Background: This paper presents findings from a follow-up evaluation of the 63 graduates of the f... more Background: This paper presents findings from a follow-up evaluation of the 63 graduates of the first two cohorts of an HIV Nurse Practitioner (HNP) program that was initiated in Zambia in 2009. Methods: This was a descriptive study that incorporated a mixture of quantitative and qualitative data collection methods. A structured interview guide was used to collect data during structured interviews with 40 of the 63 graduates of the HNP program, 39 of their supervisors, and 49 of their patients. In addition 566 charts were audited to assess the quality of care provided by the graduates. Results: Findings indicate that the graduates were assuming the expanded roles for which they were prepared , and many were working in other units in addition to the ART clinic. Patients reported a high level of satisfaction with the quality of care provided by the graduates, and reported that the graduates were providing quality care. The data from the chart audits indicated that although the graduates are generally documenting and providing care appropriately, there are areas that should be improved and emphasized in refresher courses and in the future HNP educational programs. Conclusions: Findings are consistent with findings from the limited number of other published studies suggesting that nurses can provide high-quality care for patients with HIV and AIDS. Further research is recommended to assess the impact of such programs on morbidity and mortality indicators, and on staff retention and job satisfaction of nurses and also of the HNPs.
Objective: The objective of the study was to determine factors contributing to acceptability of H... more Objective: The objective of the study was to determine factors contributing to acceptability of Highly Active Anti-Retro Therapy (HAART) by HIV-positive clients co-infected with tuberculosis accessing care at health facilities in Livingstone district, Zambia. Design: An explorative descriptive design study was conducted at three major chest clinics in Livingstone; namely Livingstone General Hospital, Mahatma Gandhi and Sepo health centers. The study population was all the TB/HIV co-infected patients aged between 18 and 49 years who were referred for HAART in the previous one month or more prior to the study and were not critically ill. The respondents were selected using systematic sampling method. A total number of 131 TB/HIV co-infected patients who were being attended to at the selected chest clinics in Livingstone were enrolled into the study. Data were collected using a structured interview schedule and focus group discussion guide to enable the investigator collect both quantitative and qualitative data. Epi-info version 6 and SPSS 12.0 for windows software computer packages were used to analyze the quantitative data. Chi-square was used to measure association between the dependent variable (acceptability of HAART by TB patients) and the independent variables. With the confidence interval set at 95%, the p value was used to ascertain the degree of significance by using the decision rule which rejects the null hypothesis if p value is equal or less than 0.05. Results: This study revealed that the most significant factors associated with acceptability of HAART by TB patients and accessibility of HAART were knowledge of TB and HIV relationship including HAART, HIV-related stigma and discrimination and support from health care providers regarding HAART. A significant association was found between knowledge of TB and HIV relationship and safety of taking HAART while on TB treatment, 77.9% of the respondents who did not know the relationship between TB and HIV indicated that it was not safe to take HAART concurrently with TB treatment (p value 0.000). There was also significant association knowledge of commencement of HAART in TB patients and discussion of HAART and its benefits with the counselor. Of the 52 respondents who did not know that HAART could be commenced in TB patients, majority (71.2%) did not discuss HAART and its benefits with the counselor (p value 0.001). In addition, there was a significant association between HIV-related stigma and discrimination and acceptability of HAART. Majority (78.7%) of the respondents who were treated differently because of HIV reported that they would not go back to the ART clinic for medication (p value 0.002). Furthermore, respondents whose HAART concerns were not addressed (74.1%) would not go back to the ART clinic for HAART (p value 0.008). The results further showed that factors such as TB-related stigma and discrimination, sex, age, marital status and
Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In ... more Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In 2009 the HIV Nurse Practitioner (HNP) program was implemented to address the disease burden of HIV and AIDS that is worsened by a critical shortage of health care workers and in Zambia. The objective of this study was to analyze the perceptions of supervisors of the first three cohorts of graduates of the HNP program regarding the HNP role, the impact of the role on the quality of care for HIV patients and their families, and perceived challenges in integrating the HNP graduates into the Zambian health system. Methods: This paper reports findings from a cross-sectional survey of the supervisors from the first three cohorts of Zambian HNP graduates who completed the program between 2010-2012. Thematic analysis was used to identify themes from the responses of 60 supervisors. The project received approval from the University of Zambia Biomedical Research Ethics Committee and from the University of Alabama at Birmingham Institutional Review Board. Results: The HNP graduates' supervisors reported an understanding of the role, and a positive perception of the impact of the HNP cadre on the quality of HIV and AIDS care for patients and their families. The perceived challenges to integration of the HNP into the Zambian health system included the need to clarify job descriptions and responsibilities for the new role within the Ministry of Health, addressing issues related to the shortage of nurses to meet other health needs, ensuring appropriate referral of complex cases, and providing ongoing HNP supervision. Conclusion: The findings in this study can be used to guide the development of this program and the development of future task-shifting programs to provide comprehensive care to patients with HIV and AIDS.
