International Journal of Africa Nursing Sciences最新文献_第8页

Lifestyle modification programs for the prevention of diabetes mellitus type 2 in Sub-Saharan Africa: A scoping review 生活方式改变计划在撒哈拉以南非洲预防2型糖尿病：一项范围综述

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI: 10.1016/j.ijans.2025.100968

Lynnete Chilala Mukonka , Geldine Chironda , Ntombifikile G. Mtshali

Introduction

Cases of type 2 diabetes mellitus (T2DM) are increasing worldwide, and projections are that the numbers will continue to rise. However, if measures or programs for prevention are established and implemented, the incidence rate may go down. The scoping review was conducted to identify the knowledge gap in T2DM prevention programs and thus support the research the authors were conducting, to develop a lifestyle modification program for the prevention of T2DM in a Sub- Saharan Africa (SSA) country. The findings may also be used by policy makers and other researchers.

Objective

The objective of this scoping review was to map and synthesize the available evidence on lifestyle modification programs for prevention of type 2 diabetes mellitus in Sub-Saharan Africa.

Methods

The Joanna Briggs Institute Scoping Review Methodology was used to guide the review process. An electronic search was conducted for articles published between January 2006 and March 2024. English articles that reported T2DM prevention programs using lifestyle modification in SSA were included. Rayyan software (2016) was used to store the selected literature.

Results

A total of nineteen (19) articles were included in the review. Some articles included were from the years 2019 and 2020 (n = 4, 21.1 %). Most of them were descriptive narrative reviews (n = 10, 52.6 %). Two programs for the prevention of T2DM which were on trial were identified and articles that focused on lifestyle modification were included. The most common setting was the desktop (n = 12, 63.2 %) then communities (n = 5, 26.3 %) and health facilities (n = 2, 10.5 %).

Conclusion

There is need for country and culture specific T2DM prevention programs and trials need to be done to ensure this is achieved. The need for more research was evidenced by few articles that mapped program characteristics, outcomes and gaps in SSA. Awareness campaigns should include adults and young children. There is also need for large scale trial programs to test adaptability of already established programs from other countries.

2型糖尿病（T2DM）的病例在全球范围内呈上升趋势，预计这一数字将继续上升。然而，如果建立和实施预防措施或规划，发病率可能会下降。进行范围审查是为了确定T2DM预防计划的知识差距，从而支持作者正在进行的研究，以制定撒哈拉以南非洲（SSA）国家预防T2DM的生活方式改变计划。这些发现也可能被政策制定者和其他研究人员使用。目的本综述的目的是绘制和综合撒哈拉以南非洲地区生活方式改变计划预防2型糖尿病的现有证据。方法采用乔安娜布里格斯研究所范围审查方法指导审查过程。对2006年1月至2024年3月期间发表的文章进行了电子检索。纳入了报道在SSA中使用生活方式改变预防T2DM的英文文章。使用Rayyan软件（2016）存储所选文献。结果共纳入文献19篇。部分纳入的文章来自2019年和2020年（n = 4, 21.1%）。其中大部分为描述性叙事性评论（n = 10, 52.6%）。确定了两个预防2型糖尿病的试验项目，并纳入了关注生活方式改变的文章。最常见的环境是桌面（n = 12, 63.2%），其次是社区（n = 5, 26.3%）和卫生设施（n = 2, 10.5%）。结论：有必要针对国家和文化制定T2DM预防方案，并开展试验以确保实现这一目标。需要更多的研究是由一些文章来证明的，这些文章描绘了SSA的项目特征、结果和差距。提高认识运动应包括成人和幼儿。还需要进行大规模的试验项目，以测试其他国家已经建立的项目的适应性。

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引用次数: 0

Flap cover for pressure ulcer 压疮皮瓣盖

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2025-12-18 DOI: 10.1016/j.ijans.2025.100943

