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Challenges Experienced by Nurse Educators in Promoting Acquisition of Clinical Reasoning Skills by the Undergraduate Nursing Students: A Qualitative Exploratory Study

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Open Journal of Nursing 2024年第8期14卷 459-476页

作者： Omero. G. Mwale mukwato-katowa patricia Marjorie Kabinga-Makukula School of Nursing Sciences University of Zambia Lusaka Zambia School of Nursing University of Zambia Lusaka Zambia Department of Basic and Clinical Nursing University of Zambia Lusaka Zambia

Background: Clinical reasoning is an essential skill for nursing students since it is required to solve difficulties that arise in complex clinical settings. However, teaching and learning clinical reasoning skills is difficult because of its complexity. This study, therefore aimed at exploring the challenges experienced by nurse educators in promoting acquisition of clinical reasoning skills by undergraduate nursing students. Methods: A qualitative exploratory research design was used in this study. The participants were purposively sampled and recruited into the study. Data were collected using semi-structured interview guides. Thematic analysis method was used to analyze the collected data The principles of beneficence, respect of human dignity and justice were observed. Results: The findings have shown that clinical learning environment, lacked material and human resources. The students had no interest to learn the skill. There was also knowledge gap between nurse educators and clinical nurses. Lack of role model was also an issue and limited time exposure. Conclusion: The study revealed that nurse educators encounter various challenges in promoting the acquisition of clinical reasoning skills among undergraduate nursing students. Training institutions and hospitals should periodically revise the curriculum and provide sufficient resources to facilitate effective teaching and learning of clinical reasoning. Nurse educators must also update their knowledge and skills through continuous professional development if they are to transfer the skill effectively.

关键词： Acquisition Clinical Reasoning Skills Undergraduate Nursing Student Nurse Educator

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Adherence to Radiation Therapy among Cervical Cancer Patients at Cancer Diseases Hospital in Lusaka, Zambia

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Journal of Biosciences and Medicines 2022年第5期10卷 25-39页

作者： Etambuyu Akufuna Victoria Mwiinga-Kalusopa Kabwe Chitundu katowa-mukwato patricia Cancer Diseases Hospital Lusaka Zambia Department of Basic and Clinical Nursing Sciences University of Zambia Lusaka Zambia Department of Mental Health and Psychiatric Nursing University of Zambia Lusaka Zambia

Background: Radiation therapy has the potential to improve cure rates and provide palliative relief for cervical cancer patients. Despite adherence to radiation therapy being a key treatment modality, patients rarely follow prescriptions. Poor adherence to radiation therapy is associated with low survival and high mortality rates. This study therefore sought to investigate the levels of adherence and factors influencing adherence to radiation therapy among cervical cancer patients being treated at Cancer Diseases Hospital. Methods: A cross-sectional analytical study design was used, 142 patients were selected from the outpatient department using a fishbowl sampling method. A structured interview schedule was used to collect data. Data was entered and analyzed using SPSS, the binary logistic regression analysis was used to predict levels of adherence to treatment and to identify factors associated with adherence to RT among cervical cancer patients. Results: The findings showed that 93% of the participants adhered to radiation therapy while 7% did not adhere to treatment. Majority of the patients 77.1% had experienced side effects of radiation therapy. About 28% of patients had severe psychological distress. By using binary logistic regression, there was a statistically significant association between adherence and perceived quality of health care services (p = 0.001). The analysis showed that patients who perceived poor quality of health care services were 0.005 (99.5%) times less likely to adhere to radiation therapy. The other independent variables were not statistically significant despite being associated with adherence among cervical cancer patients. Conclusions and Recommendations: The findings showed that patients who perceived good quality of health care services had higher chances of adherence compared to those who perceived poor quality of health care services. There is therefore a need for quality service provision which could include good maintenance of

关键词： Cervical Cancer Adherence to Radiation Therapy Psychological Distress Health Care Systems Side Effects Economic Status and Stage of the Disease

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Information Needs and Self-Care Practices of Diabetic Patients in Mbala, Northern Province, Zambia

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Journal of Biosciences and Medicines 2023年第3期11卷 136-146页

作者： Chisha Jones Simuyemba patricia katowa-mukwato patricia Kabwe Chitundu Michael Mumba Kanyanta Facalty of General Nursing Mbala College of Nursing and Midwifery Mbala Zambia Department of Basic and Clinical Nursing Sciences University of Zambia Lusaka Zambia Department of Mental Health and Psychiatric Nursing University of Zambia Lusaka Zambia

Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patien

关键词： Information Needs Self-Care Practices Knowledge Attitude Diabetes Mellitus

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Postnatal Care within Six Hours Following Delivery at Two Selected General Hospitals of Zambia—Mothers’ Experiences

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Open Journal of Nursing 2018年第6期8卷 355-371页

作者： Muleya Mutinta Crecious Mwape Lonia katowa-mukwato patricia Maimbolwa Margaret University of Zambia School of Nursing Sciences Lusaka Zambia

Background: The days and weeks following childbirth (the postnatal period or puerperium), are a critical phase in the lives of mothers and new-born babies. The most vulnerable time for both is during the few hours and days after birth. The period places major demands on the physiological processes of mother and new-born as they adapt the changes of pregnancy and intrauterine life respectively. However, this is the most neglected time for the provision of quality services. Postnatal care is an integral part of the midwife’s role in providing care and support to the individual mother and her baby. Postnatal care encompasses aspects of observing and monitoring the health of the mother and her baby, as well as offering support and guidance in breastfeeding and parenting skills. Aim of the study: The aim of the study was to explore the experiences and expectations of mothers concerning care during the immediate postnatal period. Methods and materials: A qualitative approach was utilised to collect data from mothers in their immediate postnatal period using recorded in-depth interviews. A total of thirty (30) mothers were interviewed from two general hospitals. Thematic content analysis was used to analyse the data. Findings: From the study, three main themes emerged;inadequate physical examination, information needs and professional support, and varied staff attitude. The findings of the study have highlighted the inadequacies that are still there regarding immediate postnatal care. Conclusion and recommendations: It can be concluded that mothers have a lot of needs and expectation during this period which are usually not met. One most important conclusion is the lack or poor information given to the women regarding the care of the new-born and subsequent care. This could be one of the reasons mothers do not come back for the subsequent postnatal visit. There is an evidence of poor quality of postnatal care being offered to women during the immediate postnatal period. Th

关键词： Postnatal Care Immediate Postnatal Care Mothers Experiences Expectations

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Ultrasound Scanning Competencies in Midwifery Education in Zambia: Findings from a Desk Review and Needs Assessment

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Health 2024年第6期16卷 535-552页

作者： Mutinke Zulu Sebean Mayimbo patricia katowa-mukwato Department of Midwifery Womens and Child Health School of Nursing Sciences University of Zambia Lusaka Zambia Department of Basic and Clinical Sciences School of Nursing Sciences University of Zambia Lusaka Zambia

Introduction: Ultrasound is an essential component of antenatal care. Midwives provide most of the antenatal care but they do not perform ultrasound as it has been beyond their scope of practice. This leaves many women in Low and Middle-Income Countries without access to ultrasound scanning. The aim of this study was to identify competencies in ultrasound scanning in midwifery education. Methods: A desk review and needs assessment were conducted between July and October 2023. Articles and curricula on the internet, Google scholar and PubMed were searched for content on ultrasound scanning competencies. A Google form consisting of 20 questions was administered via email and WhatsApp to 135 participants. Descriptive statistics were used to analyse data. Results: The desk review showed that it is feasible to train midwives in ultrasound scanning. The training programs for midwives in obstetric ultrasound were conducted for 1 week to 3 months with most of them running for 4 weeks. Content included introduction to general principles of ultrasound, physics, basic knowledge in embryology, obstetrics, anatomy, measuring foetal biometry, estimating amniotic fluid and gestational age. Experts like sonographers trained midwives. Theory and hands on were the teaching methods used. Written and practical assessments were conducted. Needs assessment revealed that majority of participants 71 (53%) knew about basic ultrasound training for midwives. All participants (100%) said it is necessary to train midwives in basic ultrasound scan in Zambia. Some content should include, anatomy, measuring foetal biometry, assessing amniotic fluid level, and gestational age determination. Most participants 91 (67%) suggested that the appropriate duration of training is 4 - 6 weeks. Conclusion: Empowering every midwife with ultrasound scanning skills will enable early detection of any abnormality among pregnant women and prompt intervention to save lives.

