Mildred John - Academia.edu (original) (raw)

Papers by Mildred John

Healthcare

Currently, mothers living with HIV (LWH) are challenged with different infant feeding guidelines ... more Currently, mothers living with HIV (LWH) are challenged with different infant feeding guidelines depending on the country they are living in. This may contribute to confusion, stress, and mental health issues related to decision-making about infant feeding as a mother LWH. Yet, their male partners as their closest social capital have important roles to play in reducing or aggravating this psychosocial distress. Hence, we describe the role of male partners in supporting mothers who are living with HIV in the context of infant feeding. It is based on the results of a recent study of the socio-cultural context of infant feeding among Black mothers LWH in three countries; Canada, the USA, and Nigeria. The study was a tri-national, mixed-methods, community-based participatory research (CBPR) project, informed by postcolonialism and intersectionality theories. This paper is based on the qualitative component of the study. It was a focused ethnography (FE) involving 61 in-depth individual ...

Modular health teaching tailored to the diabetic patient’s lifestyle should be an integral part o... more Modular health teaching tailored to the diabetic patient’s lifestyle should be an integral part of diabetes management. The effect of such a teaching method on learning outcomes in self-care was determined in diabetic patients admitted to the University of Calabar Teaching Hospital, in Nigeria. The structured systematic teaching module (SSTM) was developed and pre-tested on 18 subjects with a Cronbach’s alpha score of 0.89 and a test-retest coefficient of 0.81. The module was used to teach 39 experimental subjects. The 26 control subjects only received e casual teaching by ward staff. Learning outcomes in self-care were evaluated before discharge and six months later. Subjects who received structured teaching showed a significant increase in diabetes-related knowledge and skills (p<0.01), a greater compliance with self-care instructions (p=0.01), a shorter hospital stay (p= 0.01), and a lower hospital rate of readmission for diabetes-related complications. Structured teaching is,...

A continuing education programme on HIV/AIDS was organized for nurses in three hospitals in Calab... more A continuing education programme on HIV/AIDS was organized for nurses in three hospitals in Calabar in late 1998, using a modular teaching method. A prestest/post-test design was used to collected data on nurses‟ HIV/AIDS related knowledge, attitudes, practice and willingness to care using a 69 items KAP schedule. The educational programme was arranged in modules with each module dealing with a major area of HIV/AIDS. A total of 216 nurses of varying professional levels participated in the programme but only 194 returned completed questionnaires at both pre-test and post-test (89.8% return rate). Results at pre-test showed low level of knowledge, negative attitudes, a general reluctance to care for people with HIV/AIDS, a fear of contagion in the workplace and basically unsafe practice. At post-test, the level of knowledge increased significantly (p=0.0I), attitudes were more favourable (p=0.05) and safe practice increased (p=0.05). Willingness to care for people with HIV/AIDS howev...

Nursing & primary care, Jun 30, 2021

As the largest group of health care professionals, nurses are in a nodal position to ensure achie... more As the largest group of health care professionals, nurses are in a nodal position to ensure achievement of healthcare goals. Transforming Care at the Bedside (TCAB) is a global initiative whereby nurses implement innovative practices for patient satisfaction. However, the initiative has not been the focus of studies in Nigeria. This study examined TCAB practices among nurses in four hospitals in Southern Nigeria; and determined the effectiveness of capacity building on selected TCAB activities and outcomes. Triangulation (observation, descriptive and quasiexperimental) design was used to collect data from 224 randomly selected nurses working in medical and surgical units of four hospitals in two States of Southern Nigeria. Validated Observation checklist and two validated researcher-developed Questionnaires were utilized to collect data. The Intervention involved capacity building on 21 TCAB activities in four core areas: safe and reliable care; vitality and teamwork; patient-centred care; valueadded care processes. The study followed ethical processes. Data were analysed using descriptive and inferential statistics on SPSS 20. After capacity building, nurses' practice of most TCAB activities improved significantly (p≤ 0.05), except for work redesign, and improving the work environment. Nurses also spent significantly more time on value-added activities and less time on non-value-added activities after the intervention. Practice of TCAB activities was significantly associated with patient and family satisfaction, nurses' satisfaction, patients' wellbeing, nurse: patient interactions and quality of care (p <0.001). Nurses in the four hospitals implemented many TCAB activities, and this significantly increased nurse: patient interactions, patient wellbeing and satisfaction in the hospitals studied. The TCAB initiative is therefore feasible and relevant in low resource settings like Nigeria.