Social media is not only an emerging and cultural trend, but a method of communication that is ch... more Social media is not only an emerging and cultural trend, but a method of communication that is changing the way individuals and organizations throughout the world transmit and receive information. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within the health care system. Social mobile media spaces provide a platform that can assist both qualified and student nurses keep in touch with each other and share best practices and prevent isolation for those placed in far flung areas of the country. Data were obtained from WhatsApp discussions involving one group of HIV nurse practitioners followed for a period of six weeks. Data analysis was conducted by the lead investigators and took the form of thematic analysis. The data were constantly compared with the codes in order that the shift in the meaning is minimized and accuracy and confir-mability is maintained. Ethical approval was obtained from the University of Zambia, School of Medicine's Research Ethics Committee. Anonymity was maintained through the use of pseudonyms. The results revealed that social media as tool of communication in Zambia has been used by HIV Nurse Practitioners in both urban and rural areas for sharing best practices and prevention of professional isolation. The tool is also used for emotional and social support as well as a source of motivation for its users. Mobile Instant Messaging (MIM) is a resource that can benefit the nursing profession in keeping abreast with the new trends in the care of patients and prevention of professional isolation. However, it is important to ensure that the interaction is structured to prevent digression from the core purpose which might lead to loss of direction.
This study seeks to explore the use of social media to support the learning of nursing students i... more This study seeks to explore the use of social media to support the learning of nursing students in Zambia. Data was collected from the WhatsApp and email conversation chats involving 76 nursing students at the University of Zambia School. The content of the conversation chats was analyzed in terms of common themes, patterns and interrelationships. It was established that nursing students can take a leading role in empowering themselves by taking charge of their continued learning by using social media responsibly. Key findings that emerged from the WhatsApp and e-mail discussions are: Knowledge enhancement and sharing of best practices were significant in the WhatsApp Group, Virtual Classroom community, was significantly stronger in the WhatsApp group, WhatsApp group had a minimally more positive placement experience, other measures (social capital/knowledge applica-tion/learning dimension community) did not differ significantly. The use of social mobile media is not only limited to professional nurses but also nursing students. As the training of nurse professionals evolves in the midst of high technology use, more and more students may seek to prefer the use of social mobile media as a tool for continuous learning. In comparison to the email platform, students in the WhatsApp were able to maintain conversations up to the end of the allocated period of the study. The information gathered from this project can be useful to fostering a unified understanding of professional knowledge and a feeling of belongingness among nursing students.
The purpose of this study was to develop a pain assessment tool for use among post-operative pati... more The purpose of this study was to develop a pain assessment tool for use among post-operative patients in Zambia (Post-operative Pain Assessment tool for Zambia: POPAZ). Phase 1 of this project was an epidemiological quantitative analytic study conducted at the University Teaching Hospitals, Lusaka in Zambia. The sample size were key informants comprising 30 surgeons and nurses who had worked consecutively on the surgical wards for three or more months and were actively involved in providing direct patient care to post-surgical patients. An adapted Clinical Decision Making Survey tool was used to collect the data.
The study revealed five (5) relevant measures of post-operative pain. These included patient mobility/activity, level of tolerance to activity, facial expressions, vital signs and overall patient behaviour. Findings of this phase have thus provided a framework for the development of a post-operative pain assessment that can be used on post-surgical patients following major abdominal surgery.
Diabetes mellitus is a major public health problem that is approaching epidemic proportions world... more Diabetes mellitus is a major public health problem that is approaching epidemic proportions worldwide. Uncontrolled disease can lead to complications which can eventually result in reduced life expectancy and major health cost. Glucose control is fundamental in delaying the onset of complications as such patients are required to practice regular self-care in order to achieve optimal blood glucose levels and prevent complications. Higher self-efficacy has been shown to contribute to improved self-care behaviour and better glycaemic control. The study therefore sought to evaluate the relationship between self-efficacy and self-care practices, in glycemic control among adults with diabetes mellitus, receiving care at Kitwe Teaching Hospital, Zambia. A cross sectional correlational study design was utilized. A total of 112 patients participated in a study. They were selected using a simple random sampling method. A structured interview schedule was used to collect data on self-care practice. Self-efficacy was measured using a modified Diabetes Self-efficacy Scale and glycemic control was obtained by calculating the average of three consecutive fasting blood sugar results. Data was entered and analyzed using the Statistical Package for Social Sciences (SPSS) for Windows version 25.0. The Chi-square and Fisher's exact tests were used to test the associations between variables. The Binary logisticregression was used to determine the true predictor variables to glycemic control. The study results showed that more than three quarters (79.4%) of the participants had poor glycemic control, more than half (61.6%) of the participants had high self-efficacy and about two thirds (66%) of the participants practiced good self-care. The study results showed a statically significant relationship between glycaemic control and self-efficacy p<0.001. The finding of the binary logistic regression analysis was statistically significant (p<0.01) as it showed that patients who practiced good self-care had 6.64 times greater odds of glycaemic control (OR: 6.64, CI: .46, .88). There is, therefore, need to strengthen the educational programs with emphasis on selfcare activities to help achieve normal glycaemic levels. Self-efficacy should also be incorporated in the diabetic treatment protocols as it enhances self-care practice.
