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Abdalla ME, Taha MH, Onchonga D, Magzoub ME, Au H, O'Donnell P, Neville S, Taylor D. Integrating the social determinants of health into curriculum: AMEE Guide No. 162. Med Teach 2024; 46:304-316. [PMID: 37677074 DOI: 10.1080/0142159x.2023.2254920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
The World Health Organization (WHO) defines the Social Determinants of Health (SDOH) as the non-medical factors influencing health outcomes. SDOH is associated with conditions in which people are born, grow, work, and live. Medical schools and licensing bodies are increasingly recognizing the need for doctors and healthcare professionals to be aware of their patient's social context and how it impacts their states of health and disease. However, there is considerable variation in the approaches of different institutions and countries to incorporating SDOH into their curricula. In order to allow clinicians to adopt a holistic approach to patient health, equipping them with extensive knowledge of SDOH would give learners the confidence, skills, knowledge, and attitudes needed to effectively engage with patients and their families. This approach aids health professionals with knowledge of the influence of the social context and cultural factors that affect patients' behaviors in relation to health. Incorporating the SDOH in medical and health professional school curricula would contribute towards adequately preparing future healthcare practitioners to provide effective, comprehensive, and equitable care, especially to marginalized and underserved populations. The Guide will take an evidence-based approach grounded in the available contemporary literature and case studies. The focus will be on integrating SDOH into undergraduate and postgraduate medical curricula to promote an understanding of the social factors that influence patients' and communities' health. Ultimately, this guide seeks to contribute to the reduction of inequalities in health.
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Affiliation(s)
| | - Mohamed Hassan Taha
- College of Medicine and Medical Education Center, University of Sharjah, Sharjah, UAE
| | - David Onchonga
- School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Hosanna Au
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | | | - Siobhán Neville
- School of Medicine, University of Limerick, Limerick, Ireland
| | - David Taylor
- Gulf Medical University, Al Jurf, Ajman, United Arab Emirates
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Onchonga D, Mohamed EA. Integrating social determinants of health in medical education: a bibliometric analysis study. Public Health 2023; 224:203-208. [PMID: 37826887 DOI: 10.1016/j.puhe.2023.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/15/2023] [Accepted: 09/07/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVES Social determinants of health (SDH) are the prevalent enablers of health among populations, and integrating them in medical education will advance clinical care by integrating social and economic risk data into medical diagnosis and treatment. Despite the numerous publications on SDH and medical education, the publication trends are not known. The study aims to analyse publication trends in integrating SDH into medical education and the corresponding thematic areas. STUDY DESIGN This was a bibliometric analysis study. METHODS Bibliometric was used. Data from Scopus databases from January 2006 to June 2023 were retrieved with no language restriction. VOSviewer software was used for analysis. Bibliographic coupling was used to identify the clusters of published literature on the integration of SDH into medical education, followed by the analysis of annual distribution and growth trends, authors and co-author relationships and collaborations. RESULTS A total of 1047 articles were retrieved. The annual research publication exhibited a swift surge in the studies conducted during the reviewed period. Five clusters of information were derived: relating to curriculum development, community engagement and service-learning, stakeholder collaborations, development of assessment methods and tools for SDH, and the impact of integrating SDH into medical education. CONCLUSION Bibliometric analysis has revealed a growing trend in the field of integrating SDH into medical education, and the study has highlighted the research impact through bibliographic coupling by identifying the five thematic areas. This study lays a foundation for advancing knowledge on what has been published and possible areas for improvement in the integration of SDH into medical education.
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Affiliation(s)
- D Onchonga
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland; Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, SR1 3SD, England.
| | - E A Mohamed
- School of Medicine, University of Limerick, Limerick, V94 T9PX, Ireland
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Macharia JM, Gakenye GW, Rozmann N, Onchonga D, Mwangi RW, Kaposztas Z, Mathenge JM, Pusztai D, Pinter M, Sugar M, Raposa BL. An empirical assessment of the factors influencing acceptance of COVID-19 vaccine uptake between Kenyan and Hungarian residing populations: A cross-sectional study. Sci Rep 2022; 12:22262. [PMID: 36564451 PMCID: PMC9786518 DOI: 10.1038/s41598-022-26824-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
The development of effective, safe, and acceptable vaccines is a long process. COVID-19 vaccine hesitancy continues to elicit mixed reactions among different quarters despite numerous evidence of their effectiveness. This study aimed to determine the availability and acceptance rates of SARS-CoV-2 vaccines, among Kenyan and Hungarian residing populations and the underlying reasons contributing to the hesitancy of uptake. A non-probability, snowball sampling design was employed, and a survey questionnaire tool link was expeditiously disseminated. Data were carefully analyzed descriptively. Demographic variables, COVID-19 awareness, possible exposure, reasons associated with hesitancy in taking up a vaccine, choice of a vaccine, and availability of vaccines among other important variables were tested to explore their associations with vaccine acceptance rates between the two distinct countries. A total of 1960 participants were successfully enrolled in the research study, while 67 participants were excluded based on the inclusion criterion set. There was, however, no significant difference in COVID-19 public awareness between the Kenyan and Hungarian-residing participants, p = 0.300. Of the respondents, 62.4% were willing and ready to receive vaccines against COVID-19 disease. There was a significant difference (p = 0.014) between the Kenyan and Hungarian-residing respondents concerning vaccine uptake and acceptance rates. The vaccine acceptance rates in Hungary were higher than in Kenya, with mean = 0.27, SD = 0.446, S. E = 0.045 for the Hungarian population sample and mean = 0.40, SD = 0.492, S. E = 0.026, for the Kenyan sample respectively. Concerning gender and vaccine acceptance, there was a notable significant difference between males and females, p = 0.001, where the mean for males and females were 0.29 and 0.46 respectively. Acceptance rates among males were higher than among females. The functions of One-Way ANOVA and Chi-square were used to establish any significant differences and associations between means and variables respectively. Concerns regarding the safety, efficacy, and accuracy of information about the developed vaccines are significant factors that must be promptly addressed, to arrest crises revolving around COVID-19 vaccine hesitancy, especially in Kenya and among females in both populations, where acceptance rates were lower. Expansion of the screening program to incorporate antibody (serology) tests, is also highly recommended in the present circumstance. Equitable distribution of vaccines globally should be encouraged and promoted to adequately cover low- and middle-income countries. To enhance effective combat on vaccination hesitancy and apprehension in different countries, mitigation techniques unique to those countries must be adopted.
