Healthcare in Low-resource Settings

Distribution of the pattern, incidence, and determinants of sexually transmitted infections among patients attending Adari Hospital, Hawassa City, Sidama Region, Ethiopia

Melese Birmeka — 2024-09-27

Sexually Transmitted Infections (STIs) cause serious medical and psychological health problems in Ethiopia and vary in different localities. Thus, this study aimed to investigate patterns, status, and the association of sexually transmitted infections and local risk factors in the patients attending Adari Hospital. An institutional-based cross-sectional study was carried out from September 2021 to June 2022. Systematic simple random sampling was used to select a total of 385 patients. In addition, five years of retrospective data were collected. Data were collected through blood tests, urethral and vaginal discharge swabs, structured questionnaires, interviews, and observations. Variables with p-values less than 5% are considered as significant. The overall prevalence of sexually transmitted infections was 74.4%. The odds of STIs in patients who were urban, single, presence of two and above sexual partners, illiterate, sexual intercourse without using a condom, and sex after drinking alcohol and chewing khat were more likely to be infected with STIs as compared with their counterparts. STIs were highly prevalent and one of the health challenges of Hawassa city.

Sociodemographic correlates of dietary habits among university students of health sciences in Kosovo

Naim Jerliu — 2024-09-26

We aimed to assess the prevalence and sociodemographic correlates of selected dietary habits among students of health sciences in Kosovo. A cross-sectional study was conducted in Kosovo in 2024, including 470 students of health sciences (≈86% females; mean age: 20.7±2.7 years; response rate: 70%). Information on selected dietary habits and sociodemographic factors of the students was gathered. Independent positive correlates of a lower fruit intake (<1 time/day) included male gender (OR=2.3, 95% CI =1.3-4.2) and a lower economic level (OR=1.5, 95% CI =1.0-2.3). Furthermore, positive independent correlates of a higher frequency of consumption of fried foods (≥1 time/day) included male gender (OR=2.2, 95% CI =1.2-4.1), urban residence (OR=1.6, 95% CI =1.0-2.6) and a lower economic level (OR=1.7, 95% CI =1.0- 2.7). Conversely, excessive salt intake was positively and strongly correlated to a lower economic level (OR=3.5, 95% CI =2.1-6.0), but inversely related to students’ age (OR=0.4, 95% CI =0.2-0.9). Male gender and particularly a lower economic level were strong correlates of poor dietary habits among university students in Kosovo. Targeted interventions are needed to address dietary habits among youths, with a focus on providing support and resources to economically disadvantaged individuals.

The essential care required by stroke survivors and families: an ethnography study

Kartika Setia Purdani — 2024-08-01

From a cultural point of view, ethnographic research was needed to understand the essential care of stroke survivors and their families. Half of stroke survivors were dependent on family caregivers during neuroplasticity time, which could raise several burdens for both. This study aimed to analyze the essential care required for stroke survivors and their families. Focus ethnography design was employed with 64 participants selected purposively. The data collection methods were observation, in-depth interviews, and Focus Group Discussion (FGD). The techniques used were writing field notes for the content analysis, using thematic analysis to analyze data, and using COREX 32-items for reporting qualitative studies. The six themes identified were i) unclear information before discharge planning; ii)clear information from community nurses; iii) family brotherhood; iv) home visits; v) government health insurance obstacles; vi) counseling services for families. In this study, healthcare facilities with stroke services were preferred in stroke care, while optimal stroke care consisted of four main components that had to work together: health workers in health facilities, stroke survivors, family as successors of care in community settings, and the availability of health insurance facilities. In principle, the most important party in this situation was the family, including the nuclear or extended family; they could be the determinant in saving the lives of stroke survivors.