EAS journal of nursing and midwifery, Mar 27, 2024
Introduction: The research was conducted to evaluate the health-related quality of life in indivi... more Introduction: The research was conducted to evaluate the health-related quality of life in individuals diagnosed with type 2 diabetes mellitus at Levy Mwanawasa University Teaching Hospital, located in Lusaka, Zambia. Diabetes mellitus has become a serious global public health concern with huge impact on human life and health expenditures (Khan et al., 2020). With many people affected, diabetes mellitus has an impact on individual's functional capacities and quality of life, which leads to significant morbidity and mortality (Rantahal et al., 2015). Methodology: The research employed an analytical cross-sectional research design to assess the health-related quality of life in patients with type 2 diabetes at Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia. It involved a comprehensive review of current knowledge and the gathering of primary sources to build a theoretical model based on existing evidence. The study sample consisted of 134 respondents, and data were collected using structured interview schedules. Simple random sampling method was used to select the study respondents, and a sampling frame was employed every day and randomly sampled some respondents. To assess and identify factors associated with health related quality of life in type 2 diabetes mellitus patients, Chi-square and multivariate logistic regression analyses were employed through SPSS version 23. The Odds Ratio with a 95% confidence interval was computed to determine the level of association. The variables with p-value less than 5%, in the multivariate analysis were considered as statistically associated, association between covariates and Health Related Quality of Life. Results: The findings revealed that a significant portion, 43.3%, of type 2 diabetes mellitus patients at LMUTH reported a low quality of life. This low quality of life was found to be associated with various socio-demographic factors. Specifically, individuals who were not employed, lacked regular exercise, and had lower levels of education were more likely to experience a lower quality of life. On the other hand, those with secondary or tertiary education, older individuals, and those who self-reported good management of their quality of life tended to have better outcomes. Conclusion: The study underscores the importance of patient empowerment, emphasizing the need for counseling and self-care education to enhance the quality of life among LMUTH's type 2 diabetes patients. Targeting interventions at younger patients with lower educational levels, those who are unemployed, and those with a sedentary lifestyle is crucial. One of the key recommendations arising from the study is the implementation of a comprehensive, multidisciplinary care approach. This approach would involve collaboration between medical professionals, psychologists, nutritionists, and social workers to provide holistic support to patients, addressing not only their medical needs but also their psychological wellbeing. This integrated approach aims to improve the overall quality of life for individuals living with type 2 diabetes at LMUTH.
Background: There is evidence that multidisciplinary healthcare teams can provide better quality ... more Background: There is evidence that multidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article is based applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia. Methods: Four distinct but interrelated approaches, namely desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed. Results: Several models of interprofessional education currently in existence and used successfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the “didactic program, community-based experience, and interprofessional-simulation experience” models. To apply the models, modules of seven ...
BACKGROUND In a bid to enhance eLearning at Mulungushi University School of Medicine and Health S... more BACKGROUND In a bid to enhance eLearning at Mulungushi University School of Medicine and Health Sciences in Kabwe - Zambia, the Strengthening Health Professional Workforce Education Programs for Improved Quality Health Care in Zambia (SHEPIZ) project in 2020, conducted an evaluation of Mulungushi University's level of preparedness for eLearning as an initial step towards building the university’s capacity. OBJECTIVE This article provides a systematic description of the evaluation process, lessons learned, and implications for the future in enhancing eLearning programs at Mulungushi University School of Medicine and Health Sciences. METHODS The evaluation process took a two-phased approach. The first phase involved a desk review of literature on eLearning evaluation that informed the development of a framework to be used in the evaluation process. In the second phase, actual data was gathered through key informant interviews and a thorough physical assessment of ICT infrastructur...
Introduction: There is a significant shortage of medical subspecialists in Zambia. The government... more Introduction: There is a significant shortage of medical subspecialists in Zambia. The government of Zambia, through programmes at the Ministry ofHealth, spends considerable resources to send patients outside the country for subspecialist medical treatment. The objective of this analysis was to evaluate the current situation pertaining to medical subspecialty training at the University of Zambia School of Medicine (UNZASOM) and to illustrate the new programmes that are to be introduced. Methods: We collected data from formal desk reviews on the state of medical specialisation in Zambia, the UNZASOM graduation archives and patient referral records at the Ministry of Health (MoH). In addition, information on planned subspecialist programmes is presented. Results: From the first graduates in 1986up to 2019, UNZASOM produced 3 51 medical specialists, 63 (18%) in Internal Medicine, 77 (22%) in Obstetrics & Gynaecology, 82 (23%) in Paediatrics&Child Health, 68 (19%) in General Surgery, 1...
BACKGROUND Health practitioners across the globe are rapidly adopting social and mobile media in ... more BACKGROUND Health practitioners across the globe are rapidly adopting social and mobile media in their professional practices. However, this appropriation carries considerable risks and requires the development of digital professionalism. OBJECTIVE The objective of this study was to examine the potential of an interactive scenario-based mobile learning tutorial for the training of social and mobile media guidelines and compare it to the standard route of distributing and studying paper-based guidelines. METHODS To do so, an experiment was conducted in which 71 Zambian nurses were randomized into two groups. Participants in the first group (n=27) worked through a simple, smartphone-based tutorial with authentic text scenarios and reflective prompts and questions that drew on newly developed social and mobile media guidelines for Zambian nurses and midwives. In the second group (n=31), the nurses studied the paper guideline directly, which is the standard way of guideline disseminatio...