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Affiliation(s)
- John M Macharia
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pecs, Vorosmarty Mihaly Str. 4, Pecs, 7621, Hungary.
| | - Grace W Gakenye
- Faculty of Business and Economics, University of Pecs, Pecs, Hungary
| | - Nóra Rozmann
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pecs, Vorosmarty Mihaly Str. 4, Pecs, 7621, Hungary
| | - David Onchonga
- School of Medicine, University of Limerick, Limerick, Ireland
| | - Ruth W Mwangi
- Faculty of Science, Department of Biological Sciences, Egerton University, Nakuru, Kenya
- Doctoral School of Horticultural Sciences, Institute of Vegetables and Mushroom Growing, Hungarian University of Agriculture and Life Sciences, Budapest, Hungary
| | - Zsolt Kaposztas
- Faculty of Health Science, University of Pẻcs, Pẻcs, Hungary
| | - John M Mathenge
- School of Agriculture and Enterprise Development, Kenyatta University, Nairobi, Kenya
| | - Dorina Pusztai
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pecs, Vorosmarty Mihaly Str. 4, Pecs, 7621, Hungary
| | - Marton Pinter
- Faculty of Health Science, University of Pẻcs, Pẻcs, Hungary
| | - Miklos Sugar
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pecs, Vorosmarty Mihaly Str. 4, Pecs, 7621, Hungary
| | - Bence L Raposa
- Faculty of Health Science, University of Pẻcs, Pẻcs, Hungary
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Amer F, Hammoud S, Onchonga D, Alkaiyat A, Nour A, Endrei D, Boncz I. Correction: Amer et al. Assessing Patient Experience and Attitude: BSC-PATIENT Development, Translation, and Psychometric Evaluation-A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2022, 19, 7149. Int J Environ Res Public Health 2022; 19:12319. [PMID: 36232286 PMCID: PMC9566665 DOI: 10.3390/ijerph191912319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/15/2022] [Indexed: 06/16/2023]
Abstract
The authors wish to make the following corrections to this paper [...].
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Affiliation(s)
- Faten Amer
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
| | - Sahar Hammoud
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
| | - David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
| | - Abdulsalam Alkaiyat
- Division of Public Health, Faculty of Medicine and Health Sciences, An Najah National University, Nablus P.O. Box 7, Palestine
| | - Abdulnaser Nour
- Faculty of Economics and Social Sciences, An Najah National University, Nablus P.O. Box 7, Palestine
| | - Dóra Endrei
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
| | - Imre Boncz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pécs, H-7621 Pécs, Hungary
- National Laboratory for Human Reproduction, University of Pécs, H-7621 Pécs, Hungary
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Onchonga D, Bhaskar L. 2019 SARS-CoV-2 (COVID-19) Pandemic and Mental Health: Challenges to Homeless Children and Youths. Int J Prev Med 2022; 13:97. [PMID: 35958360 PMCID: PMC9362754 DOI: 10.4103/ijpvm.ijpvm_508_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary,Address for correspondence: Dr. David Onchonga, University of Pecs, Doctoral School of Health Sciences, Pécs, Vörösmarty Mihaly utca 4, 7621, Hungary. E-mail:
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Alfatafta H, Alfatafta M, Onchonga D, Hammoud S, Khatatbeh H, Zhang L, Boncz I, Lohner S, Molics B. Effect of the knee replacement surgery on activity level based on ActivPAL: a systematic review and meta-analysis study. BMC Musculoskelet Disord 2022; 23:576. [PMID: 35705950 PMCID: PMC9199222 DOI: 10.1186/s12891-022-05531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
Background The knee replacement (KR) surgery aims to restore the activity level and reduce the risk of experiencing disabilities. The outcomes of this surgery are evaluated mainly with subjective tools or low validity objective tools. However, the effect of the surgery on activity level using high validity objective accelerometer is still in question. Methods A systematic review and meta-analysis were conducted to evaluate the benefit of KR surgery alone to enhance physical activity recommendations based on high validity accelerometer. Two independent reviewers evaluated five electronic databases (Cochrane-Central-Register-of-Controlled Trials, EMBASE, PubMed, Web of Science, and Scopus) to find relative studies between January 2000 and October 2021. The quality assessments and risk of bias assessments were examined. Results Three articles were included with 202 participants (86 males, 116 females), with an average age of 64 years and an average 32 kg/m2 body mass index. The results found that the number of steps was significantly improved up to 36.35 and 45.5% after 6-months and 1-year of the surgery, respectively. However, these changes did not meet the recommended activity level guideline and could be related to the patients’ health status and their activity level before the surgery. No significant changes were seen in sedentary time, standing time, and upright time after 6-months and 1-year follow-ups. Heterogeneity among studies was low to moderate (0–63%). Conclusion Knee replacement surgery is an effective treatment for improving patients’ quality of life with severe knee injuries. However, various factors impact the success of surgical and achieving maximum benefit of the surgery. One factor, sedentary time, can be reduced by implementing pre-and post-surgery exercise or physical activity recommendations. Further studies are needed to understand the benefit of surgery with or without rehabilitation assessed using high validity monitors. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-022-05531-2.
