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Nurses’ perspective of the research-practice gap in nursing  [PDF]
Clara Agbedia, Ijeoma Okoronkwo, E. Onokayeigho, Mary Ann Agbo
Open Journal of Nursing (OJN) , 2014, DOI: 10.4236/ojn.2014.42013

This work aims to explore the views of Nigerian nurses on research-practice gap in the clinical practice and the challenges in the utilization of nursing research. The results from in-depth interview and focus group discussion demonstrated that a research-practice gap existed in the clinical setting. The nurses generally did not utilize research findings in their practice. Some useful suggestions were recommended to solve the problem.

Enhancers and hindrances to doctor-nurse interdisciplinary collaborative practice in Nigeria  [PDF]
Ijeoma L. Okoronkwo, John E. Anieche, Anthonia U. Chinweuba, Afam C. Ndu
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.32022

The purpose of this study was to identify factors that enhance and hinder interdisciplinary collaborative practice (ICP) among doctors and nurses at the Nnamdi Azikiwe teaching hospital, Nnewi, southeast Nigeria. The study was a cross-sectional descriptive survey and the quantitative method of data collection was employed. The population was all doctors irrespective of area of specialty and all nurses employed and working in the hospital as at the time of study. Proportionate stratified and convenience sampling methods were used to select study participants according to their categories. Using validated structured questionnaire, data were collected from 110 doctors and 95 nurses in the teaching hospital on their perception on ICP and factors that enhance/hinder ICP. Data were analyzed using both descriptive and inferential statistics. Specifically, frequencies, percentages, standard deviation and graphic presentation were used for descriptive analysis of scores while the unpaired t test of mean score using Graph Pad Prism, Version 5.30 was used to determine the influence of profession, gender, and years of experience on perception of ICP at 0.05 level of significance. The study found that both doctors and nurses have positive perception on ICP. Their years of experience have significant influence on their perception. Clear individual roles and good working relationships enhance ICP while giving priority to professional status rather than expertise was seen as a prominent hindrance to ICP. The study recommends collaborative continuing education for doctors and nurses to enhance ICP in patient care. In addition, the inclusion of interdisciplinary collaborative practice programmme into the curriculum of medical and nursing students (where it does not exist) would go a long way to strengthen ICP and decrease hindrances when they graduate.

Relationships between Demographic Variables and Breast Self-Examination among Women in a Rural Community South East of Nigeria  [PDF]
Ada C. Nwaneri, Eunice Ogonna Osuala, Ijeoma Okoronkwo, Patricia Uzor Okpala, Anthonia Chidinma Emesowum
Health (Health) , 2016, DOI: 10.4236/health.2016.81012
Abstract: This study examined the relationships between demographic variables of women in a rural community, South East of Nigeria and their practice of Breast Self-Examination (BSE). A descriptive survey design was adopted. The study population of 349 was drawn using system atichousehold sampling technique. Two research questions and three null hypotheses guided the study. The instruments used for data collection were validated structured questionnaire which was interview administered. Demographic information of the women such was also obtained for the study. The result indicated significant correlation between respondents’ educational level and BSE. There was however no significance difference between age, parity and BSE. There was need for community health nurses to reinforce home visits in order to enhance the awareness of breast cancer and needed skill for BSE among the rural populace while liberal education irrespective of age should be instituted by the Government.
Students’ perception of effective clinical teaching and teacher behaviour  [PDF]
Ijeoma L. Okoronkwo, Jane-Lovena Onyia-pat, Mary-Ann E. Agbo, Pat U. Okpala, Afam C. Ndu
Open Journal of Nursing (OJN) , 2013, DOI: 10.4236/ojn.2013.31008
Learning in the clinical environment is an integral part of nursing education programme. In tertiarybased nursing courses, students spend time learning in the clinical setting as they do in their classroombased studies. The purpose of this study was to explore teaching skills considered by undergraduate student nurses as effective in the clinical setting as well as qualities that make a clinical teacher effective. A descriptive design was employed using questionnaires to collect data. Respondents comprised year four undergraduate student nurses admitted through direct entry (DE) and university matriculation examination (UME) results. Using validated structured questionnaire, data were collected from 101 students who had completed their six months consolidated clinical experience on their perception of teaching skills and teacher qualities considered effective in the clinical setting. Data were analyzed using both descriptive and inferential statistics. Specifically, frequencies, percentage and standard deviation were used for descriptive analysis of scores while chi square and Mann-Whitney tests were used to test the mean differences in the teaching skills and to test whether there was a significant difference in their perception of teacher behaviours respectively at 0.05 level of significance. The result showed that having both clinical (professional) and teaching knowledge were the most important teaching skills for effective clinical teaching. Five qualities ranked by students as teacher behaviours important for effective teaching include being honest with students, motivation to teach, willingness to listen and using good communication skills, supervising students effectively and being positive role model. These factors could be considered when recruiting future clinical teachers and when planning inservice education programmes for clinical teachers to promote student learning.