International Journal of Nursing Education Scholarship, 2011
This article describes the implementation and evaluation of a program to prepare HIV Nurse Practi... more This article describes the implementation and evaluation of a program to prepare HIV Nurse Practitioners in Zambia. Thirty nurses from all nine Zambian provinces participated in this program. Data on a variety of indicators were collected at baseline and throughout the one-year program including student and supervisor assessments, student performance on pre- and post-tests, clinical and case study assessments, documentation of care in patients’ health records, and their performance on final oral and written examinations. Findings indicated that the students were able to achieve the identified competencies and that their supervisors perceived that they would be able to implement their expanded skills to improve care for patients with HIV and AIDS in Zambia. Lessons learned from this initial pilot project will be used to expand the program in order to ensure successful task-shifting to address the critical shortage of health workers in Zambia in the context of the HIV/AIDS epidemic.
Background: Making changes in the existing curriculum aims, objectives, course contents learning ... more Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern's six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally; 2) Administration of the needs assessment questionnaire to key informants; 3) Strengths, weakness, opportunities and threat analysis; 4) Consultative meeting with major stakeholders; 5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some "A" level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for How to cite this paper:
Objective : The objective of the study was to determine factors contributing to acceptability of ... more Objective : The objective of the study was to determine factors contributing to acceptability of Highly Active Anti-Retro Therapy (HAART) by HIV-positive clients co-infected with tuberculosis accessing care at health facilities in Livingstone district, Zambia. Design : An explorative descriptive design study was conducted at three major chest clinics in Livingstone; namely Livingstone General Hospital, Mahatma Gandhi and Sepo health centers. The study population was all the TB/HIV co-infected patients aged between 18 and 49 years who were referred for HAART in the previous one month or more prior to the study and were not critically ill. The respondents were selected using systematic sampling method. A total number of 131 TB/HIV coinfected patients who were being attended to at the selected chest clinics in Livingstone were enrolled into the study. Data were collected using a structured interview schedule and focus group discussion guide to enable the investigator collect both quant...
Background: This paper presents findings from a follow-up evaluation of the 63 graduates of the f... more Background: This paper presents findings from a follow-up evaluation of the 63 graduates of the first two cohorts of an HIV Nurse Practitioner (HNP) program that was initiated in Zambia in 2009. Methods: This was a descriptive study that incorporated a mixture of quantitative and qualitative data collection methods. A structured interview guide was used to collect data during structured interviews with 40 of the 63 graduates of the HNP program, 39 of their supervisors, and 49 of their patients. In addition 566 charts were audited to assess the quality of care provided by the graduates. Results: Findings indicate that the graduates were assuming the expanded roles for which they were prepared , and many were working in other units in addition to the ART clinic. Patients reported a high level of satisfaction with the quality of care provided by the graduates, and reported that the graduates were providing quality care. The data from the chart audits indicated that although the graduates are generally documenting and providing care appropriately, there are areas that should be improved and emphasized in refresher courses and in the future HNP educational programs. Conclusions: Findings are consistent with findings from the limited number of other published studies suggesting that nurses can provide high-quality care for patients with HIV and AIDS. Further research is recommended to assess the impact of such programs on morbidity and mortality indicators, and on staff retention and job satisfaction of nurses and also of the HNPs.
Objective: The objective of the study was to determine factors contributing to acceptability of H... more Objective: The objective of the study was to determine factors contributing to acceptability of Highly Active Anti-Retro Therapy (HAART) by HIV-positive clients co-infected with tuberculosis accessing care at health facilities in Livingstone district, Zambia. Design: An explorative descriptive design study was conducted at three major chest clinics in Livingstone; namely Livingstone General Hospital, Mahatma Gandhi and Sepo health centers. The study population was all the TB/HIV co-infected patients aged between 18 and 49 years who were referred for HAART in the previous one month or more prior to the study and were not critically ill. The respondents were selected using systematic sampling method. A total number of 131 TB/HIV co-infected patients who were being attended to at the selected chest clinics in Livingstone were enrolled into the study. Data were collected using a structured interview schedule and focus group discussion guide to enable the investigator collect both quantitative and qualitative data. Epi-info version 6 and SPSS 12.0 for windows software computer packages were used to analyze the quantitative data. Chi-square was used to measure association between the dependent variable (acceptability of HAART by TB patients) and the independent variables. With the confidence interval set at 95%, the p value was used to ascertain the degree of significance by using the decision rule which rejects the null hypothesis if p value is equal or less than 0.05. Results: This study revealed that the most significant factors associated with acceptability of HAART by TB patients and accessibility of HAART were knowledge of TB and HIV relationship including HAART, HIV-related stigma and discrimination and support from health care providers regarding HAART. A significant association was found between knowledge of TB and HIV relationship and safety of taking HAART while on TB treatment, 77.9% of the respondents who did not know the relationship between TB and HIV indicated that it was not safe to take HAART concurrently with TB treatment (p value 0.000). There was also significant association knowledge of commencement of HAART in TB patients and discussion of HAART and its benefits with the counselor. Of the 52 respondents who did not know that HAART could be commenced in TB patients, majority (71.2%) did not discuss HAART and its benefits with the counselor (p value 0.001). In addition, there was a significant association between HIV-related stigma and discrimination and acceptability of HAART. Majority (78.7%) of the respondents who were treated differently because of HIV reported that they would not go back to the ART clinic for medication (p value 0.002). Furthermore, respondents whose HAART concerns were not addressed (74.1%) would not go back to the ART clinic for HAART (p value 0.008). The results further showed that factors such as TB-related stigma and discrimination, sex, age, marital status and
Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In ... more Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In 2009 the HIV Nurse Practitioner (HNP) program was implemented to address the disease burden of HIV and AIDS that is worsened by a critical shortage of health care workers and in Zambia. The objective of this study was to analyze the perceptions of supervisors of the first three cohorts of graduates of the HNP program regarding the HNP role, the impact of the role on the quality of care for HIV patients and their families, and perceived challenges in integrating the HNP graduates into the Zambian health system. Methods: This paper reports findings from a cross-sectional survey of the supervisors from the first three cohorts of Zambian HNP graduates who completed the program between 2010-2012. Thematic analysis was used to identify themes from the responses of 60 supervisors. The project received approval from the University of Zambia Biomedical Research Ethics Committee and from the University of Alabama at Birmingham Institutional Review Board. Results: The HNP graduates' supervisors reported an understanding of the role, and a positive perception of the impact of the HNP cadre on the quality of HIV and AIDS care for patients and their families. The perceived challenges to integration of the HNP into the Zambian health system included the need to clarify job descriptions and responsibilities for the new role within the Ministry of Health, addressing issues related to the shortage of nurses to meet other health needs, ensuring appropriate referral of complex cases, and providing ongoing HNP supervision. Conclusion: The findings in this study can be used to guide the development of this program and the development of future task-shifting programs to provide comprehensive care to patients with HIV and AIDS.
