Browsing by Author "Aziato, L."
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Item Behavioural beliefs of Ghanaian radiographers and reporting of child physical abuse(Radiography, 2019-02) Antwi, W.K.; Reeves, P.; Ferris, C.; Aziato, L.Introduction Radiographers are well placed to flag non accidental injury in children due to their unique position within the imaging chain. Being able to identify (or suspect) physical abuse in children and reporting the incident are, however, two different issues. This study was conducted to explore the external influences in the decision making of the Ghanaian radiographer to report suspected child physical abuse (CPA). Method This was a qualitative study which applied interpretive phenomenology. Semi-structured interviews were conducted with 20 radiographers who were selected from various hospitals throughout the ten regions of Ghana using purposive sampling. Data was thematically analysed and managed with NVivo Version 10. Themes developed formed the basis of this discussion. Results Several socio-cultural beliefs and behaviours impacted on the Ghanaian radiographers’ decisions to report suspected child physical abuse. The findings of this study indicated that cultural solidarity, superstition and police frustrations were among other factors that characterised the Ghanaian radiographer’s inability to report child physical abuse when it occurred. Conclusion Radiographers reported fear of both physical and spiritual attack when child physical abuse was reported. This paper argues that, to achieve the fight against child physical abuse in some African countries such as Ghana, radiographers would have to be educated and counselled against belief in superstition and adherence to some cultural values which affect child protection.Item Beliefs of people living with epilepsy in the Accra Metropolis, Ghana(Seizure: European Journal of Epilepsy, 2019-10-23) Deegbe, D.A.; Aziato, L.; Attiogbe, A.Purpose: The study aimed at describing the beliefs that People Living with Epilepsy (PLWE) have about the disease. Methods: A descriptive-exploratory qualitative design was employed to guide the study. Thirteen (13) participants living with epilepsy in the Accra Metropolis were purposively sampled. Face-to-face in-depth interviews were conducted and data were analysed using the content analysis approach. Results: The themes that emerged from the data were beliefs about signs and symptoms, causes, consequences and beliefs about cure and control of epilepsy. Participants believed epilepsy was a disgraceful illness. Most participants believed epilepsy was due to spiritual causes. Seizures resulted in injuries and were believed to have affected the education, work and relationships of the PLWE. Conclusion: The results suggest that the false beliefs about the causes of epilepsy were an indication of knowledge gap on the causes of epilepsy among the PLWE. Health care professionals should intensify health education campaigns on epilepsy to demystify traditional beliefs about epilepsy and promote greater understanding and acceptance of PLWE.Item Determinants of nurses’ knowledge gap on pain management in Ghana(Elsevier Ltd., 2013-08) Aziato, L.; Adejumo, O.There are concerns about adequacy of nurses’ knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses’ inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses’ inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required.Item Determinants of nurses' knowledge gap on pain management in Ghana(Nurse Education in Practice, 2014) Aziato, L.; Adejumo, O.There are concerns about adequacy of nurses' knowledge and skill in effective pain management since effective pain management promotes early recovery after surgery. This study explores factors that accounted for Ghanaian nurses' inadequate knowledge of postoperative pain management using a focused ethnographic design for data collection at a tertiary teaching hospital in Ghana. Fourteen nurses designated as key informants with different backgrounds as nurse educators and leaders were purposively sampled to participate. Data were collected through in-depth individual interviews; all interviews were conducted in English, audio-taped and transcribed verbatim. The study revealed that nurses' inadequate pain management knowledge might have resulted from curriculum gaps during training; inadequate clinical supervision, study days, and workshops for practising nurses; lack of funding for organising regular workshops; and, negative attitudes of nurses whereby new information learned at workshops was not readily applied in clinical practice. It was concluded that nursing curricula at all levels of training in Ghana should incorporate credit-bearing courses on pain management, and appropriate pain management education programmes should be instituted for