NRU :: Browsing by Author "Nabirye, Rose C."

Browsing by Author "Nabirye, Rose C."

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Adherence to Antihypertensive Medication: An Interview Analysis of Southwest Ugandan Patients’ Perspectives
(Annals of Global Health, 2020) Najjuma, Josephine Nambi; Brennaman, Laura; Nabirye, Rose C.; Ssedyabane, Frank; Maling, Samuel; Bajunirwe, Francis; Muhindo, Rose
Hypertension is a significant cardiovascular disease (CVD) and driver to CVD disorders in sub-Saharan Africa. It is a major independent risk factor for heart failure, stroke, and kidney failure. Persons living with hypertension attend to many aspects of self-care to manage their condition, including high blood pressure medication adherence to control of blood pressure. Rates of medication non-adherence, and thus uncontrolled hypertension, remain high and contribute to poor health outcomes. Understanding barriers and facilitators to adherence to hypertension therapies can help improve health outcomes.The aim of the study was to describe the common reasons for adherence and non-adherence to antihypertensive medication from patients’ perspectives.A qualitative study engaged clients of an out-patient clinic of a regional referral hospital in southwestern Uganda who were living with hypertension as participants. One-on-one in-depth interviews provided the narrative data. The interview transcripts were analyzed using thematic analysis.Sixteen participants provided the data for the findings. The themes identified as facilitators for adherence to antihypertensive medication were patients’ understanding of prescribed medication, availability of medication for hypertension, family support for patients living with hypertension, and regular review appointments at the hypertensive clinics. Conversely, lack of supply in government dispensaries, use of self-prescribed analgesic medication, and stigma were identified as barriers and challenges of adherence to antihypertensive medication.There is an urgent need for the health ministry to improve availability of high blood pressure medication and for health care providers to deliver individualized patient centered care, and sensitization on danger of self-prescription and measures that reduce stigma. These strategies may improve adherence to high blood pressure medication.
Adherence to modern contraceptives among female refugee adolescents in northern Uganda: A prospective single cohort study
(A prospective single cohort study, 2022) Bakesiima, Ritah; Gemzell-Danielsson, Kristina; Beyeza-Kashesya, Jolly; Ayebare, Elizabeth; Cleeve, Amanda; Larsson, Elin C.; Nabirye, Rose C.
Background: Contraceptive adherence is the current and consistent use of a contraceptive method as prescribed by a health worker or family planning provider so as to prevent pregnancy. Globally, adherence is lowest among adolescents. This has greatly contributed to the high burden of adolescent pregnancies. Adherence and reasons for discontinuation among refugee adolescents are poorly understood. The aim of this study was to determine the rates and predictors of adherence to modern contraceptives among female refugee adolescents in northern Uganda. Methods: A prospective single cohort study, nested into a randomised controlled trial (RCT) assessing the effect of peer counselling on acceptance of modern contraceptives. The RCT was conducted among female refugee adolescents in Palabek refugee settlement, northern Uganda. The study involved 272 new starters of modern contraceptives who were followed up for six months from May 2019 to January 2020. The outcome was measured at one, three and six months after receiving a contraceptive method. Data was analysed using STATA version 14.0. Results: Adherence rates were low and reduced over time. By the end of the six months, only 44% of the participants were using a contraceptive method. The commonest reasons for non-adherence were side effects and partner prohibition. Participants using long acting reversible contraceptives (LARC) were more likely to adhere compared to those who were using short acting reversible contraceptives (SARC) (OR: 3.37, 95% CI: 1.914-5.937, p=<0.001). There was no difference in adherence between participants who received peer counselling and those who received routine counselling. Conclusion: Adherence to modern contraceptives was low, leaving adolescents at risk of unintended pregnancies. Participants using LARC were more likely to adhere than those using SARC. Interventions addressing fear of side effects and partner prohibition should be studied and implemented to enable adherence to modern contraceptives
