EXPLORATION OF ADOPTION OF HEALTH LIFESTYLE FOR SECONDARY PREVENTION OF NON COMMUNICABLE DISEASES (STROKE, DIABETES AND HYPERTENSION) AMONG CLIENTS AT MZUZU CENTRAL HOSPITAL MALAWI, 2013

Background: Noncommunicable diseases (NCDs) kill more than 36million people each year. Nearly 80% of NCD death (29 million) occurs inlow and middle income countries (WHO, 2010). In Malawi, NCDs accountfor at least 12% of total Disability Adjusted Life Years (WHO 2010) .Objective: The main objective was to explore adoption of healthy lifestylefor secondary prevention of stroke, diabetes and hypertension among clientsreceiving treatment at Mzuzu Central Hospital. Methods: A cross sectionalanalytical study design was used. Sixty three participants aged 18 years andabove were selected using a purposive sampling technique, who had all, ortwo or one of the following NCDs; stroke, diabetes or hypertension, andreceiving treatment at Mzuzu Central Hospital participated in the study. Aninterviewer administered questionnaires was used to collect data. Findings:The majority were females (74.6%; 47/63), and the median age of theparticipants was 60 years (Q1=51; Q3=65). Although most participantsfailed to define stroke, diabetes and hypertension (88.9%), failed to mentionthe recommended healthy lifestyle (65.1%) as regards its prevention and alsofailed to mention complications of NCDs (85.7%), the majority (85.7%)indicated to have received health education on NCDs. Furthermore, thefindings revealed that 71.4% did not perceive to be at risk of developingcomplications from their diagnosed condition despite the given healtheducation. Participant consumed fewer servings of fruits and vegetables per day, and did not practice healthy lifestyle in general. Conclusion: Healtheducation need to comprehensively cover interventions for prevention ofNCDs. Besides that, reinforcement of acquired knowledge on NCDs amongclient should be emphasized so as to increase the chances to adopt andpractice healthy lifestyle

Perceptions of nursing students trained in a new model teaching ward in Malawi

This study aimed to investigate the perceptions of nursing students trained in a new model teaching ward in Malawi. A total of 90students from five nursing colleges were randomly assigned to one model ward and two ordinary wards in a single teaching hospital. The students were administered a revised version of the Student Evaluation of Clinical Education Environment questionnaire. Significant differences among the three wards were found in all items in the communication/feedback subscale, with the exception of the item “nursing staff provided constructive feedback” (P=0.162). Within the learning opportunities subscale all items showed significant differences among the three wards, whereas 50% of the items in the learning support/assistance subscale had significantly different responses among the three wards. Within the department atmosphere subscale, no significant differences were found in the items assessing whether an adequate number and variety of patients were present in the ward (P=0.978). The strategies that are being implemented to improve the educational environment showed positive results. Students scored the model teaching ward highly. Students who underwent precepting in the model teaching wards reported having more learning opportunities and a positive learning environment

Enhancing nursing education via academic–clinical partnership: An integrative review

A competent nursing workforce is important for an effective healthcare system. However, concerns on the poor quality of nursing care and poor competencies among nursing students, nurses, and midwives are increasing in Malawi. Anecdotal notes from stakeholders show shortfalls in nursing education. Furthermore, a large gap between theory and practice exists. This study described the role of academic–clinical partnership in strengthening nursing education. A search of ScienceDirect, PubMed, Medline, and PsychINFO on EBCSOhost and Google Scholar was conducted using the following key words: academic–clinical collaboration, academic–clinical partnership, academic practitioner gap, and college hospital partnership or/and nursing. Furthermore, peer reviewed reports on academic–clinical partnership in nursing were included in the search. Thirty-three records from 2002 to 2016 were reviewed. Six themes emerged from the review: mutual and shared goals, evidence-based practice, resource sharing and collaboration, capacity building, partnership elements, and challenges of academic clinical partnership. The review highlighted that academic–practice partnerships promote shared goal development for the healthcare system. The gap between theory and practice is reduced by the sharing of expertise and by increasing evidence-based practice. Academic clinical partnership improves competencies among students and the safety and health outcomes of patients. The study concluded that the nursing education implemented within an academic clinical partnership becomes relevant to the needs and demands of the healthcare system

