MST-Department of Medical Surgical Nursing and Pre-clinical Services
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Item 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 WalaEnd 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.Item Compliance with Hemodialysis Treatment among End Stagekidney Disease Patients in Nyeri County, Kenya.(Kenyatta University, 2022) Chege, Jacinta Wanjiku; Grace Githemo; Lister OnsongoThe 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.Item Correlates associated with Adherence among Female Sex Workers on HIV pre-Exposure Prophylaxis in Nairobi City County, Kenya(Kenyatta University, 2024-03) Litiema, Edith Amahwa::LC:C‘>§p?§llrg _prophylaxls (PrEP) is the use of ante-retroviral drug to prevent HIV .L,n ive lndmlduals who are at risk of acquiring HIV from becoming infected with HIV. l_’lEP use requires one to commit to taking the drug every day. The effectiveness of PrEP is conclalgd to adherence to regular uptake of medication. Barriers to good adherence should be identified and strategies to enhance adherence to PrEP be implemented. Female sex workers (FSW) are a susceptible group, and they face higher risk of HIV infections. Truvadz'a, a recommended drug for PrEP contains Tenofovir and emtricitabine. It is a nonnucleotides reverse transcriptase inhibitor (NRTI) that inhibits viral replications in the body, thus limiting number of HIV infected cells. The key objective of this study was to measure correlates for adherence in HIV negative Female Sex Workers to PrEP. This was accomplished by assessing the levels of knowledge about PrEP, evaluating adherence levels, examining factors influencing adherence, and analyzing strategies to improve PrEP adherence. A cross-sectional study design employing a mixed-method approach, incorporating both qualitative and quantitative data collection methods, was conducted from March to May 2021. The study enrolled 345 female sex workers (FSWs). Among them, 72% were unfamiliar with the name of PrEP, 39% reported missing PrEP doses, and 33% acknowledged missing appointments for PrEP refill. Qualitative data indicated a recommendation for monthly PrEP engagement meetings to bolster adherence. The research helped in identifying the need for clinical trials to test new products such as long acting injectable and monthly PrEP pills. This will reduce barriers to adherence thus enhancing HIV prevention.Item Determinants of Chronic Kidney Disease among Type 2 Diabetes Mellitus Patients at Gatundu Level 5 Hospital, Kiambu County, Kenya(Kenyatta University, 2023-12) Mwega, BernardThe prevalence of chronic kidney disease (CKD) is rising throughout the world, and it is one of the major public health menaces due to the significant morbidity and mortality it is associated with. The burden of CKD inexplicably affects low-income nations like Kenya, where the two main public health concerns responsible for the growing prevalence of CKD are hypertension and diabetes mellitus. The aim of this study was to assess the determinants of chronic kidney disease among type 2 diabetes mellitus patients. A hospital-based cross-sectional study design was conducted at Gatundu level 5 Hospital in Kiambu County, central Kenya, among adult (≥18 years) diabetes mellitus patients. Sample size was determined using Yamane Taro formula. Informed written consent was obtained from each participant and data was collected by interview and chart review. Glomerular filtration rate (GFR) was estimated from serum creatinine using modification of diet in renal disease (MDRD) formula, while CKD was defined as estimated GFR (eGFR) of less than 60mls/min/1.73m2 for more than three months. Multivariate logistic regression was used to identify independent determinants of CKD and a p-value of <0.05 was considered statistically significant. Majority of the participants (43.42%) were aged between 50-60 years and 95 (62.5%) of them were female. The researcher found out low level of patient awareness (25.8%) and high prevalence of CKD (78.2%). Factors associated with chronic kidney disease were gender, high blood pressure, type 2 diabetes mellitus, smoking, family history of CKD, obesity, poor knowledge of CKD and long duration of hypertension. The researcher observed a high prevalence rate of CKD amomg diabetic patients and hence recommended that the National and County Governments‟ Department of Health should take measures to increase the awareness about CKD prevention among high risk populations such as patients with diabetic mellitus.Item 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 GithemoAbstractItem 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 NgugiNeonatal 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.Item Determinants of Peritoneal Dialysis Utilization in the Management of End Stage Renal Disease at Kenyatta National Hospital, Kenya(Kenyatta University, 2022-10) Yonga, Maureen AnyangoAbstractItem Determinants of Quality of Hemodialysis Services in Selected County Dialysis Centers in Nyanza Region, Kenya(Kenyatta University, 2024-05) Nyabaro, DoreenBackground: Hemodialysis is a common management intervention in patients with Chronic Kidney Disease and End-Stage Renal Disease. Globally, there are approximately 1 billion renal patients on hemodialysis. Despite the increase in utilization of maintenance hemodialysis in low- and medium-income countries, there have been fewer efforts to assess the quality of hemodialysis services. Thus, there is a need to assess the quality of hemodialysis services. Objective: To evaluate the quality of hemodialysis services at selected county dialysis centers. Methodology: The study was a cross-section descriptive study. The study adopted a census method where 118 hemodialysis