Permanent URI for this collection
- ItemRestrictedAssessing Women’s Perception towards Cervical Cancer Screening at Mponela Rural Hospital, Dowa(2023-01-11) Kawale Chiphangwi, FlorenceSTUDY DESIGN: This will be descriptive qualitative research study, assessing women’s perception towards cervical cancer screening at Mponela rural hospital. INTRODUCTION/BACKGROUND: Cervical cancer is listed among the top gynaecologic cancers worldwide. It is ranked fourteenth among all cancers and fourth-ranked cancer among women worldwide. It is estimated that 85% of all cervical cancer deaths occur in developing countries. Malawi has the highest cervical cancer mortality rate in the world with 51.5 death per 100. 000 deaths per year. This is seven times the global rate, and double the rate in Eastern Africa. A call for cervical cancer elimination has been made and Malawi has adopted cervical cancer elimination strategies, which among them is cervical cancer screening. PROBLEM STATEMENT: Despite the available cervical cancer screening strategies that have been put in place in Malawi, and specifically Mponela Rural Hospital, cervical cancer screening rate still remains low. Currently only 4% of women in Mponela have accessed cervical cancer screening, against the 80% national target for cervical cancer screening. No studies have been done to establish the communities’ perceptions of cervical cancer and cervical cancer screening at Mponela Rural Hospital. Therefore the aim of this study is to assess the women’s perceptions towards cervical cancer screening STUDY OBJECTIVES: This study aims at assessing the women’s perceptions towards cervical cancer screening at Mponela Rural Hospital. SPECIFIC OBECTIVES 1. To assess women’s knowledge on cervical cancer 2. To explore women’s belief towards cervical cancer screening 3. To assess the barriers and facilitators to cervical cancer screening 4. To identify strategies that can promote cervical cancer screening METHODOLOGY: A descriptive qualitative research design using in-depth interviews to 30 women aged between 25 and 64 years of age who have never undergone cervical cancer screening at Mponela Rural Hospital. Eligible women waiting for other services, and have never had cervical cancer screening will be selected purposefully. In-depth interview will be done using a semi structured thematic interview guide to deeply explore women’s perceptions on cervical cancer screening. The instrument will be tested at Mtengowanthenga Mission Hospital, and trustworthiness of the instrument will be determined. EXPECTED FINDINGS: It is expected that women’s perceptions on cervical cancer screening at Mponela Rural Hospital will be identified. This will help in establishing policies and strategies that can help in increasing the uptake of cervical cancer screening. ETHICAL CONSIDERATION: Prior to starting the study, approval of the study will be sought from College of Medicine Research and Ethics Committee and permission will be obtained from Dowa District Health Office research committee. Explanation about the search study will be explained to the eligible women, and informed consent will be sought. DATA ANALYSIS: Thematic data analysis will be used to describe and interpret the data, as well as to select code and construct themes. DISSEMINATION OF THE RESULTS: The results will be disseminated to College of Medicine Research and Ethics Committee, Kamuzu University for Health Sciences, Dowa District Health research committee as well as publishing in a nursing journal
- ItemRestrictedPerceived determinants of health-related quality of life among cancer patients at KCH and QECH in Malawi, version 1.0(Kamuzu University of Health Sciences, 2022-08-05) Banda, Jonathan ChiwandaType of study: Qualitative study Problem to be studied: Perceived determinants which could influence quality of life among patients living with cancer at Kamuzu and Queen Elizabeth Central Hospitals. In Malawi, there is lack of studies evaluating health-related quality of life themes among cancer patients which limit the possibility of ascertaining type of physical, psychological and social problems experienced by them and how to approach them. Aim: To explore main determinants influencing health-related quality of life among cancer patients at Kamuzu and Queen Elizabeth Central Hospitals in Malawi. Objectives: 1. To explore individual level factors affecting health-related quality of life among cancer patients at Kamuzu and Queen Elizabeth Central Hospitals in Malawi. 2. To explore system level factors affecting health-related quality of life among cancer patients and hospital staff at Kamuzu and Queen Elizabeth Central Hospitals in Malawi. Methods: A phenomenological qualitative study to measure the in-depth lived experiences for patients, guardians and health workers at the oncology clinics by exploring their perception of health-related quality of life themes and insights. The study will be conducted between May and June 2022 at oncology units from Kamuzu and Queen Elizabeth Central Hospitals in Malawi. Purposive sampling of the twenty-six participants in both study sites will be used. This sample size will surpass the minimum requirement of at least 12 participants to achieve saturation for qualitative studies Participants will be recruited in four categories based on the type of information being investigated. Ethics consideration: The permission to conduct the study will be sought from Kamuzu Central Hospital (KCH) and Queen Elizabeth Central Hospital (QECH). Ethics approval will be sought from the Kamuzu University of Health Sciences Research Ethics Committee. Data collection will follow informed written consent to be obtained from participants before enrolment. Participants names will be kept anonymous by disguising all identifying names of participants during analysis. Expected findings: 1) Perceived individual level determinants of health-related quality of life among cancer patients. 2) Perceived systemic level determinants of health-related quality of life among cancer patients. Dissemination of results: The findings of this study will be disseminated to the public through COMREC, scientific conferences and via international peer-reviewed journals publication. The results will also form part of the thesis for the principal investigator.