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Affiliation(s)
- Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary.
| | - Mahmoud Alfatafta
- Orthotics and Prosthetics Department, Rehabilitation Sciences School, University of Jordan, Amman, Jordan
| | - David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Sahar Hammoud
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Lu Zhang
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, 7621, Vörösmartyutca 4, Pécs, Hungary
| | - Imre Boncz
- Institute for Health Insurance, Faculty of Health Sciences, University of Pecs, Pécs, Hungary
| | - Szimonetta Lohner
- Cochrane Hungary, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Bálint Molics
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pecs, Pécs, Hungary
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Khatatbeh H, Al‐Dwaikat T, Oláh A, Onchonga D, Hammoud S, Amer F, Prémusz V, Pakai A. The relationships between paediatric nurses' social support, job satisfaction and patient adverse events. Nurs Open 2021; 8:3575-3582. [PMID: 33934553 PMCID: PMC8510783 DOI: 10.1002/nop2.907] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/03/2021] [Accepted: 04/14/2021] [Indexed: 11/17/2022] Open
Abstract
AIMS To explore the relationships of family, co-worker and manager support with paediatric nurses' satisfaction and their perception of adverse events. Furthermore, this study aimed to assess the job satisfaction, social support and the perceived patient adverse events. DESIGN This study used a cross-sectional correlational design. METHODS A convenient sample of 225 paediatric nurses was selected from nine hospitals in Jordan. Both the Pearson correlations and multiple regression tests were used in the analysis. The study was prepared and is reported according to the STROBE checklist. RESULTS Significant and positive correlations were found between paediatric nurses' job satisfaction and the social support they receive. Significant negative correlations were also found between adverse events and both family and manager support. The multiple regression results showed that manager support is a significant negative predictor of both pressure ulcers and patient falls, and family support significantly predicted paediatric nurses' job satisfaction.
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Affiliation(s)
- Haitham Khatatbeh
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Tariq Al‐Dwaikat
- Department of Community and Mental HealthFaculty of NursingJordan University of Science and TechnologyIrbidJordan
| | - András Oláh
- Institute of Nursing Sciences, Basic Health Sciences and Health VisitingFaculty of Health SciencesUniversity of PécsPécsHungary
| | - David Onchonga
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Sahar Hammoud
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Faten Amer
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Viktória Prémusz
- Doctoral School of Health SciencesFaculty of Health SciencesUniversity of PécsPécsHungary
| | - Annamária Pakai
- Institute of Nursing Sciences, Basic Health Sciences and Health VisitingFaculty of Health SciencesUniversity of PécsPécsHungary
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Onchonga D, Keraka M, MoghaddamHosseini V, Várnagy Á. Does institutional maternity services contribute to the fear of childbirth? A focus group interview study. Sex Reprod Healthc 2021; 30:100669. [PMID: 34583286 DOI: 10.1016/j.srhc.2021.100669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/05/2021] [Accepted: 09/16/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The quality of institutional maternity services offered significantly determine the health outcomes of pregnant women and their infants. OBJECTIVES The study aimed at understanding perceptions and experiences of new mothers diagnosed with the fear of childbirth in Kenya; regarding the institutional maternity services offered and if they contribute to the fear of childbirth (FOC). METHODS This was a qualitative descriptive study. A total of 29 women who had given birth recently in a maternity institution, and had been screened with the fear of childbirth at 32 weeks' gestation period participated in focus group interviews. The Framework for Assessing the Quality of Care of institutional maternity services (FAQC) developed by the University of Southampton was adopted in this study. Thematic analyses were used. RESULTS It was reported that institutional maternity services contributed directly and indirectly to FOC. The direct contribution included the performance of unintended caesarian sections, severe and prolonged labour pains and negative attitude of healthcare providers. The indirect contribution was in form of challenges in the provision of care and the experience of care in the maternity institutions. In the provision of care; human and physical resources, inadequate referral systems, and inadequate management of emergencies were reported. In the experience of care; lack of cognition, respect, dignity, equity and inadequacies in emotional support were reported. CONCLUSION The study identified systemic challenges related to both the provision and the experience of care. Therefore, there is need to astutely analyze all critical steps identified in the FAQC, as this will greatly improve the uptake of institutional maternity services.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary; School of Public Health, Kenyatta University, Kenya.
| | | | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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Onchonga D, Alfatafta H, Ngetich E, Makunda W. Health-seeking behaviour among pregnant women during the COVID-19 pandemic: A qualitative study. Heliyon 2021; 7:e07972. [PMID: 34541362 PMCID: PMC8432977 DOI: 10.1016/j.heliyon.2021.e07972] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2021] [Revised: 08/12/2021] [Accepted: 09/08/2021] [Indexed: 12/23/2022] Open
Abstract
Background The novel coronavirus pandemic has killed millions of people globally while significantly destroying the social, economic, and political wellbeing of people. The global pandemic has negatively impacted pregnant women's access to prenatal care. The current study sought to understand the health-seeking behaviour of women who were pregnant during the onset of the COVID-19 pandemic in Kenya. Methods The “Three Delay” model theoretical framework was applied to piece together the pregnant women's health-seeking behaviour during the early stages of the pandemic through focus group discussions. The collected qualitative data was analysed using thematic analysis. Results The delays in deciding to seek care, delays in reaching healthcare facilities and delays in receiving quality healthcare services at the healthcare facility were a result of the fear of contracting the virus. These delays were occasioned by participants’ personal experiences and uncertainties about COVID-19 pandemic, compulsory quarantines, national cessation of movements, compulsory lockdowns, loss of income to many households and the influence of traditional birth attendants (TBAs). Conclusion The current study found that fear of COVID-19 was a major factor that hindered access to maternal healthcare services. In this regard, there is a need to upscale awareness creation on the significance of seeking maternal health services during the pandemic to reduce the possibility of obliterating the gains made in reducing poor health-seeking behaviours among pregnant women.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Enoch Ngetich
- School of Public Health, Mount Kenya University-Nairobi, Kenya
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Alfatafta H, Onchonga D, Alfatafta M, Zhang L, Boncz I, Lohner S, Molics B. Effect of using knee valgus brace on pain and activity level over different time intervals among patients with medial knee OA: systematic review. BMC Musculoskelet Disord 2021; 22:687. [PMID: 34384421 PMCID: PMC8362244 DOI: 10.1186/s12891-021-04513-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 06/08/2021] [Indexed: 11/19/2022] Open
Abstract
Background The Knee valgus brace is one of the accepted conservative interventions for patients with medial compartment knee osteoarthritis to correct the knee varus and increase functional activity level. Nevertheless, comprehensive overview of the effects of using this brace on self-reported pain activity level over time is not available. Thus, this study aimed to systematically review the effect of using this brace on pain and activity levels in the last 20 years in patients with medial compartment knee osteoarthritis. Methods Five databases were searched to find articles from the year 2000 to the end of November 2020: Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, PubMed, Web of Science, and Scopus. Two reviewers independently evaluated the available articles for eligibility and assessed quality. The risk of bias in each study was assessed by two reviewers independently according to the Strengthening the Reporting of Observational Studies in Epidemiology tool (STROBE) for the non-randomized controlled studies and the Cochrane risk-of-bias tool for the randomized controlled studies. Results Seven randomized controlled studies and 17 cohort studies (in total 579 participants) were included in the systematic review. Most of these studies found using a knee valgus brace effective in reducing pain and improving activity level over different time intervals. The majority of the included studies (14 studies) evaluated the impact of the brace for a considerably short-term (less than 6 months). Thus, limited evidence is available on the long-term use of the knee valgus brace and its associated complications. Conclusion The knee valgus brace is an effective conservative intervention to improve the quality of life and reduce pain during daily activities for some patients. However, the long term of using this brace is still not very convenient, and the patients who benefit most from using the brace should be identified with high methodological quality studies. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04513-0.
