School of Nursing and Midwifery

EFFECTIVENESS OF MIDWIFE LED DEBRIEFING ON POSTPARTUM DEPRESSION IN WESTERN, KENYA

Sun, 01 Sep 2024 00:00:00 GMT

EFFECTIVENESS OF MIDWIFE LED DEBRIEFING ON POSTPARTUM DEPRESSION IN WESTERN, KENYA Oronje, Sally Jepkosgei Childbirth is a stressful event in women’s lives and could influence emotions which may lead to mental ill health like depression in the postnatal period if not resolved. Depression is a common mental disorder with serious consequences especially during the postpartum period. Many African countries have not explored interventions to reduce or prevent postpartum depression, though the prevalence of postpartum depression has been the focus and there is evidence that it exists among postpartum women. Postpartum midwife-led debriefing has not been explored in low-Middle Income Countries including Kenya. Therefore, this study aimed to investigate the effectiveness of midwife led debriefing on Postpartum Depression in Western region, Kenya. Specifically, to examine the effectiveness of approaches used in midwife-led debriefing, to assess factors influencing Midwife led debriefing, to determine the outcome of midwife led debriefing on postpartum depression and to develop Midwife led debriefing protocol on Prevention of postpartum depression. The study was a quasi-experimental design with pre and post-test assessments. Systematic random sampling was used to identify and allocate participants to both intervention and control groups of the study. The target population were the women of child bearing age. The study participants were women who gave birth during the study period, of which a sample of 212 participated in the study. The 165 participants were allocated to the intervention group while 47 participants being in the control group. Data was collected using standard questionnaire. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 26. Chi-square was used to test association between dependent and independent variables, odds ratio was used to determine the strength between variables that were more likely to influence the debriefing outcome. Logistic regression model was used to assess the influence of time-based outcome variables, social cultural and demographic characteristics of women on midwife-led debriefing. Following midwife-led debriefing, depression levels were found to have decreased according to the study's significant findings on group approach, parity, and social support (p=0.02; p=0.004; p=0.001). Additionally, it showed that debriefing lead by a midwife significantly reduced the risk of postpartum depression (t-statistic=14.672, pvalue= 0.003< 0.05). The Odds ratio (OR= 5.41) indicated association between the intervention of midwife led debriefing and the outcome being reduced signs and symptoms of depression as compared with the standard care. In conclusion, at the 5% significance level, the null hypothesis was rejected (p=0.003), suggesting that postpartum depression might potentially be prevented using midwife-led debriefing. The coefficient of B=0.871 shows a proportional shift in postpartum depression prevention of 0.871 units for every unit increase in midwife-led debriefing. Women's postpartum depression scores could be significantly lowered by midwife-led debriefing following delivery. A proposed protocol from this was recommended for early identification of symptoms of postpartum depression and to improve the quality of life for both the mother and the child.

EFFECTIVENESS OF EXERCISE ON MUSCULOSKELETAL PAIN AMONG CHILDREN WITH SICKLE CELL DISEASE IN WESTERN REGION OF KENYA

Sun, 01 Jan 2023 00:00:00 GMT

EFFECTIVENESS OF EXERCISE ON MUSCULOSKELETAL PAIN AMONG CHILDREN WITH SICKLE CELL DISEASE IN WESTERN REGION OF KENYA Abwalaba, Asiko Roselyne Musculoskeletal pain is the most cardinal sign of sickle cell disease among children which occurs due to vaso-occlusion causing disability. Exercise has proven to be helpful in musculoskeletal pain and should be used like any other therapy. World Health Organization guidelines recommend all children to be active for 60 minutes daily for 3 months to achieve health benefits in health and illness. Therefore, the aim of this study was to analyze the effectiveness of exercise in musculoskeletal pain among children with sickle cell disease. Specifically, to determine the relationship between socio demographic characteristics and musculoskeletal pain among children with sickle cell disease, examine strategies used in management of musculoskeletal pain, analyze factors that influence management of musculoskeletal pain and assess the outcome of exercise on musculoskeletal pain. This study was guided by the theory of Bio-psychosocial theory of Health and Illness. The study adapted a quasi experimental pre and post design with two arms control and intervention groups. Intervention group was introduced to a 12 week exercise while the control group continued with their routine. Both groups were recruited live from sickle cell and hemophilic clinics. Quantitative data was collected using questionnaire and analyzed by chisquare test of independence and mixed model anova.Qualitative data was collected using key informant guides and indepth interviews and analysed by thematic content analysis.The study had a sample size of 176 children, 22 respondents participated in indepth interviews.The results found no statistically significant association between socio demographic characteristics and musculoskeletal pain among children with sickle cell disease. The majority of the respondents in intervention group reported mild musculoskeletal pain after the intervention (n=104, 59.1%). The results of the Chi-square test for hemoglobin levels (χ2 (2) = 23.99, p < .001), hospital visits (χ2 (2) = 22.033 p <0.01), exercise participation p <0.01) and painful attacks p <0.01 were significant. There was a statistical significant difference in intervention group on baseline and post intervention pain levels as measured by Wong Baker Faces Pain Rating Scale self-reported pain p<0.01, unlike in control group, where there was no significance difference in baseline and post intervention results. Economic,sociocultural,individual factors influenced musculoskeletal pain management.Drugs were used as one of the strategies. A mixed model analysis of variance (ANOVA) with one within-subjects factor and one between-subjects factor was conducted to determine whether significant differences existed among pain- post and pain-pre between the levels of group. The main effect for group was significant, F (1, 174) = 135.02, p < .001, indicating that there were significant differences in painpost and pain-pre between the levels of group. The main effect for the within-subjects factor was significant, F (1, 174) = 278.76, p < .001, indicating that there were significant differences between the values of pain post and pain pre. For the intervention category of group, pain post was significantly less than pain pre, t (174) = -28.72, p < .001.Effectiveness of exercise was measured using partial eta squared(np2) where by above 0.14 indicates a large effect while 0.01 indicate a small effect. In conclusion, these results suggest that the intervention was effective in reducing musculoskeletal pain in this population with np2 of 0.44,0.62.0.60 . The study recommends use of exercise to reduce musculoskeletal pain among children with sickle cell disease.

