Relationship between family support and quality of life of type-2 diabetes mellitus patients attending family medicine clinic, federal medical centre, Ido–Ekiti.

Background: Diabetes mellitus is a chronic disease with increase morbidity and mortality. It could be associated with significant adverse outcomes including poor quality of life. In Sub-Saharan Africa, Nigeria has a large share of the morbidity and mortality of DM. Several factors have been found to be associated with better quality of life among diabetes mellitus (DM) patients. There is a dearth of local research work on the relationship of family support and quality of life of this group of patients.Objective: This study sought to determine the relationship between family support and quality of life of type 2 diabetes mellitus patients attending family medicine clinic, Federal Medical Centre, Ido-Ekiti, Ekiti State, Nigeria.Materials and Methods: A cross-sectional study of 250 adult patients with type 2 diabetes mellitus was carried out over twenty (20) weeks. Respondents' family support was measured using Perceived Social Support – Family Scale {PSS- Fa}, while their quality of life was measured using the short version of the World Health Organization quality of life assessment tool (WHOQOL-BREF).Results: The level of family support was significantly associated with quality of life at p-value less than 0.001. Majority [n = 104 (59.8%)] of the respondents who reported having strong family support had fair quality of life. Also, a significant percentage (85.7%) of all respondents who had good quality of life were found to have strong family support. The converse was true of respondents with poor quality of life as only 5(10.4%) of them reported having strong family support. Also, majority [n = 33 (68.8%)] of respondents with poor quality of life reported having weak family support. Strong family support was an independent predictor of good quality of life among study participants. Respondents with strong family support were 14 times more likely to have good quality of life than those with no family support.Conclusion: Good family support positively correlated with better quality of life of respondents. Hence, Family Physicians should utilise this resource by advocating for an active involvement of family members in management plans of DM patients to enhance their quality of life

Prevalence of Home Based Blood Pressure Measurement and Its Relationship with Hypertension Control among Patients Seen at a Family Practice Clinic in Nigeria

Background: Hypertension remains a major non-communicable disease with numerous complications when poorly managed. Presently, there is a growing emphasis on home blood pressure measurement (HBPM) particularly in the developed world. There is a dearth of local literature on the relevance of HBPM in hypertension management and it is not routinely prescribed for hypertensive patients in our practice population. This study was conducted to determine HBPM prevalence and its association with hypertension control.Methods: A cross-sectional study was conducted among 209 respondents at the general outpatient clinic of a tertiary hospital in Nigeria. Demographic characteristics and blood pressure readings were obtained. HBPM was assessed using an intervieweradministered structured questionnaire.Results: The prevalence of HBPM among the 209 respondents was 51(24.4%); 42(82.35%) of respondents who did HBPM achieved optimal BP control as opposed to 81(51.27%) of no HBPM respondents. In addition, HBPM was significantly associated with optimal BP control (p = 0.016) and was an independent predictor of optimal BP control as an outcome.Conclusion: The prevalence of HBPM is low in our practice setting. HMBP is significantly associated with optimal hypertension control. Hence, it should be a routine recommendation for hypertensive patients Key words: Home based blood pressure monitoring, Hypertension, Control, Prevalence, Relationshi

Motivational interviewing: Exploring its relevance for improving family medicine trainees' motivation in Sub-Saharan Africa

The need for scaling up training to attain a critical mass of family physicians in Africa was affirmed in 2012 by participants at the African Regional Conference of the World Organization of Family Doctors (WONCA) and at the workshop organised by the Primary Health Care and Family Medicine Education (PRIMAFAMED) Network. Significant progress has been made regarding this. However, trainers often encounter postgraduate trainees who show ambivalence towards completing their training. This has impacted on the number of those who complete their training, and on the goal of achieving a sufficient number of family physicians needed in the region. Motivational Interviewing has been used in clinical and academic settings to address issues that require behavioural change. The principles can be adopted by family medicine trainers in sub-Saharan Africa to resolve trainees' ambivalence towards their training, improve motivation towards completion of their postgraduate training and their intention to practice within the region. Keywords: Motivational Interviewing, Postgraduate Family Medicine Trainees, Ambivalence, sub -Saharan Afric

Exploring gaps, strategies and solutions for primary care research mentorship in the African context: A workshop report

BACKGROUND: Primary care needs research to generate evidence relevant to community needs; however, there is a lack of research engagement among primary care physicians, especially in sub-Saharan Africa. Improved research mentorship for family physicians (FPs) can help address prevailing knowledge and practice gaps in primary care research.Workshop process: During the 6th annual Africa Regional Conference of the World Organization of Family Doctors (WONCA), we conducted three workshops on research mentorship for African FPs. Two workshops (one online and one onsite at the pre-conference) were geared towards the young doctors' movement of WONCA Africa. The third was onsite during the main conference. Following a brief presentation on the concept of research mentorship and known gaps, participants broke into small groups and discussed additional gaps, solutions and anticipated readiness for implementing these solutions. We used a content analysis to summarise key concepts and had participants to review the findings.Workshop findings: Identified gaps related to mentees' difficulty initiating and maintaining mentorship relationships and an overall shortage of capable and willing mentors. Organisational solutions focused on capacity building and creating a culture of mentorship. Interpersonal solutions focused on reducing the power distance and increasing reflectivity and feedback. Increasing the use of research networks and both peer and online mentorship were advocated. Barriers to readiness included resource constraints and competing priorities. CONCLUSION: A multi-level approach is needed to address the gaps in research mentorship for African FPs. Identified solutions hold potential for supporting the research engagement needed to improve the population health across Africa

Implementation of online research training and mentorship for sub-saharan african family physicians

Background: To improve the delivery and reach of primary health care, a robust scientific foundation driven by research is needed. However, few family physicians conduct research, especially in sub-Saharan Africa. Early-career and trainee family physicians are a key part of the primary care research pipeline and have an expressed need for research training and mentorship. Objective: AfriWon Research Collaborative (ARC) was an online research training and mentorship pilot program whose objective was to increase research activity among participants from AfriWon Renaissance, the family physician young doctors’ movement of sub-Saharan Africa. Methods: ARC utilized a 10-module online curriculum, supported by peer and faculty e-mentorship, to guide participants through writing a research protocol. The feasibility, acceptability, and scalability of this program was evaluated via a mixed-methods RE-AIM-guided process evaluation using descriptive statistics and inductive/deductive thematic analysis. Findings: The pilot reached participants from Botswana, Democratic Republic of the Congo, Ghana, Nigeria and Sierra Leone and was adopted by mentors from 11 countries across three continents. Four of the 10 pilot participants completed a full research protocol by the end of the six-month core program. Seven out of the 10 participants, and nine out of the 15 mentors, planned to continue their mentorship relationships beyond the core program. The program helped instill a positive research culture in active participants. Some participants’ and mentors’ engagement with the ARC program was limited by confusion over mentorship structure and role, poor network connectivity, and personal life challenges. Conclusions: Online research training and mentorship for trainee and early-career family physicians in sub-Saharan Africa is feasible and acceptable to participants and mentors. Similar programs must pay careful attention to mentorship training and provide a flexible yet clearly organized structure for mentee-mentor engagement. Additional work is needed to determine optimal implementation strategies and ability to scale