practising nurses. Regular monitoring and evaluation of the impact of such education programs is required. © 2013 Elsevier Ltd.Item Experience of epilepsy: Coping strategies and health outcomes among Ghanaians living with epilepsy(Epilepsy & Behavior, 2020-01-29) Deegbe, D.A.; Aziato, L.; Attiogbe, A.Purpose: The purpose of this studywas to assess the coping strategies of people livingwith epilepsy (PLWEs) and their health outcomes. Methods: Thiswas a descriptive-exploratory, qualitative study. Face-to-face, in-depth interviews were carried out on a purposive sample of 13 PLWEs using a semi-structured interview guide. Interviews were audiotaped and transcribed verbatim, and the data were analyzed using the content analysis approach. Results: Positive coping strategies adopted included problem-focused coping, faith inGod, social support, and lifestyle changes. Negative coping strategies adopted were thinking and worrying and concealing diagnosis. Treatment modalities for epilepsy were spiritual intervention, traditional, or orthodox medicines or a combination of two or more. A reduction in the frequency and severity of seizures was a positive outcome, and the worsening of seizures was a negative outcome. Conclusion: The consultation of spiritualists and herbalists for treatmentwas a reflection of their beliefs about the causes of epilepsy among the participants. There is a need for increased education on epilepsy in Ghana.Item Experiences of People Living with Epilepsy in the Accra Metropolis(University of Ghana, 2015-07) Deegbe, D.A.; Attiogbe, A.; Aziato, L.; University of Ghana, College of Health Sciences, School of NursingThe study explored the experiences of People Living with Epilepsy (PLWE) in the Accra Metropolis. The study aimed at describing the beliefs that PLWE have about the disease, their coping strategies and health outcomes. A descriptive-exploratory design was employed and the Leventhal‘s common sense model was used to guide the study. Participants were purposively sampled and saturation was achieved at the 13th participant. Face-to-face in-depth interviews were conducted and data were analysed using the thematic content analysis approach. The themes and sub themes were illness representations (identity, cause, timeline, consequences, cure and control, illness coherence, and emotional response), coping with epilepsy (problem focused coping; lifestyle changes; social support; faith in God; concealing diagnosis; thinking and worrying) and health outcomes (negative outcomes, positive outcomes and adjustment to work). Participants labelled epilepsy as a disgraceful illness. Most participants attributed the disease to spiritual causes which indicated a knowledge gap in the actual causes of epilepsy. Seizures caused injuries and affected their education, work and relationships. Fear, anxiety and sadness concerning seizures were commonly expressed. Treatment modalities for epilepsy were spiritual intervention, traditional or orthodox medicines or a combination of two or more. A reduction in the frequency and severity of seizures was a positive outcome and the worsening of seizures was a negative outcome. It was recommended that health care workers in collaboration with the media should intensify health education campaigns on epilepsy to demystify traditional concepts about epilepsy and help bring Ghanaians towards greater understanding and acceptance of PLWE.Item Experiences of Spouses of Women with Mastectomy Resulting From Breast Cancer in the Accra Metropolis(University of Ghana, 2015-07) Kotei, B. A.; Avadu, P.; Aziato, L.; University of Ghana, College of Health Sciences, School of NursingBreast Cancer is the leading cause of death and most commonly diagnosed cancer in women. The most common treatment is surgery in the form of mastectomy. Breast Cancer (BC) and mastectomy does not affect the well-being of only the woman but also that of the husband or partner. Breast cancer is therefore referred to as a couple‟s disease. The purpose of this study was to explore the experiences of spouses of women with mastectomy as a result of their wives‟ BC in the Accra Metropolis. The Quality of Life Model Applied to Family Caregivers by Betty Ferrell was the organizing framework for this study. A qualitative exploratory descriptive design was employed. A purposive sampling technique was used and data were saturated with the twelfth participant. Data were collected with a semi-structured interview guide. All interviews were audio taped and transcribed verbatim. Data were analyzed using thematic content analysis. During the study, anonymity and confidentiality were ensured. The four themes stipulated by the model; physical, social, psychological and spiritual well-being of spouses was identified. Emerging themes were support and spousal involvement in diagnosis and