关键词： Ultrasound Scanning Midwifery Education Competencies

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Experiences of Mothers on the Utilization of Elimination of Mother to Child Transmission of HIV Services at Mtendere Clinic, Lusaka

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Journal of Biosciences and Medicines 2024年第4期12卷 298-318页

作者： Ireen Kasongo Silavwe patricia katowa mukwato Sebean Mayimbo Febiano Phiri Laura Lubinda Kanyama First Level Hospital Ministry of Health Lusaka Zambia School of Nursing Sciences The University of Zambia (UNZA) Lusaka Zambia Department of Nursing Sciences South Valley University Qena Egypt

Introduction: Acquired immunodeficiency syndrome is one of the leading causes of mortality among women of reproductive age and Mother to Child Transmission of Human immunodeficiency virus is still a challenge affecting many countries. Globally, an estimation of 180,000 children under 15 years acquire the Human immunodeficiency virus every day, and more than 90% of those infections are due to Mother to Child Transmission. The study sought to explore the experiences of mothers on the Elimination of Mother to Child Transmission-HIV services at Mtendere Clinic, Lusaka. Materials and Methods: Qualitative interpretive phenomenology study design was employed using in-depth interviews to collect data from a sample that was selected using purposive sampling technique. Thirteen participants were recruited, and these were HIV-positive mothers at least between the ages of 15 and 49 years and enrolled in the Elimination of Mother To Child Transmission-HIV program. The in-depth interviews were audiotape recorded and transcribed verbatim. Data was analyzed using thematic method. Findings: Three main themes that emerged are;living with HIV, support system and barriers to utilization of Elimination of Mother To Child Transmission-HIV services. Most of the participants expressed having acquired knowledge from the program, and received counselling and support from spouses, family as well as health personnel at Mtendere health facility which culminated into a positive experience and enhanced their uptake of the Elimination of Mother to Child Transmission-HIV services. However, barriers to service utilization were identified and these included fear of stigma, negative attitudes from health workers, long waiting times, lack of support and lack of transport to the health facility. Conclusion: Interventions such as community awareness campaigns on Elimination of Mother To Child Transmission-HIV, male involvement and implementing mother-to-mother peer support strategies in Elimination of Mo

关键词： Elimination of Mother-to-Child Transmission Experiences Barriers Utilization HIV/AIDS

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Adverse Pregnancy Outcomes Following Cryotherapy, Thermal Ablation and Loop Electrosurgical Excision Procedure for Cervical Intraepithelial Neoplasia Treatment: A Pilot Study among Zambian Women

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 7-17页

作者： Victoria Mwiinga-Kalusopa Johanna E. Maree Concepta Kwaleyela patricia katowa-mukwato Department of Basic and Clinical Nursing University of Zambia Lusaka Zambia Department of Nursing Education University of Witwatersrand Johannesburg Gauteng South Africa School of Health Sciences Mulungushi University Kabwe Central Province Zambia

Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003)

关键词： Adverse Pregnancy Outcomes Cervical Intraepithelial Neoplasia Cryothera-py Thermal Ablation Loop Electrosurgical Excision Procedure Pilot Repro-ductive Age

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Women’s Experience with Socio-Economic Factors Associated with Perinatal Morbidity and Mortality in Lusaka and Mumbwa Districts of Zambia

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Health 2019年第6期11卷 733-754页

作者： Maimbolwa Connie Margaret mukwato katowa patricia Muleya Mutinta Kwaleyela Concepta Kalusopa Mwiinga Victoria Emmanuel Musenge Jon Oyvind Odland Babil Stray-Pedersen School of Nursing Sciences University of Zambia Lusaka Zambia Faculty of Health Sciences University of Troms&#248 Troms&#248 Norway Faculty of Health Sciences University of Oslo Oslo Norway

Background: More than half a million women and four million infants are reported to die every year due to complications related to pregnancy and child bearing. The efforts to improve quality maternity care have been on the World Health Organization member countries’ agenda. Zambia has been striving to reduce maternal mortality by ensuring universal access to maternal and child health care services. Our study aimed to explore women’s experience with socio-economic factors associated with perinatal morbidity and mortality in Lusaka and Mumbwa districts, Zambia. Methodology: This hermeneutic phenomenological study was conducted at four health facilities in Mumbwa and Lusaka Districts of Zambia. A purposeful sample of 45 consenting women organized in four groups was selected. Each group comprised of 11 to 12 women. The focus group discussion guide was used to direct the discussion and the Olympus Digital Voice Recorder WS-852 (Olympus Corporation, Shinjuku, Tokyo, Japan) was used to record the discussions. The audio data was manually transcribed and verbatim transcript analyzed using *** 8.0 qualitative data software (*** Scientific Software Development GmbH, Berlin, Germany) to ascertain patterns of relationships between themes and quotations. Results: Money, husbands and family support, adequate health care resources, and good nurses attitude simplify the burden of pregnancy, delivery and child rearing for the health care providers, mothers and society. Conclusion: Having money and all the necessary resources during pregnancy simplifies the burden of pregnancy, delivery and child rearing for the health care providers, mothers and society. Women are still ignorant and believe in myths and need information on the dangers of depending on herbs and God in preparation for labor and care of the new born, but also seek help from qualified medical personnel when labor starts. Nurse’s attitude needs to change to ensure a reduction in women and newborn mortalities. Nu

