Protocols

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    Evaluation of functional capacity, physical activity levels and health-related quality of life of community-dwelling older Malawian population in Blantyre
    (Kamuzu University of Health Sciences, 2020-06-10) Nyasa, Charles
    The population of older people in Malawi is rising and this may be good news considering the many ways in which older people may contribute to realization of national development goals. While it is clear that old age is associated with deterioration in physiological reserves and functional abilities due to either diseases that are associated with old age or the ageing process itself, evidence suggests that investing in older people’s health and long-term care assists in improving their functional abilities and overall quality of life. This has been shown to translate into improved capacity to keep a job and maintain gainful employment, increased agricultural productivity, full participation in family and community activities, and less pressure on a nation’s health and economic systems. The nation of Malawi needs to respond to the rise in population ageing by formulating policies and implementing long-term programmes that position older people favourably in the society. In order to do this, high-quality information on current health states and quality of life of older Malawians is required to adequately inform policy and allow effective implementation of interventions. At the moment, this is a challenge as studies on health characteristics and lifestyle of older Malawians are scarce. Although some researchers have previously studied individual components of socio-economic status (such as family structure), and prevalence of geriatric syndromes among older Malawians, which have an impact on quality of life in general, functional capacity and quality of life scores among older Malawians have not been previously studied in Malawi. This challenge was also acknowledged in the current National Policy for Older Persons, 2016, which calls responsible ministries and institutions to stimulate development of research agendas for the elderly sector and promote dissemination of research findings on population ageing. This proposed study aims at evaluating functional capacity, physical activity levels and health related quality of life of older Malawians who are ageing in place in Blantyre. A cross-sectional study design with a mixed-methods approach incorporating both quantitative and qualitative methods will be employed in this study. It is believed that findings of this study when published and presented to policy makers and academics will assist in informing formulation of appropriate policies and long-term-care investment programmes. In addition, the study will provide baseline data from which future studies may be designed, and the availability of data itself will inspire other professionals to develop interest in issues of population ageing.
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    Accessibility of physiotherapy services post-hospital discharge after stroke in Blantyre, Malawi: The patient’ perspectives
    (Kamuzu University of Health Sciences, 2021-12-16) Gondwe, Hellen
    Stroke is the fourth leading cause of mortality and acquired disability in Malawi(1).Despite challenges faced by people with disability, studies shows that physiotherapy treatment improves the functional status of patients with stroke by minimising impairments hence increasing their quality of life (2). However, anecdotal evidence shows that most Malawian patients with stroke do not attend physiotherapy services after acute hospital discharge and the underlying reasons for such a trend are not empirically established. Therefore, this study aims at exploring the perspectives of people with stroke with regards to accessing and utilising physiotherapy services post-hospital discharge at Queen Elizabeth Central Hospital Blantyre Malawi. Type of the study This research will be a cross-sectional qualitative study Problem Statement The principal investigator has observed that there is an increase in the number of patients diagnosed with a stroke at Queen Elizabeth Central Hospital and these patients do not return for physiotherapy services after being discharged from the hospital after acute medical care. There is no documented evidence to show why patients with stroke do not attend physiotherapy treatment despite given an appointment date. This study aims at exploring the perspectives of people with stroke with regards to accessing and utilising physiotherapy services post-hospital discharge in Blantyre, Malawi. Objectives  To explore the patient's perspectives and experiences with accessing physiotherapy services post-hospital discharge.  To ascertain the patient's understanding of the benefits of utilising physiotherapy services post-hospital discharge.  To investigate challenges faced by patients with stroke on accessing and utilising physiotherapy services post-hospital discharge.  To obtain possible solutions from the patients with stroke for the challenges they face on accessing and utilising physiotherapy services post-hospital discharge. Methodology Study place The study will be conducted in patient’s homes residing in Blantyre within 70km of the discharging hospital Queen Elizabeth Central Hospital. Study population Discharged patients with stroke from Queen Elizabeth Central Hospital between 6 weeks to 12 months during the time of study Study period Three months from December 2021 to February 2022 Sample size In qualitative research, 15 interviews are recommended to reach saturation (19,20) Data collection In-depth interviews using a semi-structured questionnaire will be used to collect data from purposively recruited participants according to the inclusion criteria. Data Management The recorded interviews will be transcribed verbatim for analysis. All identifiable information for the individual participant will be removed and replaced by study code and saved in a password computer. The anonymised data will be analysed using a thematic content approach using both deductive and inductive methods. Expected Findings Financial challenges, lack of mobility aids and inadequate information as being some of the reasons for not accessing and utilising physiotherapy services. Dissemination A copy of the manuscript resulting from this study will be shared with COMREC Committee. The results will also be presented and submitted to the School of Therapeutic Sciences at The University of the Witwatersrand. Oral presentation to the QECH Research Committee and Physiotherapy department respectively.
