ABSTRACT
Malaria remains a critical public health challenge in sub-Saharan Africa, with pregnant women being particularly susceptible due to severe health implications for both mother and fetus. This study investigates the awareness of health promotion interventions for malaria prevention among pregnant women in the Iberekodo community of Abeokuta, Nigeria. Using a sample of 79 pregnant women, selected through purposeful sampling technique, data were collected via questionnaires and analyzed using descriptive statistics. This study utilized the descriptive; a quantitative method of research design is used for data collection. The target population for this study consists primarily of pregnant women attending antenatal clinics in the Iberekodo Community and there are about 98 pregnant women from diverse socio-demographic backgrounds attending the primary health care clinic at Iberekodo. A sample size of 79 respondents was drawn from the research population using Taro Yamane formula. A structured questionnaire with both close ended and open-ended questions was used as a research instrument to collect quantitative data to assess the level of awareness among pregnant women in the community regarding malaria prevention measures during early pregnancy. The study found that while there is an acceptable level of knowledge about the causes and consequences of malaria, awareness of preventive interventions such as insecticide-treated nets (ITNs) is influenced by factors including limited access to information and cultural practices. The findings highlight the need for targeted health promotion programs to enhance awareness and utilization of malaria prevention strategies during pregnancy. Recommendations include increasing the visibility of ITN campaigns, engaging family members in health education, and incorporating counseling on ITN use into post-abortal care. Further qualitative studies are suggested to explore additional factors influencing ITN use among pregnant women.
Keywords: Malaria Prevention, Health Promotion, Pregnant Women, Iberekodo Community, Insecticide-Treated Nets (ITNs), Maternal Health, Public Health.
TABLE OF CONTENT
Title Page i
Declaration ii
Certification iii
Dedication iv
Acknowledgement v
Table of content vii
Abstract ix
CHAPTER ONE: INTRODUCTION
1.1
Background to the Study 1
1.2
Statement of the Problem 2
1.3
Objectives of the Study 4
1.4
Research Questions 5
1.5
Research Hypothesis 5
1.6
Significance of the Study 5
1.7
Scope of the Study 6
1.8
Definition of Terms 7
CHAPTER TWO: LITERATURE REVIEW
2.1 Conceptual
Review 9
2.1.1 Concept of Malaria in Pregnancy 9
2.1.2 Epidemiology 10
2.1.3 Pathogenesis 10
2.1.4 Mode
of Transmission 11
2.1.5 Incubation
Period 11
2.1.6 Clinical
Presentation 12
2.1.7 Risk
Factors 12
2.1.8 Awareness
on Impact of Health Promotion on 13
Malaria
Prevention during Early Pregnancy
2.2 Theoretical
Review 14
2.2.1 Application
of theory 17
2.3 Empirical
Review 18
2.4 Appraisal of Literature Review 19
CHAPTER THREE: RESEARCH METHODOLOGY
3.1 Area
of study 21
3.2 Research
Design 21
3.3 Research
Population of the Study 21
3.4 Sample
size and Sampling Technique 21
3.5 Instrument
for Data Collection 23
3.6 Validity
of Instrument 23
3.7 Reliability
Instrument 23
3.8 Method
of Data Collection 23
3.9 Method
of Data Analysis 24
3.10 Ethical
Considerations 24
CHAPTER FOUR: RESULT OF FINDINGS AND
DISCUSSIONS
4.1. Presentation
of Data 25
CHAPTER FIVE: SUMMARY, CONCLUSION AND
RECOMMENDATIONS
5.1 Discussion
of Findings 28
5.2 Implications
of Findings to Nursing Practice 30
5.3 Limitations
of the Study 30
5.4 Summary
of Findings 30
5.5 Conclusion
31
5.6 Recommendations
31
5.7 Suggestion
for Further Studies 32
References 33
Appendix 36
Questionnaire 37
CHAPTER
ONE
INTRODUCTION
1.1 Background
to the Study
End-of-life
care is provided to patients with cancer during the last days and weeks of
life. End-of- life care may also be required where people with major organ
failure are at risk of death. The end-of-life care provided by nurse is of
particular importance as they can focus on facilitating patient choice, and
managing symptoms such as pain, without increasing the risk of death (Laube, et
al, 2021). In such cases, end-of-life discussions with nurses are crucial
(Salifu, et al, 2021), particularly as those with heart failure often
experience sudden and unexpected changes and deteriorations in their condition
(Suwanabol, et.al, 2018). Nevertheless, it is often unclear how to best
approach such conversations from the perspective of clinicians.
A
recent review of the literature highlighted the importance of analyzing the
views of care professionals regarding the provision of end-of-life care for
people with cancer in order to understand how their care performance is
affected (Gedefaw, et al, 2021). Elsewhere, health professionals have
identified the lack of an accurate prognosis of advanced cancer a barrier to providing
quality end of-life care discussions (Sayed, et al, 2021). Family caregivers who provide care at home
for people with cancer also need to engage in high quality conversations about
end- of- life care (Kim,et al, 2020). Yet while the literature has explored
challenges relating to end-of-life care discussions for those with critical
health failure from the perspective of doctors and family caregivers, the
nurses’ point of view in this field has received less attention. Families’
perspectives and nurses ‘perceptions of the challenges in providing end-of-life
care and related discussions have not yet been analyzed in Nigeria at all. This
is concerning given that nurses provide the majority of end-of-life care and
more often initiate associated conversations, both of which can improve quality
of life of patients with cancer. Considering the above, the aim of this
research was to explore nurses ‘perceptions of the challenges involved in
providing of end-of-life care to patient with cancer.