Kusum Kumari , Sharal Fernandes

Pressure ulcers are a big problem in healthcare because they affect people who can’t move around or can barely move. The main aim of this study was to assess steps and types of flap cover surgery for stage-IV pressure ulcers. It depends on how bad the damage is that pressure ulcers can be classified into Stage-I to stage-IV. A flap cover might be a good way to treat stage-IV pressure sores, which have full-thickness tissue loss and bone, tendon, or muscle that is showing. The gluteus maximus musculocutaneous flap is a type of flap that is often used to fix a spinal pressure sore during surgery. When a patient doesn’t get enough nutrients, their diabetes isn’t under control, or there aren’t enough blood vessels to the affected area, flaps may not be the best way to treat a pressure ulcer.

压疮是医疗保健中的一个大问题，因为它影响的是那些不能四处走动或几乎不能动的人。本研究的主要目的是评估iv期压疮皮瓣覆盖手术的步骤和类型。根据损伤的严重程度，压疮可分为i级到iv级。皮瓣覆盖可能是治疗iv期压疮的好方法，iv期压疮有全层组织丢失，骨，肌腱或肌肉出现。臀大肌肌皮瓣是外科手术中常用的一种用于修复脊柱压疮的皮瓣。当病人没有得到足够的营养，他们的糖尿病没有得到控制，或者没有足够的血管到受影响的区域，皮瓣可能不是治疗压疮的最好方法。

引用次数: 0

Nursing and Midwifery Students’ perceptions of clinical placements in Hospitals: A Cross-Sectional study in Mogadishu, Somalia 护理和助产学学生对医院临床实习的看法：索马里摩加迪沙的横断面研究

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2025-12-29 DOI: 10.1016/j.ijans.2025.100973

Abdishakur Mohamud Hassan Hidigow , Najib Isse Dirie , Abdullahi Hassan Elmi , Hodo Aideed Asowe , Abdinasir Muhidin Abdulle Madaale

Background

The clinical learning environment (CLE) shapes nursing and midwifery students’ experiences. Poor supervision, unstable leadership, and a lack of clinical staff help may impact students’ education perceptions.

Objective

To evaluate the viewpoints of nursing and midwifery students on their clinical learning environment.

Methods

This study used a cross-sectional design and the CLES + T evaluation instrument. 160 nursing and midwifery students participated in the study. Data was collected using IBM SPSS version 27.0 and a self-administered questionnaire. Descriptive statistics and inferential analysis were used; specifically multiple linear regression was used.

Results

With an overall mean CLES + T score of 3.30 (SD = 0.87), the results revealed a moderate perception of the clinical learning environment. The nurse teacher’s role was the most highly evaluated dimension (M = 3.31, SD = 1.27), followed by the ward’s nursing premises (M = 3.28, SD = 1.21) and the educational environment (M = 3.25, SD = 1.22). However, issues with student-

临床学习环境（CLE）影响着护理助产学学生的学习体验。监督不力，领导不稳定，缺乏临床工作人员的帮助可能会影响学生的教育观念。目的评价护理助产学专业学生对临床学习环境的看法。方法采用横断面设计和CLES + T评价仪。160名护理和助产学学生参与了这项研究。数据收集采用IBM SPSS 27.0和自填问卷。采用描述性统计和推理分析；具体使用多元线性回归。结果患者的总体平均CLES + T评分为3.30 (SD = 0.87)，对临床学习环境的感知处于中等水平。护理教师角色是评价最高的维度（M = 3.31, SD = 1.27），其次是病房护理场所（M = 3.28, SD = 1.21）和教育环境（M = 3.25, SD = 1.22）。然而，学生的问题

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引用次数: 0

“Who cares?” – Enabling and barriers to parent-to-child communication concerning sexual reproductive health issues in Salima, Malawi “谁在乎?”-在马拉维萨利马，促进和阻碍父母与子女就性生殖健康问题进行交流

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2025-12-26 DOI: 10.1016/j.ijans.2025.100967