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    The prevalence and associated risk factors of musculoskeletal disorders in physiotherapists and nurses at Queen Elizabeth Central Hospital
    (Kamuzu University of Health Sciences, 2022-04-13) Mbenje, Benson; Mtolongo, Japhet; Mwenyekonde, Patience; Mzama, Omega; Muhaniwa, Ernest
    Type of research The research study will be a quantitative descriptive cross-sectional study done on 198 registered PTs and Nurses at QECH for 6 weeks. Problem Musculoskeletal disorders (MSDs) are inflammatory or degenerative impairments that have increased the need for rehabilitation services worldwide. They were also reported to be the second leading cause of global disability in 2016. Literature postulates that HCWs, especially PTs and Nurses have a high prevalence of MSDs in both middle- and low-income countries. However, no known study has been conducted in Malawi to establish the prevalence of MSDs among PTs and Nurses. Therefore, this study seeks to bridge that knowledge gap. Objectives The main objective is to assess the prevalence and associated risk factors of MSDs among Physiotherapists and Nurses working at Queen Elizabeth Central Hospital, Blantyre. Specifically, the study will determine the prevalence of MSDs among PTs and Nurses at QECH, identify the risk factors that may contribute to MSDs among PTs and Nurses at QECH, estimate the duration of which one has been with MSDs among PTs and Nurses at QECH and will analyze the most common MSDs among PTs and Nurses at QECH. Methodology Date will be collected using the Standard Nordic Musculoskeletal questionnaire and BMI will be assessed. All COVID-19 preventive measures will be followed. Data will be analyzed using SPSS version 23 as well as descriptive and inferential statistics. Results will be presented in graphs, table and pie charts. Expected findings It is expected that the study will provide information on the prevalence and associated risk factors of musculoskeletal disorders among nurses and Physiotherapists and Nurses at QECH.
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    Experiences of Physiotherapists Working in Government Hospitals in Malawi with Regards to Clinical Practice and Career Development
    (2022-04-13) Bande, Blessings; Chisale, Christina; Phiri, Caroline; Machongo, Ida
    Type of Research Study This study will be a Qualitative exploratory that will utilize the cross-sectional design. Problem Physiotherapists play a crucial role in rehabilitation. Malawi has a shortage of physiotherapists and in regards to such, training more physiotherapists would be a long-term solution to this shortage. For a more immediate solution; there is need to strengthen the skills of the working physiotherapists and to create conducive clinical environments for them. This strengthening can be achieved through continued professional development and educational advancement. However, there is an inadequacy of literature about the experiences of physiotherapists in Malawi in regards to clinical practice and career development. Objective To explore the experiences of physiotherapists working in government hospitals in Malawi with regards to clinical practice and career development Methodology This study will be conducted in all government hospitals in Malawi at all levels of health care. The study population will be physiotherapists working in those government hospitals. Participant recruitment will be through convenience sampling. It will include physiotherapists with a minimum of one year working experience as a physiotherapist (be them Malawian or internationally trained). It will exclude those working in the private sector, administration and academics. Expected Findings According to literature findings, it has been shown that most African activities have less EBP, and CPD activities. It was also noted that most clinical settings have poor working environments. As such, Malawi being a low-income African country, we might find similar results as in the studies done in various African countries. The specific areas of need that will be highlighted byparticipants in this study might provide useful information that might influence policy and review of training curriculum for physiotherapy professionals. Dissemination Dissemination will be through oral presentations at the Kamuzu University of Health Sciences’ physiotherapy department. Copies of the final report will be shared with the College of Medicine Research and Ethics Committee, the Kamuzu University of Health Sciences Library, the Physiotherapy Association of Malawi, the research supervisors and the Research Dissemination Conference.