treatment. Few of the men experienced sleep disruption and fatigue. The relationship of most of the spouses with their wives became better after the surgery. Spouses feared their wives could die during surgery. Spiritually, spouses derived meaning and hope from God. The spouses gave their wives domestic and emotional support. Most of the spouses were actively involved in the treatment and diagnosis of their wives. It was recommended that spouses be included in the provision of care for women with BC and educational material should be prepared and given to the spouses.Item Experiences of Women with Advanced Breast Cancer: A Study at the Kumasi Metropolis(University of Ghana, 2013-06) Bonsu, A.B.; Aziato, L.; Clegg-Lamptey, J.N.The purpose of this study was to explore and describe the experiences of Ghanaian women living with advanced breast cancer in the Kumasi Metropolis. The study employed a qualitative exploratory descriptive design. A purposive sampling was used and data was saturated with 10 participants varying in age between 32 years and 65 years. All interviews were audio-taped and transcribed. Data was analyzed based on the techniques of content analysis. During the study, anonymity and confidentiality were ensured. Research supervisors audited data to ensure credibility. Eight major themes describing the participants‘ lived experiences emerged: impaired activities of daily living, malignant wound, body image, physiological effects, emotional reactions, support, coping, and lost hopes. The women indicated that they experienced distress because of concerns about body image and worries about the effect of stress on their illness. The stress emanated from fear of dying, fear of disease progression and debilitation, the loss of their future, and practical concerns. The women also experienced a decline in their daily activities due to physical symptoms of the illness and the side effects of the treatments. Most of the women had emotional, social, financial, and spiritual support from spouses, families, churches, work place, and health professionals. It was recommended that health care providers involved in breast cancer management need opportunities for training to enhance effective and holistic care of women diagnosed with the disease. Also, patients with advanced disease should be given multidisciplinary management by trained oncology and palliative care team.Item Exploration of Ghanaian radiographers’ reporting of suspected physical abuse amongst children(Elsevier, 2021) Antwi, W.K; Reeves, P.J.; Ferris, C.; Aziato, L.The success of the child protection process is dependent on rapid actions by healthcare professionals who encounter a child in possible need of protection and make appropriate referrals to statutory agencies. Clear rules that promote inter-professional working among health professionals is necessary to enhance child protection. Aim: To explore the internal factors leading to bystander attitude towards reporting of suspected physical abuse amongst Ghanaian radiographers. Methods: Twenty radiographers across Ghana who have encountered suspected child physical abuse during practice interviewed. Data was collected using qualitative methodology using semi-structured interviews. Participants were radiographers who were selected using purposive sampling. Data was thematically analysed and managed with NVivo version 10. Themes developed formed the basis of the discussion. Results: Participants reported barriers such as training deficits, lack of knowledge in reporting regula tions, and the absence of a framework or structures in place to guide suspected physical abuse (SPA) management. The results showed that the majority of participants were ignorant of the role of the social worker in identified cases of SPA. Additionally, there was no teamwork in the majority of the hospitals in the management of suspected physical abuse. Conclusions: Participants’ behaviour towards child protection was congruent with the situation where an individual would assess the consequences of an action. Fear, lack of direction and collaboration char acterised the management of suspected physical abuse. Implication for practice: The timely identification of child abuse is key to providing the necessary intervention for the child. However, the mere identification of abuse would be of no use to the child when no action was taken by radiographers handling the case as a result of impediments on their wayItem Exploring the safety and clinical use of herbal medicine in the contemporary Ghanaian context: A descriptive qualitative study(Journal of Herbal Medicine, 2017) Aziato, L.; Odai, P.N.A.Many individuals remain skeptical about the safety and use of herbal medicine thereby slowing the efforts being made to integrate herbal medicine into Ghana's healthcare system. This study sought to