DSpace Collection: 1 - 140

Maternal Mortality Determinants in Rural Kenya: An Audit of Three Hospitals

Wed, 01 Jan 2025 00:00:00 GMT

Title: Maternal Mortality Determinants in Rural Kenya: An Audit of Three Hospitals Authors: Masaba, Brian Barasa; Mmusi‑Phetoe, Rose M.; Rono, Bernard; Muthiani, Daniel Kyalo; Taiswa, Jonathan; Ojiambo, Stephenie Lydia; Moraa, Damaris Abstract: Background: Global health agencies advocate that no mother should die while giving life, more so from preventable causes. However, there are persistently high maternal mortalities in various regions with a current global maternal mortality ratio of 211/100,000 live births. This study sought to investigate the causes and determinants of maternal mortality. Materials and Methods: A four‑year retrospective, cross‑sectional study was conducted in three tertiary hospitals within Migori county in Kenya. Data were extracted from 101 maternal mortality records from January 1, 2016 to December 31, 2019. Results: Leading complications were hemorrhage 34.70%, eclampsia 20.80%, and sepsis 15.80%. Mothers who were unmonitored using partograph, had reactive HIV status, were in the postpartum period, were referred from periphery facilities, and low socioeconomic levels were most vulnerable. Conclusions: Improvement in healthcare systems to enable optimal care to mothers diagnosed with leading complications and socioeconomically empowering women in Migori county is urgently needed.

Early Clinical Deterioration Risk Assessment in Inpatient Units of a Public University Hospital

Wed, 01 Jan 2025 00:00:00 GMT

Title: Early Clinical Deterioration Risk Assessment in Inpatient Units of a Public University Hospital Authors: Esteves, Mariana de Souza; Lourenço, Laura B. de Araujo; Meszaros, Mariana de Jesus; Silva, Michele de Freitas Neves; São‑João, Thais Abstract: Background: Clinical deterioration occurs due to changes in vital signs, which can be identified early to prevent negative outcomes. We used the NEWS2 system to assess the potential for early clinical deterioration in adult inpatient units at a public university hospital in southeastern Brazil. Materials and Methods: This was an exploratory study conducted at a public hospital in southeastern Brazil, following the guidelines of the Reporting of Strengthening Observational Studies in Epidemiology (STROBE) initiative. Data was collected from January to April 2021, involving 251 inpatients. A questionnaire was used to gather sociodemographic and clinical data, and the Brazilian version of NEWS2 was used to assess the risk of clinical deterioration. Data analysis included descriptive analyses, linear correlation tests, and comparative tests. Results: The average NEWS2 score was 2.9 points among 251 patients, indicating a moderate level of care complexity and recommending assessment by a registered nurse every 4–6 hours. There was no significant correlation between age and NEWS2 score, but the NEWS2 score was significantly higher for men. Conclusions: This study highlights the necessity of using robust assessment tools to evaluate the risk of early clinical deterioration, enabling clinicians to manage patient conditions effectively

Why Do Nurses Fail to Implement Pain Assessment Instruments for Hospitalized Infants?

Wed, 01 Jan 2025 00:00:00 GMT

Title: Why Do Nurses Fail to Implement Pain Assessment Instruments for Hospitalized Infants? Authors: Elsagh, Azamolmolouk; Ebadi, Abbas; Dalvandi, Asghar; Tabarsi, Beheshteh Abstract: Background: Effective pain assessment in neonatal care is crucial for ensuring the well‑being of newborns. However, barriers to its successful implementation persist. This study aims to identify the obstacles that hinder effective neonatal pain assessment by Neonatal Intensive Care Units (NICUs) nurses. Materials and Methods: This qualitative study was conducted using the method of conventional content analysis. Purposive sampling was employed from February to September 2023, selecting 14 female nurses working in NICUs of hospitals in Tehran and Karaj as participants. Indepth, semistructured interviews were conducted to collect the data. The software “MAXQDA” version 2016 was utilized for managing qualitative data. Results: Four main themes and eleven subthemes were identified: “Overtasked,” “Discordant atmosphere,” “Soulless care,” and “Lack of awareness.” Each of these main themes is further elaborated through the subsequent subthemes. Conclusions: This study found that the lack of knowledge and understanding of neonatal pain assessment tools, the busyness of nurses, lack of time, excessive documentation, and the inadequacy of staff relative to the number of newborns were the most significant obstacles to the assessment of newborn pain. Addressing these challenges is critical for optimal neonatal pain assessment and management, promoting the well‑being of newborns.

The Effect of The Mental Health Literacy Promotion Program on Emotion Regulation Strategies of Family Caregivers of Patients with Chronic Psychiatric Disorders in Isfahan, Iran

Wed, 01 Jan 2025 00:00:00 GMT

Title: The Effect of The Mental Health Literacy Promotion Program on Emotion Regulation Strategies of Family Caregivers of Patients with Chronic Psychiatric Disorders in Isfahan, Iran Authors: Pirallahi, Zeynab; Alavi, Mousa; Akbari, Mohammad; Aliyari, Najme Abstract: Background: Emotion regulation strategies help family caregivers of chronic psychiatric patients to manage caring behaviors. However, evidence pointed out problems and therefore a need to execute respective programs to improve emotion regulation for caregivers. This study aimed to investigate the effectiveness of mental health literacy promotion programs on emotion regulation strategies of family caregivers of chronic psychiatric patients. Materials and Methods: This is a clinical trial study, with two‑group pretest–post‑test design with a follow‑up period conducted in 2023. Sixty family caregivers of chronic psychiatric patients were randomly allocated to intervention control groups. Data collection was done using a demographic characteristics questionnaire and Gross and John’s Emotion Regulation Scale. The mental health literacy promotion program was implemented for the intervention group in six sessions weekly. Immediately and 1 month after the last meeting, the questionnaires were completed. The data were analyzed using Chi‑squared and Fisher’s exact tests, Mann–Whitney test, and analysis of covariance by SPSS‑22. The significance level was set to 0.05. Results: The results showed that the frequency distribution of demographic variables in the control and test groups had no statistically significant difference (p > 0.05). The intervention had significant effects on the mean score of emotion regulation strategies, and its subscales included re‑evaluation and suppression of family caregivers of chronic psychiatric patients in both the post‑test and follow‑up periods (p < 0.001). Conclusions: According to improving the emotion regulation of family caregivers of chronic psychiatric patients through the mental health literacy promotion program, it is suggested to use this program to achieve the desired emotion regulation