Nursing students' perceived consequences of self-medication: a qualitative study

Self-medication Patterns and Knowledge Among Undergraduate Health Sciences Students: A Cross-Sectional Study

Introduction

Self-medication (SM) is a practice wherein an individual consumes medicines without consulting a physician. This growing practice can lead to serious consequences, such as adverse drug reactions or treatment failure. Evidence suggests that SM is particularly common among young adults.

Objective

To assess the patterns and knowledge of SM among undergraduate health sciences students.

Methods

The cross-sectional study was conducted on 571 undergraduate health sciences students from January to March 2023. Data on SM practices and associated factors were collected using a self-administered questionnaire. A convenient sampling method was employed to recruit the students. The collected data were analyzed using descriptive and inferential statistics with SPSS software.

Results

Self-medication was reported by 83.5% of participants. Knowledge of SM was satisfactory in 56% and unsatisfactory in 44%. Practice scores were unsatisfactory in 70% and satisfactory in 30%. Pharmacies (61.1%) and the Internet (53.5%) were the main information sources. Significant correlations were found between SM and chronic disease (χ2 = 10.846, p = .0009) and lack of medical insurance (χ2 = 84.175, p = .0001). Painkillers and antipyretics were the most commonly used SM drugs with 51.7% and 45.4%, respectively. Chronic diseases were reported by 8% of participants, of which 27.1%, 18.8%, 22.9%, and 31.2%, reported glucose-6-phosphate dehydrogenase deficiency, hypothyroidism, asthma, and anemia, respectively.

Conclusion

A significant proportion of the respondents practice SM. Although knowledge of SM was satisfactory, it is recommended to be aware risks of SM among students and enforce stricter supervision on the sale of over-the-counter drugs.

Exploring self-care choices: a qualitative study of self-medication insights among university students in Lira City, Northern Uganda

Background

Self-medication, the practice of treating health issues without professional medical guidance, is a widespread phenomenon among students globally, raising concerns about potential consequences. This study investigates perceptions and knowledge of self-medication among students from a university in Uganda.

Methods

We conducted a qualitative study, with 20 in-depth interviews and 3 focus group discussions among students. Data were processed and analysed using NVivo V.12.

Results

This study found both positive and negative perceptions of self-medication among university students. Positive views highlighted the perception that self-medication was convenient and time-efficient method for managing health concerns as access drug shops enabled students to swiftly acquire medications, bypassing prolonged wait times. Self-medication shielded female students from potential stigma and judgement, by enabling them to discretely manage their menstrual health. By bypassing the need for clinic visits and accessing medications directly from drug shops, students could avoid the discomfort and inconvenience associated with public healthcare facilities, and allowing them to allocate time more productively for academic pursuits. However, students were concerned about potential negative consequences that encompassed drug resistance, overdose, complications, and potential fatality.

Conclusion

Limited access to convenient healthcare options, the concern for discrete access, particularly for potentially stigmatised conditions, coupled with the exigencies of academic life that demanded them to optimise time management, create a conducive environment for the prevalence of self-medication practices among university students. These themes demonstrate the intersection of health-seeking behaviours and contextual factors, shedding light on the pragmatic strategies adopted by students to navigate healthcare challenges, sometimes at the risk of harmful consequences. These issues also show the need for culturally and gender-sensitive healthcare approaches, regulatory oversight on medication practices and public health campaigns promoting safe medication practices among students.

Workplace access, burnout, and prescription drug misuse among Korean hospital nurses: a cross-sectional study

BACKGROUND

Prescription drug misuse has been identified as a global issue of concern. Nurses' prescription drug misuse is linked to personal health problems and impaired nursing care. This study explored the level of South Korean hospital nurses' prescription drug misuse and examined associations with workplace access and burnout.

METHODS

This cross-sectional study used data from 1142 nurses working in South Korean hospital settings. Nurses completed the online survey anonymously. Descriptive analysis, logistic regression, and Shapley value assessment were conducted.

