Search

Abstract Background Deaths can be caused by terminal illnesses, accidents, or natural disasters. However, medically, death can be hastened by healthcare providers, patients themselves, or their relatives. In advanced cancers where the patient’s quality of life is compromised, Euthanasia can be used to hasten death. Inadequate medical resources and low socioeconomic status have been cited as factors influencing Euthanasia. This study sought to explore nurses’ and midwives’ knowledge and perspectives on Euthanasia in resource-constrained health facilities. Methods A qualitative exploratory, descriptive design was used to recruit 24 nurses and midwives from three major referral hospitals, two regional hospitals, and one district hospital. Data was collected through individual in-depth face-to-face and telephone interviews. Braun and Clarke’s (2006) thematic data analysis approach was used. Findings : Three main themes and eight subthemes were generated from the data: the main themes include Knowledge of Euthanasia, health system resource constraint-driven euthanasia and family resource constraint-motivated euthanasia. The findings indicate that nurses and midwives lack understanding of some terminologies related to the act. Strict policy decisions, inadequate resources, and misunderstanding of palliative care resulted in the practice of Euthanasia. Additionally, unbearable pains and financial constraints of families of critically ill patients made them request Euthanasia in the health facilities. Conclusion The study highlights the challenges of end-of-life care in resource-constrained settings, emphasizing the need for provider training, increased healthcare capacity, and clearer national guidelines for ethical decision-making.

Abstract Background Caring for children with cancer by parents in Ghana is associated with diverse psychological and emotional burdens. However, such parents utilize coping strategies to adjust to their distressing situations. There is dearth of literature on the coping strategies of parents of children diagnosed with cancer in Ghana. Therefore, this study sought to explore the coping strategies adapted by parents of children with cancer. Methods A qualitative exploratory descriptive design was employed to conduct the study. Purposive sampling method was used to recruit seventeen parents of children with cancer. Semi-structured interview guide was used to conduct in-depth data collection. Data was analysed using content analysis approach. Results and discussion Parents reported that emotional and spiritual support enhanced parental coping to the ordeal associated with caring for children with cancer. The parents shared that counselling, self-motivation and inspiration from family and health professionals immensely assisted them to cope. Spiritual support through personal belief in God, religious activities and support from their priests and church members were other strategies parents employed to cope with the traumatising experience associated with caring for children with cancer. Conclusion This study concludes that parents of children with cancer are better able to cope with the distress encountered in their children’s care journey through emotional and spiritual support.

Nearly 31% of the Ghanaian population are adolescents, and these populations persistently face high rates of teenage pregnancies and unsafe abortions. This is despite sexual and reproductive health (SRH) being taught in the school curriculum. In this qualitative study, we explore the factors affecting adolescents’ access to, and experiences of, SRH services in Accra, Ghana. We conducted 12 focus group discussions (FGDs) with adolescents and 13 key informant interviews (KIs) in Ghana. The FGDs were conducted with school-going and out-of-school adolescents. KIIs were conducted with various stakeholders working with adolescents or in SRH services. All interviews were conducted in English, audio recorded and transcribed verbatim. We applied the Dahlgren-Whitehead Rainbow model of health determinants and used a thematic analysis. Eight themes were identified, across micro, meso and macro levels, that influence adolescents’ SRH access and experience in Accra. These included: family, social networks, the role of schools, health providers and services, the policy landscape, gender norms, cultural norms, and poverty. The findings highlight several factors that influence adolescents’ access to appropriate SRH services in this context and demonstrate the need for a multisectoral effort to address structural factors such as harmful gender norms and persistent poverty.

Background Climate change and extreme weather events significantly threaten neonatal and child health. This review aims to provide a comprehensive overview of the current evidence on the impact of climate change on child health, using the evidence gap map (EGM) to address knowledge gaps and establish a foundation for evidence-based interventions and future research.Method From inception, academic databases (such as MEDLINE, EMBASE, Global Health, CINAHL and Scopus) and grey literature were systematically searched. We included climate change-related studies involving children aged 0–5 worldwide. Covidence facilitated a rigorous screening process, and we conducted a critical appraisal. Two independent reviewers handled screening and data extraction. Eligible studies underwent coding and extraction using Evidence for Policy and Practice Information (EPPI) reviewer software. The EGM was constructed using EPPI Mapper, and comprehensive findings were presented through live links and figures.Result We identified 196 studies, comprising 59.2% children and 40.8% neonates, with diverse research approaches, including 94% quantitative studies. There has been a notable increase in research publications over the past 5 years. Evidence is heavily concentrated in Asia (93 studies) and Africa (47 studies). The most frequently studied exposures are those related to extreme climate events, followed by drought and floods. However, there are gaps in the study of extreme cold and storms. The significant outcomes comprised preterm birth (55 studies), low birth weight (27 studies), malnutrition (59 studies) and diarrhoeal diseases (28 studies). Evidence on mental health problems and congenital disabilities receives relatively less attention.Conclusion This EGM is crucial for researchers, policymakers and practitioners. It highlights knowledge gaps and guides future research to address the evolving threats of climate change to global child health.Trial registration number INPLASY202370086

Abstract Background Evidence shows that patients who visit the surgical and trauma emergency units may be discharged with untreated or increased pain levels. This study explored nurses’ pain assessment and management approaches at a trauma-surgical emergency unit in Ghana. Methods Seventeen nurses who work in the trauma department participated in this qualitative exploratory descriptive study. In-depth individual interviews were conducted, and the thematic analysis was utilized to identify emerging themes and subthemes. Results Three main themes were identified: patient pain indicators, pain management, and institutional factors influencing pain management. The study revealed that nurses rely on verbal expressions, non-verbal cues, physiological changes, and the severity of pain communicated. The findings highlighted staff shortage, inadequate resources, and lack of standardized guidelines as factors affecting pain and management. Conclusions Although the study offers critical new perspectives on nurses’ experiences regarding pain related issues at the trauma-surgical emergency units, its small sample size limited its generalizability.

The 2023 World Menstrual Hygiene Day (WMHD) celebration at the University of Health and Allied Sciences (UHAS) sought to create awareness about menstruation. Toward normalizing menstruation, the 3-day event brought together key stakeholders and engaged community members on various topics relating to menstruation. Among the stakeholders were basic school teachers (13), school children (155), in a 2:1 female vs. male ratio within the ages of 10–17 years, School Health and Education Program Coordinators (2), Health Officers (4), Academicians (15), University students (35), Media representatives (3), and Civil society representatives (130). Particular among these discussions were the biology of menstruation, nutrition related facts during menstruation, sociocultural, and mental health issues surrounding menstruation. These discussions were intended to incite more conversations about menstruation, and contribute toward the agenda 2030 goal of making menstruation a normal fact of life. The paper describes activities conducted to improve menstrual health, reduce period poverty, and involve men in breaking the stigma around menstruation. This contributes to creating supportive environments for menstruating individuals. Meanwhile, the lessons from the activities to celebrate WMHD in Ghana are relevant for other communities to consider replicating with consideration for contextual differences.