patients was considered. The participants were sampled consecutively based on the inclusion criteria. SERV-QUAL tool was used to measure perceived quality of hemodialysis services. Chi squares test for the association was used to determine the association between the patient, institutional factors, healthcare professional factors, and the quality of Hemodialysis services. Binary logistic regression analysis was used to determine predictors of quality hemodialysis services. Statistical Package for Social Sciences (SPSS version 26) was used for data analysis. Results: Majority of the patients 61.9%(n =73)were male, with 28.8%(n =34) of the respondents being aged 60 years and above. The findings further showed that 44.1% of the participants had secondary level education. The perceived quality of hemodialysis services was moderate with 56%. Bivariate analysis revealed that gender, level of education, presence of comorbidities, admission due to side effects, receiving social support, waiting time, receiving education before dialysis session and satisfaction with care were associated with quality of hemodialysis services. Multivariate analysis using logistic regression established that being male (AOR =3.75, 95%CI: 1.11 – 12.64, p =0.033), having secondary level education (AOR =2.31, 95%CI: 1.41 – 4.97, p =0.046), having been admitted due to side effects since the beginning of hemodialysis sessions (AOR =0.22, 95%CI:0.15 – 0.86, p<0.001), having received social support from family and friends (AOR =11.49, 95%CI: 1.79 -73.95, p =0.010) and not waiting longer to be allocated a HD (AOR = 0.21, 95%CI: 0.05 – 0.93, p =0.041) were significant predictors of perceived good quality of hemodialysis services: Conclusion and recommendation: The perceived quality of hemodialysis services remains moderate. Gender, education level, admission due to side effects waiting time and receiving social have been identified as predictors of perceived quality of hemodialysis services. Therefore, increased health education, training more staff on the needs of patients and reviewing appointment period based on the number of machines available is essential to improved care.Item 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 GithemoAbstractItem 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, JoashAbstractItem Determinants of Timely Referral and Safe Transport of Neonates Referred to and those Transferred Out of Makueni County Referral Hospital, Kenya(Kenyatta University, 2024-12) Iluka, Francisca NdukuInternationally, 2.5 million babies lose their lives before first 28 days of life, many of the deaths occurs in the under developed countries and a third occurs on day one of life. According to the World Health Organization, many neonate deaths are preventable by simple interventions. The primary goal of the study was to establish determinants of timely referral and safe transport of neonates in Makueni County Referral Hospital. The study employed cross-sectional study design. The researcher collected data from 50 neonates through consecutive sampling. The researcher used a self-administered questionnaire, document reviews of the patients’ files and structured data checklist. Patients condition on admission was obtained from the health record. The researcher analyzed the data quantitatively using the Statistical Package for Social Sciences version 26 (SPSS V26). The data obtained was summarized using frequency tables. Inferential statistics such as Chi-square tests Fishers Exact, bivariate and multivariate analysis were used to test for associations. Graphs, text, tables and pie charts were used to present the ultimate results. In total 50 admitted neonates were recruited to the study and results analyzed. According to the study findings, the researcher found out that there was no significant association between timely referral and safe transport and neonatal and maternal variables. Conversely, analysis of institutional characteristics highlights several significant factors associated with the likelihood of timely referral and safe transport during a referral. Patients who did not receive stabilization were found to be more prone to experiencing a lack of timeliness and safe transport during referral (P=0.004), patients who did not undergo vital signs monitoring were 9.25 times more prone to experiencing delays and unsafe transportation (P = 0.035). The results suggest that patients with a response time exceeding 2 hours were more likely to face a lack of timeliness and safe transport during referral (P=0.032). The availability of an ambulance emerged as a significant factor, with 59.5% (25) reporting waiting for an ambulance as the reason for the delay. The study concludes that institutional factors influenced safe transport and timely referral to include patient stabilization, vital signs monitoring, response time for referral, and the availability of an ambulance. The study recommends that ambulances should be availed timely, in adequate numbers, and be equipped with the necessary drugs and equipments so that in the event of a problem, the healthcare provider can intervene appropriately. Also, hospitals should be supplied with all the necessary equipments and drugs to aid in stabilization of patients.Item Experiences of Mothers of Neonates Born with Gastroschisis in the Neonatal Intensive Care Unit at Kenyatta National Hospital: A PhenomeHlogical Study(Kenyatta university, 2023-11) Thaiya , Rosemary MuthoniThe researcher carried out research on experiences of mothers with neonates born with gastroschisis in Kenyatta National Hospital and admitted in Neonatal Intensive Care Unit. The research focused on the lived experiences of mothers with neonates born with gastroschisis, the