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Item Knowledge, attitudes and practices of pregnant women regarding tobacco and alcohol use in pregnancy at Mariental Clinic, Hardap region, Namibia(University of Namibia, 2024) Hamutenya, SelmaGlobally, alcohol and tobacco use during pregnancy is considered a challenge and has been linked to negative effects on a person’s health and wellbeing. The Mariental Hospital's maternity records 2019 revealed that 76 of the 443 women who gave birth claimed that they had drunk alcohol or smoked tobacco during their pregnancy. In addition, in 2019 it was noted that 6 % of premature babies were delivered to mothers who smoked during pregnancy, and 25 percent of premature babies were born to mothers who consumed alcohol during pregnancy. The main aim of this study was to investigate the knowledge, attitudes and practices of pregnant women attending antenatal care at Mariental clinic regarding the use of tobacco and alcohol in pregnancy. The study adopted a quantitative research approach with a descriptive, cross-sectional, analytical design. The study population were all pregnant women aged 18 years and above attending antenatal care at Mariental clinic during the study period. Informed consent was obtained from all respondents prior to data collection. The data was collected from 211 respondents who were selected through a systematic sampling method. The data was analysed by means of Statistical Package of the Social Sciences (SPSS) version 27. Fisher’s Exact test at 0.05 alpha level was used to determine the association between variables. Only marital status showed a significant association with the attitudes towards alcohol use (p=0.042). Educational levels showed a significant association with practices towards tobacco smoking (p=0.042). The majority 92 (43.6%) of respondents were aged between 18-24 years, while 186 (88.15%) of the respondents were single. The findings indicated that 148 (70.1%) had high levels of knowledge towards smoking during pregnancy. About 165 (78.2%) respondents showed a positive attitude towards alcohol use during pregnancy. A total of 63 (29.86%) respondents were classified as having bad practices towards alcohol ii use in pregnancy. A total of 21 (10.0%) respondents were classified as having bad practices towards tobacco use in pregnancy. The study concluded that pregnant women exhibited a significant amount of awareness regarding the impacts of alcohol and tobacco usage during pregnancy. Additionally, the participants displayed favourable attitudes towards abstaining from alcohol and tobacco consumption during pregnancy. The study recommends that the Ministry of Health and Social Services develops guidelines and policies on preventative measures and awareness programs on tobacco and alcohol use during pregnancyItem Experiences of patients with chronic renal failure regarding hemodialysis in Oshana region, Namibia(University of Namibia, 2024) Petrus, Auguste NdapewoshaliMotivation: Hemodialysis is a life-sustaining procedure for the treatment of patients with chronic renal failure. Long-term hemodialysis therapy is very costly, time extensive and requires adherences to treatment regimens, fluids and dietary restrictions. This usually results in many limitations such as freedom, social life, physical activities and loss of financial income. These changes affect the whole person and may also affect how the patients on hemodialysis experienced it. All health care workers need to understand the experiences of patients on hemodialysis in order to give proper evidence based quality care. It is against this background that a descriptive study on the patient’s experiences with chronic renal failure on hemodialysis was undertaken. Aim: The overall aim of this study was to explore and describe the lived experiences of patients diagnosed with chronic renal failure on hemodialysis in the Oshana Region of Namibia with the intention of making recommendations on how to address future improper administration of hemodialysis procedures. Methods: The research design was qualitative, explorative, and descriptive in nature. The population consisted of participants who were diagnosed with chronic renal failure on hemodialysis, and purposive sampling was utilized. The data was collected through in-depth interviews conducted at an intermediate hospital in Oshakati. A total of twelve (12) participants were interviewed, and the data collection ended as saturation was reached. The sample size was determined by saturation of data as reflected in repeated themes. Data on participant’s experiences with chronic renal failure on hemodialysis was obtained through individual interviews. During these interviews, participants were asked one (1) central question: "What are your experiences as a patient with chronic renal failure on hemodialysis?” followed by probing questions to encourage the participants to expand on the given responses. Interviews were tape recorded and field notes were taken during the interview to ensure that all experiences of the participants were captured. Interview data was transcribed verbatim. The data was analyzed according to Tesch’s eight (8) steps of coding. Findings: The study findings were presented in six (6) main themes namely; diverse emotions and misconceptions regarding chronic renal failure and hemodialysis as v experienced by the participants, the effects of hemodialysis, challenges encountered by participants during hemodialysis treatment, experiences regarding lifestyle modification, experiences with regard to coping with the condition and strategies for improving the care of chronic renal failure patients on hemodialysis. Findings revealed that hemodialysis patients have different experiences: experiences of lifestyle modification, experiences of physical discomfort and physiological body changes, problems and challenges such as financial burden. Recommendations: It was recommended that supportive care toward patients with chronic renal failure on hemodialysis should be emphasized to reduce the burden from various experiences. Community mobilization and health education programs as well as support groups to create awareness should be established to improve the quality of life, improve their knowledge to foster life style changes. Furthermore, there is a need for extensive and intensive research in this areaItem Views of emergency and intensive care unit nurses regarding family presence during emergency procedures at the hospitals in Walvisbay, Erongo region, Namibia(University of Namibia, 2023) Manetti, Benjamin Sebulon KlaasThe purpose of the study was to explore and describe the views of emergency and intensive care unit nurses regarding family presence during emergency procedures at the hospitals in Walvis Bay, Erongo Region, Namibia. Moreover, the significance of this study was mainly to understand the challenges faced by nurses when family members were present during emergency procedures and encouraging the creation and implementation of policies regarding family presence during emergency procedures with the aim of caring for the patient holistically using a patient-and family-centred approach. The main objectives of this study were to explore and describe the views of emergency and intensive care unit nurses regarding family presence during emergency procedures at the studied hospitals in Walvis Bay, Namibia. The study employed a qualitative approach utilizing exploratory, descriptive, and contextual research design to determine the