Climate change poses unique challenges to maternal well-being and increases complications during pregnancy and childbirth globally. This evidence gap map (EGM) aims to identify gaps in existing knowledge and areas where further research related to climate change and its impact on maternal health is required. The following databases were searched individually from inception to present: Medline, EMBASE, and Global Health via OVID; Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost; Scopus; and organizational websites. In this EGM, we integrated 133 studies published in English, including qualitative, quantitative, reviews and grey literature that examined the impact of climate change on maternal health (women aged 15-45). We used Covidence to screen studies and Evidence for Policy and Practice Information (Eppi reviewer)/Eppi Mapper software to generate the EGM. Data extraction and qualitative appraisal of the studies was done using critical appraisal tools. The study protocol was registered in International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) # INPLASY202370085. Out of 133 included studies, forty seven studies were of high quality, seventy nine moderate equality and seven low quality. This EGM found notable gaps in the literature regarding the distribution of research across regions. We found significant research in North America (51) and Asia (40 studies). However, Africa and the Caribbean had fewer studies, highlighting potential disparities in research attention and resources. Moreover, while the impact of extreme heat emerged as a prominent factor impacting maternal well-being, there is a need for further investigation into other climate-related factors such as drought. Additionally, while preterm stillbirth and maternal mortality have gained attention, there is an overlook of malnutrition and food insecurity indicators that require attention in future research. The EGM identifies existing research gaps in climate change and maternal health. It emphasizes the need for global collaboration and targeted interventions to address disparities and inform climate-responsive policies.

Background: The stereotype of having prostate cancer (PCa) and possible impairment in sexuality may lead to a deterioration of the mental health of patients with PCa. However, there is paucity of data on the psychological wellbeing and coping strategies of unmarried men with PCa in Ghana. We explored the psychological wellbeing and coping strategies of unmarried men with PCA in the Accra Metropolis of Ghana. Methods: In this qualitative study, we recruited ten (10) unmarried men as participants and interviewed them using a semi-structured interview guide. Data collection and analysis were done concurrently using thematic content analysis techniques with the aid of Nvivo 10. Ethics approval was obtained from the Ethics Review Committee of the 37 Military Hospital. Results: The findings revealed psychological symptoms of anxiety, depression, distress and suicidal ideation were exhibited by participants. Worries about treatment and recurrence of symptom as well as erectile dysfunction caused anxiety among participants. Some participants were depressed as a result of frequent urinary retention, severe pains and having to deal with an indwelling catheter whereas others associated their depression with cost of treatment and erectile dysfunction. The participants employed diverse strategies of coping with their condition. Subsequently, three sub-themes of coping were identified; lifestyle modification, social contact, and acceptance. Conclusion: Unmarried men with PCa have devastating effect on their psychological wellbeing and harbor suicidal ideations. We recommend psychological management of unmarried men with PCa.

Background: Post-surgical pain can have a major impact on patients’ postoperative recovery. An in-depth exploration of patients’ post-surgical pain experiences can contribute to improving the quality of postoperative care. This study aimed to explore the post-surgical pain experiences and determinants (related factors) among patients who had undergone abdominal surgeries within Dormaa, Ghana. Methods: An exploratory, descriptive qualitative study was conducted among 13 adult postoperative patients who were purposively sampled at a health facility in Dormaa, Ghana. Data were collected through individual face-to-face semi-structured interviews. Data were analysed using thematic analysis. Results: Postoperative patients experienced severe pain after their surgical interventions, which they attributed to previous experience, fear, sadness and excessive thinking. Patients felt mild to severe pain, mainly at the incision site, yet utilised verbal and non-verbal means to express their post-surgical pains. Although nurses responded to patients’ pains through pharmacological and non-pharmacological interventions, some patients resolved not to express pain due to social, cultural, and religious factors related to their age, sex, financial status and faith in God or Allah. Conclusion: Healthcare professionals should consider postoperative patients’ pain experiences and manage them effectively according to their sociocultural contexts and religious preferences.

Abstract Aim The aim of the study was to explore and describe the mothers' perspectives on issues associated with caring for Ghanaian children aged 0–14 years living with tuberculosis. Design Exploratory descriptive qualitative design. Methods Semi‐structured individual interviews were conducted face to face with 15 purposively sampled mothers from two health facilities in the Greater Accra area. Transcribed data were analysed using computer‐enhanced thematic analysis. Results Findings were grouped into (1) physical burden on the mothers and (2) psychological burden on mothers. The eight subthemes indicate that mothers of children living with tuberculosis experienced tiredness, sleeplessness, body pains, weight loss and sicknesses as they cared for their children. In addition to worrying, mothers experienced stigma and negative emotions such as sadness, guilt, fear and loneliness. Conclusion Mothers of children diagnosed with tuberculosis in Ghana experience physical and psychological health problems related to their caregiving roles. Nurses and other healthcare providers should identify specific problems and offer broad‐based emotional and other support for these women.

Abstract Aim The purpose of this study was to explore the perceived benefits and challenges of online distance education and computer‐based testing (CBT) among registered nurses and midwives in a sample of government‐owned health facilities and health training institutions in Ghana. Design Exploratory descriptive qualitative design. Methods Individual semi‐structured interviews were conducted with 45 participants (i.e. 25 nurses and 20 midwives). The data were manually processed and analysed using Braun and Clarke’s thematic analysis approach (November 2019‐February 2020). Results Nurses and midwives prefer online distance education for three reasons: convenience, cost‐effectiveness and learning centre proximity to the workplace. The course schedule’s flexibility allowed participants to work and study simultaneously. Others acknowledged online distance education as a viable option for overcoming the challenges of obtaining study leave. However, the lack of recognition of certificates by some employers, poor Internet connectivity and perceived excessive course load were noted as deterrents. Regarding the CBT, many of the participants said that it was useful. Among the advantages of CBT are: (1) a decrease in examination malpractices, (2) a decrease in examination costs and (3) a rise in students’ interest in information, communication and technology (ICT). This finding emphasizes the necessity of integrating ICT into nursing and midwifery education and examinations, as well as maximizing its benefits.

Abstract Background Childhood cancer is proportionately higher in Africa and these result in increased demands on caregivers. The inability of affected children to take care of themselves; coupled with prescribed medical interventions presents physical and social burdens on family caregivers. Aims and methods This study used a qualitative exploratory design to explore the physical and socioeconomic challenges for family caregivers of children diagnosed with cancer and receiving care at one of the biggest tertiary hospitals in Ghana. A total of thirteen family caregivers of children with cancer were interviewed. Findings Two major themes were identified: Burden of care on Physical Health and Socioeconomic burdens of caregiving on the family caregiver. It was reported that family caregivers encounter physical challenges such as Aches and Pains when performing caregiving activities, Loss of Appetite, Fatigue, Compromised Functional State and Sleep Disruption. The second theme, Socioeconomic burdens of caregiving on family caregivers account for the consequences of caregiving on social lives, family relationships, finance and employment. Conclusions and recommendations The study recommends that measures that provided relief for the caregivers such as teaching them to adopt local measures of pain relief such as massage should be encouraged. Policies should adopt measures that encourage caregivers to have some days of rest whiles providing care to their children with cancer. Also, health insurance packages that provide relief for the cost of accessing healthcare, should be extended to children with cancers to support their caregivers.

