Care-recipient perspectives on the responsiveness of Orthopedic surgical services in a tertiary center in Nigeria

Responsiveness optimisesthe system-based approach to meeting legitimate demands by healthcare recipients. This study assessed the responsiveness of orthopaedic services at the University of Port Harcourt Teaching Hospital (UPTH) from the perspectives of the care recipients. Methods:Descriptive cross-sectional study among 442 consecutively recruited recipients of orthopaedic services at UPTH from March to June 2020. Close-ended questionnaire with responsiveness conceptualised by five constructs: dignity, autonomy, confidentiality, quality of basic amenities and choice of care provider, each measured along 4-point response scale. The internal consistency reliability of the responsiveness scale was determined by the Cronbach's alpha coefficient. Descriptive (frequency, percentages, bar charts) and inferential (ordinal logistic regression) statistics were conducted and p-values ≤ 0.05 were considered statistically significant. Results: Response rate was 97.3% and the Cronbach's alpha coefficient for the responsiveness scale was 0.83. Participants' mean age was 38.5±14.8years with more being males (55.8%), privately employed (34.9%) and completed secondary education (82.5%). Proportion of respondents who gave excellent ratings across responsiveness domains were dignity (32.8%), autonomy (34.2%), confidentiality (26.3%), amenities (25.8%) and no excellent rating for choice of provider. Marital, employment and visit status were the most consistent factors associated with feedback on autonomy, choice of providers, confidentiality domains.Conclusion: More orthopaedic patients were pleased with the level of autonomy and dignity than choice of providers and quality of basic amenities. There is the need for enhanced responsiveness of orthopedic services to meeting the unique needs of patients and achieving improved quality of care and patient outcomes

Obstructed Labour and Maternal Outcome at the Intensive Care Unit of the University of Port Harcourt Teaching Hospital: A Ten Year Review

ntroduction:Obstructed labour is a major cause of maternal mortality. Admissions into the intensive care unit (ICU) especially for post-delivery monitoring and treatment of patients with obstructed labour entails critical care for favourable outcome for the mother.Aim:To evaluate the maternal outcome of mothers admitted into the intensive care unit who had obstructed labour at the University of Port Harcourt Teaching Hospital (UPTH).Methodology:The study was a retrospective study of all the cases of obstructed labour admitted into the ICU of UPTH between 1stJanuary, 2007 to 31stDecember, 2016. Information were retrieved from the patients case note and analyzed using SPSS version 20.Results:A total of1549 patients were admitted into the ICU for the period under review, of which 218(14.1%) were obstetric admissions. One hundred and forty were unbooked mothers while 78 were booked. The mean age was 30 ± 2 years and the modal parity was 2. All the 64 cases of obstructed labour were unbooked mothers and comprised 29.4% of the obstetric admissions. The number of maternal deaths from obstructed labour were 23, which comprised of 10.6% of the obstetric admissions. Conclusion:The study revealed that the maternal deaths following obstructed labour admitted into the ICU was high. The reason is that these patients present late. There is therefore need for patients at risk of obstructed labour to register for antenatal care early and delivery conducted by skilledbirth attendant for improved outcome.

Prevalence of and Severity of Depression among Parkinson Disease Patients

Background:The objectives of the study were to determine prevalence and severity of depression among patients with Parkinson’s diseaseand compare with a control group that has comparable disability with PD and ascertain the correlation of depressive symptoms severity with the severity of motor symptoms in Parkinson’s disease (PD).Methods: This was a comparative cross-sectional descriptive study conducted at the Neurology clinic of University of Port Harcourt Teaching Hospital (UPTH).The presence and severity of depression in patients with PD measured using Becks Depression Inventory (BDI) and severity of PD using Unified Parkinson’s DiseaseRating Scale (UPDRS)-motor.Results:A total of 40 PD patients and 40 patients with non-complicated hypertension werestudied. This study showed that the prevalence of depression among subjects with Parkinson’s disease was significantly higher 72.5% as compared with control group, further comparing the mean BDI for PD and Hypertension using independent t-test shows statistical significance (t=-3.306, p-value< 0.001). However, there is no significant difference between the severity of depression among PD patients and control. The study also reported difference in the pattern of depressive symptoms as the PD progresses.Conclusions: Theprevalence of depression in this study was significantly higher (72.5%) among patients with PD, with no significant difference in severity of depression. however, the pattern of depressive symptoms shows significant difference as PD progresses.We recommend the integration of mental health services into the care of Parkinson’s disease to ensure regular assessment of their mental health status and prompt treatment.

Prevalence and Pattern of Mental Illness among School Age Children Seen at the University of Port Harcourt Teaching Hospital: A Six Year Study

Background: A sound mental health in school age children is critical for good academic achievements and a better transition from childhood to adulthood. The increasing prevalence of mental illness in school age children, especially the adolescents, is of great public health concern globally.Aim: The aim of this study therefore was to determine the prevalence and pattern of mental health disorders among school age children seen at the University of Port Harcourt Teaching Hospital (UPTH).Methodology: Consent for the study was obtained from the research ethical committee of the hospital. Medical case notes of all patients aged 5years to 18 years seen in the clinic by Consultant Child and adolescent Psychiatrists from 2015 to 2019 were retrieved and thoroughly reviewed. Data was analyzed using the SPSS version 20 statistical package and results presented using descriptive and analytical methods.Results: Out of 7,856 patients seen in the Neuropsychiatry Clinic within the period under review, 408(5.2%) were children aged between 5 to 18 years. Male was higher with 232(56.9%). The most prevalent mental illnesses were anxiety disorders, 58(14.2%), depressive illnesses 46(11.3%), schizophrenic illness 44(10.8%), mental and behavioural abnormality secondary to substance abuse (MABD) 43 (10.5%), bipolar affective disorders 37(9.1%), while conversion disorders was the least with 3 (0.7%).Conclusion: Mental disorders are common among school age children seen in UPTH and often impair the emotional wellbeing of this population. A detailed and well worked out plan of management is needed to provide optimal mental health services to children and adolescents. Well-coordinated mental health services should be inculcated into the School Health Programme in Nigeria