Baccalaureate prepared nurses as the new entry-level nursing cadre in Uganda: A qualitative study of BSN student and faculty perspectives in two universities
(Nurse education today, 2019) Abedi, Aisha A.; Ogwal, Dominic S.; Pintye, Jillian; Nabirye, Rose C.; Hagopian, Amy
Background: Low-income countries suffer chronic problems in producing, employing and distributing their health workers. The World Health Organization advocates for upgrading the number and quality of nursing professionals. As nurses and midwives comprise more than 60% of the health workforce in Uganda, the country's goal to improve nursing education is consistent with international recommendations. Objectives: To understand the dimensions of Uganda's relatively new baccalaureate-prepared nurse cadre (BSN), we explored the views of students and faculty in relation to training, job prospects, scope of practice, and satisfaction of BSNs in Uganda. Design: We used a descriptive qualitative design. Setting and participants: We interviewed BSN students and faculty at two large public nursing schools in Uganda in 2017. Methods: We conducted focus group discussions and key informant interviews and used a thematic analysis approach to analyze data. Results: The four overarching themes were: 1) BSN training is viewed as distinct from “bedside” training, 2) A rift between nursing cadres undermines workplace harmony, 3) BSNs are dissatisfied with their salary scale, and 4) BSNs are motivated to move abroad. Discussion: At this moment in the transition, the professional nursing culture within Uganda is not conducive to encouraging BSN entry. To gain traction and momentum for BSNs as an entry-level cadre in Uganda, policy makers might align incentives to encourage BSN trainees, as there are few BSNs within training programs and clinical settings. Increasing lower cadre nurses' understanding of the role of BSNs may help improve relations between nursing cadres. Aligning job descriptions with pay differentials in clinical settings and expanding meaningful job opportunities could help retain BSNs within Uganda.
Beliefs, perceptions and health-seeking behaviours in relation to cervical cancer: a qualitative study among women in Uganda following completion of an HPV vaccination campaign
(Global health action, 2016) Hasahya, Olivia T.; Berggren, Vanja; Sematimba, Douglas; Nabirye, Rose C.; Kumakech, Edward
Cervical cancer remains a leading cause of morbidity and mortality in Uganda. Despite earlier information campaigns to introduce human papilloma virus (HPV) vaccination, which also targeted cervical cancer, misinterpretation and misunderstanding of the subject remain high. Women in Uganda present with cervical cancer at an advanced stage due to poor health-seeking behaviours, with an associated high mortality rate. This project explored beliefs, attitudes, perceptions, and health-seeking behaviours in relation to cervical cancer among women in Uganda after an HPV vaccination project had been rolled out. Design: A qualitative study design was used, with six focus group discussions (FGDs) that included 36 women, aged 25 49 years, with no previous history of cervical cancer symptoms or diagnosis. The women were interviewed in February and March 2013. The transcribed data was analysed using content analysis. Results: Three themes emerged: feeling unprotected and unsafe, misbelief and wondering about cervical cancer, and fear of the testing procedure. Participating women had heard of cervical cancer but preferred to wait to access cervical cancer screening until symptom debut. Conclusions: There are still barriers to cervical cancer screening among women in Uganda, where there is a need for culture-specific, sensitive information and interventions to address the issues of improving the cervical cancer screening uptake among these women. Societal context needs to be taken into account when implementing community-based health education.
The burden of maternal morbidity and mortality attributable to hypertensive disorders in pregnancy: a prospective cohort study from Uganda
(BMC pregnancy and childbirth, 2016) Nakimuli, Annettee; Nakubulwa, Sarah; Kakaire, Othman; Osinde, Michael O.; Mbalinda, Scovia N.; Kakande, Nelson; Nabirye, Rose C.; Kaye, Dan K.