Background: Cervical cancer is a major public health issue globally. In Ghana, there is paltry of information on the perspectives of young adults on cervical cancer. Aim: The study explored the perception of young adults between the ages of 17-24 on cervical cancer screening at a hospital in the Sekondi-Takoradi Metropolis of the western region of Ghana. Methods: Qualitative exploratory descriptive method was employed in this study. 13 participants who met the inclusion criteria were purposively selected for the study. Respondents were interviewed face-to-face using a semi structured interview guide designed based on the research objectives. All interviews were audio taped, transcribed verbatim and analysed using thematic content analysis. Results: Younger adults had adequate knowledge on cervical cancer but inadequate information on its screening methods. All young adults in the study had never done screening because they did not see themselves susceptible to the development of cervical cancer and some opined that, cervical cancer is a disease for older and pregnant women. Conclusion: Participants had an incorrect perception on cervical cancer screening so more education should be put in place in our institutions to increase their knowledge on the dangers of cervical cancer and the screening methods available in its prevention.

Abstract Background Females in developing countries are likely to suffer from visual impairment more than their male counterparts. People living with blindness or any other form of disability also have the right to reproduce and care for their children like all other humans. There is paucity of literature in the experiences of blind mothers in Ghana. Therefore, this study explored the experiences of blind mothers as they navigated the process of motherhood. Methods Qualitative exploratory descriptive design was used to conduct the study. Nineteen blind mothers were interviewed individually. Permission was sought for data to be audiotaped, transcribed and content analyzed inductively. Results Three main themes emerged from the data: mothering role and difficulties (sub-themes; feeding, disciplining and protection), mothering challenges (sub-themes; discrimination and prejudice, financial distress and psychological distress) and coping strategies (prayer, children and self-motivation). Most of the mothers reported difficulties in playing their roles in the areas of feeding, disciplining and protection. Challenges were poverty, discrimination, prejudices on their ability to be mothers and psychological distresses such as depression. They coped with their challenges with prayers, self motivation and the hope they had in their children. Conclusion A lot of public education is needed to make the lives of people living with disability better. Health professionals must be trained to treat blind mothers with dignity and respect.

Abstract Background The World Health Organization endorses exclusive breastfeeding for the first six months of every child’s life since exclusive breastfeeding has the potential of saving thousands of infants’ lives. The global exclusive breastfeeding rate among mothers is sub-optimal. This predisposes infants born to teenage mothers to all types of ailments. Therefore, this study explored the factors that inhibit the practice of exclusive breastfeeding as perceived by pregnant teenagers in the Greater Accra Region of Ghana which is an urban area. Methods The study used techniques in qualitative descriptive exploration to collect data from 30 pregnant teenagers through focus group discussions. Six focus group discussions were conducted and each group was made up of five participants. Informed consent was obtained from participants who were 18 years and above as well as parents of participants below 18 years while informed assent was obtained from participants below 18 years after purposive sampling. Interviews were audiotaped, transcribed and data were analysed through content analysis. Results Two major themes and eight sub themes emerged from the data after analysis. Personal related barriers (negative emotional feelings, irrational thinking, perceived health risks to the baby and perceived self-inefficacy) and social related barriers (provider-client interaction, disapproval of exclusive breastfeeding by close relatives, unfriendly workplace policies and social myths) were the perceived factors that discouraged exclusive breastfeeding among teenage mothers. Conclusion Health professionals should be trained to provide culturally sensitive care to teenage mothers in order to promote exclusive breastfeeding. The media, religious leaders and politicians should help debunk misconceptions about breastfeeding expressed by participants in the study.

Abstract Background Families, whether at home or at the hospital, should be a vital part of newborn care. However, most families are excluded from hospital care, particularly in neonatal intensive care units (NICUs). This is incompatible with the concepts of Family-Centered Care (FCC) and may compromise care continuity and family satisfaction following discharge from neonatal intensive care facilities. The purpose of this study was to examine FCC practices in Ghanaian neonatal intensive care units and provide the experiences and contextual practices of FCC from the perspectives of families and clinicians. Methods The study qualitatively examined the contextual practices of FCC from the perspectives of families and clinicians in neonatal intensive care units using an exploratory descriptive design. With the help of MAXQDA software, 36 transcripts were generated and their contents were analyzed. Results Contextual practices of FCC, family experiences of FCC and clinician experiences of FCC emerged as three main categories from the data. Respect and dignity, culture and religion and a multidisciplinary approach were the contextual practices. Emotional stress, lack of information and coping strategies were all common family experiences. Support, counseling, education and financial problems have all been experienced by clinicians. Conclusions Shared decision-making, counseling and education, as well as respect/dignity amongst clinicians, managers and families using a multidisciplinary approach are the fundamental concepts of FCC approach in Ghana. Acceptance and integration of FCC approach into neonatal intensive care units may reduce the burden of care as well as improve the quality of care. Further studies are needed to map out strategies and interventions for the integration of FCC into intensive care units.

Abstract Background Evidence-based health system guidelines are pivotal tools to help outline the important financial, policy and service components recommended to achieve a sustainable and resilient health system. However, not all guidelines are readily translatable into practice and/or policy without effective and tailored implementation and adaptation techniques. This scoping review mapped the evidence related to the adaptation and implementation of health system guidelines in low- and middle-income countries. Methods We conducted a scoping review following the Joanna Briggs Institute methodology for scoping reviews. A search strategy was implemented in MEDLINE (Ovid), Embase, CINAHL, LILACS (VHL Regional Portal), and Web of Science databases in late August 2020. We also searched sources of grey literature and reference lists of potentially relevant reviews. All findings were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Results A total of 41 studies were included in the final set of papers. Common strategies were identified for adapting and implementing health system guidelines, related barriers and enablers, and indicators of success. The most common types of implementation strategies included education, clinical supervision, training and the formation of advisory groups. A paucity of reported information was also identified related to adaptation initiatives. Barriers to and enablers of implementation and adaptation were reported across studies, including the need for financial sustainability. Common approaches to evaluation were identified and included outcomes of interest at both the patient and health system level. Conclusions The findings from this review suggest several themes in the literature and identify a need for future research to strengthen the evidence base for improving the implementation and adaptation of health system guidelines in low- and middle-income countries. The findings can serve as a future resource for researchers seeking to evaluate implementation and adaptation of health system guidelines. Our findings also suggest that more effort may be required across research, policy and practice sectors to support the adaptation and implementation of health system guidelines to local contexts and health system arrangements in low- and middle-income countries.

