Effective communication with people with learning disabilities with epilepsy and their carers.

People with learning disabilities constitute about 2% of the general population. Epilepsy is more prevalent among people with learning disabilities compared with the general population. Effective communication is central to the management of people with learning disabilities and epilepsy. It has both therapeutic and health promotion functions including psycho-social benefits to the individual and their carers. Carers play vital roles in supporting individuals who live in the community to manage their conditions and the need for effective communication between service users and health care professionals is crucially important. Effective communication may not only lead to improved quality of life but may reduce mortality through the promotion of better understanding of seizures and encouraging efficient use of medication. Despite this communication regarding community-based adults with mild learning disabilities has not been fully studied, in particular the service users views and experiences regarding communication has been a neglected area. Yet, the service users views may be the best source for the definition of effective communication. This study was triggered by the paucity of research that investigated service users views and experiences regarding communication. Furthermore, numerous health policies have been formulated that emphasise the involvement of patients as consumers in the provision and delivery of health services. This study is purported to bridge this communication gap by offering service users a rare opportunity for them to express their views and experiences regarding communication to inform health policies and clinical practice. This study adopts a naturalistic qualitative approach and employs in-depth semi-structured interviews to solicit service users and their carers views and experiences regarding communication. The interviews also investigated service users and carers perspectives in regard to communication with health care professionals. Carer communication diaries were used to supplement the carers interview data and also to endorse the credibility of the study findings. Six main findings emerged from this study that described service users and carers views and experiences regarding communication: communication needs and expectations; engagement as a predictor of effective communication; strategies of communication; facilitating factors of communication; methods of communication; barriers to communication. This study suggests that effective communication with people with learning disabilities and epilepsy requires a reflective model that incorporates self-assessment and awareness of the individuals communication needs and expectations. The model and recommendations that emerged from this study may be a useful resource for health and social care professionals

Barriers to Communication: The Views of People with Learning Disabilities with Epilepsy and Their Careers

People with learning disabilities experienced more health inequalities compared with the general population. Under-diagnosis is common among people with learning disabilities leading to unmet health needs compared with the general population. Numerous communication barriers have been reported in the literature but little is known regarding people with epilepsy and learning disabilities. The presence of epilepsy may further compound the communication needs of people with learning disabilities. The study investigated communication barriers between people with epilepsy and learning disabilities and carers.Method: Exploratory qualitative approach was adopted. Pictures and photographs were used when necessary to facilitate and elicit responses from participants. The interviews were recorded with participant consent.Analysis: The recorded interviews were transcribed verbatim and analysed thematically (Miles and Huberman, 1994).Findings: Service users and carers reported a range of communication barriers. These included; Stigma, discrimination, lack of knowledge, impairments and lack of alternative augmentative communication methods Keywords: Communication, epilepsy, learning disabilities, carers, healthcare professionals

“I always find myself very tired and exhausted”: The physical impact of caring; a descriptive phenomenological study of the experiences of prostate cancer caregivers in Cape Coast, Ghana

Introduction: Prostate cancer is a significant public health burden and a significant cause of morbidity and mortality among men worldwide. This study, therefore, explored how caring affects the physical health of family caregivers of prostate cancer patients. Method: The study adopted a descriptive phenomenological method. Twelve participants were recruited using the purposive sampling technique. A semi-structured face to face, in-depth interviews were conducted with family caregivers of patients living with prostate cancer. The interviews were transcribed verbatim, and the data were analysed using Colaizzi’s phenomenological approach. Findings: The family caregiver’s experience with the physical impact associated with caregiving uncovered two significant themes with six sub-themes. “Rest and Sleep” emerged as the first central theme, with sleeplessness, fatigue, pain, and worsening pre-existing conditions as the sub-themes. The second main theme was ‘Nutrition’ with altered eating patterns and weight loss emerging as sub-themes. Conclusion: The study suggests that family caregivers of patients treated for prostate cancer may struggle with physical consequences associated with the caregiving role, which impacts their physical health. It is of great importance, especially for nurses, to come up with measures to minimise these adverse physical effects on the family caregivers through formal education programmes and training on how to care for these patients at home

Challenges encountered by family caregivers of prostate cancer patients in Cape Coast, Ghana: a descriptive phenomenological study

