Menstruation behaviour influencer model: a grounded theory of menstrual experiences of shame, embarrassment, stigma and absenteeism among pubescent girls in semi-urban and rural secondary schools in Enugu State, Nigeria.

Introduction: severally, studies had identified menstrual-associated shame, embarrassment, stigma, and absenteeism among pubescents in school with resultant challenges on their bio psycho-social functioning. However, what is not clear is the contribution of the home and school to the experiences. The objectives of the study were to explore the experiences with menstruation and menstrual hygiene management; explore the experiences with menstrual-associated shame, embarrassment, stigma, and absenteeism among participants; explore the bio-psycho-social issues associated with the experiences; understand the meaning of the experiences and propose a mid-range theory that explains the influences on pubescents´ menstrual behaviours. Methods: constructivist grounded theory design was used to explore the experiences of 20 purposively recruited pubescents from rural and semi-urban secondary schools. In-depth Interviews, focused group discussions, key informant interviews, and observations were employed to collect data until data saturation. Open and focused coding was conducted to identify emerging themes and sub-themes. These themes were returned to participants and literature for verification. Results: four (4) categories and eleven (11) sub-categories emerged from the data and formed four (4) themes that influence pubescents´ menstrual behaviour. They include: 1) individuals´ bio-physiological status, knowledge of menstrual health and menstrual characteristics; 2) regimenting school through strict rule enforcement, punishment/motivation, forced participation, and compliance; 3) scheduling academic activities/examination, sporting and other extra curricula activities; and 4) providing menstrual support by individual and institutional efforts to pubescents. Based on the relationship with other themes, the menstrual behaviour influencer model was proposed. Conclusion: menstrual influencers require the interaction between menstrual support and menstrual enablers by institutions for positive menstrual behavior. Failure to achieve this balance will lead to menstrual-associated shame, embarrassment, stigma, absenteeism, and school drop-out.

Sexually transmitted infection (STI): A malady with skewed marital unfaithfulness, the Nigerian experience

Marital unfaithfulness is a major contributor to sexually transmitted infections in both sexes; however, societal view of the menace seems to use various lenses for the different sexes. Globally, evidence suggests that marital infidelity has existed in history. In Africa, as well as in Western society, infidelity is a problem facing many families and accounts for high incidence of divorce. This narrative review described and synthesized literature on marital infidelity and its association with sexually transmitted infections. We conducted informal interviews with married women on their experiences with marital infidelity in Nigeria. Associated physical, social and psychological cultured imposed consequences were experienced by women in Nigeria. The recurrent themes felt helplessness, enduring physical, emotional and psychological torture, accepting fate with reservation and being strangers in marital union. This narrative review could initiate critical thoughts and discussions on the factors in skewed marital unfaithful and the contribution to reproductive health and family life.

Obtaining informed consent: psychiatric nurses' knowledge and practice at federal neuropsychiatric hospital Enugu, Nigeria / Obtención de consentimiento informado: conocimiento y práctica de enfermeras de psiquiatría En El Hospital Federal de Neuropsiquiatría Enugu, Nigeria / Obtendo consentimento informado: conhecimento e prática de enfermeiras psiquiátricas no Hospital Federal Neuro-Psiquiátrico Enugu, Nigéria

Abstract: Background: Within a psychiatric care setting, informed consent is the voluntary acceptance of a plan for medical care by a competent patient after full disclosure of the care plan, its risks, benefits, and alternative approaches. This implies that the patient must have full information about any treatment options and must be competent to make the needed decisions. Objective: To assess psychiatric nurses' knowledge and practices of obtaining informed consent. Research Method: The study used a quantitative, descriptive cross-sectional survey design. Data were collected from a random sample of 99 nurses selected from a total of 131 nurses of different professional cadres working in the hospital, by means of a structured questionnaire constructed by the researchers. Data were analyzed using descriptive statistics. Results: Respondents' score on Knowledge of Informed Consent was above average (15.06 ± 2.671 out of a possible total score of 25). Likewise, their score on the disclosure of full information to psychiatric patients before treatment was well above average (6.01 ± 2.198 out of a maximum possible score of 8). However, respondents' score on the practice of obtaining Informed Consent was below average (2.41 ± 0.940 out of a maximum possible score of 5). Conclusion: Though a majority of the participants indicated good knowledge of informed consent, there was no corresponding correct practice of obtaining informed consent from patients in the hospital.

Resumen: Antecedentes: En un establecimiento de cuidado de la salud mental, el consentimiento informado es la aceptación voluntaria de un plan de cuidado médico de un paciente competente después de haber recibido información completa del plan, sus riesgos, beneficios y alternativas posibles. Esto implica que el paciente debe tener información completa acerca de las opciones de tratamiento y debe ser competente para realizar las decisiones necesarias. Objetivo: Evaluar el conocimiento y la práctica de obtención de consentimiento informado de enfermeras de psiquiatría. Método de investigación: El estudio usó un diseño de encuesta transversal cuantitativo y descriptivo. Los datos fueron recolectados de una muestra al azar de 99 enfermeras seleccionadas de un total de 131 de diferentes grupos profesionales que trabajan en el hospital, mediante un cuestionario estructurado desarrollado por los investigadores. Los datos se analizaron mediante estadística descriptiva. Resultados: El puntaje de los encuestados sobre el conocimiento de consentimiento informado fue mayor del promedio (15.06 ± 2.671 de un posible puntaje total de 25). De la misma forma, su puntaje sobre la entrega de información completa a los pacientes de psiquiatría antes del tratamiento fue bastante mayor que el promedio (6.01 ± 2.198 de un máximo posible de 8). Sin embargo, los puntajes de los encuestados sobre la práctica de obtención de consentimiento informado fue por debajo del promedio (2.41 ± 0.940 de un máximo posible de 5). Conclusión: Aunque una mayoría de los participantes indicó un buen conocimiento del consentimiento informado, no hubo en correspondencia una práctica correcta de obtención de consentimiento informado de pacientes en el Hospital.