Nonadherence Factors and Sociodemographic Characteristics of HIV-Infected Adults Receiving Antiretroviral Therapy in Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
Ijeoma Okoronkwo,Uchenna Okeke,Anthonia Chinweuba,Peace Iheanacho
ISRN AIDS , 2013, DOI: 10.1155/2013/843794
Abstract: Adherence to treatment instructions with antiretroviral therapy (ART) is very crucial for successful treatment outcome. However, sticking to treatment instructions pose-great challenges to HIV/AIDS patients. This cross-sectional study was on HIV infected adults attending ART clinic in Nigeria to explore nonadherence factors in relation to their socioeconomic characteristics. Validated structured questionnaire was administered to 221 participants. Results showed a high nonadherence rate of 85.1%. The commonest occurring factors of non-adherence were forgetfulness (53.8%), busy schedule (38.8%), side effects of drugs (31.9%), and stigma (31.9%). Males were more likely to complain from busy schedule, feeling healthy, fear of partner disclosure, long waiting period, and long term regimen. Patients with no formal education were more likely to attribute non-adherence to poor communication, side effects of drugs, and stigma. Employed patients seemed to miss their drugs more than the unemployed and artisans. The high non-adherence rate has serious implications for the control of HIV in infected individuals and management of HIV in general. Nurses should intensify efforts on patient education and counseling. 1. Introduction HIV/AIDS is one of the major public-health problems worldwide, affecting mostly people who are at the most productive stage of life. Out of the estimated 34 million people living with HIV/AIDS globally as at the end of 2010, 68% reside in Sub-Saharan Africa [1]. Nigeria has an HIV prevalence of 4.1% and currently an estimated 3.6 million people are living with HIV/AIDS [2] which puts Nigeria as the second country with the largest number of people living with HIV (PLWH) after South Africa. The development and availability of antiretroviral therapy (ART) became a turning point in the control and prevention of the epidemic. With the success of ART in improving the quality of life of PLWH and reducing morbidity and mortality, HIV has become a chronic manageable disease [3]. Studies have shown a correlation between higher levels of adherence and improved virological and clinical outcomes [4, 5]. However, ensuring that PLWH receive, and adheres to their highly active ART poses a challenge to the treatment efficacy [6]. In Nigeria ART was commenced (i.e., combining at least 3 drugs from various classes of ART into a cocktail that produces a dramatic reduction in viral load and allows immune suppression) in 2002 and coverage stood at 359,181 in 2010 [2]. Adherence to ART according to Carter [7] refers to timely intake of the right dose of prescribed
Complementary and alternative medicine use among adults in Enugu, Nigeria
Jane-lovena E Onyiapat, Ijeoma L Okoronkwo, Ngozi P Ogbonnaya
BMC Complementary and Alternative Medicine , 2011, DOI: 10.1186/1472-6882-11-19
Abstract: The study areas were three local government areas in Enugu urban of Enugu State. Cross-sectional survey using questionnaires were administered to randomly selected households. All consenting participants were used for the study732 participants (37.2% males and 62.8% females) were used for the study. Ages ranged from 18 - 65 years. 620 (84.7%) of the adult population have used CAM ranging from one single type to twenty different types while 112 (15.3%) have not used any form of CAM. The most commonly used CAM product was the biological products, followed by prayer/faith healing. Major reasons for using CAM include their natural state and also for health promotion and maintenance.There is need for adequate policy formulation and regulation to ensure safety and efficacy of CAM products. Measures to ensure rational use of CAM should be instituted.It has been observed that many adults use different health products or measures under the umbrella of CAM. Reason for use could either be that they are imported or approved by National Agency for Food, Drug Administration and Control (NAFDAC), or they are believed to promote health, with little or no knowledge about the compositions, uses and side effects. NAFDAC is a parastatal of the Federal Ministry of Health established to regulate and control the manufacture, importation, exportation, distribution, advertisement, sale and use of food, drugs, cosmetics, chemicals, medical devices and packaged water.The National Centre for Complementary and Alternative Medicine (NCCAM) [1] defines CAM as "a group of various medical and health care systems, practices, and products that are not presently considered to be an aspect of conventional medicine". Complementary interventions are healthcare approaches used in conjunction with conventional interventions, whereas alternative medicines are used in place of conventional medicine [2]. CAM as used in this study is an umbrella term which includes traditional medicine in-addition to other wes
Improving quality of malaria treatment services: assessing inequities in consumers' perceptions and providers' behaviour in Nigeria
Obinna Onwujekwe, Eric Obikeze, Benjamin Uzochukwu, Ijeoma Okoronkwo, Ogochukwu C Onwujekwe
International Journal for Equity in Health , 2010, DOI: 10.1186/1475-9276-9-22
