Experiences of patients living with HIV and AIDS on antiretroviral therapy in Accra, Ghana.

BACKGROUND:  The human immunodeficiency virus and acquired immunodeficiency syndrome (HIV and AIDS) pandemic has greatly affected Africa, particularly Ghana. The pandemic remains a public health concern, particularly in terms of accessing essential medication and improving quality of life for people living with the disease. OBJECTIVES:  This study aimed to explore and describe the experiences of persons diagnosed and living with HIV who are on antiretroviral therapy. METHOD:  A qualitative, exploratory, descriptive, and contextual design was used. The research population included persons diagnosed with HIV who were receiving antiretroviral therapy at three public hospitals in Ghana. Data saturation was achieved after conducting 15 semi-structured interviews. Creswell's six steps of data analysis were used to analyse the data, which resulted in the emergence of one main theme and six sub-themes. RESULTS:  The main theme identified by the researchers highlighted the participants' diverse experiences of being diagnosed and living with HIV. It was found that the study participants expressed shock, disbelief, surprise, and fear of death after being diagnosed with HIV. The participants also experienced stigmatisation, discrimination, and rejection. CONCLUSION:  There is a need for further research on the extent of discrimination and stigmatisation and the effect on optimal adherence to antiretroviral therapy. Continuous public education on HIV is required to limit the extent of discrimination and stigmatisation.Contribution: The study has highlighted the various emotions related to stigma and discrimination expressed by persons living with HIV (PLHIV). The findings will guide policy on eliminating discrimination and stigmatisation for people living with HIV.

Nurses' knowledge on assessment and management of cancer therapy-associated oral mucositis.

AIM: This study aimed to explore baseline nursing knowledge on assessment and management of patients at risk for developing cancer therapy-associated oral mucositis (OM) at a tertiary hospital in Ghana. DESIGN: A descriptive generic qualitative study design was conducted. The study population were nurses who cared for patients diagnosed with cancer. METHODS: Participants were recruited using a purposive non-probability sampling technique. Data were obtained through face-to-face interviews using semi-structured interview guide. Data collection and analysis were done concurrently. RESULTS: The study found that nurses had knowledge on the pre-treatment assessment of clients undergoing cancer treatment; however, they had insufficient knowledge on the standardized tool for the assessment of OM. They also lack a definitive approach to prevent and treat OM. Nurses provided general education on cancer treatment but paid little attention to the education on the possible side effect that includes OM. Additionally, insufficient knowledge level of nurses on cancer treatment-associated mucositis and lack of structured protocol for OM coupled with unavailable tools for assessing the oral mucosa were also identified as militating against the management of OM. Findings from this study will guide policy that will improve the care that clients who are at risk of oral mucositis receive.

Narratives of type 2 diabetes mellitus patients regarding the influence of social issues on diabetes self-management: Implications for patient care.

AIM: To explore the perspectives of individuals living with type 2 diabetes mellitus on the influence of social factors on diabetes self-management in Ghanaian context. DESIGN: Hermeneutic phenomenological approach to qualitative research was used. METHOD: A semi-structured interview guide was used to collect data from 27 participants who were newly diagnosed with type 2 diabetes. Analysis of data was carried out by using content analysis approach. One main theme with five subthemes emerged. RESULTS: Participants experienced social stigma due to the changes in their physical appearance. Mandatory isolation was created by participants in order to manage the diabetes. The financial status of the participants was affected by the diabetes self-management. Differing from the social issues, the overall participants' responses to experiences living with type 2 diabetes mellitus culminated with psychological or emotional hassles, and therefore, patients resorting to alcohol consumption to deal with diabetes related stress, fears, anxiety, apprehension and pain among others.

Psychosocial experiences of patients diagnosed with COVID-19 at a teaching hospital in Ghana.

Objectives: The number of people affected with COVID-19 keeps rising globally resulting in increasing fear and anxiety among patients and their families. However, literature on the psychosocial experiences of these patients with COVID-19 in Africa is limited. Hence, this research explored the psychosocial experiences of patients infected with COVID-19 and undergoing treatment. Methods: The study employed a qualitative phenomenological approach. The sampling technique chosen for this study was purposive with a sample size of 34 determined by data saturation. Participants were selected from Korle-Bu Teaching Hospital, Ghana, and were interviewed face-face using a semi-structured interview guide. Data were analyzed using Interpretive Phenomenological Analysis. Results: Two main themes and seven sub-themes were generated from this study. The two themes included emotional burden of COVID-19 patients and effects of COVID-19 on patients and relatives. Sub-themes formulated under the emotional burden were reactions to COVID-19 diagnosis, suicidal thoughts, and sadness by fear of the unknown. Social restriction/isolation, stigmatization and disclosure, effect of COVID-19, and positive attitudes of staff emerged under the effect of COVID-19 on patients and relatives. Conclusion: Even though the recovery rate of COVID-19 has improved since the introduction of the COVID-19 vaccine, there is generally a global surge with respect to the incidence of the condition and an increasing number of patients on admission. Most interventions are targeted at the prevention of the disease than the effect of the psychosocial experience on the quality of life of the individuals affected which is equally essential. It is therefore recommended that current studies focus on improving the quality of life of those affected.

Integrative literature review of evidence-based guidelines on antiretroviral therapy adherence among adult persons living with HIV.

