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Item Mastery of the World Health Organization’s techniques of handwashing by the nursing students at the University of Namibia(2016) Amakali, Kristofina; Ndjalo, PeneyayambekoHand hygiene practice is essential to prevent cross infection during health care delivery. Poor hand hygiene by health care providers can be a source of hospital acquired infections among patients. In their first year of studies, nursing students are taught the skills of correct hand washing according to the World Health Organization (WHO)’s techniques to prevent cross infection. Hence, they are expected to demonstrate the mastery of hand hygiene practice and to apply the skills in clinical practice when providing care to patients. A quantitative, cross sectional descriptive study assessed the practice of hand hygiene by the second year nursing students at the University of Namibia (UNAM), main campus during their placement in clinical practice. The primary quantitative data was gathered through a structured questionnaire with the sections on the students’ demographic and the practice of hand washing according to the WHO set standards. The findings revealed that in exemption to the few (33%), the majority (67%) of the participants have low compliance with hand hygiene practice. In conclusion, recommendations were made with regard to teaching, environmental factors, processes of caring and attitudes of health care staff which may influence the practice of hand hygiene by the nursing students.Item The relationship of socio-economic status on contraction of Tuberculosis among TB patients in Windhoek District, Namibia: a public health practice perspective(2014) Murimba, Winnie; Kopano, Robert; Amakali, Kristofina; Amukugo, Hans J.The purpose for this study was to identify the risk factors of inpatients infected with Tuberculosis at Katutura Intermediate Hospital in Windhoek district, Namibia. A quantitative descriptive study was conducted among patients from the Windhoek district who were on first-line treatment for Tuberculosis at Katutura Intermediate Hospital, during the period of the study (June-August 2011). The universal sampling method was used and all 38 inpatients with Tuberculosis participated in the study. The socio-economic factors which are conducive to the transmission of Tuberculosis infection among the participants were identified and described. The findings revealed that the highest rate of TB infection was among the participants of the most productive age of 21-50 years. Moreover, the majority (70%) of the participants were the residents of the severely poverty stricken informal settlements in the Windhoek district. Consequently, the results concluded that lack of education, subsequent unemployment, low wages, poor housing and poor nutrition, alcohol abuse, smoking among the participants seem to fuel the high rate of infection with Tuberculosis, while stigma that is associated with the disease delays seeking of treatment.Item Tobacco smoking among University of Namibia students: Behaviors, reasons, attitudes, awareness and knowledge of associated health risks(2013) Amakali, Kristofina; Haoses-Gorases, Lischen; Taukuheke, LethaThe purpose of the study was to establish tobacco smoking as a behavior, and to recommend measures to protect and discourage tobacco smoking among students at the University of Namibia. A cross sectional study was conducted among students at the University of Namibia, to assess the determinants of tobacco smoking and smoking as a behavior. Two mixed methods, namely, quantitative and qualitative design were used for gathering the data for this survey. A probability sampling method was used and a sample of 996 out of about 10,000 students registered at the University of Namibia for the academic year 2002 were selected. Demographical data, reasons, attitudes towards and the knowledge of health risk from tobacco smoking as the determinants of tobacco smoking (independent variables) and smoking of tobacco as a function thereof (dependent variable) were analyzed. The results indicated that 169 of the participants, which translates to 17% of the then student population at the University of Namibia aged 15-35 years smoked different types of tobacco such as cigarettes, cigar and, even the dagga. The results demonstrated a significant relationship between demographical data of gender and age and smoking. Male students smoked more than female students (OR 4:1). Furthermore, the results indicated that male and female students of age 15 -19 smoked tobacco the most (32% of 12% respectively). The need to cope with the life experiences and subjective norms to peer pressure were some of the reasons for tobacco smoking among the students. In conclusion, the findings demonstrated a significant trend of tobacco smoking among the students at the University of Namibia. In that regards, a declaration of all university campuses as tobacco -free environment to protect students from being exposed to the cues to tobacco smoking and complemented with teaching health risks from tobacco smoking and the skills that are necessary to protect the students from being lured into the use of tobacco were recommendable.Item Motivations for the use of Problem-Based Learning (PBL) for preparation of undergraduate nursing students for professional competences: A literature review(2012) Amakali, KristofinaTraditional nursing education as characterized byclassroom approaches inter alia the lectures, where students are merely passive listeners and more concern about the final grade than learningtends to produce graduate with information to memorize while unable to apply knowledge into practicefor problem solving. Thus the intensive basic lectures, followed by equally exhausting clinical teaching has proven ineffective in preparing professional nurses who are problem-solvers. These factors dictate the need for a shift from a focus on teaching to a focus on learning by adoptinga problem-based, student-centered and self-directed learning approach in a form of problem-based learning for both classroom and clinical teaching context. As opposed to the traditional reductive lecturing