views of emergency and intensive care unit nurses regarding family presence during emergency procedures at the two hospitals in Walvis Bay, Namibia. The population of this study comprised of thirty-five (35) nurses who provide nursing care in emergency rooms and intensive care units, including high-care units at the Walvis Bay State Hospital and a private hospital specializing in emergency and critical care. The sample size consisted of thirty-one (31) participants. Rich data on the views of nurses working in the ER and ICU regarding family presence was collected using an interview guide until data saturation was reached. The three (3) fundamental ethical principles guided the researcher namely: principle of respect for persons, principle of beneficence and principle of justice which were adhered to during the study. After gaining consent, the researcher physically interviewed the participants using an interview guide, voice recorder and field notes. iv Data were analysed using Tesch’s eight steps of data analysis and content analysis. Four (4) themes emerged, and (9) sub themes emerged from nine predetermined questions to each interviewee and formed part of the study’s results. The findings of the study reveal that nurses hold varyingly strong views regarding family presence during emergency procedures and that both the family and nurses are affected by this practice, Intensive Care Unit nurses were more receptive to FPDEP and many nurses felt that a formal evidenced based policy would encourage best practices. The study's findings may help identify potential benefits of family presence during emergency procedures and encourage understanding of the challenges faced with the drafting and implementation of policies and procedures regarding family presence during emergency procedures. Thus, it is intended that the study findings may provide information contributing to the body of knowledge. It is recommended that the study's findings be used to develop policies for family presence during an emergency procedure and incorporate such policy with a patient and family-centred approach to health care, training ‘nurse counsellors by a tertiary institution in conjunction with health services that are empowered to facilitate the activities of family member presence. Further studies on the of patient’s and family members views regarding being present during emergency procedures would further add to the profession's body of knowledgeItem Assessment of the practices and experiences on mentorship and mentoring of nurse educators in the school of nursing, University of Namibia(University of Namibia, 2023) Tjiurutue, Ingenesia Popii VekumininaMentoring in nursing academia is receiving more attention as many senior academics are retiring and new nurse educators are joining nursing education. Mentoring is an important tool for clinical practice, nursing education, administration, and research that contributes to the competencies of many new nurse educators, who are recruited with a clinical background and little or no experience in an academic environment. It is expected for an expert nurse to become a novice in a new environment or role and needs mentoring to become an expert nurse educator. Despite the emphasis on the mentoring relationship among nursing academics, there is no established standard practice and nurse educators experience difficulty in their new role in the absence of mentoring. This study aimed to assess and describe the practices and experiences of nurse educators in the School of Nursing1 at the University of Namibia on mentorship and mentoring. The study adopted a comparative descriptive convergent parallel mixed method where quantitative and qualitative data were collected at the same time, analyzed separately, and merging occurred by comparing the two data sets and representing the merging results in a narrative discussion. The target population was nurse educators who were registered nurses by profession, teaching at the four campuses of the University of Namibia where the School of Nursing was established among the 12 campuses. The researcher opted for the same individuals in both quantitative and qualitative objectives that help to minimize threats during data collection and allowed the results to be compared. Likewise, both strands focused on the same study concepts of mentorship and mentoring to allow interpretation and comparison. For objective one, which was quantitative and focused on the practices, due to small population of nurse educators employed in the School of Nursing the total target population of 74 was included in the study as it was small and feasible for the researcher to contact everyone using a self-administered questionnaire. The target population was stratified as per campus and various teaching ranks. The mentees were nurse educators who were registered nurses by profession who had worked for less than five years at the School of Nursing while mentors should have worked for five years or more at the same school. The response rate for the quantitative strand was 82% (n= 40 questionnaires received out of 49 for the mentees and 96 % for the mentors (n=24 questionnaires received out of 25). Purposive sampling was done for objective two, which was qualitative to select the participants who participated in the semi-structured interviews at each campus as per respective study groups. For the qualitative strand, data saturation was determined per campus due to the different settings and heterogenous teaching ranks that had different experiences. A total of 36 mentees and 16 mentors participated across the different campuses. The interpretation of data sets shows convergent and discordant results in the quantitative data between the mentees and mentors in mentorship and mentoring practices. Likewise, similar four main themes emerged from both groups, with some variants of unique sub-themes across the groups. The quantitative results show that mentees and mentors agreed on mentorship practices but had discordant results on mentoring aspects as mentees disagreed with mentors’ positive ratings. Variables with significant p-values were identified and compared first within each group of mentees and mentors first and then finally with the finding from the qualitative data set. Equally, the qualitative results also had convergent and discordant results between mentees and mentors as well within each group supported by various sub-themes. The common approach of primary data analysis integration procedure was used. The representation of merging integration results was done by a side-by-side comparison of significant p- values of quantitative and main themes and sub-themes of the qualitative results through a narrative discussion. The discussion narrated how qualitative themes and sub-themes either confirm, disconfirm, or complemented the quantitative results or vice versa. This study concluded that mentoring and mentorship practices were described differently by mentors and mentees as well that positive and negative experiences emerged in both groups. Recommendations included the facilitation of good relationships as well as establishing trust, respect, and healthy communication between mentors and mentees. It was also recommended for the School of Nursing to have a school-specific orientation for nurse educators and develop a formal mentoring programme. Finally, there was a need to revisit the workload of nurse educators and develop a guideline for virtual mentoring of menteesItem Factors associated with