MST-Department of Medical Surgical Nursing and Pre-clinical Services

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Browsing MST-Department of Medical Surgical Nursing and Pre-clinical Services by Subject "Kenya"

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    Adherence to Post Kidney Transplant Treatment and Lifestyle Changes among Kidney Recipients at Kenyatta National Hospital, Nairobi City County, Kenya
    (Kenyatta University, 2021) Nyambura, Anne Mumbi; Grace Githemo; Jonathan Wala
    End stage kidney disease (ESKD) prevalence has become a global public health burden. Kidney transplantation is the best remedy for cases suffering from ESKD. Adherence to post kidney transplant treatment and lifestyle changes is critical in maintaining graft function. However, non-adherence leads to graft loss necessitating the patients to revert to dialysis or re-transplantation. This descriptive cross-sectional study aimed at describing adherence to post kidney transplant treatment and lifestyle changes among kidney recipients at Kenyatta National Hospital. Census sampling method was used to recruit 106 study participants attending transplant clinic. Data collection was done using interviewer and self-administered questionnaire. Descriptive statistics were used to describe patients’ characteristics. Chi square test of significance was used to determine the relationship between the independent and dependent variable. A p value of less than 0.05 was considered statistically significant. Logistic regression was used to determine the predictors of adherence. The study findings revealed that most of the respondents 63(60%) were non adherent to clinic attendance while 49(46%) were non-adherent to medication. Forgetfulness and cost of medication were reported to be the major contributing factors to non-adherence to medication. Frequency of medication dosing was a statistically significant factor influencing non-adherence to medication (x2 (1) = 6.61, p = .019, p= <.005) while distance to the hospital statistically significance influence of non-adherence to clinic attendance, (x2 (2) = 12.63, p = .002, p<.005). The study concluded that non adherence is a major concern in post kidney transplant recipients occasioned by drug cost and distance to the hospital. The study recommends that the government and non-governmental organizations should offer financial support for medicines. Also decentralization of post kidney transplant services to the county referral hospitals and use of daily dose drugs should be embraced.
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    Compliance with Hemodialysis Treatment among End Stagekidney Disease Patients in Nyeri County, Kenya.
    (Kenyatta University, 2022) Chege, Jacinta Wanjiku; Grace Githemo; Lister Onsongo
    The number of End Stage Kidney Disease (ESKD) patients on hemodialysis (HD) globally has become a public health concern. Compliance with hemodialysis recommendation aids to improve health outcomes and prevent complications. However, non-compliance to hemodialysis among ESKD patients has been a major problem. The purpose of the study was aimed at describing the level of compliance with hemodialysis and the associated factors among ESKD patients in three selected dialysis centers in Nyeri County. A descriptive cross-sectional study, utilizing quantitative research method and targeting 80 participants was done. Census method was used to recruit the study participants. Data was collected through administration of a questionnaire and analyzed by use of computer software, statistical package for the social science (SPSS) version 24. Descriptive statistics was used to determine the level of compliance to hemodialysis. Inferential statistics was used to determine factors associated with compliance to hemodialysis. SPSS version 24 was used in data analysis.The study findings revealed that compliance with hemodialysis treatment was 53%. The findings showed that there was significant association between compliance and; marital status, x2 (2, N=30) = 5.151, p =0.029, income, x2 (4, N=12) = 11.322, p =0.045, and number of hospital admissions, x2 (3, N=I) = 38.069, p =0.0001. Shortened hemodialysis,(aOR = 5.5, p = 0.002) and waiting time for two hours prior to start their hemodialysis session (aOR =4.11, p =0.005) were independent predictors of noncompliance with hemodialysis treatment.Despite opening new hemodialysis centers in Nyeri County to increase availability and accessibility of hemodialysis services, compliance still remains a major challenge among patients. Shortening of hemodialysis sessions, low economic status, inadequate machines and failure to repair machines when they break down were major barriers to hemodialysis compliance. Therefore, adequate resource allocation should be considered when opening new hemodialysis centers.