method of teaching, Problem-Based Learning approach is more inductive; students learn contents as they try to solve the problems. Problem-Based Learning approach therefore facilitates the development of disciplinary knowledge bases, skills and problem solving strategies by placing the students in the active role of problem solvers for the problems that are aligned with real-life situation.Item Perceptions of health workers regarding the occupational health services rendered at Onandjokwe hospital, Namibia(2015) Amukugo, Hans J.; Amakali, Kristofina; Sipa, Kristofina T.Objective: Health care workers are exposed to a variety of health hazards in their daily work. This exposure puts them at risk of acquiring occupational related diseases, including psychological stress, which can lead to mental illness, absenteeism and job dissatisfaction. In view of the potential risks and occupational hazard, a comprehensive health and safety programme for all employees is mandatory to minimize injury among the employees and therefore for the institution to fully harness the potential of its employees. The programme should indicate management goals, objectives and policy implementation, as well as responsibility and accountability for each role player. The aim of this study was to determine the challenges facing health workers regarding the occupational health services (OHS) at Onandjokwe Hospital in Northern Namibia. The objectives of the study were to determine the existing situation relating to the OHS rendered at Onandjokwe Hospital and to explore and describe the perceptions of health workers regarding OHS at the hospital. Methods: The study employed both quantitative and qualitative methodology that included the use of a checklist for collection of quantitative data on evidences of practice of OHS in different departments of the hospital; interviews and focus group discussions for collection of the data on the workers’ perception on OHS in the hospital. Epi-info software version 3.5.1 was used to analyses the quantitative data while Tech’s method of qualitative analysis was used for the qualitative data. Results: The study revealed that the provision of OHS in the hospital was extremely limited. Many key documents guiding the provision of effective OHS were found to be lacking in several hospital departments. Limited training had been conducted and as a result, there was low awareness on OHS among the employees in the hospital. Both management and staff cited lack of key personnel to drive the process as an important impediment to strengthening OHS in the hospital. Conclusions: The main recommendations that arose from the research include the need for the hospital management to comply with the guidelines on Occupational health, acquire and avail key guiding documents for occupational health practice in all the departments; provision of necessary resources for OHS including OHS staff and implementation of OHS programme to safeguard the health of the employees.Item Clinical care for the patient with heart failure: A nursing care perspective(2015) Amakali, KristofinaProviding clinical nursing care to a patient with a heart disease requires the application of the knowledge of disease process which informs the nursing intervention. This paper presents a discussion on some priority aspects of clinical care for the patient with heart failure from the perspective of nursing care as summarized in the figure below. A brief summative overview of the disease process and the central concept in heart failure as fundamental to the conceptualization of clinical care needs for a patient with heart failure was presented. Application of the framework of the nursing process in providing clinical nursing care for a patient with a heart disease and the application of ethical principles were discussed. Thus, competent and therefore safe clinical care for a patient with heart failure requires comprehensive nursing care which embraces both the scientific approach and ethics of careItem Beyond routine care for children with heart diseases from the vulnerable context: A clinical practice perspective(2014) Amakali, Kristofina; Small, Louis F.The statistics of children with heart diseases are notable in Namibia many of whom are from the rural area. While waiting for surgical corrections or when the child is a case for palliative care, these children have to be cared for at home, a task that can be doubtful for a rural caregiver. A qualitative, exploratory, phenomenological and contextual study was conducted to describe the experiences of rural caregivers regarding provision of home care for children with heart disease. The children’s experiences of living with the disease at home were also assessed because the burden of the diseases intensifies the demands for care. The findings revealed that both the caregivers and the children experience challenged emotions, disruptive social functioning, lacking of support from the family, lack of support from societal organisations as well as experiences of low vitality among the children. These experiences together, signify the overall poor coping by the caregivers and the children. Therefore, caring for a child with a heart disease at home requires a plan of individualized care which considers the context and the socio-economic status of the caregivers as the determinants for coping with providing care at home. Based on the findings, key recommendations were made among others to the clinical practice setting as an entry point to the care provided to these children. This paper provides a detailed description of the proposed health care intervention in the clinical setting to facilitate effective home care to children with heart diseases from the rural context.Item Application of elements of the informed choice of modern contraceptives among reproductive aged women in the Khomas region of Namibia(2016) Nelumbu, Petrina N.; Amakali, Kristofina; Hofnie-//Hoëbes, KA gap still exists between the propositions of the policy and guidelines on the application of the elements of informed choice in family planning services and the reality in practice. This paper presents the findings of the study that was