Department of Adult Health

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    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 services
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    Risk Factors for Cervical Cancer in Ghana
    (Cancer Reports, 2024) Nartey, Y.; Amo-Antwi, K.; Dassah, E.T.; et al.
    Background: The major burden of cervical cancer occurs in low- and middle-income countries. In Ghana, it is the second most common cancer among women. Infection with high-risk human papilloma virus (HPV) has been established as the cause of cervical cancer. As such, it is important to identify risk factors that may affect progression from HPV infection to cancer. Aims: We assessed the risk factors associated with cervical cancer in Ghana. Methods: To identify the risk factors for cervical cancer, we conducted an unmatched case–control study in two hospitals in Ghana where most cervical cancer cases are diagnosed. Women with histologically confirmed cervical cancer were the cases, whereas women without cancer seeking care at the two hospitals were controls. A structured questionnaire was administered to the women, after which cervical samples were sent for HPV deoxyribonucleic acid (DNA) testing. Results: Overall, 206 cases and 230 controls were recruited. After adjusting for possible confounders, women with the highest educational level had a significantly lower risk of cervical cancer than those with no or little formal education. Parity was a major risk factor (odd ratio [OR] for five or more children=7.9; 95% CI: 2.3–27.6), with risk increasing with increasing parity (p for trend <0.001). Women reporting the use of a homemade sanitary towel during menstruation also had an increased risk of cervical cancer compared with women who used a pad (OR: 7.3; 95% CI: 2.5–22.0). Conclusion: In this Ghanaian population, high parity and poor personal hygienic conditions were the main contributing factors to the risk of cervical cancer after adjustment for the presence of high-risk HPV genotypes.
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    Covid-19 and mental health of children and adolescents: A systematic review
    (Cogent Psychology, 2022) Aarah-Bapuah, M.; Oppong, S.S.; Yawson, A.O.; et al.
    The outbreak of the COVID-19 pandemic had imposed considerable risk on public health, and had generated unprecedented levels of panic. There are increasing concerns over the possible negative impact of COVID-19 on the mental health of children and adolescents. This review was conducted to describe the impact of COVID-19 affects the mental health of children and adolescents. An electronic search was conducted in PubMed, CINAHL, MEDLINE, and the WHO Global Health database on COVID-19. The 2020 updated Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guideline and an adapted Joanna Briggs aetiology review methodology were followed in conducting this review. A total of 21 studies from 8 different countries located on 4 continents (Asia, Europe, North America & South America), reporting a sample size of 56,368 that met the inclusion criteria. Using the JBI critical appraisal tool for studies reporting on prevalence data, the quality of most of the studies were assessed as moderate. Prevalence of depression and anxiety and stress was estimated to range from 7.2% to 78%; of anxiety, from 15% to 78%, depression, from 7.2% to 43.7% and stress, at 17.3%. Correlates for COVID-19 −19 related mental health outcomes were identified as female gender and social isolation, among others. The COVID-19 pandemic has negatively affected the mental health of children and adolescents. It is recommended that governments and health agencies prioritize mental health, especially for children and adolescents. prevent long-term effects on them.
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    Promoting maternal mental health in Ghana: An examination of the involvement and professional development needs of nurses and midwives
    (Nurse Education in Practice, 2019) Adjorlolo, S.; Aziato, L.; Akorli, V.V.
    Insight into the involvement and professional development needs (PDNs) of non-mental health nurses and midwives with respect to promoting maternal mental health is necessary to integrate mental health services into primary healthcare delivery. Using a cross-sectional survey and self-report methodology, the study investigates the involvement, PDNs, knowledge and attitudes of 309 nurses and midwives in promoting maternal mental health in Ghana. Data were analyzed using descriptive and inferential statistics, namely Analysis of Variance, bivariate and logistic regression, and cluster analysis. The results showed that the majority of the participants (94%) indicated they were involved in promoting maternal mental health. Knowledge about maternal mental health correlated significantly with involvement in promoting maternal mental health (p < .05), whereas at titude towards maternal mental health did not. An overwhelming proportion of the participants (83%–94%) expressed profound interest in professional development education across a range of maternal mental health areas. Enhancing the mental health knowledge-base of nurses and midwives could contribute significantly to promoting maternal mental health.