Mirrium Banda , Anne Nancy Msosa , Patrick Mapulanga , Tiwonge Ethel Mbeya-Munkhondya

Background

Parent-to-child communication in sexual and reproductive health (SRH) is an important tool for reducing risky sexual behaviors among adolescents. Parent‒child communication (PCC) regarding sexual issues is a challenging phenomenon worldwide. The evidence suggests that inadequate parent-to-child communication results in unintended teenage pregnancies, unsafe abortions, sexually transmitted infections, HIV and AIDS, school problems, and other sexual risk behaviors among adolescents. Understanding the effects of transparent and direct communication between parents and adolescents on SRH can help reduce SRH-related problems among adolescents. This study explored adolescents’ perspectives on parent‒child communication with respect to SRH issues to identify enablers and barriers aimed at developing a transparent, direct, and comprehensive approach to enhance such communication.

Methods

This study utilized a descriptive qualitative design. Fifteen (15) adolescents aged 12–19 years were purposively sampled to participate in the in-depth interviews that were guided by an interview guide. Data were organized using excel and analyzed manually using thematic analysis.

Findings

Three themes emerged from the study, including adolescents’ perceived importance of parent–child SRH communication; perceived enablers of parent-to-child communication on SRH and perceived barriers to parent–child communication on SRH. Generally, the findings revealed that clear and open communications between parents and adolescents positively influence adolescents’ SRH decision-making. Enabling parent‒to-child communication is essential for improved adolescents’ understanding of SRH issues, while addressing existing barriers is indispensable for more effective parent–child SRH communication.

Conclusion

A thorough understanding of how communication between parents and adolescents impacts SRH can help reduce SRH issues and improve decision-making and culturally acceptable behaviors. This study provides initial insights into SRH communication between parents and adolescents. Therefore, further research is necessary to expand knowledge of SRH communication in this context.

性与生殖健康（SRH）方面的亲子沟通是减少青少年危险性行为的重要工具。关于性问题的亲子沟通（PCC）在世界范围内是一个具有挑战性的现象。有证据表明，亲子沟通不足会导致青少年意外怀孕、不安全堕胎、性传播感染、艾滋病毒和艾滋病、学校问题以及其他性风险行为。了解父母与青少年之间透明和直接的沟通对性行为健康的影响，有助于减少青少年中性行为健康相关的问题。本研究探讨了青少年在性健康与生殖健康问题上对亲子沟通的看法，以确定促进因素和障碍，旨在制定一种透明、直接和全面的方法来加强这种沟通。方法本研究采用描述性定性设计。有针对性地抽取15名12-19岁的青少年参加深度访谈，访谈指南指导深度访谈。使用excel组织数据，并使用主题分析手工分析数据。研究发现了三个主题，包括青少年对亲子性生殖健康沟通的重要性的认知；感知到的SRH上父母与孩子沟通的促进因素和感知到的SRH上父母与孩子沟通的障碍。总体而言，父母与青少年之间清晰、开放的沟通对青少年的性生殖健康决策有积极影响。促进父母与子女之间的沟通对于提高青少年对性与生殖健康问题的理解至关重要，而解决现有的障碍对于更有效的亲子性与生殖健康沟通是必不可少的。结论深入了解父母与青少年之间的沟通如何影响性生殖健康，有助于减少性生殖健康问题，改善决策和文化上可接受的行为。本研究为父母与青少年之间的性行为健康交流提供了初步的见解。因此，有必要在这一背景下进行进一步的研究，以扩大对SRH传播的认识。

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引用次数: 0

Coping strategies of hospitalised school-age children undergoing treatment at the Cape Coast Teaching Hospital, Ghana 在加纳海岸角教学医院接受治疗的住院学龄儿童的应对策略

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2026-02-10 DOI: 10.1016/j.ijans.2026.101024

Millicent Aba Appiah , Evelyn Sunnu , Sarah Ama Amoo

Background

Hospitalisation is not an easy experience to face especially for school-age children. They go through stress during hospitalisation which adversely affects them psychologically. Children who stay in the Paediatric ward of the Cape Coast Teaching Hospital for long periods have been observed to experience increased stress.