stillbirths during intrapartum care at the Windhoek central hospital and intermediate hospital Katutura, Khomas region, Namibia(University of Namibia, 2023) Runone, Kalista S.Intrapartum stillbirths account for 1.3 million deaths worldwide, which is half of all stillbirths occurring during labour and delivery. NSA (2020), states that the current stillbirths’ rate in Namibia is not calculated due to the limitations of data. The present study investigated factors associated with stillbirths during intrapartum care at the Windhoek Central Hospital and Intermediate Hospital Katutura, Khomas region, Namibia. A quantitative, descriptive and retrospective study was used on a total population of 186 patients’ records of babies who died during labour and delivery. The sample and the population were the same (186 patients’ records). Data were collected by means of a structured checklist, analysed with SPSS 27, and presented as descriptive statistics in the form of frequency distributions of study variables. Furthermore, bivariate analyses in the form of Pearson Chi-Square test of association were obtained to determine whether there exists a significant association between variables. The study concluded that there was no association between the sociodemographic and obstetric factors, (mother’s place of residence, mode of baby delivery, presentation of a baby, mother’s age and gestational age) with stillbirths during intrapartum care. The study also found that there was a significant association between a fetal factor (placenta abruptio) and intrapartum stillbirths. The study also concluded that there was a substantial association between the modifiable factor (delay to provide care once the mother arrived at the health facility) with intrapartum stillbirth. The study also concluded that intrapartum stillbirths accounted for one third (30%) of the overall stillbirths in the study settings. Recommendations for further research to study the quality of intrapartum care given to women would provide a better indicator of the quality of maternal and new-born health services. With one-third of stillbirths occurring intrapartum, perinatal death evaluations (audits) should be encouraged and strengthened at the facility level. Standards for ANC and intrapartum care services should be strengthened to improve labour monitoring and quality care.Item Factors associated with relapse among mentally ill patients at intermediate hospital Oshakati, Oshana Region, Namibia(University of Namibia, 2023) Katangolo, Hilma Nakashwa J.Many patients suffering from mental illness receive treatment as outpatients, with their caregiver’s taking responsibility for their continuing care. Relapse due to mental illness has an impact on societal costs and many of these patients experience relapse throughout their life. The purpose of this study was to determine factors associated with relapse among mentally ill patients according to the patients and their caregivers’ views at Intermediate Hospital Oshakati, Oshana Region, Namibia. This study employed a quantitative, cross sectional and analytical design to determine these factors. Data from caregivers were collected using a self-administered questionnaire and researcher administered questionnaire was used for patients. Respondents were recruited from the Outpatient Department at Oshakati Psychiatric Unit. A total of 396 respondents were sampled in the study by means of simple random sampling. Based on the information given by respondents, SPSS software was employed to summarise, evaluate, and analyse numerical information. Multiple linear regression analysis was used to identify the greatest predictors for relapse on mentally ill patients at IHO. The dependent variable (relapse) and independent variables (factors) were entered into bivariate logistic regression to determine statistical association between these variables. Findings revealed that non-adherence to medication due to side effects, and the non-availability of medicines at rural areas makes it costly to travel, thereby leading to relapse. Substance use and lack of health education were found to be associated with relapse by both respondents group. The results show a strong correlation between stressful life events and relapse. Visual hallucination, inability to sleep were found to have an association with mental illness relapse (OR 2.94, 0.03 and OR, 0.22, p=0.00 respectively). Based on these findings, recommendations were made as follows: proper health education, home visits and provision of atypical antipsychotic.Item Clinical learning experiences of nursing degree students at public training hospitals in the Khomas region, Namibia(University of Namibia, 2023) Kadhila, Joseph GalukeniClinical placement provides an opportunity for students to be socialised into the health system, achieve clinical skills in a real-life setting and observe the delivery of care by other healthcare professionals. Despite the obvious benefits of placements for students, poor relationships with the supervising nurse, environments that fail to promote belongingness and a lack of supervision hinder learning in the clinical setting. The purpose of the study was to assess the clinical learning experiences of nursing degree students practising in general wards at public training hospitals in the Khomas region of Namibia. The objective of the study was to explore and describe the clinical learning experiences of nursing degree students in general wards at public training hospitals in the Khomas region. The study aimed at answering the following central question: “What are your experiences during placement in general wards of the training hospitals in the Khomas region? The researcher selected a qualitative, explorative, descriptive and contextual design. Fifty-one participants from the undergraduate second, third and fourth years were recruited. Data collection included eleven (11) individual face-to face interviews and eight (8) Focus Group Discussions. Data was coded and analysed using Tesch’s method of data analysis. Four themes emerged from the exploration and description of nursing students ‘clinical learning experiences, namely, a non-conducive learning environment, negative staff attitude, communication barriers and shortage of staff. The results show that there were indeed constraints to learning in the clinical setting across all the years of study. Recommendations were made to the Nursing Education Institution, the training hospitals and the Ministry of Health and Social Services. Further research is needed on the clinical learning experiences of nursing students in other regions, the clinical learning experiences of male nurses and the lecturers’ experiences on clinical accompaniments.Item Assessment of knowledge, attitude and practices of male adults regarding the uptake of HIV counselling and testing in Opuwo district, Kunene region, Namibia(University of Namibia, 2022) Tjipundi, Sewako ThekelaHuman Immunodeficiency Virus (HIV) voluntary counselling and testing (VCT) are one among the different approaches implemented to curb the spread of HIV infections and minimise the impact on individuals and families. VCT are considered effective strategies in risk reduction among sexually active individuals, hence, the involvement of men in HIV services is critical to ensure the success of such services. Efforts by government and civil society organisations to get more men involved in HIV services in Namibia over the years have yielded little benefits. This research focused on