Browsing by Author "Attafuah, P.Y.A."
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Item Comparing patient safety culture in primary, secondary and tertiary hospitals in Ghana(Ghana Medical Journal, 2023) Abuosi, A.A.; Anaba, E.A.; Attafuah, P.Y.A.; Tenza, I.S.; Abor, P.A.; Setordji, A.; Nketiah-Amponsah, E.Objective: This study compared patient safety culture among health professionals in tertiary, secondary and primary hospitals. Design: We conducted a cross-sectional survey among thirteen primary, secondary and tertiary hospitals in Ghana. A structured questionnaire was administered to 1,656 health professionals. Data were analysed using descriptive statis tics and One-Way Analysis of Variance (ANOVA). Setting: This study was conducted in the Greater Accra, Bono and Upper East regions, representing the southern, middle and northern ecological zones, respectively. Participants: Health professionals Main outcome measures: The primary outcome was patient safety culture. Results: Five patient safety culture dimensions were rated moderate positive response, while five were rated high positive response. We found a statistically significant difference in patient safety culture across primary, secondary and tertiary hospitals (p < 0.05). For instance, the mean difference between tertiary and secondary hospitals was sta tistically significant (p < 0.05). Additionally, the mean difference between tertiary and primary hospitals was statisti cally significant (p < 0.05). There was also a significant difference in the means between secondary and primary hospitals (p < 0.05). Conclusion: This study has demonstrated a variation in patient safety culture across Ghana’s tertiary, secondary and primary hospitals. Therefore, healthcare managers and professionals should prioritise patient safety.Item Health and social needs of older adults in slum communities in Ghana: a phenomenological approach used in 2021(Archives of Public Health, 2023) Attafuah, P.Y.A.; Everink, I.H.J.; Lohrmann, C.; Abuos, A.; Schols, J.M.G.A.Slum-dwellers lack several essential amenities (such as water, sanitation, and electricity) which make them more vulnerable than non-slum dwellers. As there is limited to no access to health and social care services in slums, the slum environment is expected to be an even more dangerous environment for older adults, negatively impacting their quality of life (QoL). To provide an overview of the perceived (unmet) health and social care needs and how it affects the QoL, this study aims to explore the self-perceived health and social needs of older adults in urban slums in Ghana. Using a phenomenological approach, 25 semi-structured interviews were conducted between May and June 2021, in the homes of older adults in two slums in Ghana. After coding and analysing the transcripts, five main themes emerged: (a) perception of health; (b) (de)motivators of health service use; (c) perception of social care, (d) social needs, and (e) influence of phenomena on QoL. It appeared that older adults believed that spiritual powers were causing illnesses and influenced their use of formal health services. Other factors such as expired insurance cards and the attitude of healthcare workers served as demotivators for using health services. Perceived health needs were mainly current disease conditions (arthritis, diabetes, hypertension, vision/hearing challenges), challenges with health insurance, the behaviour of some health professionals, the proximity of health facilities, and unnecessary queues at major health facilities. Unmet social needs identified by this study were a sense of neglect by family (need for companionship), requiring assistance with activities of daily living, and the need for financial support. Participants had more health needs than social needs. Health providers do not usually prioritize the care of slum-dwelling older adults. Most participants still have challenges with the National Health Insurance Scheme (NHIS). Their social needs were mainly related to financial difficulties and help with some activities of daily living. Participants expressed that they desired companionship (especially the widowed or divorced ones) and the lack of it made them feel lonely and neglected. Home visits by health professionals to older adults should be encouraged to monitor their health condition and advocate for family members to keep older adults company. Healthcare providers should exhibit positive attitudes and educate older patients on the advantages of formal health services use, as well as the need to seek early treatment as this will influence their QoL to a large extent.Item ‘I decided to attend to him because it’s my duty’: Student Nurses perception and attitude towards care of older adults(BMC, 2022) Attafuah, P.Y.A.; Amertil, N.; Sarfo, J.O.; Deegbe, D.A.; Nyonator, D.; Amponsah‑Boama, C.; Abuosi, A.A.Background and Aim: Nurses perception and attitude towards an older patient can positively or negatively influence the quality rendered. As students under training, the views of this population needs to be sought and shaped to improve the quality of care the older patients receive. This is because life expectancy is on the rise. The study aimed to explore students’ perception of ageing and their attitude towards care of the older adults. Methods and materials: An exploratory descriptive design was