Hypertensive disorders of pregnancy are a major cause of morbidity and mortality. The objective was to estimate the disease burden attributable to hypertensive disorders of pregnancy in two referral hospitals in Uganda. Methods: Through a prospective cohort study conducted in Jinja and Mulago hospitals in Uganda from March 1, 2013 and February 28, 2014, hypertension-related cases were analyzed. Maternal near miss cases were defined according to the WHO criteria. Maternal deaths were also analyzed. The maternal near miss incidence ratio, the case-specific severe maternal outcome ratio, the case-specific maternal mortality ratio and the case-fatality ratio were computed. Results: Of 403 women with hypertensive disorders of pregnancy, 218 (54.1 %) had severe preeclampsia, 172 (42.7 %) had eclampsia, and 13 had chronic hypertension or Hemolysis, elevated liver enzymes or low platelets (HELLP) syndrome. The case-specific maternal near miss incidence ratios was 8.60 per 1,000 live births for all hypertensive disorders, 3.06 per 1,000 live births for severe preeclampsia and 5.11 per 1,000 live births for eclampsia. The casespecific severe maternal outcome ratio was 9.37 per 1,000 live births for all hypertensive disorders, and was 3.25 per 1,000 live births for severe preeclampsia and 5.61 per 1,000 live births for eclampsia. The case-specific maternal mortality ratio was 780 per 100,000 live births for all hypertensive disorders, and was 1940 per 100,000 live births for severe preeclampsia and 501 per 100,000 live births for eclampsia. The case-fatality ratio was 5.1 % overall (for all hypertensive disorders), but was 8 times higher for eclampsia compared to severe preeclampsia. Cyanosis, abnormal respiration, oliguria, circulatory collapse, coagulopathy, thrombocytopenia, and elevated serum lactate were significantly associated with severe maternal outcomes. Conclusion: There is high morbidity attributable to hypertensive disorders in pregnancy. Since some of the complications associated with morbidity can be recognized early, it is possible to prevent severe morbidity through early intervention with delivery, antihypertensive therapy and prophylactic magnesium sulphate treatment. The findings highlight the feasibility of implementing a facility-based surveillance system for severe maternal morbidity due to hypertensive disorders.
Cervical cancer screening among HIV‑positive women in urban Uganda: a cross sectional study
(BMC Women's Health, 2022) Najjuka, Sarah M.; Olwit, Connie; Kaggwa, Mark M.; Nabirye, Rose C.; Ngabirano, Tom D.
Background: Women living with Human Immunodeficiency Virus (HIV) are at a high risk for early development of cervical cancer. Adherence to cervical cancer prevention strategies in this population is vital for the early detection and treatment of cervical cancer. This study aimed to determine the prevalence and factors associated with cervical cancer screening among HIV-positive women attending an urban HIV care center in Uganda. Methods: This cross-sectional study included 205 HIV-positive women receiving care at an urban HIV care center. An interviewer-administered questionnaire was used to capture sociodemographic information, history of screening for cervical cancer, and reproductive health characteristics. Logistic regression analysis was used to determine the factors associated with cervical cancer screening. Results: Of the 205 HIV-positive women with a mean age of 37.5 ± 8.87 that participated in the study, majority (n = 201, 98%) were aware of cervical cancer screening. Ninety participants (44%) had ever been screened for cervical cancer and only 33 (16.1%) had been screened in the past year. Obtaining information about cancer of the cervix and cervical cancer screening from health care professionals was significantly associated with higher levels of cervical cancer screening (adjusted odds ratio = 5.61, 95% confidence interval: 2.50–12.61, p value < 0.001). Conclusion: This study highlights the low prevalence of cervical cancer screening among HIV-positive women and underscores the role of health professionals as an effective source of information on cervical cancer and cervical cancer screening. Patient education programs in HIV prevention and care facilities should emphasize cervical cancer screening messages to enhance the uptake of screening services.
Disclosure of Parental HIV Status to Children: Experiences of Adults Receiving Antiretroviral Treatment at an Urban Clinic in Kampala, Uganda
(AIDS research and treatment, 2017) Osingada, Charles P.; Okuga, Monica; Nabirye, Rose C.; Sewankambo, Nelson K.; Nakanjako, Damalie
Limited data are available on the experiences of parental HIV disclosure to children in Uganda. We conducted a qualitative study comprising sixteen in-depth interviews and four focus group discussions with parents receiving highly active antiretroviral therapy. Analysis was done using Atlas.ti qualitative research software. Back-and-forth triangulation was done between transcripts of the indepth interviews and focus group discussions, and themes and subthemes were developed. Barriers to parents’ disclosure included perceptions that children are too young to understand what HIV infection means and fears of secondary disclosure by the children. Immediate outcomes of disclosure included children getting scared and crying, although such instances often gave way to more enduring positive experiences for the parents, such as support in adherence to medical care, help in household chores, and a decrease in financial demands from the children. Country-specific interventions are needed to improve the process of parental HIV disclosure to children and this should encompass preparation on how to deal with the immediate psychological challenges associated with the parent’s disclosure.
