Barriers to the effective treatment and prevention of malaria in Africa: A systematic review of qualitative studies

<p>Abstract</p> <p>Background</p> <p>In Africa, an estimated 300-500 million cases of malaria occur each year resulting in approximately 1 million deaths. More than 90% of these are in children under 5 years of age. To identify commonly held beliefs about malaria that might present barriers to its successful treatment and prevention, we conducted a systematic review of qualitative studies examining beliefs and practices concerning malaria in sub-Saharan African countries.</p> <p>Methods</p> <p>We searched Medline and Scopus (1966-2009) and identified 39 studies that employed qualitative methods (focus groups and interviews) to examine the knowledge, attitudes, and practices of people living in African countries where malaria is endemic. Data were extracted relating to study characteristics, and themes pertaining to barriers to malaria treatment and prevention.</p> <p>Results</p> <p>The majority of studies were conducted in rural areas, and focused mostly or entirely on children. Major barriers to prevention reported included a lack of understanding of the cause and transmission of malaria (29/39), the belief that malaria cannot be prevented (7/39), and the use of ineffective prevention measures (12/39). Thirty-seven of 39 articles identified barriers to malaria treatment, including concerns about the safety and efficacy of conventional medicines (15/39), logistical obstacles, and reliance on traditional remedies. Specific barriers to the treatment of childhood malaria identified included the belief that a child with convulsions could die if given an injection or taken to hospital (10/39).</p> <p>Conclusion</p> <p>These findings suggest that large-scale malaria prevention and treatment programs must account for the social and cultural contexts in which they are deployed. Further quantitative research should be undertaken to more precisely measure the impact of the themes uncovered by this exploratory analysis.</p

An exploration into suicide prevention initiatives for mental health nurses: A systematic literature review

Mental health and suicide prevention are national health priorities in Australia, with research currently focussed towards the ZERO Suicide (ZS) initiative. The aim of this review was to evaluate the impact of suicide prevention programmes, in particular the ZS prevention initiative. A systematic review using the PRISMA guidelines was conducted using six EBSCO Host databases; Academic Search Complete, Australian/New Zealand Reference Centre, CINAHL Complete, MEDLINE, APA PsycINFO, and APA Psyc Articles. The data extracted from the eligible papers were analysed using a thematic approach. The final data set consisted of fourteen (n = 14) peer-reviewed articles meeting the eligibility criteria, which included quantitative (n = 10), mixed methods (n = 2), and qualitative studies (n = 2). Results indicated variances between suicide prevention programmes with some papers examining single workshops and others assessing multimodal, organizational interventions. Five major themes were produced from this review including measuring the success of suicide prevention programmes, improvements to the delivery of suicide prevention programmes, barriers to implementing changes, cultural considerations, and further research required for suicide prevention programmes. This review concludes that further long-term research is required to evaluate the implementation and efficacy of suicide prevention programmes in health care. Cultural awareness in suicide prevention training is another area that may benefit from further research. A growing body of evidence establishes the need for multimodal and organizational approaches for suicide prevention initiatives. © 2021 John Wiley & Sons Australia, Lt

Nurse‐led integration of palliative care for chronic obstructive pulmonary disease: An integrative literature review

Aims and objectives: To uncover what is known about nurse-led models or interventions that have integrated palliative care into the care of patients with chronic obstructive pulmonary disease. Background: Chronic obstructive pulmonary disease is a highly symptomatic, incurable disease characterised by chronic symptoms that without appropriate palliation can lead to unnecessary suffering for patients and their caregivers. While palliative care practices can relieve suffering and improve quality of life, most palliative models of care remain cancer-focused. New models, including nurse-led care that integrates palliative care for patients with chronic obstructive pulmonary disease, could address patient suffering and therefore need to be explored. Method: A mixed-studies integrative review was undertaken. Seven databases were searched for articles published between 2008–2018. The PRISMA framework was applied to the search, and six studies met the review eligibility criteria. Content analysis of the articles was undertaken, and data were compared, looking for different nurse-led models and outcomes related to palliative care in chronic obstructive pulmonary disease. Results: Nurse-led, integrated palliative care models for patients with chronic obstructive pulmonary disease are rare and just four of the six articles found in this review had published results. Advance care planning was found to be the most common focus for nurse-led interventions in chronic obstructive pulmonary disease, and in all cases, results demonstrated an improvement in end-of-life discussions and completion of advance care directives. Of the reviewed articles, none used a qualitative framework to explore nurse-led models that integrated palliative care in chronic obstructive pulmonary disease. Conclusion: While nurse-led advance care planning was one type of palliative care practice associated with positive patient outcomes, there is a need for deeper exploration of nurse-led models that holistically address the bio-psycho-social-spiritual needs of patients with chronic obstructive pulmonary disease, and their caregivers. Relevance to clinical practice: Integrating nurse-led supportive care clinics into chronic obstructive pulmonary disease services could be a way forward to address the unmet bio-psycho-social-spiritual needs of patients with chronic obstructive pulmonary disease, and their caregivers