The objective of the study was to assess the kinds of stressors hospitalised school-age children experience and the methods employed to cope.

Quantitative research was used, with a descriptive cross-sectional approach. The population of the study was paediatric patients on admission over a three month period. The sample was limited to children between 6 and 12 years. Convenience sampling was used to select participants. A structured questionnaire for the child and the caregiver was used for data collection and a descriptive statistical analysis was done using Microsoft excel.

Major causes of stress were cancer and fractures having mean scores of 3.7 and 3.4 respectively, followed by environmental factors. Coping strategies identified were “crying”, with a mean score of 3.63, though it was reported to be unhelpful. The most effective coping strategies were reported to be “presence of parents and siblings”, “pretend play with toys” and “watching cartoons”.

Children experiencing hospitalisation for the first time had a challenging time adapting to the hospital environment. Young children have a greater need for help in coping with admission. Special attention should be given to children whose disease causes a lot of pain, as their need for coping is greater.

住院治疗并不是一件容易的事情，尤其是对学龄儿童来说。他们在住院期间承受压力，这对他们的心理产生了不利影响。据观察，长期住在海岸角教学医院儿科病房的儿童压力增加。本研究的目的是评估住院学龄儿童所经历的各种压力源以及所采用的应对方法。定量研究采用描述性横断面方法。研究对象为住院三个月以上的儿科患者。样本仅限于6至12岁的儿童。采用方便抽样的方法选择参与者。数据收集采用结构化的儿童和照料者问卷，并使用Microsoft excel进行描述性统计分析。造成压力的主要原因是癌症和骨折，平均得分分别为3.7分和3.4分，其次是环境因素。被确定的应对策略是“哭泣”，平均得分为3.63，尽管据报道这是没有帮助的。据报道，最有效的应对策略是“父母和兄弟姐妹在场”、“假装玩玩具”和“看动画片”。第一次住院的儿童在适应医院环境时遇到了困难。年幼的孩子在处理入学申请时更需要帮助。应特别注意那些疾病引起很大痛苦的儿童，因为他们需要更大的应对能力。

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引用次数: 0

Indications and rate of primary cesarean sections in a tertiary maternity hospital in southwestern Tanzania: A cross-sectional study 坦桑尼亚西南部一家三级妇产医院的指征和剖宫产率：一项横断面研究

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2026-01-31 DOI: 10.1016/j.ijans.2026.101010

Agapiti H. Chuwa , Maguzu L. Nganga

Introduction

Primary cesarean section (PCS) rates are increasing globally, including in low-resource settings. Understanding the indications and determinants of PCS in referral hospitals is key to improving intrapartum decisions and maternal outcomes.

Objective

To determine the proportion of PCS, identify common indications, and describe associated maternal and fetal factors.

Methods

A retrospective hospital-based cross-sectional study was conducted using delivery records from November 2023 to January 2024. Data on maternal characteristics, fetal status, and neonatal outcomes were extracted from the hospital records. The determinants of PCS were identified using multivariable logistic regression analysis. Statistical significance was set at p ≤ 0.05.

Results

Among 1,558 deliveries, 35.2% were vaginal, 38.7% were repeat cesarean sections (CS), and 26.1% were PCS, yielding an overall CS rate of 64.8%, which was 29.6% higher than vaginal birth. PCS occurred most frequently among women aged 20–24 (26.6%), 25–29 (27.2%), and 30–34 (22.3%) years, with 12.3% aged ≤ 19. The leading indications for PCS were non-reassuring fetal status (46.2%) and cephalopelvic disproportion (28.2%). At the time of decision, 91.4% of the women were normotensive, 83.1% had hemoglobin levels ≥ 11 g/dL, and 88% had no preexisting conditions. Hypertension reduced the odds of PCS (OR 0.146 [95% CI: 0.041–0.529], p = 0.003). Bradycardia increased the odds (OR 2.299, [95% CI: 1.041–5.075], p = 0.039), whereas tachycardia decreased the odds (OR 0.026, [95% CI: 0.003–0.199], p < 0.001).