Existence, triggers, and coping with chronic sorrow: a qualitative study of caretakers of children with sickle cell disease in a National Referral Hospital in Kampala, Uganda
(BMC psychology, 2018) Olwit, Connie; Mugaba, Maureen; Osingada, Charles P.; Nabirye, Rose C.
Background: Worldwide, sickle cell disease is recognized as one of the major causes of morbidity and mortality. Caregivers and patients with such chronic illnesses experience economic, physical, social and psychological distresses which may lead to chronic sorrow. Chronic sorrow is viewed as a normal reaction to loss, however it can progress to a pathological state such as depression if the coping styles are ineffective. Therefore, the aim of this study was to explore the existence of chronic sorrow, triggers and coping with grief related feelings among caretakers of children with sickle cell disease. Methods: A descriptive qualitative study was conducted. Twelve in-depth interviews were conducted with eligible participants who were purposively selected. Deductive thematic analysis methods were used for data analysis. Results: Many (9 out of 12) of the caretakers experienced chronic sorrow. The grief related feelings were triggered by health worker related, disease related and support related factors. Caretakers used both external and internal coping strategies. External support was derived from community, family and health facility. Internal coping strategies were behavioral and cognitive. Conclusion: Caretakers of children with sickle cell disease experienced chronic sorrow and employed both internal and external coping strategies to deal with it, which could be either effective or ineffective. This study recommends that health workers should routinely screen for chronic sorrow among caretakers of children with sickle cell disease and assist caretakers to strengthen effective coping strategies to ameliorate the negative effects of chronic sorrow
Experiences of patients undergoing chemotherapy - a qualitative study of adults attending Uganda Cancer Institute
(African health sciences, 2016) Wampaalu, Peter B.; Eriksson, Lars E.; Naamala, Allen; Nabirye, Rose C.; Wettergren, Lena
Background: Cancer is a global public health challenge and how patients in countries with poor healthcare infrastructure experience cancer treatment is largely unknown. Purpose: The objective of this study was to describe adult Ugandan cancer patients’ experiences of undergoing chemotherapy treatment. Methodology: Using a qualitative descriptive design, seven in-patients with varying cancer diagnoses at the Uganda Cancer Institute were interviewed about their experiences of undergoing chemotherapy treatment; the interviews were transcribed and analysed thematically. Results: The analysis resulted in nine subthemes, which were categorized under three main themes: ‘experiences related to the body’, with the subthemes dry and sensitive skin, changes in eating and bowel habits, fever and feelings of abnormal body sensation; ‘thoughts and feelings’, with four subthemes reflecting the psychosocial impact of chemotherapy; and ‘actively dealing with discomfort’, with three subthemes describing how patients dealt with side effects, such as by sticking to a diet. Conclusion: Receiving chemotherapy treatment is difficult, and the side effects negatively influenced patients’ bodies and moods. Dealing actively with discomfort and accepting negative impacts in hope of a cure helped the participants manage the acute complications related to the treatment. We recommend the development of interventions to ease discomfort due to chemotherapy.
Intimate partner violence among pregnant women in Uganda
(African Journal of Midwifery and Women's Health, 2019) Epuitai, Joshua; Udho, Samson; Auma, Anna G.; Nabirye, Rose C.
Background: Intimate partner violence may be more prevalent during pregnancy as women are more vulnerable. Aims: To determine the prevalence of intimate partner violence and associated factors among pregnant women at Soroti Regional Referral Hospital, Uganda. Methods: A cross-sectional study was conducted among 180 pregnant women. Data were collected using a pre-tested, semi-structured questionnaire. Intimate partner violence was measured using the revised Conflict Tactile Scale 2. Findings: The overall prevalence of intimate partner violence during pregnancy was 27.8%. Household average monthly income, experiences of intimate partner violence before pregnancy and marital conflicts were independently associated with intimate partner violence during pregnancy. Conclusions: Screening should be done during antenatal care among women with low household income, marital conflicts, and history of intimate partner violence before pregnancy to identify and manage cases of intimate partner violence. More research is needed to identify interventions for reduction of intimate partner violence during pregnancy.
