11 Records out of 22207 Records

A survey on knowledge, attitude and practice regarding cardiopulmonary resuscitation of pregnant women among Anesthesiology and Obstetrics registrars in Kenyatta National Hospital

Author: Kivungi, Patience Koka

Awarding University: University of Nairobi, Kenya

Level : MMed

Year: 2012

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: Cardiopulmonary resuscitation--CPR/Physicians/Pregnancy/Women/Obstetrics/Gynecology/Kenyatta National Hospital, Nairobi, Kenya ;

Abstract:

Kenyatta National Hospital is the largest of the two main level 6 ( National Referral Hospital) health facilities in Kenya. It has one labour ward, with a bed capacity of twenty six. Though it is supposed to handle referrals mainly from public and sometimes private hospitals, it handles more walk in patients than referrals. Most of the times the hospital is not forewarned of the referrals so as to get prepared. Some of these mothers may require CPR (Cardiopulmonary Resuscitation) at some point during their management. Resuscitation of these mothers is done by a team consisting of obstetrics and gynaecology registrars (postgraduate students undertaking their masters degree) nurses and sometimes the anesthesiology registrars. Objective The objective of the study was to assess knowledge, attitude and practice of CPR of pregnant women among anesthesiology and obstetrics registrars. Methods It was a cross-sectional descriptive study was to assess knowledge, attitude and practice of CPR of pregnant women among anesthesiology and obstetrics gynaecology registrars. The target population was all anesthesiology registrars (n=26) and all Obstetrics Gynaecology (n=59). A pretested questionnaire was used to collect data which was then be analyzed using Statistical Package for Social scientists (version 11.0; SPSS, Chicago, IL) Results 78 (97.5%) felt training on resuscitation of pregnant woman was important. More than 51.2% of the registrars felt they were more than 50% knowledgeable. It was observed that resuscitation of pregnant women in KNH was done by obstetrics registrars covering the floor with the help of nurses and sometimes requested for resistance from the anesthesiology registrar on call. Majority of the anesthesiology registrars 20 (80%) felt that the team leader should be the Obstetrics registrar while majority of the Obstetrics registrars 51 (93%) felt that the anesthesiology registrar should be the team leader. 13 (15%) of the registrars felt that resuscitation was not necessary in some conditions. Majority (6) felt that resuscitation was not necessary in cases of prolonged cardiac arrest. Lack of equipment 62 (77.5%), lack of knowledge 52 (65%) and lack of team work 45 (55%), were graded as the major factors affecting CPR respectively. Anesthesiology registrars felt supine position was inappropriate for a pregnant woman and should instead be placed in the left lateral position to avoid aortocaval compression by the gravid uterus. More than half of the obstetrics registrars (58.2%) practice was in keeping with what the first responder should do according to the 2010 Algorithm on maternal cardiac arrest CPR. Anesthesiology registrars consider defibrillation to be an important part of resuscitation compared to the obstetrics registrars. 3 (5.5%) of obstetrics registrars would not defibrillate due to concerns about effect of the shock on the foetus. Despite the willingness to perform defibrillation on pregnant women by the registrars, very few of them actually adhere to the modified CPR protocol of removal of foetal monitors before defibrillation. 2 (3.6%) of the obstetrics registrars had ever performed a perimortem cis (Procedure of cesarean delivery concurrent with maternal C.P.R). 99% of the anesthesiology registrars were conversant with anatomical changes in the airway compared to obstetrics registrars 89.1%. Conclusion: Obstetrics and anaesthesiology registrars are more likely to encounter cardiac arrest in pregnancy. Although the incidence of this is small, this is not a reason for these cadres of doctors not to have knowledge on resuscitation of parturients and not to have the right attitude. Therefore these doctors should receive regular trainings on resuscitation focusing on parturients.