关键词： Maternity Care Antenatal Care Postnatal Care Women’s Health Quality of Care Midwifery

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Enhancing Evidence-Based Practice and Critical Thinking Skills of Nursing Students: Lessons from the Review of the Bachelor of Science in Nursing Curriculum of the University of Zambia

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Open Journal of Nursing 2022年第2期12卷 155-169页

作者： Mwiinga-Kalusopa Victoria Maimbolwa Margret Connie Wahila Ruth katowa-mukwato patricia Vwalika Bellington Nzala Selestine Kabinga-Makukula Marjorie Chigunta Micheal Kampata Linda Kayamba Violet Kafumukache Elliot Simuyemba Moses Musenge Emmanuel Mwiinga Christabel Goma Fastone School of Nursing Sciences The University of Zambia Lusaka Zambia School of Medicine The University of Zambia Lusaka Zambia School of Public Health The University of Zambia Lusaka Zambia School of Medicine and Health Sciences Eden University Lusaka Zambia

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 team building and the development of leadership skills and a whole-of course perspective on the curriculum.

关键词： Bachelor of Science Nursing Curriculum Evidence-Based Practice Critical Thinking Review

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Contextualisation of Early and Enhanced Clinical Exposure Model through Development of Curricula for Advanced Practice Nursing and Midwifery

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Open Journal of Nursing 2022年第7期12卷 525-536页

作者： katowa-mukwato patricia Mwiinga-Kalusopa Victoria Maimbolwa Margaret Connie Kabinga-Makukula Marjorie Kayamba Violet Kafumukache Elliot Simuyemba Moses Musenge Emmanuel Mwiinga Christabel Linda Kampata Selestine H. Nzala Cosmas Zyaambo Trevor Kaile Goma Fastone School of Nursing Sciences University of Zambia Lusaka Zambia School of Medicine University of Zambia Lusaka Zambia School of Public Health University of Zambia Lusaka Zambia School of Medicine South Valley University Mazabuka Zambia School of Medicine and Health Sciences Eden University Lusaka Zambia

Background: An Advanced Practice Nurse is a generalist or specialized nurse who has acquired thorough graduate education a minimum of a master’s degree. The need for Advanced Practice Nurses is increasingly recognized globally. This paper describes the process, which was undertaken by School of Nursing Sciences, University of Zambia in reviewing and developing advanced practice nursing and midwifery curricula which will be implemented using the Early and Enhanced Clinical Exposure model (EECE). Materials and Methods: The curricula development/review process utilized a modified Taba’s Model which followed a step-by-step approach including: 1) desk review, 2) diagnosis of needs (needs assessment), 3) stakeholder consultations, 4) content development, 5) validations and approval from which several lessons were learnt and recommendations made. Findings and recommendations from different stages were used as a basis for reviewing and developing advanced practice nursing and midwifery curricula. Results: Desk review needs assessment and stakeholder consultations identified both strengths and weaknesses in the existing curricula. Major strengths were duration and core courses which met the minimum requirement for postgraduate nursing and midwifery training. Major weaknesses/gaps included some content that was too basic for the master’s level and the delayed exposure to practicum sites which limited the development of advanced practice skills. Others were inadequate competence for advanced practice, inadequate research methodology course, lack of content to foster development of personal soft skills and predominant use of traditional teaching methods. Stakeholders recommended implementing advanced, clinical and hands-on Masters of Nursing and Midwifery programmes which resulted in the review of four existing and development of five demand-driven curricula. Conclusion: The reviewed and developed curricula were strengthened to close the identified gaps. Both the reviewed and d

关键词： Advanced Practice Nursing/Midwifery Curricula Development Early Enhanced Clinical Exposure Model

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