Maternal near misses from two referral hospitals in Uganda: a prospective cohort study on incidence, determinants and prognostic factors
(BMC pregnancy and childbirth, 2016) Nakimuli, Annettee; Nakubulwa, Sarah; Kakaire, Othman; Osinde, Michael O.; Mbalinda, Scovia N.; Nabirye, Rose C.; Kakande, Nelson; Kaye, Dan K.
Background: Maternal near misses occur more often than maternal deaths and could enable more comprehensive analysis of risk factors, short-term outcomes and prognostic factors of complications during pregnancy and childbirth. The study determined the incidence, determinants and prognostic factors of severe maternal outcomes (near miss or maternal death) in two referral hospitals in Uganda. Methods: A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, where cases of severe pregnancy and childbirth complications were included. The clinical conditions included abortion-related complications, obstetric haemorrhage, hypertensive disorders, obstructed labour, infection and pregnancy-specific complications such as febrile illness, anemia and premature rupture of membranes. Near miss cases were defined according to the WHO criteria. Multivariate logistic regression analysis was conducted to identify prognostic factors for severe maternal outcomes. Results: Of 3100 women with severe obstetric complications, 130 (4.2 %) were maternal deaths and 695 (22.7 %) were near miss cases. Severe pre-eclampsia was the commonest morbidity (incidence ratio (IR) 7.0 %, case-fatality rate (CFR) 2.3 %), followed by postpartum haemorrhage (IR 6.7 %, CFR 7.2 %). Uterine rupture (IR 5.5 %) caused the highest CFR (17.9 %), followed by eclampsia (IR 0.4 %, CFR 17.8 %). The three groups (maternal deaths, near misses and non-life-threatening obstetric complications) differed significantly regarding gravidity and education level. The commonest diagnostic criteria for maternal near miss were admission to the high dependency unit (HDU) or to the intensive care unit (ICU). Thrombocytopenia, circulatory collapse, referral to a more specialized unit, intubation unrelated to anaesthesia, and cardiopulmonary resuscitation were predictive of maternal death (p < 0.05). Gravidity (ARR 1.4, 95 % C1 1.0–1.2); elevated serum lactate levels (ARR 4.5, 95 % CI 2.3–8.7); intubation for conditions unrelated to general anaesthesia (ARR 2.6 (95 % CI 1.2–5.7), cardiovascular collapse (ARR 4.9, 95 % CI 2.5–9.5); transfusion of 4 or more units of blood (ARR 1.9, 95 % CI 1.1–3.1); being an emergency referral (ARR 2.6, 95 % CI 1.2–5.6); and need for cardiopulmonary resuscitation (ARR 6.1, 95 % CI 3.2–11.7), were prognostic factors. Conclusions: The analysis of near misses is a useful tool in the investigation of severe maternal morbidity. The prognostic factors for maternal death, if instituted, might save many women with obstetric complications
Midwives’ practice and perception of labour and delivery care at the Mulago National Referral Hospital, Uganda
(African Journal of Midwifery and Women's Health, 2020) Namwaya, Ziidah; Kaye, Dan; Nalwadda, Gorrette; Edwards, Grace; Nabirye, Rose C.
Background/Aims The majority of maternal deaths occur during labour, delivery, or within the first 4 hours after birth. This can be reduced by the care that midwives provide. At Mulago Hospital, little is documented on midwives’ current practice and their perception of care offered during labor and delivery. The number of maternal and neonatal deaths as a result of preventable causes such as postpartum haemorrhage, obstructed labour, ruptured uterus and sepsis remains high. The aim of this study was to document the current practice of midwives, explore midwives’ perception towards practice and identify factors that influence practice during birth in Uganda, to identify possible areas for improvement. Methods A cross-sectional study was conducted of midwives working in the three labour wards at the Mulago National referral hospital: the general ward, the private ward and the midwifery-led ward. Midwives’ perceptions were explored using a semi-structured questionnaire, which asked midwives about their current practice and their perception of the care offered. Findings Care was found to be lacking in several areas. Only one-fifth (20.0%) of midwives reported always checking temperature every 4 hours. Only 20.5% reported that women are always supported in being mobile during labour. Less than half of the midwives (44.4%) knew the recommended drugs for managing the third stage of labour. Infection prevention practices were poor. Only 54% of midwives knew how to prepare magnesium sulphate for management of severe pre-eclampsia and eclampsia. Overall, the general labour ward was found to have the most gaps in midwives’ knowledge. Lack of continuing education, supplies, teamwork and clinical guidelines were reported to affect practice. Staff shortages and midwives’ decisions being underlooked by obstetricians were also reported to affect practice.