Conclusion

The rate of cesarean deliveries was higher than that of vaginal births. The primary indications for PCS were non-reassuring fetal status (NRFS) and cephalopelvic disproportion (CPD). Strengthening intrapartum fetal monitoring and ensuring adherence to guideline-based criteria may reduce unwarranted variations in PCS decision-making.

全球一级剖宫产率正在上升，包括在资源匮乏地区。了解转诊医院PCS的适应症和决定因素是改善产时决策和产妇结局的关键。目的确定PCS的比例，确定常见适应症，并描述相关的母胎因素。方法对2023年11月至2024年1月的分娩记录进行回顾性横断面研究。从医院记录中提取有关产妇特征、胎儿状态和新生儿结局的数据。使用多变量logistic回归分析确定了PCS的决定因素。p≤0.05为差异有统计学意义。结果1558例分娩中，阴道分娩占35.2%，再次剖宫产占38.7%，剖宫产占26.1%，总剖宫产率为64.8%，比阴道分娩高29.6%。PCS最常见于20-24岁（26.6%）、25-29岁（27.2%）和30-34岁（22.3%）的女性，其中年龄≤19岁的占12.3%。PCS的主要适应症是胎儿状态不稳定（46.2%）和头骨盆比例失调（28.2%）。在做出决定时，91.4%的女性血压正常，83.1%的女性血红蛋白水平≥11 g/dL， 88%的女性没有既往疾病。高血压降低了PCS的发生率（OR 0.146 [95% CI: 0.041-0.529], p = 0.003）。心动过缓增加了发病率（OR 2.299, [95% CI: 1.041-5.075], p = 0.039），而心动过速降低了发病率（OR 0.026, [95% CI: 0.003-0.199], p < 0.001）。结论剖宫产率高于顺产率。PCS的主要适应症是胎儿状态不稳定（NRFS）和头骨盆比例失调（CPD）。加强产时胎儿监测并确保遵守基于指南的标准可以减少PCS决策中不必要的变化。

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引用次数: 0

Prevalence of hypertension and its associated factors among rural adults in a Ghanaian municipality 加纳某城市农村成年人高血压患病率及其相关因素

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2026-01-30 DOI: 10.1016/j.ijans.2026.101014

James Attom Nkrumah , Margaretta Gloria Chandi , Francis Kwaku Wuni

Cardiovascular disease (CVD) is the leading cause of death worldwide, wreaking havoc in both developed and developing countries. Hypertension (HPT) is the leading cause of death and the third leading cause of disability-adjusted life years. HPT cases are increasing in the Ejisu Municipality, but there is a lack of accurate information on hypertension and its determinants in the municipality. The purpose of this study was to find out how common hypertension is and what factors contribute to it in rural adults in Ejisu Municipality.

This study used a descriptive cross-sectional study design, with a structured questionnaire administered via face-to-face interviews, to residents of fourteen rural communities in the municipality. Simple random sampling was used to select community-level participants for the study.

The collected data was entered into Microsoft Excel, cleaned and exported to Stata/SE version 14.0 for analysis. Chi-squared tests were used to determine the relationship between the quantitative and independent variables. The strength of association was determined using multivariable logistic regression analysis.

The study showed a prevalence rate of 28.9% hypertension among rural residents. Females (64.89%) were found to be more hypertensive compared to males (35.11%). Risk factors significantly associated with hypertension among the study population were age, family history, and smoking.