Abstract The year 2022 saw COVID‐19 as the primary public health concern, with vaccine rollout and mandates at the forefront. Other viral infectious diseases, such as Monkeypox and Ebola, emerged as public health concerns. Climate change and political conflicts significantly impacted global health, increasing the demand for humanitarian assistance and protection. In 2023, it remains crucial to identify global and public health priority areas to coordinate and implement effective solutions. Through discussions with public health practitioners and researchers, we have identified key priority areas for 2023, namely, health systems, the mental health crisis, substance abuse, infectious diseases, malnutrition and food insecurity, sexual and reproductive health challenges, environmental pollution, the climate crisis, cancer, and diabetes. These priority areas highlight shared concerns that should be addressed to facilitate proactive and innovative health interventions and practices. To achieve universal healthcare targets for 2030, prioritization, financial investment, international cooperation, and collaboration in addressing these global health challenges are crucial. This requires coordination among public health decision‐makers, the private health sector, and opinion leaders to implement country‐specific healthcare financing and food security measures. Research, scientific knowledge, and technical capacities must be leveraged to produce sustainable interventions that effectively reduce health disparities and improve health system responsiveness to prevent these challenges from progressing to public health emergencies.

Objective: The choice of the sick to access health care services in Ghana or consult a health care provider depends on the individuals’ beliefs about the disease and available services. This paper seeks to explore the health beliefs of cervical cancer survivors in Ghana. Methods: We employed an exploratory qualitative approach in this study. We interviewed 12 participants to gain an in-depth understanding regarding the beliefs, causes, prevention and treatment of cervical cancer in Ghana. Data collection and analysis were done concurrently, and themes and subthemes were generated through content analysis. Verbatim quotes were used to support the findings. Results: Three themes emerged. 1. Beliefs about the causes of cervical cancer, which include the choices of cloths and criminal abortions. 2. Beliefs on cervical cancer prevention; early education of the girl child on vagina hygiene and avoidance of highly processed food products. 3. Beliefs on cervical cancer treatment; participants believed that cervical cancer is one of the diseases not well managed in hospitals in Ghana. Conclusions: Mistrusts for orthodox cancer treatment is the leading rationale patients report late to the hospital in Ghana. Much is desired for public education on contemporary treatment and cure for cervical cancer disease.

Abstract On 23 July 2022, the World Health Organization reported monkeypox cases in over 75 countries and, as a result, declared the virus a Public Health Emergency of International Concern (PHEIC). Despite Africa being the centre of the zoonotic disease evolution, its healthcare systems have not provided optimum attention to the problem. The African healthcare system is under the threat of a repeat of the situation that transpired during the COVID‐19 pandemonium if stringent measures are not implemented immediately. Lessons learned from the COVID‐19 pandemic should inform emergency preparedness and response from African countries. Concerted and sustainable efforts can be achieved by reviewing and redesigning strategic preparedness plans for testing and vaccination as in previous pandemics. Africa needs to drive this response with collaboration and a united response, and with the use of strategic communication and a sense of urgency. Africa should prioritise access to available vaccines and invest in systems development for local vaccine production. In this article, we argue that monkeypox virus has serious public health implications in Africa and the region.

This study aims to explore the perceptions of patients and family caregivers on the image of nurses and midwives in Ghana. The study adopted a qualitative exploratory descriptive approach. A total of 25 participants were interviewed during data collection. Content and thematic analysis were applied in the data analysis to develop themes. The findings are captured under two major themes that describe the primary influences on participant images of nurses: Thus, (1) nurses’ and midwives’ attributes with four subthemes; staff appearance, communication strategies and behaviors, work attitudes, and professional competence and (2) patients’ status and subthemes were; uneducated poor and educated rich. We conclude that patients and families in Ghana recognize the professional attributes of the nurse and midwife, which reflect in their personality, grooming, communication, competencies, and attitudes. However, low publicity of the professional roles of nurses and midwives may have negative repercussions for their professional image. A policy to perform a regular public audit on the image of the Nurse/Midwife is important for professional advancement.

Abstract Background Herbal medicine administration in conventional health care services is gaining popularity lately. Much has not been documented on the perceived enhancers and challenges to herbal medicine administration at the hospital. The study sought to explore the facilitators and barriers to the clinical administration of herbal medicine in Ghana. Method Qualitative descriptive exploratory design was employed. Fourteen participants among the consented and purposively sampled nurses were interviewed. Data was transcribed and analysed using content analysis. Results The participants disclosed that facilitators to the clinical administration of herbal medicine include doctors’ prescription, affordability of herbal medications by patients, patients’ willingness to use herbal medicine and availability of herbal medicine. Barriers to the clinical administration of herbal medicine were inadequate knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration and policies on herbal medicine administration at the hospital. Other barriers were negative mindset of patients and lack of national health insurance scheme (NHIS) coverage. Conclusion Clinical administration of herbal medicine is faced with an array of challenges. Doctor’s prescription, nursing education on herbal medicine and NHIS coverage of herbal medicine are imperative to improve herbal medicine administration in hospitals. Plain English summary Herbal medicine addition into mainstream health care services is surging high in many countries. This study aimed at finding out what nurses consider as the issues that make it easy or difficult to serve herbal medicine in the hospital. Qualitative method was employed, in-depth face-to-face interviews were conducted and data collected was typed verbatim. The typed data was content analysed and findings supported with the nurses’ statements. The findings of the study showed that facilitators to the clinical use of herbal medicine include doctors’ prescription, affordability of the herbal drug, patient’s willingness to use the herbal medication, patient’s belief about herbal medicine and availability of herbal medicine. Challenges to the clinical use of herbal medicine disclosed were lack of knowledge on herbal medicine, lack of publicity, unclear integration, lack of collaboration between health professionals and herbal medicine providers. Other barriers include negative mindset of patients and lack of national health insurance (NHIS) coverage. The researchers came to a consensus that nurses need further training on herbal medicine to enhance herbal medicine use at the hospital. Health professionals need to collaborate with herbal medicine service providers and NHIS must be reviewed to cover herbal medications.

Abstract Aim This study was undertaken to discover the socioeconomic impact of breast cancer on young women in Ghana. Methods A qualitative exploratory and descriptive design was used to recruit 12 young women from the University of Ghana hospital, 37 Military hospital and Ridge hospital. Individual interviews were conducted face to face and data transcribed verbatim and analysed using content analysis. Results Three themes emerged: perceptions and beliefs; economic concerns; and secrecy. Participants perceived that breast cancer was a test of faith, a spiritual disease that is contagious and disgraceful. Mostly, participants stopped work to cater for themselves, and as a result, they encountered financial challenges. Their challenges were compounded with conscious efforts to keep diagnosis secret to avoid being stigmatized. Conclusion Young women living with breast cancer need support physically, economically and socially from healthcare providers, their families and the society at large.

