Medicine
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- ItemUtilization of modified early warning score among ward nurses at Konkola mine hospital, Chililabombwe, Zambia.(The University of Zambia, 2025) Kanyenda, Regina MutolwaBackground: Hospitalized patients, including those in the Intensive Care Unit, often experience clinical deterioration. The Modified Early Warning Score helps healthcare providers monitor patients’ conditions to anticipate serious adverse events. The recognition, response, and treatment of deteriorating patients are essential for improving patient outcomes and reducing unexpected deaths,length of stay, and cost of Intensive Care Unit care. Therefore, improving patient monitoring, using a simple and user-friendly tool like the Modified Early Warning Score system, remains crucial for early detection and prompt treatment to prevent severe adverse effects. Aim: To establish the utilization of Modified Early Warning Score and its associated factors among ward nurses at Konkola Mine Hospital, Chililabombwe, Zambia. Methods: A cross-sectional descriptive study was conducted among 81 randomly selected nurses using simple random sampling. Data were collected using a validated structured questionnaire. All ethical guidelines were upheld. Data was analyzed using SPSS version 27 employing Chi-square and binary logistic regression tests. Results: The study results revealed suboptimal utilization of the Modified Early Warning Score at 68% with significant associations between age group (p= 0.029), gender (p = 0.001), level of education (p = 0.001), training in Modified Early Warning Score (p = 0.001), attitude (p = 0.001), and knowledge (p = 0.001). Training had a significant impact on Modified Early Warning Score utilization as respondents who had not received training were less likely to utilize MEWS compared to those who had received training (AOR = 11.76; 95% CI, 1.34–103.19; p = 0.026). Respondents with a positive attitude towards Modified Early Warning Score were more likely to utilize it compared to those with a negative attitude (AOR = 5.28; 95% CI, 1.08–6.24; p = 0.003). Knowledge was another important predictor, with respondents who had adequate knowledge of MEWS being more likely to utilize it than those with inadequate knowledge (AOR = 3.05; 95% CI, 0.01–0.32; p = 0.002). Conclusion: This study highlights the suboptimal utilization of Modified Early Warning Score among ward nurses, with significant gaps in knowledge and training. The results underscore the need for targeted education and training programs to enhance nurses' understanding and adoption of Modified Early Warning Score, ultimately improving early detection and response to patient deterioration. Addressing these gaps is critical to ensuring the effective implementation of Modified Early Warning Score and enhancing patient safety and outcomes. Keywords: Modified early warning score, utilization, clinical deterioration, intensive care unit
- ItemQuality of life and coping strategies for breast cancer patients who have undergone mastectomy at St Francis Mission hospital in Katete, Zambia.(The University of Zambia, 2025) Zimba, FordsonGlobally, approximately 310,720 new cases of invasive breast cancer were diagnosed in women, with around 56,500 cases of ductal carcinoma. Breast cancer is the most prevalent cancer among women in Africa, with an estimated 198,553 new cases. In Zambia, total number of women diagnosed with breast cancer is 1,111 cases. St Francis Mission Hospital has an average of 5 breast cancer surgery cases monthly Following mastectomy, women experience quality of life in different dimensions. Therefore, quality of life includes patients’ physical, psychological, social, and spiritual aspects of everyday life. Coping strategies in cancer involved were positive affirmation, social interaction and having hope. The study aimed at investigating the quality of life and coping strategies among breast cancer women who have undergone mastectomy. The study employed a qualitative descriptive phenomenological design. In-depth interviews guided by an interview guide were conducted on the 15 participants after attaining data saturation. Thematic analysis was utilized for data analysis using themes generated from participant’s responses. Five themes were identified in this study: physical pain, emotional distress turmoil, social issues after social isolation, psychological journey after surgery and spiritual life. Participant’s experienced impaired quality of life. Physical pain resulted into experiences of fatigue and limited activity hence the participants were unable conduct activities of daily living both at home and their places of work. For emotional distress turmoil had encompassed self-image with low self-esteem because of the mastectomy which had distorted their body image. Social issues after social isolation included personal relationships and employment interferences due to hospital admissions. Psychological journey after surgery ranged from anxiety, fear, and anger. Participants had fear of death and cancer reoccurrence. Positive affirmation as coping strategy showed that the participant had a positive mind and hope that they would still live longer. The study showed that the quality of life was impaired because of the effect on physical, psychological, emotional and social domains. This study recommends provision of psychosocial support programs such as engagement of more cancer support groups for cancer patients. Nursing implication includes implementing an individualised patient-ccare that consider psychological sensitivity and coping strategies that will enhance the overall quality of oncology nursing practice. Key Words: Breast cancer, quality of life and Coping strategies.
