School of Nursing and Midwifery

EFFECTIVENESS OF EDUCATIONAL PROGRAM ON UTILIZATION OF ALTERNATIVE BIRTHING POSITIONS DURING SECOND STAGE OF LABOUR AMONG PARTURIENT WOMEN IN FORMER WESTERN KENYA

2026-04-16T09:35:58Z

EFFECTIVENESS OF EDUCATIONAL PROGRAM ON UTILIZATION OF ALTERNATIVE BIRTHING POSITIONS DURING SECOND STAGE OF LABOUR AMONG PARTURIENT WOMEN IN FORMER WESTERN KENYA Bore, Wilfrida Chemutai Alternative birth positions are one of the interventions in reducing maternal and neonatal mortality and morbidity (WHO, 2020).The use of supine positions during second stage has been associated with maternal neonatal complications. supine or lithotomy positions is the most used position in both develop and developing countries, despite of evidenced based literature which discourages its utilization, this has been associated to lack of knowledge among parturient women. The study, therefore aimed at investigating effectiveness of educational program on utilization of alternative birth positions during second stage of labor among parturient mothers in western Kenya. The study was a non-equivalent pre and post test quasi experimental research design. Antenatal register was used as sampling frame and systematic sampling was used to identify and allocate participants to both groups of study.Sample size was computed using fleis formular with a total 500 as the sample size. The intervention group received two sessions of 2 hours each of the training between the 32th to 37th weeks of gestation. Data was collected using standard questionnaire, checklist,and focus group discussions. Data was analyzed using Statistical SPSS version 28. Chi-Square, paired t-test, logistic regression were the main statistical tests with p<0.05.Lithotomy position was the most used birth position during the last delivery, with 94.6% control,93.3% intervention. Both groups had limited Knowledge about alternative birth positions at baseline, with only 1.68%(intervention) and 1.23% (control group).The intervention group had increase in knowledge of alternative birth positions, from 0% at baseline to 68.5% at end line ( χ2= 41.6, p < 0.001),control group remained static, with no knowledge reported at baseline and only 9.4% at end line(after education).The intervention group uptake alternative positions from 6.7% to 68.5% at end line, control group (5.3% to 10.7% in end line), χ2= 16.8, p= < 0.001.Being married ( p = 0.028) or being unemployed (housewives or farmers) ( p = 0.044) decreased uptake of alternative birth position. Necessary resources, facilitated utilization of alternative birth position (AOR = 28.64; p < 0.0001). Previous birthing experiences negatively influenced decision regarding birth positions (AOR = 0.40; p = 0.037). Spontaneous labor was also more in the intervention group (51.0%),control group (49.0%), χ2=4.6, p=0.032).Intact perineums (62.1%) and a lower rate of episiotomies (4.7%) compared to the control group, with (χ2=96.4, χ2=306.7, respectively, p= 0.0001. Intervention group had higher rate of blood loss less than 500ml (53.6%), control group (46.4%), χ2 =27.1, p=< 0.0001 and a lower rate of augmentation during the second stage of labor (28.6%) ,control group (71.4%), χ2 =6.6 , p= 0.010 was also observed. Likewise intervention group had shorter mean duration of the second stage of labor (18.9 minutes) compared to the control group (62.1 minutes), with a t-test = -18.8, p=< 0.0001 and had a higher rate of 1st Minute APGAR scores ≥7 (57.4%),control group (42.6%), with a p= < 0.0001.In conclusion the study showed that educating Parturient women during prenatal visits increases the knowledge on alternative birth positions and improves uptake of alternative birth positions during second stage of labour. Marital status, occupation, previous birthing experiences, access to equipment are critical factors influencing the uptake of alternative birth positions educating parturient women on alternative birth positions during second stage will enable them to make inform choice and enhance the overall positive birth outcomes. the study recommend incorporating educational program into routine prenatal care to ensure that all parturient women have access to information on alternative birthing positions.