CONTRIBUTIONS OF PEER MENTORSHIP TO BACHELOR OF SCIENCE NURSING STUDENTS’ ACADEMIC PERFORMANCE AND SOCIAL ADJUSTMENT IN UNIVERSITIES IN KENYA

Sun, 01 Oct 2023 00:00:00 GMT

CONTRIBUTIONS OF PEER MENTORSHIP TO BACHELOR OF SCIENCE NURSING STUDENTS’ ACADEMIC PERFORMANCE AND SOCIAL ADJUSTMENT IN UNIVERSITIES IN KENYA Okanga, Anne Asiko Student success has always been onAe BofS tThRe AmCaiTn goals of education. Regardless of a lot of literature showing evidence that the peer mentorship has benefits if implemented, its utilization in the schools of nursing in institutions of higher learning in Kenya has remained low. The study sought to investigate the contributions of peer mentorship to bachelor of science nursing students’ academic performance and social adjustment in universities in Kenya. The specific objectives included assessing effects of peer mentorship on student academic and social adjustment, determining mentorship factors influencing student academic performance and social adjustment, examining perceptions of nursing students on peer mentorship with an aim of proposing a model for peer mentoring. The study was quasi experimental adopting mixed methods of data collection. It was conducted in four universities namely MMUST, GLUK.UEAB and Uzima. Target population were second year nursing students in sampled universities in Kenya where a total of 386 served as peer mentees and 60 third years who were peer mentors. Quantitative data was analyzed using descriptive statistics (mean, standard deviation and percentages while inferential statistics employed paired sample t-test, independent t-test and regression analysis. Qualitative data was analyzed thematically. The mean age of students was approximately 20 years and 54.4% of them were female. Findings showed a correlation coefficient of 0.455, t=-12.9 and 0.659, t=-6.43 for association between clinical and class results when exposed to mentorship and not respectively. P< 0.05 indicated a significant positive association between results achieved when there is mentorship and when not. There was a significant difference in the mean scores P< 0.05 for clinical and class results between the experimental and control groups under each pair with t of 12.90 and 6.43 above the t critical of 1.97. All components of social adjustment had a positive Pearson correlation level P<0.05 with coefficients as RTR=coefficient 0.168 and P< 0.05 and MR/SC=coefficients 0.127 and P≥ 0.05. Faculty and institutional factors revealed absence of peer mentorship in schools. Mentees narrated positive experiences of peer mentorship thus appreciating the programme. The study further proposed a peer mentorship model for universities. In conclusion, there was a significant relationship between peer mentorship and student academic performance and social adjustment thus rejecting the null hypothesis and adopting the alternate hypothesis. The study recommends that institutions of higher learning should utilize peer mentorship as an approach of student support.

EFFECTS OF GEOHELMINTHIASIS AND MALARIA CO-INFECTION ON MATERNAL HEALTH AND BIRTH OUTCOMES IN BUNGOMA COUNTY, KENYA

Thu, 01 Nov 2018 00:00:00 GMT

EFFECTS OF GEOHELMINTHIASIS AND MALARIA CO-INFECTION ON MATERNAL HEALTH AND BIRTH OUTCOMES IN BUNGOMA COUNTY, KENYA Wekesa, Antony Wanyonyi SMP/H/0I/2014