Perceptions and attitudes of pregnant women towards caesarean section in Ado Local Government Area, Ekiti, Southwest Nigeria.

Caesarean Section (CS) is a life-saving obstetric surgery, often necessitated to resolve complications of pregnancy. This study investigated the perceptions and attitudes of women of childbearing age in Ado Local Government, Ekiti State, Nigeria, concerning Caesarean section as a delivery option. A quantitative, descriptive research design of survey type was adopted for the study. One hundred and twenty-two pregnant women attending antenatal clinic were randomly selected as study participants. Data for the study were collected using researcher-administered questionnaires. The reliability and validity of the instruments were ascertained. The participants were aware of their rights and responsibilities as study participants. Data were analyzed with descriptive and inferential statistics. The hypotheses formulated were tested at 0.05 significance level. Findings revealed that the study participants have positive perception and attitude towards cesarean. The study indicated no significant relationship between Caesarean section delivery and reproductive failure since the calculated significance value (0.072) was greater ( >) than the significance value (0.05). The study also revealed no significant relationship between Caesarean section delivery and death warrant as the calculated significance value (0.067) was greater ( >) than the significance value (0.05). Awareness programs on the importance and advantages of Caesarean section should be included in antenatal clinics education and mass media propaganda.

Helping babies survive: Thermal and umbilical cord care practices for neonates in Ado-Ekiti, Southern Nigeria.

Newborn care practices immediately after delivery can decrease newborns' risk of diseases and death in early neonatal life. This study assessed thermal and umbilical cord care practices among mothers in randomly selected health care facilities in Ado-Ekiti, Ekiti State. Descriptive quantitative research design was used and 211 mothers were selected through convenience sampling techniques. Semi-structured questionnaire, adapted from a previous study was utilized to collect data which was analyzed using descriptive and inferential statistics. The majority of the respondents were Yoruba aged 20-29 years; 70% of the respondents were aware of the standard cord care practice; 90% agreed that heat should be applied to the newborn's umbilical cord. 70.5% of mothers used methylated spirit to clean the umbilical cord; 39.5% claimed that they used menthol ointment; while 20.5% used the standard prescribed chlorhexidine. On thermal care practices, 10% dried their babies, 39.5% bathed their babies immediately, while 50% of mothers wrapped their newborns in heavy clothing. Factors influencing common thermal and umbilical cord care include religion and cultural preferences. Efforts should be devoted towards providing tailored health education approaches on proper thermal and umbilical cord care practices to mothers and the community at large.

Assessment of nurses' perception of role of genetics in development of breast cancer at Federal Teaching Hospital, Ido-Ekiti / Evaluación de la percepción de las enfermeras sobre el papel de la genética en el desarrollo del cáncer de mama en el Hospital Universitario Federal de Ido– Ekiti

Objective: Changes in the traditional approaches to prevention, diagnosis, and therapeutic management of breast cancer are becoming increasingly genetically based. It is therefore important for nurses to have competency in underlying biology of carcinogenesis and the molecular rationale underlying strategies to prevent, diagnose, and treat breast cancer. The risk for breast cancer is increased in individuals carrying a mutation in a predisposing gene and in others with a number of affected relatives with early age of disease onset. The authors investigated perception of nurses on the role of genetics in the development of breast cancer. Methods and material: A descriptive quantitative research design was adopted as the research design. The instrument for data collection was an adapted, pre-tested semi-structured, and self-administered questionnaire. Study participants were 187 nurses working at a tertiary health institution in Ekiti State. Data were analyzed and summarized using both descriptive and inferential statistics with level of significance set at P < .05. Results: The mean age of respondents was 39 ± 9.1 years and majority (86.2%) were females and B.Sc. (Bachelor of Science) (53.2%), with more than a decade working experience (62.2%). The study revealed that knowledge of the role of genetics in development of breast cancer was low among respondents with only a few (25.6%) having good knowledge. (AU)