The administration of sea hare gonad and moringa leaf formula increases body weight hemoglobin in female Wistar rats

Wiralis Wiralis — 2024-08-08

Sea hare gonad and moringa leaf contain essential nutrients for growth and tissue formation and have physiological effects on the body. The research was to study the effects of sea hare gonad flour and moringa leaf flour formula on body weight and Hemoglobin (Hb) levels in female Wistar anemic rats. This research was conducted in a laboratory using a randomized control pretest-posttest design. The study sample consisted of 30 female Wistar rats (Rattus norvegicus) aged 5-7 months and weighing 100-150 g, all of which were anemic. The rats were divided into five treatment groups: K+ received 1.1 mg/week of iron supplementation, K- received no treatment, F1 received 3 g of sea hare gonad formula, F2 received 3 g of sea hare gonad formula and 1 g of moringa leaf flour, and F3 received 3 g of sea hare gonad formula and 2 g of moringa leaf flour. The intervention lasted for 24 days, and measurements of body weight and Hb levels were taken before and after the intervention. The change in body weight before and after the intervention in each group was as follows: K-=51.5±17.1 g, K+=-41.2±2.6 g, F1=14.3±5.7 g, F2=30.4±8.6 g, and F3=55.1±16.2 g. There was a significant difference in the increase in body weight among the groups (p=0.002). Hb levels also increased after the intervention, with changes as follows: K-=-2.56±0.95 g, K+=9.10±1.87 g, F1=7.10±1.2 g, F2=8.68±0.22 g, and F3=8.98±2.7 g. There was a significant difference in the increase in Hb levels among the intervention groups (p=0.000). The administration of sea hare gonad formula and moringa leaf flour can increase body weight and Hb levels in female anemic rats. This finding suggests the potential use of these ingredients as beneficial nutritional supplements to improve nutritional status in individuals with anemia.

Using electronic health record data for chronic disease surveillance in low- and middle-income countries: the example of hypertension in rural Guatemala

Sean Duffy — 2024-07-31

Hypertension is the leading preventable cause of death worldwide. Two-thirds of people with hypertension live in Low- and Middle-Income Countries (LMIC). However, epidemiological data necessary to address the growing burden of hypertension and other Non-Communicable Diseases (NCDs) in LMICs are severely lacking. Electronic Health Records (EHRs) are an emerging source of epidemiological data for LMICs, but have been underutilized for NCD monitoring. The objective of this study was to estimate the prevalence of hypertension in a rural Indigenous community in Guatemala using EHR data, describe hypertension risk factors and current treatment in this population, and demonstrate the feasibility of using EHR data for epidemiological surveillance of NCDs in LMIC. We conducted a cross-sectional analysis of 3646 adult clinic visits. We calculated hypertension prevalence using physician diagnosis, antihypertensive treatment, or Blood Pressure (BP) ≥140/90 mmHg. We noted antihypertensives prescribed and BP control (defined as BP<140/90 mmHg) for a total of 2496 unique patients (21% of whom were men). We constructed mixed-effects models to investigate the relationship between BP and hypertension risk factors. The estimated hypertension prevalence was 16.7%. Two-thirds of these patients had elevated BP, but were not diagnosed with or treated for hypertension. Most patients receiving treatment were prescribed monotherapy and only 31.0% of those with recognized hypertension had controlled BP. Male sex, older age, increasing weight, and history of hypertension were associated with increasing systolic BP, while history of hypertension, history of diabetes, and increasing weight were associated with increasing diastolic BP. Using EHR data, we estimated comparable hypertension prevalence and similar risk factor associations to prior studies conducted in Guatemala, which used traditional epidemiological methods. Hypertension was underrecognized and undertreated in our study population, and our study was more efficient than traditional methods and provided additional data on treatment and outcomes; insights gleaned from this analysis were essential in developing a sustainable intervention. Our experience demonstrates the feasibility and advantages of using EHR-derived data for NCD surveillance and program planning in LMICs.