provide an in-depth description of the clinical use of herbal medicine in Ghana through interviews with participants at two locations—a national research centre and a private clinic. The study adopted a descriptive qualitative design involving individual patient and key informant interviews. Data were collected from 13 key informants. Interviews were audio-taped and transcribed verbatim. Data analysis was conducted applying the procedures of content analysis. Two major themes were generated, focusing on the production and processing of herbal medicine and its use. The sub-themes generated were production of herbs and herbal medicine; analysis of herbal products; training of herbalists, ‘client assessment’, herbal medicine treatment decisions and adjuvant therapy. It was realized that there were difficulties acquiring sustainable raw materials for herbal medicine production. Quality aspects include the input of research institutions and regulatory bodies to ensure that safe herbal products are used, and the formal training of herbalists. Patients at the study locations are assessed using orthodox means and may be treated with adjuvant therapies as well as herbal medicine. The themes raised provide insight into the issues and possibilities of integrating herbal medicine into a wider healthcare system. © 2016 Elsevier GmbHItem Facilitators and barriers to the clinical administration of herbal medicine in Ghana: a qualitative study(BMC Complementary Medicine and Therapies, 2021) Asare, C.; Aziato, L.; Boamah, D.Background: Herbal medicine administration in conventional health care services is gaining popularity lately. Much has not been documented on the perceived enhancers and challenges to herbal medicine administration at the hospital. The study sought to explore the facilitators and barriers to the clinical administration of herbal medicine in Ghana. Method: Qualitative descriptive exploratory design was employed. Fourteen participants among the consented and purposively sampled nurses were interviewed. Data was transcribed and analysed using content analysis. Results: The participants disclosed that facilitators to the clinical administration of herbal medicine include doctors’ prescription, affordability of herbal medications by patients, patients’ willingness to use herbal medicine and availability of herbal medicine. Barriers to the clinical administration of herbal medicine were inadequate knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration and policies on herbal medicine administration at the hospital. Other barriers were negative mindset of patients and lack of national health insurance scheme (NHIS) coverage. Conclusion: Clinical administration of herbal medicine is faced with an array of challenges. Doctor’s prescription, nursing education on herbal medicine and NHIS coverage of herbal medicine are imperative to improve herbal medicine administration in hospitals.Item Factors influencing nurses’ pain assessment and management of road traffic casualties: a qualitative study at a military hospital in Ghana(BMC Emergency Medicine, 2024) Tata, T.K.; Ohene, L.A.; Dzansi, G.A.; Aziato, L.Background Evidence shows that patients who visit the surgical and trauma emergency units may be discharged with untreated or increased pain levels. This study explored nurses’ pain assessment and management approaches at a trauma-surgical emergency unit in Ghana. Methods Seventeen nurses who work in the trauma department participated in this qualitative exploratory descriptive study. In-depth individual interviews were conducted, and the thematic analysis was utilized to identify emerging themes and subthemes. Results Three main themes were identified: patient pain indicators, pain management, and institutional factors influencing pain management. The study revealed that nurses rely on verbal expressions, non-verbal cues, physiological changes, and the severity of pain communicated. The findings highlighted staff shortage, inadequate resources, and lack of standardized guidelines as factors affecting pain and management. Conclusions Although the study offers critical new perspectives on nurses’ experiences regarding pain related issues at the trauma-surgical emergency units, its small sample size limited its generalizability.Item Ghanaian radiographers experience and commitment to the mandatory reporting law regarding suspected child physical abuse(Radiography, 2023) Antwi, W.K.; Aziato, L.Introduction: The best interests of the child shall be paramount in any matter concerning a child and it should be the primary consideration by any court, person, institution, or other body in any matter concerned with a child. This study sought to explore the influence of legislation on and professional commitment of radiographers towards suspected child physical abuse. Method: A