Barriers and outcomes of therapeutic communication between nurses and patients in Africa: a scoping review.

BACKGROUND: Therapeutic communication (TC) promotes effective patient care, emotional wellbeing, and improves patient outcomes. The purpose of this review was to synthesise evidence on barriers and outcomes of TC between nurses and patients in Africa and to inform future studies and systematic reviews. METHODS: Search for the records was done in four major databases including PubMed, Science Direct, PubMed CENTRAL, and JSTOR. Additional searches were done in Google Scholar and Google. Results and findings from published studies and grey literature were included. A total of 16 articles met the eligibility criteria and were included in the review. This scoping review followed the guidelines by Askey and O'Malley. RESULTS: Barriers associated with TC were grouped under five main themes: sociodemographic factors, patient-related factors, nurse-related factors, environmental and health service-related. Age, and religious beliefs were the main sociodemographic factors that hindered TC while stress and inadequate knowledge and skills were identified among the nurse-related barriers to TC. Extreme weather conditions and mosquito infestation were environmental factors while lack of access to TC educational programmes on TC was a health service-related factor that interfered with TC. Both positive and negative outcomes of TC were also identified. CONCLUSION: Continuous professional development on TC is necessary to improve nurses' attitudes and update their skills to enable them to render culturally competent nursing care to patients.

Transtheoretical-Based Model of Intervention for Diabetes and Prediabetes: A Scoping Review.

Diabetes is considered a public health problem worldwide, fostered by population growth, an increase in the overall quality of life, changes in dietary patterns, modifications in lifestyle habits, and the natural process of getting older. To properly control diabetes, the transtheoretical model (TTM) may be useful. This scoping review is aimed at identifying TTM interventions for diabetes. The study followed Arksey and O'Malley's six steps in conducting the scoping review. Four main databases (PubMed, Central, JSTOR, and ScienceDirect), Google Scholar, Google, and a reference list of identified articles were searched for literature. The study included peer-reviewed articles published online from 2000 to 2023 and published in the English language. At the end of the search, 3,514 entries were found in the four main databases, and 23 records were identified through Google, Google Scholar searches, and reference lists. After a thorough screening, 22 records were used for this review. The study found that the primary interventions based on the TTM for managing diabetes and prediabetes were educational materials to promote physical activity among diabetes and prediabetes individuals, health education, exercise, motivational interviews, self-tracking, and dietary changes. Further interventions on diabetes and prediabetes management could adopt the identified transtheoretical interventions to improve the health of their patients.

Gender Differences in Academic Resilience and Well-Being among Senior High School Students in Ghana: A Cross-Sectional Analysis.

Senior high school (SHS) students are at risk of stress and other adverse exposures that may negatively affect their well-being and possibly cause attrition. The concepts of academic resilience and well-being share commonality as psychological attributes linked to positive functioning among students. Despite this connection, there seems to be limited research exploring these concepts across genders among SHS students in developing regions. This study examined the gender difference in academic resilience and well-being among SHS students in Ghana. Using a cross-sectional survey design, 190 SHS students in three schools from Kwahu North and South district (i.e., Afram Plains) of Ghana's Eastern Region completed the Academic Resilience Scale (ARS-30) and College Student Subjective Wellbeing Questionnaire (CSSWQ). The sample consists of 102 males and 88 females, with a mean age of 17.83 years. The data were analyzed using independent samples t-tests and hierarchical regression. The study established that students have a moderate level of academic resilience and a higher level of well-being, with no statistically significant variation in students' academic resilience (t = 0.718; p = 0.474) or well-being (t = -1.596; p = 0.112) across gender. Further, the study discovered that resilience significantly predicted academic well-being (B = 0.425; SE = 0.050; t = 8.50; p < 0.001). This study highlights the importance of promoting gender-sensitive intervention strategies that enhance the academic resilience and well-being of SHS students and help boost their educational attainment.

Risk Factors of Malnutrition among In-School Children and Adolescents in Developing Countries: A Scoping Review.