- ItemRestrictedAssessing the acceptability of paclitaxel as treatment for Kaposi Sarcoma in patients and clinic providers in Mangochi(Kamuzu University of Health Sciences, 2022-07-11) Kachedwa, FrancisType of Study: This is a qualitative study that seeks to assess the acceptability of Paclitaxel as treatment for Kaposi Sarcoma in patients and clinic providers in Mangochi. Background of the problem: Kaposi Sarcoma patients in Malawi have long been treated with Vincristine either as a monotherapy or in combination with bleomycin. Given many reports of toxicity in vincristine patients at higher dosages albeit with little or no concomitant benefits of dosage increases, the government of Malawi revised the first line treatment for Kaposi Sarcoma. In this regard, the Malawi Ministry of Health (MOH), has embarked on rolling out Paclitaxel for Kaposi Sarcoma treatment to district hospitals, Mangochi inclusive, with only a few districts remaining. As this is a new intervention, there is a considerable knowledge gap as regards to patients’ and providers’ perceptions on Paclitaxel among other aspects. Such varying perceptions may have a significant bearing on the acceptability of Paclitaxel in the target population. Studies are therefore required especially in this preliminary stage of the intervention in order to unravel areas that require urgent addressing of quality issues among others. Therefore, in this regard, this study seeks to explore the acceptability of paclitaxel at the district hospital level of care. Objectives of the study: Broadly, the aim of the study is to assess the acceptability of paclitaxel as treatment for Kaposi Sarcoma (KS) among patients and providers in Mangochi district. The study seeks to specifically highlight perceptions of patients and providers on Paclitaxel usage and explore some pertinent barriers and enablers to acceptability of paclitaxel at a district hospital level of health care. Methodology: This is a qualitative study design that shall employ a phenomenological approach. The study will take place at Mangochi District Hospital in Mangochi District. The study population shall include of 32 participants comprising of 16 patients and 16 clinic providers selected through Non-probabilistic purposive sampling. Data will be collected through in-depth interviews using interview guides for both patients and providers. A focus group discussion will be conducted among providers for issues of maintaining patients privacy and confidentiality. The protocol shall be submitted for COMREC approval and approved written consents shall be administered or read to the participants to seek their consent. No names of participants shall be used in this study and the digital files and transcripts shall be stored under lock and key/ passwords with access limited to the research team. Data will be analysed manually using content analysis as guided by the Theoretical framework of acceptability. Dissemination of Expected findings: The study is expected to unravel any possible acceptability issues associated with Paclitaxel as treatment for Kaposi Sarcoma. The findings of this study will be shared to COMREC, COM library, Mangochi DHO, and at an annual dissemination conference organized by KUHeS, among other such conferences. A publishable manuscript will be submitted to relevant local and international journals. 11-Jul-2022 vii Study Protocol Version 1.3 15 th June 2022 Possible constraints Some study participants may refuse to be enrolled or withdraw for fear of delays to receive their treatment. The study conduct shall ensure that participants receive their treatment unhindered prior to commencement the in-depth interviews. There may be fears of interviews taking too long, effecting the participants time of getting home or conducting other planned activities hence leading to refusal of enrollment. The investigator shall make sure to use time management techniques to ensure that the interviews and discussions are completed by or before the allotted time as described in the informed consent.
