Browsing by Author "Nalubega, Sylivia"

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    Ethical and practical considerations in HIV drug trial closure: perspectives of research staff in Uganda
    (Research Ethics, 2021) Nalubega, Sylivia; Cox, Karen; Mugerwa, Henry; Evans, Catrin
    There is a gap in evidence regarding how research trial closure processes are managed to ensure continuity of HIV care for HIV positive participants following trial closure within low income settings. This research aimed to establish how research staff in Uganda understood and practised post-trial care for HIV positive trial participants. A grounded theory study was conducted using in-depth individual interviews and focus group discussions with 22 research staff from three different trials in Uganda. The results indicated that researchers engaged in three main activities to support trial participants, including: (i) preparing for post-trial care, which included instituting trial closure guidelines, planning necessary resources, and informing trial participants about post-trial care; (ii) facilitating participants during trial exit by engaging in psychological and practical support activities and (iii) providing follow up care and support for participants after trial exit, to respond to the needs of trial participants which often arose after trial exit. This study established a need for a holistic approach to post-trial-care of HIV positive trial participants in Uganda, and the need to engage multiple stakeholders including ethics authorities.
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    Nurses as Street Level Bureaucrats: Experiences from Diabetes Care Nurses in Kuwait
    (Open Journal of Nursing, 2021) Alshammari, Muna; Nalubega, Sylivia
    Street-level bureaucrats are described as public service workers who interact directly with citizens in the course of their work and who have substantial discretion in the execution of their work. This article is a reflection of the primary author’s doctoral research experience, which investigated the role of nurses in caring for long-term diabetes patients in two selected hospitals in Kuwait. Nurses working in diabetes care in Kuwait were reported to operate under difficult conditions and utilized the tool of discretion to provide patient care, hence were exemplary street-level bureaucrats.
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    The practice of pilot/feasibility studies in informing the conduct of HIV related clinical trials in sub-Saharan Africa: A scoping review
    (Contemporary Clinical Trials Communications,, 2022) Nalubega, Sylivia; Obado Osuwat, Lawrence; Agyeiwaa, Poku Brenda; Evans, Catrin; Matovu Junior, John Bosco
    Pilot/feasibility studies represent a fundamental phase of the research process and play a vital role in the preliminary planning of a full size HIV clinical trial. Published HIV clinical trial protocols were reviewed to establish the extent to which the proposed HIV clinical trials are informed by a prior pilot/feasibility study. Methods: The JBI methodology for scoping reviews was followed. Six databases were systematically searched to identify articles for inclusion. Results: Thirty two (32) published HIV study protocols were included. Articles were in the English language and were published in the past 10 years (2011–2020). The review results showed that the majority of HIV-related clinical trials in sub-Saharan Africa were not informed by pilot/feasibility studies. The results further indicated that the number of HIV clinical trials informed by a pilot/feasibility study have been on the increase in the 8 years’ period since 2012, a trend that indicates positive uptake of pilot studies in HIV related studies. A few select countries (South Africa, Uganda, Zimbabwe, Malawi and Kenya) comprised more than 70% of all clinical trials that were informed by a pilot/feasibility study, conducted in sub Saharan Africa. Conclusions: Although there is an increasing interest among researchers to integrate pilot/feasibility studies in HIV related research, limited countries in sub-Saharan Africa appear to have embraced this trend. Strategies that can motivate researchers to engage in a culture of incorporating pilot/feasibility studies in HIV related research should be implemented.
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    Qualitative systematic reviews and their role in evidence-based HIV nursing
    (AUTUMN, 2014) Nalubega, Sylivia; Evans, Catrin
    Decisions for healthcare delivery and health policies should be based on the highest level of existing research evidence.Achieving this can be challenging given the large body of existing literature generated by empirical studies, which may have biases, methodological flaws or may be time and/or context specific. Additionally, individual studies can reach conflicting conclusions making it hard to decide which results should inform policy or practice decisions. Systematic reviews, which bring together the results of primary studies, offer a solution to such concerns. Systematic reviews are described as explicit, reliable, reproducible scientific methods which limit bias by identifying, selecting, critically appraising and synthesising all literature on a given topic from all relevant individual studies. As such, they provide the most accurate and trustworthy results, which are more acceptable and accessible to decision-makers [3–6], enabling health care professionals to offer focused and individualised care, in which up-to-date evidence is integrated with patients’ own values and needs. There are many different types of systematic reviews. The most common are those based on quantitative evidence which may or may not include meta-analysis, and those based on qualitative evidence. This paper aims to describe the method and process of qualitative systematic reviews and their importance in informing evidence-based HIV nursing practice.
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    The views and experiences of HIV research participants in sub-Saharan Africa: a worked example of a qualitative systematic review
    (HIV Nursing, 2014) Nalubega, Sylivia; Evans, Catrin
    HIV clinical trials are increasingly being conducted in sub-Saharan Africa [1–3]. There is a tension between the pressure to increase levels of research participation whilst at the same time ensuring informed consent and the protection of participants’ rights [4,5]. Researchers need to be aware of the particular ethical issues that underpin HIV research conducted in lowincome settings. This necessitates hearing from those who have agreed to participate in research and who have experienced the research process.This qualitative systematic review aims to synthesise existing qualitative literature to answer the question: What are the views and experiences of HIV research participants in sub-Saharan Africa? The review aims to highlight key issues that need to be addressed to ensure high-quality ethical HIV research practice in sub-Saharan Africa.