Assessing sexual-abuse prevention knowledge and related factors among adolescent girls with intellectual disabilities in Padang: a cross-sectional study

Arif Mansur — 2024-08-08

Sexual abuse among adolescents With Intellectual Disabilities (ID) has been significantly under-researched despite their high vulnerability. This study aimed to assess the sexual abuse prevention knowledge of adolescent girls with ID in Padang and explore how various respondents’ characteristics relate to the risk of sexual abuse. Findings from this study may inform future prevention strategies and support services. A descriptive cross-sectional approach was utilized, and involved 50 adolescent girls from five special education schools in Padang. Respondents were assessed using the Illustrated Scale Measuring Sexual Abuse Prevention Knowledge, which covered five key domains. The study analyzed the risk of sexual abuse and related factors. The findings revealed significant knowledge disparities, especially in identifying abusive situations, with notably low scores. Statistical analysis showed a strong correlation between the disability category and additional mental or physical conditions, indicating an increased risk of sexual abuse. The results emphasize the urgent need for customized educational programs to address the specific challenges faced by adolescents with ID. Enhancing sexual abuse prevention knowledge is crucial for reducing their victimization risk. The study recommends comprehensive educational strategies and supportive interventions tailored to their cognitive and physical profiles.

Enhancing mental well-being in coronary heart disease patients: the impact of integrated spiritual care and murottal auditory therapy on reducing anxiety and depression

Aris Citra Wisuda — 2024-08-08

Coronary heart disease, the most prevalent non-communicable disease, poses both physical and psychological challenges, including anxiety and depression. Addressing these issues requires a holistic approach that integrates biological, psychological, social, and spiritual dimensions. Spiritual care interventions can alleviate psychological distress and enhance patient satisfaction in nursing care. This study explored the impact of combining spiritual care with murottal auditory therapy to reduce anxiety and depression in patients with coronary heart disease. In this quasi-experimental study, 110 participants were divided into intervention and control groups, each with 55 participants selected based on specific criteria. Anxiety and depression levels were assessed using the validated Depression Anxiety Stress Scale (DASS). The intervention group received daily murottal therapy sessions lasting 15 to 20 minutes for three days at Siti Khadijah Islamic Hospital in Palembang from March to July 2023. Pre-test and post-test assessments were conducted. The results indicated that a significant proportion of patients in the intervention group experienced mild anxiety (52.7%) and reduced depression (65.5%) after murottal therapy. Significant differences in anxiety and depression levels were observed between the intervention and control groups, with p-values of 0.000 for both. murottal auditory therapy, mainly using Surah Ar-Rahman, effectively reduces anxiety and depression in patients with coronary heart disease, offering a promising complementary treatment approach.

Anxiety among nurses in caring for COVID-19 patients: a qualitative study

Sri Eka Wahyuni — 2024-07-25

This study aimed to explore anxiety among nurses in caring for Coronavirus Disease 2019 (COVID-19) patients. A qualitative descriptive design was used and the number of participants was 13 nurse managers selected using the purposive sampling method. Data collection was conducted using in-depth interviews coupled with a tape recorder and camera following the consent of participants, while framework analysis was used to analyze data. The results showed that participants, comprising 12 females and one male, had work duration in the range of 1-10 years. The identified five major themes included: i) anxiety response, ii) risk factor, iii) protective factor, iv) interventions, and v) anticipated support from nurses. Nurses were found to experience anxiety when caring for COVID-19 patients, underscoring the need for mental health and psychosocial support to reduce risk factors, increase protective factors, and improve coping mechanisms, fostering resilience. The results provided data to help nurses overcome anxiety when facing cases of infection such as the COVID-19 pandemic. Furthermore, this study offered valuable insights for the government and hospitals in establishing policies regarding the importance of mental and psychological health support to maintain the well-being of nurses.

Self-efficacy in older adults with depression: a qualitative study

Tri Nurhidayati — 2024-07-25

Older people suffering from depression often exhibit low selfefficacy, which causes them to quickly give up on challenges caused by various problems related to ageing, such as physical, social and mental aspects, including depression, which ultimately impact their quality of life and productivity. Depression in the elderly is caused by physical, psychological, and social interactions with other people, especially caregivers in nursing homes. This study employed a phenomenological approach to analyse self-efficacy among older adults suffering from depression through qualitative inquiries. The participants who met the inclusion criteria lived in nursing homes for more than one year and experienced depression. In-depth interviews were conducted using a structured guide with a general self-efficacy scale (GSES), Indonesian version. The study was conducted in an older adult nursing home in 2022 with 14 older adults. The results were divided into four themes – accompanying performance, vicarious learning, verbal encouragement and emotional states – and indicated that older adults with depression experienced poor self-efficacy and described how to cope with poor self-efficacy.