Objetivo: Los cambios de los enfoques tradicionales para la prevención, diagnóstico y manejo terapéutico del cáncer de mama se basan cada vez más en la genética. Por tanto, es importante que las enfermeras adquieran competencia en cuanto a la biología subyacente de la carcinogénesis y el fundamento molecular subyacente a las estrategias para la prevención, diagnóstico y tratamiento del cáncer de mama, cuyo riesgo se incrementa en los individuos portadores de mutaciones en genes predisponentes, y aquellos otros con familiares afectados por la enfermedad, con aparición temprana de la misma. Los autores investigaron la percepción de las enfermeras acera del rol de la genética en el desarrollo del cáncer de mama.Métodos y Material: Se adoptó un diseño de investigación cuantitativo y descriptivo. El instrumento para la recopilación de los datos fue un cuestionario adaptado, probado previamente, semiestructurado y autoadministrado. Participaron en el estudio 187 enfermeras que trabajaban en una institución sanitaria terciaria del Estado de Ekiti. Los datos fueron analizados y resumidos utilizando estadísticas descriptivas e inferenciales con un nivel de significación establecido en p < 0,05.Resultados: La edad media de los respondedores fue de 39 ± 9,1 años, siendo la mayoría mujeres (86,2%) y Licenciadas en Ciencias (53,2%), con más de una década de experiencia (62,2%). El estudio reveló que el conocimiento del papel de la genética en el desarrollo del cáncer de mama fue bajo entre los respondedores, y que solo el 25,6% de ellos tenía un buen conocimiento. (AU)

[Cultural myths on the use of analgesia in labor: A cross-sectional study in Nigerian women]. / Mitos culturales sobre el uso de la analgesia en el trabajo de parto: estudio transversal en mujeres nigerianas.

OBJECTIVE: Pain is termed as a subjective phenomenon, however almost all women acknowledge that labor pain is the most severe form of pain a woman experiences in her lifetime. Obstetric analgesia is underutilized in developing countries due to cultural myths and taboos. Hence, the present study aims to identify Nigerian women's knowledge of labor analgesia and to explore what myths and factors hinder with the use of analgesia in labor. METHOD: A quantitative descriptive cross-sectional design was adopted in this study. The population of the study predominantly consisted of pregnant women from the «Yoruba ethnic group¼. An adapted semi-structured questionnaire was used to obtain data from participants from selected Health Care Centers in Ekiti state, Nigeria. The collected data was analyzed using a descriptive and inferential statistics and was represented in form of tables and charts with level of significance set at p ≤ 0.05. RESULTS: A total of 236 respondents were included in the study (n = 236). Findings from this study revealed that, the participants showed very poor knowledge on labor pain management strategies, with only 26.3% being aware of pain management strategies used in relieving labor pain. An elevated number of the participants (56.8%) believed that labor pain should not be relieved with the use of drugs, strongly agreeing that analgesia was «a sign ofweakness¼ (57.2%). Also, more than half (51.7%) of participants had fears that pain relief administered during labor can cause harm to the unborn baby. Belief that experiencing labor pain completes one's motherhood (49.6%), Religion (50.4%) and Culture (54.5%), were reported as factors influencing the uptake/acceptance of labor analgesia among participants. Furthermore statistical significant association was found between educational level of participants and knowledge of labor analgesia among participants (p value = 0.000; p ≤ 0.05). CONCLUSIONS: Cultural myths on the use of analgesia exist among participants. It is suggested that women-centered education should be targeted toward eliminating these myths and increasing awareness about labor analgesia.