心血管疾病（CVD）是世界范围内导致死亡的主要原因，在发达国家和发展中国家都造成了严重破坏。高血压（HPT）是死亡的主要原因，也是残疾调整生命年的第三大原因。额济苏市的HPT病例正在增加，但该市缺乏关于高血压及其决定因素的准确信息。摘要本研究旨在了解济苏市农村成人高血压的常见程度及影响高血压的因素。本研究采用描述性横断面研究设计，通过面对面访谈对直辖市14个农村社区的居民进行结构化问卷调查。采用简单随机抽样的方法，选取社区层面的研究对象。收集到的数据输入到Microsoft Excel中，清洗后导出到Stata/SE version 14.0进行分析。采用卡方检验确定定量变量和自变量之间的关系。使用多变量logistic回归分析确定关联强度。调查显示，农村居民高血压患病率为28.9%。女性（64.89%）高血压发生率高于男性（35.11%）。在研究人群中，与高血压显著相关的危险因素是年龄、家族史和吸烟。

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引用次数: 0

Psychosocial support and therapeutic compliance among adolescents living with HIV/AIDS at Etoug-Ebe Baptist Hospital etog - ebe浸信会医院感染艾滋病毒/艾滋病的青少年的社会心理支持和治疗依从性

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2026-01-26 DOI: 10.1016/j.ijans.2026.100992

Nangue Tekem Hermine Nadège, Grace Tadzong-Awasum

The intersection of Human Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV/AIDS) and mental health presents a critical global health challenge, particularly among adolescents, with 1.7 million young people living with HIV worldwide and 14% of adolescents experiencing mental disorders. This public health concern is especially evident in Africa, where the HIV pandemic continues to pose significant challenges. In Cameroon, HIV prevalence is estimated at about 2.7% among adults aged 15–49, and national survey data suggest that approximately 57,000 young people aged 15–24 are living with HIV. Despite the clear need for comprehensive support services, Cameroon’s healthcare system currently lacks adequate mental health and psychosocial support infrastructure for adolescents living with HIV/AIDS.

Methodology

A qualitative descriptive study was conducted at the Etoug-Ebe Baptist Hospital in Cameroon. Data was collected through semi-structured interview guides with 19 Adolescents and 14 healthcare workers.

Findings

The study identified a range of psychosocial support approaches, including counseling, coping strategies, brief cognitive behavioral therapy, support groups, peer mentorship, and family or community involvement. Adolescents demonstrated stronger adherence to their medication regimens when they felt emotionally supported and socially connected. However, several barriers, such as stigma, limited resources, and a shortage of trained mental health personnel, affected access to these services. The findings underscore the importance of strengthening psychosocial support for adolescents and offer guidance for future programs and policy development aimed at improving treatment adherence.

人类免疫缺陷病毒和获得性免疫缺陷综合症（艾滋病毒/艾滋病）与心理健康的交叉是一项重大的全球健康挑战，特别是在青少年中，全世界有170万年轻人感染艾滋病毒，14%的青少年患有精神障碍。这一公共卫生问题在非洲尤其明显，因为艾滋病毒流行病继续构成重大挑战。在喀麦隆，15-49岁的成年人中艾滋病毒感染率估计约为2.7%，全国调查数据表明，约有57,000名15-24岁的年轻人感染艾滋病毒。尽管需要全面的支持服务，喀麦隆的医疗保健系统目前缺乏为感染艾滋病毒/艾滋病的青少年提供足够的精神卫生和社会心理支持基础设施。方法在喀麦隆etog - ebe浸信会医院进行定性描述性研究。通过对19名青少年和14名卫生保健工作者的半结构化访谈指南收集数据。该研究确定了一系列心理支持方法，包括咨询、应对策略、简短的认知行为疗法、支持小组、同伴指导以及家庭或社区参与。当青少年感受到情感支持和社会联系时，他们对药物治疗方案的依从性更强。然而，一些障碍，如耻辱、资源有限和缺乏训练有素的精神卫生人员，影响了获得这些服务。研究结果强调了加强对青少年的社会心理支持的重要性，并为未来旨在提高治疗依从性的项目和政策制定提供了指导。