Abstract Background The World Health Organization has admonished member countries to strive towards achieving universal health coverage (UHC) through actionable health policies and strategies. Nurses and midwives have instrumental roles in achieving UHC via health policy development and implementation. However, there is a paucity of empirical data on nurses and midwives’ participation in policy development in Ghana. The current study explored nurses and midwives’ participation in policy development, reviews and reforms in Ghana. Methods A qualitative descriptive exploratory design was adopted for this study. One-on-one individual interviews were conducted after 30 participants were purposefully selected. Data was audiotaped with permission, transcribed and analyzed inductively using the content analysis procedures. Results Two main themes emerged from the data: participation in policy development and perspectives on policy reviews and reforms. The findings showed that during health policy development and reviews, nurses in Ghana were overlooked and unacknowledged. Policy reforms regarding bridging the pre-service preparation gap, staff development and motivation mechanisms and influence on admission into nursing schools were raised. Conclusion The authors concluded that nurses and midwives are crucial members of the healthcare systems and their inputs in policy development and reviews would improve health delivery in Ghana.

Abstract Aim The aim of the study is to investigate factors hampering the provision of mental health services by nurses and midwives to childbearing women to assist in the prioritization and distribution of limited mental health resources. Design This is a cross‐sectional self‐report study. Methods Data collected from 309 nurses and midwives were analysed using descriptive and inferential statistic, namely chi‐square and analysis of variance (ANOVA). Results The barriers reported by the participants include unavailability of mental health services (77%), lack of knowledge of mental health in women from different tribes (75.7%), lack of a clear mental healthcare pathway (75.1%), heavy workload (74.1%) and lack of knowledge of mental health issue (74.1%). These barriers are less likely to be reported by participants who are males, old and who have practiced for a long time. Conclusions Systematic effort to restructure the healthcare delivery system, including equipping healthcare professionals with requisite knowledge, skills and competencies in maternal mental health, is highly recommended.

Abstract Background Young women diagnosed with breast cancer face challenges that interfere with their entire life with psychological and physical effects. Method We employed a qualitative exploratory descriptive design, and recruited twelve participants through purposive and snowball sampling methods to conduct 12 face to face individual interviews. A reputable review board in Ghana; Noguchi Memorial Institute for Medical Research, gave ethical clearance for data collection. Data were transcribed verbatim and analysed using thematic content analysis. Results Three themes emerged from the data; physical effects of breast cancer, effects of treatment on body image, and emotional effects of breast cancer diagnosis and treatment. The negative effects of treatment incapacitated most of the women and limited their activities of daily living. Some experienced severe bodily weakness and stayed indoors for days. Most participants felt they looked unattractive because they have had a mastectomy done, and used pieces of rags and handkerchiefs as breast prostheses. Those who had hair loss through chemotherapy used different kinds of wigs to cover their baldness. Almost all the participants cried, felt depressed, and became emotionally unstable when they were told their diagnosis. Some denied their diagnoses and displaced their anger on healthcare personnel. A few of them felt they had brought disgrace to their families because breast cancer is perceived, a disgraceful disease. Conclusion Young women diagnosed with breast cancer require psychological interventions and physical support from healthcare personnel and their families.

Abstract Background Breastfeeding and caring for children demand time, energy and effort. Mothers with physical impairments in Ghana require special needs to be able to achieve optimal motherhood as society demands. Globally, literature on breastfeeding and caring for children among mothers with physical disabilities is limited. Similarly, there is dearth of literature on the experiences of mothers with physical impairments in Ghana. Therefore, this study sought to add to literature by exploring the experiences of mothers with physical impairments with regards to breastfeeding and how they care for their children. Methods Qualitative descriptive exploratory design was used. Twelve mothers with physical impairments who had been purposively sampled gave informed consent before data was collected through in-depth one-on-one interviews. Data was recorded, transcribed and analyzed inductively using the content analysis technique. Results Mothers with physical impairments perceived breastfeeding as difficult and expensive due to issues relating to disruption of sleep, dysfunctional limbs and the need for breastfeeding mothers to eat nutritionally balanced meals. Participants felt prejudged and discriminated at different points in their daily encounters. Conclusion Mothers with physical impairments have challenges. Therefore, attitudinal change should be advocated in the Ghanaian society with respect to issues concerning people living with disabilities.

Managing postoperative pain require good understanding of the bio-ethical principles in order to preserve patients’ rights. Bio-ethical principles in health care include autonomy, beneficence, justice and nonmaleficence. It is important that health care professionals understand that patients in pain have the right to satisfactory management. Good insight on ethical principles and how they relate to pain management places the nurse on a better pedestal to manage postoperative pain effectively. However, there is scanty literature on the level of Ghanaian nurses’ knowledge and application of bio-ethical principles in postoperative pain management. Therefore, the study objectives were to: explore nurses’ understanding of the bio-ethical principles in postoperative pain management; explore how nurses apply bioethical principles in postoperative pain management. The study employed qualitative exploratory descriptive design. Purposive sampling technique was used to recruit participants from the surgical wards. Semi-structured interview guide was designed for data collection. Data saturation was reached at the fourteenth participant. Thematic analysis method was used and themes emerged inductively. Three main themes identified through inductive content analysis of data were: beneficence, autonomy and justice. Findings showed that nurses had some appreciable level of knowledge of the fundamental principles related to ethics and applied them in postoperative pain management. Nurses knew their duties in advocating for patients. Patients rights to refuse treatment was also appreciated by some nurses. Nurses also demonstrated humanity by helping patients financially to settle hospital debts which explicitly shows the empathetic characteristics of nurses. The study concluded that nurses are knowledgeable in bioethical principles underpinning post operative pain management and also applied these principles when caring for surgical patients.

Objective Nursing regulators are important governance structures for nurses who are critical to the achievement of universal health coverage (UHC). This study examined the perspectives of the heads of nursing education institutions (NEIs) in Ghana and South Africa on the functioning and effectiveness of the respective nursing regulators.Design This was a cross-sectional survey.Setting This study was conducted in Ghana and South AfricaParticipants Heads of accredited NEIs in Ghana (n=65) and in South Africa (n=39).Results In South Africa, the mean score for overall functioning of the South African Nursing Council (SANC) was 4.6 (SD 1.97), whereas the mean score for overall functioning of the Nursing and Midwifery Council of Ghana (N&MC) was 7.1 (SD 1.7) (p

Nurses and midwives are the majority of healthcare professionals globally, including Africa, and they provide care at all levels of the health system including community levels. Nurses and midwives contribute to the care of patients with rigid or dogmatic religious beliefs or those with suicidal ideations. This review paper discusses acute and chronic diseases that have suicidal tendencies such as terminal cancer, diseases with excruciating pain, physical disability, stroke, end-stage renal failure, and diabetics who are amputated. It was reiterated that nurses and midwives taking care of these patients should be alert and observant to identify their suicidal tendencies. The paper also discusses religious or spiritual inclinations that negatively affect healthcare access and adherence, especially to biomedical or western medicine. It was emphasized that some religious beliefs do not allow their followers to employ biomedical treatment and nurses and midwives should not impose their faith on patients and their families. The paper ends with a discussion on the specific roles of nurses and midwives in the care of patients with suicidal ideations such as assessment, counseling, administering medication, observation, social interaction, ensuring safety measures, and providing an enabling environment for the family to part of the care and for the observation of religious coping strategies. Nurses and midwives should enhance their knowledge and skills on suicide and increase public education on suicide prevention and identification of those at risk.

