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Papers by alex chebor
Journal of Health, Medicine and Nursing, 2016
Background Cervical cancer poses a great challenge in the world and especially in developing coun... more Background Cervical cancer poses a great challenge in the world and especially in developing countries. Global cancer statistics ranked the disease seventh of all the cancers (Globocan, 2008). It is the leading cause of death from cancer among women in the developing countries where 90% of the cases are reported (WHO, 2009). Cervical cancer is a preventable disease, and if high uptake of screening is achieved, a great reduction in the incidence and the disease burden can be realized. Sexual habits constitute a major factor in the disease development and are attributed majorly to the Human Papilloma Virus. Increasing the number of women who have cervical cancer screening, the overall 5-year survival can be realized. Objective The main objective for this study was to determine the uptake of cervical cancer screemng among women of ages 21-65 years seeking health services in Uasin-Gishu district hospital. Methodology A quantitative and qualitative descriptive cross-sectional hospital based study was conducted on women aged 21-65 years seeking health services in Uasin-Gishu Hospital. The study was carried out between August 2012-June 2013. Data was collected through administration of questionnaires, key informant interviews and focused group discussions. A randomly selected sample of 168 respondents, one medical officer and 20 women who participated in focused group discussions was used to obtain information for the study. Qualitative data was coded through content analysis according to themes and quantitative data was analyzed using statistical data analysis (Stata) version 12 software. Results There was a very low uptake of cervical cancer screening among the respondents, 8.8% reported to have screened and 91% not screened. There was an association between knowledge of cervical cancer symptoms and age [25-29 (p=0.03)] [30-34(p=0.001)], tertiary education (p=0.002) and marital status (p=0.04). There was an association between knowledge of risk factors and tertiary education (p=<O.OOI), salaried employment (p=0.03), and those respondents who had 1-4 children (p=O.OI). There was an association between knowledge of prevention strategies of cervical cancer and secondary education (p=O.03), tertiary education (p=<O.OOl), and salaried employment (p=O.OOl). Conclusion and Recommendations This study concludes that there is a very low turnout for cervical cancer screening among women seeking health services in Uasin-Gishu Hospital and therefore, Health workers should provide health education on cervical cancer and screening to all women seeking health services in all health facilities
International Journal of Africa Nursing Sciences
Introduction: World Health Organization (WHO) defines disease surveillance as continuous, systema... more Introduction: World Health Organization (WHO) defines disease surveillance as continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice. Its aims are to serve as an early warning system for impending public health emergencies, document the impact of an intervention, or track progress towards specified goals and monitor and clarify the epidemiology of health problems, to allow priorities to be set and to inform public health policy and strategies (WHO, 2016). The need for disease surveillance networking in India arose from the challenges encountered in the year 2009 when Pune city experienced the major effect of H1N1 pandemic (Ministry of Health and Family Welfare, [MHFW] 2009). A large proportion of the population was affected. The situation was made worse by a lack of prepared public health surveillance system, unregulated private health sector and a large urban population ...
American Journal of Nursing Science, 2016
Preceptorship is a model of clinical training in which a qualified nurse, referred to as a precep... more Preceptorship is a model of clinical training in which a qualified nurse, referred to as a preceptor, is assigned to one or a group of nursing students, for the purpose of facilitating learning in the clinical setting. This study was done in Maua Methodist {M. M. H (Meru County, Kenya)} and Preyspeterian Churches East Africa (P. C. E. A) Chogoria (Tharaka-Nthi County, Kenya) hospitals in Meru, Kenya and its main objective was to determine the perceived need for preceptor-student nurse partnership in nursing training institution. A sample size of one hundred (100) respondents was randomly selected from a target population of one hundred and eighty (180) preceptees, by use of convenient sampling method. Ten (10) preceptors were also selected conveniently to participate in the study. One hundred and ten (110) questionnaires were distributed out of which ninety nine (99) were received back {(ninety-one-91) from preceptees and eight (8) from preceptors)}. Both, qualitative and quantitative descriptive survey designs was utilized. Descriptive statistics were used to analyse the resultant data. Regarding to the importance of having preceptors, results showed that eighty five out of ninety {85/90 (94.44%)} of the student nurses agreed that they are important while three (33.33%) disagreed. Eight out of nine {8/9 (88.88%)} of the preceptors agreed on the importance of preceptorship while one {1/9 (11.11%)} was not sure. The reasons according to students why they need these preceptors included; provision of directions and guidelines (90%), supervision (79%), resolve clinical conflicts between them and staff nurses (76%) and to have a role model to emulate (83%). For the preceptors-to have a good working environment (78%) and to act as role model (56%). Hence the need for the student-preceptor partnership during students nurses training period.