Modern contraceptive use among female refugee adolescents in northern Uganda: prevalence and associated factors
(Reproductive Health, 2020) Bakesiima, Ritah; Cleeve, Amanda; Larsson, Elin; Tumwine, James K.; Ndeezi, Grace; Danielsson, Kristina G.; Nabirye, Rose C.; Kashesya, Jolly B.
Background: Adolescent pregnancies are persistently high among refugees. The pregnancies have been attributed to low contraceptive use in this population. The aim of this study was to determine the prevalence and factors associated with modern contraceptive use among female refugee adolescents in northern Uganda. Methods: This was a cross sectional study using both descriptive and analytical techniques. The study was carried out in Palabek refugee settlement in Northern Uganda from May to July 2019. A total of 839 refugee adolescents who were sexually active or in-union were consecutively enrolled. Interviewer administered questionnaires were used for data collection. Results: Modern contraceptive prevalence was 8.7% (95% CI: 7.0 to 10.8). The injectable was the most commonly used modern contraceptive method [42.5% (95% CI: 31.5 to 54.3)], and most of the participants had used the contraceptives for 6 months or less (59.7%). Reasons for not using modern contraceptives included fear of side effects (39.3%), partner prohibition (16.4%), and the desire to become pregnant (7.0%). Participants who were married (OR = 0.11, 95% CI: 0.04 to 0.35, p < 0.001), cohabiting (OR = 0.43, 95% CI: 0.20 to 0.93, p = 0.032) or having an older partner (OR = 0.93, 95% CI: 0.86 to 0.99, p = 0.046) were less likely to use modern contraceptives. Conclusion: Modern contraceptive use among female refugee adolescents was very low, and few reported a desire to become pregnant, leaving them vulnerable to unplanned pregnancies. Least likely to use modern contraceptives were participants who were married/cohabiting and those having older partners implying a gender power imbalance in fertility decision making. There is an urgent need for innovations to address the gender and power imbalances within relationships, which could shape fertility decision-making and increase modern contraceptive use among refugee adolescents.
Musculoskeletal disorders among nursing staff: a comparison of five hospitals in Uganda
(The Pan African Medical Journal, 2014) Munabi, Ian G.; Buwembo, William; Kitara, David L.; Ochieng, Joseph; Nabirye, Rose C.; Mwaka, Erisa S.
Introduction: Low and middle income countries have severe nursing staff shortages which is associated with risk of poor quality of patient care and increased patient exposure to adverse events. This is accompanied with increased risk of musculoskeletal disorders to the nursing staff. This paper sets out to identify and compare factors associated with musculoskeletal disorders among nursing staff in 5 different hospitals in Uganda. Methods: This was a cross sectional study on nurses from 5 different hospitals in Uganda. The study used a 12 month recall of reported Musculoskeletal disorders (MSD) among nurses. Ethical approval was obtained. Logistic regression analysis and ANOVA were used. The level of significance was set at 0.05 for all statistical tests. Results: There were 755 respondents of whom 433 (58.4%) were nurses. The prevalence of MSD at anybody site was 80.8%. There were significant differences in reported MSD among nursing staff across different hospital settings which were worse in the public hospitals as compared to the private and private not for profit hospitals (p <0.001). Age (adjusted OR 1.03, 95% CI 1.01- 1.06), self reported poor general health status (adj OR 4.5, 95% CI 2.8-7.24) and stress as suggested by waking up tired in the morning (adj OR 3.4, 95% CI 2.17-5.32) were significant associated factors for MSD in this population. Conclusion: Reported MSD among nursing staff across 5 different hospitals is worse in public as compared to private hospitals. Age, self reported poor general health status and stress were important factors for MSD in this population.
Nurses’ knowledge of the principles of acute pain assessment in critically ill adult patients who are able to self-report
(International Journal of Africa Nursing Sciences,, 2016) Kizza, Irene B.; Muliira, Joshua K.; Kohi, Thecla W.; Nabirye, Rose C.