Malnutrition among in-school children is a complex issue influenced by socio-economic, environmental, and health-related factors, posing significant challenges to their well-being and educational trajectories in developing countries. This review synthesized evidence on the multifaceted aspects of child malnutrition within the educational setting in developing countries. This review followed the six steps outlined by Arksey and O'Malley's framework. Four main databases (PubMed, CENTRAL, JSTOR, and Scopus) were searched. Additional searches were conducted in WHO Library, ProQuest, HINARI, Google Scholar, and Google. Reference lists of eligible papers were checked. This review found that low family income, varying family sizes, parental employment status, and educational levels significantly impact malnutrition among in-school children and adolescents. Environmental elements, including rural/urban residence, household sanitation, and living conditions, also influence malnutrition. In addition, nutrition knowledge, dietary habits, nutrient deficiencies, physical activity, and prevalent health conditions compound the risk of malnutrition. This study underscores the extensive health impact of malnutrition on general health, specific nutrient deficiencies, fetal/maternal health concerns, and overall morbidity. Also, malnutrition affects school performance and attendance, impacting cognitive abilities, and academic achievements. Addressing these challenges requires comprehensive policy actions aligned with Sustainable Development Goals, emphasizing poverty alleviation, health literacy, and gender equity.

Self-management needs, strategies and support for sickle cell disease in developing countries: a scoping review protocol.

INTRODUCTION: Sickle cell disease (SCD) poses a significant global health burden, particularly affecting individuals in developing countries with constrained healthcare resources. While research on self-management in the context of SCD is emerging, it has predominantly focused on primary studies, and there is a notable dearth of evidence synthesis on SCD self-management in developing countries. This scoping review aims to identify and map self-management needs of individuals living with SCD, the strategies they employed to meet those needs, and the support systems available to them. METHODS AND ANALYSIS: The review will be conducted following the Arksey and O'Malley's (2005) 29 framework to comprehensively examine the landscape of SCD self-management research. Searches will be performed in PubMed, Scopus, Embase and Dimensions AI, with additional searches in other databases and grey literature. Indexed literature published in English from inception to January 2024 will be included. Reference list from included studies will also be searched manually. Two teams will be constituted to independently screen titles, abstracts and full text against the eligible criteria. Data will be extracted from included studies onto a customised data extraction form. ETHICS AND DISSEMINATION: Ethical approval is not required for this review due to the fact that it synthesises information from available publications. The findings will be disseminated through publication in a peer-reviewed journal. Also, the findings will possibly be presented at relevant international and national conferences. This protocol has already been registered with the Open Science Framework. The study characteristics such as design and setting will be descriptively analysed and presented as graphs, tables and figures. Thematic analysis will also be conducted based on the study objectives and presented as a narrative summary.

In-school adolescents' sociodemographic correlates of serious unintentional injuries in Saint Vincent and the Grenadines: A cross-sectional study.

Background: As a public health concern, serious adolescent injuries constitute considerable global morbidity and mortality. Despite the proliferation of literature on this problem, the evidence on the determinants of injuries among in-school adolescents in Saint Vincent and the Grenadines (SVG) is insufficient. Method: The study analyzed data from the 2018 Global School-based Student Health Survey to examine the prevalence and determinants of serious injuries in a nationwide adolescent sample in SVG. χ 2 And binomial logistic regression analyses were carried out, along with an adjusted odds ratio and a 95% confidence interval. Results: Serious injuries among this population were estimated at 50.5%. Student grades, gender, truancy, amphetamine or methamphetamine use, marijuana or alcohol use, cigarette smoking, physical assault, physical fight, cyberbullying, suicidal behavior (ideation, plan, and attempt), parental or guardian tobacco use, and multiple sexual partners were significantly associated with serious injuries. After adjusting for other variables, being a male, having experienced a physical attack, fighting physically, attempting suicide, and having multiple sexual partners predicted serious injuries among in-school adolescents in SVG. Conclusion: The use of integrative health promotion and injury prevention programmes (e.g., antiviolence campaigns) and educational measures could help minimize or eradicate this menace in SVG.