mental symptoms given by the mothers and the support needed by these mothers.The study employed phenomenological descriptive research design. The study assessed mothers whose neonates were admitted was conducted in the NICU at Kenyatta National Hospital. Purposive sampling technique was used to interview twenty-five (25) mothers. Primary data was collected using the semi-structured interview guide. The refined qualitative data was manually analysed. Data collected was transcribed verbatim and coded using structured code book. Thematic analysis was done inductively. The collected data was then developed into themes and subthemes then analysed.Data was presented using tables. The research indicated that mothers were positive about their pregnancies and attended antenatal clinics, mental symptoms exhibited by these mothers due to the nature of the neonates and the kind of support they needed from family and health care providers. The study found that there was both positive and negative relationship between mothers and healthcare providers. It was also found that mental symptoms led to fatigue. The study found that mothers experienced support from spouses, family members, health care givers and peers.The study concluded Prenatal Experiences of Mothers with neonates with gastroschisis was positive and majority of them were happy that they were pregnant and were ready to follow doctors' guidelines throughout the period. Postnatally, the mothers experienced various mental challenges due to inadequate support from close family members and inadequate information about the condition before their children were born. They too were unprepared to deal with the stress and difficulties related to the children's disease. Majority of the mothers received support from the family members and fellow mothers with similar experiencesA more thorough prenatal screening is recommended to assist in the early detection of such congenital disorders, which can direct birth preparations for the mother and child.Healthcare providers should consider the mental health of the mothers with neonates born with congenital anomalies other than concentrating on the neonates alone.To assist in easing the mental and emotional strain placedspit on parents, hoal staff should provide professional counselling. They should also encourage peer counselling from among mothers.Item ntegration of Critical Care Nurses in Antimicrobial Stewardship; Opportunities and Barriers at Thika Level 5 Hospital, Kiambu County, Kenya(Kenyatta University, 2025-05) Chege, Joseph WaithanjiAntimicrobial stewardship optimizes appropriate use of antimicrobials through agent selection, route, dosing, and duration of therapy. It serves to optimize clinical outcomes of patients and limit adverse reactions of antimicrobials. Nurses are frontline implementers of antimicrobial stewardship. However, they face issues on inter-professional jurisdiction, hierarchical power relations within hospitals and limited training on antimicrobial stewardship. The main objective of this study is to explore the integration of nurses into antimicrobial stewardship activities in the critical care unit at Thika Level 5 Hospital. TL5H was selected for this study due to the availability of an antimicrobial stewardship program whose implementation suffers a disconnect among healthcare providers. The study used exploratory descriptive qualitative research design. Data collection was done through semi-structured interviews and NVIVO 14 software was used for thematic analysis of data. A total of 11 nurses working in the critical care unit were purposively selected and interviewed. Patient advocacy, communication and collaboration, monitoring and documenting, and patient education and empowerment emerged as important roles that nurses play in antimicrobial stewardship. Participants highlighted continuous medical education, inclusion of antimicrobial stewardship in formal nursing education, team work and organization support as major facilitators of nurses’ roles in antimicrobial stewardship. The study findings revealed that stringent regulatory requirements, heavy workload, poorly regulated systems and limited knowledge on antimicrobial stewardship as the major barriers that limit nurses’ role in antimicrobial stewardship. Education, teamwork, open communication and organizational support increase nurses’ awareness of AMS and ensures a coordinated approach in its implementation. Nurses’ inputs in decision making process on treatment plans and antimicrobial use is invaluable in promoting judicious use of antimicrobials. Future research should focus on redefining the nature, scope and influence of perceived nurses’ role in antimicrobial stewardship.Item Nurses’ Perception of the Quality of Patient Care in Selected County Hospital Critical Care Units in Kenya(Kenyatta University, 2023-05) Mulinge, KelvinThe global Intensive Care Units (ICUs) perception of quality of care remains below :\e:;?