Background: Pain sustained from burns is usually quite severe and has been linked to extreme distress, preventing patients from contributing to their care. Nurses have legal and professional obligations to promptly assess burns pain by using pain assessment tools and by relying on the patient’s behaviour and expressions. Objectives: To explore nurses' perceptions on pain behaviours among burn patients in a Ghanaian tertiary hospital. Methods: A qualitative descriptive design was used. A total of 11 nurses were recruited through a purposive sampling technique from a burns unit of a tertiary facility in Ghana. Semi-structured face-to-face interviews were conducted. Analysis was done using thematic content analysis, from which two major themes and nine subthemes were identified. Findings: Patients express their pain by adopting both verbal and non-verbal communication means. However, due to the subjective nature of pain, nurses’ perceptions of pain were not sufficient to effectively assess the degree of pain. Verbal indicators that nurses perceived to be pain behaviours of burn patients were screaming, crying, praying and groaning, while frowning, reduced sense of humour, and body language were some non-verbal indicators nurses used to confirm the existence of burns pain. Nurses in Ghana must adopt the use of objective pain assessment tools, in conjunction with perceived pain behaviours, for optimal pain management outcomes. Conclusions: Patients with burns experience intense pain from both the burns and the procedures that are done for them to aid in their healing. A systematic pain assessment by nurses, as part of the health care team, is a vital guide to pain management. To ensure consistency in the assessment of pain, there is a need to design protocols and policies to guide all nurses in the assessment of burns pain in the burns unit.

Background: COVID-19 has impacted negatively on people physically, psychologically, spiritually, and socioeconomically worldwide. Nurses’ ability to prepare towards case management is imperative because the potential of one coming across the virus at the hospital is inevitable. This study intended to explore and describe nurses’ perspectives on preparation towards fighting COVID 19 in Ghana. Methods: A qualitative exploratory descriptive design was adopted. Nine major health facilities designated for COVID-19 treatment centres in four regions in Ghana were involved in the study. A semi structured interview guide was used to interview twenty-nine nurses via telephone based on data saturation. Ethics approval was obtained from the Ethics Review Committee of the Nursing and Midwifery Council of Ghana. Result: data yielded two major themes and four subthemes. The two main themes were 1. Health facilities’ preparation of nurses towards COVID-19, with its subthemes; targeted training, and selection of experienced staff. 2. Nurses’ individual preparedness towards COVID-19 with the subthemes; information sourcing and sharing. Nurses in Ghana prepared for combating COVID-19 by going through training on infection prevention and control, and case management using demonstrations and simulations. Experienced nurses in Ghana volunteered to be at the frontline managing cases. Continuous updates on the virus and its management through information tracking sharing played a key role. Conclusion: Nurses in Ghana need to have more specialty training targeted at diseases of public health importance. Key words: Nurse; preparedness; covid-19.

Background: Exclusive breastfeeding for the first 6 months can prevent diseases, boost immunity and improve quality of lives of infants. Ghana implemented programmes aimed at reaching the global target of increasing exclusive breastfeeding for the first 6 months to at least 50% by the year 2025. The country witnessed a decline in the overall rate of exclusive breastfeeding and an increase in the number of teenage mothers. Globally, teenage mothers are less likely to breastfeed than mothers of other age groups. Understanding enablers of exclusive breastfeeding by teenage mothers is important for any intervention aimed at improving exclusive breastfeeding rates and the quality of lives of infants. Method: The study used a qualitative, exploratory, descriptive and contextual design, with focus groups. A total of six group discussions were conducted with 30 pregnant teenagers recruited from six public hospitals. Results: Seven enablers emerged from the analysis of data. These included positive beliefs about the benefits of breast milk, family history of positive exclusive breastfeeding outcomes, support of the intimate partner, approval of closed-family members, expert opinions of antenatal care staff, teenage-oriented breastfeeding education and community-based breastfeeding education. Conclusion: Health professionals and policy makers could learn from these enablers and use them to promote exclusive breastfeeding practices amongst teenage mothers in Ghana.

Abstract Background Suicide is higher among adults with disabilities compared to their counterparts without disabilities and suicide is mostly preceded with suicidal ideations. For each successful suicide, there could be many ideations and attempts. Limited scientific data exist on the issue of mothers with disabilities and suicidal ideations. Therefore, this study explored suicidal ideations and coping strategies of mothers living with physical disabilities in Ghana. Methods Qualitative descriptive exploratory design was used and data was collected through individualized in-depth interviews. All participants were purposefully selected after informed consent was sought. Data was audiotaped, transcribed and analyzed inductively using content analysis technique. Results Almost all the women in this study reported suicidal ideations from time to time. Poisoning was the most predominant means which the women had considered to use if they ever attempted the suicide. Suicidal thoughts were precipitated mainly by discrimination. Their resilience and ability to cope were due to self-motivation, children, counselling, assistance from relatives and prayer. Conclusion We concluded that, it is crucial for all health professionals to explore and identify suicidal intentions among mothers with disabilities for them to be referred to the appropriate units for necessary help.

Abstract Background The purpose of the study was to explore surgical patients’ experiences of discharge planning and home care in the Northern part of Ghana. Methods The study was conducted at a referral hospital located at the Northern part of Ghana. A qualitative explorative descriptive design was adopted for the study. Purposive sampling technique was used to recruit participants. Data was saturated with 15 participants aged between 23 and 65 years. All the interviews were audio-taped and transcribed verbatim. Data analysis was done using the processes of content analysis. Results Nurses educated surgical patients on discharge to avoid smoking, alcohol drinking, chewing cola nuts and strenuous exercise to promote healing and prevent complications. Patients were educated to keep their wound dry and clean. Patients were advised to eat nutritious food, vegetables and fruits and take their medications as prescribed. They were to report drug effects and come to the hospital for follow-up visits. Patients were urged to come for daily wound dressing at the outpatient department. On the contrary, some nurses did not educate patients on signs of wound healing or infection. Some nurses were rude to the patients during wound dressing. Nurses did not visit patients at home when they were discharged from the hospital. Conclusions The study showed that although nurses were able to educate discharged patients on how to manage their health at home, there is the need to improve communication and attitude to enhance care.

Abstract Background Prior to the advent of modern obstetric services, traditional birth attendants (TBAs) have rendered services to pregnant women and women in labour for a long time. Although it is anticipated that women in contemporary societies will give birth in hospitals and clinics, some women still patronize the services of TBAs. The study therefore sought to gain an in-depth understanding of the initiation of TBAs and their traditional and spiritual practices employed during pregnancy and childbirth in Ghana. Methods The design was an exploratory qualitative one using in-depth individual interviews. Data saturation was reached with 16 participants who were all of Christian faith. Interviews were conducted with a semi-structured interview guide, audiotaped and transcribed verbatim. Content analysis was employed to generate findings. Results The findings showed that TBAs were initiated through apprenticeship from family members who were TBAs and other non-family TBAs as well as through dreams and revelations. They practice using both spiritual and physical methods and their work was founded on spiritual directions, use of spiritual artefacts, herbs and physical examination. TBAs delay cutting of the cord and disposal of the placenta was associated with beliefs which indicated that when not properly disposed, it will have negative consequences on the child during adulthood. Conclusion Although, TBAs like maternal health professionals operate to improve maternal health care, some of their spiritual practices and beliefs may pose threats to their clients. Nonetheless, with appropriate initiation and training, they can become useful.