RESULTS

Pain relievers (44.2%), IV drips (26.8%), and antibiotics (13.5%) were the most commonly misused drugs among hospital nurses. Accessibility in the workplace was high, with nurses reporting frequent administration of IV drips, pain relievers, and antibiotics and perceiving these drugs as easily accessible. Logistic regression demonstrated that perceived availability was significantly related to misuse across all drug types. Burnout was associated with IV drips, sleeping pills, and steroids, increasing the likelihood of misuse. Shapley feature importance analysis highlighted perceived availability as the most influential factor for IV drips, pain relievers, and steroids, while burnout emerged as crucial for antibiotics and sleeping pills. Notably, age played a significant role in appetite suppressant misuse, distinguishing it from other drugs.

CONCLUSION

Our results revealed that workplace access and burnout are associated with nurses' prescription drug misuse. Effective educational strategies are essential for enhancing nurses' willingness to seek help for personal health issues. Hospital organizations play a crucial role in facilitating access to healthcare and fostering a supportive environment for nurses to seek treatment when necessary. Additionally, governmental policies should prioritize the implementation of active surveillance systems to monitor medication usage in healthcare settings, thereby mitigating drug misuse among healthcare professionals. By addressing these issues, we can ensure the well-being of nurses and promote a safer healthcare environment.

Subchronic doses of artemether-lumefantrine, ciprofloxacin and diclofenac precipitated inflammatory and immunological dysfunctions in female Wistar rats

Recents reports have shown increases in the abuse of anti-malaria, antibiotic and analgesic drugs. This study evaluated the effects of co-administration of artemether-lumefantrine (AL), ciprofloxacin (CPX) and diclofenac (DFC) on inflammatory and immunological status of female Wistar rats. Ninety-six female Wistar rats were assigned into eight groups of twelve animals each. Group A was control, groups B, C, D, E, F, G and H were administered AL, CPX, DFC, AL + CPX, AL + DFC, CPX + DFC and AL + CPX + DFC respectively. Dosages of administered drugs were 178 mg/kg b/w of AL, 185 mg/kg b/w of CPX and 9 mg/kg b/w of DFC. Animals were sacrificed after 6 and 12 weeks of oral administration. Blood was obtained through cardiac puncture. The liver was harvested and processed for immunohistochemical analysis. Differential leukocyte count and neutrophil adhesion test was conducted on whole blood. Immunological response was assessed by the serum levels of C-reactive protein (CRP), interleukin-1β (Il-1β), interleukin-6 (Il-6), monocyte chemoattractant protein-1 (MCP-1), vascular cell adhesion molecule-1 (VCAM-1), myeloperoxidase, and total immunoglobulin G. Data were analyzed with Graph pad prism 5, using one way analysis of variance at 5 % level of significance. Total leukocyte, lymphocyte and basophils count increased (p<0.05) in B, C, E, F, G and H, while neutrophil count decreased (p<0.05) in D, E, G and H at 6 weeks. Neutrophil adhesion decreased (p<0.05) in B, E, F, G and H at 6 weeks. There was no significant difference (p>0.05) in the expression of Il-6, MCP-1 and VCAM-1 across the groups. Il-1β decreased in H, while CRP increased in H at 6 weeks and 12 weeks. MPO activity decreased (p<0.05) in B, C, D, E, G and H at 6 weeks, but increased (p<0.05) in D and G at 12 weeks. Immunohistochemical analysis indicated increase (p<0.05) in tumour necrosis factor-α in liver tissues of B, C, D, E, F and G, while nuclear factor erythroid 2-related factor 2 increased (p<0.05) in C, D, E, F and G, but decreased (p<0.05) in H at 12 weeks. The co-administration of AL, CPX and DFC induced inflammatory responses with attendant immunological dysfunctions and liver damage.