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    Determinants of Kidney Transplantation Uptake among Patients with End Stage Kidney Disease on Haemodialysis at Selected National Referral Hospitals in Kenya
    (Kenyatta University, 2023-05) Nduati, Joseph Mwororo; Joseph Nduati; Grace Githemo
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    Determinants of Neonatal Care Practices among Postnatal Mothers at the Kiambu and Thika Hospitals, Kiambu County, Kenya
    (Kenyatta University, 2022) Kariuki, Lilian .W.; Grace Githemo; Maina Ngugi
    Neonatal health is necessary in decreasing child mortality but often gets minimal attention. Research evidence in third world countries has shown that practices such as poor cord care and breastfeeding practices impact on neonatal health. This study aimed to determine the neonatal care practices among postnatal mothers and the relationships between various factors and these practices at the Kiambu and Thika County Hospitals. This was a cross sectional descriptive study design. Stratified sampling method was used to identify the sample for the study. Self-administered and interviewer administered questionnaires were used to collect data, practice was assessed through a likert scale, analyzed through SPSS and presented using descriptive statistics. Chi square test of significance (p ≤0.05) was used to test the relationships between the various explanatory factors and the neonatal care practices among postnatal mothers. A total of 128 postnatal mothers participated in the study with the mean age being 26 ±5.8 years. There was negative relationship between information received on breastfeeding, eye care, thermoregulation, immunization and actual care practices (p<0.05). Adequate knowledge was found towards cord care with gaps in practice existing in breastfeeding, eye care and thermoregulation. Social demographic, socio-economic, socio-cultural and institution factors did not influence neonatal care practices. More emphasis should be put on maternal education regarding neonatal care practices (thermoregulation, eye care, skin care and breastfeeding practices). Further research is recommended to find out why there are negative practices on breastfeeding and eye care despite being knowledgeable on those practices.
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    Determinants of the Quality of Life of Caregivers of Children with Sickle Cell Disease at Siaya County Referral Hospital, Kenya
    (Kenyatta University, 2023-07) Okinyi, Joash; Sarah Bett; Grace Githemo
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    Nursing Handover Experiences and Perspectives in the Critical Care Unit at Murang’a County Referral Hospital, Kenya
    (Kenyatta University, 2023-11) Murigi, Mwangi; Nickcy Mbuthia; Lucy Meng’anyi
    Continuity in delivery of nursing care to patient in the critical care unit is of utmost importance. To achieve this consistency, nurses engage in a process of transfer of patients’ clinical information in the form of nursing handover, The adoption of various handover procedures result in variation of the information exchanged. In the critical care unit, the intricacy of the patient condition compounded by the advanced patient monitoring translates into a more complex nature of the nursing handover. Despite the existence of handover guidelines and formats, gaps have been detected regarding the contents of the handover and its effects on the continuity of care. The focus of the study was to explore the experiences and perspectives of nurses with nursing handover in the critical care unit. To realize the aim of the proposed study, a phenomenological qualitative design was adopted while utilizing a deductive approach. Indepth interviews were carried out on nine critical care nurses from the Murang’a County Referral Hospital after obtaining ethical approval from relevant institutions. Thematic analysis was done manually for the qualitative data. The study results showed that critical care nurses believed they were individually equipped with adequate knowledge to carry out effective departmental and interdepartmental handover. The existence of handover policies in the critical care unit was considered a major enabler of the handover. They also believed that strained human resource, lack of standardized handover tools and deviation from the set handover rules negatively impacted the handover process. Furthermore, they reported perceived insufficiency in the management’s role in handover evaluation and feedback. Moreover, all participants advocated for improvement of the current handover practices for improved quality of patient care as well as sense of self-accomplishment among the nurses. There are pertinent implications in the findings of this research for critical care nurses, nurses in other departments and policy makers. Based on the study findings the handover process would benefit from enhanced adherence to the existing handover policies. Handover training targeting nurses in other departments would promote communication of patient information between critical care unit and other departments. Periodic audits of the handover documentation and process with subsequent feedback would be acontrol for evaluation of the handover. Further, addressing scarcity of resources and implementing the nurses’ perceived strategies would ensure a seamless handover
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    Predictors of Quality of Life of Kidney Donors at Kenyatta National Hospital, Nairobi City County, Kenya