determining the knowledge, attitudes, and practices of male adults regarding the use of VCT services in Opuwo District, Kunene Region, in Namibia. Data were collected in Opuwo town, Otuzemba and Katutura locations. The aim was to determine the role played by the male adults’ knowledge, attitudes, or practices in the uptake of HIV testing. The purpose of this research was to appraise the level of knowledge, attitude, and practice of VCT and to determine their association with demographic data on HIV uptake of the male adults in Opuwo district. The study employed a descriptive cross section study, method was used to select the respondents from a population which was done from September to November 2019. The simple random sampling of men aged between 15-50 years and above. The sampling formular used was EPI-INFO version 7 with a confidence interval of 95% and a power of 80%, which gave a sample of 113 participants. Data were gathered from 113 participants using a structured questionnaire that was distributed by the researcher and with the help of two people. The theoretical framework that was utilised in this study was the Health Belief Model, which submits the way beliefs guide individual actions and the process that people go through to change their behaviour The study was guided by ethical principles of beneficence, principle of respect for person and principle of justice. The research sought to determine the degree of knowledge regarding attitude and ii consumption of VCT services by male participants. The association between the data of the participants and other variables was tested using a Chi square. The participants in the study were men who had an average age of 30years. While 95.5% of the participants were knowledgeable about HIV/VCT, 60% had a negative attitude towards VCT, and 60% of the participants had never tested for HIV. The fear of positive results, stigma and discrimination, and confidentiality of test results if they were positive was reported as the main barrier for VCT uptake among men. Arguably, if male participation in accessing VCT services is to be enhanced, VCT programme should reduce, HIV stigma and improve access and trust towards VCT in the district. Other possible interventions are the setting up of regular home-based VCT programmes and the mainstreaming of HIV Testing Services in community development programmes. The chi-square test showed that the type of occupation has an influence on the knowledge of HIV. Finally, the study concluded that outreach programmes that target the testing of men should be encouraged or introduced by Community Based Organisations, and the Ministry of Health and Social Services.Item Organisational role stress and work engagement among nurses working in intermediate hospital Oshakati, Namibia(University of Namibia, 2022) Ashipala, Petrus ShigwedhaGenerally, Organisational Role Stress (ORS) arises when there is no balance between one’s work requirement and conditions, and capabilities, which is due to the organisational role of one’s occupation. Health care organisations are characterised by industrialisation, urbanisation, and technological advancements that lead to rising stress. Globally, it is reported that work-related stress among nurses is increasing as they are exposed to several role stressors and demands of the workplace, this can poorly decrease their work engagement. This study was conducted to determine the relationship between organisational role stress and work engagement among nurses working in Oshakati Intermediate Hospital (IHO). A quantitative cross-sectional and analytical study design was conducted among 222 nurses in Intermediate Hospital Oshakati. It composed of 122 registered nurses and 100 enrolled nurses. A self-administered questionnaire was used to collect the data. Descriptive statistics were used to describe the sample characteristics. The Chi-square was used to determine the association between organisational role stress and work engagement based on p-value <0.05. Pearson’s correlation coefficients were used to determine the strength and direction of relationships between variables. The results revealed that most of the responders had a certain level of organisational role stressors. Even though the results on organisational role stress showed a high level of stress among nurses, this study revealed that the majority of nurses has high positive affectivity towards their work engagement. The study further revealed that there is a strong relationship between the variables of organisational role stress and work engagement among nurses and it was clear from the analysis that there was no statistically significant correlation between total organisational role stress and total work engagement (r^=0.02, p-value=0.054). The recommendations are that administrators and policy makers need to design an attractive working climate to decrease the level of organisational role stress and uplift their work engagement among nurses.Item Knowledge and experiences of nurses regarding the preparation of adolescents with congenital heart disease for adulthood at Windhoek central hospital, Windhoek, Namibia(University of Namibia, 2022) Njembo, CharmineThe purpose of the study was to determine the nurse’s knowledge and explore the experience of nurses regarding the preparation of adolescents with Congenital Heart Disease (CHD) for adulthood. A convergent mixed method design was used. A descriptive design was applied to describe the nurses’ knowledge on preparation of the adolescents with CHD for adulthood according to the following domains: a) prevention of complications, b) physical activities, c) sexuality and heredity, d) contraception and pregnancy planning for the quantitative data. For qualitative data, a phenomenological descriptive approach was followed to explore and describe the experience of the nurses with regards to the educating, and counselling of adolescents with CHD in preparation for adulthood at Windhoek Central Hospital’s In- and Out-patient cardiac departments. Out of 26 nurses who provide care at Windhoek Central Hospital’s cardiac departments, only 17 nurses who met the inclusive criteria were interviewed. Due to the low numbers, all participants were eligible for both methods. The quantitative data was analyzed and synthesized using the Statistical Package of Social Science (SPSS-version 27) software, which is designed for quantitative data analysis. Descriptive factor analyses were produced using statistical methods using SPSS version 27. The qualitative raw data for this study were analysed through Atlas.ti using the coding system, then the most descriptive words were converted into themes. To achieve the aim of the study, two objectives were set: (a) to determine the nurses’ knowledge on preparation of adolescents with congenital heart disease for adulthood with regard to the prevention of complications, physical activities, sexuality and heredity, contraception and pregnancy planning; and (b) to Explore the nurses’ experience with regards to education, counselling, and preparation of adolescents with CHD for adulthood. ii Objective (a): The study comprised mostly of registered nurses (76.5%), with 17.6% enrolled nurses and only 5.9% of nurses are cardiac specialist nurses. The findings revealed that most nurses (52.9%) who provide direct nursing care to the adolescents with congenital heart disease in a transition period qualified for a long time as nurses and they have appropriate experience for preparing the adolescents with CHD