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- ItemManagement of postoperative pain by nurses at the University Teaching Hospital, Kitwe Central Hospital, Levy Mwanawasa and Chipata General Hospital(The University of Zambia, 2014) Chirwa, Medayi;Post-operative pain management is of great importance to the patients' outcome. The better the management the more the benefit to the patient and the hospital. Benefits such as patient satisfaction, low hospital costs, reduced hospital stay and decreased complications. Effective pain management also ensures good healing process and decreases the morbidity from nosocomial infections.The main objective of this study was to explore nurses management of post-operative pain related to major surgery pain at The University Teaching Hospital, Levy Mwanawasa General, Chipata General and Kitwe Central Hospitals in Zambia.In this study, it was hypothesized that there was an association between post-operative pain management an<* nurses' knowledge and attitude.A quantitative non-interventional descriptive design was used. The study was conducted at University Teaching Hospital (UTH), Levy Mwanawasa General Hospital, Chipata General Hospital and Kitwe Central Hospital in Zambia. The study population comprised Enrolled, Registered and Bachelor of Science Nurses working in Obstetric and Surgical Wards. A non-probability purposive homogeneous sampling was used. The sample size for the whole study was 200 respondent's however, only 174 agreed to participate. For data collection, a self-administered questionnaire was used. The data was analysed electronically using SPSS Version 16.0., and to determine associations between variables Chi square test of association was performed.In this study not all the independent variables were significantly associated with post-operative pain management. It was found that there was no association between attitude and post-operative pain management (p-value 0.58). However, there was an association between knowledge and post-operative pain management (p-value 0.00). Majority 77 (88.7%) of the respondent's who showed that they had a positive attitude 92 (52.9%) did not manage post-operative pain adequately. Of those who had a negative attitude only 16 (19.5%) managed post-operative pain adequately. Therefore, having a positive or negative attitude was not a factor in managing post¬operative pain adequately.Out of a total of 174 respondent's only 44 (25.3%) representing less than quarter had high knowledge on post-operative pain management and 45 (25.9%) had medium knowledge. The Majority 85 (48.9%) accounting for almost half of the total respondent's had low knowledge. In all the knowledge levels the majority did not adequately manage post-operative pain, accounting for 29 (65.9%), 34 (75.6%), 80 (94.1%) of those with high, medium and low knowledge on post¬operative pain management respectively.In conclusion the researchers found that there is under-management of post-operative pain in health institutions, which is due to nurses not having adequate knowledge on the subject. In order to adequately manage post-operative pain nurses knowledge with regards to post-operative pain management should be improved.Based on our study findings, main recommendations made to the Ministry of Health and Ministry of Community Development Mother and Child Health, General Nursing Council of Zambia and the hospitals were to facilitate learning of the nurses' involved in caring for post¬operative patients, formulate policies which will facilitate effective and efficient delivery of post¬operative care to patients and they should also make medical and surgical supplies necessary for the management of post-operative pain readily available.
