Nigerian Journal of Family Practice

Burnout syndrome among health care professionals: Implications for health care professionals and patients' safety

2022-03-17T12:03:47+00:00

Health care delivery systems are desperately in need of quality improvement and cost efficiency despite increasing rates of chronic diseases, co – morbidities, overwhelming workload etc. globally. To navigate through these challenges, the health care professionals' daily activities are critical to improved quality of healthcare delivery. Regrettably, failure of the Health Insurance Schemes to meet its laudable objectives and poor funding of private and public health facilities have put enormous pressure on the health care professionals (HCPs); the result of which is burnout among the HCPs. The HCPs are severally faced with the challenge of empathising with patients who are unable to bear the cost of healthcare. Often, they pay the patient's healthcare bill from their pocket to provide emotional and physical care coupled with unconducive work environment and inadequate reward system. Furthermore, the HCPs are left with little or no input into the processes and systems in their work environment leading ultimately to poor health delivery and compromised patient safety. This article's aim is to examine burnout amongst HCPs and its implication for them and their patients. The HCPas a patient in need of health care, relationship between burnout and patient safety, risk factors, diagnosis and management approaches to burnout will be explored. The management approaches that will prevent or ameliorate burnout lies on employers and employees of health care delivery services, health care and allied institutions, health care policy makers and health system managers with health care quality improvement as the driving force. Finally, it must be noted that burnout syndrome is prevalent across all health care professionals and health care settings and have been shown to impair health care providers' capacity to ensure safe practices and detect emerging patient safety threats.

Socio-demographic predictors of job-related stress among all cadres of health care workers in a Tertiary Health Institution, South western Nigeria: A need for holistic approach

2022-03-17T12:38:57+00:00

No Abstract

Evaluation of National Health Insurance Scheme(NHIS) enrollees' satisfaction with the medical care provided in a Tertiary Hospital in North Central Nigeria

2022-03-17T12:52:34+00:00

Background: The National Health Insurance Scheme (NHIS) was designed to provide good and affordable healthcare to all Nigerians. The scheme has additional responsibility to maintain continuous quality assurance. This is the first attempt to evaluate patient satisfaction of NHIS enrollees in the study site in 15 years. The study determined the enrollees' satisfaction with NHIS services, it also assessed the patient and operational factors associated with satisfaction.

Methods: Using a cross sectional study, we recruited 306 NHIS enrollees from five outpatient clinics of the study institution and assessed their level of satisfaction in six domains, namely: General Satisfaction, Technical Quality, Interpersonal Manner, Communication, Financial Aspects, Time Spent with Doctor, Accessibility and Convenience, using the Patient Satisfaction Questionnaire - Short Form (PSQ-18). We analysed the data using the SPSS version 21. A P-value of < 0.05 was considered as statistically significant.

Results: General Satisfaction with services was 50.25%. Satisfaction from the six domains ranged from 53.55% to 81.25%. The highest level of satisfaction was from Communication (81.25%) and the lowest was from the Financial Aspects (53.55%). Enrollees who were new, male or non-staff of the health institution had higher satisfaction levels. HMO type was associated with satisfaction level, while enrollee age, referral status, occupation, level of education, marital status and number of children had no association with satisfaction.

Conclusion: We found an average General Satisfaction level. The finding that NHIS enrollees were least satisfied with Accessibility and Financial Aspects of their care is of concern because protecting enrollees from financial burden and ensuring accessibility to good healthcare are the core mandates of NHIS.

Pattern and severity of menopausal symptoms experienced by middle-aged Nigerian women attending the family medicine clinic of the university of Ilorin Teaching Hospital, north-Central Nigeria

2022-03-17T13:01:25+00:00

Background: The burden of caring for women experiencing severe menopausal symptoms is increasing due to increasing life expectancy globally, and partly due to more awareness of its tremendous impacts on their quality of life. The aim of the study was to describe the pattern and severity of menopausal symptoms among middle-aged women attending a clinic in Nigeria with a view to early detection of symptoms and appropriate management.

Methods: It was a cross-sectional study involving 322 women between 40 to 60 years of age. Data was collected using mainly the Menopausal Rating Scale, and data analysis was performed using the IBM SPSS Version 21 statistical software.

Results: The mean age of the participants was 48 ± 5 years, and 60.0% of them were postmenopausal. The overall prevalence of menopausal symptoms among the participants was 51.1% and the top-three most prevalent menopausal symptoms among them were joint discomfort (83.9%), physical exhaustion (67.4%), and depressive mood (64.0%). However, anxiety, hot flushes, and sleep problems were found to be the most severe menopausal symptoms among them with prevalence of 77.3%, 74.5%, and 62.1% respectively.