Resumo: Background: Em um ambiente de cuidados psiquiátricos o consentimento informado é a aceitação voluntária de um plano para cuidado médico, por um paciente competente, depois da apresentação integral do plano de tratamento, seus riscos, benefícios e abordagens alternativas. Isso implica que o paciente deve ter informação completa sobre quaisquer opções de tratamento e deve ser competente para tomar as decisões necessárias. Objetivo: Avaliar conhecimento e práticas de enfermeiras psiquiátricas ao obter consentimento informado. Método de Pesquisa: O estudo utilizou um desenho de levantamento transversal descritivo, quantitativo. Os dados foram coletados de uma amostragem aleatória de 99 enfermeiras selecionadas de um total de 131 enfermeiras de diferente quadros profissionais trabalhando no hospital, por meio de um questionário estruturado construído pelos pesquisadores. Os dados foram analisados usando estatística descritiva. Resultados: O escore dos respondentes no Conhecimento do Consentimento Informado esteve acima da média (15.06 ± 2.671 de um escore total possível de 25). Da mesma forma, seus escores na apresentação de informação completa para pacientes psiquiátricos antes do tratamento esteve bem acima da média (6.01 ± 2.198 de um escore máximo possível de 8). Entretanto, o escore dos respondentes na prática de obter Consentimento Informado esteva abaixo da média (2.41 ± 0.940 de um escore máximo possível de out 5). Conclusão: Embora a maioria dos participantes indicou bom conhecimento do consentimento informado, não houve prática correta correspondente em obter o consentimento informado dos pacientes no hospital.

A modified Delphi consensus on generic indicators for a low- and middle-income country's quality nursing care measurement.

AIM: This study aimed to develop generic quality nursing care indicators for a low- and middle-income country's quality nursing care measurement through a modified Delphi consensus. DESIGN: A three-round modified Delphi process guided the items' development and acceptance consensus. METHODS: Twenty-four academic and clinical nursing experts from different parts of Nigeria participated in the Delphi rounds. In the first round, 96 items (structure - 31, process - 38, and outcome - 27) were distributed to the panellists through e-mail. The same method guided round 2. In round 3, the panellists reached a consensus on the number and structure of the items. RESULTS: In round 1, the initial items were reduced to 75 that met the Delphi consensus. In round 2, the items were modified further and reduced to 74. In round 3, the experts reached a consensus on 70 items (structure - 28, process - 32, and outcome - 10).

Economic burden of moderate to severe burns and its association with health-related quality of life of Nigerian women.

BACKGROUND: Burns cases are frequent in Nigeria hospitals, however, literature on its economic burden and the association with health-related quality of life (HRQOL) of women in Nigeria is scarce. This study determined the burden of hospitalization after burns on women's economic status and its associated HRQOL. METHODS: This was a three-month cross-sectional study of female patients ≥ 25 years, treated of mixed or full thickness burns in four teaching hospitals in south-east Nigeria, discharged between September-November, 2018. Study instruments were participants' case notes for socio-demographic and disease history, interviewer-administered questionnaires, namely-economic-burden-of-burns questionnaire and English version of the EuroQol Five-Dimensions-Three-Level Health Questionnaire for Nigeria. Data were collected on second- or third-day post-discharge through home visits or phone calls. This lasted for 13 weeks. RESULTS: A total of seventy-three female patients with burn were successfully enrolled. Most participants were married, fairly educated, mainly traders or housewives. Thirty-four (46.6%) had subjective estimated family monthly income below NGN 50,000 (low economic status). Participants' average monthly income reduced drastically after hospitalization. Their average family monthly income was NGN110,439 (USD307), while their average total expenses incurred during hospitalization was NGN691,093 (USD1,920). Almost all (93.2%) had at least one surgical intervention during management. Their average length of hospital stay was 35.4 days; eleven consequently lost their job. Many had moderate to severe economic burden of treatment; only eleven could bear all the treatment expenses independently. Anxiety/depression and pain/discomfort were common problems reported, However, these Euroqol dimensions varied according to their SES, education and occupation. Women in the low economic class were more inclined to poor HRQOL (Mean ± SD VAS = 53.33 ± 17.619) than women in high economic class (Mean ± SD VAS = 76.67 ± 21.794). CONCLUSION: Burns places high level of economic burden on women and unfortunately, Nigerian government's commitment to healthcare of burns patients is low. The long course of hospitalization and economic depletion impact negatively on the women's HRQOL. Based on these findings, we recommend that government parastatals create special trust fund for burns treatment and the National Health Insurance Scheme be restructured for more accessibility.