All women deserve humane, considerate, sensitive and respectful care in childbirth. Respectful ma... more All women deserve humane, considerate, sensitive and respectful care in childbirth. Respectful maternity care (RMC) is human right and standard midwifery practice. However there have been To determine clients' experience of respectful maternity care and midwives' caring behaviour, two hospitals in Calabar, Nigeria were selected for this study. This descriptive study collected data from 83 purposively selected postnatal women who had spontaneous vaginal delivery, and 51 midwives caring for them. Ethical clearance was obtained from Cross River State Ministry of Health and informed consent from participants. Clients and midwives identified respectful maternity care received/practiced from the RMC checklist. RMC was reported by 58 (69.9%) clients while 25 (30.1%) reported lack of it in different categories. Non-respectful care reported included lack of privacy, lack of information about progress of labour, denying preference and choice of childbirth position, lack of sensitivity...

Traditional beliefs, attitudes and practices dominate the care of the newborn and child in most c... more Traditional beliefs, attitudes and practices dominate the care of the newborn and child in most countries. Some common traditional practices, especially female genital mutilation, are harmful. However there are other subtle indigenous practices which are inimical to children's health but rarely reported. Aim of study was to describe the indigenous practices of child care in some Niger Delta communities of Nigeria and highlight their health implications. Three hundred and seven mothers/guardians of children 0 to 5 years were purposively selected from 10 rural communities in Cross River and Bayelsa states. Mixed methods, focus group discussion, in-depth interview and observation, were used to collect data on child care beliefs and practices, and these were grouped into five categories; "immediate care of the newborn", "routine and general care", "child protection/prevention of illness", "treatment of illness", and "delayed milestones&qu...

Nursing & Primary Care, 2018

Spousal agreement is important for couples with HIV because of shared risk for health outcomes. A... more Spousal agreement is important for couples with HIV because of shared risk for health outcomes. Although high spousal agreement (concordance) is expected on most issues because of close daily contact and common living conditions, studies have shown discrepancies between husbands' and wives' reports on several family issues. Understanding spousal concordance on HIV-related issues offers opportunity to develop interventions that promote better health for both partners. This study assessed the extent of spousal agreement on reproductive decision making, self-management, and health promotion; and determined how spouses' responses reflect their partner's attitude and preferences on such issues. Mixed method was used to collect qualitative and quantitative data from 25 purposively selected, consenting couples living with HIV and attending two HIV Counselling & Testing clinics in Cross River State, Nigeria. Husband-wife pairs were interviewed separately and concordance was calculated. Ethical clearance was obtained from relevant gatekeepers as well as informed consent from participants. Significant male domination in reproductive decision making was identified. Concordance was poor for decision making power of the wife on sexual/reproductive issues (24%, kappa 0.16), changes in sexual relations (28%, kappa 0.22); communicating sexual and fertility issues with spouse (28%, kappa 0.24), and mutual support (35% (kappa 0.40); while strong concordance existed for starting medication & adherence to ART (72%, kappa 0.60), health promotion (85%, kappa 0.80) and self-management (89%, kappa 0.81). Spousal agreement is therefore poor for sex-related matters but good for health promotion and self-management. Partner agreement on HIV-related issues contributes to a fuller understanding of decision making among spouses. Knowledge of this by health providers is critical for effective counselling and interventions for couples with HIV.

Nursing & Primary Care, 2017

Pakistan Journal of Nutrition, 2015

ABSTRACT Background: Vesico-vaginal fistula (VVF) is an abnormal communication between the urinar... more ABSTRACT Background: Vesico-vaginal fistula (VVF) is an abnormal communication between the urinary bladder and the vagina resulting in the continuous involuntary discharge of urine. In Sub-Saharan Africa between 30,000 and 130,000 women develop fistulas each year during childbirth. This study aimed to examine the psychosocial impact and coping strategies of women affected by VVF in Akwa Ibom State, Nigeria. Method: This was a cross-sectional descriptive study: 120 women with VVF were interviewed using a structured questionnaire, combined with unstructured interview schedule. SPSS version 17.0 was used to analyse the quantitative data and thematic content analysis for qualitative data. Results: The quantitative analyses showed a significant influence of isolation and depression on the coping strategies of women affected by VVF. Analysis for social isolation revealed higher mean scores and higher r-value (X ̅passive = 53.29, SD = 7.17 and r-cal = 0.487). For depression, the analysis s...

This descriptive study was aimed at determining the pattern, quantity and quality of sleep and th... more This descriptive study was aimed at determining the pattern, quantity and quality of sleep and the prevalence, causes and effect of sleep deprivation / disturbance among patients hospitalized in two hospitals in Calabar. A prospective design was used, and 183 adult patients admitted into the two hospitals and 80 nurses caring for them, were selected purposively and enrolled in the study. Patients’ sleep data were collected using an observation checklist (the Sleep Behaviour Observation Tool – SBOT) and a patients’ self-report interview schedule (Sleep Quality Tool – SQT). Nurses’ data were collected through a structure questionnaire and examination of nurses’ night reports. Patients’ sleep was significantly disturbed during early period of hospitalization. Sleep disturbances was in the form of delayed onset of sleep or early awakening, both of which resulted in a short duration of total sleep time. Although sleep quantity and quality improved significantly as from the 7th day of adm...