for adulthood. The findings from the quantitative data indicated that although nurse demonstrate good knowledge that adolescent with CHD should consult health facilities in case of side effects of medication (94.1%), avoidance of physical demanding occupation (100%) however only 76.5% of nurses agreed that adolescents with CHD in transition should not partake in any competitive sport. While nurses acknowledged that adolescents with CHD may engage in sexual activities that they are capable of performing (70.6%) and that adolescents with CHD are at risk of pregnancy related complications (100%). However, the respondents nevertheless had average knowledge about action adolescents with CHD should take in event of medication side effect (52.9%), poor knowledge about risks incurred by engagement in sexual activities (11.8%), subsequent poor knowledge about risk of hereditary of CHD to the offspring (11.8%) and average knowledge about the choices of contraceptive for adolescents with CHD, most respondents 82.4% correctly recommended the Implanon as the suitable method of contraceptive for adolescents with CHD, however this method of contraceptive is standard for all adolescents with CHD at Windhoek central hospital cardiac department, without considering the specific cardiac lesion, type of cardiac surgical intervention and treatment regimen for an individual adolescent with congenital heart disease, as proposed by Sable et., (2011) and World Health organization (2009). Additionally, the findings indicated that nurses use a holistic approach when preparing the adolescent with CHD for adulthood by focusing on key aspects of preparation such as: iii prevention of complications, physical activities, sexuality, heredity, contraception and pregnancy. Objective (b): Nurses felt that, they encouraged disease acceptance during counselling as this might result in better physical and mental well-being of the adolescents with congenital heart disease. It is worthy to note that most of the participants in the interviews spoke highly on the importance of treatment adherence. Moreover, nurses had the impression that sufficient knowledge is provided to adolescents with adolescents with CHD with regard to International Normalized Ratio training. Although a holistic approach on other matters that affect the adolescents with CHD is used by nurses to ensure a smooth transition, the nurses’ perceive that there is still a need for psychological support to help the adolescents to cope with the disease as CHD requires ongoing medical attention as CHD causes limitations to the patient’s daily activities. Nurses felt that although activities intolerance was mostly discussed with the transitioning adolescents with CHD, nurses’ did not discuss the benefits of exercise. Therefore, adolescents with CHD could risk developing perceived physical activity restrictions. From the qualitative section, the main themes which emerged were Inform patients on the nature of CHD, Extreme physical activities, The future of adolescents living with CHD, Educate on sexual activities, Educate on career choice, Nurses knowledge, Care and empathy psychological support and Policy/guideline. The researcher recommended the implementation of a checklist to guide the nurses in assessing the needs of adolescents with CHD in the transition period as well as in-service training for nurses to initiate an effective and efficient education and counselling to the adolescent with CHD in a transition period.Item Factors associated with low Apgar score in newborn babies at a hospital in Namibia(University of Namibia, 2022) Lungameni, JustinaAll newly born infants have to go under examination after birth and again for five minutes to check how well they are tolerating the birth process and the environment outside the uterus. The study aimed to identify factors associated with low Apgar scores among newborn babies in Onandjokwe Intermediate Hospital. The quantitative, 1:1 ratio case-control matching, retrospective, a descriptive research design was used. The target population was cases of 376 maternal records with low Apgar scores. Simple random sampling methods were used to select the sample size for maternal records of low Apgar score babies which was 194 and for babies with normal Apgar scores 194 will give a total of 388 maternal records. Data were collected from June to August 2020 in Onandjokwe Intermediate Hospital using a document review checklist as the data collection tool. A pilot study was done on 10% of maternal records. Data were entered and analyzed using SPSS version 26. Dependent variables were analyzed using Binary Logistic Regression to measure changes in the Independent Variables and results were presented in tables and graphs in the form of frequencies and percentages. In this study, the level of significance was determined by factors with a p-value less than 0.05. The results show that 161 (82.9%) of newborn babies had a low Apgar score at immediate Apgar scoreand of these 30 (18.6%) had severe low Apgar score while 131 (81%) had moderate low Apgar score The demographic and maternal factors were significantly associated with immediate low Apgar scores were gravidity (p<0.021), parity (p<0.029), Haemoglobin during the first Ante-natal care (ANC) visit (p<0.011), Antepartum haemorrhage (APH) (p<0.004), membrane status (p< 0.000), duration of labour (p< 0.000), and neonatal factors include; gestational age (p<0.000) as well as birth weight (p<0.000). The results of Apgar scores after five minutes showed that 33 (8.5%) of newbornbabies had low Apgar scores and those with normal Apgar scores were 355 (91.5%). Factors associated with low Apgar scores at five minutes after birth are maternal age (p<0.015), urinary tract infection (UTI) (p<0.000), other pregnancy comcomplications<0.000), and gestational age (p<0.000) and birth weight (p<0.000). Binary Logistic regression model results show factors that were found to be strong predictors on immediate Apgar score are: total duration of labour (OR 4.263; 95% CI:2592-7.010; p-value=0.000), foetal presentation (OR 2.988; 95% CI: 1.182-7.554; p-value=0.021) and cord around the neck (OR 18.473, 95% CI;1.936-176.262; p-value=0.021). While after five minutes Apgar score, proper monitoring of partograph (OR 2.228; 95% CI:1.656-2.997, p-value=0.000) and gestational age (OR 1.475; 95% CI: 1.259-1.728; p-value=0.000) were the factors that increase chances of neonates persisting with a low Apgar score. Maternal and neonatal factors associated more with low Apgar scores are identified, the study concluded that in-service training for midwives on effective monitoring of pregnant women during antenatal care and labor is needed. In addition, health education about the importance of antenatal care would contribute more to the early detection of complications for prompt action.Item Experiences of patients diagnosed with drug susceptible tuberculosis regarding lost to follow-up in Engela district, Ohangwena region(University of Namibia, 2022) Venokulavo, Teresia KakunavaliLost to Follow-Up (LTFU) amongst Tuberculosis (TB) patients is referred to as a patient diagnosed with TB who interrupts treatment for two consecutive months or more. LTFU has been cited as a major risk factor for the re-emergence of TB strains resistant to first line anti-tuberculosis drugs. Namibia has been reporting increasing levels of patients LTFU over time, with some districts such as Engela reporting a 10% LTFU in quarter 4 of 2017 and 11% in quarter 1 of 2018 and constantly