An evaluation of doctor-patient communication : a case of study of Meridian Medical Clinic at the Nation Centre in Nairobi

Author: Ochuodho, Jedida

Awarding University: Daystar University, Kenya

Level : MsC

Year: 2011

Holding Libraries: Daystar University Library ;

Subject Terms: Communication ; Patients ; Physicians ; Physician patient relationships ; Meridian Medical Clinic, Nairobi, Kenya ;

Abstract:

In Kenya, cases of patients accusing medical practitioners of negligence resulting in damage to health or even death are on the rise. These complaints are not necessarily due to professional incompetence but some result from improper diagnosis or incorrect adherence to prescribed treatment due to ineffective communication. This study comprised three research objectives, namely, to evaluate factors that affected doctor-patient communication, to determine barriers to effective doctor-patient communication, and to establish ways of improving doctor-patient communication. Uncertainty Reduction Theory (1975) and Social Penetration Theory (1973) were the theoretical basis of this research to evaluate doctor-patient communication.The research used both qualitative and quantitative approaches to collect data that was analyzed to get findings. Questionnaires were administered to 200 patients. Subsequently, in-depth interviews were conducted with four doctors and six patients. Secondary sources were also used to strengthen the research. A content analysis of the transcribed interviews was performed while the responses from the questionnaires were analyzed using SPSS 17. Findings revealed that 89% of the patients were satisfied with the way the doctors communicated with them. The major elements of communication the respondents highlighted were effective listening, trust, doctors? communication style and self-disclosure. A lot of factors such as use of jargon, differences in age, gender and culture and length of interaction also hindered effective communication. It was observed that doctor patient communication can be improved by training doctors in communication

Impact of promotional activities on product adoption : a case of pharmaceutical sales representatives' influence on prescribing habits of physicians

Author: Wang'ang'a, George

Awarding University: United States International University-Africa, Kenya

Level : MBA

Year: 2010

Holding Libraries: ;

Subject Terms: Sales promotions/Product choice/Pharmaceutical industry/Sales representatives/Physicians ;

Abstract:

ABSTRACT NOT AVAILABLE

Lifestyle-related risk factors for non-communicable diseases among professionals in Nairobi

Author: Omar, A Omar

Awarding University: University of Nairobi, Kenya

Level : MPH

Year: 2007

Holding Libraries: University of Nairobi Medical Library ;

Subject Terms: Health risk assessment ; Diet ; Smoking ; Alcohol use ; Exercise ; Accountants ; Attorneys ; Physicians ; Lifestyles ; Nairobi, Kenya ;

Abstract:

In the developing world, infectious diseases remain a major cause of death. Over the past two decades, any advances against infectious diseases have been reversed by the rise of HIV -related disorders. Against this gloomy background, noncommunicable diseases are emerging as a major problem as well. In absolute numbers, many people died from Non-Communicable Diseases (NCDs) in the developing than in the developed world: 18.7 million versus 9.4 million. This study assessed NCDs risk factors among a sample of accountants, doctors and lawyers in Nairobi. The specific lifestyle-related risk factors assessed included: alcohol intake, smoking, level of physical activity, dietary intake and Body Mass Index. This was a descriptive cross- sectional study conducted between January and July 2003. Data was collected using the WHO stepwise approach to non'Communicable diseases surveillance of risk factors. Information on tobacco use, alcohol use, physical activity and dietary intake were assessed using a questionnaire. Physical measurements (height and weight) were taken to assess for presence or absence of overweight and obesity. Respondents were randomly selected from each of the three professions. A minimum of 340 respondents were required but 356 participants were recruited and interviewed. Each stratum had minimum number of respondents to allow for comparison to be done, Data was entered and analyzed using SPSS version 10.0. The results showed that all risk factors (except tobacco use) were higher in the study population than in the general population. The risk perception is low, despite the education level of the respondents. CONCLUSION: The study population is at a higher risk of Non-Communicable diseases than the general population. RECOMMENDATION: The Ministry of Health should develop NCD policy to guide prevention and control strategies. Further research should be conducted to establish extent and magnitude of NCD risk factors in the population.

Influence of marketing mix on medical doctors' choice of prescription drugs in Nairobi.