Introduction: Nurses play a critical role in managing and alleviating acute pain among critically ill adult patients (CIAP). The purpose of this study was to determine nurses’ level of knowledge about principles of acute pain assessment in CIAP. Methods: A descriptive cross-sectional study design and questionnaire survey were employed to collect data from 170 nurses caring for CIAP at Uganda’s national hospital. Results: The mean knowledge score of nurses was 71% indicating adequate knowledge levels. However, a large proportion of nurses was not knowledgeable about aspects related to pre-emptive analgesia when performing procedures for CIAP such as; airway suctioning (45.3%); invasive line placement (46.5%); and spontaneous breathing trials (63.5%). A large number of nurses did not know or believe that a patient can rate their pain accurately (43.5%). Nurses’ knowledge about pain assessment principles was significantly associated with their understanding of the need to assess for pain and pre-emptive analgesia for physical procedures such as; patient repositioning (OR = 0.103, CI = 0.031–0.345); drain removal (OR = 0.088, CI = 0.025–0.314); and invasive line placement (OR = 0.039, CI = 0.011–0.140). Conclusion: The nurses had adequate general knowledge about the principles of acute pain assessment in CIAP. However, some knowledge gaps exist about key concepts in pain assessment and these can curtail the efforts to ensure quality pain assessment and management in CIAP. The findings entrench the need for focused professional training and continuing professional education about best practices for pain assessment and management in CIAP.
Prevalence, barriers and factors associated with parental disclosure of their HIV positive status to children: a cross-sectional study in an urban clinic in Kampala, Uganda
(BMC Public Health, 2016) Osingada, Charles P.; Okuga, Monica; Nabirye, Rose C.; Sewankambo, Nelson K.; Nakanjako, Damalie
Background: Disclosure of parental HIV status is associated with a number of positive outcomes such as improved adherence to clinic appointments, lower levels of parental anxiety and depression, and mutual emotional support between parents and their children. Very few studies in low-resource settings have addressed the issues of parental disclosure of their HIV status to their children. Methods: A cross-sectional study was conducted among adult parents attending HIV/AIDS prevention, care and treatment clinic at Makerere University Infectious Diseases Institute (IDI), Kampala, Uganda. Participants were interviewed using the Parent Disclosure Interview (PDI) questionnaire which is a standard tool developed specifically for HIV infected parents. Data were analyzed using STATA version 13.1. Results: Of 344 participants, only 37 % had told at least one of their children that they were HIV positive. Barriers to disclosure were fear that children may tell other people about the parent’s HIV status, desire not to worry or upset children and perceptions that children may not understand. Age of the parent, religion and having someone committed to care of the children were positively associated with parental disclosure of their HIV positives status. Attainment of tertiary level of education was negatively associated with parental disclosure of their HIV status. Conclusions: Parental disclosure of a positive HIVstatus to their children is still low in urban Kampala. There is therefore need to develop locally relevant interventions so as to increase rates of parental disclosure of a positive HIV status to their children and thus promote open and honest discussions about HIV/AIDS at family level
Public knowledge about oral cancer in Uganda: a free dental camp experience
(Journal of health research, 2019) Nabirye, Rose C.; Kamulegeya, Adriane
The purpose of this paper is to assess the levels of awareness and knowledge about oral cancer, its causes and or risk factors among Ugandan patients seeking oral healthcare. Design/methodology/approach – This was a cross-sectional study on adult patients who attended a free dental camp. An assistant-administered questionnaire either in English or Luganda was provided to every even-numbered registered adult who consented to participate in the study. Information on demographics and known risk factors for oral cancer were captured. The two knowledge questions on oral cancers were scored by adding up all the correctly identified causes, non-causes and risk factors then scored out of the total. Data analysis was done by calculating proportions, Student’s’ t-tests and χ2 tests with significant p-value set at 0.05. Findings – The results showed a low level ofawareness/knowledge about oral cancer in studied population. In total, 60 percent and less than 50 percent of respondents identified smoking and alcohol use as risk factors for oral cancer, respectively. Majority of respondents (88.8 percent) would seek help from medical personnel if diagnosed with oral cancer. Screening for cancer was low despite awareness and knowledge that it improves the chances of successful treatment. Research limitations/implications – Emphasis on risk factors including alcohol use in public health messages, use of mass media, religious and community leaders to disseminate messages to the communities and further research were recommended. Practical implications – We need to emphasize the role of alcohol in oral cancer causation just as we do for tobacco consumption. Originality/value – No study has been conducted in Uganda on the level of awareness yet the incidence of the disease and use of high-risk products are rising
Still births, neonatal deaths and neonatal near miss cases attributable to severe obstetric complications: a prospective cohort study in two referral hospitals in Uganda
(BMC pediatrics, 2015) Nakimuli, Annettee; Mbalinda, Scovia N.; Nabirye, Rose C.; Kakaire, Othman; Nakubulwa, Sarah; Osinde, Michael O.; Kakande, Nelson; Kaye, Dan K.