Mitos culturales sobre el uso de la analgesia en el trabajo de parto: estudio transversal en mujeres nigerianas / Cultural myths on the use of analgesia in labor: A cross-sectional study in Nigerian women

Objetivo: El dolor se califica como un fenómeno subjetivo, sin embargo, casi todas las mujeres reconocen que el dolor de parto es la forma más severa de dolor que una mujer experimenta en su vida. La analgesia obstétrica está infrautilizada en los países en desarrollo debido a mitos y tabúes culturales. Por lo tanto, el presente estudio pretende identificar los conocimientos de las mujeres nigerianas sobre la analgesia del parto y explorar qué mitos y factores dificultan el uso de la analgesia en el parto. Método: En este estudio se adoptó un diseño cuantitativo descriptivo transversal. La población a estudio consistió predominantemente en mujeres embarazadas de la «etnia Yoruba». Se utilizó un cuestionario semiestructurado adaptado para obtener datos de las participantes de los centros de salud seleccionados en el estado de Ekiti, Nigeria. Los datos recogidos se analizaron mediante estadística descriptiva e inferencial y se representaron en forma de tablas y gráficos. El nivel de significación estuvo fijado en p ≤ 0,05. Resultados: Un total de 236 encuestadas fueron incluidas en el estudio (n = 236). Los resultados de este estudio revelaron que las participantes tenían un conocimiento muy pobre de las estrategias de tratamiento del dolor del parto, ya que solo 26,3% conocía las estrategias de tratamiento del dolor utilizadas para aliviar el dolor del parto. Un elevado número de las participantes (56,8%) creía que el dolor del parto no debía aliviarse con el uso de fármacos, estando muy de acuerdo en que la analgesia era «un signo de debilidad» (57,2%). Asimismo, más de la mitad (51,7%) de las participantes temían que el alivio del dolor administrado durante el parto pudiera causar daños al feto. La creencia de que experimentar el dolor del parto completa la maternidad (49,6%), la religión (50,4%) y la cultura (54,5%) se señalaron como factores que influyen en la aceptación de la analgesia del parto entre las participantes.(AU)

Objective: Pain is termed as a subjective phenomenon, however almost all women acknowledge that labor pain is the most severe form of pain a woman experiences in her lifetime. Obstetric analgesia is underutilized in developing countries due to cultural myths and taboos. Hence, the present study aims to identify Nigerian women's knowledge of labor analgesia and to explore what myths and factors hinder with the use of analgesia in labor. Method: A quantitative descriptive cross-sectional design was adopted in this study. The population of the study predominantly consisted of pregnant women from the «Yoruba ethnic group». An adapted semi-structured questionnaire was used to obtain data from participants from selected Health Care Centers in Ekiti state, Nigeria. The collected data was analyzed using a descriptive and inferential statistics and was represented in form of tables and charts with level of significance set at p ≤ 0.05. Results: A total of 236 respondents were included in the study (n = 236). Findings from this study revealed that, the participants showed very poor knowledge on labor pain management strategies, with only 26.3% being aware of pain management strategies used in relieving labor pain. An elevated number of the participants (56.8%) believed that labor pain should not be relieved with the use of drugs, strongly agreeing that analgesia was «a sign ofweakness» (57.2%). Also, more than half (51.7%) of participants had fears that pain relief administered during labor can cause harm to the unborn baby. Belief that experiencing labor pain completes one's motherhood (49.6%), Religion (50.4%) and Culture (54.5%), were reported as factors influencing the uptake/acceptance of labor analgesia among participants.(AU)

Traditional beliefs in the management and prevention of neonatal jaundice in Ado-Ekiti, Nigeria.

AIM: Traditional beliefs about neonatal jaundice persist in Sub-Saharan Africa, and because those beliefs might worsen the outcomes of the disease by delaying care or by treating it at home with unproven remedies; our study sought to identify the traditional beliefs of antenatal mothers regarding the management and prevention of neonatal jaundice in rural areas of Ekiti State, Southwestern Nigeria. METHODS: The study employed a descriptive cross-sectional design. A total of 190 women who attended two primary health care centers in Ekiti State were recruited for the study from April 1 to May 31, 2017, by convenience sampling through the antenatal clinic register. Data was collected by the use of an adapted self-administered, structured questionnaire. RESULTS: Of the women selected, 56% had at least one child before.36% of all the respondents would use pawpaw extract to treat neonatal jaundice, 30% would use sunlight, 26% would use antibiotics, 16% would use over the counter drugs, and 5% would use phototherapy. With regards of preventive measures, 48% indicated that neonatal jaundice can be prevented by breast feeding, 11% by drinking herbal concoctions by both mother and baby, 26% by giving glucose water to the baby and 12% of respondents by avoidance of cold water when pregnant. CONCLUSION: Our study showed that traditional beliefs regarding the management and prevention of neonatal jaundice are prevalent in Ado Ekiti, Nigeria.