failing to attain the WHO recommended LTFU of below 5%. Patients diagnosed with drug-susceptible TB and registered for treatment after lost to follow up might have different experiences that can lead to them defaulting on treatment and being lost to follow up. Therefore, it was necessary to conduct a study aimed at exploring and describing the experiences of patients diagnosed with drug-susceptible and registered patients LFTU in Engela District, Ohangwena Region. Qualitative research with exploratory, descriptive and contextual designs were used in this study. The data was collected through in-depth interviews conducted at different sites in Ohangwena Region. A sample of 11 patients diagnosed with drug-susceptible TB and registered as patients LFTU were selected using a purposive sampling technique. The sample size was determined by saturation of data as reflected in repeating themes. Interviews were recorded and field notes were taken during the interview to ensure that all experiences of the participants were captured. The data was analysed using Tesch’s eight steps of coding. The results showed that patients diagnosed with drug-susceptible TB had different experiences that led to the patients being lost to follow up on TB treatment. Some patients experienced physical malaise prior to being diagnosed with TB, while others experienced chest pain. The participants iii became lost to follow up to their TB treatment for various reasons such as a lack of adequate information upon commencement of TB treatment and the importance of adherence to therapy, stigma at work and in the community, alcohol indulgence, a lack of proper nutrition and having travelled far away from the area where they initiated treatment. The study recommends the development of holistic LTFU mitigation strategies/interventions aimed at improving organisational and administrative health system challenges impeding health education delivery to patients and the communities and provision of patient-centred care by health care workers. Further, it is important to look into addressing stigma issues and changing labour policies and laws that disadvantage sick people in the workplace and lead them to default therapy.Item Perceptions of registered nurses on emotional needs and their role in meeting emotional needs of patients at Engela hospital, Ohangwena region, Namibia(University of Namibia, 2022) Ndaikile, Rainhold V.Meeting emotional needs is considered a central component of nursing care. Nurses today are expected to meet emotional needs of patients. It is however not clear whether nurses perceive their role in meeting the emotional needs of patients rather than physical needs only. Therefore, the study titled: The perceptions of registered nurses on their role in meeting emotional needs of patients at Engela Hospital, Ohangwena region, Namibia” was conducted. The aim was to explore and describe the perceptions of registered nurses on their role in meeting emotional needs of patients at Engela Hospital, Ohangwena Region, in order to make recommendations for the reinforcement of emotional support for patients. In order to meet the aims and objectives, this study has used the qualitative, exploratory, descriptive research design to determine the perceptions of registered nurses on their role in meeting the emotional needs of patients at Engela Hospital. In-depth face-to-face interviews were conducted at Engela hospital. Twenty (20) registered nurses employed at Engela hospital and purposively sampled, participated in this study. The interviews were conducted until data saturation. Interviews were recorded with audio-recorder and transcribed verbatim. Data was analysed following the methodology provided by Botma et al (2010). The study identified four (4) themes and several sub-themes forming part of the findings of the study. The four identified themes were: Participants perceived different negative emotions during patient’s hospitalisation that needs to be met such as anger, anxiety, fear, stigma and depression. Participants perceived psycho-social and physical factors that contribute to patient’s emotions such as pain, diagnosis, isolation, relationships, and ii cultural and spiritual factors. Participant perceived their roles in meeting emotional needs such as reassuring, referring, counseling, rendering holistic care and allowing personal preferences. Finally, Participants perceived barriers to fulfill their role in meeting emotional needs of patients such as shortage of staff, lack of privacy and lack of freedom in patients they express their feelings. Therefore, the study concluded that registered nurses perceived their role in meeting patient’s emotional needs. However, the study has also identified barriers that affect the registered nurses from meeting the emotional needs of patients at Engela hospital. Finally, the study recommends supervision by management on emotional support by nurses, nurse educators emphasise on emotional care and further methodological sound research obtaining the views of both parties involved.Item Knowledge, attitudes and practice of patients diagnosed with diabetes regarding diabetic self-care management in intermediate Rundu hospital, Kavango east region(University of Namibia, 2022) Sakeus, JacobinaDiabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. The majority of people with diabetes have type 2 diabetes. The study aimed to assess the level of knowledge, attitudes and practice of self-care management among patients diagnosed with diabetes at Rundu Intermediate Hospital. A quantitative, cross-sectional and analytic study was conducted among patients diagnosed with diabetes. Self-reporting questionnaires were used to collect data from 198 participants diagnosed with diabetes mellitus at Rundu Intermediate hospital. The data were analysed using SPSS version 25. Chi-squared test was used to analyse the possible associations among variables. The study findings indicated that the majority of respondents were female 125 (63%) and belonged to the age group of 60 and above 76 (38.4%). Most, 91 (47%), of the patients were uneducated, 115 (58.5%) on oral medications. 79 (39.9%), were on insulin and only 4 (2%) were on both oral medication and insulin. Almost half, 97 (49%) of patients had adequate knowledge regarding self-care management mainly on domains such as meal plan 184 (92.9%), medication-taking 195 (98.5%), and physical exercise 112 (56.6%). However, 154 (77.8%) had inadequate knowledge of diabetic foot care. The study revealed average attitudes 113 (57.4%) toward self-care management. Poor practice was observed in glucose monitoring 111 (59%). The study found a highly significant association knowledge among participants with university and secondary education levels. Finally, he study found a significant association between age, education level and employment status with the practice of self-care management of diabetes p-<0.05. Awareness creation to the community through health education should be emphasised on lifestyle changes, physical exercise, and foot care, cessation of smoking and healthy dietary habits.Item Experiences of patients with extensive drug-resistant tuberculosis regarding prolonged isolation in a TB ward at a selected hospital in Namibia.