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Family Centered Care versus Child Centered Care: The Malawi Context

Health 2015年第6期7卷 741-746页

作者： maureen daisy majamanda Tiwonge Ethel Mbeya Munkhondya Miriam Simbota Maria Chikalipo Kamuzu College of Nursing University of Malawi Blantyre Malawi

Family Centered care is a model that is practiced and encouraged in child health care. It considers family as partners and collaborators in care of children. It aims at involving family in all aspects of child care. Family centered care also mentions involvement of child. However, emphasis is given more on family than child and does not take into account the older child’s capacity for independent decision making and right to privacy. As such, child’s needs are missed out. With child centered care, children are involved and supported at all levels of care based on their age and developmental stage. This paper aims to stress the importance of involving children within family centered care. Involving children in their care, makes them feel less threatened by the health care professional and their self esteem is promoted. Currently, no studies have been identified in Malawi that demonstrates full partnership between the family, child and the nurse. Furthermore, Family Centered Care and Child Centered Care as models are not fully practiced. It is therefore important to practice both family and child centered care in child health care if the needs of both family and children are to be addressed concurrently.

关键词： Family Centered Care Child Centered Care Child Involvement Child Participation

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Experience of Conducting Objective Structured Clinical Evaluation (OSCE) in Malawi

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Open Journal of Nursing 2014年第10期4卷 705-713页

作者： Tiwonge Ethel Mbeya Munkhondya Gladys Msiska Evelyn Chilemba maureen daisy majamanda Kamuzu College of Nursing University of Malawi Lilongwe Malawi

In Malawi various nursing educational institutions have increased the enrollment of nursing students in order to respond to the rampant nursing shortage prevalent in the Malawian clinical settings. With this increase in intake, nurse educators are met with so many questions as to whether the nurses being trained are competent and fit for practice. To ensure that these nurses have appropriate competences, Objective Structured Clinical Evaluation (OSCE) has been embraced as a key strategy to evaluate student’s competence. The paper describes the lessons learnt from conducting OSCE to undergraduate student nurses at Kamuzu College of Nursing in Malawi. The paper considers the background and context of the school, the preparation of students, the formulation of OSCE tasks, recruitment of examiner and simulated patients and the evaluation of the OSCE. The paper concludes that OSCE can be a worthwhile valid strategy of teaching and assessing nursing students as long as it is properly designed. Nonetheless, profound commitment of all stakeholders involved is very vital.

关键词： OSCE Student Nurses Undergraduates

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Associative Factors for Birth Asphyxia at Queen Elizabeth Central Hospital—Malawi

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Journal of Biosciences and Medicines 2017年第5期5卷 22-31页

作者： Edith Tewesa Ellen Chirwa maureen daisy majamanda Alfred Maluwa Angela Chimwaza Queen Elizabeth Central Hospital Blantyre Malawi University of Malawi—Kamuzu College of Nursing Malawi

Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. Queen Elizabeth Central Hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia. This study was conducted to explore associative factors for birth asphyxia at QECH. Methodology: The study design was descriptive cross sectional that employed quantitative methods of data collection and analysis. Data sources were case notes of neonates and their mothers.? Sample size was 87 neonates with birth asphyxia and 87 neonates admitted with conditions other than birth asphyxia as controls. Data were collected from November to December 2013. Statistical Package for Social Science (SPSS) version16.0 was used to analyze data. Results: Findings revealed that there were no maternal associative factors for birth asphyxia, however, foetal distress, prolonged first and second stage of labour were significant associative factors for birth asphyxia. Conclusion: Associative factors for birth asphyxia at QECH are Foetal distress, prolonged first and second stage of labour. These factors can be prevented if quality care is provided to women in labour through close monitoring of foetal heart, appropriate use of the partograph, prompt decision making and early interventions.

关键词： Neonates Birth Asphyxia Risk Factors

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Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi

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Journal of Biosciences and Medicines 2017年第6期5卷 46-59页

作者： Edina T. Kholowa Angela F. Chimwaza maureen D. majamanda Alfred O. Maluwa Nursing and Midwifery Department Malamulo College of Health Sciences Malawi Adventist University Thyolo Malawi Faculty of Nursing Kamuzu College of Nursing University of Malawi Blantyre Malawi

Background: Inadequate pain management is a problem in hospitalized children. Objectives: To explore knowledge and attitudes of nurses in management of pain in children. Methods: A descriptive design using qualitative methods was used to conduct the study. 17 nurses with prior pain management training were interviewed using a semi-structured interview guide. Ethical approval was obtained from College of Medicine Research and Ethics Committee. Data were analysed using thematic content analysis. Results: Nurses had some knowledge of pain assessment methods, treatment and use of morphine. Gaps, however, existed on how to use pain assessment scales, analgesics to use at each step of the WHO analgesic ladder, and how to effectively use morphine for pain relief. Although most nurses had positive attitudes towards children’s pain and use of morphine, negative attitudes were evident in some nurses regarding administration of morphine to neonates or acutely ill children. Conclusion and Implications: The study has revealed knowledge and attitude gaps which may reflect deficiencies in the pain education nurses received, non-availability of pain scales and lack of support for nurses to link theory with practice. Nurse leaders are challenged to provide repeated comprehensive education for nurses on pain assessment and management. Furthermore, user friendly pain scales should be developed, and nurses educated and demonstrated on their use. In addition, opportunities for supportive supervision with nurses in the clinical setting should be created for linkage of theory and practice.

关键词： Children Pain Assessment Caregivers/Parents/Guardians Nurses Pain Management

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