Strategies used by Kenyan patients on maintenance haemodialysis for coping with stress related to intradialytic events

Background: Patients on haemodialysis experience various challenges associated with their disease as well as complications related to therapy. Intradialytic events, such as cramping, hypotension and shivering, are major stressors for persons on haemodialysis. In an attempt to cope with stress associated with dialysis, most patients tend to adopt emotion-orientated coping strategies. This study aimed at evaluating the coping strategies used by patients at Kenyatta National Hospital, to deal with stress related to intradialytic events. Methods: A cross-sectional study was conducted among 96 participants undergoing maintenance haemodialysis. They were selected through convenience sampling. Data were collected using a researcher-administered questionnaire for demographic data, a visual analogue scale to assess stress, and the Jaloweic coping scale. Data were analysed using SPSS version 23. Results: The majority (62%) of the participants were male. Muscle cramps (55%), headaches (54%) and hypertension (47%) were the most commonly experienced intradialytic events. The mean level of stress on the Jaloweic scale was 5.1 ± 2.1. The commonly used coping strategies were confrontational (45%), fatalistic (46%) and supportive (48%). The level of stress explained 66% of the variance associated with the use of a coping style (P = 0.01). Conclusions: Intradialytic events were common among our participants and the majority used confrontational, fatalistic and supportive coping strategies. Tailored counselling services are recommended to reinforce effective coping

Rethinking the Design of Low-Cost Point-of-Care Diagnostic Devices

Reducing the global diseases burden requires effective diagnosis and treatment. In the developing world, accurate diagnosis can be the most expensive and time-consuming aspect of health care. Healthcare cost can, however, be reduced by use of affordable rapid diagnostic tests (RDTs). In the developed world, low-cost RDTs are being developed in many research laboratories; however, they are not being equally adopted in the developing countries. This disconnect points to a gap in the design philosophy, where parameterization of design variables ignores the most critical component of the system, the point-of-use stakeholders (e.g., doctors, nurses and patients). Herein, we demonstrated that a general focus on reducing cost (i.e., “low-cost”), rather than efficiency and reliability is misguided by the assumption that poverty reduces the value individuals place on their well-being. A case study of clinicians in Kenya showed that “zero-cost” is a low-weight parameter for point-of-use stakeholders, while reliability and standardization are crucial. We therefore argue that a user-driven, value-addition systems-engineering approach is needed for the design of RDTs to enhance adoption and translation into the field

The Association of Physical Activity and Diet with Metabolic Syndrome among University Students in Kenya

The occurrence of these lifestyle related practices and dietary habits at early age has been shown to increase the predisposition towards metabolic syndrome. Metabolic syndrome refers to disorders occurring together resulting in an increase in the risk of diabetes and cardiovascular diseases. Prevalence rate was established at 1.9% indicative of occurrence of predisposing risks of metabolic syndrome in university students. A cross-sectional, quantitative research design was used. 323 participants were sampled from a population of 40,000 students with stratification according to the various school sizes. A self-administered questionnaire was used to collect data. 61.3% of the respondents did not exercise regularly, 72.3% snacked frequently, 60.6% of the subjects that were not diagnosed with metabolic syndrome were fit, 37.2% needed to work on their fitness while only 2.2% were out of shape. The relationship between sedentary lifestyle as a risk factor and metabolic syndrome was statistically significant, as was the relationship between dietary habits and metabolic syndrome. The study established that 85.4% of the subjects were not sure of the amount of calories they consumed in a day and 13.9% of the subjects reported they had weight issues that affected their academics. Modifications in lifestyle habits, physical activity and dietary composition can result in a positive impact on metabolic syndrome and its progression. A mandatory extra co-curricular program requiring students to participate in exercise and sports activities should be enforced to positively engage university students. Vulnerable groups such as the pre-hypertensive and obese should also be closely monitored