- ItemA study to determine factors contributing to underutilization of postnatal care services in monze, choma, chikankata and chongwe districts(The Universirty of Zambia, 2013-06-12) Sicheeba, M. C.The Postnatal period or puerperium begins one hour after delivery of the placenta and continues until six weeks after birth during which the mother undergoes a transitional period of recovery from physiological changes of pregnancy, trauma of labour and delivery. During this period, care is provided to the mother and her newborn in order to promote healthy behaviours such as infant feeding, and to identify and manage complications if and when they arise.Research has indicated that postnatal mothers are underutilising postnatal care services due to various factors. The aim of the study was to determine factors related to underutilisation of postnatal care services in the four district of Zambia namely; Chongwe, Monze, Choma and Chikankata. The relevant literature review was on global, regional and national level.The theoretical framework that guided the study was on knowledge of utilisation of postnatal care services, attitude and cultural beliefs towards utilisation of postnatal care services.This quantitative descriptive study using a cross section design involved consenting mothers who attended postnatal care services between six days and six week after delivery. The respondents were chosen using convenient sampling method. Data was collected from 200 mothers, 50 from each district. A semi structured interview schedule was used to collect data from the respondents and data was analysed using Statistical Package for Social Sciences Version 16.0 and a scientific calculator. Chi square test was used to describe the relationship between attendance and knowledge on postnatal care services, age, parity, educational level and, socio cultural practices including relationship between waiting time and staff attitude.The study results indicate that 32.5% (65) were aged between 15 and 19 years, 51% (102)were housewives, 70.5% (141) had 1 -3 children and 50% (100) had attained secondary school education. The study revealed high knowledge of postnatal care services among mothers (68%). 87.5% of mothers had heard about postnatal care services and the majority 93% heard from health professionals. However, mothers' main reason for attending postnatal clinic was to have their infants immunised 71%. Another major finding was that 77.5% of mothers delivered their youngest child at the health institution, 80.7% were advised to attend postnatal clinic by the health provider but only 52% attended postnatal clinic at six days and six weeks.Most mothers, 52.5%, who attended postnatal care services were not examined by a health professional. Of the 95 who were examined, 47.4% were not adequately examined. Most mothers 43% lived within 2km from the health facility and did not incur any cost to access the health facilities and 96% were pleased with reception of the health professional at the health facility.Regarding socio cultural practices most mothers stated that they observed some socio cultural practices 51.5% and mainly practiced seclusion during puerperium 73.1%.The current study showed a signficant association between the mothers' knowledge levels and attendance of postnatal clinic (P Value 0.000) as well as waiting time and staff attitude (P value 0.003). Based on the results of the study it was recommended that the Ministry of Health should develop or formulate protocol guidelines on the components of Information, Education and Communication on postnatal care in order to improve on the quality and content of information, Education Care to be given to mothers. The Ministry of Health should also intensify on conducting refresher courses for health care providers so as to keep them abreast with new trends in health care delivery. The District Health Management Teams/Hospital management should improve on supervision of health care provision in the health centres to ensure that improved and updated standards of care are offered.
- ItemFactors associated with Elevated Plasma levels of Liprotein (a) in indegenous black Zambians with Diabetes Mellitus type 2 in the outpatient medical clinic at the University Teaching Hospital,Lusaka,ZambiaSinyani, AngelaIntroduction: Diabetes mellitus (DM) is an established risk factor for cardiovascular disease (CVD) and is considered to be a CVD equivalent. Lipoprotein(a) [Lp(a)] is an independent risk factor for cardiovascular diseases. Since Diabetes Mellitus Type 2 (T2DM) patient numbers continue to rise, and since patients continue to present with cardiovascular disease-related complications, it is possible that some of these patients have high plasma levels of Lp(a). The aim of the study was to investigate the plasma levels of Lp(a) in T2DM patients and also to assess the factors that may be associated with the plasma levels of Lp(a) among indigenous black Zambians with T2DM. Materials and methods: We conducted a cross sectional study that enrolled 155 participants, 79 T2DM patients attending the outpatient medical clinic of the University Teaching Hospital and 76 community-based healthy individuals. A short questionnaire was used to record the social demographic characteristics and anthropometric measurements. 