IOSR Journal of Nursing and Health Science, 2014
The nursing practice environment has been defined as the organizational characteristics of a work... more The nursing practice environment has been defined as the organizational characteristics of a work setting that facilitate or constrain professional nursing practice 5. Examples of these characteristics include the nature of nurses' relationships with managers and physicians, and the status of nurses within the hospital hierarchy. The purpose of this study was to assess the nurses' perception of the work environment and the subsequent work morale using the Practice Environment Scale of the Nursing Work Index (NWI-R).Specific Objectives: 1).To determine the nurses' work morale at the Moi teaching and referral hospital. 2). To determine the nursephysician relationship levels at the Moi teaching and referral hospital. We used a cross-sectional study design with consecutive sampling. Data was collected from 167 nurses working in various units in the month of August 2013. Analysis was done using the SPSS version 18.0, item total of all the five scales of the NWI-R factor analysis was done whereby the subscale mean scores were obtained. Qualitative responses were grouped according to similarities of phrases used to the NWI-R scales. These phrases were then used in the discussion. Of those interviewed, males were 29 and females138. Majority of the nurses (53%) had a feeling that they are not in control of their own practice. One third (32%) felt they rarely participate in policy decisions for the hospital. With regard to staffing, 55.7% agreed with the presence of adequate support services that allow them time to spend with their patients. Most of the nurses do not agree (means below 2.5) that they participate in hospital affairs, that there is nursing foundations for quality care that there is adequate staffing and resources and lastly that there is collegial relationship between them and physicians. It is only on the nurse manager ability, leadership and support that they seem to agree (mean of 2.8). Based on this study it is evident there is low morale among the nursing staff at the Referral Hospital (NWI-R score of below 2.5). The working relationship between nurses and physicians is poor (NWI-R score of below 2.5) There is need to engage nurses in morale boosting activities like refresher courses, recognition of a job well done, and engaging them more often in decision making activities in the hospital.
Open Journal of Epidemiology, 2018
Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic ... more Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women's perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63-314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12-0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening.
The purpose of the study was to explore the perspectives of Kenyan male nursing students undertak... more The purpose of the study was to explore the perspectives of Kenyan male nursing students undertaking Bachelor of Science in Nursing (BSc,N), regarding the role of nursing education in developing a professional identity. Methods: A qualitative design was applied.Twenty seven (27) forth year degree Kenyan male nursing students who were drawn from three Kenyan Universities namely Masinde Muliro, Maseno (public) and Baraton (private) werechosen randomly. Approval to conduct the study was sought from Research council of each University. Semi-structured interviews were used to collect the data. Results: Reality–expectation incompatibility” was cited by sixity nine percent (18/27) of study participants”. Lack of trust and not bieng defended by those taking care of their professional development as verbalized in the following verbatims; (10/20) “When we could not do nursing care correctly,clients or patients did not trust us; they even did not speak to us. and by (12/20) “We were insulted b...