Causes, enablers and perceived solutions to teenage pregnancy: a qualitative study in a South-Western State in Nigeria.

Introduction: teenage pregnancy remains a major public health issue in Nigeria with many teenagers being fated to early motherhood resulting in a life filled with turmoil. The aim of this study was to explore the perspectives of teachers and students of high schools on the causes, enablers and solutions to teenage pregnancy. Methods: this study employed an exploratory design using a qualitative approach. Participants were selected using purposive sampling technique and a total number of 33 participants interviewed. Data collection was done by means of audio-recorded semi-structured interviews and data were analysed using a thematic analysis approach. Descriptive statistics were used to generate participants' demographic profile. Results: three themes emerged from the study. They include perception of teachers and students on the causes of teenage pregnancy, perceived enablers of teenage pregnancy and solutions to teenage pregnancy. Findings revealed that the majority of the participants had knowledge of teenage pregnancy but had limited knowledge of contraceptives, particularly the students. Almost all participants viewed teenage pregnancy as a more common occurrence in their community than in schools. Participants identified poverty, peer pressure and poor parental control as causes of teenage pregnancy. Participants further identified poverty, substance abuse and lack of education as enablers of teenage pregnancy while perceived solutions included poverty eradication, abstinence from sexual activities, girl child education and government involvement. Majority of the participants disagreed with giving condoms to teenagers in schools. Conclusion: among other causes of teenage pregnancy identified in this study, poverty was a recurring theme. Therefore, there is, a need for the government of Nigeria to combat poverty at all levels, as a strategy to curb teenage pregnancy while not neglecting other causes.

Tocophobia experience and its impact on birth choices among Nigerian women: a qualitative exploratory study.

INTRODUCTION: while pregnancy is a very beautiful and memorable experience for most women, some women may experience apathy towards childbirth and have feelings of fear and anxiety (tocophobia). Tocophobia can be far reaching with adverse physiologic and emotional consequences for mothers, infants and families. This study therefore explored tocophobia experiences among primigravid women and explored its influence on birth choices among antenatal women. METHODS: the study employed a qualitative exploratory research design. Participants who were primigravida (women who had never experienced childbirth), were selected using purposive sampling technique on antenatal clinic days. Data was obtained using semi-structured interview questions. Data was analyzed using content analysis approach and thematic categorization. RESULTS: results showed that few of the women experienced tocophobia and these fears were not strong enough to make them opt for caesarian section. Reasons attributed to tocophobia experience among the participants included "horror stories" told in the neighborhood, "past experiences" of close acquaintance and "entertainment videos" broadcast. Furthermore, all the participants preferred to have vaginal delivery. CONCLUSION: few of the primigravid women in Ekiti State, Nigeria, experience tocophobia and this experience does not influence their choice of delivery option, as all participant´s preferred vaginal delivery to caesarian section. It is important for midwives to be aware of their role in counselling and identifying women with tocophobia in order to promote good and safe transition from pregnancy to motherhood.

Seeking Divine Intervention to Manage the Advanced Stages of Breast Cancer in Southwestern Nigeria.