‘g:t\]:u:czz:; ]l:(?ca:ors such as highv mor?a.lity and high infection rates been reported 9 | gical advancements in critical care medicine. Studies have reported ;‘:::;:‘;:“:: :::011;;31!::6 1;1;rses anld the institutior} to havcf. a profound impact on the i perspectiveci) ” y]‘ car'e the Patlent rece.lvfs. This study assessed the CCU S quality patient care, the association between nurses’ characteristics and the perception of patient care, the association between institutional characteristics and perception of patient care and the predictors of the perception of care in selected hospitals critical care units in Kenya. The study was a correlational study that’s used stratified sampling and census sampling to collect data. Over a 6-month period between May and December 2021, a questionnaire named, nurses’ perception of the quality of patient care in selected county hospital critical care units in Kenya was distributed to 103 nurses in Machakos, Embu, Muranga and Nyeri CCUs. The study findings revealed that one third (33%)of the nurses rated the quality of care as good while the rest two thirds (67%) rated the quality of care in their unit as fair or poor. Test for association (Chisquare) was conducted to investigate demographic characteristics and nurses’ perception of quality of patient care and revealed that years worked in ICU (p<0.001), specialization in CCU (p=0.023) and © sadre (p<0.001) were significantly associated with the nurses’ perception of quality patient care. In investigating the association between institutional characteristics and the nurses’ perception of quality patient care provided using chi-square, the findings revealed that all institutional factors assessed were significantly associated with the nurses’ perception of quality patient care .(pfoAOOI) apart from multidisciplinary teamwork in the unit where there was no assocm.tlon f.ound (] =0.253). Regression analysis revealed that determinants like: years of experience in CCU, specialized in CCU, adherence to aseptic procedure, moisture and incontinence checks t resources were independently associated with the and availability of VAP managemen , . nurses’ perception of quality patient care. This study concluded that nurses perceptions of quality of patient care in selected critical care units was below average and was greatly i ializati rsing cadre and institutional influenced by nurses’ experience, specialization, nursing characteristics.Item 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’anyiContinuity 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 handoverItem Patient Safety Culture among Health Care Professionals at the Kakamega County Referral Hospital, Kenya(Kenyatta University, 2025-05) Mulusa, Elizabeth OsagaPatient safety is a crucial global measure of healthcare quality, as emphasized by the World Health Organization (WHO). A poor safety culture among healthcare professionals can lead to more adverse events, longer hospital stays, increased healthcare costs, and higher morbidity and mortality rates. A significant challenge in this area is the complex assessment of patient safety, with existing literature focusing mostly on managerial, staff, or policy perspectives. However, comprehensive studies examining the interplay between these elements are lacking. To address this gap, a study was conducted at Kakamega County Referral Hospital in Kenya, targeting the determinants affecting patient safety within critical care teams. Using an analytical cross-sectional design, the research included all healthcare providers in the Critical Care Units (CCUs). Data were collected via a self-administered questionnaire, which was analyzed using SPSS version 21. The questionnaire comprised eight sections, assessing healthcare professionals’ perceptions of patient safety. The study summarized demographic variables such as age, gender, and years of experience, with descriptive statistics. Inferential analyses, including chi-square tests, evaluated perception variations between different professional groups, particularly nurses and doctors. Multivariate regression analyses explored the relationship between perceived safety factors and overall safety perceptions. Findings revealed a wide range of confidence levels among healthcare professionals regarding existing patient safety protocols. While some noted improvements, others pointed out substantial gaps. Demographic factors, particularly years of experience and education level, significantly influenced safety perceptions. Key issues affecting these perceptions included inadequate staffing, resource challenges, and the implementation of non-punitive error reporting systems. Identified barriers were communication failures, insufficient training on safety protocols, and systemic operational challenges within the hospital. The study highlighted the urgent need for improved training programs, enhanced communication strategies, and the cultivation of an organizational culture that promotes transparency around safety issues. A correlation was established between healthcare professionals’ perceptions and measurable patient safety outcomes, such as incident reporting and adverse events. These insights can inform policy changes and practice improvements to enhance patient care. The recommendations stress the importance of healthcare systems prioritizing training on communication, teamwork, and error management; fostering a non-punitive culture for transparent error reporting; and optimizing resource allocation to resolve staffing issues. Strengthening interdepartmental communication through standardized protocols and regular evaluations, including staff feedback, is vital for ongoing improvement. Future research should focus on gender disparities in safety perceptions, organizational culture influence, training intervention effectiveness, long-term impacts of such interventions, comparative studies across various healthcare settings, and incorporating patient perspectives to drive significant safety enhancements.Item 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 OnsongoBackground: 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 lifeItem 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 TaiAbstractItem 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 GithemoHaemodialysis 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.Item Self-care abilities of patients on maintenance hemodialysis at Kenyatta National Hospital Renal Unit, Nairobi City County, Kenya(Kenyatta University, 2022-09) Tangus, Cecily C.