EFFECTIVENESS OF BëST SOCIAL SUPPORT MODEL ON MENTAL HEALTH OUTCOMES AMONG STUDENTS EXPERIENCING INTIMATE PARTNER VIOLENCE IN UNIVERSITIES IN WESTERN KENYA

2026-04-16T09:32:48Z

EFFECTIVENESS OF BëST SOCIAL SUPPORT MODEL ON MENTAL HEALTH OUTCOMES AMONG STUDENTS EXPERIENCING INTIMATE PARTNER VIOLENCE IN UNIVERSITIES IN WESTERN KENYA Tuitoek, Doris Jeptalam Intimate partner violence (IPV) encompasses sexual, psychological and physical abuse committed by a partner either during marriage, cohabitation, or any other type of partnership. Global estimates of IPV are at 30% among women, a range of 21-32% among college students. The detrimental effects of IPV on health classify it as a major priority for prevention and intervention. Various researchers have evidently linked IPV to poor mental health outcomes; however, studies among the college students have yielded contradictory findings. Therefore, this study sought to evaluate the effectiveness of the BëST social support model on mental health outcomes among students experiencing intimate partner violence in universities in Western Kenya. It assessed the characteristics of study participants at baseline, examined the effects of IPV on mental health, determined the mental health outcomes of using the model, explored factors influencing its use, and evaluated its effect on perceived levels of social support. This research adopted a quasi experimental study design utilising mixed method. Data was collected using questionnaires, FGDs and interviews. Snowball sampling was used to identify study participants whose sample size was determined using the Solvin’s formula. All four universities in the region were recruited; two were for the control group, which did group counselling, and two were for the intervention group, which underwent the BëST social support model. The sessions for both groups were done twice weekly for a duration of one month. A pilot study using 10% of the participants was done at Maseno University; the study also utilised validated screening tools. NVivo and the Statistical Analysis System software were used to analyse the findings. 426 participants completed the study, and the findings reveal that the majority (62%) were aged 20–29 years, and 67% were male. Student leaders shared their views on IPV awareness, its impact on students, and the support systems available within the universities. This study found a significant effect of IPV on mental health at baseline. Physical and psychological violence had an effect on depression (p-value 0.012 and 0.022, respectively), while sexual violence did not have a significant effect on IPV. However, over a varied period of time it had an effect on PTSD (p-value 0.049). Both therapies were effective in improving depression and anxiety (p < 0.0001); despite the intervention group showing a significant decrease in the mean scores for PTSD, depression and anxiety, the findings on PTSD were not significant. The themes that emerged from the focus group discussion (FGD) regarding factors influencing the use included navigating trust and decision-making, dynamics of the perpetrator, emotional complexity, and the uptake of institutional support services. On the effect of BëST support on perceived levels of social support, there were improved mean scores with significant p-values (<0.0001). This study concludes that IPV substantially affects the mental health outcomes of university students, highlighting the noticeable effects of physical and psychological violence on depression and anxiety. This study found that the BëST support model improved depression and anxiety and resulted in a steady decrease in PTSD mean scores. The Focus Group Discussions (FGDs) highlighted the necessity of structuring the BST support to foster trust, tackle emotional complexity and decision-making, and effectively address the perpetrator's dynamics. This study recommends strengthening the informal support system, screening IPV participants on mental health outcomes and initiating tailored support for the victims, such as the adoption of this model. In addition, there is a need to identify other intervention programs that may help support PTSD victims.

EFFECTIVENESS OF PEER SUPPORT ON FOOT SELF-CARE PRACTICES FOR PREVENTION OF FOOT COMPLICATIONS AMONG PATIENTS WITH DIABETIC MELLITUS IN WESTERN KENYA

