Thesis & Dissertations

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    Assessment of knowledge, practices and barriers to foot care among patients with diabetes mellitus at Zomba Central Hospital, Malawi
    (2019-05-01) Chibwe, Evelyn
    Foot ulceration is one of the most common complications among patients suffering from Diabetes Mellitus. Good knowledge and practice regarding foot care has been documented to reduce the risk of such foot complications and amputation. This descriptive cross sectional study was conducted to assess knowledge, assess practices and identify barriers to foot care among patients with diabetes at Zomba Central Hospital. A structured questionnaire was used to assess foot care knowledge, practices, and other related variables of 81systematically selected diabetic patients. Data obtained were analyzed using Statistical Package for the Social Sciences Software version 20.0. Descriptive statistics and bivariate correlations with 95% confidence interval were computed and findings have been presented in tables and figures. Of 81 Diabetes patients, 82.7% (n=62) had good knowledge and 26.6 % (n=21) had good practice on foot care. With regard to knowledge, 90.1% (n=73) were aware of the first thing to be done when they found redness/bleeding between their toes and 75.3% (n=61) were aware of the importance of inspecting the feet. Poor foot practices included; 81.5% (n=66) walked bare footed and 66.7% (n=54) used a stone to clean their feet. Barriers to foot care reported by respondents were: lack of knowledge and lack of money to buy appropriate materials. The findings have highlighted the gaps in knowledge, practices and barriers to foot care in DM patients. The study recommends enhancement of health education on foot care, continual motivation and support to patients with Diabetes. The study was done in one hospital, if multiple sites where used the data could have been enriched.
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    Open Access
    Assessment of knowledge and practices on hypertension among adult outpatients of unknown hypertension status at Nathenje Health Centre in Lilongwe, Malawi
    (2019-06-01) Katanga, Pempho Carol
    Hypertension is one of the most common non-communicable diseases with a high burden of disease both globally and locally. In Malawi, it is prevalent in about a third of the adult population, and is estimated to be the second leading cause of deaths. It places a great economic burden yet 94.9 % of hypertensive adults are not aware of their state. Adequate hypertension control requires public awareness which facilitates adoption of healthy lifestyles by individuals. The main objective of the study was to determine knowledge and practices on hypertension among adults of unknown hypertension status in the general outpatient department of Nathenje Health Centre in Lilongwe, Malawi. The specific objectives were to: assess knowledge of adults on hypertension; identify sources of information about hypertension among adults; describe practices of adults that relate to hypertension; determine the prevalence of modifiable risk factors for hypertension among adults, and; examine the relationship between awareness of hypertension and participants’ age, education, marital status, gender and number of health facility visits. A quantitative cross sectional study was conducted among 384 adults, aged 18 years and above, at Nathenje Health Centre. Systematic random sampling was used to select participants. Data were collected using a questionnaire and was analysed using SPSS version 20; descriptive statistics and Pearson’s Chi square test were used in the analysis. Among the study participants, 40.6 % had never heard about hypertension. Stress, excess salt intake and diabetes were the most well known risk factors. Only 11.4 % of those who had heard about hypertension were aware of the asymptomatic nature of hypertension, 28.5 % were aware of the lifelong nature of hypertension treatment, 64.9 % were aware that hypertension has complications and 64.5 % knew that hypertension can be prevented. Misconceptions regarding hypertension were present. Association was noted between awareness of hypertension and participants’ age (p = 0.021) and education level (p = 0.000). The study highlights the presence of knowledge gaps and practices that facilitate hypertension development. Gaps and opportunities in the role of health workers and institutions in hypertension prevention have been highlighted. Prevention strategies for hypertension to include the effective use of information dissemination channels.
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    Factors influencing adherence to recommended lifestyle modification amongst hypertension clients at Malamulo Hospital, Thyolo
    (2019-04-01) Kamanga Chitani, Ndaona
    Adherence to recommended lifestyle modification regarding hypertension control remains a serious problem despite widely publicized hypertension treatment guidelines and lifestyle modification recommendations. As such, blood pressure control is still poor in Malawi. This study examined factors that influence hypertensive clients’ adherence to recommended lifestyle modification at Malamulo hospital, Thyolo. It was a descriptive quantitative study. Data was collected through face-to face interviews with 108 clients, using a structured questionnaire. Systematic random sampling was used to recruit respondents into the study. Statistical packages for the social sciences (SPSS) version 22 was used for descriptive analysis; and logistic regression for multivariate data analysis. Results showed knowledge rate of 92%, and adherence rate of 53.8%. Multivariate analysis of significant variables, in a logistic regression model, indicated that having family support was found to be nearly 5 times more likely to facilitate adherence to recommended lifestyle modification than in cases where families were not involved in the care of their clients (OR = 4.587, 95% CI: 1.625, 12.947). Having support groups was also found to be 4 times likely to facilitate adherence compared to situations where there were no support groups (OR = 4.043, 95% CI: 1.496, 10.926). The study also revealed that poor provider-client relationships were also found to be nearly 5 times more likely to hinder adherence as compared to cases where provider-client relationship was good (OR = 4.653, CI: 1.633, 13.256). Furthermore, being away from home was found to be nearly 3 times more likely to hinder adherence as compared to cases where clients are at home (OR = 2.783, CI = 1.042, 7.734). Patients demonstrated adequate knowledge on recommended lifestyle modification. However, their practices were found to be poor. There is need for encouraging family support, improving provider-client relationships and emphasizing on the importance of modifying lifestyles at Malamulo Hospital in order to facilitate adherence behaviors amongst clients.
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    Assessing cardiopulmonary resuscitation knowledge and attitudes among nurses working in adult general wards at Kamuzu Central Hospital, Malawi
    (2019-06-01) Macias, Madalo Kalukusha
    This study looked at knowledge of nurses in diagnosing patients who need cardiopulmonary resuscitation; examined nurse’s knowledge on how to conduct cardiopulmonary resuscitation; and nurse’s attitude towards cardiopulmonary resuscitation in adult general ward at Kamuzu Central Hospital. A descriptive quantitative survey approach was used for the study. Data was collected using a self-administered questionnaire which also included 10 questions adopted from American Heart Association written Basic Life Support exam version 11 of year 2010. Analysis of the data was done using Statistical Package for Social Science version 23 and Excel packages to draw out mean, frequencies and percentages. A sample of 61 nurses in adult general wards was recruited using consecutive sampling. The results of the study showed that 65% (n=40) could be able to diagnose a patient needing cardiopulmonary resuscitation. Nurse’s attitude towards cardiopulmonary resuscitation was positive in 73% (n=44) of the nurses. However, knowledge on cardiopulmonary resuscitation graded using American Heart Association pass rate of 84% was very poor as only 7 % (n=4) of the nurses passed. A chi square test using fishers exact test at 5% significance level showed that nurses with experience of less than ten years had significantly higher knowledge of cardiopulmonary resuscitation at 63.4 % compared to those between ten and fifteen years of experience at 23 % with p value of 0.042.Periodic CPR trainings for the nurses and consider CPR certification for all bedside nurses. CPR knowledge among nurses is very low but needed. CPR trainings can help to rectify the problem.