(University of Namibia, 2021) Sirongo, Eine H.The focus of this study is to understand the experiences of participants with Extensive Drug Resistance (XDR) regarding prolonged isolation. The participants with XDR-TB are admitted in isolation for a minimum of twenty (20) months in the hospital. Different factors contributed to the participants not adhering to the rules of isolation in the TB ward. The fact that the isolation TB ward does not have proper measures to keep patients enclosed imposes the risk of cross infection to the public. The study aimed to explore and describe the experiences of patients with XDR-TB regarding prolonged isolation at a selected hospital in Namibia. The objectives of the study were to: Explore and describe the experiences of participants with XDR-TB regarding prolonged isolation at the TB ward at the selected hospital in Namibia. This study adopted a qualitative, explorative, descriptive, and contextual approach to understanding in-depth the participants’ experiences of being isolated for a longer period. A purposive sampling approach was used to select the study participants and saturation was achieved at seventh (7th) participants. The data was collected using face-to-face individual interviews and analyzed using the thematic content method of analysis. Four main themes became apparent after the data was analyzed: Isolation, Challenges regarding basic needs, Psychological Support, and Improved health status. This study concluded that the participants experienced some psychosocial problems due to prolonged isolation. Living in isolation deprived them of a normal social lifestyle which resulted in pain, loneliness, anxiety, fear and depression. It was also revealed that participants believed that completing XDR-TB treatment guaranteed them cured.Item Effects of the shortage of midwives on performance and quality of care, in maternity ward, Rundu Intermediate hospital and Nyangana district hospital, Kavango East region(University of Namibia, 2021) Kandjimi, EmilieMidwives play a vital role in improving maternal and neonatal health. An adequate number of professional midwives is associated with improved quality of care and decreased maternal and newborn mortality. An increased workload due to the shortage of staff exposes midwives to unnecessary pressure, which might affect the quality of care they provide to patients. Addressing barriers that hinder midwives from providing quality care is a step towards improving the health care deliverance and hence, a step towards achieving the Millennium Developmental Goal (MDG) 5 and the Standard Developments Goal (SDG) 3. The aim of this study was to assess the effects of the shortage of midwives on their performance and quality of care, in the maternity ward of Rundu Intermediate Hospital and Nyangana District Hospital, Kavango East Region, Namibia. A quantitative analytic descriptive cross-sectional study was conducted using a purposive, non-random sampling method on fourty (40) midwives, in which thirty-one (31) were from Rundu Intermediate Hospital and nine (9) from Nyangana District Hospital. A self-administered questionnaire was used. The results revealed that the major effects of the shortage of midwives on their performance were as follow: increases workload (100%), feelings of fatigue and emotional exhaustion (97.5%), increases stress levels (95%), causes burnout and moral distress (87.5%), increases job dissatisfaction (87.5%), decreases willingness to work (70%), causes high staff turnover (65%), decreases the ability to work (65%) and increases medical errors committed among midwives (60%). Moreover, late attendance to patients (95%), poor monitoring of patients’ conditions (92.5%), inadequate or poor patient care (90%), delay in treatment of patients (87.5%), delay in initiating emergency interventions (82.5%) and lack of performance in the implementation of the EmOC (Emergency Obstetric Care) guideline (82.5%), were among the effects of the shortage of midwives on the quality of care. Other effects on the quality of care included increase in mortality rate (i.e. still birth, neonatal and maternal death) (77.5%), unnecessary complications that delay recovery (75%), negative attitude of health workers towards patients (67.5%) and medical errors committed by midwives (67.5%). The study concluded that the shortage of midwives has negative effects on both midwives’ performances and quality of care. The study recommended the followings: the MoHSS and the professional councils to come up with proper midwife-to-patient ratio to reduce workload pressure; the human resource of the MoHSS to make provision of recruiting adequate staff in maternity sections; and provide adequate equipment to enhance performance of few staff. In addition, the obstetric care trainings need to be provided to all midwife staff prior to allocation to maternity sections. The MoHSS should make provision of a service that provides the midwives with emotional and psychological support, to assist them on coping with stress from work-related pressures and help them deal with their emotions. The MoHSS should also create a conducive working environment to attract more staff, therefore, overcome staff shortage, and eventually, minimise effects of the shortage of midwives.Item Experiences of patients with extensive drug-resistant Tuberculosis regarding prolonged isolation in a TB ward at a selected hospital in Namibia(University of Namibia, 2021) Sirongo, Eine K HThe focus of this study is to understand the experiences of participants with Extensive Drug Resistance (XDR) regarding prolonged isolation. The participants with XDR-TB are admitted in isolation for a minimum of twenty (20) months in the hospital. Different factors contributed to the participants not adhering to the rules of isolation in the TB ward. The fact that the isolation TB ward does not have proper measures to keep patients enclosed imposes the risk of cross-infection to the public. The study aimed to explore and describe the experiences of patients with XDR-TB regarding prolonged isolation at a selected hospital in Namibia. The objectives of the study were to: Explore and describe the experiences of participants with XDR-TB regarding prolonged isolation at the TB ward at the selected hospital in Namibia. This study adopted a qualitative, explorative, descriptive, and contextual approach to understanding in-depth the participants’ experiences of being isolated for a longer period. A purposive sampling approach was used to select the study participants and saturation was achieved at seventh (7th) participants. The data was collected using face-to-face individual interviews and analyzed using the thematic content method of analysis. Four main themes became apparent after the data was analyzed: Isolation, Challenges regarding basic needs, Psychological Support, and Improved health status. This study concluded that the participants experienced some psychosocial problems due to prolonged isolation. Living in isolation deprived them of a normal social lifestyle which resulted in pain, loneliness, anxiety, fear and depression. It was also revealed that participants believed that completing XDR-TB treatment guaranteed them cured.Item Assessment of quality of midwifery care during labour at maternity departments of intermediate and refferral hospitals in Namibia(University of Namibia, 2021) Nghifikwa, JoniaQuality of midwifery care can be defined as care delivered by midwives, which is safe, effective, efficient, accessible, acceptable, patient-centred, equitable, and results in a positive pregnancy outcome. This research aims to assess the quality of midwifery care rendered during labour at the intermediate and referral hospital in Namibia. In Namibia, the Ministry of Health