Richard Adongo Afaya

Background: Given evidence that existing “one size fits all” diabetes self‐management education approaches are not a universal fit for all people with type 2 diabetes mellitus, cultural tailoring of interventions is undertaken to better meet specific needs of underserved population groups. Aim: To evaluate the effectiveness of culturally tailored self‐management interventions in people with type 2 diabetes mellitus. Methods: The search retrieved 1402 articles of which 17 studies (15 randomized controlled trials and 2 quasi‐experimental studies) were included, with 7 studies in the meta‐analysis. Results: Most studies ( n = 9) were conducted in the United States of America among ethnic minority groups. Of the 17 studies, 14 measured self‐management behaviors with 9 showing substantial improvements in adherence to self‐management behaviors (i.e., diet, foot care, medication, physical activity, self‐testing of blood glucose). The meta‐analysis showed that there was significant improvement in Glycated Hemoglobin (HbA1c) levels (−0.57 [95% CI −1.15, −0.25] p < 0.01) post intervention. Linking Evidence to Action: Culturally tailored interventions have the potential to improve HbA1c and self‐management behaviors in people with type 2 diabetes mellitus. While maintaining a collaborative approach with experts including nurses, future interventions should adopt participatory approaches with persons living with T2DM and their families, considering their perspectives, unique needs, and priorities. Trial Registration: PROSPERO number: CRD42022375630

Family caregivers' role in sending their mentally ill relatives to the mental health service (MHS) has been vital in the era of community mental healthcare. They are the determinants of where mentally ill relatives are sent for care. There is currently no evidence about the motivators of MHS use among these major stakeholders in the Bolgatanga municipality. This study, therefore, sought to explore the perceived utilization and the motivating factors for the utilization of MHS in the Bolgatanga municipality. A descriptive qualitative study design was employed to conduct the study in two health facilities (Presbyterian Psychiatric Hospital and the Upper East Regional Hospital). A semi‐structured interview guide was used to conduct in‐depth interviews among 19 purposively sampled participants consisting of 15 family caregivers of mentally ill relatives, two MHS providers, and two MHS administrators. Audio‐recorded interviews were transcribed verbatim and thematically analyzed. Two main themes emerged including perceived utilization of MHS by family caregivers and motivating factors for the utilization of MHS. The study showed that most participants sought MHS for their mentally ill relatives. The study further identified multilevel factors such as individual factors, interpersonal factors, organizational factors, and policy‐level factors that motivated the utilization of MHS in the Bolgatanga municipality. There is a need to embark on activities that will further strengthen the factors that have been identified as motivators to encourage the continuous utilization of MHS in the municipality.

Introduction: This study examined postpartum depression (PPD) among mothers in the Bawku municipality of Ghana, aiming to assess its prevalence and associated risk factors.Methods: A total of 242 women, 2–12 weeks postpartum, were randomly recruited for this cross‐sectional analytical study. The Edinburgh Postnatal Depression Scale was used for depression screening, and multivariate logistic regression analysis was employed to assess the factors associated with PPD.Results: The study showed that 34.7% of the postpartum mothers were within the age range of 25–29, with a mean age of 27.9 (standard deviation [SD] ± 6.33). The prevalence of PPD was 50.4% (95% confidence interval [CI] 43.9–56.9). Several significant risk factors were identified, including inadequate prenatal visits (adjusted odds ratio [aOR] = 13.44, 95% CI 3.66–49.37, P < 0.001), obstetric complications (aOR = 3.39, 95% CI 1.23–11.19, P = 0.019), less than 3 weeks postpartum (aOR = 8.14, 95% CI 1.95, 33.94, P = 0.004), 6–8 weeks postpartum (aOR = 7.72, 95% CI 1.71–34.80, P = 0.008), and stressful life events (aOR = 3.30, 95% CI 1.23–8.89, P = 0.018).Conclusion: The study concluded that the prevalence of PPD in the Bawku municipality is higher than previously reported in Ghana, emphasizing the need for early identification of pregnant women at risk for PPD.