semi-structured interview was conducted with 20 radiographers selected across all the regions in Ghana. The interviews were conducted exclusively by the first author with radiographers who reporting having experience of handling suspected child physical abuse cases. There were 14 male respondents with an age range of 30e54 years and six females aged from 25 to 57 years. Upon attaining data saturation, the thematically analysed data was managed using NVivo10 software. Results: Findings from the study showed that the legal framework for mandatory reporting of suspected child physical abuse was not known by radiographers. A lack of professional commitment to report cases of suspected child physical abuse was also identified. Themes that emerged from the study formed the basis of the discussion. Conclusion: This study revealed that radiographers interviewed were not well acquainted with national legislation requiring mandatory reporting. There is the urgent need to train radiographers on the laws protecting children to enhance their commitment to the reporting of suspected child physical abuse. Implication for practice: The understanding of the legal framework under which radiographers operate is imperative when considering obligations to report suspicious injuries among children.Item The Ghanaian surgical nurse and postoperative pain management: A clinical ethnographic insight(Pain Management Nursing, 2014) Aziato, L.; Adejumo, O.Nurses form an indispensable part of the clinical team that manages postoperative pain (POP). Within a particular clinical context, nurses perceive and respond to pain based on specific factors. This study aimed at illuminating the perceptions and responses of Ghanaian surgical nurses regarding their patients' POP. It also identified the factors that influenced nurses' pain responses. A focused ethnography was used, and data were collected through individual interviews. Sampling was performed purposively to include junior, senior, day, and night nurses who cared for surgical patients. Concurrent data analysis was performed and data were saturated with 12 individual interviews. The findings indicated that nurses perceived POP as an individual phenomenon, and nurses responded to patients' pain by administering analgesics and by using nonpharmacologic measures. Factors that influenced the nurses' response were individual factors, such as commitment, discretion, fear of addiction, and organizational factors, such as organizational laxity and challenges of teamwork. The study recommended that nurses should be educated, supported, and encouraged to ensure pain relief after surgery and that they should see pain relief as a priority postoperative care to avert the negative repercussions of poorly managed POP. © 2014 American Society for Pain Management Nursing.Item Ghanaian women beliefs on the causes, prevention and treatment of cervical cancer: A qualitative Study(International Journal of Africa Nursing Sciences, 2023) Asakitogum, D.A.; Aziato, L.; Ohene, L.A.Objective: The choice of the sick to access health care services in Ghana or consult a health care provider depends on the individuals’ beliefs about the disease and available services. This paper seeks to explore the health beliefs of cervical cancer survivors in Ghana. Methods: We employed an exploratory qualitative approach in this study. We interviewed 12 participants to gain an in-depth understanding regarding the beliefs, causes, prevention and treatment of cervical cancer in Ghana. Data collection and analysis were done concurrently, and themes and subthemes were generated through content analysis. Verbatim quotes were used to support the findings. Results: Three themes emerged. 1. Beliefs about the causes of cervical cancer, which include the choices of cloths and criminal abortions. 2. Beliefs on cervical cancer prevention; early education of the girl child on vagina hygiene and avoidance of highly processed food products. 3. Beliefs on cervical cancer treatment; participants believed that cervical cancer is one of the diseases not well managed in hospitals in Ghana. Conclusions: Mistrusts for orthodox cancer treatment is the leading rationale patients report late to the hospital in Ghana. Much is desired for public education on contemporary treatment and cure for cervical cancer disease.Item ‘I wish I was not a Woman’: The Pain of Women within the Reproductive Age in Ghana(2017-10-03) Aziato, L.Pain is a universal phenomenon experienced by all and it is the most common reason why people seek health care. Women within the reproductive age continue to experience excruciating menstrual pain and labour pain. Due to the subjective and abstract nature of pain, qualitative research was conducted to gain an in-depth insight into the menstrual and labour pain experiences of women. Therefore, this