Social media is not only an emerging and cultural trend, but a method of communication that is ch... more Social media is not only an emerging and cultural trend, but a method of communication that is changing the way individuals and organizations throughout the world transmit and receive information. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within the health care system. Social mobile media spaces provide a platform that can assist both qualified and student nurses keep in touch with each other and share best practices and prevent isolation for those placed in far flung areas of the country. Data were obtained from WhatsApp discussions involving one group of HIV nurse practitioners followed for a period of six weeks. Data analysis was conducted by the lead investigators and took the form of thematic analysis. The data were constantly compared with the codes in order that the shift in the meaning is minimized and accuracy and confir-mability is maintained. Ethical approval was obtained from the University of Zambia, School of Medicine's Research Ethics Committee. Anonymity was maintained through the use of pseudonyms. The results revealed that social media as tool of communication in Zambia has been used by HIV Nurse Practitioners in both urban and rural areas for sharing best practices and prevention of professional isolation. The tool is also used for emotional and social support as well as a source of motivation for its users. Mobile Instant Messaging (MIM) is a resource that can benefit the nursing profession in keeping abreast with the new trends in the care of patients and prevention of professional isolation. However, it is important to ensure that the interaction is structured to prevent digression from the core purpose which might lead to loss of direction.
This study seeks to explore the use of social media to support the learning of nursing students i... more This study seeks to explore the use of social media to support the learning of nursing students in Zambia. Data was collected from the WhatsApp and email conversation chats involving 76 nursing students at the University of Zambia School. The content of the conversation chats was analyzed in terms of common themes, patterns and interrelationships. It was established that nursing students can take a leading role in empowering themselves by taking charge of their continued learning by using social media responsibly. Key findings that emerged from the WhatsApp and e-mail discussions are: Knowledge enhancement and sharing of best practices were significant in the WhatsApp Group, Virtual Classroom community, was significantly stronger in the WhatsApp group, WhatsApp group had a minimally more positive placement experience, other measures (social capital/knowledge applica-tion/learning dimension community) did not differ significantly. The use of social mobile media is not only limited to professional nurses but also nursing students. As the training of nurse professionals evolves in the midst of high technology use, more and more students may seek to prefer the use of social mobile media as a tool for continuous learning. In comparison to the email platform, students in the WhatsApp were able to maintain conversations up to the end of the allocated period of the study. The information gathered from this project can be useful to fostering a unified understanding of professional knowledge and a feeling of belongingness among nursing students.
The purpose of this study was to develop a pain assessment tool for use among post-operative pati... more The purpose of this study was to develop a pain assessment tool for use among post-operative patients in Zambia (Post-operative Pain Assessment tool for Zambia: POPAZ). Phase 1 of this project was an epidemiological quantitative analytic study conducted at the University Teaching Hospitals, Lusaka in Zambia. The sample size were key informants comprising 30 surgeons and nurses who had worked consecutively on the surgical wards for three or more months and were actively involved in providing direct patient care to post-surgical patients. An adapted Clinical Decision Making Survey tool was used to collect the data.
The study revealed five (5) relevant measures of post-operative pain. These included patient mobility/activity, level of tolerance to activity, facial expressions, vital signs and overall patient behaviour. Findings of this phase have thus provided a framework for the development of a post-operative pain assessment that can be used on post-surgical patients following major abdominal surgery.