    (Kenyatta University, 2021) Nyarera, Diviner Kemunto; Grace Githemo; Lister Onsongo
    Background: There‟s an increasing prevalence of End Stage Kidney Disease (ESKD) globally and the disease is an important contributor of morbidity and mortality among these patients. Compared to dialysis Kidney transplantation is well established as the best treatment for restoring quality of life to patients with ESKD. The information regarding living donors‟ QoL has been reported to have a positive influence towards the prospective donor‟s attitude to kidney donation. The aim of the study was to examine the socio-demographic, socio-economic, and psychological and health factors that impact on the donors‟ QoL in Kenya. Aim: The study aimed at assessing QoL of kidney donors after kidney donation at Kenyatta National Hospital. Methodology: This was a descriptive cross-sectional study design of Kidney donors at Kenyatta National Hospital Renal department, between January 2010 and December 2017. A convenience sampling method was used with an anticipated sample size of 105 kidney donors. Data was collected through the use of questionnaires administered directly to individual participants. Data was analyzed using descriptive and inferential analysis. Multiple regression analysis was also applied to identify the predictors of QoL of the kidney donors. Qualitative data was analyzed thematically. Ethical approval was sort from KU and KNH ethics committees before data collection. Results: A total of 99 donors were interviewed, 54.5%, (n=54) were male while 45.5% (n =45) were female. The mean age of the respondents at the time of donation was M =38.65 SD ± 9.04. The QoL of kidney donors in this study was high as represented by 83% of the respondents. The predictors of QoL were, Current monthly income, =24.793, (p 0.05) (QoL-psychological factors), marital status after kidney donation =10.261(p 0.05), Employment status after kidney donation =11.474 (p 0.05) and BMI r(0.835), p<0.05 in health and functioning.Conclusions: the overall quality of life of kidney donors at Kenyatta National Hospital was high. The study concluded that socio-demographic and economic factors particularly, BMI, marital status after kidney donation, current employment and current monthly income had significant contribution towards quality of life of kidney donors at Kenyatta National Hospital. Current employment had a positive significant predictive association with donor‟s quality of life
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    Psychosocial Burden and Its Determinants among Caregivers of Children with Colostomy at Kenyatta National Hospital, Nairobi City County Kenya
    (Kenyatta University, 2023-06) Ronoh, Lilian Chebet; Grace Githemo; Sarah Tai
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    Self-Care Abilities of Patients on Maintenance Hemodialysis at Kenyatta National Hospital Renal Unit, Nairobi City County, Kenya
    (Kenyatta University, 2022) Tangus, Cecily C.; Grace Githemo
    Haemodialysis is the most common management modality for patients suffering from End Stage Renal Disease. A high number of haemodialysis patients have been reported to have inadequate self-care abilities which negatively affect their haemodialysis treatment outcomes. This cross-sectional study aimed at evaluating self-care abilities among patients on maintenance haemodialysis at Kenyatta National Hospital Renal Unit. Census method was used to identify study participants who met the eligibility criteria. Self- and interviewer administered semi-structured questionnaire was used in data collection. SPSS version 24 was used in the analysis of data. Descriptive statistics was used to summarise the data. Chi square was used to determine the relationship between independent and dependent variables while predictors of self-care abilities were determined using logistic regression. The findings revealed that majority of the patients on hemodialysis treatment had adequate self-care ability. Patients with secondary and tertiary education were more likely to follow recommended diet (OR 0.824, 95% CI 0.545-1.739) and (OR 0.428, 95% CI 0.251-0.834) respectively. The married and widowed patients were more likely to practice AVF arm site care (OR 1.44, 95% CI 0.671-23.259) and (OR 1.17, 95% CI 0.928-11.32) respectively. The patients who received social support on compliance to fluid restriction were more likely to follow recommended fluid (OR 2.714, 95% CI 1.856-5.21). Clients who received social support on care of vascular access site were more likely to keep catheter access site clean and dry (OR 5.819, 95% CI 1.05-29.187).The study concluded that self-care ability was significantly influenced by marital status, education level, social support and healthcare provider support. It was recommended that health care team should provide education on self-care to clients with low level or no education in simple ways that they will be able to understand so as to improve self-care abilities. Health care providers to continue offering frequent support to their patients in order to improve their self-care knowledge and skills. Multidisciplinary team to encourage social support as it was shown from the study findings to positively influence self-care abilities among hemodialysis patients.
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    Stressors and Coping Strategies among Women Breast Cancer Survivors at Kenyatta National Hospital, Nairobi City County, Kenya
    (Kenyatta University, 2023-11) Chege, Kuria Patrick; Grace Githemo; Nelson Menza
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