used. Data form containing the sociodemographic attributes of the students and a semi-structured interview form developed by the researchers in line with the literature. The participants interviewed were student nurses who had been in clinical practice for at least one semester. Four focus group discussions (FGD) were held. Results: Average age of the participants was 22.30 years. An equal number of males and females (15 each) were recruited to have a balance in gender. Students expressed that they saw the older adults as their grandparents so they try to accord them respect and care. However, older adults are perceived not receptive to nurses in training. The students stated that registered nurses neglected the basic care of older adults such as diaper changes, bathing, and feeding, and would rather beckon student nurses to attend to the older adults. Conclusion: Gerontology as a stand-alone course is necessary for early years of training to give an in-depth education to nursing students and instill a positive attitude towards older adult patients.Item ‘I decided to attend to him because it’s my duty’: Student Nurses perception and attitude towards care of older adults(BMC, 2022) Attafuah, P.Y.A.; Amertil, N.; Sarfo, J.O.; Deegbe, D.A.; Nyonator, D.; Amponsah‑Boama, C.; Abuosi, A.A.Background and Aim: Nurses perception and attitude towards an older patient can positively or negatively influence the quality rendered. As students under training, the views of this population needs to be sought and shaped to improve the quality of care the older patients receive. This is because life expectancy is on the rise. The study aimed to explore students’ perception of ageing and their attitude towards care of the older adults. Methods and materials: An exploratory descriptive design was used. Data form containing the sociodemographic attributes of the students and a semi-structured interview form developed by the researchers in line with the literature. The participants interviewed were student nurses who had been in clinical practice for at least one semester. Four focus group discussions (FGD) were held. Results: Average age of the participants was 22.30 years. An equal number of males and females (15 each) were recruited to have a balance in gender. Students expressed that they saw the older adults as their grandparents so they try to accord them respect and care. However, older adults are perceived not receptive to nurses in training. The students stated that registered nurses neglected the basic care of older adults such as diaper changes, bathing, and feeding, and would rather beckon student nurses to attend to the older adults. Conclusion: Gerontology as a stand-alone course is necessary for early years of training to give an in-depth education to nursing students and instill a positive attitude towards older adult patients.Item Institutional drivers for integrating palliative care services in a hospital in a sub-Saharan African military hospital context(Palliative Care & Social Practice, 2024) Boateng, S.A.; Okyere, J.; Attafuah, P.Y.A.; Dzansi, G.Background: The growing burden of life-threatening illnesses and advancements in care interventions call for the intentional integration of palliative care services into existing care systems. The absence of active, functioning palliative care services in most hospitals in Ghana is a major concern. This study explored the factors influencing the integration of palliative care services in one of such institutions. Objectives: The aim of the study was to explore the institutional drivers of palliative care integration in a military health facility. Design: Exploratory qualitative study. Methods: We employed a qualitative exploratory study design situated within a constructivist paradigm. A purposive sampling method was used to select and interview 11 healthcare professionals. A semistructured interview was used to conduct face-to-face, in-depth interviews with participants between April and May 2022. A thematic data analysis was done based on the Braun and Clarke analysis process with the aid of QSR NVivo-12. Results: The six themes that describe the institutional driving factors for integrating palliative care services were cognitive restructuring, supportive logistics and infrastructure, staffing, healthcare professional skills, institutional policies and priorities, and utilization of focal persons. It was observed that a paradigm shift in the mindset of healthcare professionals and administrators was a major driver that would determine the integration of palliative care services. A cognitive restructuring will facilitate a more aggressive integration of palliative care services because logistics, staffing, and medication access will be prioritized. Conclusion: Institutions have the responsibility of aligning with the WHO policy on palliative care service access and must invest in training, staffing, prioritizing palliative care needs and policies, procurement of essential drugs, and the provision of logistics and supportive infrastructure to scale up the implementation of palliative care servicesItem Instruments used to assess quality of life of older adults in African countries: a scoping review(BMC Geriatrics, 2021) Attafuah, P.Y.A.; Everink, I.H.J.; Halfens, R.J.G.; Lohrmann, C.; Abuosi, A.; Schols, J.M.G.ABackground: Over 60% of the population in