End-of-life
care aims at improving the quality of life for people with life-limiting
conditions (Kelley, 2015). This includes managing the patient’s pain and
symptoms and addressing the burden and psychosocial issues of both the patient
and family (Ascherfeld, et al, 2017). Other researchers have established that
palliative care goes beyond the patient’s physical and psychological health to
include the quality of life of the families of patients suffering from chronic
disease in order to promote physical and psychological health (Aparicio, et al,
2017). Evidence suggests that patients suffering from chronic and life-limiting
diseases such as prostate cancer and hepatocellular carcinoma receive
inadequate care which could be linked to inadequate palliative care training for
physicians and communication challenges (Sabih, et al, 2017). Similarly, poorly
trained palliative care nurses were found to have limited palliative care
knowledge and exhibited poor attitudes towards patients receiving palliative
care than trained nurses (Reichstein, et al, 2018). Some nurses possess the
skills to effectively manage the symptoms of patients with chronic conditions
despite the fact that their knowledge of palliative care may be lacking (Sayed,
et al, 2021
In
Africa, various obstacles have been recognized as barriers to the successful
implementation of palliative care, including late diagnosis, poverty, lack of
knowledge, and limited access to palliative care services (LaVigne, et al,
2018)
1.2 Statement
of the Problem
End-of-life
care delivery is more prevalent in industrialized Western countries, such as
the United States and the United Kingdom, than it is in African countries such
as Ghana (Adejoh, et al, 2021). In Ghana, there are only three hospitals that
deliver palliative care services (George, et al, 2020). These hospitals are the
Korle-Bu Teaching Hospital, Tetteh Quarshie Memorial Hospital, and Komfo Anokye
Teaching Hospital which are all located in urban areas. Thus, patients living
in rural areas often face barriers to accessing palliative care services as the
facilities and experts in this field are located in urban centers. In Africa,
including Nigeria, there is a lack of understanding about the experiences of
patients and nurses who provide palliative care services (Anyane, etal, 2021).
Understanding how palliative care can be successfully delivered and how it can
be improved will benefit patients, their families, and the healthcare providers
delivering this care. Therefore, the purpose of the study was to explore the
roles and challenges of nurses providing palliative care services for patients
with cancer and other co-morbidities at a tertiary hospital in Nigeria which is
one of the facilities providing palliative care. However, it is on this note
that this study is conducted to evaluate the challenges in End-Of-life care in
nursing, at oncology
ward in Federal Medical Centre Idi-aba Abeokuta, Ogun State.
1.3 Objectives
of the Study
The
objectives of this study therefore;
i.
To assess the experience
on End-of-life care among nurses at oncology ward in Federal Medical Centre Idi-aba
Abeokuta, Ogun State
ii.
To examine the challenges
in End-of-life care among nurses at oncology ward in
Federal Medical Centre Idi-aba Abeokuta, Ogun State
1.4 Research
Questions
The
research questions to be used in this study include;
i. What is the
experience on End-Of-life care among nurses at oncology ward in Federal Medical Centre
Idi-aba Abeokuta, Ogun State?
ii. What are the
challenges in End-Of-life care among nurses at oncology ward in Federal Medical Centre
Idi-aba Abeokuta, Ogun State?
1.5 Research Hypothesis
H₀: There is no significant
relationship between nurses’ experience and the quality of end-of-life care
provided in the Oncology ward at FMC Idi-aba Abeokuta, Ogun State.
H₁:
There is a significant relationship between nurses’ experience and the quality
of end-of-life care provided in the Oncology ward at FMC Idi-aba Abeokuta, Ogun
State.
1.6 Significance
of Study
The
results from this study will provide us with a valuable insight into some of
the views of End-of-life care in Nursing at Oncology ward at FMC Idi-aba
Abeokuta, Ogun State. The study will explore the various challenges encountered
by nurses attending to patients Oncology ward. The study will also enlighten,
nurses, doctors. The findings of this will also educate both nursing students
and other college of health student on the importance of providing quality
health care services to patients Oncology ward.
1.7 Scope of Study
The
study focuses on challenges in End-Of-life care in Nursing, in the Oncology
ward at FMC Idi-aba Abeokuta, Ogun State. Geographically, the study will be
carried out in FMC, Abeokuta Ogun state. The unit of analysis will be based on
nurses’ perspective and experience in the studied health center.
1.8 Operational
definition of terms
·
Nursing:
It is a
profession within the health care sector focused on the care of individuals,
families, and communities so they may attain, maintain, or recover optimal
health and quality of life.
·
Oncology Ward: A specialized hospital unit focused on the
treatment and care of patients with cancer. For this study, it is the setting
in FMC Idi-Aba where the challenges of providing end-of-life care are
evaluated.
·
Nursing
care: These refer to essential medical care offered
by professional nurses, which are also part of their primary assignment.
·
End-of-life
care: Care given to people who are near the
end of life and have stopped treatment to cure or control their disease.
End-of-life care includes physical, emotional, social, and spiritual support
for patients and their families.
·
Federal
Medical Centre (FMC) Idi-Aba, Abeokuta:
A tertiary healthcare institution in Abeokuta, Ogun State, Nigeria, where the
oncology ward is located. It serves as the setting for this study, focusing on
evaluating end-of-life care challenges within this specific hospital
environment.
·
Ogun
State: A southwestern state in Nigeria, bordered
by Lagos State to the south, Oyo and Osun states to the north, Ondo State to
the east, and the Republic of Benin to the west. It is known for its diverse
ethnic groups, mainly the Yoruba, and serves as a major economic and cultural
hub. Abeokuta, the capital of Ogun State, hosts various significant
institutions, including the Federal Medical Centre Idi-Aba, where this study is
conducted.
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