Self-consciousness of type 2 diabetes mellitus patients

Dikha Ayu Kurnia — 2024-07-25

The characteristics of self-consciousness of people with diabetes mellitus are determined by knowledge about diabetes mellitus, the signs and symptoms of acute and chronic complications, and the side effects of diabetes treatment. Knowledge plays an important role in the consciousness of behavioural change and diabetes self-management skills. People with diabetes recognize diabetes when they have experienced chronic complications, both macrovascular and microvascular. The study aims to explore how diabetics manage their chronic problems and their daily lives through a qualitative description of the experiences of 20 diabetes patients. This study used a descriptive-qualitative method, conducted a semi-structured interview, then transcribed and uploaded it into manual coding for analysis. Respondents were recruited from one of the community health centres in Jakarta, Indonesia. The themes were i) “Realizing diabetes is a health problems that cannot be resolved alone”, paying attention to body signs becomes the beginning of self-consciousness; ii) “Coping with diabetes requires self-consciousness”, having adequate knowledge and growing personally with healthcare providers about early diabetes can prevent chronic complications. This study provides implications that self-consciousness greatly affects the self-management of diabetic patients in the long term.

Self-reported practices of sepsis and septic shock among health care providers working at intensive care units at tertiary hospitals in Jordan

Saleh Al Omar — 2024-08-30

Self-reported practices of sepsis and Septic Shock (SS) among healthcare providers were rarely discussed in the literature. The aim of the study was to describe the level of adherence among nurses and physicians to the self-reported practices of sepsis and SS treatment in six Intensive Care Units (ICU) of two tertiary hospitals in Jordan. A cross-sectional descriptive design was used. A questionnaire was administered to 119 nurses and physicians. Descriptive statistics were used to describe sample characteristics and practices of sepsis treatment. The results showed that most nurses and physicians reported they “often” or “always” adhere to these practices. However, there was insufficient adherence to using a prone position in patients with sepsis-induced acute respiratory distress syndrome. Moreover, there was insufficient practice of testing serum lactate levels within one hour of diagnosing patients. Nurses’ and physicians’ self-reported adherence to sepsis and SS treatment is satisfactory, but further improvement is required.

Risks associated with laser radiation reflections in a healthcare environment: a surface reflectance study in the range 250 nm – 25 μm

Giacomo Insero — 2024-07-25

Biomedical applications relying on optical radiation, particularly with the advent of lasers, have experienced exponential growth in the last 20 years. Powerful optical sources are now found not only in universities, hospitals, and industries but also in beauty centers, used for tasks such as tattoo removal, and even in our homes. Despite their widespread use, managing the risks associated with lasers, particularly in non-research contexts, has not kept pace with their proliferation. While the risks associated with direct exposure to radiation to the eye and skin are relatively well understood, the hazards posed by reflected and diffuse radiation remain less characterized and monitored. Therefore, there is a critical need to assess potential eye and skin hazards in spaces where lasers and non-coherent light sources are used. This necessitates a detailed analysis of reflective surfaces, with particular emphasis on evaluating their reflectance characteristics at relevant wavelength ranges. This study investigates the reflectance and transmittance (where relevant) properties of commonly used materials in biomedical settings, including fabrics, plastics, and metals, across a broad spectrum from 250 nm (UVA) to visible light and into the infrared (IR) region up to 25 μm. Both specular (at 45° incidence) and diffuse reflectance spectra were measured using spectrophotometric techniques and used to provide a straightforward parameter to classify the specular/diffusive behavior of the different surfaces. Besides, small-angle reflectance measurements in the IR range were performed by Fourier transform infrared spectrometry. The knowledge of the material optical properties used in environments where optical radiation is employed allows for accurate assessment of associated risks. This facilitates the determination of appropriate preventive measures and the establishment of safer protocols, for both operators and, where applicable, patients and the general public. For this scope, the creation of a database of material reflective properties has been initiated.