Factors associated with the consumption of chlorine dioxide to prevent and treat COVID-19 in the Peruvian population: a cross-sectional study

BACKGROUND

Chlorine dioxide has been promoted as an alternative for the prevention and treatment of COVID-19, especially in Peru, despite the lack of evidence to support its efficacy. This study aimed to evaluate the factors associated with chlorine dioxide consumption in the Peruvian population.

METHODS

Analytical cross-sectional study. An adult Peruvian population was evaluated where chlorine dioxide consumption was divided into two groups according to the purpose of use: as prevention (individuals without COVID-19 history) and as treatment (individuals with COVID-19 history). The associated factors in each group were evaluated using Poisson regressions with the bootstrapping resampling method.

RESULTS

Of 3610 participants included, 3213 reported no history of COVID-19, and 397 had been infected. The prevalence of chlorine dioxide consumption to prevent or treat COVID-19 was 8 and 16%, respectively. Factors either positively or negatively associated with chlorine dioxide consumption for prevention were male sex (aPR: 1.36; 95% CI: 1.09-1.71), being an adult or older adult (aPR: 0.54; 95% CI: 0.35-0.82), having a health sciences student within the family unit (aPR: 1.38; 95% CI: 1.02-1.87), using medical information as the main source of information of COVID-19 (aPR: 0.57; 95% CI: 0.40-0.80), having comorbidities for COVID-19 (aPR: 1.36; 95% CI: 1.01-1.82), considering COVID-19 dangerous and deadly (aPR: 0.57; 95% CI: 0.45-0.74), using medications (aPR: 1.59; 95% CI: 1.25-2.06) and plants to prevent COVID-19 (aPR: 1.69; 95% CI: 1.21-2.36), considering chlorine dioxide ineffective (aPR: 0.18; 95% CI: 0.18-0.24), and being uninformed of its efficacy (aPR: 0.21; 95% CI: 0.16-0.28). In addition, factors associated with chlorine dioxide consumption for treatment were considering COVID-19 dangerous and deadly (aPR: 0.56; 95% CI: 0.33-0.96), considering chlorine dioxide ineffective (aPR: 0.22; 95% CI: 0.12-0.42), and being uninformed of its efficacy (aPR: 0.15; 95% CI: 0.07-0.32).

CONCLUSIONS

The prevalence of chlorine dioxide consumption to treat COVID-19 was higher than prevent. It is important to apply information strategies, prioritizing population groups with certain characteristics that are associated with a higher consumption pattern.

Psychometric evaluation of medication safety competence scale for clinical nurses

BACKGROUND

Nurses are the most important members of the health care system for medication safety, there are few tools to evaluate their medication safety competence. This study aimed to translate the Medication Safety Competence Scale into Chinese and validate its reliability and validity among clinical nurses.

METHODS

A total of 894 clinical nurses were recruited from three cities in China. The original version of the Medication Safety Competence Scale was translated into Chinese using the backward and forward translation procedure. The reliability of the scale was measured by internal consistency, split-half reliability, and stability. The validity of the scale was assessed by the content validity index, exploratory factor analysis and confirmatory factor analysis.

RESULTS

The Cronbach's coefficient of the scale was 0.940, and the coefficient values for the six domains ranged between 0.843 and 0.948. The split-half reliability and stability were 0.671 and 0.703, respectively. The content validity index of the scale was 0.952. The 6-factor structure, supported by the eigenvalues, total variance explained, and scree plot accounted for 71.485 % of the total variance. Moreover, as a result of the confirmatory factor analysis, the average variance extracted values were 0.55 to 0.70, and the model fitting indexes were all in the acceptable range.

CONCLUSIONS

The Chinese version of the Medication Safety Competence Scale had ideal reliability and validity among clinical nurses. The evaluation results of the scale can provide a reference for nursing managers to formulate education plans and intervention measures to improve clinical nurses' safe medication competence.