2026-04-16T08:48:22Z

EFFECTIVENESS OF PEER SUPPORT ON FOOT SELF-CARE PRACTICES FOR PREVENTION OF FOOT COMPLICATIONS AMONG PATIENTS WITH DIABETIC MELLITUS IN WESTERN KENYA Kavinguha, Lucy Kageha Individuals with chronic conditions such as diabetes need assistance in learning, mastering and sustaining complex self-care practices that support healthy living and prevent development of complications. Peer support is an effective and cost friendly intervention in self-management of chronic health conditions. Despite numerous literature showing evidence that peer support has benefits if implemented, its effectiveness on foot self-care practices among diabetic patients remains variable with very few studies documenting its use. This study sought to determine the effectiveness of peer support on foot self-care practices for prevention of foot complications among diabetic patients in Western Kenya. This was achieved by assessing performance of foot self-care practices, examining the factors influencing peer support and analyzing the outcome of peer support strategies in foot self-care practices with the aim proposing a peer support framework that will promote foot self-care practices among diabetes patients in Western Kenya. The study’s underlying theoretical model was social support theory by Don Drennon-Gala and Francis Cullen that describe the forms of support required to sustain healthy behavior and prevent complications in chronic illnesses. This was a quasi-experimental non-equivalent post-test only study that utilized bot quantitative and qualitative approaches. Target population was diabetic patients in sampled hospitals in western Kenya. Questionnaires, focused group discussions and key informant interviews were utilized to collect data. Sampled participants were put in two groups with one being the intervention group while the other the control group. Ethical considerations were adhered to accordingly. Quantitative data was analyzed using measures of central tendency and dispersion. Relationships were elicited using ANOVA and regression analysis between and within variables. Qualitative data was analyzed thematically. The mean age of participants was 51.7±10.9 years. Majority of the participants were females (55.2%), had attained secondary level of education (44%), were employed (362%), married (72.4%), had no comorbidities (71.6%), had type two diabetes (62.9%) and had diabetes for more than 10 years (56.9%). The mean foot self-care practices score was notably higher in the intervention group at 61.1 (95% CI: 59.5 - 62.8) compared to control group at 35.7 (95% CI: 34.2 - 37.1) with a significant P value of <0.001 and a substantial partial Eta2 of 0.84. Instrumental support (P-value 0.034), Informational support (P- value 0.04), appraisal support (P- value 0.008), level of education (P-value 0.048) and employment status (P-value 0.013) significantly influenced effectiveness of peer support. Improved coping, emotional resilience, emotional connection and understanding, dependable support, helpful support and increased confidence were amongst the outcomes of the peer support strategies. The PEER-CARE framework, derived from the study, presents a structured approach for implementing peer support in foot self-care among diabetics. The study therefore concluded that peer support is effective in improving foot self- care practices among diabetes patients and further recommends that healthcare providers should incorporate structured peer support in their daily management of patients with diabetes based on the proposed peer-care framework. Regular evaluations of the framework's impact on diabetes management and prevention of diabetic foot complications can inform ongoing improvements and adaptations. Information dissemination will be done in relevant forums including conference presentations and publications.

EFFECTIVENESS OF LEMON AND LEMONGRASS COMBINATION AS AROMATHERAPY ON STRESS REDUCTION AMONG PARENTS OF CHILDREN WITH INTELLIGENCE DISABILITY IN KAKAMEGA COUNTY, KENYA

2026-04-16T08:41:47Z

EFFECTIVENESS OF LEMON AND LEMONGRASS COMBINATION AS AROMATHERAPY ON STRESS REDUCTION AMONG PARENTS OF CHILDREN WITH INTELLIGENCE DISABILITY IN KAKAMEGA COUNTY, KENYA Kosgey, Sharon Jepchumba Parents of Children with Intelligence Disability (PCID) undergo stress and societal stigma in their daily lives as they raise up these children with Intelligence Disability (ID). Aromatherapy, a type of complementary and alternative medicine (CAM), uses plants to extract essential oils which are used as aromatherapy through inhalation. The main aim of this study was to authenticate lemongrass and lemon essential oils and assess its effectiveness as aromatherapy on stress reduction among PCID. The study utilized a quasi-experimental pre- post non-equivalent study design. Gas Chromatography-mass spectrometry (GC-MS) was done to authenticate the lemon and lemongrass essential oils. Lemon essential oil contained 42 components with D Limonene (33.15%) and Cyclopentene, 3-isopropenyl-5,5-dimethyl- (26.73%) as the major components. Lemongrass essential oil contained 82 components with β- Myrcene (11.34%) and Geranial (18.19%) as the major components respectively. Quantitative and qualitative approach was used and data was collected using a stress indicator tool, informant interviews and focus group discussions. Through snowballing sampling technique, the sample size consisted of 228 PCID. Majority of the PCID were women (72.4%) and most of the ID children were < 5 years old (52.2%). Lemongrass essential oil performed better in post-test on physical, sleep and emotions domains with a mean difference in stress reduction {-30.18 (p < 0.0001)}, {-28.66 (p < x x x x x 0.0001)} and {-22.51 (p < 0.0001)} respectively. Mean differences in systolic blood pressure {(-24.42; p < 0.0001)} and heart rate {(-21.76; p < 0.0001)} were highest in the group that used a blend of lemon and lemongrass essential oils. Four themes that emerged on the factors that influence effectiveness of lemon and lemongrass essential oils were: Calming and relaxing effect of the drug, frequency of exposure, cost effectiveness and pleasant aroma with non-allergy reaction. In conclusion, Lemongrass essential oil and a blend of lemongrass and lemon essential oils are effective in reducing stress. A lemongrass and lemon essential oil protocol and algorithm is proposed to guide on the use of these essential oils on the management and reduction of stress among the PCID and community at large. This study therefore recommends that PCID use lemongrass and lemon essential oils since its natural, cost effective and readily available.