Suicidal Behaviour among School-Going Adolescents in Saint Lucia: Analysis of Prevalence and Associated Factors.

Suicide poses a debilitating threat to adolescents' lives worldwide. Although suicide prevention efforts are evident globally, there is limited evidence on the prevalence and correlations of suicidal behaviour among school-going adolescents in Saint Lucia. We used a dataset from the 2018 Global School-based Student Health Survey to examine the prevalence and associated factors of suicidal behaviour among 1864 students from schools in Saint Lucia. Prevalence rates of 25.5%, 22.1%, and 17.5% were found for suicidal ideation, suicide plan, and suicide attempt, respectively. After adjusting for other factors, being male and having understanding parents were protective against suicidal behaviour. However, suicidal ideation was predicted by being physically attacked and bullied, parental guidance, tobacco use, loneliness, and worry. Moreover, being a victim of physical attacks and bullying, having close friends, being lonely, and worrying were predictive of making suicidal plans among adolescents. Attempting suicide was predicted by cigarette smoking, current use of tobacco and related products, bullying, having close friends, being lonely, and worrying. School-based preventive interventions are required to help address triggers of suicidal behaviour among adolescents in Saint Lucia and to help attain the targets for suicide prevention in the global Sustainable Development Goals.

Prevalence and Predictors of Alcohol Use among School-Going Adolescents in Panama: A Population-Based Cross-Sectional Study.

This study investigated the prevalence and predictors of alcohol use among school-going-age adolescents in Panama. Using a national school-based cross-sectional survey, data from a proportionate sample of school-going adolescents aged 13-17 years were obtained from the 2018 Panama Global School-based Student Health Survey [GSHS]. Data were analysed with a Pearson's Chi-square test and weighted binary logistic regression. The results were reported with their corresponding adjusted odds ratio (AOR) at a 95% confidence interval (CI) and level of significance set at p < 0.05. The prevalence of alcohol use among adolescents in Panama was 30.6%. The odds of alcohol use were lower among adolescents in a lower grade than those in upper grades, and lower in those who did not eat from a restaurant than those who ate from a restaurant. Further, the likelihood of alcohol use was significantly high among those who engaged in physical fights, were seriously injured, were mostly worried, and whose parents used any form of tobacco. Other results showed that the odds of alcohol use were high among sedentary respondents, those who had multiple sexual partners and those who used amphetamines. Based on the present findings, a collaborative approach (i.e., stakeholders- the Ministry of Social Development and the Ministry of Education- community-individual levels) towards the development and adherence of appropriate interventions aimed at reducing alcohol use is required in Panama. Specific preventive interventions would be fundamental in promoting a positive school climate to help reduce adolescents' alcohol use and, perhaps, other anti-social behaviours (e.g., physical fights and bullying).

Self-Determination Theory and Quality of Life of Adults with Diabetes: A Scoping Review.

Background: Diabetes is one of the leading causes of sickness, death, and decreased quality of life globally. The prevalence of diabetes keeps rising globally due to lifestyle changes and urbanization. Therefore, improved quality of life (QoL) and appropriate diabetes self-management practices, including treatment adherence, are crucial to improving and sustaining the health of diabetic patients. Some studies have adopted the self-determination theory (SDT) to study diabetes interventions, but less is known about its effectiveness in improving QoL, treatment adherence, and diabetes self-management. Aim/Objective. This review assessed the effectiveness of SDT in improving self-management practices, treatment adherence, and QoL among adult diabetic patients. Method: We followed the six-stage framework by Arksey and O'Malley in conducting the review. PubMed, JSTOR, Central, and ScienceDirect databases were searched for published articles from January 2011 to October 2021 using keywords and Boolean logic. Furthermore, we screened a reference list of related articles. Also, Google Scholar, Z-library, and web-based searches were carried out to retrieve other relevant evidence that applied SDT in improving QoL, diabetes self-management, and treatment adherence. Findings. Fifteen studies met the inclusion criteria, from which data were extracted as findings. SDT effectively improved QoL, diabetes treatment adherence, and diabetes self-management among diabetic patients. Of these studies, 11 provided data on SDT and diabetes self-management and affirmed the effectiveness of the theory in improving appropriate diabetes self-management practices. Two studies confirmed the effectiveness of SDT in improving treatment adherence. SDT and QoL were assessed in 4 of the studies, which demonstrated the effectiveness of SDT in enhancing the QoL of diabetic patients. Conclusion: SDT effectively improved QoL, diabetes treatment adherence, and diabetes self-management. The application of SDT in diabetes management will improve the health and QoL of diabetic patients. Hence, diabetes management interventions could adopt SDT to guide treatment.

