The Health of Office-Based Workers in Kingston, Jamaica.

The health status of Jamaican workers was evaluated as a baseline for workplace health promotion interventions. Socio-demographic, health status, and lifestyle data were collected from 1,087 employees. Blood pressure, glucose and cholesterol levels, and body mass index were measured for study participants. The most common illness reported by the study participants was migraine headaches (16.0%), followed by hypertension (13.5%) and asthma (6.1%). Based on blood pressure measurements, 34.1% were pre-hypertensive (120-139/80-89 mmHg), 13.1% had Stage 1 hypertension (140-159/90-99 mmHg), and 2.3% Stage 2 hypertension (≥160/≥100 mmHg). Furthermore, 33% were overweight, 16.7% were obese, and 10% were extremely obese. Most (55.1%) of the study participants reported excessive fast-food consumption in the last 7 days. The high rates of obesity, hypertension, and fast-food consumption reported in this study emphasized the need for focused health promotion strategies. Universality across institutions presented an excellent opportunity for national workplace health intervention programs.

Attitudes of patients towards being cared for by male nurses in a Jamaican hospital.

AIM: To determine the attitudes of patients towards male nurses in a Jamaican hospital. BACKGROUND: More males in nursing will help to address the nursing shortage and provide diversity in the profession. Patient attitudes towards male nurses will influence recruitment and retention. METHODS: A cross-sectional study was used. Data were collected using a self-administered questionnaire and an attitudinal measuring scale. RESULTS: Seventy-three patients responded (response rate 91%). Male nurses were perceived negatively by 51% of respondents. However, only 10% had a negative perception of the care they received from male nurses. More males (80%) than females (54%) had a negative attitude towards receiving an enema from a male nurse. CONCLUSIONS: Patients generally had a negative attitude towards male nurses but had a positive view if they were cared for by a male nurse. These traits can be used as the basis of changing the gender balance of nurses in Jamaica.

The lived experiences of adolescents with sickle cell disease in Kingston, Jamaica.

AIM: To explore the lived experiences of adolescents with sickle cell disease, in Kingston, Jamaica. METHOD: A descriptive qualitative design was used for this research. In-depth interviews were conducted with six adolescents with sickle cell disease at a Sickle Cell Unit operated by the University of the West Indies. Interviews were audiotaped, transcribed, and thematically analyzed. RESULTS: The majority of the adolescents demonstrated a positive self-concept. They reported strong family, school, and peer support which made them feel accepted. All were actively engaged in social activities such as parties, but had challenges participating in sporting activities. Various coping strategies were utilized to address challenges of the disease including praying, watching television, and surfing the Internet. CONCLUSION: Sickle cell disease can be very challenging for the adolescent, but with positive self-concept and increased social support, especially from family and peers, these adolescents were able to effectively cope with their condition and live productive lives.

Satisfaction with nursing care in the emergency department of an urban hospital in the developing world: A pilot study.

INTRODUCTION: Nurses form the largest group of the workforce in hospitals and as such the quality of nursing care is a critical indicator of patient satisfaction. OBJECTIVE: To determine the level of patient satisfaction with nursing care in the emergency department of an urban teaching hospital in Jamaica. METHODS: This descriptive cross-sectional study used a convenience sampling technique to recruit 142 adult patients who accessed nursing care in the emergency and intermediate areas of the emergency department. Data were collected using a 22- item questionnaire adapted from the Patient Satisfaction with Nursing Care Quality Questionnaire and managed using SPSS® version 19.0 for Windows®. RESULTS: The response rate was 77.6%; most respondents (62%) were female, and educated at the secondary level (42.3%). The mean satisfaction score was 32.60 (± 7.11) out of a possible 42. Most (59.9%) patients reported that they were very satisfied with nursing care in the emergency department. Satisfaction with nursing care was associated with clients' education. Perceived health status and empathy of nursing care offered were associated with patient's satisfaction with care (p = 0.05). CONCLUSIONS: Patients were highly satisfied with nursing care in the emergency department studied. Client's education, perceived health status and empathy of care were predictors of satisfaction.

Lifestyles of Jamaican men with hypertension.

