeen S. Ali, Zahra Shaheen Premani, Esnat D. Chirwa, Rachel Jewkes

School of Nursing & Midwifery

Violence against youth is a global issue; one form of youth victimization is school corporal punishment. We use baseline assessments from a cluster randomized controlled trial to examine the prevalence of school corporal punishment, by gender, and the relationship to levels of peer violence at school, parent corporal punishment, youth food security and youth academic performance and school attendance in Pakistan. Forty homogenous public schools in the urban city of Hyderabad, Pakistan were chosen for randomization into the trial evaluating a youth violence prevention intervention. 1752 6th graders, age 11-14 years, were selected as the target population. Since schools are …

Comparison Of Undergraduate Educational Environment In Medical And Nursing Program Using The Dreem Tool, Salima Farooq, Rehana Rehman, Mehwish Hussain, Jacqueline Maria Dias

School of Nursing & Midwifery

Introduction: Educational environment (EE) in a health educational institute can bring about an enduring impact on the students' motivation, knowledge, critical thinking along with their social life. Therefore, identifying strengths and the need for change in the education environment is vital for the enhancement of the students' learning.
Objective: This study aimed to compare the perceptions of nursing and medical students about their EE in a private university, Karachi Pakistan.
Methodology: Data from two cross-sectional studies of 884 students from both medical and nursing schools of Aga Khan University was acquired and analyzed. EE was measured by …

“I Should Have Started Earlier, But I Was Not Feeling Ill!” Perceptions Of Kalenjin Women On Antenatal Care And Its Implications On Initial Access And Differentials In Patterns Of Antenatal Care Utilization In Rural Uasin Gishu County Kenya, Roselyter Riang’A, Anne Nangulu, Jacqueline Broerse

Population Health, East Africa

Aim: The aim of this study was to explore how Kalenjin women in rural Uasing Gishu County in Kenya perceive antenatal care and how their perceptions impede or motivate earlier access and continuous use of antenatal care services.

Methods: A study was conducted among 188 pregnant and post-natal mothers seeking care in 23 rural public health facilities. Gestational age at the initial antenatal care booking was established from their medical cards. Further researcher-administered questionnaire with closed and open-ended questions was used. Key informant interviews with traditional birth attendants (n = 6) and maternal and child health nursing officers (n = …

A Framework For Cyclical Nursing Curriculum Review Across Multi-Site And Multi-Country Campuses, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Cyclical curriculum review and continuous course improvement is an unarguable measure of quality nursing education. Higher education and professional regulators across the Middle East and North Africa (MENA) and African (Afro) regions are increasingly mandating cyclical review within accreditation and programme approval standards. Many nursing education providers in the region operate multi-site and multi-country campuses. A key challenge is to ensure that programmes keep pace with international standards in nursing education, and, that inter-campus drift does not occur in programme content and quality. Cyclical review offers a process whereby programmes can be updated to current best practice and consistent cross-campus …

Supporting The Nationally Mandated Transition To Competency-Based Nursing Curricula In Egypt, Sharon Brownie, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Egypt has a substantive and rich history in nursing education with continuous evolution over many years. A government commitment to further enhance the capacity of the nursing workforce recently required all nursing curricula to be upgraded and presented in a competency-based format. In response to this directive, lead agencies in Egypt, including the Educational Development Fund and the Nursing Sector Group of the Supreme Council of Universities, have garnered internal and external nursing expertise to provide guidance in the curriculum reform process. The authors of this presentation are currently working in close partnership with several Egyptian nursing education providers supporting …

Using Theories And Models For Operationalization Of Patient Trust In Doctors In Chronic Disease Response In Low Income Africa: ‘Best Fit Approach’, Kahabi Isangula

School of Nursing & Midwifery, East Africa

Background: Recent evidence suggest that improved patient trust in doctors can facilitate their healthcare seeking, adherence and continuity with care. With the growing burden of chronic disease in low income Africa (LIA) characterized by challenges of poor patient healthcare seeking, non-adherence and poor continuity with care, trust forms an important entry point for addressing these challenges. However, the topic of trust has generally received weaker attention among researchers in LIA contexts. To date, there has been no attempts to generate a clear guide for theory-driven inquiries as a means of operationalization of trust as a public health lens for chronic …

Setting The Stage: Reviewing Current Knowledge On The Health Of New Zealand Immigrants—An Integrative Review, Blessing Kanengoni, Sari Andajani-Sutjahjo, Eleanor Holroyd

School of Nursing & Midwifery, East Africa

The growth of migrant communities continues to rise globally, creating unique and complex health challenges. Literature on immigrant health in New Zealand (NZ) remains scant. This integrative literature review was conducted drawing on peer-reviewed research articles on immigrant health in NZ published between 2012 and 2018. The objectives were to: (i) provide a critical overview of immigrant health in NZ; (ii) identify general trends in health research conducted in NZ on immigrants; (iii) compare, contrast, and evaluate the quality of the information; (iv) develop a summary of research results and; (v) identify priorities and recommendations for future research. A search …