sub-Saharan Africa, live in informal settlements (slums) with little or no resources. To be prepared to meet the needs of older people living in slums, it is necessary to know more about their quality of life (QoL). The objective of this review is to identify instruments, which can be used by researchers to assess the QoL of older adults living in African countries, especially those dwelling in slums. Methods: A scoping review was performed using the databases Scopus, PubMed, and ISI Web of Science to retrieve studies published from January 2008 – September 2020. Studies were included if they reported generic QoL instruments, focused on adults with a mean age ≥ 50 and were conducted in African countries. Results: In total, 18 studies were included using 7 unique instruments to measure QoL (EUROHIS-QOL-8, SWLS, WHOQOL-OLD, the WHOQOL-BREF, SF-36, SF-12 and RAND-38). All instruments could be interviewer-administered and had 5–36 items. However, little is known about their psychometric properties (validity and reliability), timeinvestment and cultural sensitivity of the domains included in the instruments. Conclusions: Even though this review retrieved instruments used to assess QoL of older adults in African countries, there is a need for further research on adjustment and validation of currently existing QoL instruments. In addition, the development and validation of a new instrument which can be used in (illiterate) older populations, living in slums in Africa should be considered.Item Nurses knowledge and attitude towards care of older patients: A cross-sectional study(Elsevier, 2022) Attafuah, P.Y.A.; Amertil, N.P.; Abuosi, A.A.; Nyonator, D.The older adult population is very vulnerable and access health care frequently because of their changing needs. Additionally, nurses are the main carers of the older population when they visit the hospital. It is said that in- dividual beliefs and values influence how we perceive and act towards the older population. This study aims to assess the knowledge and attitude of nurses towards older adults. The knowledge and attitude of nurses towards the care of older adults has not been studied in Ghana. Hence a survey study was conducted among 40 nurses who had enrolled on a Bachelor of Nursing program using the Fact on Aging Quiz 1, and Kogan’s Attitudes toward Old People Scale from 25th July to 8th August 2019. Results of the study show that even in a country with reverence for older adults and recognised family bonds, poor knowledge and attitudes of nurses toward older adults can affect the quality of health care provided. These findings have implications for nursing education, and clinical practice. Changes across these sectors based on the findings may contribute to improving the quality of health care older adults receive.Item Quality of life of older adults and associated factors in Ghanaian urban slums: a cross-sectional study(BMJ, 2022) Attafuah, P.Y.A.; Everink, I.; Abuosi, A.A.; Lohrmann, C.; Schols, J.M.G.A.Objective This study provides insight into the quality of life (QoL) of older adults living in urban slums in Ghana. Design The study employed a community-based, cross-sectional design to assess QoL among older adults in two slums between April and May 2020. QoL was assessed using the WHO Quality of Life-Brief version (WHOQOL-BREF) questionnaire. Settings Participants were drawn from two slums in Ghana, one in a fishing-dominated community and the other in an industrial community. Participants This study included 400 participants aged 60 and above who had lived in either slum for at least 1 month and were able to communicate verbally. Results Although the means of all participants’ transformed scores were poor in the physical and psychological domains, they were moderate in all other domains. When viewed as a whole, the perceived overall QoL is neither poor nor good and participants were neither satisfied nor dissatisfied with their health. Participants had a moderate level of QoL in the WHOQOL-BREF psychological (mean score 45.7), social (mean score 57.0) and environmental (mean score 51.6) domains. The mean score for physical QoL of older adults was 43.3, which denotes poor QoL. In all domains, male participants have a significantly higher mean QoL than their female counterparts. An analysis of variance comparing the living arrangements of participants showed that those who lived with extended family had high mean scores in environmental QoL, overall QoL and satisfaction with health. Regression analysis revealed that QoL was influenced mostly by the environmental (46.2%), followed by the psychological (43.7%), physical (31%) and social (20.4%) domains. Conclusions The findings from this study show that older adults living in slums had moderate psychological, social and environmental QoL and poor physical QoL. Although the mean scores for QoL are higher than anticipated, health policy development must take into account the specific needs of older adults.Item Response to patient safety incidents in healthcare settings in Ghana: the role of teamwork, communication openness, and handoffs(BMC Health Services Research, 2023) Poku, C.A.; Attafuah, P.Y.A.; Anaba, E.A.; Abor, P.A.; Nketiah-Amponsah, E.; Abuosi, A.A.Background Patient safety incidents (PSIs) in healthcare settings are a critical concern globally, and Ghana is no exception. Addressing PSIs