Abstract: Questionnaire was used to interview randomly selected healthcare providers about the technical quality of their malaria treatment services. Exit polls were used to obtain information about perceived quality from consumers. A socio-economic status (SES) index and comparison of data between urban and rural areas was used to examine socio-economic status and geographic differences in quality of services.The lowest technical quality of services was found from patent medicine dealers. Conversely, public and private hospitals as well as primary healthcare centres had the highest quality of services. Householders were least satisfied with quality of services of patent medicine dealers and pharmacy shops and were mostly satisfied with services rendered by public and private hospitals. The urbanites were more satisfied with the overall quality of services than the rural dwellers.These findings provide areas for interventions to equitably improve the quality of malaria treatment services, especially for patent medicine dealers and pharmacy shops, that are two of the most common providers of malaria treatment especially with the current change of first line drugs from the relatively inexpensive drugs to the expensive artemisinin-based combination therapy, so as to decrease inappropriate drug prescribing, use, costs and resistance to artemisinin-based combination therapy.Malaria is a major public health problem in Nigeria and its treatment is sought from a broad spectrum of public and private healthcare providers [1,2]. The erosion of the public health system, arising from mismanagement, has contributed to the growth of the private sector and, in particular, the rise in the "informal" private sector as a source of treatment [1]. Patients often resort to the unregulated private commercial sector, where treatment may be inappropriate but at a lower cost [1]. The informal private sector is now a major source of anti-malarial drugs, but these providers, especially patent medicine d
A Rare Classical Presentation of Bardet-Biedl Syndrome in a Three-Year-Old Male from South East Nigeria: A Case Report  [PDF]
Nneka C. Okoronkwo
Case Reports in Clinical Medicine (CRCM) , 2016, DOI: 10.4236/crcm.2016.58044
Abstract: Bardet-Biedl Syndrome (BBS) is a rare autosomal recessive ciliopathy characterized by obesity, post-axial polydactyly, renal abnormalities, mental retardation, pigmentary retinopathy and hypogenitalism. Diagnosis is rare in early childhood, and only few of the features are present at that age. This is because the disease is slow evolving. However, it is possible to find majority of the component of this syndrome in very young children. A 3-year old very obese male presented with clinical features of sepsis and congestive cardiac failure. He is a product of non-consanguineous marriage with unremarkable family history. Both parents are of the Ibo tribe in Nigeria. Polydactyly was noticed at birth. There was delay in some aspects of his developmental milestone. Examination revealed mild hypertelorism and retrognathia, polydactyly of both feet with syndactyly of the big and second toes. Other findings were short broad hands, mottled pigments on the retina, moderate mental retardation, hypogenitalism, nephrotic syndrome, renal tubulopathy, hyperglycaemia and hypopigmented skin lesions. A case of BBS with all the primary features and some secondary manifestations in a very young child is hereby reported. A high index of suspicion for BBS should be shown in any young child with at least one of the features of this syndrome. This will enhance earlier diagnosis and improve disease outcome.
Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
Obinna E Onwujekwe, Benjamin SC Uzochukwu, Eric N Obikeze, Ijeoma Okoronkwo, Ogbonnia G Ochonma, Chima A Onoka, Grace Madubuko, Chijioke Okoli
BMC Health Services Research , 2010, DOI: 10.1186/1472-6963-10-67
Abstract: The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS.All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this studyThere is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. The real challenge of health care financing in Nigeria as in many countries in sub-Saharan Africa (SSA) lies not primarily in the acute scarcity of resources, but in the absence of intermediation and insurance mechanisms to manage risk, and inefficient resource allocation and purchasing practices [1]. User fees fall within the broader concept of "cost-sharing", a practice whereby benefici
Estimation of Costs-Savings and Improved Patient Outcomes of Implementing a Consultation-Liaison Service at Health Sciences North  [PDF]
Elendu Okoronkwo
Open Journal of Psychiatry (OJPsych) , 2019, DOI: 10.4236/ojpsych.2019.93017
Abstract: Objective: The study was conducted to assess the implementation of a psychiatric consultation-liaison service (C-L) from the perspective of cost-savings, staff satisfaction, patient satisfaction and to assess the general features of patients referred to the C-L service. Methodology: Cost-savings were evaluated using a large cohort of referrals to the hospital were identified using data derived from the Institute of Clinical Evaluative Sciences (N = 2246); these data were divided into pre and post periods with respect to imitation of the C-L service. To evaluate staff satisfaction, 170 nurses and physicians completed an online survey. Patient satisfaction was assessed through a survey assessing various aspects of their experiences with the C-L service that was completed by each patient (N = 40). Finally referrals to the C-L service (N = 445) were analyzed to discern indicators of the C-L service’s efficacy (i.e. reasons for referral, time to accommodate referral). Results: The data indicated: 1) a reduction in the number of re-admissions and length of stay after the initiation of the C-L service translating into significant cost-savings for the hospital, 2) that increased staff satisfaction was associated with providing confidence, support, and improved communication, and 3) that the C-L service accommodated approximately 90% of patients within 1 day. Conclusion: The results of this study support stakeholders’ decisions to implement C-L services and also indicate areas of improvement that may improve the quality of C-L services within other institutions.
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