Abstract Background Patient advocacy has been identified as a core duty of the nurse, and certain nurse characteristics influence the performance of the role. However, these characteristics have not been adequately explored in Ghana. This study aimed to explore the perspectives of nurses about the characteristics of nurses that influence their role as patient advocates. Methods An exploratory descriptive qualitative study was conducted among 15 nurses from a regional hospital in Ghana. Purposive sampling was used to select participants and individual in-depth interviews were conducted in English using a semi-structured interview guide. The interviews were audio-taped and transcribed. Data analysis was done concurrently employing the principles of thematic analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute of Medical Research and the Ghana Health Service Ethical Review Committee. Results Themes generated revealed nurse traits which enhanced the advocacy role of nurses such as being empathetic, nurturing, ethical, assertive and persistent and nurse states which hindered the performance of the role such as fatigue and frustration. However, “compassionate” emerged as an additional nurse trait from this study. Out of empathy, participants availed themselves for patients to share their problems with them. In their nurturing roles, spending more time with patients and providing personal care fostered closeness which helped in identifying patients’ problems. Helping patients navigate the health system was also found. They perceived patient advocacy as a moral responsibility and identified good communication skills and determination to help patients get their problems solved as important in patient advocacy. Some participants also described compassion-based activities such as pleading on patients’ behalf, providing material and financial assistance, facilitating care and providing emotional support in their advocacy. However, heavy workload and lack of appreciation from patients were found to hinder the performance of the advocacy role. Conclusions We concluded that nurse characteristics that influence patient advocacy are comparable to those identified internationally such as being empathetic, assertiveness and fatigue. Enhancing these characteristics could help nurses overcome the negative states that undermine the patient advocacy role of nurses.

Abstract Background Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Thus, this study sought to gain a detailed insight into the experiences of midwives on pharmacological and non-pharmacological labour pain management strategies in a resource limited clinical context. Methods A descriptive exploratory qualitative design was adopted for this study which allowed in-depth follow-up of the midwives’ comments resulting in a full understanding of emerging findings. Face-to-face individual interviews were conducted, transcribed and data were analysed using content analysis procedures. Verbatim quotes were used to support the findings. Results Midwives employed different pain control measures including pharmacological and non-pharmacological methods such as psychological care, sacral massage and deep breathing exercises. Doctors prescribed analgesics most of the time while in some cases, the midwives independently administered the drugs. They assisted women who had epidural anaesthesia given by anaesthetists. The midwives did not administer adequate analgesics because of fear of side effects of analgesics. Although the midwives exhibited knowledge on drugs used for labour pain management, they did not regularly administer analgesics and non-pharmacological care provided were inadequate due to increased workload. Some of the midwives showed empathy towards women and supported the women. Most of the midwives perceived labour pain as normal and encouraged women to bear pain. Conclusion Midwives require regular education on labour pain management and they should pay attention to women in labour individually and administer the care that meets their need.

Background: The World Health Organization (WHO) recognizes the significance of families’ caregiving roles for sick children, especially in the case of cancer and other chronic diseases. Objectives: This study aimed to explore the psychological and spiritual wellbeing of family caregivers of children with cancer at a teaching hospital in Ghana. Methods: A qualitative exploratory descriptive design was employed. Purposive sampling technique was used to recruit participants who met the inclusion criteria. A total of thirteen (13) participants were interviewed one-on-one, using a semi-structured interview guide. All interviews were audio taped and transcribed verbatim. Data were analyzed using thematic content analysis. Findings: It was identified that caregiving affected the psychological and spiritual wellbeing of family caregivers. Four subthemes emerged as psychological experiences and these include; fear and anxiety, distress and sadness, blame, confusion and helplessness. Spiritual wellbeing focused on inner strength and exercise of faith. Three subthemes emerged as spiritual wellbeing: hope, meaning to life, and religious rituals. Conclusions: Several challenges mark the care trajectory of child cancer patients which impinge on the psychological wellbeing of family caregivers. In the light of limited psychological care for family caregivers of child cancer patients, caregivers (mostly mothers) rely on their religious faith and rituals to invoke deeper spiritual understanding and purpose to life.

Postoperative pain remains a challenge in many healthcare settings. It is unethical if pain is not managed adequately. However, there is inadequate literature on nurses’ ethical decision making on pain management. Thus, this study aimed at exploring the factors influencing ethical decision making for postoperative pain management among nurses in Ghana. Qualitative exploratory descriptive design was used and participants were purposively sampled from the surgical wards of the study hospital. Semi-structured interview guide was used for data collection and saturation was reached at the 14th participant. Thematic analysis was done and three themes emerged: Institutional factors influencing ethical decision making, leadership roles in nurses’ ethical decision making, and inter-professional relationships influencing ethical decision making. Lack of protocols on pain management, no disciplinary and ethics committees, and unavailability of analgesics were perceived to negatively influence ethical decision-making for postoperative pain management. Nurses stated that establishing ethics committee would address ethical issues on pain management. Constructive feedback from clinical unit leaders was also perceived to influence decision making for postoperative pain management positively. The study concluded that, there is need for the nurse to place emphasis on ethically sound decisions when managing postoperative pain since it is a fundamental human right for patients to have their pain managed properly.

Objective: The objective of this study was to explore how Community Psychiatric Nurses experienced stigma in their line of duty. Methods: The study adopted qualitative exploratory descriptive design. Participants were selected from three district hospitals (Ga South, Ga Central and Okaikoi) all in the Accra Metropolis. Twelve (12) participants between the ages of 26 and 40 were selected using a purposive sampling technique. After transcribing verbatim audio-taped individual interviews, the data were analysed using content analysis procedures. Results: Five (5) themes emerged including: Mocking and labelling, discrimination, expression of genuine concern about their safety, poor image and associative stigma. Mostly, the community psychiatric nurses felt ridiculed and belittled as they experienced open negative labelling in the community. Conclusions: The findings draws attention for the need for all Community Psychiatric Nurses to be respected and not ridiculed so they can work effectively and ensure decentralization of care. Stigma can be reduced through extensive education using various media outlets. Adequate logistics is necessary to enhance the work of community psychiatry nurses.

Objective: The objective of this study was to explore surgical patients’ experiences of preoperative and intraoperative nursing care. Materials and methods: The study was conducted at the Regional Hospital, Bolgatanga, Ghana and employed a qualitative explorative descriptive design. Purposive sampling technique was used to recruit participants. The data was saturated with 15 participants aged between 23 and 65 years. All the interviews were audio-taped and transcribed verbatim. Results: The nurses reassured, counseled and pre-habilitated patients where necessary. They also provided physical care to patients but failed to involve patients in their care. Nurses did not take patients’ medical history. Nurses poorly managed patients’ pain during surgery and safety measures were not adequately employed resulting in some patients sustaining minor injuries due to poor usage of theatre equipment such as diathermy machines. Nurses also provided inadequate information to patients and this resulted in patients being confused and anxious. Conclusions: The study showed that some nurses require further training to provide better care to their surgical patients.

