Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

<p>Abstract</p> <p>Background</p> <p>The use of Complementary and Alternative Medicine (CAM) by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E), Nigeria</p> <p>Method</p> <p>Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005.</p> <p>Results</p> <p>160 patients were interviewed; 68 (42.5%) were males and 94 (57.5%) were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0%) have used CAM at some time during their current cancer illness; 56 (35.0%) patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%), faith/prayer healing (49.4%), aloe vera (23.1%), Forever Living Products (16.3%), medicinal tea (14.4%), and Blackstone (12.5%). Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3%) did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8%) will not repeat CAM or recommend its use for cancer. The majority of patients (55.8%) did not mention their use of CAM to their doctors – mostly because the doctor did not ask.</p> <p>Conclusion</p> <p>CAM use is common among cancer patients in Nigeria. Most users do not obtain the expected benefits, and adverse events are not uncommon. Every clinician in the field of oncology should ask his/her patients about the use of CAM; this knowledge will enable them to better counsel the patients.</p

NURSES’ KNOWLEDGE OF GLASGOW COMA SCALE IN NEUROLOGICAL ASSESSMENT OF PATIENTS IN A SELECTED TERTIARY HOSPITAL IN EDO STATE, NIGERIA

Glasgow Coma Scale (GCS) is a reliable and objective neurological assessment tool used for assessing and recording the level of a person’s conscious state. An assessment of consciousness levels is considered a primary action of doctors and nurses who care for patients with neurological or neurosurgical problems. This study assessed the knowledge of Glasgow coma scale in neurological assessment of patients among nurses working in a tertiary hospital, in Edo state, Nigeria. A descriptive survey design was used. The respondents were all nurses (226) working in wards/units where unconscious patients are nursed. The instrument for data collection was the pre-tested and administered questionnaire developed by the researchers. Data collected were analysed in proportions and percentages and means; and inferential statistics were used for test of hypotheses at P ≤0.05 level of significance. Result showed that 41.7% of respondents had good, 25.2% moderate and 33.0% had poor knowledge of the GCS. Respondents scored highly (&gt;75%) on knowledge questions eliciting purpose, components, and the behavioural rating scores of GCS domains, but poor (&lt;36%) to moderate (&lt;67%) on questions that concern clinical application of results and GCS use in special situations. Significant differences were found in the GCS knowledge of the nurses across the various wards/units (p= 0.000) with neurological ward nurses having the highest (31.8%) score. There were no significant associations (P&gt; 0.05) between nurses’ age, gender, educational level, years of experience, and GCS knowledge. Continuous professional development and update training for nurses on GCS were recommended

Clinical nurses knowledge, skills and learning needs about glasgow coma scale for neurological patients’ assessment in tertiary hospitals in Edo state, Nigeria: A mixed method study

Background: The Glasgow Coma Scale (GCS) is a nurse’s/physician’s clinical tool for assessing patients’ level of consciousness. Evidence suggests that nurses’ show poor integration of GCS knowledge into clinical practice. GCS knowledge and use among nurses in Nigeria has been under studied. Aim: This study assessed the knowledge, skills, and learning needs of clinical nurses in using the GCS for neurological patients’ assessment. Method: A convergent parallel mixed methods design was adopted. Quantitatively, 212 nurses working in purposively selected hospitals/wards/units were surveyed using a structured questionnaire and observational checklist; while qualitatively, using explorative descriptive design, an in-depth interview of 20 purposively selected nurse managers using an interview guide was conducted. Quantitative data were analysed using descriptive statistics and t-test at 5% level of significance. Qualitative data were content analysed using thematic approach following Creswell’s steps. Result: Most of the respondents had poor knowledge (169 = 79.71%) of the GCS, and demonstrated a poor level of skills (205 = 96.69%) with no significant differences between institutions in knowledge and skills (p greater than 0.05). Qualitatively, two major themes emerged with five subthemes: 1. Nurses reported negative experiences with neurological patients’ assessment (Lack basic knowledge, wrong interpretation/application of GCS skills, and non-usage of GCS in practice), and 2. Nurses identified learning needs (a. challenges in using GCS, and b; proffered solutions). Conclusion: With poor GCS knowledge and skills established in this mixed method study, there is need to develop and implement a self-instructional educational package embodying theoretical and practical demonstrations of GCS knowledge and skills for nurses’ use in clinical patient assessment

Health-related Quality of Life (HRQOL) of Patients with Type 2 Diabetes Mellitus and People without Diabetes at a Tertiary Hospital in Port-Harcourt, Rivers State, Nigeria

Background: Health-related quality of life (HRQOL), a patient-sensitive outcome globally, has become the clinician’s primary goal of care. Evidence suggests that diabetes mellitus (DM) and its treatment/care impair patients’ HRQOL, which varies depending on the patient population/factors. Diabetics’ HRQOL in South-South Nigeria is largely unknown. Objectives: This study assessed and compared the HRQOL of patients with type 2 diabetes attending the outpatient diabetic clinic at a tertiary hospital in Port-Harcourt, Rivers State, South-South Nigeria with age-/gender-matched nondiabetics living within the same environment. Materials and Methods: This descriptive cross-sectional comparative study recruited 200 respondents, respectively those with type 2 diabetes (cases) and nondiabetics (controls). Data were collected by using the World Health Organization Quality of Life–BREF (WHOQOL-BREF) questionnaire and analyzed by using descriptive and inferential statistics at P≤ 0.05 level of significance. Results: The two groups (200 each) had no significant differences (P = 0.35 - P = 0.98) in terms of their demographic variables. The diabetic group's mean scores were significantly (P = 0.00) lower than that of the non-diabetics in terms of WHOQOL-BREF overall, health satisfaction, physical, psychological, and social domains. Diabetics with tertiary education (58%) had a significantly higher mean score (P = 0.012) in terms of overall WHOQOL-BREF than those with secondary and primary education (42%). Ninety-two patients (46%) with diabetes had comorbidities that increased significantly with age (P = 0.00) and expressed less satisfaction with their health (P = 0.04). Conclusion: Patients with diabetes had lower HRQOL scores than nondiabetics, implying the negative impact of diabetes and its treatment/care on their life. Diabetics’ HRQOL should be routinely evaluated and enhanced by empowering diabetic self-care activities that aid diabetes control and retard complications