Background: In Ghana, prostate cancer is more prevalent than all other cancers, with a mortality rate of 75% partly due to late presentation to the health care facilities. Limited health services provision across the country and shortages of skilled nurses place a significant demand on family caregivers who are often ill-equipped for the caring role, resulting in many challenges. As they are expected to provide complex care at home with little resources, information, and support, the healthcare system rarely addresses the challenging needs of these family caregivers. This study explored the challenges encountered by family caregivers of people with prostate cancer. Methods: We conducted interviews using a descriptive phenomenological approach. Twelve family caregivers of prostate cancer patients were selected through a purposive sampling technique at the Cape Coast Teaching Hospital. All interviews were recorded, transcribed, and analysed using Colaizzi’s (1978) data analysis approach. Results: Three main themes were identified as critical challenges: education and training needs, resources and caregiver-nurse relationship issues. Under the three main themes emerged seven sub-themes that collectively hindered the family caregiver’s ability to meet the care demands. Sub-themes that emerged were; lack of preparedness towards the caring role, lack of knowledge about condition/ treatment, misconception about the condition, lack of accommodation facilities, financial constraints, poor communication, and poor staff attitude. Conclusion: Caregiving is associated with significant challenges that hinder the family caregiver’s ability to care for the patient effectively, further diminishing the caregiver’s quality of life and patient care. Therefore, healthcare professionals, especially nurses, should consider these challenges family caregivers face and take measures to obviate them through education, preparation and support

Ghanaian women's knowledge on whether malaria treatment is covered by the national health insurance: a multilevel regression analysis of national data

Background: To obviate malaria and other healthcare costs and enhance healthcare utilization, the government of Ghana introduced the National Health Insurance Scheme (NHIS) in 2005. Nonetheless, there is dearth of empirical evidence on Ghanaian women's knowledge about whether malaria treatment is covered by the NHIS or not. The current study, therefore, investigated factors associated with knowledge of malaria treatment with the NHIS among women aged 15-49 in Ghana. Methods: The study is a secondary analysis of data from women respondents in the 2014 Ghana Demographic and Health Survey. A total of 2,560 women participated in this study. Descriptive computation of the weighted proportion of women who knew that malaria is covered by NHIS was conducted at 95% confidence interval (CI). A multilevel logistic regression analyses was carried out with Stata's MLwinN package version 3.05. We declared significance at 5% alpha. Findings from the models were reported as adjusted odds ratios (aOR) and credible intervals (CrIs). Results: In all, 81.0% of Ghanaian women included in the study knew that NHIS covers malaria treatment. Women aged 45-49 had higher odds of knowing that NHIS covers malaria relative to those aged 15-19 age category [aOR=1.5;95%crl=1.2-2.1]. Women with higher education (post-secondary) had higher odds of knowing that NHIS covers malaria treatment compared with women who had no formal education [aOR=1.6;95%Crl=1.2-2.0]. Richest women were more likely to know that NHIS covers malaria treatment compared to the poorest women [aOR=1.3;95%Crl=1.2-1.7]. Women who had subscribed to the NHIS were more likely to report that NHIS covers malaria treatment [aOR=1.5;95%Crl=1.2-1.8]. The study revealed that the variance in the tendency for a woman to be aware that NHIS covers malaria treatment is attributable to 10.8% community level factors. Conclusion: This study has shown that individual, community and regional level factors affect women's knowledge on whether NHIS covers malaria treatment or not. As knowledge that malaria treatment is covered by NHIS may increase use of malaria prevention and treatment services in health facilities, we recommend that the Ghana Health Service intensifies community level education and awareness creation efforts, targeted at women among whom awareness levels are currently low

Psychological impact of COVID-19 on diabetes mellitus patients in Cape Coast, Ghana: a cross-sectional study

Introduction: COVID-19 pandemic has had a greater psychological impact on patients with chronic ailments such as diabetes mellitus, tuberculosis, and HIV/AIDS compared to those without chronic conditions. We explored the psychological impacts of COVID-19 among people living with diabetes mellitus in Ghana. Methods: this study employed a hospital-based cross-sectional design involving 157 diabetes mellitus patients aged 20 years and above. We assessed diabetes distress by the seventeen-item diabetes stress (DDS17) scale and COVID-19 worries by 3 specific benchmarks: “worry about overly affected due to diabetes if infected with COVID-19”, “worry about people with diabetes characterized as a risk group” and “worry about not able to manage diabetes if infected with COVID-19”. A close-ended questionnaire was used in data collection. Results: of 157 diabetic patients interviewed, the majority had type 2 diabetes mellitus with known complications and only 42.7% were managing COVID-19 symptoms. The participants showed moderate to high level of COVID-19 specific worry, moderate fear of isolation, and low level of diabetes-associated distress. About 33.8% of the study population expressed a sense of worry towards the pandemic. The logistic regression showed that age, employment status, and presence of other chronic diseases were significantly associated with worries about being overly affected if infected with COVID-19 due to their diabetes status. Age and sex were associated with worries about people with diabetes being characterized as a risk group and age, sex and employment status were associated with participants who were worried about not being able to manage diabetes if infected with COVID-19. Conclusion: the general trend indicates a sense of worry among diabetes patients during the COVID-19 pandemic which is associated with poorer psychological health. Clients' education and counseling on COVID-19 are necessary to address some of their concerns to minimize the level of anxiety and emotional stress in these individuals