Introduction: There are a number of factors that influence health promotion activities among the youth. This study sought to gain a comprehensive understanding of the facilitators and inhibitors of health promotion among the youth from the perspectives of community leaders in a rural setting in South Africa. Methods: The study adopted an exploratory, descriptive and contextual qualitative approach involving community leaders in rural South Africa. Data saturation occurred after individual interviews with 21 participants. Data analysis employed the principles of content analysis. Results: We found that facilitators of health promotion were access to education on the benefits of health promotion activities, efforts of organizations and community leaders/teachers, access to health care services and engaging in physical activities, and youth motivation and positive role modelling. The themes that described the inhibitors of health promotion were inadequate recreational and health facilities and health personnel, the impact of stringent religious doctrines, unemployment, social vices and poor parenting. Conclusion: We concluded that there is the need to implement more engaging activities and opportunities for the youth and parents in rural communities to enhance health promotion. Keywords: Health promotion, Young adults, Qualitative research, Rural community

Aim: This study sought to identify ways of coping with breast cancer diagnosis and its treatment challenges among young Ghanaian women living in the Accra metropolis. Methodology: The study used an exploratory descriptive qualitative approach to recruit twelve participants aged 28–45 years through purposive and snowball sampling methods from three hospitals in the Accra metropolis. Participants were interviewed using a face to face approach and interviews were audio recorded with participants’ permission. Verbatim transcription was done and data were analyzed using content analysis procedures. Findings: Participants believed God is the ultimate healer. They prayed and read the Bible. Some believed God could replace their breasts, they voided sinful acts and used religious artefacts such as the Rosary, special oil prepared by pastors, pictures of pastors. They obtained physical and emotional support from their families, partners and significant others. They compared themselves with others who had worse health challenges such as those with end-stage breast cancers who were on admission and those who have died. Participants also listened to music, read storybooks, took a walk in flower gardens to cope with breast cancer diagnosis and treatment. Conclusions: Young women living with breast cancer rely more on God and support from their families, friends and the church in coping with their condition. These young women need to be attended to by multidisciplinary healthcare team the clinical psychologist and a spiritual leader to enable meet their physical, psychosocial and spiritual needs. Keywords: Breast cancer, Coping, Ghana, Spirituality, Social support, Young women

Introduction For nursing practice to be responsive to the needs of patients, it must be driven by contextual research evidence. To guide institutional and national nursing research policy, there is need to determine the quantity and quality of nursing research in Ghana. Purpose The purpose of this integrative literature review was to quantify, critically evaluate, and describe nursing research publication in Ghana from January 2007 to December 2016 with regard to the country's research capacity to sustain evidence-based practice. Results Sixty (60) out of 749 articles identified from EBSCOhost, ProQuest, PubMed, Science Direct, Scopus, Wiley Online Library, and Google Scholar using three keywords (nursing, health, and Ghana) were included. A total of 60,778 human subjects were used in these studies. There were more quantitative (28) studies than qualitative (23) studies. These studies recorded 219 authors from 120 institutions, 55 of which were outside Ghana. Forty-five percent of the articles were published in journals with impact factor. There was a steady increase in publication in Ghana over the decade. A majority of the studies published in education were in curriculum implementation and evaluation. Conclusions The increasing number of peer-reviewed nursing research publications in Ghana and the curriculum implementation and evaluation in Ghana signified an increasing capacity of the country to implement and sustain evidence-based practice. Recommendations It is recommended that regular research be conducted to evaluate the responsiveness to old and new nursing programs in Ghana.

Quality of acute care has attracted attention in recent years with policy initiatives in Ghana. Such initiatives need to be complemented with patient feedback systems for strengthening quality. Therefore the goal of this study is to examine factors associated with quality of acute care and to propose a range of options for improving the existing model of healthcare delivery. Methods: Cross-sectional data were collected from 379 patients presenting to emergency centres in five public health facilities. A structured questionnaire developed based on the literature and expert advice by physicians and nurses was used to collect data. Principal component analysis (PCA) was used to extract the factors salient to patients’ perspective of quality of care. Logistic regression was then used to examine association between these factors and overall quality of acute care. Results: The majority of the patients (17.2%) presented with obstetrical related conditions, 15% with Road Traffic Accidents (RTAs), 11.3% with diarrhoea related problems and the least number (8.4%) with bronchial asthma. The average days of admission was high for patients with bronchial asthma (mean = 9), RTA (mean = 8) and burns (means = 7). The PCA produced four factors of quality (interpersonal care; prompt care; physical environment and privacy; drugs and equipment) all of which had a positive statistically significant association with overall quality of acute care after controlling for patient’s socio-demographic characteristics. Conclusion: Study findings provide important feedback not only for optimising clinical operations but also for improving in-hospital quality of acute care with short-term and long-term approaches.

Background: Oxygen therapy is an integral part of emergency and immediate post-operative management. Objectives: The study sought to gain full understanding on nurses’ perspectives on clinical administration of oxygen within the emergency and immediate post-operative environment. Methods: The study employed a descriptive qualitative design to achieve its objectives. The study was conducted at the adult emergency unit, Surgical Medical Emergency, and the Cardiothoracic Intensive Care Unit of the Korle-Bu Teaching Hospital (KBTH). The target population was nurses. A purposive sample of 12 nurses; six from each unit were involved in the study. Data was collected through individual face-to-face interviews which were audiotaped and transcribed verbatim. Data was analyzed concurrently applying the principles of content analysis. Results: Themes generated on commencement and monitoring of oxygen therapy included initiation of oxygen therapy, and assessment and monitoring of patient. Other themes on challenges of oxygen therapy were knowledge and information gap, lack of protocol, availability and cost of delivery devices, and oxygen supply. Conclusion: Nurses require further training in oxygen therapy and there is the need to develop appropriate protocols to guide oxygen therapy.

Clinical guidelines involve statements that guide clinicians to provide effective care to patients. However, there are no context appropriate clinical guidelines for post-operative pain (POP) management in Ghana. This study sought to develop such a clinical guideline. The study adopted a participatory approach drawing from the existing literature to develop the guideline with the involvement of 27 experts and stakeholders including nurses, doctors, anaesthetists, pharmacists, patients, and patients’ relatives. Also, the guideline statements were discussed and finalised at a multidisciplinary consensus forum made up of 29 members. Consensus was achieved by employing procedures similar to a modified nominal group technique. Purposive sampling was employed. The guideline was made up of four dimensions described in a conceptual Radial Venn which emphasised inter-relationships among patient and family education, team work, monitoring and input by hospital leadership, and application of appropriate scientific recommendations for POP management. The effective collaboration with stakeholders resulted in the adoption of the clinical guideline by the Ghana Health Service for use within the Ghanaian health system.