A middle-range model for improving quality of nursing education in Malawi

Background: Despite a global consensus that nurses and midwives constitute the majority and are a backbone of any country’s health workforce system, productive capacity of training institutions remains low and still needs more guidance. This study aimed at developing a middle-range model to guide efforts in nursing education improvements. Objective: To explore challenges facing nursing education in Malawi and to describe efforts that are being put in place to improve nursing education and the process of development of a model to improve nursing education in Malawi. Method: The study used a qualitative descriptive design. A panel discussion with eight nursing education and practice experts was conducted guided by core concepts derived from an analysis of research report from a national nursing education conference. Two focus group discussions during two quarterly review meetings engaged nurse educators, practitioners and clinical preceptors to fill gaps from data obtained from a panel discussion. A qualitative abductive analysis approach was used for the development of the model. Results: Transforming and scaling up of nursing education emerged as the main concept of the model with nursing education context, academic practice partnership, regulation, competent graduate and nursing workforce as sub concepts. Key main strategies in the model included curriculum reforms, regulation, transformative learning, provision of infrastructure and resources and capacity building. Conclusion: The model can be used to prioritise nursing education intervention aimed at improving quality of nursing education in Malawi and other similar settings

Using preceptors to improve nursing students' clinical learning outcomes: A Malawian students' perspective

Objective: Clinical environment remains an important aspect in the development of student's competence, confidence and fulfillment of their expected learning outcomes. Preceptors and clinical teachers play a significant role in preparing students to achieve their professional goals through continuous support and resource provision. This study explored the students' perception of using clinical preceptors to improve their clinical learning outcomes. Methods: The researchers used semi structured interviews to collect qualitative data. A total of 48 students were purposively and conveniently sampled from 8 hospitals to participate in the study. Content analysis was used to analyse the data. Findings: Two themes emerged from the study findings namely: creating a positive clinical learning environment and facilitating academic clinical collaboration. Conclusions: The findings of the study revealed that students gained more confidence and competence in clinical practice when supported by preceptors as well as achieved clinical learning outcomes. These findings suggest the need to train more clinical preceptors for improvement of students' clinical learning outcomes

Epidemiology of human seasonal coronaviruses among people with mild and severe acute respiratory illness in Blantyre, Malawi 2011–2017

BackgroundThe aim of this study was to characterize the epidemiology of human seasonal coronaviruses (HCoVs) in southern Malawi.MethodsWe tested for HCoVs 229E, OC43, NL63, and HKU1 using real-time polymerase chain reaction (PCR) on upper respiratory specimens from asymptomatic controls and individuals of all ages recruited through severe acute respiratory illness (SARI) surveillance at Queen Elizabeth Central Hospital, Blantyre, and a prospective influenza-like illness (ILI) observational study between 2011 and 2017. We modeled the probability of having a positive PCR for each HCoV using negative binomial models, and calculated pathogen-attributable fractions (PAFs).ResultsOverall, 8.8% (539/6107) of specimens were positive for ≥1 HCoV. OC43 was the most frequently detected HCoV (3.1% [191/6107]). NL63 was more frequently detected in ILI patients (adjusted incidence rate ratio [aIRR], 9.60 [95% confidence interval {CI}, 3.25-28.30]), while 229E (aIRR, 8.99 [95% CI, 1.81-44.70]) was more frequent in SARI patients than asymptomatic controls. In adults, 229E and OC43 were associated with SARI (PAF, 86.5% and 89.4%, respectively), while NL63 was associated with ILI (PAF, 85.1%). The prevalence of HCoVs was similar between children with SARI and controls. All HCoVs had bimodal peaks but distinct seasonality.ConclusionsOC43 was the most prevalent HCoV in acute respiratory illness of all ages. Individual HCoVs had distinct seasonality that differed from temperate settings

Epidemiology of Human Seasonal Coronaviruses Among People With Mild and Severe Acute Respiratory Illness in Blantyre, Malawi, 2011-2017

The aim of this study was to characterize the epidemiology of human seasonal coronaviruses (HCoVs) in southern Malawi. We tested for HCoVs 229E, OC43, NL63, and HKU1 using real-time polymerase chain reaction (PCR) on upper respiratory specimens from asymptomatic controls and individuals of all ages recruited through severe acute respiratory illness (SARI) surveillance at Queen Elizabeth Central Hospital, Blantyre, and a prospective influenza-like illness (ILI) observational study between 2011 and 2017. We modeled the probability of having a positive PCR for each HCoV using negative binomial models, and calculated pathogen-attributable fractions (PAFs). Overall, 8.8% (539/6107) of specimens were positive for ≥1 HCoV. OC43 was the most frequently detected HCoV (3.1% [191/6107]). NL63 was more frequently detected in ILI patients (adjusted incidence rate ratio [aIRR], 9.60 [95% confidence interval {CI}, 3.25-28.30]), while 229E (aIRR, 8.99 [95% CI, 1.81-44.70]) was more frequent in SARI patients than asymptomatic controls. In adults, 229E and OC43 were associated with SARI (PAF, 86.5% and 89.4%, respectively), while NL63 was associated with ILI (PAF, 85.1%). The prevalence of HCoVs was similar between children with SARI and controls. All HCoVs had bimodal peaks but distinct seasonality. OC43 was the most prevalent HCoV in acute respiratory illness of all ages. Individual HCoVs had distinct seasonality that differed from temperate settings