- ItemRestrictedAssessing immunosuppressive status in HIV clients with cervical cancer at Queen Elizabeth Central Hospital, Gynaecology Unit(Kamuzu University of Health Sciences, 2022-04-11) Maluwa, Thokozani; Dinala, YusufType of study Retrospective folder review study. Problem Women living with HIV have increased risk of developing cervical cancer which is associated with an increase in mortality rate. Malawi being one of the countries with high HIV prevalence rate, this study wants to determine the immunosuppressive status of HIV positive women with cervical cancer. Broad objective • To assess immunosuppressive status in HIV clients with cervical cancer Specific Objectives • To determine the effect that cervical cancer has on HIV viral load status and CD4 count. • To explore association of viral load status in HIV patients with cervical cancer with age, cancer stage, socio-economic status and level of education. • To assess how ART adherence, affect HIV viral load status in HIV patients with cervical cancer. methodology This will be a retrospective folder review study. A total of 87 HIV clients with cervical cancer files will be obtained from QECH, gynecology department. A simple random sampling method will be used to sample the files. Variables such as age socio-economic status, level of education, stage of cancer, ART intake will be collected through a questionnaire. CD4 count and Viral load data between 2016-2021 will be collected from the files of the selected clients. Expected findings The viral load of HIV patients with cervical cancer will increase while CD4 will decrease. This is because HIV and AIDS patients have reduced immunity and the cancer lowers the immunity further hence the virus replicates rapidly. PowerPoint presentation will be done at Kamuzu College of Health Sciences (KUHeS) and at any designated Research Conferences. A final copy will be sent to the research supervisor(s), QECH, COMREC, Head of department and the Library. Manuscripts will also be prepared and be submitted at journal for publications. 11-Apr-2022 Assessing immunosuppressive status in HIV clients with cervical cancer at Gynecology unit, QECH, Blantyre; Malawi V2.0 21 March 2022
- ItemRestrictedDevelopment of a paediatric oncology short learning program for nurses in Malawi(2022-03-16) Majamanda, MaureenExecutive summary The type of research study This is a sequential multi method study which will use purposive sampling technique. The problem Care of children with cancer is highly specialised and requires well educated, trained and dedicated nurses to provide high quality care (‘Andersson et al. 2012). In Malawi, the curriculum for nurses has limited content for oncology nursing, as such nurses receive little or no paediatric oncology-specific education during pre-service education (Hockenberry et al., 2020). Unlike in high income countries (HIC) and other low and middle income countries (LMIC), where nurses are given an orientation education programme when newly hired or allocated to paediatric oncology settings, in Malawi, no such education and training is available. Most preparation occurs as part of institutional orientation and nurses learn on the job through experience, intuition, doctors’ instructions and everyone teaches them as they see fit (Tynjälä, 2008). This has also been seen to promote transfer of negative characteristics at the work place as nurses may be learning from mistakes (Hussein et al. 2017; Tynjälä, 2008). In addition, nurses are rotated to other units within the hospital annually or every two years, a practice which further compromises sustainability and quality of care (Gundo et. al. 2019; So et al., 2016). Consequently, nurses provide substandard care to children with cancer, thus contributing to poor patient outcomes (Day et al., 2015). In Malawi, many children who are newly diagnosed with cancer report to hospital with advanced disease. This makes it difficult to treat cancer that is curable when treatment is instituted early and make cancer treatment to be expensive. These issues and many more provide a complex and unique situation for Malawi. As such there is need for well-prepared nurses with appropriate knowledge, skills and attitudes to properly provide individualised and holistic care to children with cancer and their families. Education and training of nurses in paediatric oncology specialty has been identified as an important step in improving care of children with cancer in LMIC (Challinor et al., 2014). In Malawi, there is no paediatric oncology education and skills training program for nurses working in paediatric oncology settings. As such the learning needs of nurses in paediatric oncology care remain unexplored. Main Objective To develop a paediatric oncology short learning program for nurses in Malawi. Specific Objectives 1. To explore the paediatric oncology learning needs of nurses in Malawi according to nurses, other health care professionals and parents/guardians. 2. To validate a paediatric oncology short learning programme for nurses in Malawi. 3. To evaluate a paediatric oncology short learning programme for nurses in Malawi. Methodology The data collection methods in this study will include scoping review, focus group discussions, pre and post-test questionnaire, semi structured interviews and participants to the short learning program will respond to a learning program evaluation form with open ended questions. Expected Findings and Dissemination Findings of this study will inform the development of a paediatric oncology short learning programme for nurses in Malawi. The developed short learning programme will empower nurses with appropriate knowledge, skills and attitudes to provide evidenced based nursing care that will lead to improved health outcomes of children with cancer in Malawi. Findings from this study will be published in peer reviewed journals and will be presented at local and international conferences. A PhD thesis will be submitted to the University of the Witwatersrand, Kamuzu University of Health Sciences libraries and College of Medicine Research Ethics Committee.
- 1 (current)