conducted to partially assess and describe the application of the elements of informed choice by the nurses in providing modern contraceptives at the health care facilities in Khomas region of Namibia. A quantitative descriptive study design was employed among the study populations of 7,401 women of reproductive age (15-49 years) who use family planning services at the four (4) urban and two (2) rural health care facilities in Khomas region. Systematic random sampling was done for the urban and rural health facilities, while a convenience sampling was employed to select a sample of 184 client participants from the total population using the computer probability of 95% and the confidence limit of 5%. The data were collected through exit interviews of the clients and analysed using EPI Info. The findings indicated a glaring lack of the provision of the information which can constitute the basis for an informed choice by the clients. Based on the findings, the study recommended among others the provision of in-service training in family planning and communication skills for nurses, development and dissemination of Information Education and Communication (IEC) materials for the clients and the availability of more family planning methods for the clients.Item The plight of parents/caregivers of children with heart disease in the rural areas of Namibia: A problem of coping(2013) Amakali, Kristofina; Small, Louis F.Providing care for a child with heart disease is a daunting task for any parent/caregiver, particularly for those living in poor conditions in rural Namibia. A qualitative, exploratory, phenomenological and contextual study was conducted to describe such parents’/caregivers’ experiences of providing care for a child with a heart disease. The study also examined the children’s experiences of living with the burden of disease at home. The findings revealed experiences of emotional turmoil, disruptive social functioning and social relations, lack of support from the family, lack of organised forms of support from societal organisations, as well as experiences of low vitality among the children. These experiences together signify the overall poor coping by the parents/caregivers and the children. This paper presents the findings of a situational analysis of the experiences of caring for a child with heart disease and of living with heart disease.Item Empowerment of the rural parents/caregivers of children with heart diseases in Namibia to facilitate coping with the demands of caring at home(2013) Amakali, Kristofina; Small, Louis F.Aim: The purpose of this study was to describe how the parents/caregivers of children with heart diseases cope with the demands of caring for these children at home, with the purpose to develop a home-based health care programme to facilitate the parents/caregivers’ coping with the demands of care. Methods: A qualitative, exploratory, descriptive, and contextual study was conducted. Phenomenological data on the lived experiences of coping with the demands to care by the parents/caregivers and of living with the burden of the disease by the children were gathered and interpreted from a purposefully selected sample of 5 multiple cases of parents/caregivers and children with heart disease from the rural areas. Results: The findings have revealed poor coping with the demands of caring among the parents/caregivers, as characterized by the experiences of emotional challenges, disruptive social functioning and social relations, lack of support from the family and societal organizations, financial difficulties and of course the experiences of decreased vitality by the children. As a result, the need to empower the parents/caregivers for them to cope with providing a continuum care to their children who have heart disease was identified. The dynamics to mitigate the negative experiences were conceptualized. Therefore, the interventions of a home-based health care programme as an interface to facilitate the parents/caregivers to cope with the challenges caused by the demands to care were developed. Conclusions: The need for empowerment of these parents/caregivers can be met through the implementation of multi-component interventions, which draw together all the possible determinants factors and the coping methods to facilitate coping.Item A support programme for caregivers of children with heart disease in rural Namibia(2014) Amakali, Kristofina; Small, Louis F.The majority of children suffering from heart disease in Namibia receive treatment as outpatients, with their caregivers taking responsibility for their continuing care. To provide the care required by these children, the caregiver has to remain vigilant. Many of these children live in rural areas and their caregivers may have only a limited educational background, as well as limited financial resources, as they depend on subsistence agriculture for a living. The development of the support programme discussed in this article originated from the results of a qualitative, exploratory, phenomenological study that addressed the issue of how these caregivers managed this responsibility. The findings of this study revealed that the caregivers generally had poor coping experiences. Subsequently, these findings formed the basis for the proposal about a support programme for the rural caregivers of children with heart disease in Namibia. As part of the study, interventions for home-based health care were developed, implemented and evaluated in order to facilitate the caregiver’s coping with the demands of home care. The findings of an outcomes evaluation indicated that the caregivers’ knowledge of the child’s condition, as well as the skills for providing care at home and the information about community-based resources that could provide them with support to cope, increased. If the programme were to be extended to other families in similar contexts, the programme interventions could make a difference in terms of their coping with the demands of care. This paper describes the implementation process involved in a home-based health care programme intervention of the study, and the subsequent outcomes of the programme evaluation.