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

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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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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COVID-19 Pandemic through the Lenses of Nurses and Midwives in Zambia: Exploring Depression, Anxiety and Stress

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Open Journal of Psychiatry 2022年第1期12卷 11-22页

作者： Lonia Mwape Kestone Lyambai Esther Chirwa Mavis Mtonga patricia katowa-mukwato Agatha Lloyd School of Nursing Sciences Levy Mwanawasa Medical University Lusaka Zambia School of Nursing Sciences University of Zambia Lusaka Zambia Lusaka District Health Office Lusaka Zambia

Following the declaration of COVID-19 as an international health emergency, Zambia like many other countries implemented measures to limit human interaction and curb the spread of the disease. In the midst of these measures, nurses and midwives continue to provide care to suspected and confirmed cases of COVID-19, which puts them at risk of contracting the disease and compromising their psychological wellbeing. The aim of this study was to assess the levels of depression, anxiety, and stress experienced by nurses and midwives working in health facilities in two districts of Zambia during the COVID-19 pandemic. This descriptive cross-sectional study involving 187 nurses and midwives was conducted between July and December 2020 in selected health facilities in Lusaka and Chilanga Districts. The Depression Anxiety and Stress Scale (DASS) 21 was used to collect the data which was analysed using univariate analysis. Majority of the respondents were female (84%) and mean age at 30.1 (SD 9.05) years, 58.3 percent were married, and 50.84 percent had children. The mean work experience was 6.63 (SD 4.75) years, and 54 percent had worked for less than five years. Overall, 22.5 percent of nurses and midwives reported depression, 52.4 percent had anxiety and almost half (42.2%) had varying levels of stress. Anxiety and stress correlated significantly with working in COVID Isolation departments (P = 0.001). Strategies such as strict adherence to infection prevention measures, seeking help from family and friends and recognition by hospital management were a significant supportive measure (P < 0.001). Nurses and Midwives working directly with COVID-19 patients reported greater incidence of depression, anxiety and stress, similar to findings from previous research around the world. Therefore, efforts should be focused on developing and providing counselling and other support services to mitigate the effects of COVID-19 and enhance psychological wellbeing for health professions.

关键词： COVID-19 Pandemic Nurses Midwives Depression Anxiety and Stress

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Information Needs of Breast Cancer Patients at Cancer Diseases Hospital, Lusaka, Zambia

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Advances in Breast Cancer Research 2020年第2期9卷 34-53页

作者： Beauty Lilala Namushi Marjorie Kabinga Makukula patricia katowa mukwato Cancer Diseases Hospital Lusaka Zambia School of Nursing Sciences University of Zambia Lusaka Zambia

Background: Breast cancer is the second most common cancer worldwide and the second most common among Zambian women. Breast cancer diagnosis being a stressful experience, causes psychological and emotional disruption that can be abated by meeting information needs of the affected patients. In light of the escalating cases of Breast cancer among the Zambian women, the study examined a special aspect of cancer management which is usually neglected in most cases. Aim: The main objective of the study was to assess information needs of breast cancer patients at the Cancer Diseases Hospital in Lusaka, Zambia using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Methods: A descriptive cross-sectional design was used to elicit the information needs of breast cancer patients. One hundred and ten (97% response rate) participants were selected using simple random sampling method and data was collected using a modified structured interview schedule adopted from the Toronto Information Needs Questionnaire-Breast Cancer (TINQ-BC). Stata 10.0 (StataCorp, 2008) was employed for all quantitative data analysis and graphical presentation of data. Results: The overall score for information needs was obtained by adding the scores across all the five information needs categories which were further divided into three categories namely: low important scores, of less than 50%, moderately important scores of 50% - 70% and highly important scores ranged above 70% of the 200 total scores. Out of the 110 participants recruited, 88 (80%) indicated that the information across the five categories was moderately important. Logistic regression of information needs and posited determinants revealed that anxiety levels;education level;presence of co-morbidity;and being on treatment were significant determinants of patients’ informational needs (Effect’s p ≤ 0.05). Conclusion: The findings of this study support the idea that bre

关键词： Information Needs Breast Cancer Breast Cancer Patients

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Confinement Following Child Birth and Associated Postpartum Mental Distress

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Open Journal of Psychiatry 2018年第2期8卷 152-167页

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

Objective: This study sought to explore confinement following childbirth and its association with mental distress. Methods: A descriptive-analytical cross sectional study design was used. The study was conducted in two districts of Zambia representing an urban and rural setting, targeting parenting mothers during the first two months after delivery. Systematic random sampling technique was used to select the participants. Every second case seen at the study sites between March to August 2017 was selected to participate in the study. The data were collected using the Edinburgh Postnatal Depression Scale and analyzed using the Statistical Package for Social Sciences (SPSS) version 22. Pearson correlation coefficient was used to determine the relationship between the dependent and independent variables while binary logistic regression was used to check the combined impact of independent variables on mental distress. Ethical approval was obtained from the local Research Ethics Committees. Participation in the study was voluntary. Results: A total of 200 women participated in the study. The results revealed a high prevalence of mental distress, with 42 percent of women reporting severe levels, and 36.0 percent showing moderate levels. A statistically significant relationship was found between mental distress and confinement (X² = 29.289;P = 0.001), residential type (X² = 16.863;P = 0.001), and age (X² = 17.996;P = 0.006). Suicidal thoughts during confinement were also found to be prevalent in 16 percent of the participants. Binary logistic regression revealed that changes in confinement period from below 2 weeks to between 2 weeks and 1 month raised the odds of suffering mental distress 5.127 times while changes from a confinement period of between 2 weeks and 1 month to over 1 month raised the odds of suffering mental distress 7.737 times. Conclusion: The study results confirmed an association between confinement and mental distress, revealing that the longe

