Breast cancer awareness: survey of participants at annual walk in Kigali

Background: Breast cancer is the leading cause of cancer death in low-income countries and the second leading cause in high-income countries. Most women in sub-Saharan Africa are diagnosed later, with limited access to timely and effective treatment.Objectives: The main objective was to identify the awareness of breast cancer warning signs among participants attending the 2016 Breast Cancer Awareness Walk.Methods: A cross-sectional study of 93 participants was conducted after the Annual Breast Cancer Awareness Walk in Kigali on 23 October 2016. Participants, 15 years or older, completed the survey. Data were analyzed using descriptive statistics and Chi-square test.Results: The breast cancer warning sign “breast lump” was identified by over half of the women (54%) and many men (41%), though the majority (70%) did not know that the lump could be painless. The majority of participants were unaware of the many other breast cancer signs, and that the risk increases with age. Threepotential barriers to delay seeking healthcare for a serious breast problem included lack of insurance or money to pay, difficulty to make appointment with doctor, and fear of removal of breast.Conclusion: Increased public awareness and early detection is imperative to help reduce the morbidity and mortality related to breast cancer in Rwandan women and men.Keywords: Breast cancer awareness, warning signs, age-related risk, breast checking, delays to care, sub-Saharan Africa, women’s healt

Anxiety and depression among cancer patients: prevalence and associated factors at a Rwandan referral hospital

Background: Cancer patients frequently experience psychological problems related to reactions of cancer diagnosis, cancer type, treatment effects, recurrence, fear of end-of-life, survivorship, and financial burden. Psychological assessment has been integrated into cancer care in some countries, but there is limited knowledge about the practice in Rwanda.Objective: To assess the prevalence and associated factors of anxiety and depression among patients with cancer attending a private referral hospital in Rwanda.Methods: A descriptive cross-sectional study design was used with the Hospital Anxiety and Depression Scale (HADS) instrument to assess cancer patients. A probability systematic random sampling technique was used to recruit 96 patients. Data were analysed using descriptive statistics to determine the association of variables with anxiety and depression.Results: The majority of cancer patients had depression (67.7%) and anxiety (52.1%). Anxiety was associated with employment status (p=0.02), cancer stage (p=0.02), weight loss (p=0.00) and depression (p=0.00). Depression was associated with cancer stage (p=0.02), pain (p=0.03), weight loss (p= 0.03), cancer treatment (p=0.02) and anxiety (p=0.001).Conclusion: Anxiety and depression were reported in over half of the study population indicating a need to create and integrate psycho-oncology into standard oncology care.Keywords: Cancer, anxiety, depression, prevalence, associated factor

Perceived effects of burnout on patients and its management among nurses in the Intensive Care Unit and Emergency Department of a Rwandan University Teaching Hospital

Background: The level of burnout among nurses working in the Intensive Care Unit (ICU) and Emergency Department (ED) is high, which adversely affects health and work-related outcomes for both nurses and patients. Little is known about burnout among ICU and ED nurses in Rwanda.Objective: To explore the perceived effects of burnout among nurses and its management at a referral hospital in Rwanda.Methods: A qualitative study design was carried out using focus groups. A purposive sample of six ICU and six ED nurses were recruited from the referral hospital in the capital city of Kigali. The discussions were audio-recorded in Kinyarwanda, transcribed verbatim into English and analysed inductively using thematic analysis.Results: Burnout among the 12 nurses was high and the five main themes namely, high burnout, the Variability of care, Incomplete care, Erratic care and Improving situation to prevent burnout.Conclusion: The results of this study indicated that burnout is high between the ICU and ED study population and nurses need to be taken care of too. A good working environment addressing adequate staffing, specialty training, operational materials, and social activities are needed to improve unit functioning, and patient satisfaction and safety.Keywords: Burnout, nurses, Intensive Care Unit, emergency department, patient car

Burnout among nurses working in critical care settings: a case of a selected tertiary hospital in Rwanda

Background: Intensive Care Unit (ICU) and Emergency Department are more stressful areas therefore nurses in those areas are prone to high level of burnout than others. In Rwanda, studies on burnout among nurses are limited and there is no research targeting specifically nurses working in ICU and Emergency Department. Therefore, this study aimed to determine the level of burnout among nurses working in ICU and Emergency Department in a selected referral hospital of Kigali.Methods: A quantitative approach was adopted. The descriptive cross-sectional design was used. Sixty nurses were involved in the study and they were selected using a total population sampling strategy. A self-administered questionnaire and Maslach Burnout Inventory Human Service Survey were used to collect data. Data were analysed using SPSS version 21.0.Results: The study found high level of burnout among 61.7% of the participants under study. High workload and intention to leave were associated with burnout (P<0.05). Burnout was measured by high Emotional Exhaustion (EE) 29 (48.3%), high Depersonalization (DP) 15 (25%) and low Personal Accomplishment (PA) 30 (50%).Conclusions: The high level of burnout identified among ICU and emergency department nurses is mainly associated with high workload and intention to leave the work within the next 12 months

Roles and activities of nurses in cancer prevention and early detection in low- and middle-income countries: A scoping review

Objective: Nurses play a crucial role in cancer control. Prior reviews presented the effectiveness of nursing interventions such as tobacco cessation counseling and cervical cancer screening but did not focus on low- and middle-income countries (LMICs). This scoping review addresses a gap in the literature by describing the roles and activities of nurses in cancer prevention and early detection in LMICs. Methods: Following Arksey and O'Malley's scoping review framework, we searched seven databases using subject headings and keywords from 1990 to January 2021 and updated in April 2022. The reference lists of relevant studies were also searched. Two reviewers independently screened the relevance of studies through Rayyan, assessed full text articles, and extracted data using a Google Form. Conflicts were resolved by a third reviewer. Results: A total of 180 studies were included, representing all six World Health Organization regions and 48 LMICs. The largest number of studies were from the African region (n ​= ​72), the Americas (n ​= ​49), and South-East Asia region (n ​= ​29). The main nursing roles featured were patient/community education (n ​= ​113), history taking and cancer risk assessment (n ​= ​63), performing screening exams (n ​= ​136), care coordination (n ​= ​57), and training other healthcare professionals (n ​= ​9). Conclusions: This scoping review provides a comprehensive picture of nurses’ role in cancer prevention and early detection in LMICs, across all six World Health Organization regions. Additional cancer workforce data sources at the country level are needed to fully understand the activities of nurses in cancer prevention. Future research is also needed to measure the impact of nursing educational and other interventions in both primary and secondary cancer prevention