Background Despite a large proportion of women attending ANC during pregnancy, a significant perc... more Background Despite a large proportion of women attending ANC during pregnancy, a significant percentage still avoid delivering at the health facility thus increasing the risk of adverse pregnancy outcomes and death. Knowledge of factors associated with the women`s decision against health facility delivery is limited. The main objective of this study is to examine factors associated with women`s decision against health facility delivery despite ANC attendance in Kakamega Central Sub-County, Kakamega county, Kenya. Methodology Design: A community based cross sectional study. Sample size: 302 women who attended ANC but did not deliver in a health facility. Sampling. Simple random sampling Analysis. Analyzed using SPSS V19. The statistical significance level was set at p<0.05. Descriptive statistics and associations-using chi-square was utilized. Results: Significant associations between education level of the women and poor staff availability and unfriendliness (P=0.049), Marital status and high cost of delivery (p=0.050), parity with poor preparatory service (p=0.000), long distance (p=0.000), high cost of delivery (p=0.000) and poor staff availability and unfriendliness (p=0.000) and other costs and health facility delivery (p=0.0063) were found to be some of the factors discouraging women from Kakamega Central sub-county from delivering in a healthy facility. Conclusion and recommendation Women need to be empowered economically, mentally and socially in order for them to make sound decisions when it comes to delivery.
The ages ranged between 4 days and 79 yrs with a mean of 7.9 (SD 13.7)years. Males were 179 (59.3... more The ages ranged between 4 days and 79 yrs with a mean of 7.9 (SD 13.7)years. Males were 179 (59.3%) with a mean age of 7.8 (SD13.1) years while females were 123 (40.7%) and had a mean age of 8.3 (SD14.7) years. Children below 5 years were 221 (73.4%) and had a mean age of 1.9 years (SD 1.3). Those older than 5 years were 80 (26.6%) and had a mean age of 27.8 (SD18.1) years. Site of injury Most of the patients sustained burns in more than one site. Upper limbs with 121 incidents (25.5%) were most involved while the least was inhalational burns (Table 1). Causes of the burn injuries Scalds were the leading cause and accounted for 204 (67.5%) of the burn injuries. This was followed by open fi re with 79 injuries (26.2%). The least common cause was chemical injury. Table 2 shows the causes of burn injuries as seen in MTRH in relation to gender, occupation and surrounding circumstances.
Journal of Health, Medicine and Nursing, 2016
Background Cervical cancer poses a great challenge in the world and especially in developing coun... more Background Cervical cancer poses a great challenge in the world and especially in developing countries. Global cancer statistics ranked the disease seventh of all the cancers (Globocan, 2008). It is the leading cause of death from cancer among women in the developing countries where 90% of the cases are reported (WHO, 2009). Cervical cancer is a preventable disease, and if high uptake of screening is achieved, a great reduction in the incidence and the disease burden can be realized. Sexual habits constitute a major factor in the disease development and are attributed majorly to the Human Papilloma Virus. Increasing the number of women who have cervical cancer screening, the overall 5-year survival can be realized. Objective The main objective for this study was to determine the uptake of cervical cancer screemng among women of ages 21-65 years seeking health services in Uasin-Gishu district hospital. Methodology A quantitative and qualitative descriptive cross-sectional hospital based study was conducted on women aged 21-65 years seeking health services in Uasin-Gishu Hospital. The study was carried out between August 2012-June 2013. Data was collected through administration of questionnaires, key informant interviews and focused group discussions. A randomly selected sample of 168 respondents, one medical officer and 20 women who participated in focused group discussions was used to obtain information for the study. Qualitative data was coded through content analysis according to themes and quantitative data was analyzed using statistical data analysis (Stata) version 12 software. Results There was a very low uptake of cervical cancer screening among the respondents, 8.8% reported to have screened and 91% not screened. There was an association between knowledge of cervical cancer symptoms and age [25-29 (p=0.03)] [30-34(p=0.001)], tertiary education (p=0.002) and marital status (p=0.04). There was an association between knowledge of risk factors and tertiary education (p=<O.OOI), salaried employment (p=0.03), and those respondents who had 1-4 children (p=O.OI). There was an association between knowledge of prevention strategies of cervical cancer and secondary education (p=O.03), tertiary education (p=<O.OOl), and salaried employment (p=O.OOl). Conclusion and Recommendations This study concludes that there is a very low turnout for cervical cancer screening among women seeking health services in Uasin-Gishu Hospital and therefore, Health workers should provide health education on cervical cancer and screening to all women seeking health services in all health facilities
International Journal of Africa Nursing Sciences
Introduction: World Health Organization (WHO) defines disease surveillance as continuous, systema... more Introduction: World Health Organization (WHO) defines disease surveillance as continuous, systematic collection, analysis and interpretation of health-related data needed for the planning, implementation, and evaluation of public health practice. Its aims are to serve as an early warning system for impending public health emergencies, document the impact of an intervention, or track progress towards specified goals and monitor and clarify the epidemiology of health problems, to allow priorities to be set and to inform public health policy and strategies (WHO, 2016). The need for disease surveillance networking in India arose from the challenges encountered in the year 2009 when Pune city experienced the major effect of H1N1 pandemic (Ministry of Health and Family Welfare, [MHFW] 2009). A large proportion of the population was affected. The situation was made worse by a lack of prepared public health surveillance system, unregulated private health sector and a large urban population ...