This study assessed the factors responsible for absenteeism from lectures and clinical experience... more This study assessed the factors responsible for absenteeism from lectures and clinical experiences among nursing students in the university of Calabar, Nigeria. The objectives were to establish the record of absenteeism, identify student’s roles during training period, the reason for students poor attendan ce in class and clinical experiences and ascertain how the poor attendance influence their academic performance. Data for the study was collected from 240 respondents comprising 200 to 500 students through the use of structured questionnaire. A stratified sampling technique was used to select the 240 respondents. Results showed that out of 240 respondents, 92.9 % reported being absent from lectures and clinical practice from time to time. About 70.9% were engaged in menial job, 29.6% were pregnant during the tenure of their programme , 62.9% were engaged in extracurricular activities/holding organizational post. Students had many reasons for missing lectures which include ill-heal...

Tropical doctor, 2004

A 10-year retrospective study of hysterectomies performed on teenagers in Calabar was carried out.

Mary Slessor Journal of Medicine, 2004

Spiritual-church based health clinics identified by public health coordinators were visited, betw... more Spiritual-church based health clinics identified by public health coordinators were visited, between May 2002 and September 2002. Practitioners were interviewed regarding their obstetric practices and facilities available to them. The 47 spiritual church based birth places were located in urban and sub-urban area, with majority of labour rooms attached to the churches. Fifteen (36.9%) of each birthing places had concrete floor, running (tap) water and electricity. Thirty-three (70.2%) had vono beds while 15(31.9%) had babies' cots, and orthodox delivery instruments in 10 (21.3%). For conducting delivery, 33 (70.2%) used delivery couch or wooden tables, 9(11.1%) had native earthen bed while 5(10.6%) conducted delivery on mats spread on the floor. The attendants were women aged between 25 and 65 years with 20 (20.6%) married to Pastors in charge of the church, and 54 (55.7%) had no formal education. Twenty-one (44.7%) of the centers kept delivery records with no records of deaths or complicated cases. Twenty-eight (59.6%) centers performed vaginal examination during pregnancy and out of these 17 (60.7%) used their bare hands lubricated with olive oil. All attendants prescribed prayers and fasting at least monthly to pregnant women with administration of “holy water” and olive oil. Their predictions of complicated cases were based on God's revelation in 21 (44.7%). During delivery, attendants in 14 (29.8%) centers used gloves while 33 (70.2%) used bare hands with or without olive oil. Regarding what each center does when confronted with complications, majority 26 (55.3%) offer prayers and invite prayer band, while 14 (29.8%) refer patients to orthodox health facilities. Suggestions are made on how to improve their quality of obstetric care with the aim of reducing maternal mortality in our environment. Mary Slessor Journal of Medicine Vol.3(2) 2003: 51-56

Nurse Education in Practice, 2013

Continuing professional development (CPD) is a key aspect of any profession and fundamental to th... more Continuing professional development (CPD) is a key aspect of any profession and fundamental to the development of a nation. The Mandatory Continuing Professional Development Program (MCPDP) as it is known in the nursing profession in Nigeria is aimed at sustaining capabilities and introducing new skills for modern day practice needs. It also offers the prospect for nurses to improve and broaden their knowledge, expertise and develop the personal and professional qualities. This study analysed the experiences of nurses, both participants and facilitators of MCPDP during the 34th session of the MCPDP in Calabar, Cross River State, Nigeria. A sequential explanatory mixed method design was adopted for the study. All the eighty nurses in attendance participated in the study. A self-developed semi-structured questionnaire was used to collect the quantitative data. Qualitatively, eight participants and two facilitators were selected for in-depth interviews. The findings revealed that 18.9% of the respondents attended the MCPDP for license renewal, 18.9% attended to update their knowledge on current practices, while 59.5% attended for both purposes. The challenges in attending MCPDP were lack of time 24.6%, lack of relief staff 23.3%, and high cost of MCPDP registration 20.9%. Organizational challenges included lack of finance due to low turnout of participants. Majority of the participants expressed willingness to participate in MCPDP in the future, while the few retired ones expressed having no need for MCPDP afterwards. The study disclosed that the existing approach for the program may require some form of adjustment so as to meet participants' and facilitators' needs. It was therefore recommended that the Nursing and Midwifery Council of Nigeria should review the program structure and organisation.

Nursing & Primary Care, 2017

Healthcare

Nursing & primary care, Jun 30, 2021

Nursing & Primary Care, 2018

Nursing & Primary Care, 2017

Pakistan Journal of Nutrition, 2015

Tropical doctor, 2004

A 10-year retrospective study of hysterectomies performed on teenagers in Calabar was carried out.

Mary Slessor Journal of Medicine, 2004

Nurse Education in Practice, 2013

Nursing & Primary Care, 2017