Background: Globally, breast cancer is the most common cancer type and the leading cause of cancer mortality among women in developing countries. A high prevalence of late breast cancer diagnosis and treatment has been reported predominantly in Low- and Middle-Income Countries (LMICs), including those in Asia. Thus, this study utilized a mixed-methods systematic review to synthesize the health system barriers influencing timely breast cancer diagnosis and treatment among women in Asian countries.Methods: We systematically searched five electronic databases for studies published in English from 2012 to 2022 on health system barriers that influence timely breast cancer diagnosis and treatment among women in Asian countries. The review was conducted per the methodology for systematic reviews and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, while health system barriers were extracted and classified based on the World Health Organization (WHO)‘s Health Systems Framework. The mixed-methods appraisal tool was used to assess the methodological quality of the included studies.Results: Twenty-six studies were included in this review. Fifteen studies were quantitative, nine studies were qualitative, and two studies used a mixed-methods approach. These studies were conducted across ten countries in Asia. This review identified health systems barriers that influence timely breast cancer diagnosis and treatment. The factors were categorized under the following: (1) delivery of health services (2) health workforce (3) financing for health (4) health information system and (5) essential medicines and technology. Delivery of health care (low quality of health care) was the most occurring barrier followed by the health workforce (unavailability of physicians), whilst health information systems were identified as the least barrier.Conclusion: This study concluded that health system factors such as geographical accessibility to treatment, misdiagnosis, and long waiting times at health facilities were major barriers to early breast cancer diagnosis and treatment among Asian women in LMICs. Eliminating these barriers will require deliberate health system strengthening, such as improving training for the health workforce and establishing more healthcare facilities.

AimThe objective of the study was to determine the clinical factors associated with knowledge and self-care practice among adults living with type 2 diabetes mellitus.DesignDescriptive cross-sectional design.MethodsA convenience sample of 330 participants was recruited over 3-months in 2018 and data were collected using a structured instrument.ResultsParticipants on insulin treatment modality had four times higher odds of knowledge on diabetes (B = 4.17, p = 0.023) while those on combined therapy (both oral hypoglycaemic agent and insulin) had 7.26 times higher odds of knowledge (B = 7.26, p < 0.001). Participants without medically confirmed diabetic complications had 3.66 higher odds of knowledge of diabetes (B = 3.66, p = 0.002). Participants on insulin treatment modality had a 1.4-fold higher odds of self-care practice (B = 1.4, p = 0.028). It was revealed that participants with hypertension and diabetic foot had lower odds of self-care practice (B = -1.13, p = 0.021).ConclusionIn particular, participants who were on insulin and combined therapy (tablet and insulin) had higher knowledge and better self-care practice. Self-care was significantly influenced among those with, than those without diabetic foot and hypertension as complications.

Introduction Female breast cancer is now the most often diagnosed cancer in the world. Breast cancer screening aims to reduce mortalities related to cancer, and morbidity associated with advanced stages of the disease, through timely detection in asymptomatic women. This study aims to conduct a comprehensive assessment and evaluation of the evidence on the factors that influence the provision and uptake of breast cancer screening among women in sub-Saharan Africa (SSA). Methods and analysis PubMed, Web of Science, EMBASE and the Cumulative Index to Nursing and Allied Health Literature including Google Scholar will be searched to identify published studies on barriers and facilitators to breast cancer screening from January 2010 to 2021. Two reviewers will independently assess the quality of all the included studies using the Mixed Methods Appraisal Tool version 2018. We envisage that this review will adduce evidence on common barriers and facilitators to breast cancer screening in SSA. Identifying these barriers and facilitators will help guide the initialisation of effective interventions that will improve breast cancer screening uptake among women in SSA. This review will also guide future research in developing, implementing and evaluating appropriate interventions tailored toward increasing breast cancer screening uptake. Ethics and dissemination Ethics approval for this protocol is not required since it does not involve collecting data from human participants. The outcomes of this study will be published in a peer-reviewed journal.