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    ‘‘Tougher than ever’’: An exploration of relapse prevention strategies among patients recovering from poly-substance use disorders in Ghana
    (Drugs: Education, Prevention and Policy, 2018) Appiah, R.; Boakye, K.E.; Ndaa, E.; Aziato, L.
    Objective: Drug dependency has been typified as a persistent relapsing disorder. Overall, 65% of people with substance use disorders relapse within one year after treatment. Recent interventions have focussed on contextually relevant relapse prevention strategies. This study explored relapse prevention strategies utilised by patients recovering from poly substance use disorders one year after treatment at a Psychiatric Rehabilitation Unit in Ghana. Methods: The study adopted a descriptive phenomenology design and was conducted at the Psychiatric Rehabilitation Unit of the Regional Hospital, Sunyani, Ghana. A purposive sample of 15 patients recovering from poly-substance use disorders were recruited. Data were collected through in-depth interviews with a semistructured guide and analysed using the content analysis procedures. Results: Five key themes emerged from the analysis of the data that described participants’ relapse prevention strategies. These include clinical strategies, self initiated tactics, spirituality and religious engagements, communalism and social support network. Conclusions: The evidence from this study supports a multilevel treatment strategy for patients with poly-substance disorders. We found that a combination of clinical, individual and contextual factors significantly contribute to relapse prevention efforts in the Ghanaian context. Clinicians and treatment services should explore, evaluate, strengthen and incorporate these emerging themes into their relapse prevention interventions protocols
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    Exploring factors having an impact on attitudes and motivations towards volunteering in the undergraduate nursing student population − A comparative study of the UK and Ghana
    (Nurse Education in Practice, 2021) Dyson, S.E.; Korsah, K.A.; Liu, L.Q.; O’Driscoll, M.; van den Akker, O.B.A.
    This study explores attitudes and motivations towards volunteering in nursing students in Ghana compared with nursing students in the United Kingdom (UK). Ghana traditionally follows a western model of nurse education, with students studying programmes commensurate in theory and practice, making Ghana a suitable location for a comparative study. We explored similarities and differences in attitudes and motivation towards volunteering to challenge and inform our common place practice towards nursing pedagogy. Ghanaian students displayed positive attitudes towards volunteering, although these did not translate into increased motivation to volunteer while at university. Students reported financial constraints as reasons for not volunteering as did UK students, although Ghanaian students used available resources for daily living expenses, whereas UK students prioritised available resources to pay down student debt. Structured volunteering was absent from both Ghanaian and UK nursing programmes, despite its potential to increase the variety of social groups or situations to which students are exposed, to increase self-confidence and to encourage greater reflection on practice through doing. Structural challenges within countries may provide a better explanation of variation in student motivation towards vol unteering, than cross-cultural variation in attitudes towards volunteering between countries.
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    Development of nurse education in Saudi Arabia, Jordan and Ghana: From undergraduate to doctoral programmes
    (Nurse Education in Practice, 2020) Anthony, D.; Alosaimi, D.; Dyson, S.; Korsah, K.A.; Saleh, M.
    Doctoral programmes in nursing have a long history in the US where traditional research based PhDs and more clinically based doctoral programmes are common. In the rest of the world PhDs are better accepted though professional doctorates with a thesis component are common in the UK. In countries with newly established or planned doctoral programmes in nursing the research PhD seems the degree of choice. Here we discuss developments in Jordan, Saudi Arabia and Ghana. This study used official documents, strategic plans, curriculum developments and other documentary evidence from Saudi Arabia, Jordan and Ghana. We compared doctoral programmes and development with other countries by reference to the literature. We offer the example of public health and non-communicable diseases in particular as one area where doctorally trained nurses applying international standards in collaboration internationally may be of benefit.