A qualitative study of the communication and information needs of people with learning disabilities and epilepsy with physicians, nurses and carers

Abstract Background Living with a chronic condition such as epilepsy can have a debilitating effect on the individual and their carers. Managing epilepsy among people with learning disabilities may present a challenge because of limited communication and may require a multidisciplinary approach. The study investigated the communication and information needs of people with learning disabilities with epilepsy and their physicians, nurses and carers. Methods Qualitative designed was adopted to collect data from 15 community-based people with mild learning disabilities with epilepsy and 13 carers. Recorded data were transcribed verbatim and analysed thematically. Results A range of findings emerged related to patient communication and information needs. These included: Knowledge regarding epilepsy; involvement; honesty and openness when giving information and consistency in provision of information. Conclusion People with learning disabilities with epilepsy and their carers would like to know more about epilepsy, to be more involved decision makings through communication in the management of epilepsy to enable them feedback information regarding their health

Effective communication with people with learning disabilities with epilepsy and their carers

People with learning disabilities constitute about 2% of the general population. Epilepsy is more prevalent among people with learning disabilities compared with the general population. Effective communication is central to the management of people with learning disabilities and epilepsy. It has both therapeutic and health promotion functions including psycho-social benefits to the individual and their carers. Carers play vital roles in supporting individuals who live in the community to manage their conditions and the need for effective communication between service users and health care professionals is crucially important. Effective communication may not only lead to improved quality of life but may reduce mortality through the promotion of better understanding of seizures and encouraging efficient use of medication. Despite this communication regarding community-based adults with mild learning disabilities has not been fully studied, in particular the service users‘ views and experiences regarding communication has been a neglected area. Yet, the service users‘ views may be the best source for the definition of effective communication. This study was triggered by the paucity of research that investigated service users‘ views and experiences regarding communication. Furthermore, numerous health policies have been formulated that emphasise the involvement of patients as consumers in the provision and delivery of health services. This study is purported to bridge this communication gap by offering service users a rare opportunity for them to express their views and experiences regarding communication to inform health policies and clinical practice. This study adopts a naturalistic qualitative approach and employs in-depth semi-structured interviews to solicit service users‘ and their carers‘ views and experiences regarding communication. The interviews also investigated service users‘ and carers‘ perspectives in regard to communication with health care professionals‘. Carer communication diaries were used to supplement the carers‘ interview data and also to endorse the credibility of the study findings. Six main findings emerged from this study that described service users‘ and carers‘ views and experiences regarding communication: communication needs and expectations; ‗engagement‘ as a predictor of effective communication; strategies of communication; facilitating factors of communication; methods of communication; barriers to communication. This study suggests that effective communication with people with learning disabilities and epilepsy requires a reflective model that incorporates self-assessment and awareness of the individual‘s communication needs and expectations. The model and recommendations that emerged from this study may be a useful resource for health and social care professionals.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Qualitative Inquiry into Challenges Experienced by Registered General Nurses in the Emergency Department: A Study of Selected Hospitals in the Volta Region of Ghana

Registered General Nurses (RGNs) play crucial roles in emergency departments (EDs). EDs in Ghana are primarily staffed by RGNs who have had no additional formal education in emergency care. Additionally, basic, master’s, or doctoral level nursing education programs provide limited content on the complexities of emergency nursing. Nurses in EDs are affected by many challenges such as growing patient population, financial pressures, physical violence, verbal abuse, operational inefficiencies, overcrowding, and work overload. There is a paucity of research on challenges experienced by RGNs in EDs in the Volta Region of Ghana. In this qualitative study, twenty RGNs in EDs from three selected hospitals in the Volta Region of Ghana were interviewed. All recorded interviews were transcribed, reviewed several times by researchers and supervisors, and analyzed using content analysis. Five thematic categories were identified. These thematic categories of challenges were lack of preparation for ED role, verbal abuse from patients relatives, lack of resources in ED, stressful and time consuming nature of ED, and overcrowding in ED. Formal education of RGNs in the advanced role of emergency care, adequate supply of resources, increased hospital management support, and motivations for RGNs working in ED are necessary to improve the practice of emergency care