to improve health outcomes requires various initiatives to be implemented including improving patient safety culture, teamwork and communication between healthcare providers during handoffs. It is essential to acknowledge the significance of teamwork, communication openness, and effective handoffs in preventing and managing such incidents. These factors play a pivotal role in ensuring the well-being of patients and the overall quality of healthcare services. Aim This study assessed the occurrence and types of PSIs in health facilities in Ghana. It also examined the role of teamwork, handoffs and information exchange, and communication openness in response to PSIs by health professionals. Methods A cross-sectional study was conducted among 1651 health workers in three regions of Ghana. Using a multi-staged sampling technique, the Survey on Patient Safety Culture Hospital Survey questionnaire and the nurse reported scale were used to collect the data and it was analysed by descriptive statistics, Pearson correlation, and linear multiple regression model at a significance of 0.05. Results There was a reported prevalence of PSIs including medication errors (30.4%), wound infections (23.3%), infusion reactions (24.7%), pressure sores (21.3%), and falls (18.7%) at least once a month. There was a satisfactory mean score for responses to adverse events (3.40), teamwork (4.18), handoffs and information exchange (3.88), and communication openness (3.84) among healthcare professionals. Teamwork, handoffs and information exchange and communication openness were significant predictors of response to PSIs, accounting for 28.3% of the variance. Conclusions Effective teamwork, handoffs and information exchange, and communication openness in the healthcare environment are critical strategies to enhance PSI response. Creating a culture that encourages error response through teamwork, communication and handoffs provides healthcare professionals with opportunities for learning and improving patient outcomes. Training programs should therefore target health professionals to improve patient safety and competency. Through the implementation of evidence-based practices and learning from past incidents, the healthcare system will be able to deliver safe and high-quality care to patients nationwide. Patient safety must be recognized as an ongoing process. Therefore, a meaningful improvement in patient outcomes requires all stakeholders’ commitment.Item Self-Determination Theory and Quality of Life of Adults with Diabetes: A Scoping Review(Journal of Diabetes Research, 2023) Sarfo, J.O.; Obeng, P.; Kyereh, H.K.; Ansah, E.W.; Attafuah, P.Y.A.Background. Diabetes is one of the leading causes of sickness, death, and decreased quality of life globally. The prevalence of diabetes keeps rising globally due to lifestyle changes and urbanization. Therefore, improved quality of life (QoL) and appropriate diabetes self-management practices, including treatment adherence, are crucial to improving and sustaining the health of diabetic patients. Some studies have adopted the self-determination theory (SDT) to study diabetes interventions, but less is known about its effectiveness in improving QoL, treatment adherence, and diabetes self-management. Aim/Objective. This review assessed the effectiveness of SDT in improving self-management practices, treatment adherence, and QoL among adult diabetic patients. Method. We followed the six-stage framework by Arksey and O’Malley in conducting the review. PubMed, JSTOR, Central, and ScienceDirect databases were searched for published articles from January 2011 to October 2021 using keywords and Boolean logic. Furthermore, we screened a reference list of related articles. Also, Google Scholar, Z-library, and web-based searches were carried out to retrieve other relevant evidence that applied SDT in improving QoL, diabetes self management, and treatment adherence. Findings. Fifteen studies met the inclusion criteria, from which data were extracted as findings. SDT effectively improved QoL, diabetes treatment adherence, and diabetes self-management among diabetic patients. Of these studies, 11 provided data on SDT and diabetes self-management and affirmed the effectiveness of the theory in improving appropriate diabetes self-management practices. Two studies confirmed the effectiveness of SDT in improving treatment adherence. SDT and QoL were assessed in 4 of the studies, which demonstrated the effectiveness of SDT in enhancing the QoL of diabetic patients. Conclusion. SDT effectively improved QoL, diabetes treatment adherence, and diabetes self-management. The application of SDT in diabetes management will improve the health and QoL of diabetic patients. Hence, diabetes management interventions could adopt SDT to guide treatment.Item Work-related psychosocial challenges and coping strategies among nursing workforce during the COVID-19 pandemic: a scoping review(BMC Nursing, 2023) Iddrisu, M.; Poku, C.A.; Mensah, E.; Attafuah, P.Y.A.; Dzansi, G.; Adjorlolo, S.Background Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O’Malley’s review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them. Methods We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria. Results Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping. Conclusions The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.