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Affiliation(s)
- Huda Alfatafta
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty utca 4, 7621, Pécs, Hungary.
| | - David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty utca 4, 7621, Pécs, Hungary
| | | | - Lu Zhang
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Vörösmarty utca 4, 7621, Pécs, Hungary
| | - Imre Boncz
- Faculty of Health Sciences, Institute for Health Insurance, University of Pecs, Pécs, Hungary
| | - Szimonetta Lohner
- Clinical Center, Medical School, Cochrane Hungary, University of Pécs, Pécs, Hungary
| | - Bálint Molics
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Khatatbeh H, Pakai A, Al-Dwaikat T, Onchonga D, Amer F, Prémusz V, Oláh A. Nurses' burnout and quality of life: A systematic review and critical analysis of measures used. Nurs Open 2021; 9:1564-1574. [PMID: 33991408 PMCID: PMC8994939 DOI: 10.1002/nop2.936] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/18/2021] [Accepted: 04/28/2021] [Indexed: 11/11/2022] Open
Abstract
Background Nurses’ burnout might affect their quality of life, productivity and nursing care services. Aim The aim of this systematic review was to systemically review the relationship between nurses’ burnout and quality of life and to introduce practical recommendations to reduce nurses’ BO and improve their QOL. Methods In April 2021, MeSH terms (("Nurses"[Mesh]) AND "Burnout, Professional"[Mesh]) AND "Quality of Life"[Majr] were used to search five electronic databases: CINAHL, PubMed, Medline, Psychology and Behavioral Sciences Collection and Google Scholar. Results The search produced 21 studies exploring nurses’ burnout and their quality of life within the last ten years (2009–2021). Most of these studies found significant relationships between the burnout dimension(s) and quality of life dimension(s) among the nurses. Conclusion Nurses have moderate to high levels of burnout and were negatively associated with poor quality of life. Interventional programs are needed to decrease nurses’ burnout and improve their quality of life.
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Affiliation(s)
- Haitham Khatatbeh
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Annamária Pakai
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | | | - David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Faten Amer
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Viktória Prémusz
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - András Oláh
- Institute of Nursing Sciences, Basic Health Sciences and Health Visiting, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
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Hoang HH, Tran ATN, Nguyen VH, Nguyen TTB, Nguyen TAP, Le DD, Jatho A, Onchonga D, Duong TV, Nguyen MT, Tran BT. Attention Deficit Hyperactivity Disorder (ADHD) and Associated Factors Among First-Year Elementary School Students. J Multidiscip Healthc 2021; 14:997-1005. [PMID: 33958873 PMCID: PMC8096448 DOI: 10.2147/jmdh.s301091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/19/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Attention deficit hyperactivity disorder (ADHD) is a mental health disorder commonly in children. This study aimed to examine the prevalence of ADHD and risk factors among first-year pupils in Vietnam's urban city. PATIENTS AND METHODS A cross-sectional study was conducted in four randomly selected primary schools. Information on 525 pupils in grade 1 (ages 6 to 7 years) was collected from 525 parents/caregivers and 28 teachers. We used the Vanderbilt Assessment Scales with two separate versions for parents and teachers to screen children with ADHD symptoms. RESULTS Among the total of 525 pupils, 24 (4.6%) were found to have ADHD symptom types (boy: 6.5%; girl: 2.1%). The combined ADHD type accounted for the highest proportion of 3.4%, followed by predominantly inattentive and predominantly hyperactivity type. ADHD prevalence rated by teachers was higher than those rated by parents. High agreement between parents and teachers was reported (κ > 0.6). The risk of ADHD increased in male participants (aOR=4.90, 95% CI 1.51-15.85), those having a first-degree relative with ADHD (aOR=85.2, 95% CI 1.66-4371.8), in-utero exposure to tobacco smoke (aOR=4.78, 95% CI 1.31-17.44), and prenatal alcohol drinking (aOR=8.87, 95% CI 2.29-34.42). CONCLUSION These findings suggest the importance of ADHD screening for pupils attending elementary schools, particularly those with a family history of ADHD. Public health programs should reduce prenatal exposure to the potential risk factors of ADHD (smoking and alcohol consumption).
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Affiliation(s)
- Hai Huu Hoang
- Student’s Affairs Office, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | | | - Van Hung Nguyen
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Thi Thanh Binh Nguyen
- Department of Paediatrics, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Thi Anh Phuong Nguyen
- Faculty of Nursing, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Dinh Duong Le
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Alfred Jatho
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
| | - David Onchonga
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - Tuyen Van Duong
- School of Nutrition and Health Sciences, Taipei Medical University, Taipei, 110-31, Taiwan
| | - Minh Tu Nguyen
- Undergraduate Training Office, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Binh Thang Tran
- Faculty of Public Health, Hue University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
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Onchonga D, Várnagy Á, Amer F, Viktoria P, Wainaina P. Translation and validation of the Swahili version of the Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). Sex Reprod Healthc 2021; 29:100626. [PMID: 33971430 DOI: 10.1016/j.srhc.2021.100626] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/28/2021] [Accepted: 04/18/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Prenatal fear of childbirth is a common health concern that negatively affects the emotional wellbeing of women during pregnancy. Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A) is used extensively to measure fear of childbirth during pregnancy. Nevertheless, previous studies have not evaluated its psychometric characteristics among the Swahili-speaking pregnant women. Therefore, the aim was to translate and test the validity and reliability of the questionnaire into Swahili as the popular language in Kenya. METHODS In the current descriptive cross-sectional study, the W-DEQ-A, together with the Edinburgh Postnatal Depression Scale (EPDS) and Beck Anxiety Inventory (BAI) were administered to a group of 628 pregnant women to explore the dimensionality of W-DEQ-A using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), respectively. RESULTS EFA and CFA of the Swahili version of W-DEQ-A identified five-factor loadings: lack of self-efficacy, fear, negative emotions, negative appraisal, and social isolation. However, this model failed to support the unidimensional structure of the original W-DEQ-A. The Swahili version of the W-DEQ-A correlated well with EPDS and BAI at acceptable levels. The Cronbach alpha values of the subscales ranged from 0.867 to 0.967, an indication of an excellent internal consistency of the instrument. CONCLUSION The current study findings provide support for the Swahili version of the W-DEQ-A to be considered as a valid and reliable measuring tool for the fear of childbirth among Swahili-speaking pregnant women in Kenya, and the entire East and Central African region. Also, due to its multidimensional structure, the original W-DEQ-A should not be used in its original form.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary.
| | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
| | - Faten Amer
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
| | - Prémusz Viktoria
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs-Hungary, Hungary
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Onchonga D, Ngetich E, Makunda W, Wainaina P, Wangeshi D, viktoria P. Anxiety and depression due to 2019 SARS-CoV-2 among frontier healthcare workers in Kenya. Heliyon 2021; 7:e06351. [PMID: 33644428 PMCID: PMC7901492 DOI: 10.1016/j.heliyon.2021.e06351] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 10/26/2020] [Accepted: 02/19/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The novel coronavirus disease continues to spread across the globe, causing anxiety and depression among healthcare workers. OBJECTIVES The current study aimed to determine the levels of anxiety and depression due to the coronavirus pandemic among healthcare workers in Kenya. METHODS A total sample of 476 respondents participated. The 7-item Generalized Anxiety Disorder Scale (GAD-7) and Patient-Health Questionnaire (PHQ-9), together with a socio-demographic questionnaire, were applied. Stratified sampling was used. Data was analysed using the Statistical Package Programme for Social Science Version 23.0.0. Kruskal Wallis test and Mann-Whitney U test were employed to establish the differences in levels of anxiety and depression across socio-demographic characteristics. Ordinal logistic regression analysis was used to establish the predictors of levels of anxiety and depression, and associations were considered significant at p < 0.05. RESULTS A total of 35.1% (n = 167) of the participants had mild anxiety, and 13.4% (n = 64) severe anxiety. Approximately 53.6% (n = 255) had mild depression while 9.2% (n = 44) had severe depression. The univariate analysis illustrated a statistical difference in anxiety levels in gender (p > 0.027), years of work experience (p = 0.005), and the cadre of respondents (p = 0.0028). Gender was statistically significant with the level of depression (p = 0.045). About 62.6% (n = 298) of healthcare workers had been trained, and only 9% (n = 43) were confident in managing COVID-19 cases. A large proportion, 98% (n = 458) had concerns about the availability of personal protective equipment. CONCLUSION The study findings indicated that the majority of healthcare workers had mild anxiety and depression. Female healthcare workers were more likely to experience severe anxiety and depression. Also, levels of anxiety and depression differed across different cadres of healthcare workers.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
| | - Enoch Ngetich
- School of Public health, Mount Kenya University, Nairobi, Kenya
| | | | | | | | - Prémusz viktoria
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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15
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Onchonga D, Hammoud S, Kuriakose S, Muhammad EAK. Exploring fear of childbirth in Kenya through evaluation of the readability of Wijma Delivery Expectancy/Experience Questionnaire Version A (W-DEQ-A). Sex Reprod Healthc 2021; 28:100605. [PMID: 33626433 DOI: 10.1016/j.srhc.2021.100605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 01/24/2021] [Accepted: 02/02/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Several tools measuring fear of childbirth (FOC) have been developed in the last three decades, however concerns about their readability have been raised. AIM To explore the fear of childbirth in a sample of women of reproductive age by evaluating the readability of Wijma Delivery Expectancy/Experience Questionnaire version A (W-DEQ-A). METHODS The Flesch Reading Ease Formula, the Flesch-Kincaid Grade Level, the FOG Scale, the SMOG Index, the Coleman-Liau Index, the Automated Readability Index, and the Linsear Write Formula were used to evaluate the readability of the W-DEQ-A. Also, focus group discussions were held to validate the findings of the readability scales mentioned above. FINDINGS The SMOG Index (score = 7.6), Coleman-Liau Index (score = 7.6), and the Linsear Write Formula (score = 9.4) were easily readable by women of reproductive age who had at least secondary school education (grade 12). Concerns were raised over some terms used such as desolate and deserted, which were rarely used in day to day English language conversations. CONCLUSIONS In this study, participants observed that W-DEQ- A was readable if administered to expectant women with a basic secondary school certificate; but there is a need to simplify some words. It was emphasized that societal dynamics play an important role in the fear of childbirth and therefore the questionnaire should address all aspects contributing to fear of childbirth and not merely the feelings and thoughts women may have at the prospect of labor and delivery.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, University of Pécs, Hungary.
| | - Sahar Hammoud
- Doctoral School of Health Sciences, University of Pécs, Hungary.