Physiological Basis of Empathy and Emotionality in Nursing Practice

Empathy is a form of connection with a cognitive emotive response that stems from the apprehension of another person’s emotional and physical state of distress. The physiological context of empathy as related to emotionality and related behavior in nursing is a motivating challenge into adventures of high order mental functions. Since our responses are coordinated in the brain, understanding different contexts and processes complete the cycles of initiation, coordination, and memory is essential. The theoretical basis of Emotional Intelligence and Self Determinism for emotionality and empathy related behavior are applied. The pursuit of empathy as a centrally vital competence in healthcare is an interesting discovery and its regulation is a beautiful process. A conceptualized relationship model isillustrated to manifest a candid relationship between and among emotionality and empathy related behavior in nursing. Empathy builds on a likened emotional believe that humans have the capacity to demonstrate empathy or portray empathy related behavior to self and other people. Emotions and emotionality rule our daily lives. We choose activities and hobbies based on the emotions they incite in us. We make decisions based on whether we are happy, angry, sad, bored, or frustrated. The decisions we make impact to us and to others in a considerable emotional measure. Empathizing means we leave our comfort zones and delve into our clients’ phenomena and socialize with them within their imaginary and actual realms. This zone is almost always vulnerable for nurses

Effect of a community-based approach of iron and folic acid supplementation on compliance by pregnant women in Kiambu County, Kenya: A quasi-experimental study.

IntroductionIron and Folic Acid Supplementation (IFAS) is an essential and affordable intervention strategy for prevention of anaemia during pregnancy. The supplements are currently provided for free to pregnant women in Kenya during antenatal care (ANC), but compliance remains low over the years. There is need for diversification of IFAS programme implementation by exploring other distribution channels to complement existing antenatal distribution and ensure consistent access to IFAS supplements.ObjectivesTo determine the effect of a community-based approach of IFAS distribution on compliance and assess side-effects experienced and their mitigation by pregnant women in Kiambu County.MethodologyA pretest-posttest quasi-experimental study design was used, consisting of an intervention and a control group, among 340 pregnant women 15-49 years, in five health facilities in Lari Sub-County in Kiambu County, between June 2016 and March 2017. Community health volunteers provided IFAS supplements, counselling and weekly follow-up to pregnant women in the intervention group while the control group followed standard practice from health facilities. Baseline and endline data were collected during antenatal care and compared. Quantitative data was analyzed using STATA version 14. Analysis of effect of intervention was done using Difference-In-Difference regression approach.ResultsLevels of compliance increased by 8% in intervention group and 6% in control group. There was increased awareness of IFAS side-effects across groups. The intervention group reported experiencing less side-effects and were better able to manage them compared to the control group.ConclusionImplementation a community-based approach improved maternal compliance with IFAS, awareness of IFAS side effects and their management, with better improvement being recorded in the intervention group. Hence, there is need to integrate community-based approach with antenatal distribution of IFAS to improve supplementation

Rethinking the Design of Low-Cost Point-of-Care Diagnostic Devices

Reducing the global diseases burden requires effective diagnosis and treatment. In the developing world, accurate diagnosis can be the most expensive and time-consuming aspect of health care. Healthcare cost can, however, be reduced by use of affordable rapid diagnostic tests (RDTs). In the developed world, low-cost RDTs are being developed in many research laboratories; however, they are not being equally adopted in the developing countries. This disconnect points to a gap in the design philosophy, where parameterization of design variables ignores the most critical component of the system, the point-of-use stakeholders (e.g., doctors, nurses and patients). Herein, we demonstrated that a general focus on reducing cost (i.e., “low-cost”), rather than efficiency and reliability is misguided by the assumption that poverty reduces the value individuals place on their well-being. A case study of clinicians in Kenya showed that “zero-cost” is a low-weight parameter for point-of-use stakeholders, while reliability and standardization are crucial. We therefore argue that a user-driven, value-addition systems-engineering approach is needed for the design of RDTs to enhance adoption and translation into the field.This article is published as F. W. Kimani, S. M. Mwangi, B. J. Kwasa, A. M. Kusow, B. K. Ngugi, J. Chen, X. Liu, R. Cademartiri, and M. M. Thuo “Rethinking the Design of Low-Cost Point-Of-Care Diagnostic Devices” Micromachines 2017, 8(11), 317; DOI: 10.3390/mi8110317. Posted with permission.</p