Health impact of security agents’ COVID-19 lockdown control tactics on citizens of north-central Nigeria: evidence and policy options

Chukwuka Eugene Ugwu — 2024-07-25

The COVID-19 lockdown control tactics used by security agents on the citizens of north-central Nigeria were studied for their effects on health The convenience sampling method was employed to select six states of the study area. Due to the nature of the data collected, quantitative data analysis was limited to percentages, while state-by-state evaluation was used to summarize qualitative data sources. Additionally, hospital records from five privately owned and two government-owned hospitals in each of the study area’s states were generated, for a total of 42 hospitals sampled for the research. The obtained medical records demonstrate that the COVID-19 lockdown control actions by security agents have a detrimental effect on the health and well-being of the citizens in the study area. Amputation (0.27%), bacterial vaginosis (3.43%), coughing (11.16%), cataracts in the eyes (7.69%), etc., were reported. There was an association found between victims’ health issues and security agents’ use of force. Proposed were reforms and least invasive methods of managing public health, including social marketing, education, democratic policing tactics, and facilitation engagement.

Application of foot massage therapy to reduce pain scale of elderly with rheumatoid arthritis

Nadi Aprilyadi — 2024-07-31

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder characterized by systemic inflammation, joint damage, and persistent pain, particularly in older adults. The debilitating nature of RA significantly impairs individuals' quality of life, leading to diminished independence and increased reliance on pharmacological interventions. While pharmaceutical treatments play a crucial role in managing RA symptoms, complementary and alternative therapies, such as massage, have garnered attention for their potential to alleviate pain and improve overall well-being. This study adopts a descriptive approach to examine the efficacy of foot massage as an intervention for RA-related pain in older adults. Two participants diagnosed with RA were selected for the case study. Family nursing care principles were integrated into the intervention to provide holistic support. Pain scale assessments were conducted before and after each foot massage session to measure changes in pain intensity. Analysis of the data revealed a significant reduction in pain intensity among participants following the foot massage sessions. Pain levels decreased from moderate to mild, indicating the efficacy of foot massage in alleviating RA-associated pain in older adults.The findings of this study support the notion that foot massage can serve as a viable intervention for managing RA-related pain in older adults. The mechanisms underlying the efficacy of foot massage, including its ability to stimulate vasodilation and enhance endorphin production, highlight its potential therapeutic benefits for individuals grappling with RA. Foot massage emerges as a promising adjunctive therapy for alleviating pain and improving the well-being of older adults living with Rheumatoid Arthritis. Integrating foot massage into holistic care approaches can enhance pain management strategies and contribute to the overall quality of life for individuals affected by this debilitating condition. Further research is warranted to explore the long-term effects and optimal frequency of foot massage in RA management.

The effect of spiritual emotional freedom technique impact to pain in cervical cancer post-chemoradiation: a review article

Hamidah Hamidah — 2024-07-22

Chronic pain that is subjective is experienced by patients with advanced cervical cancer. Simple movements are used in spiritual emotional freedom technique (SEFT) therapy, a therapeutic approach that improves performance and achievement, addresses psychological and physical pain issues, and promotes happiness and serenity in life. In this systematic review study, we evaluate how SEFT affects patients with cervical cancer who have had chemotherapy and radiation treatment. Using databases from 2003 to 2023, including Google Scholar, PubMed, ScienceDirect, PsycINFO, and Ovid, this study employs a systematic review methodology. The keywords “spiritual emotional freedom technique (SEFT)”, “emotional freedom technique (EFT)”, and “cervical cancer” form the basis of the search strategy. Experiments and observational studies with a minimum sample size of two participants involving patients with cervical cancer meet the inclusion criteria. The results show that among patients with post-chemoradiation cervical cancer, SEFT therapy is beneficial in lowering pain, stress, and depression. Cancer patients who experience pain may see a reduction in their quality of life as well as physical health issues. Cervical cancer patients can experience marked improvements in their pain, stress, and depression when the SEFT therapy theory is applied.