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Onchonga D. Prenatal fear of childbirth among pregnant women and their spouses in Kenya. Sexual & Reproductive Healthcare 2021; 27:100593. [DOI: 10.1016/j.srhc.2020.100593] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 12/09/2020] [Accepted: 12/29/2020] [Indexed: 11/25/2022]
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17
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Onchonga D. Assessing the usability of a willingness-to-quit smoking questionnaire in a sample of active tobacco smokers in Kenya: A qualitative study. Tob Prev Cessat 2020. [DOI: 10.18332/tpc/128438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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18
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Onchonga D, Omwoyo J, Nyamamba D. Assessing the prevalence of self-medication among healthcare workers before and during the 2019 SARS-CoV-2 (COVID-19) pandemic in Kenya. Saudi Pharm J 2020; 28:1149-1154. [PMID: 32837218 PMCID: PMC7426227 DOI: 10.1016/j.jsps.2020.08.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/08/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Self-medication plays a key role in public health as it influences both negatively and positively on the health of individuals and the existing healthcare systems. This is especially the case during public health emergencies like the 2019 SARS-CoV-2 disease. OBJECTIVES The study aimed at assessing the prevalence of self-medication before and during the outbreak of COVID-19 pandemic among healthcare workers and its associated factors. METHODS Stratified sampling was used to select 379 study respondents. The authors developed an online questionnaire, pretested and submitted to various online professional groups of different cadres of healthcare workers. Collected data was analysed using descriptive and inferential statistics. The data was presented in tables, graphs, percentages, and cross-tabulation with different variables. Multivariable logistic regression was used to ascertain factors that influence an individual's desire to self-medicate and associations were considered significant at p < 0.05. RESULTS The overall prevalence of self-medication increased from 36.2% (n = 137) before the pandemic to 60.4% (n = 229) during the pandemic. The respondents' gender, level of education, age, marital status, participation in physical activity, and drug reaction events, were significantly associated with self-medication before and during the outbreak (P < 0.05). Multivariable logistic regression analyses showed that participants engaging in physical activities, working during the day and being healthy were less likely to self-medicate (p < 0.01). CONCLUSION Self-medication is an important health issue, especially during the COVID-19 pandemic. Continuous awareness creation and sensitization could help in reducing self-medication practices among healthcare workers.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
- Ministry of Health- Samburu County, Kenya
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Onchonga D, Khatatbeh H, Thuranira M, Lennox K, Venkatesh MBR. Assessing the usability of a Willingness to Quit smoking questionnaire in a sample of active tobacco smokers: A qualitative study. J Addict Dis 2020; 39:3-10. [PMID: 32838698 DOI: 10.1080/10550887.2020.1800891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background and objectives: Tobacco products are conceivably the most accessible addictive substances. Its use contributes to numerous negative health outcomes both in the developed and developing world. The objective of the study was to assess the usability of a Willingness to Quit smoking questionnaire; a concise questionnaire used to assess the readiness of active tobacco smokers to stop smoking, and also guiding in constructive conversations between healthcare workers and clients regarding stopping smoking.Methods: In this study, 25 active tobacco smokers and four healthcare workers of different cadres were interviewed. Participants were given the Willingness to Quit smoking questionnaire and asked to fill and comment on its usability, ease of comprehension and plausibility in the healthcare system settings.Results: All the 25 active tobacco smokers demonstrated their readiness to stop smoking. It was reported that the Willingness to Quit smoking questionnaire triggered the intention to stop smoking and effectively guided the interviews between the healthcare workers and clients who had expressed the intention of stopping smoking.Conclusion: The Willingness to Quit smoking questionnaire is a valuable tool in clinical practice as it can be used to prompt tobacco cessation dialogues between healthcare workers and clients attempting to stop smoking.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, University of Pécs, Hungary.,County Department of Health Services Samburu-Kenya
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20
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Onchonga D. A Google Trends study on the interest in self-medication during the 2019 novel coronavirus (COVID-19) disease pandemic. Saudi Pharm J 2020; 28:903-904. [PMID: 32641903 PMCID: PMC7299852 DOI: 10.1016/j.jsps.2020.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 12/23/2022] Open
Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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Onchonga D, MoghaddamHosseini V, Keraka M, Várnagy Á. Prevalence of fear of childbirth in a sample of gravida women in Kenya. Sex Reprod Healthc 2020; 24:100510. [PMID: 32217359 DOI: 10.1016/j.srhc.2020.100510] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 03/07/2020] [Accepted: 03/19/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The aim of the study was to determine the prevalence of fear of childbirth (FOC) using a sample of gravida women in Kenya, a developing country where it is not fully acknowledged. MATERIALS AND METHODS This were a cross-sectional study on gravida women visiting health facilities to receive routine antenatal care. The study applied multistage sampling to enrol eligible expectant women. A researcher-developed questionnaire was used alongside Wijma Delivery Expectancy/Experience Questionnaire (version A) to collect respondents' demographic characteristics and to measure their fear of childbirth levels, respectively. RESULTS Approximately 29.5% had low, 40.4% moderate, 22.1% high, and 8% recorded severe FOC levels. Comparing by parity, the prevalence of severe FOC was higher on primigravida at 13.8% than multigravida, 8.0%. The results revealed a significant relationship between marital status (p = 0.045), parity (p = 0.000), literacy status (p = 0.000), regular check-up of pregnancy at health facilities (p = 0.003), having trust in healthcare providers (p = 0.000), and physical activity for gravida women with fear of childbirth (p = 0.000). CONCLUSION From the findings, special attention on the identified predictors of fear of childbirth during prenatal sessions would help in managing fear of childbirth before they give birth.