Conclusion: We have provided evidence that middle-age Nigerian women suffer menopausal symptoms similar in pattern and severity to the ones reported in studies among African, African-American, Asian, and South-American women. Consequently, we suggest that middle-aged women should be screened regularly for menopausal symptoms so that those with severe symptoms can be

Family dynamics and sexual behaviour of in-school adolescents in a rural community in Southwest Nigeria

2022-03-17T13:20:31+00:00

Background: Family characteristics could contribute to the burden of adolescent sexual problems in Nigeria, especially in the rural communities
where cultural values are strongly upheld. Previous studies had not considered the relationship between the spectrum of family characteristics and adolescent sexual behaviour. This study was conducted to determine the relationship between family dynamics and sexual behaviour among in-school adolescents in a rural community in southwest, Nigeria.
Methods: A cross-sectional analytical study was conducted using cluster sampling method to select 373 students from 5 public schools. Asemi structured interviewer-assisted questionnaire was used to obtain information on a spectrum of family factors such as family structure, consistency, stability, functionality etc., and sexual behaviour. Sexual behaviour was determined using sexual experience in the preceding 12-months and use of condom at last sexual intercourse. Data were analyzed using descriptive statistics and Chi-square test at p=0.05.
Results: Mean age was 16.2±1.5 years and 61.7% were females. Above half (56.0%) were from functional family, 86.3% lived with both parents. 66.7% of their parents were married and living together, 60.4% received social support and 38.6% were from polygamous family setting. About one-fifth were sexually active and of these, 45.1% had sex 12 months preceding the survey and 52.1% used condom in the last sexual intercourse. Adolescents from poorer family (p =0.001) and those with inadequate social support (p=0.001) were more likely to engage in risky sexual behaviour.
Conclusion: Risky sexual behaviour was commoner among in-school adolescents from poor family and those with inadequate social support.
Interventions to address family-related determinants of risky sexual behaviour are hereby advocated among policy makers.

Factors affecting medication adherence in patients with hypertension attending a tertiary hospital in southern Nigeria

2022-03-17T13:52:45+00:00

Introduction: Hypertension is one of the leading causes of morbidity and mortality globally. Blood pressure control is poor among patients with hypertension due to poor health-seeking behaviour, poor medication adherence, financial burden etc. This study aimed to determine the factors affecting medication adherence in patients with hypertension attending Irrua Specialist Teaching Hospital, Irrua, Nigeria. Its findings will improve blood pressure control among hypertensives and reduce the attendant overall morbidity and mortality.
Methods: This was a descriptive cross-sectional, hospital-based study that was conducted in the Family Medicine clinic of Irrua Specialist Teaching Hospital, Irrua, Nigeria. A total of 192 adult patients with hypertension were consecutively recruited. Data was collected using the open data kit with a semi-structured, interviewer-based questionnaire. Analysis was done using the Statistical Package for Social Sciences version 21.
Results: In this study, out of 192 respondents, 105 (54.7%) were males, 151 (78.7%) were married, 117 (60.9%) had secondary school education, 122 (63.5%) were non-NHIS (National Health Insurance Scheme) enrolees and 93 (48.4%) had uncontrolled blood pressure at presentation. The mean age of the respondents was 51±12 years. There was an association between medication adherence and female sex, being married, high monthly income, NHIS enrolees, and clinic appointment keeping. There was also association between blood pressure control and reduction in salt intake. Conclusion: Ensuring good financial status, with enrolment in health insurance scheme as well as advocating for regular clinic appointment will go a long way in achieving good blood pressure control and reducing related morbidity and mortality.

Factors associated with non-adherence to medication among psychiatric out-patients in Benin-City, Nigeria

2022-03-17T14:05:05+00:00

Background: Non-adherence to medication is common among patients with major psychiatric illnesses, and it is related to poor treatment outcome.
Aims and Objectives: To determine the prevalence of non-adherence to psychotropic medication among adult outpatients with major psychiatric illnesses; assess the risk factors for non-adherence and determine the effect of non-adherence on patients' functional status.
Methods: Adescriptive cross-sectional study was conducted among 355 outpatients of the psychiatric unit of a tertiary hospital. The Morisky Medication Adherence Scale (MMAS-8), The Global Assessment of Functions (GAF) and a Socio-demographic and clinical variable questionnaire were used to collect data which were analyzed using SPSS version 21. Level of statistical significance was set at 5% (P< 0.05).
Results: The overall prevalence of non-adherence to medication was 69.6%. The non- adherence rates in patients with bipolar disorder, major depression and schizophrenia were 62.4%, 67% and 77.7% respectively. Low educational level, poly-therapy, comorbidity, disturbing side effects and lack of insight were independent predictors of non-adherence. Mean GAF scores were significantly higher in adherent than non-adherent patients; non-adherent patients had a higher risk of low functional status.
Conclusions: The prevalence of non-adherence to medication was high among the sample of psychiatric patients in this study. Since, patients hardly spontaneously report their non-adherent behavior, physicians have the critical responsibility of assessing their patients for possible non-adherence, in order to achieve optimal treatment outcome.