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    Perception of Dieners Regarding Social Acceptance and the Right toWork: A Qualitative Study
    (SAGE Open, 2024) Dartey, F. A.; Dzansi, G.; Nyande, F. K.; et al
    Globally, the right to work is a modest human right. It is a right acknowledged under the Universal Declaration of Human Rights which delineates the various types of work. As such, each person is at liberty to take up any job granted that one has the capacity and skills. This decision must be free from stigma or discrimination. However, this is not the case with mortuary attendants in Ghana. This study explored the viewpoints of Ghanaian mortuary attendants and how society perceives their rights to work. The study used a qualitative research approach, with exploratory and descriptive designs, that sought an indepth understanding from sampled mortuary attendants on the perception of their community members toward their work. Saturation was attained with nineteen (19) participants from nine (9) health facilities located in the three regions. Semi-structured interviews were conducted and audio recorded with concurrent data transcription and analysis using content analysis. Purposive sampling was used. The study included male or female mortuary employees with at least 1 year of working experience. The themes that emerged were as follows; self-stigma, public stigma, stigma-by-association, and structural stigma. The results were structured according to a stigma model. The study reveals high levels of stigmatization and discrimination against mortuary attendants. Researchers recommend the need for public education, and policy changes to reverse the scornful stigmatization and discrimination against death care workers and those in related profiles.
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    A qualitative study on women’s breast cancer diagnosis disclosure preferences and disclosure experiences in a middle-income country
    (International Journal of Africa Nursing Sciences, 2023) Osei-Tutu, F.; Iddrisu, M.; Dzansi, G.; et al.
    With the increasing cancer incidence in Ghana especially breast cancer among women, its diagnosis and prog nosis present enormous fear and worry for women and their families. Thus, breaking the news of breast cancer diagnosis to patients presents enormous difficulty to healthcare professionals. Aim: This study sought to explore the preferences of people living with breast cancer regarding the disclosure of their diagnosis. Methods: The study used an exploratory-descriptive qualitative design to recruit and interviewed 17 women diagnosed with breast cancer and receiving treatment in a National Radiotherapy and Nuclear Medicine Center of a major Teaching Hospital in Ghana. Data were analyzed using Braun and Clarke’s 2006 thematic analysis approach. Findings: Two major themes, six subthemes, and five sub-subthemes were generated from the data. The study found that patients preferred detailed information on the stage of their cancer diagnosis, treatment options, and the lifestyle necessary to enhance their health. The participants preferred that the news of their diagnosis be broken to them gradually in the form of a conversation with consolatory gestures, without any hidden infor mation. From the study, clinicians do not follow any specific systematic method in the disclosure process, cli nicians used a conversation approach involving consolation, encouragement, comic words, and pampering mostly in disclosing cancer diagnosis which was found relieving. In conclusion, People living with breast cancer prefer full gradual disclosure of diagnosis in a conducive envi ronment in the presence of loved ones in a humane manner
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    A qualitative exploration of cognitive and sociocultural influences on postoperative pain among urological patients in Ghana
    (International Journal of Africa Nursing Sciences, 2023) Hayford, L.; Aziato, L.; Kyei, M.Y.
    Background: Patients ascribe diverse meanings to postoperative pain (POP), usually based on personal beliefs. However, patients’ perceptions about the causes of pain are usually influenced by their traditional beliefs and misconceptions, and cultural factors such as ethnic background serve as barriers to effective pain control. The study sought to explore the cognitive and sociocultural aspects of postoperative pain experience after urological surgeries. Methods: The study employed exploratory descriptive qualitative research design. Twelve male participants who had undergone urological surgery in a teaching hospital were recruited using purposive sampling. Data were collected through individual face-to-face in-depth interviews, conducted in English and Akan languages. The interviews were audio-taped and transcribed verbatim. Ethical considerations such as informed consent, anonymity, and confidentiality were ensured. Concurrent data analysis was done engaging the processes of content analysis. Findings: Cognitive aspects of the POP revealed three themes; the knowledge of the pain, attitude, and beliefs of the patients, and meanings the patients ascribed to the pain. Similarly, sociocultural aspects revealed two emerging themes; the family dynamics and roles influencing pain experience, and individual cultural background and belief systems. The participants’ diverse views and experiences influenced their pain expression and experience after urological surgery. Conclusions: Postoperative pain is a multidimensional experience and includes socio-cultural and cognitive aspects. Therefore, contemporary pain management strategies should focus on client-centered and culturally sensitive interventions.