Author: Mwangi, Gicheha

Awarding University: University of Nairobi, Kenya

Level : MBA

Year: 2006

Holding Libraries: University of Nairobi Lower Kabete Library ;

Subject Terms: Marketing ; Drugs ; Pharmaceuticals ; Physicians ;

Abstract:

ABSTRACT NOT AVAILABLE

The colonial medical officer and colonial identity : Kenya, Uganda and Tanzania before World War two

Author: Crozier A J

Awarding University: University of London, England

Level : PhD

Year: 2005

Holding Libraries: Institute of Commonwealth Studies Library ;

Subject Terms: Colonialism ; Physicians ; East Africa ;

Abstract:

ABSTRACT NOT AVAILABLE

Factors influencing group medical practice among private general practitioners in Kenya.

Author: Nduhiu, Mathenge

Awarding University: United States International University-Africa, Kenya

Level : MBA

Year: 2004

Holding Libraries: United States International University-Africa Library ;

Subject Terms: Physicians ;

Abstract:

ABSTRACT NOT AVAILABLE

Language use in a medical setting : reconciling explanatory models of illness in the diagnostic interview among the Giriama of Kenya.

Author: Furaha Chai, Jonathan

Awarding University: University of Essex, England

Level : PhD

Year: 2003

Holding Libraries: University Microfilms International ; Institute of Commonwealth Studies Library ;

Subject Terms: Giriama (African people) ; Linguistics ; Ethnology ; Witchcraft ; Physicians ;

Abstract:

This thesis is based on an analysis of Giriama divination as a speech event comparable to the biomedical diagnostic interview. Its main objective is the reconciliation of the discourse strategies used in divination with those used in the biomedical clinic during the diagnostic interview. Interactional sociolinguistics, which incorporates anthropological approaches with sociolinguistics, guided this research and data analysis. In terms of data collection, ethnographic approaches involving participant observation and unstructured interviews were used. A total of 30 diviners and three medical doctors were observed attending their clients/patients in a period of six months between October 2000 and March 2001. Unstructured interviews were used to gather more ethnographic information from the diviners/doctors and their clients. Personal Communication (PC) with some of the Giriama diviners helped to fill in information on the belief system about witchcraft and divination among the Giriama-information that is presented in chapter two. The data collected consisted of digital recordings of the interactions. A total of 25 x 74 min. Minidisks were used to record the data. Data analysis involved first transcribing the recorded interactions. From the transcripts, a representative sample of fifteen diviners and two doctors was chosen and then questions and cases of repetition were identified, coded and quantified. It follows the principles of ethnographic discourse analysis, which makes use of participants' organisational strategies while using surrounding discourse as data in understanding some fragment of talk-in this case, questions and repetition. The research found that structurally divination and the biomedical diagnostic interview share some characteristic features. However in terms of the functions of questions and repetition as discourse strategies are used, there were some differences. These differences are the ones that need to be reconciled if doctor/patient interaction among the Giriama is to be improved. The results are significant, in that they contribute to an understanding of both divination and the doctor/patient relationship. These could also have a bearing on medical training and healthcare provision among the Giriama in particular, and other communities that make use of similar 'alternative therapies' that involve the 'revelatory'divination.

Perception of medical doctors towards personal selling practices of medical representatives of pharmaceutical firms in Kenya.

Author: Misumi, Anne

Awarding University: University of Nairobi, Kenya

Level : MBA

Year: 2003

Holding Libraries: University of Nairobi Lower Kabete Library ;

Subject Terms: Pharmaceuticals ; Marketing ; Physicians ;

Abstract:

ABSTRACT NOT AVAILABLE

The role of the medical missionary in British East Africa, 1874-1904.

Author: Thomas, Jonathan York

Awarding University: University of Oxford, England

Level : PhD

Year: 1982

Holding Libraries: University of Nairobi Jomo Kenyatta Memorial Library ;

Subject Terms: African history/British East Africa Protectorate/Missionaries/Christianity/Physicians/ ;

Abstract:

ABSTRACT NOT AVAILABLE