Introduction: Female breast cancer is currently the most commonly diagnosed cancer globally with an estimated 2.3 million new cases in 2020. Due to its rising frequency and high mortality rate in both high- and low-income countries, breast cancer has become a global public health issue. This review sought to map literature to present evidence on knowledge of breast cancer screening and its uptake among women in Ghana. Methods: Five databases (PubMed, CINAHL, PsycINFO, Web of Science, and EMBASE) were searched to identify relevant published studies between January 2012 and August 2021 on knowledge of breast cancer screening and its uptake among women. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews and the six-stage model by Arksey and O’Malley were used to select and report findings. Results: Of the 65 articles retrieved, 14 records were included for synthesis. The review revealed varied knowledge levels and practices of breast cancer screening among women across a few regions in Ghana. The knowledge level of women on breast cancer screening was high, especially in breast cancer screening practice. Breast cancer screening practice among women was observed to be low and the most identified barriers were lack of technique to practice breast self-examination, having no breast problem, lack of awareness of breast cancer screening, and not having breast cancer risk. The results further showed that good knowledge of breast cancer screening, higher educational level, increasing age, physician recommendation, and household monthly income were enabling factors for breast cancer screening uptake. Conclusion: This review showed varied discrepancies in breast cancer screening uptake across the regions in Ghana. Despite the benefits of breast cancer screening, the utilization of the screening methods across the regions is very low due to some varied barriers from the different regions. To increase the uptake of breast cancer screening, health workers could employ various strategies such as community education and sensitization on the importance of breast cancer screening.

Aim: This study aims to explore the challenges and benefits of using the nursing process in a Ghanaian Hospital.Design: The study employed a qualitative descriptive design to explore the challenges and the benefits of the utilization of the nursing process.Methods: Twelve (12) Registered Nurses were recruited for the study using purposive sampling. Recorded in‐depth interviews were conducted and data were analysed using thematic analysis.Results: The study found a low nurse‐to‐patient ratio, inadequate knowledge, apathy, inadequate logistics, poor supervision as challenges. However, quality and cost‐effective care improved nurse–patient relationships, and job satisfaction was found to be the benefits of nursing process use. Interventions to improve its utilization should be targeted towards improving the nurse‐to‐patient ratio, provision of adequate resources and inclusion of the nursing care plan in patient folders.

Diabetes mellitus is a complex disease that affects many organ systems, leading to concerns about deteriorating population health status and ever-increasing healthcare expenditure. Many people with diabetes do not achieve optimal glycaemic control and other metabolic indices, leading to a heightened risk of developing complications. Adequate knowledge of diabetes complications is a prerequisite for risk-factor reduction and prevention of the consequences of the disease. Therefore, this study aimed to evaluate the knowledge of chronic complications of diabetes among persons living with type 2 diabetes mellitus in northern Ghana. A descriptive cross-sectional study was conducted among 320 patients with type 2 diabetes mellitus in northern Ghana. The consecutive sampling technique was employed to recruit participants from September to November 2018. Data analysis was performed using IBM statistical package for social science version 23. Descriptive statistics such as frequencies and percentages were used. Both bivariate and multivariate logistic regression analysis were employed to determine associations between knowledge of diabetes complications and demographic/clinical characteristics of participants, at 95% confidence interval with statistical significance at P<0.05. The majority of participants (54.1%) had inadequate knowledge and 45.9% had adequate knowledge of diabetes complications. The factors associated with inadequate level of knowledge were female gender [AOR = 0.29 (95%CI: 0.14–0.56), p<0.001], older age [AOR = 0.45 (95%CI:0.20–0.99), p = 0.049], primary education [AOR = 0.13 (95%CI: 0.03–0.51), p = 0.004], no formal education [AOR = 0.16 (95%CI: 0.05–0.50), p = 0.002], rural dwellers [AOR = 0.50 (95%CI: 0.27–0.95), p = 0.033] and unknown family history diabetes [AOR = 0.38 (95%CI: 0.17–0.82), p = 0.014]. More than half of the studied population had inadequate knowledge of diabetes complications. Female gender, rural dwellers, and low education level were factors positively associated with inadequate knowledge of diabetes complications. A multisectoral approach is needed, where the government of Ghana together with other sectors of the economy such as the health, education and local government sectors work collaboratively in the development of locally tailored diabetes education programmes to promote healthy self-care behaviours relevant for the prevention of diabetes and its complications.