American Journal of Nursing Science, 2016
Preceptorship is a model of clinical training in which a qualified nurse, referred to as a precep... more Preceptorship is a model of clinical training in which a qualified nurse, referred to as a preceptor, is assigned to one or a group of nursing students, for the purpose of facilitating learning in the clinical setting. This study was done in Maua Methodist {M. M. H (Meru County, Kenya)} and Preyspeterian Churches East Africa (P. C. E. A) Chogoria (Tharaka-Nthi County, Kenya) hospitals in Meru, Kenya and its main objective was to determine the perceived need for preceptor-student nurse partnership in nursing training institution. A sample size of one hundred (100) respondents was randomly selected from a target population of one hundred and eighty (180) preceptees, by use of convenient sampling method. Ten (10) preceptors were also selected conveniently to participate in the study. One hundred and ten (110) questionnaires were distributed out of which ninety nine (99) were received back {(ninety-one-91) from preceptees and eight (8) from preceptors)}. Both, qualitative and quantitative descriptive survey designs was utilized. Descriptive statistics were used to analyse the resultant data. Regarding to the importance of having preceptors, results showed that eighty five out of ninety {85/90 (94.44%)} of the student nurses agreed that they are important while three (33.33%) disagreed. Eight out of nine {8/9 (88.88%)} of the preceptors agreed on the importance of preceptorship while one {1/9 (11.11%)} was not sure. The reasons according to students why they need these preceptors included; provision of directions and guidelines (90%), supervision (79%), resolve clinical conflicts between them and staff nurses (76%) and to have a role model to emulate (83%). For the preceptors-to have a good working environment (78%) and to act as role model (56%). Hence the need for the student-preceptor partnership during students nurses training period.
IOSR Journal of Nursing and Health Science, 2014
The nursing practice environment has been defined as the organizational characteristics of a work... more The nursing practice environment has been defined as the organizational characteristics of a work setting that facilitate or constrain professional nursing practice 5. Examples of these characteristics include the nature of nurses' relationships with managers and physicians, and the status of nurses within the hospital hierarchy. The purpose of this study was to assess the nurses' perception of the work environment and the subsequent work morale using the Practice Environment Scale of the Nursing Work Index (NWI-R).Specific Objectives: 1).To determine the nurses' work morale at the Moi teaching and referral hospital. 2). To determine the nursephysician relationship levels at the Moi teaching and referral hospital. We used a cross-sectional study design with consecutive sampling. Data was collected from 167 nurses working in various units in the month of August 2013. Analysis was done using the SPSS version 18.0, item total of all the five scales of the NWI-R factor analysis was done whereby the subscale mean scores were obtained. Qualitative responses were grouped according to similarities of phrases used to the NWI-R scales. These phrases were then used in the discussion. Of those interviewed, males were 29 and females138. Majority of the nurses (53%) had a feeling that they are not in control of their own practice. One third (32%) felt they rarely participate in policy decisions for the hospital. With regard to staffing, 55.7% agreed with the presence of adequate support services that allow them time to spend with their patients. Most of the nurses do not agree (means below 2.5) that they participate in hospital affairs, that there is nursing foundations for quality care that there is adequate staffing and resources and lastly that there is collegial relationship between them and physicians. It is only on the nurse manager ability, leadership and support that they seem to agree (mean of 2.8). Based on this study it is evident there is low morale among the nursing staff at the Referral Hospital (NWI-R score of below 2.5). The working relationship between nurses and physicians is poor (NWI-R score of below 2.5) There is need to engage nurses in morale boosting activities like refresher courses, recognition of a job well done, and engaging them more often in decision making activities in the hospital.