Prevalence and factors associated with serious injuries and aggressive behaviours among in-school adolescents in Panama.

Introduction: Injuries during adolescence cause lifelong harm and death. Our study used a nationally representative sample to examine the prevalence and risk factors associated with serious injuries among in-school adolescents in Panama. Methods: We analysed Panama's 2018 Global School-Based Student Health Survey data using SPSS. Percentages were used to summarise the results of the prevalence of serious injuries. Binomial logistic regression analysis was performed to examine the risk factors of serious injuries. The results were presented as an adjusted odds ratio (AOR) at a 95% confidence interval (CI). Results: The prevalence of serious injury among in-school adolescents in Panama is 45%. Furthermore, the study found that males (AOR= 1.495, CI=1.272--1.756), truancy (AOR=1.493, CI=1.249--1.785), overweight (AOR= 1.246, 95% CI=11.057--1.469), drinking alcohol (AOR= 1.397, CI=1.151--1.695), experiencing physical attack (AOR= 2.100, CI=11.646--2.681), engaging in a physical fight (AOR=1.586, CI=1.289--1.952) and bullied outside school (AOR=1.276, CI=1.005--1.621) significantly predict serious injuries among adolescents in Panama. Conclusion: Multidisciplinary approaches targeting the correlates observed will help reduce the high prevalence of serious injuries among in-school adolescents in Panama.

Nutritional status and associated factors of older persons in sub-Saharan Africa: a scoping review.

BACKGROUND: The older person population is rapidly increasing globally, including sub-Saharan Africa (SSA). Concurrently, malnutrition is also increasing among older persons in SSA, with a dearth of empirical evidence on nutritional status and associated factors among the older persons in the region to inform effective interventions to promote healthy ageing. AIM/OBJECTIVE: This review assessed the nutritional status and associated factors among older persons in SSA. METHOD: PubMed, Google Scholar, and Cochrane Library electronic databases were searched for published articles from 2010 to 2021 using keywords and Boolean logic. Also, we carried out a free web-based search to retrieve other relevant evidence that assesses the older persons' nutritional status. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow chart was used to appraise the research articles that responded to the study's research questions. FINDINGS: Twenty studies met the inclusion criteria, from which data were extracted as findings. The malnutrition prevalence was between 6 to 54% among older persons in SSA. We found that the prevalence of malnutrition vary and could be as high as 28.4% in a low socio-economic status area. Of these studies, twelve (12) provided data on undernutrition with prevalence ranging from 2.9 to 41%;10 provided data on overweight (8.1-54.1%) and 5 on obesity (2.7-44.7%). Seventeen of the studies evaluated factors associated with malnutrition; 4 studies revealed the association between socioeconomic status and malnutrition, 7 studies reported a significant association between dietary habits and malnutrition. Four studies showed an association between educational status and malnutrition. Disease conditions associated with malnutrition were reported in four of the studies. CONCLUSION: This review shows that malnutrition is a problem among older persons in SSA coupled with many risk factors which should be given critical attention. We recommend nutrition education for older persons as well as the development of nutrition interventions for this vulnerable group.

Establishing a Sickle Cell Disease Registry in Africa: Experience From the Sickle Pan-African Research Consortium, Kumasi-Ghana.