- ItemDeterminants of loss to follow up HIV exposed infants in Lusaka, Zambia.(The University of Zambia, 2022) Chemba, RuthIntroduction - Prevention of Mother-To-Child-Transmission (PMTCT) programmes aimed at preventing vertical transmission have been widely implemented in Zambia by the Ministry of Health (MoH). However, many infants are not benefitting from the programmes due to loss to follow up (LTFU) at different points of the PMTCT cascade, with the highest loss occurring at 18 months. This compromises the effectiveness of PMTCT services. The aim of this study was to establish determinants of LTFU infants born to HIV positive women in Lusaka district. Methodology - A descriptive cross sectional study design using a quantitative approach was conducted in three Lusaka Urban District Clinics. The sample size comprised of 160 caretakers of LTFU infants and 25 health care providers. Data from caretakers were collected using a semi-structured questionnaire while that from healthcare workers were through a self-administered semi-structured questionnaire. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22.0 and presented using frequency tables, bar charts, and cross tabulations. Logistic regression was used to test associations between the dependent and independent variables. The cut off point for statistical significance was set at 5%. P-values of 0.05 or less were considered statistically significant. Results - The finding showed that 42.4% caretakers were not aware that they needed to continue with follow up care, while 28.0% stated forgetting taking their infants for follow up care. The results further showed that the association between gender of caretaker [OR 0.252 (1.101-0.633) p-value 0.003], relationship between caretaker and infant [OR 0.592 (0.699-0.189) p-value 0.003], staff attitude [OR 10.012 (4.194-23.947) p-value 0.003], prophylaxis given at birth [OR 0.299 (0.131-0.684) p-value 0.004], and place of birth [OR 2.324 (1.050-5.143) p-value 0.037] and LTFU were statistically significant. Binary logistic regression indicated that association between gender of caretaker [OR 0.4 (CI, 0.287-0.966) p-value-0.040], negative staff attitude [OR-2.7 (1.050-5.114) p-valu-0.047] and waiting time [OR 0.7 (CI-0.314-5.665) p-value-0.003] and LTFU were also statistically significant. Conclusion - The results suggest that change in staff attitude and improvement in waiting time can reduce chances of loss to follow up care. Therefore, the study recommends that clinics should come up with an easy appointment scheduling process to help reduce waiting time for follow up care clients; such as providing a specific appointment time.
- ItemParental satisfaction with quality of neonatal care services provided at Kamuzu Central hospital, Ethel Mutharika nursery unit, in Lilongwe, Malawi.(The University of Zambia, 2025) Mkandawire, Mary ChibayaParental satisfaction with neonatal care is a crucial indicator of the quality of neonatal care standards. Satisfied parents comply with treatment and help reduce readmission and neonatal mortality. This study aimed to determine levels and factors associated with parental satisfaction at the Kamuzu Central Hospital, Ethel Mutharika Nursery Unit, Lilongwe, Malawi. An institutionbased cross-sectional study was conducted among 250 systematically selected parents who had neonates admitted for at least 48 hours. The satisfaction was measured using an adopted EMPATHIC-N questionnaire which was translated to a local language (Chichewa) and pre-testing of the instruments was done. The collected data was exported and analyzed using SPSS version 22. Descriptive statistics were done. Chi-Square and Fisher’s Exact test were used to identify factors associated with satisfaction. Finally, Multiple Binary Logistic regression analysis was used to predict the associations and Spearman Rank assessed the correlations. All statistical tests were set at 5% significance level. The research results indicates an overall parental satisfaction of 68%. The highest satisfaction was reported in the care and treatment domain 99.2%, lowest score in information domain 88.8%, parental participation and professional attitude domains both had 98.8% and organization had 98.4%. Tribe, health condition of neonate and admission ward were factors associated with parental satisfaction with neonatal care. Chewa Tribe, income below poverty line and admission in separated ward were important in predicting parental satisfaction. In conclusion, parental satisfaction with neonatal care services was recorded at 68%, reflecting a moderate level of contentment. Based on the findings, there is need to enhance communication, cultural sensitive care, equality and overall parental satisfaction levels in the neonatal unit. Key words: Parents satisfaction, neonatal care, quality care, family centered care.
- ItemChallenges to accessibility of emergency medical services among rural residents in the Otse cluster, Mahalapye district, Botswana.(The University of Zambia, 2025) Morake, KesegoEmergency Medical Services (EMS) are essential for timely medical intervention and improved patient outcomes, yet access to these services remains limited in rural settings. In Botswana's Otse Cluster, Mahalapye District, rising mortality rates and delayed emergency care highlight potential challenges in EMS accessibility. This study aimed to explore the challenges affecting accessibility to EMS among rural residents in the Otse Cluster to identify factors contributing to service delays and propose potential strategies to improve equitable emergency care delivery. A qualitative descriptive approach was employed, using purposive sampling to select participants with relevant knowledge of EMS challenges. Data were collected through ten focus group discussions (FGDs) involving 89 rural residents and five unstructured interviews with healthcare providers serving the Otse Cluster. The sample size was determined by data saturation, ensuring that the information gathered was rich and comprehensive. Data were coded using ATLAS.ti software and analysed thematically. The study findings revealed three main themes: infrastructure and resource constraints, community awareness and education, and strategies to improve EMS accessibility, supported by eight subthemes including staff and supply shortage, poor transport and communication networks and limited public knowledge of EMS. The findings expose systemic and multifaceted barriers to EMS access, suggesting that targeted policy reforms, infrastructure improvements, community engagement, and innovative low-cost EMS solutions are necessary to enhance emergency healthcare delivery and reduce preventable deaths in Botswana. Keywords: Emergency Medical Services, rural healthcare, access to care, Otse Cluster, Mahalapye District, Botswana, community perceptions, challenges.