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引用次数: 0

Eye healthcare utilization, cataract risk, and the access failure cascade model in rural Kenya: A pilot study 肯尼亚农村的眼科保健利用、白内障风险和访问失败级联模型：一项试点研究

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2026-01-24 DOI: 10.1016/j.ijans.2026.100997

Sylvester Nabwala Ouma , Winfridah Wangui Njung’e

Background: Cataracts, the leading cause of preventable blindness, disproportionately burden low- and middle-income countries, where access inequities exacerbate prevalence. This study examines eye healthcare utilization and contributors to cataract prevalence in rural Kenya and introduces the Access Failure Cascade Model to conceptualize systemic barriers that delay care.

Methods: A cross-sectional study at Narok County Referral Hospital (April–June 2025) systematically sampled 60 patients with confirmed cataract. Validated questionnaires and medical records assessed socioeconomic, lifestyle, clinical, and environmental factors. Analyses included descriptive statistics and chi-square trend tests with odds ratios.

Results: Mean age was 56.8 years (SD ± 15.2); 65% were female. Cataract prevalence was 28.3% among clinic attendees. Premature cataract onset was present among 56.7%. Notably, 43.3% never had prior eye exams, and 68.3% delayed care-seeking. Inadequate UV protection, observed in 96.7%, increased sun-induced eye irritation risk fourfold (OR: 4.0, 95%CI:1.1–14.8, p = 0.046). High-risk patients (≥3 risk factors) had lower recent eye care utilization (16.7%) than low-risk patients (46.7%; χ²trend = 4.12, p = 0.042). Barriers included 15.2 km (±10.3) travel distance and financial constraints (68%).

The novel Access Failure Cascade Model conceptualizes sequential barriers that collectively delay diagnosis and result in advanced disease requiring costly treatment: geographic isolation → infrastructure deficits → financial limitations → absent screening → disease progression → advanced treatment, identifying upstream intervention points.

Conclusion: Substantial access barriers and modifiable cataract risks exist in rural Kenya. The Access Failure Cascade Model provides a practical framework for designing preventive community-level strategies and policy interventions, beyond surgical reliance, to strengthen eye health systems and reduce preventable blindness in similar underserved populations.

背景：白内障是可预防失明的主要原因，对低收入和中等收入国家造成了不成比例的负担，在这些国家，获取白内障的不平等加剧了患病率。本研究考察了肯尼亚农村地区眼科保健利用和白内障患病率的因素，并引入了访问失败级联模型来概念化延迟护理的系统性障碍。方法：在Narok县转诊医院（2025年4月- 6月）系统取样60例确诊白内障患者进行横断面研究。经过验证的问卷和医疗记录评估了社会经济、生活方式、临床和环境因素。分析包括描述性统计和优势比卡方趋势检验。结果：平均年龄56.8岁（SD±15.2）；65%是女性。白内障患病率为28.3%。56.7%为早发性白内障。值得注意的是，43.3%的人从未做过眼科检查，68.3%的人推迟了求医。96.7%的人观察到，紫外线防护不足使太阳引起的眼睛刺激风险增加了4倍（OR: 4.0, 95%CI: 1.1-14.8, p = 0.046）。高危患者（危险因素≥3个）近期眼保健使用率（16.7%）低于低危患者（46.7%），χ2趋势= 4.12,p = 0.042。障碍包括15.2 km（±10.3）的旅行距离和资金限制（68%）。新的接诊失败级联模型将一系列障碍概念化，这些障碍共同延迟诊断并导致需要昂贵治疗的晚期疾病：地理隔离→基础设施缺陷→财政限制→缺乏筛查→疾病进展→高级治疗，确定上游干预点。结论：肯尼亚农村地区存在大量白内障获取障碍和可改变的白内障风险。获取失败级联模型提供了一个实用框架，用于设计除手术依赖之外的预防性社区一级战略和政策干预措施，以加强眼卫生系统并减少类似服务不足人群的可预防失明。