AIM: To summarize recommendations from available evidence-based guidelines that enhance, address or guide antiretroviral therapy adherence among adult persons living with human immunodeficiency virus. DESIGN: An integrative literature review approach. DATA SOURCE: Guidelines were accessed through Google from the databases of the Canadian Medical Association InfoBase clinical practice database, National Guidelines Clearinghouse, Writer's Guidelines database, the National Institute for Health and Clinical Excellence, UNICEF and WHO. Databases such as PubMed, Google Scholar, EBSCOhost (CINAHL, ERIC, Academic search complete, E-journals, Psych Info and MEDLINE), EMERALD INSIGHT, JSTOR, SCIENCE DIRECT and FINDPLUS were also searched, followed by a citation search. Data sources were searched between 1996 and January 2022. REVIEW METHODS: The five steps of the integrative literature review process, as described by Whittemore and Knafl, were used. These steps are as follows: step one; problem identification, step two; literature search, step three; data evaluation; step four: data analysis and the final step was data presentation. RESULTS: Sixteen guidelines related to antiretroviral therapy adherence were included for data extraction and synthesis. The findings revealed two themes as follows: theme 1: monitoring antiretroviral therapy adherence and theme 2: interventions to promote antiretroviral therapy adherence related to education and counselling, adherence tools, health service delivery and antiretroviral strategies. CONCLUSION: Antiretroviral therapy adherence in adult persons requires both interventions as well as monitoring. The various contributing factors relating to antiretroviral therapy adherence should be further explored. IMPACT: Evidence from the included guidelines can assist nurses in promoting a person's adherence to antiretroviral treatment, which could improve their health and well-being.

Experiences of women with breast cancer undergoing chemotherapy: A study at Ho Teaching Hospital, Ghana.

AIM: The study explored the experiences of women with breast cancer undergoing chemotherapy at Ho Teaching Hospital. DESIGN: A qualitative design which was exploratory and descriptive in nature was employed. METHODS: Purposive sampling was used to recruit participants. Data were collected using a semi-structured interview guide. Saturation of data was reached after the eighth participant was interviewed. The interviews were audio-recorded and lasted between 30-70 min, and the data were analysed concurrently with data collection using content analysis. Three major themes emerged. RESULTS: Participants experienced hair loss, changes in skin and nail pigmentation and social isolation. The study further revealed that inadequate access to information from healthcare providers and lack of resources coupled with financial constraints were among the major challenges participants faced. However, varied supports from significant others were of much help which enabled participants to go through their chemotherapy successfully.

Non-application of the nursing process at a hospital in Accra, Ghana: lessons from descriptive research.

BACKGROUND: Registered nurses in Ghana are trained to plan the care that they provide to their patients in a systematic and organized manner. This scientific approach to care is known as the nursing process. There is evidence that the nursing process is not being practised by professional nurses in Ghana, as expected. This research seeks to explore what informs nursing interventions in the clinical area. METHODS: A qualitative study was conducted with ten registered nurses; and this was descriptive in nature. One-on-one interviews were conducted with the research participants, as a means of collecting the data. A semi-structured interview guide was used as the data-collecting tool. The collected data were analysed by using latent-content analysis. Three main themes emerged from the data analysis. RESULTS: It was found that registered nurses did not plan their nursing care. The care that the nurses provided was based on routine nursing care and doctors' orders, both verbal and non-verbal; or written communication were the means whereby the care was provided; and that was communicated among the nurses. CONCLUSION: Registered nurses are taught the nursing process; and they are expected to implement the acquired knowledge in the clinical area. The failure of nurses to practise the expected standard of care results in their relying on the decision of other health-care professionals, such as doctors. This makes registered nurses appear to be assistants to doctors. We, therefore, conclude that nurse leaders must supervise nurses to put into practice what they were taught during their training; so that they can have professional autonomy in their practice as nurses. It is also suggested that nurses must show evidence of using the nursing process in their daily work by the use of the nursing care-plan form.

Factors that influence the clinical utilization of the nursing process at a hospital in Accra, Ghana.

BACKGROUND: The nursing process is a tool that is recommended for use by all professional nurses working in Ghana, in order to provide nursing care. However, there is currently a limited use of this tool by nurses in Ghana. The purpose of this research study was to explore the various factors that influence the utilization of this nursing process. METHOD: An exploratory descriptive qualitative-research design was employed. Ten participants were involved by using the purposive sampling method. A semi-structured interview guide was used to collect the data from the research participants; and the data were analysed by using content analysis. One main theme, with five subthemes, emerged from the analysis. RESULTS: It was found that there are factors, such as nurses not having a better understanding of the nursing process, whilst in school; the absence of the care plan in the ward, as well as the lack of adequate staff, with limited time being available for coping with contributed to the non-usage of the nursing process. CONCLUSIONS: We conclude that the clinical utilization of the Nursing process at the clinical setting is influenced by lack of understanding of Nurses on the Nursing process and care plan as well as lack of adequate nurses and time. We recommend that the care-plan form be made officially a part of the admission documents. Furthermore, the nursing administration should put measures in place to provide nurses with the needed resources to implement the nursing process. Additionally, they should ensure that the care-plan forms and other resources needed by the nurses are regularly and adequately provided. Nurses should further see the nursing process as a means of providing comprehensive care to their patients and addressing their specific problems. They should therefore make time despite their busy schedules to use it in order to improve quality of care and the image of nursing in Ghana.