Diabetes mellitus is a major public health problem that is approaching epidemic proportions world... more Diabetes mellitus is a major public health problem that is approaching epidemic proportions worldwide. Uncontrolled disease can lead to complications which can eventually result in reduced life expectancy and major health cost. Glucose control is fundamental in delaying the onset of complications as such patients are required to practice regular self-care in order to achieve optimal blood glucose levels and prevent complications. Higher self-efficacy has been shown to contribute to improved self-care behaviour and better glycaemic control. The study therefore sought to evaluate the relationship between self-efficacy and self-care practices, in glycemic control among adults with diabetes mellitus, receiving care at Kitwe Teaching Hospital, Zambia. A cross sectional correlational study design was utilized. A total of 112 patients participated in a study. They were selected using a simple random sampling method. A structured interview schedule was used to collect data on self-care practice. Self-efficacy was measured using a modified Diabetes Self-efficacy Scale and glycemic control was obtained by calculating the average of three consecutive fasting blood sugar results. Data was entered and analyzed using the Statistical Package for Social Sciences (SPSS) for Windows version 25.0. The Chi-square and Fisher's exact tests were used to test the associations between variables. The Binary logisticregression was used to determine the true predictor variables to glycemic control. The study results showed that more than three quarters (79.4%) of the participants had poor glycemic control, more than half (61.6%) of the participants had high self-efficacy and about two thirds (66%) of the participants practiced good self-care. The study results showed a statically significant relationship between glycaemic control and self-efficacy p<0.001. The finding of the binary logistic regression analysis was statistically significant (p<0.01) as it showed that patients who practiced good self-care had 6.64 times greater odds of glycaemic control (OR: 6.64, CI: .46, .88). There is, therefore, need to strengthen the educational programs with emphasis on selfcare activities to help achieve normal glycaemic levels. Self-efficacy should also be incorporated in the diabetic treatment protocols as it enhances self-care practice.
EAS journal of nursing and midwifery, Mar 27, 2024
Introduction: The research was conducted to evaluate the health-related quality of life in indivi... more Introduction: The research was conducted to evaluate the health-related quality of life in individuals diagnosed with type 2 diabetes mellitus at Levy Mwanawasa University Teaching Hospital, located in Lusaka, Zambia. Diabetes mellitus has become a serious global public health concern with huge impact on human life and health expenditures (Khan et al., 2020). With many people affected, diabetes mellitus has an impact on individual's functional capacities and quality of life, which leads to significant morbidity and mortality (Rantahal et al., 2015). Methodology: The research employed an analytical cross-sectional research design to assess the health-related quality of life in patients with type 2 diabetes at Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia. It involved a comprehensive review of current knowledge and the gathering of primary sources to build a theoretical model based on existing evidence. The study sample consisted of 134 respondents, and data were collected using structured interview schedules. Simple random sampling method was used to select the study respondents, and a sampling frame was employed every day and randomly sampled some respondents. To assess and identify factors associated with health related quality of life in type 2 diabetes mellitus patients, Chi-square and multivariate logistic regression analyses were employed through SPSS version 23. The Odds Ratio with a 95% confidence interval was computed to determine the level of association. The variables with p-value less than 5%, in the multivariate analysis were considered as statistically associated, association between covariates and Health Related Quality of Life. Results: The findings revealed that a significant portion, 43.3%, of type 2 diabetes mellitus patients at LMUTH reported a low quality of life. This low quality of life was found to be associated with various socio-demographic factors. Specifically, individuals who were not employed, lacked regular exercise, and had lower levels of education were more likely to experience a lower quality of life. On the other hand, those with secondary or tertiary education, older individuals, and those who self-reported good management of their quality of life tended to have better outcomes. Conclusion: The study underscores the importance of patient empowerment, emphasizing the need for counseling and self-care education to enhance the quality of life among LMUTH's type 2 diabetes patients. Targeting interventions at younger patients with lower educational levels, those who are unemployed, and those with a sedentary lifestyle is crucial. One of the key recommendations arising from the study is the implementation of a comprehensive, multidisciplinary care approach. This approach would involve collaboration between medical professionals, psychologists, nutritionists, and social workers to provide holistic support to patients, addressing not only their medical needs but also their psychological wellbeing. This integrated approach aims to improve the overall quality of life for individuals living with type 2 diabetes at LMUTH.
Background: There is evidence that multidisciplinary healthcare teams can provide better quality ... more Background: There is evidence that multidisciplinary healthcare teams can provide better quality of care and treatment outcomes compared to that delivered by individuals from a single health discipline. The project on which this article is based applied the interprofessional education model to university pre-licensure health students in the management of chronic care conditions in Zambia. Methods: Four distinct but interrelated approaches, namely desk review; module development workshops; review and validation of modules by experts; piloting and review of the training modules were employed. Results: Several models of interprofessional education currently in existence and used successfully by higher education institutions in other settings were identified. While several models of Interprofessional Education were identified, our project adapted the “didactic program, community-based experience, and interprofessional-simulation experience” models. To apply the models, modules of seven ...
BACKGROUND In a bid to enhance eLearning at Mulungushi University School of Medicine and Health S... more BACKGROUND In a bid to enhance eLearning at Mulungushi University School of Medicine and Health Sciences in Kabwe - Zambia, the Strengthening Health Professional Workforce Education Programs for Improved Quality Health Care in Zambia (SHEPIZ) project in 2020, conducted an evaluation of Mulungushi University's level of preparedness for eLearning as an initial step towards building the university’s capacity. OBJECTIVE This article provides a systematic description of the evaluation process, lessons learned, and implications for the future in enhancing eLearning programs at Mulungushi University School of Medicine and Health Sciences. METHODS The evaluation process took a two-phased approach. The first phase involved a desk review of literature on eLearning evaluation that informed the development of a framework to be used in the evaluation process. In the second phase, actual data was gathered through key informant interviews and a thorough physical assessment of ICT infrastructur...