4ml of venous blood was collected from which all the analytes were measured. The factors that were assessed for association with Lp(a) included; social demographic characteristics, social economic status, duration of illness, dietary composition, physical fitness, BMI, fasting blood sugar (FBS), renal function, hepatic function, acute phase response, lipid profile, and glycaemic control. Therefore the variables that were measured were as follows; Age, sex, marital status, occupation, residence, dietary fat content, dietary carbohydrate source, dietary protein source, frequency of exercise, BMI, FBS, ALT, urea, creatinine, C-reactive protein, Triglycerides, total cholesterol, low density lipoprotein, high density lipoprotein, HbA1c and lipoprotein(a) respectively. The data were expressed as median (interquartile range). The Mann-Whitney U test was used to compare the median values between the two groups of the study participants (Diabetics and healthy individuals) for continuous variables, the Wilcoxon rank-sum test or Kruskal-Wallis test for the ordinal data whereas the Chi-squared test was used to compare the proportions for the nominal data. SPSS version 21(IBM) was used to perform a multiple linear regression analysis to identify the *9/et of variables that would best predict the plasma levels of Lp(a) Results: The median plasma levels of Lp(a) in the diabetics (20.0 (11.8-37.4)mg/dl) was significantly higher (p<0.001,) than the healthy individuals (13.6 (9.4-21.5)mg/dl). 17 % of the diabetics had plasma levels of Lp(a) higher than 30 mg/dl. Of all the independent variables assessed, the results showed that glycemic control (HbA1c), FBS (glucose) triglycerides and residence were significant (p<0.001, p=0.030, p=0.040, p= 0.004 respectively) predictors of plasma levels of Lp(a). The linear relationships showed that the plasma levels of Lp(a) had a positive relationship with HbA1c (r=5.220) and FBS (r=0.660) whereas the relationship with triglycerides (r= -4.794) and residence (r= -7.165) were inverse Conclusion: . The plasma levels of Lp(a) in the T2DM patients were significantly higher than the non-diabetic healthy individuals. Glycemic control (HbA1c) , triglycerides (TG), fasting blood glucose (FBS) and social economic status (medium density residence) were predictors of serum levels of Lp(a).
- ItemA study to assess utilization of the nursing process by registered student nurses at Livingstone school of nursing.(2015-10-05) Moonde, Loveness.The main purpose of this study was to assess the utilization of the nursing process by registered nursing students. A descriptive cross section was used to assess the utilization of the nursing process by RN students. Both qualitative and quantitative methods were used. The study was conducted at Livingstone Registered Nursing School situated at Livingstone General hospital in Livingstone city. Livingstone city is situated 480 km south of Lusaka. Fifty respondents were selected from the second and third year students using a quota sampling method. Data was collected through the use of a self-administered questionnaire. Quantitative data was analyzed manually using a data master sheet and a scientific calculator while the qualitative data was analyzed using the content analysis. The quantitative data were presented in the form of frequency tables and pie charts. Cross tabulations were used to identify special relationships between variables. The study revealed that (49, 98%) of the respondents had heard about the nursing process from the classroom lectures while only (25, 50%) had utilized the nursing process.
- ItemKnowledge attitude and practice among nurses towards documentation of fluid balance chart at UTH Lusaka.(2015-10-05) Kalengo, Naomi.The main purpose of the study was to determine the Knowledge, Attitude and Practices among nurses towards the documentation of fluid intake and output chart in clinical areas at University Teaching Hospital in Lusaka. The major hypotheses were (1) the higher the knowledge on fluid balance chart, the better the practice and (2) There is an association between knowledge and practice on importance of documenting the fluid intake and output chart.A non - experimental descriptive cross sectional study was used and a total of 50 nurses were recruited in the study using convenient sampling method and a self administered questionnaire was used for data collection. The respondents in this study were from different departments at the University Teaching Hospital (UTH) such as Peadiatrics, Obstetric/gynaecology, Medical and Surgical departments and Emergency Departments. Coding and editing of data was done after data collection. Data was analyzed manually, findings presented in frequency tables, pie charts and cross tabulations. The results of the study indicated that (60%) of the respondents had high knowledge of fluid balance chart documentation. Majority of the respondents (54%) had a positive attitude towards fluid balance chart documentation. Despite such a scenario the results still indicated that even though the respondents had high knowledge and positive attitude, (80%) of the respondents had an average practice of fluid balance chart documentation. The study findings also revealed that most of the respondents were females (84%), and majority of the respondents (52%) were in the ages 20-29 years.