BACKGROUND: The World Health Organization records indicate that breast cancer is the most common cancer in women both in developed and developing regions of the world. In developed countries, breast cancer is the second cause of cancer-related deaths, whereas in developing countries, breast cancer is the leading cause of cancer-related mortality in women. The empirical literature on Nigeria indicates that women present with advanced stages of the illness. OBJECTIVES: To explore the health-seeking behaviors of Southwestern Nigerian women with advanced breast cancer from the time they noticed a breast abnormality to their eventual presentation at the hospital for the management of the illness. METHODS: Thirty women with advanced stages of breast cancer in a large tertiary, referral, teaching, and university-affiliated Southwestern Nigeria Hospital were purposively selected for study participation. Participants completed a demographic information form and an in-depth face-to-face, one-on-one, semistructured interview guided by open-ended questions. Data analysis was inductive. RESULTS: Findings revealed that women sought divine interventions for the management of breast cancer. Prayer and spirituality were associated with high levels of optimism among the study participants. CONCLUSION: Nurses should provide information and counseling to women and the general public on the etiology and appropriate management of breast abnormalities and include the importance of a spiritual dimension of care. IMPLICATIONS FOR PRACTICE: Findings indicate the need to introduce a spiritual dimension to the care of women with advanced breast cancer. Findings also indicate the need for a comprehensive population-based breast health education.

Honoring the voices of bereaved caregivers: a Metasummary of qualitative research.

BACKGROUND: Family caregiving in the context of advanced disease in particular, can be physically and emotionally taxing. Caregivers can subsequently face bereavement exhausted with few supports, limited resources and a significant proportion will develop negative psychological and social outcomes. Although some research has attended to the bereavement experiences of family caregivers who had cared for a person requiring palliative care, a comprehensive qualitative understanding of the impact of caregiving on bereavement has not been articulated. The purpose of this study was to conduct a qualitative metasummary to explore the experiences of bereaved family caregivers of people who received palliative care services, regardless of their underlying disease. METHODS: Sandelowski and Barroso's qualitative metasummary method was utilized: 1287 articles were identified through extensive database searches (i.e. - MEDLINE, PsychINFO, and CINAHL) and reviewed to determine if they fit the criteria. Those included in the review were assessed for study quality. Findings from each study were then thematically coded and a frequency of themes was calculated. RESULTS: The sample consisted of 47 qualitative studies. A total of 15 themes emerged. In descending order of frequency, the 15 themes were: the individual emotions of serenity, sadness, guilt, uncertainty, trauma, escape, and anger; post-loss experiences that helped the caregiver in bereavement; post-loss experiences that hindered; practical life changes; caregiver role identity; pre-loss experiences that helped; pre-loss experiences that hindered; caregiver context; and a need for different kinds of supports. Three key findings emerged from the themes: (1) many different aspects of the caregiving experience impact the bereavement experience, (2) every bereavement experience is unique, and (3) a variety of supports must be developed and made available to caregivers to meet these unique needs. CONCLUSIONS: Based on the metasummary findings, changes are needed in practice and policy to ensure the health and well-being of the family caregiver is maintained by offering support both during caregiving and bereavement.

Promoting Early Detection of Breast Cancer and Care Strategies for Nigeria.

Breast cancer is the most common cancer in women particularly in developing countries like Nigeria, with high mortality, and economic costs. Worldwide, it is predicted that more than one million women are diagnosed with breast cancer, and more than 400,000 will die from the disease every year. A comparative integrative review of the literature from Nigeria and Canada showed that in Canada, there is positive association between wide spread education, early detection, the disease stage at diagnosis, and survival rates. In Nigeria, presentation with the advanced stage of the disease makes survival very low. The primary factors responsible for the late presentations are lack of awareness, misconceptions about breast cancer causes, and treatment outcomes. It is recommended that guidelines and policies about breast cancer early detection, care strategies, and ongoing management pathways be produced, disseminated, and adopted. The guidelines will assist practitioners and patients in making informed decisions and choices about the most appropriate health care for their specific clinical situations. The implementation of evidence-based guidelines will most likely help to improve care processes, the quality of clinical decisions and patient treatment outcome.