Introduction: There is a significant shortage of medical subspecialists in Zambia. The government... more Introduction: There is a significant shortage of medical subspecialists in Zambia. The government of Zambia, through programmes at the Ministry ofHealth, spends considerable resources to send patients outside the country for subspecialist medical treatment. The objective of this analysis was to evaluate the current situation pertaining to medical subspecialty training at the University of Zambia School of Medicine (UNZASOM) and to illustrate the new programmes that are to be introduced. Methods: We collected data from formal desk reviews on the state of medical specialisation in Zambia, the UNZASOM graduation archives and patient referral records at the Ministry of Health (MoH). In addition, information on planned subspecialist programmes is presented. Results: From the first graduates in 1986up to 2019, UNZASOM produced 3 51 medical specialists, 63 (18%) in Internal Medicine, 77 (22%) in Obstetrics & Gynaecology, 82 (23%) in Paediatrics&Child Health, 68 (19%) in General Surgery, 1...
BACKGROUND Health practitioners across the globe are rapidly adopting social and mobile media in ... more BACKGROUND Health practitioners across the globe are rapidly adopting social and mobile media in their professional practices. However, this appropriation carries considerable risks and requires the development of digital professionalism. OBJECTIVE The objective of this study was to examine the potential of an interactive scenario-based mobile learning tutorial for the training of social and mobile media guidelines and compare it to the standard route of distributing and studying paper-based guidelines. METHODS To do so, an experiment was conducted in which 71 Zambian nurses were randomized into two groups. Participants in the first group (n=27) worked through a simple, smartphone-based tutorial with authentic text scenarios and reflective prompts and questions that drew on newly developed social and mobile media guidelines for Zambian nurses and midwives. In the second group (n=31), the nurses studied the paper guideline directly, which is the standard way of guideline disseminatio...
International Journal of Nursing Education Scholarship, 2011
This article describes the implementation and evaluation of a program to prepare HIV Nurse Practi... more This article describes the implementation and evaluation of a program to prepare HIV Nurse Practitioners in Zambia. Thirty nurses from all nine Zambian provinces participated in this program. Data on a variety of indicators were collected at baseline and throughout the one-year program including student and supervisor assessments, student performance on pre- and post-tests, clinical and case study assessments, documentation of care in patients’ health records, and their performance on final oral and written examinations. Findings indicated that the students were able to achieve the identified competencies and that their supervisors perceived that they would be able to implement their expanded skills to improve care for patients with HIV and AIDS in Zambia. Lessons learned from this initial pilot project will be used to expand the program in order to ensure successful task-shifting to address the critical shortage of health workers in Zambia in the context of the HIV/AIDS epidemic.
Background: Making changes in the existing curriculum aims, objectives, course contents learning ... more Background: Making changes in the existing curriculum aims, objectives, course contents learning outcomes and assessment strategies have become a fact of life for nurse educators. Purpose: To enhance the existing Bachelor of Science (BSc) in nursing curriculum through integration of evidence-based practice (EBP) and teaching of critical thinking skills. Materials and Methods: A needs analysis was conducted using a five-phased approach to review the BSc in nursing Curriculum. Kern's six-step model was adapted and introduced through a series of workshop exercises that highlighted the application of each step: 1) Desk review of the BSc curriculum offered globally; 2) Administration of the needs assessment questionnaire to key informants; 3) Strengths, weakness, opportunities and threat analysis; 4) Consultative meeting with major stakeholders; 5) Curriculum review. Results: The five-phased approach established some gaps in existing curricula, and identified critical core competences and best practices in integrating EPB and critical thinking in the BSc undergraduate curriculum and some "A" level content that was not in tandem with the practice of nurses. New courses were developed to support students in academic writing and enhance professionalism and duration of training was reduced from 5 to 4 years. Conclusion: The process demonstrated that BSc curriculum review, in fact, should be thoroughly scrutinized to encourage positive changes to the curriculum, provide opportunities for How to cite this paper:
Objective : The objective of the study was to determine factors contributing to acceptability of ... more Objective : The objective of the study was to determine factors contributing to acceptability of Highly Active Anti-Retro Therapy (HAART) by HIV-positive clients co-infected with tuberculosis accessing care at health facilities in Livingstone district, Zambia. Design : An explorative descriptive design study was conducted at three major chest clinics in Livingstone; namely Livingstone General Hospital, Mahatma Gandhi and Sepo health centers. The study population was all the TB/HIV co-infected patients aged between 18 and 49 years who were referred for HAART in the previous one month or more prior to the study and were not critically ill. The respondents were selected using systematic sampling method. A total number of 131 TB/HIV coinfected patients who were being attended to at the selected chest clinics in Livingstone were enrolled into the study. Data were collected using a structured interview schedule and focus group discussion guide to enable the investigator collect both quant...