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Affiliation(s)
- David Onchonga
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary.
| | - Vahideh MoghaddamHosseini
- Department of Midwifery, Faculty of Nursing and Midwifery, Sabzevar University of Medical Sciences, Sabzevar, Iran; Non-Communicable Diseases Research Centre, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | | | - Ákos Várnagy
- Doctoral School of Health Sciences, Faculty of Health Sciences, University of Pécs, Hungary
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22
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Onchonga D. The enormities and consequences of tobacco
use among youths in resource limited settings
in Kenya. Tob Induc Dis 2019. [DOI: 10.18332/tid/112082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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23
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Onchonga D. Social variations in tobacco products consumption in Kenya: The influence of education, employment status and gender. Tob Induc Dis 2019. [DOI: 10.18332/tid/111651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Onchonga D. Validation of a willingness-to-quit questionnaire for use among active tobacco products users in medical practice. Tob Induc Dis 2019. [DOI: 10.18332/tid/111850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Smith S, Koech R, Nzorubara D, Otieno M, Wong L, Bhat G, van den Bogaart E, Thuranira M, Onchonga D, Rinke de Wit TF. Connected diagnostics: linking digital rapid diagnostic tests and mobile health wallets to diagnose and treat brucellosis in Samburu, Kenya. BMC Med Inform Decis Mak 2019; 19:139. [PMID: 31331394 PMCID: PMC6647279 DOI: 10.1186/s12911-019-0854-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 06/26/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite WHO guidelines for testing all suspected cases of malaria before initiating treatment, presumptive malaria treatment remains common practice among some clinicians and in certain low-resource settings the capacity for microscopic testing is limited. This can lead to misdiagnosis, resulting in increased morbidity due to lack of treatment for undetected conditions, increased healthcare costs, and potential for drug resistance. This is particularly an issue as multiple conditions share the similar etiologies to malaria, including brucellosis, a rare, under-detected zoonosis. Linking rapid diagnostic tests (RDTs) and digital test readers for the detection of febrile illnesses can mitigate this risk and improve case management of febrile illness. METHODS This technical advance study examines Connected Diagnostics, an approach that combines the use of point-of-care RDTs for malaria and brucellosis, digitally interpreted by a rapid diagnostic test reader (Deki Reader) and connected to mobile payment mechanisms to facilitate the diagnosis and treatment of febrile illness in nomadic populations in Samburu County, Kenya. Consenting febrile patients were tested with RDTs and patient diagnosis and risk information were uploaded to a cloud database via the Deki Reader. Patients with positive diagnoses were provided digital vouchers for transportation to the clinic and treatment via their health wallet on their mobile phones. RESULTS In total, 288 patients were tested during outreach visits, with 9% testing positive for brucellosis and 0.6% testing positive for malaria. All patients, regardless of diagnosis were provided with a mobile health wallet on their cellular phones to facilitate their transport to the clinic, and for patients testing positive for brucellosis or malaria, the wallet funded their treatment. The use of the Deki Reader in addition to quality diagnostics at point of care also facilitated geographic mapping of patient diagnoses in relation to key risk areas for brucellosis transmission. CONCLUSIONS This study demonstrates that the Connected Dx approach can be effective even when addressing a remote, nomadic population and a rare disease, indicating that this approach to diagnosing, treatment, and payment for healthcare costs is feasible and can be scaled to address more prevalent diseases and conditions in more populous contexts.
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Affiliation(s)
- S Smith
- PharmAccess Foundation, AHTC Tower 4C, Paasheuvelweg 25, 1105 BP, Amsterdam, The Netherlands.
| | - R Koech
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - D Nzorubara
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - M Otieno
- PharmAccess Foundation Kenya, New Rehema House, Rhamta Road, Westlands, Nairobi, Kenya
| | - L Wong
- Fio Corporation, 111 Queen Street East Suite 500, Toronto, Ontario, M5C 1S2, Canada
| | - G Bhat
- Fio Corporation, 111 Queen Street East Suite 500, Toronto, Ontario, M5C 1S2, Canada
| | - E van den Bogaart
- Mondial Diagnostics, Meibergdreef 39, 1105 AZ, Amsterdam, The Netherlands
| | - M Thuranira
- Samburu County Government, C77, P.O. Box 3 - 20600, Maralal, Samburu County, Kenya
| | - D Onchonga
- Samburu County Government, C77, P.O. Box 3 - 20600, Maralal, Samburu County, Kenya
| | - T F Rinke de Wit
- PharmAccess Foundation, AHTC Tower 4C, Paasheuvelweg 25, 1105 BP, Amsterdam, The Netherlands
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