Stress and resilience among pregnant teenagers in Ile-Ife, Nigeria.

INTRODUCTION: The period of pregnancy is associated with some level of physical, emotional and psychological stress which can be particularly heightened and have more deleterious impact when the expectant mother is a teenager who needs higher level of resilience to cope with the challenges linked with motherhood. This study aimed to assess the level of perceived pregnancy-related stress and its relationship with the level of resilience. METHODS: An analytical cross-sectional study design was employed using a structured questionnaire and the study was conducted among 241 adolescents. Perceived stress and resilience were measured using Perceived Stress Scale, and Wagnild & Young Resilience Scale, respectively. Descriptive and inferential statistics were computed using percentages, means with standard deviations, Student's t-test, Pearson correlation, one-way analysis of variance (ANOVA) and multivariate logistic regression. RESULTS: Majority of the respondents (194; 80.5%) were categorized as having moderate level of perceived pregnancy-related stress and 186 (77.2%) had low level of resilience. A significant inverse relationship was found between perceived pregnancy-related stress and resilience (r=-0.15, p=0.02). At multivariate level, three variables emerged as independent predictors of higher level of pregnancy-related stress: feeling of shame (OR=3.39; CI: 1.01-11.34), male partner's rejection of pregnancy (OR=3.43; CI: 1.45-8.12) and lack of parental involvement in care (OR= 3.56; CI: 1.65-7.71). CONCLUSIONS: There is a significant inverse relationship between perceived pregnancyrelated stress and resilience among teenagers in Nigeria, with higher resilience among the older age groups and those who had support from significant others.

Birth preparedness, utilization of skilled birth attendants and delivery outcomes among pregnant women in Ogun State, Nigeria.

INTRODUCTION: Birth preparedness and complication readiness (BPCR) is an approach initiated to facilitate utilization of skill birth attendants (SBAs) for improved pregnancy outcomes. Despite its usefulness, many women still did not use skilled birth attendants. The purpose of this study is to assess the level of birth preparedness and complication readiness and its association with skilled birth attendants' utilization. METHODS: A descriptive sequential mixed methods design was used. In all, 350 women in their third trimester were purposively selected from healthcare facilities. Of these, 340 completed the study yielding a 97% response rate. Structured interviewer-administered questionnaire, a checklist and an in-depth interview guide were used to collect data. Data analysis was done in Statistical Package for Social Sciences version 20 using descriptive and inferential statistics at 0.05 level of significance while qualitative data were analyzed through content analysis. RESULTS: There was a significant association between level of birth preparedness and complication readiness and use of skilled birth attendants [χ2(2, 340)=19.96; p=0.0001]. Some negative delivery outcomes (complications) were significantly associated with nonutilization of skill birth attendants. Cost, family members' preference, distance, industrial action and irritation from the vaginal examination were factors that prevented women from using a skilled birth attendant. CONCLUSIONS: The study concluded that BPCR is significantly associated with the use of SBAs and better outcomes were observed in women that used SBAs in Nigeria.

Predictors of Postnatal Care Services Utilization Among Women in Nigeria: A Facility-Based Study.

PURPOSE: Adequate utilization of postnatal care (PNC) services is a major contributing factor to reducing maternal mortality among women. Hence, this study was designed to assess the level of utilization of PNC services and its predictors among postpartum women in Ekiti State, Nigeria. DESIGN: The study adopted a cross-sectional descriptive design. METHODS: A total of 405 postpartum women from primary healthcare centers in five selected local government areas in Ekiti State participated in this study. A self-structured questionnaire was used to collect data, which were analyzed using IBM SPSS Statistics version 20 (IBM Corp., Armonk, NY, USA). Data were presented using descriptive (means, frequencies, and percentages) and inferential (Pearson's chi square and binary logistic regression) statistics. FINDINGS: The mean age of the women was 27 ± 8 years. A preponderance of the respondents (98.8%) were aware of PNC services, of which only 22% utilized PNC services after their last delivery. Those who did not utilize PNC services identified some of the barriers to their utilization, which included poor attitude of the healthcare providers and insufficient financial resources. The rate of utilization was found to be significantly higher among those who were 25 to 34 years of age (p = .03), who had formal education (p = .04), who were employed (p = .01), who had made use of an antenatal care (ANC) clinic (p = .02), and who had a good level of knowledge about PNC (p = .02). Furthermore, a prior experience with PNC services reduced by almost 90% the odds of a mother's subsequent utilization after her last delivery (odds ratio 0.10; confidence interval 0.05-0.24). CONCLUSIONS: The majority of respondents in this study were aware of PNC services, but this did not translate to utilization of the services. Also, the rate of utilization of PNC services was significantly associated with certain sociodemographic factors such as age, educational status, employment status, use of an ANC clinic, and level of knowledge about PNC. CLINICAL RELEVANCE: This study provides pertinent knowledge for healthcare providers, especially nurses, who provide PNC services.

Correlates of Self-Report of Rape Among Male School Adolescents in Ile-Ife, Nigeria.

This study examined male adolescents' self-report of rape of adolescent girls and the socio-demographic variables that correlated with self-report of rape. Descriptive-correlational design was used and the study was conducted in five public senior secondary schools in Ile-Ife, Nigeria. Three hundred and thirty-eight male adolescents participated in the study. A structured questionnaire was used to collect data. Findings from the study revealed the mean age of the adolescent males to be 16 years, with the majority (73%) of them in the middle adolescent stage. Six percent of the adolescent males reported they had raped an adolescent girl in the past. Among the boys who reported rape, 55% reported they had raped their sexual partners, and 55% reported they had perpetrated gang rape. Smoking (p = .0001), alcohol consumption (p = .001), and birth order (p = .006) predicted self-report of rape. The coefficient of birth order showed that odds of self-report of rape by first-born male increases by 6 times compared with other children. Study findings also provided evidence that adolescent males are moving from lone rape to gang rape in intimate partner relationships. Male adolescents are important group to target in rape prevention programs.

Student nurses' perceived use of NANDA-I nursing diagnoses in the community setting.

PURPOSE: Study explored knowledge and perception of student nurses on the use of NANDA-I nursing diagnoses in the community setting. METHODS: Study adopted cross-sectional design. Convenient sampling method was used to select 290 nursing students. Data analysis was by descriptive and inferential statistics. RESULTS: A majority (81.3%) of the participants considered NANDA-I nursing diagnoses to be useful in the community. Significant association existed in the perception and level of education of the students (χ(2) = 8.257, d.f. = 1, p= .04). CONCLUSIONS: Knowledge and perception of the participants about the use of NANDA-I nursing diagnoses in the community is satisfactory. IMPLICATION FOR NURSING PRACTICE: Use of NANDA-I nursing diagnoses should be encouraged among community health nurses.