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引用次数: 0

Readiness of pregnant women for birth and associated factors among women attending Moatezadi Hospital, Kermanshah, Iran (2022) 在伊朗克尔曼沙阿Moatezadi医院就诊的孕妇分娩准备情况及相关因素（2022年）

Q2 Nursing

International Journal of Africa Nursing Sciences

Pub Date : 2026-01-01 Epub Date: 2025-11-15 DOI: 10.1016/j.ijans.2025.100928

Tahereh Jafari , Fatemeh Rajati , Mohsen Kazeminia , Negin Rezavand , Mojgan Rajati

Introduction

Preparation for the birth of a healthy baby is crucial for reducing maternal mortality and enhancing women’s childbirth experiences. Maternal readiness for childbirth is influenced by various factors, including awareness, social support, and cognitive aspects. This study aimed to evaluate the level of childbirth readiness and identify its associated socio-demographic and obstetrical factors among pregnant women referred to Moatezadi Hospital in Kermanshah, Iran.

Methods

This cross-sectional study included all pregnant women who presented at Moatezadi Hospital for childbirth. After reviewing the inclusion and exclusion criteria, a demographic information questionnaire and a Childbirth Readiness Scale (CRS)-child questionnaire were administered to assess the women’s readiness for childbirth, along with a checklist for related factors. The collected data were analyzed using SPSS version 22 statistical software.

Results

A total of 400 pregnant women were included in the study, with a mean age of 30.46 ± 11.65 years. The results revealed that the awareness of warning signs during pregnancy was rated as good in 50 % of the women, average in 45 %, and poor in 5 %. Regarding awareness of labor warning signs, 42.8 % rated it as good, 47.8 % as average, and 9.3 % as poor. The level of readiness for labor significantly correlated with increasing age, higher education levels, prior deliveries, improved economic status, and greater awareness of danger signs during pregnancy (P < 0.001). However, the number of prenatal visits did not correlate with women’s readiness levels (P > 0.05).

Conclusion

The readiness of pregnant women is associated with socioeconomic status, previous delivery experiences, and various other factors. As maternal readiness plays a pivotal role in the delivery process, it is recommended to enhance relevant variables, such as women’s awareness and education, to improve outcomes.

前言为健康婴儿的出生做准备对于降低孕产妇死亡率和提高妇女的分娩经验至关重要。产妇分娩准备受到各种因素的影响，包括意识、社会支持和认知方面。本研究旨在评估在伊朗克尔曼沙阿Moatezadi医院转诊的孕妇的分娩准备水平，并确定其相关的社会人口和产科因素。方法本横断面研究包括所有在Moatezadi医院分娩的孕妇。在审查纳入和排除标准后，使用人口统计信息问卷和分娩准备量表(CRS)-儿童问卷来评估妇女的分娩准备情况，并列出相关因素清单。采用SPSS 22版统计软件对收集的数据进行分析。结果共纳入400例孕妇，平均年龄30.46±11.65岁。结果显示，50%的妇女在怀孕期间对警告信号的意识被评为良好，45%的妇女被评为一般，5%的妇女被评为差。对于劳动警示标识的意识，42.8%的人认为是好的，47.8%的人认为是一般的，9.3%的人认为是差的。分娩准备水平与年龄增加、教育程度高、分娩史、经济状况改善和孕期危险迹象意识增强显著相关（P < 0.001）。然而，产前检查的次数与妇女的准备水平无关（P > 0.05）。结论孕妇的准备程度与社会经济状况、分娩经历等因素有关。由于产妇准备就绪在分娩过程中起着关键作用，因此建议加强相关变量，如妇女的意识和教育，以改善结果。

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