Sickle cell disease (SCD) is the most common clinically significant hemoglobinopathy, characterized by painful episodes, anemia, high risk of infection, and other acute and chronic complications. In Africa, where the disease is most prevalent, large longitudinal data on patients and their outcomes are lacking. This article describes the experiences of the Kumasi Center for SCD at the Komfo Anokye Teaching Hospital (KCSCD-KATH), a Sickle Pan-African Research Consortium (SPARCO) site and a SickleInAfrica Consortium member, in establishing a SCD registry for the evaluation of the outcomes of patients. It also provides a report of a preliminary analysis of the data. The process of developing the registry database involved comprehensive review of the center's SCD patient medical records, incorporating data elements developed by the SickleInAfrica Consortium and obtaining ethical clearance from the local Institutional Review Board. From December 2017 to March 2020, 3,148 SCD patients were enrolled into the SCD registry. Enrollment was during the SCD outpatient clinic visits or through home visits. A significant proportion of the patients was from the newborn screening cohort (50.3%) and was males (52.9%). SCD-SS, SCD-SC, and Sß +thalassemia were seen in 67.2, 32.5, and 0.3% patients, respectively. The majority of the patients were in a steady state at enrollment; however, some were enrolled after discharge for an acute illness admission. The top two clinical diagnoses for SCD-SS patients were sickle cell painful events and acute anemia secondary to hyperhemolysis with incidence rates of 141.86 per 10,000 person months of observation (PMO) and 32.74 per 10,000 PMO, respectively. In SCD-SC patients, the top two diagnoses were sickle cell painful events and avascular necrosis with incidence rates of 203.09 per 10,000 PMO and 21.19 per 10,000 PMO, respectively. The SPARCO Kumasi site has developed skills and infrastructure to design, manage, and analyze data in the SCD registry. The newborn screening program and alternative recruitment methods such as radio announcement and home visits for defaulting patients were the key steps taken in enrolling patients into the registry. The registry will provide longitudinal data that will help improve knowledge of SCD in Ghana and Africa through research.

Suicidal behaviours (ideation, plan and attempt) among school-going adolescents: A study of prevalence, predisposing, and protective factors in Saint Vincent and the Grenadines.

Suicide occurs throughout life and is among the leading causes of death among adolescents globally. Aside from the growing literature on this serious mental health issue, little is known about the prevalence of suicide and the variables that predispose and protect adolescents against it in Saint Vincent and the Grenadines. We analysed the Global School-based Student Health Survey data collection among school-going adolescents in Saint Vincent and the Grenadines to explore the prevalence, risk and protective variables associated with suicidal behaviours. We observed prevalence rates of 26%, 26%, and 19% for suicide ideation, plan, and attempt, respectively. Furthermore, sex (being male) and having parents or guardians who understand the problems and worries of adolescents served as protective factors against all three suicide behaviours. However, we observed truancy, cigarette smoking, bullying victims (on/off school property), being cyberbullied, loneliness, and worry as risk factors for suicide ideation among adolescents. Risk for suicide plan was predicted by truancy, cigarette smoking, physical fight, bullying victims (on/off school property), being cyberbullied, loneliness, and worry. After controlling for other factors, truancy, amphetamine or methamphetamine use, cigarette smoking, physical fight, bullying victims (on/off school property), serious injury, close friends, loneliness, and worrying about life issues predicted suicide attempt risk among adolescents in Saint Vincent and the Grenadines. Early identification and suicide prevention interventions focusing on identified protective and risk factors may help minimise the prevalence of suicide behaviours among school-going adolescents in Saint Vincent and the Grenadines.

Determinants of Use of Biotherapeutics in sub-Saharan Africa.

Biologic drugs are reshaping clinical practice in various disciplines, even while access to them is imbalanced across global settings. In sub-Saharan Africa, biotherapeutics have potential roles to play in the treatment of a range of conditions that include infectious and noncommunicable diseases (NCDs). However, the literature is scarce on guidance for addressing local access challenges, including technical, regulatory, affordability, and other healthcare delivery aspects. This article aims to assess fundamental determinants of use of biologic medicines in sub-Saharan Africa. The purpose is to inform strategic actions of scientists, physicians, policymakers, and other stakeholders that are working to improve access to innovative therapies in low resource parts of the world.