PURPOSE: Determine the extent to which the lifestyles of Jamaican men with hypertension met the guidelines of the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7). DESIGN AND METHODS: Following informed consent, a convenience sample of Jamaican men with hypertension (n = 48), of African ethnicity, attending a Type 5 Health Center was interviewed over a four week period, using a 31-item interview schedule. RESULTS: Mean age of respondents was 65.2 (± 12.1) years (range = 35-89 years) with 33% having blood pressure (BP) controlled to 130/80 mmHg. Those meeting the guidelines were normal weight 23 (47.9%), DASH (dietary approaches to stop hypertension) diet zero, medication 7 (14.6%), exercise 14 (29.2%), alcohol restriction 38 (79.2%), and smoking cessation 40 (83.3%). Medication adherence was associated with BP control (r = -0.30, p < .04). More than half of the respondents believed that hypertension could be cured and that they could stop all treatment if their BP was normal. DISCUSSION AND CONCLUSIONS: Only a third of the sample had BP controlled to ≤130/80 mmHg. Adherence to the JNC 7 lifestyle guidelines was inadequate. IMPLICATIONS FOR PRACTICE: A nurse led intervention, focusing on perceptions and lifestyle practices, is indicated.

Low adherence to secondary prophylaxis among clients diagnosed with rheumatic fever, Jamaica.

OBJECTIVES: To determine the level of adherence and possible barriers to secondary prophylaxis among clients with rheumatic fever in Kingston, Jamaica. METHODS: Cross-sectional survey of 39 clients diagnosed with rheumatic fever, receiving penicillin prophylaxis for more than a year using a 22-item self-administered questionnaire on adherence to secondary prophylaxis and knowledge of rheumatic fever. The patients' records were reviewed to determine the number of prophylaxis injections the patients received for the year 2010. RESULTS: The majority of participants (74%) were females and 51% were adults. Only 48·7% had a high level of adherence. The majority (72%) had low knowledge levels regarding their illness, while only 5% had a high knowledge level score. Most clients (70%) strongly agreed that nurses and doctors encouraged them to take their prophylaxis. However, over 60% reported that they travelled long distances and or waited long periods to get their injections. One-third reported that they missed appointments because of fear of injections and having to take time off from work or school. DISCUSSION: Clients attending the health centers studied had limited knowledge about rheumatic fever. Barriers to adherence included fear of the injections, long commutes, and long waiting periods at the facilities studied.

Doctor at triage - effect on waiting time and patient satisfaction in a Jamaican hospital.

INTRODUCTION: Waiting time in the Emergency Departments is a major source of patient dissatisfaction in hospitals. Triage attempts to have the most critically ill patients seen first with an overall reduction in waiting time. Triage teams may include specially trained nurses or alternatively a specialist physician. The aim of this study was to determine if inclusion of a specialist physician on the triage team at the University Hospital of the West Indies (UHWI) in Kingston Jamaica reduced waiting time and improved patient satisfaction. METHODS: A prospective, cross sectional survey of ambulatory care patients was undertaken in 2006. Triage was completed by a team consisting of a doctor and two nurses during the first week and by nurses only during the second week. RESULTS: The study showed that there was no significant difference in the length of time patients spent in the emergency department based on whether or not they were triaged by a physician led team or by a team of nurses only. Type of triage team did not affect the level of patient satisfaction. Waiting time was significantly influenced by factors which came into play after triage such as the wait for X-ray and laboratory services. CONCLUSIONS: There appears to be no reduction in waiting times experienced by patients at the UHWI emergency department as a result of inclusion of a specialist emergency physician in the triage process. This suggests that specialist emergency department nurses are adequately trained in triage, and that delays in the triage process at UHWI are due to other factors.

High patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica.

UNLABELLED: Abstract Objective: To explore the level of patient satisfaction with nurse practitioner delivered services at two health centres in urban Jamaica. METHOD: A cross sectional survey of 120 adult clients (age ≥18 years old) seen by Nurse Practitioner at a Type 3 or Type 5 health centre in Kingston, Jamaica was conducted using a modified self-administered Nurse Practitioner Satisfaction Survey questionnaire. Data were analysed using SPSS® version 18 for Windows®. RESULTS: The study achieved response rate of 91.6% (N = 120). The majority were females (77%) with an average age of 40 ± 16 years. Most (63%) were from the Type 5 health centre and the rest (37%) were from a Type 3 facility. The mean general satisfaction score was 81 out of a possible 90 and 83% of the respondents reported they were very satisfied with another 17% expressing that they were satisfied with the nurse practitioner services at both facilities. No respondent was dissatisfied. The mean satisfaction score was significantly higher among respondents 40 years and older than that of their younger counterparts. Socio demographic and organisation characteristics were not associated with the mean satisfaction score. CONCLUSIONS: A high level of satisfaction exists among patients seen by nurse practitioners at two facilities in Kingston, Jamaica. This may represent an opportunity for expanded role of Nurse practitioners in the delivery of primary in Jamaica.