presentation discusses the research approach employed and the key findings of menstrual and labour pain experiences of women such as pain characteristics, pain effects and management approaches within the Ghanaian clinical context. Specific socio-cultural considerations such as misconceptions and religiosity are discussed. It is emphasized that pain assessment is an important consideration for pain management and the woman in pain should be managed as an individual. It is important to prioritize pain management among women with menstrual and labour pain to prevent the negative effects of pain that can be detrimental to their health.Item The Image of Nurses and Midwives in Ghana: Patient and Family Perspectives(Global Qualitative Nursing Research, 2022) Ohene, L.A.; Acheampong, A.K.; Dzansi, G.; Kyei, J.; Adjei, C.A.; Adjorlolo, S.; Asante, I.N.A.; Woolley, P.; Nyante, F.; Aziato, L.This study aims to explore the perceptions of patients and family caregivers on the image of nurses and midwives in Ghana. The study adopted a qualitative exploratory descriptive approach. A total of 25 participants were interviewed during data collection. Content and thematic analysis were applied in the data analysis to develop themes. The findings are captured under two major themes that describe the primary influences on participant images of nurses: Thus, (1) nurses’ and midwives’ attributes with four subthemes; staff appearance, communication strategies and behaviors, work attitudes, and professional competence and (2) patients’ status and subthemes were; uneducated poor and educated rich. We conclude that patients and families in Ghana recognize the professional attributes of the nurse and midwife, which reflect in their personality, grooming, communication, competencies, and attitudes. However, low publicity of the professional roles of nurses and midwives may have negative repercussions for their professional image. A policy to perform a regular public audit on the image of the Nurse/Midwife is important for professional advancement.Item Impact of climate change on maternal health outcomes: An evidence gap map review(PLOS Global Public Health, 2024) MeheraliI, S.; Adjorlolo, S.; Aziato, L.; et al.Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15–45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need or global collaboration and targeted interventions to address disparities and inform climate responsive policiesItem An insight into the preoperative experiences of ghanaian general surgical patients(2013-03) Aziato, L.; Adejumo, O.The unknown outcome of surgery has always been a source of anxiety for patients and their relatives. However, the experiences of Ghanaian surgical patients have not been adequately explored. This study sought to have an in-depth exploration of the preoperative experiences of Ghanaian general surgical patients to inform effective preoperative care. The study employed an ethnographic design and was conducted at two hospitals in Accra. Thirteen general surgical patients were purposively recruited and interviewed. Data analysis occurred concurrently and themes that emerged included reaction to impending surgery with subthemes of inappropriate disclosure, fear of death, readiness for surgery, and effect of waiting in the theatre. Also, the theme information gap had subthemes of preoperative care, expectations at the theatre, and undue delays. The study emphasized the need for health professionals to provide effective education to the public and patients, on surgery and its effects, to curb negative perceptions about surgery.Item An Insight Into the Preoperative Experiences of Ghanaian General Surgical Patients(Clinical Nursing Research, 2014) Aziato, L.; Adejumo, O.The unknown outcome of surgery has always been a source of anxiety for patients and their relatives. However, the experiences of Ghanaian surgical patients have not been adequately explored. This study sought to have an in-depth exploration of the preoperative experiences of Ghanaian general surgical patients to inform effective preoperative care. The study employed an ethnographic design and was conducted at two hospitals in Accra. Thirteen general surgical patients were purposively recruited and interviewed. Data analysis occurred concurrently and themes that emerged included reaction to impending surgery with subthemes of inappropriate disclosure, fear of death, readiness for surgery, and effect of waiting in the theatre. Also, the theme information gap had subthemes of preoperative care, expectations at the theatre, and undue delays. The study emphasized the need for health professionals to provide effective education to the public and patients, on surgery and its effects, to curb negative perceptions about surgery. © The Author(s) 2013.
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