Social media is not only an emerging and cultural trend, but a method of communication that is ch... more Social media is not only an emerging and cultural trend, but a method of communication that is changing the way individuals and organizations throughout the world transmit and receive information. Nurses play a significant role in identification, interpretation, and transmission of knowledge and information within the health care system. Social mobile media spaces provide a platform that can assist both qualified and student nurses keep in touch with each other and share best practices and prevent isolation for those placed in far flung areas of the country. Data were obtained from WhatsApp discussions involving one group of HIV nurse practitioners followed for a period of six weeks. Data analysis was conducted by the lead investigators and took the form of thematic analysis. The data were constantly compared with the codes in order that the shift in the meaning is minimized and accuracy and confirmability is maintained. Ethical approval was obtained from the University of Zambia, School of Medicine's Research Ethics Committee. Anonymity was maintained through the use of pseudonyms. The results revealed that social media as tool of communication in Zambia has been used by HIV Nurse Practitioners in both urban and rural areas for sharing best practices and prevention of professional isolation. The tool is also used for emotional and social support as well as a source of motivation for its users. Mobile Instant Messaging (MIM) is a resource that can benefit the nursing profession in keeping abreast with the new trends in the care of patients and prevention of professional isolation. However, it is important to ensure that the interaction is structured to prevent digression from the core purpose which might lead to loss of direction.
Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In ... more Introduction: The disease burden of HIV and AIDS in Zambia is among the highest in the world. In 2009 the HIV Nurse Practitioner (HNP) program was implemented to address the disease burden of HIV and AIDS that is worsened by a critical shortage of health care workers and in Zambia. The objective of this study was to analyze the perceptions of supervisors of the first three cohorts of graduates of the HNP program regarding the HNP role, the impact of the role on the quality of care for HIV patients and their families, and perceived challenges in integrating the HNP graduates into the Zambian health system. Methods: This paper reports findings from a cross-sectional survey of the supervisors from the first three cohorts of Zambian HNP graduates who completed the program between 2010-2012. Thematic analysis was used to identify themes from the responses of 60 supervisors. The project received approval from the University of Zambia Biomedical Research Ethics Committee and from the University of Alabama at Birmingham Institutional Review Board. Results: The HNP graduates' supervisors reported an understanding of the role, and a positive perception of the impact of the HNP cadre on the quality of HIV and AIDS care for patients and their families. The perceived challenges to integration of the HNP into the Zambian health system included the need to clarify job descriptions and responsibilities for the new role within the Ministry of Health, addressing issues related to the shortage of nurses to meet other health needs, ensuring appropriate referral of complex cases, and providing ongoing HNP supervision. Conclusion: The findings in this study can be used to guide the development of this program and the development of future task-shifting programs to provide comprehensive care to patients with HIV and AIDS.
This study seeks to explore the use of social media to support the learning of nursing students i... more This study seeks to explore the use of social media to support the learning of nursing students in Zambia. Data was collected from the WhatsApp and email conversation chats involving 76 nursing students at the University of Zambia School. The content of the conversation chats was analyzed in terms of common themes, patterns and interrelationships. It was established that nursing students can take a leading role in empowering themselves by taking charge of their continued learning by using social media responsibly. Key findings that emerged from the WhatsApp and e-mail discussions are: Knowledge enhancement and sharing of best practices were significant in the WhatsApp Group, Virtual Classroom community, was significantly stronger in the WhatsApp group, WhatsApp group had a minimally more positive placement experience, other measures (social capital/knowledge application/learning dimension community) did not differ significantly. The use of social mobile media is not only limited to professional nurses but also nursing students. As the training of nurse professionals evolves in the midst of high technology use, more and more students may seek to prefer the use of social mobile media as a tool for continuous learning. In comparison to the email platform, students in the WhatsApp were able to maintain conversations up to the end of the allocated period of the study. The information gathered from this project can be useful to fostering a unified understanding of professional knowledge and a feeling of belongingness among nursing students.
Systematic, routine pain assessment using standardized clinical guidelines is the foundation of e... more Systematic, routine pain assessment using standardized clinical guidelines is the foundation of effective pain management for patients who are unable to self-report pain. In Zambia, there are no context appropriate standardised clinical guidelines for post-operative pain observations. This study sought to develop such a clinical guideline in form of an assessment tool. The study adopted an exploratory sequential mixed method through a three-phased approach and an adapted Clinical Decision Making Survey instrument was used. Snowball sampling was employed and in phases II and III, purposive sampling was used. The study was conducted at the University Teaching Hospitals where 120 participants were enrolled in the study. Phases II and III provided preliminary internal validation processes of the developed tool, where discussions, orientation and trial implementation of the tool were done. In phase II of the study, 47 participants comprising of nurses participated while in phase III, the...
International Journal of Africa Nursing Sciences, 2015
ABSTRACT This paper presents findings from a follow-up evaluation of the 63 graduates of the firs... more ABSTRACT This paper presents findings from a follow-up evaluation of the 63 graduates of the first two cohorts of an HIV Nurse Practitioner (HNP) program that was initiated in Zambia in 2009.
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Other by Ruth Wahila
The study revealed five (5) relevant measures of post-operative pain. These included patient mobility/activity, level of tolerance to activity, facial expressions, vital signs and overall patient behaviour. Findings of this phase have thus provided a framework for the development of a post-operative pain assessment that can be used on post-surgical patients following major abdominal surgery.
Papers by Ruth Wahila
The study revealed five (5) relevant measures of post-operative pain. These included patient mobility/activity, level of tolerance to activity, facial expressions, vital signs and overall patient behaviour. Findings of this phase have thus provided a framework for the development of a post-operative pain assessment that can be used on post-surgical patients following major abdominal surgery.