A Pilot Study Exploring Nursing Knowledge Of Depression And Suicidal Ideation In Kenya, Timothy Muga, Gladys Mbuthia, Samwel Gatimu, Rachel Rossiter

School of Nursing & Midwifery, East Africa

Nurses play key roles in recognizing, diagnosing, managing, and referring persons with mental disorders. This cross-sectional study assessed mental health literacy (depression and suicidal ideation) among nurses in a private urban referral hospital in Kenya. Nurses read a vignette and answered questions regarding diagnosis, treatment/interventions, and related attitudes and beliefs. Thirty-seven nurses (12 males) completed the questionnaire. Three correctly identified the diagnosis and 23 identified depression only. Although 75% noted the symptoms were extremely distressing, fear, and stigma were common reactions. This highlights challenges in mental health promotion/prevention in Kenya, and suggests continuous nursing education and curriculum enhancement is needed.

The Socio-Political Debate Of Dying Today In The United Kingdom And New Zealand: ‘Letting Go’ Of The Biomedical Model Of Care In Order To Develop A Contemporary Ars Moriendi, Rhona Winnington, Eleanor Holroyd, Shelaine Zambas

School of Nursing & Midwifery, East Africa

Death is a reality of life. Despite this inevitability, death today remains unwelcome and has been sequestered into the enclaves of medical practice as a means of quelling the rising tide of fear it provokes. Medical practice currently maintains power over the dying individual, actualised through the selective collaboration between medicine and law as a means of subverting the individual who attempts to disrupt the contemporary accepted norms of dying. There is, however, a shift on the horizon as to whether we can make the notion of a true choice become a reality in New Zealand. This serves to offer …

Health In Surroundings: Application Of The Theory Of Environment In Nursing Practice, Nasreen Rafiq

School of Nursing & Midwifery

Nursing practices are guided by theoretical frameworks which provide functional basis to nursing care. This paper discusses the application of Nightingale’s theory of environment in nursing practices. The theory highlights and explains 13 environmental cannons which include ventilation, cleanliness of walls/rooms, light, noise, personal cleanliness, bed and bedding, and taking food. Florence exquisitely explains the influence of environmental health on patients wellbeing. The application of the theory in nursing practices will help to understand and reflect the direct relation of environment on patients health.

Assessing The Impact Of A Partnership‐Based Work/Study Nursing Upgrade Programme In A Low And Middle‐Income Setting, Sharon Brownie, Samwel Gatimu, Abdul Haq Wahedna, Isabel Kambo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Aim: To evaluate the 15‐years impact of the work‐study nursing upgrading programme in East Africa.

Background: Working nurses in Africa are often primary family income earners, with limited ability to leave jobs and upgrade qualifications. In 2001, the university established a work‐study upgrade programme for enrolled‐ and diploma‐level nurses, allowing them to upgrade their qualifications while continuing to work and support families. Donor partnerships provided scholarships to further increase programme access.

Design: A mixed method design was used involving an online alumni survey and 24 interviews and 23 focus groups with 172 purposively selected representatives of nursing graduates, employers, regulatory …

Knowledge, Attitudes, And Practices Among Nurses In Pakistan Towards Diabetic Foot, Muhammad Bilal, Abdul Haseeb, Abdur Rehman, Mohammad Hussham Arshad, Aashir Aslam, Sana Godil, Saif N. Husain, Mohammad A. Qamar, Muhammad H. Polani, Araib Ayaz, Altamash S. Ghazanfar, Zaki M. Ghazali, Khurram A. Khoja, Maarij Malik, Hania Ahmad

Medical College Documents

Introduction:
Diabetic foot ulcers are a pressing complication of diabetes mellitus. Wound care requires a significant proportion of healthcare resources. It is imperative, therefore, for healthcare professionals to possess sound knowledge of the disease along with a positive attitude to ensure better clinical practice. Our literature search revealed a scarcity of data pertaining to diabetic foot ulcers. Therefore, this study aims to evaluate the knowledge and attitudes of nurses regarding diabetic foot care.
Methods:
A cross-sectional study design was employed, a pre-validated and pre-tested questionnaire was used to collect data from a sample size of 250 nurses working at two …

Physicians’ And Nurses’ Perspectives On The Importance Of Advance Directives In Tertiary Care Hospitals, Nasreen Panjwani, Raisa B. Gul, Fauziya Ali, Robyna Irshad Khan

School of Nursing & Midwifery

Objective: This study aimed to explore and identify the nurses’ and physicians’ views about Advance Directives and identified their perspectives on its importance, in the context of Pakistan.
Methodology: Using a purposive sample, six physicians and seven nurses from two tertiary care hospitals in Karachi participated in the study. Data was collected using semi structured interviews that were transcribed verbatim. The interviews were coded and categorized manually. Analysis of the data drew four categories: roles of physicians and nurses in the End of life care, challenges they faced while taking end of life care decisions; their perspectives about Advance Directives, …