and Social Services (MoHSS) in particular, has come up with many interventions aiming to reduce maternal and neonatal mortality and morbidity. Even though these programmes were implemented, the programme reviews conducted by MoHSS in 2016 identified some gaps in the quality of midwifery care and recommended the conduct of a second nationwide Emergency Obstetric and Neonatal Care (EmONC) assessment. The main objectives of this study therefore were to describe the demographic profile, conclude the standard of midwifery care rendered during the first, second, third and fourth stages of labour by reviewing maternity records and analysing the standard of midwifery care rendered during the first, second, third and fourth stages of labour of the women who gave birth at intermediate and referral hospital from 01 January to 31 March 2018. The study was a retrospective study with a descriptive quantitative design conducted on 653 maternity records at the above mentioned hospitals. The findings revealed the age group from twenty to thirty-five to be the highest age group that gave birth i.e. (78.6%), while (10.7%) were adolescents and (10.7%) of the women aged above 36 years of age. This study indicated that (95%) of these women attended antenatal care. However, obstetric history indicates that the majority of the women who had delivered 391 (59.9 %), had two to four children, followed by those who gave birth for the first time 197 (30.2 %), while the lowest were those who had five or more children 65 (10.0%). Early opening of a partograph could lead to early identification of problems and plans for interventions. This study further shows that 402 (61.6%) partographs were mostly opened with women in the active phase of labour. Few partographs 33 (5.1%) were opened in the latent phase of labour. However, partographs that were opened, the study results revealed that not all were managed according to the WHO guidelines. Poor documentation of midwifery interventions and care was noted, suggesting poor midwifery care. Most of the deliveries 499 (76.4%) were normal vaginal deliveries, followed by 151 (23.1%) who had caesarean section deliveries. The rest had assisted deliveries with one breech delivery. According to the findings of this study it can be concluded that midwifery care rendered during labour at the studied hospitals was of substandard.Item Knowledge, attitudes and practices regarding the risk of Hepatitis E virus among the residents of Havana information settlement in Windhoek, Namibia(University of Namibia, 2021) Nangolo, Risto Ndawedapo H.Globally, every year there are an estimated 20 million Hepatitis E virus infections worldwide, leading to an estimated 3.3 million symptomatic cases of hepatitis E. The 237 probable and confirmed cases at health facilities in Windhoek district are mostly from Havana informal settlement. These areas are characterized by overcrowded, poor living conditions and residents have limited access to safe drinking water, sanitation, and hygiene. The aim of this study was to determine the knowledge, attitudes and practices of the residents of Havana informal settlement regarding the risk factors contributing to the hepatitis E virus in Windhoek district, Khomas region Namibia. In this study, a quantitative and cross - sectional analytical study design was employed. The target population of this study was adults aged group 18- 60 years. A stratified sampling method was used. In this study, a structured questionnaire was developed to collect data from the participants. The data were collected through a questionnaire. The responses from each questionnaire were entered into a data entry template of the SPSS statistics software and the Chi square method was used. The study revealed that the majority of the participants 83.3% had sufficient knowledge while the least participants 16.8% had low level of knowledge regarding the risk factors of Hepatitis E virus. Majority number of participants 93.3% had a positive attitude which covers total population in the study while the fewer number of the participants 6.8% were negative attitude which was the least in the study. Study revealed that majority of the number of the participants 66.3% had poor practice while a small number of the participants 33.8% had good It is therefore recommended that the Ministry of Health and Social Services and the Ministry of Urban and Rural Development train and employ health care assistants who could help the affected residents in the community on how to implement control measures that will minimize the risk of Hepatitis E virus among residents in the Havana informal settlement.Item The knowledge, attitude and practices of nurses regarding the provision of services on Cervical cancer at healthcare facilities in Windhoek district, Namibia(University of Namibia, 2019) Shiweda, Ndahafa A.The purpose of this study was to determine the knowledge, attitudes and practices of nurses regarding the provision of services on cervical cancer at the health facilities in Windhoek district, Namibia. To achieve this aim, four objectives were set: (a) to assess the knowledge of cervical cancer and cervical cancer services among nurses (b) to determine the nurses' attitudes towards the provision of cervical cancer services (c) to assess the practices of nurses towards the provision of services on cervical cancer; and (d) to analyse the association between the key variables with regards to cervical cancer and the provision of its services. A quantitative, descriptive and analytical study, using a self-administered structured questionnaire was completed in 2019. Data on socio-demographic, knowledge, attitudes and practices regarding cervical cancer service provision was collected from nurses that are working at the randomly selected healthcare facilities such as Windhoek Central hospitals, Intermediate Katutura Hospital, Hakahana clinic, Wanaheda clinic, Okuryangava clinic and Katutura Health Centre. A total of eighty (80) participants was sampled with the means of stratified random sampling, proportionate to the size of the population at a certain health facility. With SPSS version 25, the researcher started with double data entry, descriptive statistics, recoding, redefining, scoring and finally categorising the findings. At a later stage Cross tabulation was done together with Pearson‘s Chi-squared test to determine the significance of the association between the variables, p-value < 0.05. The study comprised mostly females (78.4%) with 21.6% of males. Of the participants, 74.3% were reported to have a good level of knowledge of cervical cancer and the provision of its services. None of the nurses was found to have poor level of knowledge. All nurses in this study showed a positive attitude towards cervical cancer and its services. Many nurses 71.2% indicated to have a good practice compared to few 28.8% of the nurses with poor practice of cervical cancer service provision. The findings further reported gender to be a significant predictor of practice with the p-value=0.000. Moreover, the study revealed that the level of knowledge was not significantly associated with practice p-value= 0.366. The researcher proposed for an ongoing in-service training to improve nurses’ knowledge and to keep them updated with information on cervical cancer services. Additionally, the researcher recommended a different study to on the challenges faced by healthcare workers in providing services regarding cervical cancer and the women uptake of these services.