Open Journal of Epidemiology, 2018
Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic ... more Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women's perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63-314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12-0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening.
The purpose of the study was to explore the perspectives of Kenyan male nursing students undertak... more The purpose of the study was to explore the perspectives of Kenyan male nursing students undertaking Bachelor of Science in Nursing (BSc,N), regarding the role of nursing education in developing a professional identity. Methods: A qualitative design was applied.Twenty seven (27) forth year degree Kenyan male nursing students who were drawn from three Kenyan Universities namely Masinde Muliro, Maseno (public) and Baraton (private) werechosen randomly. Approval to conduct the study was sought from Research council of each University. Semi-structured interviews were used to collect the data. Results: Reality–expectation incompatibility” was cited by sixity nine percent (18/27) of study participants”. Lack of trust and not bieng defended by those taking care of their professional development as verbalized in the following verbatims; (10/20) “When we could not do nursing care correctly,clients or patients did not trust us; they even did not speak to us. and by (12/20) “We were insulted b...
Background Despite a large proportion of women attending ANC during pregnancy, a significant perc... more Background Despite a large proportion of women attending ANC during pregnancy, a significant percentage still avoid delivering at the health facility thus increasing the risk of adverse pregnancy outcomes and death. Knowledge of factors associated with the women`s decision against health facility delivery is limited. The main objective of this study is to examine factors associated with women`s decision against health facility delivery despite ANC attendance in Kakamega Central Sub-County, Kakamega county, Kenya. Methodology Design: A community based cross sectional study. Sample size: 302 women who attended ANC but did not deliver in a health facility. Sampling. Simple random sampling Analysis. Analyzed using SPSS V19. The statistical significance level was set at p<0.05. Descriptive statistics and associations-using chi-square was utilized. Results: Significant associations between education level of the women and poor staff availability and unfriendliness (P=0.049), Marital status and high cost of delivery (p=0.050), parity with poor preparatory service (p=0.000), long distance (p=0.000), high cost of delivery (p=0.000) and poor staff availability and unfriendliness (p=0.000) and other costs and health facility delivery (p=0.0063) were found to be some of the factors discouraging women from Kakamega Central sub-county from delivering in a healthy facility. Conclusion and recommendation Women need to be empowered economically, mentally and socially in order for them to make sound decisions when it comes to delivery.
The ages ranged between 4 days and 79 yrs with a mean of 7.9 (SD 13.7)years. Males were 179 (59.3... more The ages ranged between 4 days and 79 yrs with a mean of 7.9 (SD 13.7)years. Males were 179 (59.3%) with a mean age of 7.8 (SD13.1) years while females were 123 (40.7%) and had a mean age of 8.3 (SD14.7) years. Children below 5 years were 221 (73.4%) and had a mean age of 1.9 years (SD 1.3). Those older than 5 years were 80 (26.6%) and had a mean age of 27.8 (SD18.1) years. Site of injury Most of the patients sustained burns in more than one site. Upper limbs with 121 incidents (25.5%) were most involved while the least was inhalational burns (Table 1). Causes of the burn injuries Scalds were the leading cause and accounted for 204 (67.5%) of the burn injuries. This was followed by open fi re with 79 injuries (26.2%). The least common cause was chemical injury. Table 2 shows the causes of burn injuries as seen in MTRH in relation to gender, occupation and surrounding circumstances.