Neonatal near miss cases occur more often than neonatal deaths and could enable a more comprehensive analysis of risk factors, short-term outcomes and prognostic factors in neonates born to mothers with severe obstetric complications. The objective was to assess the incidence, presentation and perinatal outcomes of severe obstetric morbidity in two referral hospitals in Central Uganda. Methods: A prospective cohort study was conducted between March 1, 2013 and February 28, 2014, in which all newborns from cases of severe pregnancy and childbirth complications were eligible for inclusion. The obstetric conditions included obstetric haemorrhage, hypertensive disorders, obstructed labour, chorioamnionitis and pregnancy-specific complications such as malaria, anemia and premature rupture of membranes. Still births, neonatal deaths and neonatal near miss cases (defined using criteria that employed clinical features, presence of organ-system dysfunction and management provided to the newborns were compiled). Stratified and multivariate logistic regression analysis was conducted to identify risk factors for perinatal death. Results: Of the 3100 mothers, 192 (6.2%) had abortion complications. Of the remainder, there were 2142 (73.1%) deliveries, from whom the fetal outcomes were 257 (12.0%) still births, 369 (17.2%) neonatal deaths, 786 (36.7%) neonatal near misses and 730 (34.1%) were newborns with no or minimal life threatening complications. Of the 235 babies admitted to the neonatal intensive care unit (NICU), the main reasons for admission were prematurity for 64 (26.8%), birth asphyxia for 59 (23.7%), and grunting respiration for 26 (11.1%). Of the 235 babies, 38 (16.2%) died in the neonatal period, and of these, 16 died in the first 24 hours after admission. Ruptured uterus caused the highest case-specific mortality of 76.8%, and led to 16.9% of all newborn deaths. Across the four groups, there were significant differences in mean birth weight, p = 0.003. Conclusions: Antepartum hemorrhage, ruptured uterus, severe preeclampsia, eclampsia, and the syndrome of Hemolysis, Elevated Liver Enzymes, Low Platelets (HELLP syndrome), led to statistically significant attributable risk of newborn deaths (still birth or neonatal deaths). Development of severe maternal outcomes, the mothers having been referred, and gravidity of 5 or more were significantly associated with newborn deaths.
“We are never taught anything about the elderly.” Establishing the gap in elderly health care competencies in nursing education in Uganda
(BMC nursing, 2022) Nawagi, Faith; Mukisa, John; Najjuma, Josephine N.; Nabirye, Rose C.
Nurses contribute the largest portion of Uganda’s health workforce providing care to individuals of all ages and communities. However, despite the growing number of the elderly population in Uganda with improved life expectancy, there is hardly any study that has looked at the elderly health care competencies in the nursing training programs at various levels. This paper provides an overview of the gaps in elderly health care competencies in nursing education in Uganda. Methods: We conducted a descriptive qualitative cross-sectional study that involved document review, Key Informant Interviews (KIIs) with nursing leaders, and Focus Group Discussions ( FGDs) with faculty at all levels of nursing training and nurses in practice. Data was analyzed using latent and manifest content analysis with Open Code software 4.03. Common categories were identified and incorporated into a matrix to create themes. Results: Almost all the curricula and minimum standards for training nurses at certificate, diploma, and degree levels lack a module and nursing competencies on elderly nursing care. This is aggravated by a lack of faculty trained in elderly health care skills, and a lack of specialized wards for nursing elderly care clinical training among others. Conclusions: There is hardly any elderly health care training module and elderly nursing competencies at all levels of nursing training in Uganda.

Browsing by Author "Nabirye, Rose C."

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