关键词： Mental Distress Confinement Childbirth Postnatal Postpartum

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Adherence to Treatment by Patients with Type 2 Diabetes Mellitus at Monze Mission Hospital, Monze, Zambia

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Open Journal of Nursing 2021年第3期11卷 184-203页

作者： Sanford Nyirongo patricia katowa mukwato Emmanuel Mwila Musenge Victoria Mwiinga Kalusopa School of Nursing Sciences University of Zambia Lusaka Zambia

Background: Diabetes mellitus (DM) is one of the most common non-communicable diseases and among the leading causes of disability, morbidity and mortality globally. The study assessed adherence to treatment by type 2 DM patients aged 20 years and above at Monze Mission Hospital in Monze district, Zambia. Research questions: 1) What is the level of adherence to treatment by type 2 DM patients receiving care from Monze Mission Hospital? 2) What factors influence adherence to treatment by type 2 DM patients? Methods: The study was conducted in 2017. It was a cross-sectional design. Simple random sampling method was used to select respondents and data was collected using a structured interview schedule. Data was entered and analyzed using the modified self-reported Morisky Medication Adherence Scale with six scores, modified self-care management questionnaire and IBM© Statistical Package for Social Sciences. Chi-Square was used to test associations between variables and binary logistic regression was used for multivariate analysis. The Morisky Medication Adherence scale was interpreted as follows: patients who scored between 4 - 6 points on knowledge had high knowledge while those who scored between 1 - 3 points had low knowledge about the disease. Results: The sample size of the study was 138 respondents. The study showed, only 44.2% of respondents had good adherence to treatment as they scored above 4 using the Morisky Medication Adherence Scale. Majority of the patients (55.6%) had knowledge about treatment despite 65.2% of respondents reported distance and financial challenges as hindrances to adherence. The study revealed a statistical association between adherence and knowledge of type 2 DM treatment. Conclusion: The study showed that poor adherence to treatmen

关键词： Adherence Knowledge Lifestyle Self-Management Support Treatment Type 2 Diabetes Mellitus Patients

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Use of Research Evidence in Policy and Decision-Making: Views, Attitudes and Practices of Health Policy Makers in Lusaka Province of Zambia

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Health 2018年第4期10卷 502-515页

作者： patricia katowa-mukwato Lonia Mwape Mwaba Chileshe Siwale Emmanuel Mwila Musenge Margaret Maimbolwa Department of Basic and Clinical Nursing Sciences School of Nursing Sciences University of Zambia Lusaka Zambia Department of Mental Health and Psychiatric Nursing School of Nursing Sciences University of Zambia Ridgeway Campus Lusaka Zambia Department of Midwifery Women and Child Health School of Nursing Sciences University of Zambia Lusaka Zambia

Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations:

关键词： Evidence-Informed Health Policy Rapid Response Mechanisms Decision-Making

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Experiences with the Use of Vaginal Dilator by Cervical Cancer Women Who Received Pelvic Radiotherapy at Cancer Diseases Hospital, Lusaka Zambia

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Open Journal of Obstetrics and Gynecology 2021年第10期11卷 1386-1396页

作者： Alex Mwale patricia katowa-mukwato Victoria Mwiinga Kalusopa Phadaless Phiri-Sinkamba Susan Mutemwa Cancer Diseases Hospital Lusaka Zambia School of Nursing Sciences University of Zambia Lusaka Zambia

Background: Cancer of the cervix is the commonest cancer in women seen at Cancer Diseases Hospital in Zambia and Pelvic Radiotherapy is the main treatment modality used on cervical cancer patients. Radiotherapy to the pelvis has a potential to causes vaginal stenosis but the stenosis can be prevented by regular sexual intercourse or use of vaginal dilators as recommended by cancer organizations. Despite the well-established benefits of vaginal dilators, there was reluctance by women to adopt this practice as seen by the number of survivors with vaginal stenosis at Cancer Diseases Hospital. The objective of this study was to explore experiences with the use of vaginal dilators by cervical cancer women who received Pelvic Radiotherapy. Methodology: A descriptive phenomenological design was used to explore experiences with the use of vaginal dilators by cervical cancer women. The study was conducted at Cancer Diseases Hospital in Lusaka District of Zambia. Particip

关键词： Cervical Cancer Radiotherapy Experiences Vaginal Dilators Vaginal Stenosis

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