Knowledge of breast cancer in women in Sierra Leone

Breast cancer has been described as one of the life-threatening diseases affecting women and is a major problem in women's health issues. The unrecorded number of cases of breast lumps and breast cancer observed in women in Sierra Leone prompted the researcher to organize a "Breast Week" during which 1,200 women were educated on breast cancer and the importance of breast health. This research is a follow up of the "Breast Week" which was organized in Freetown, Sierra Leone The specific objective of this study was to assess whether the knowledge and teachings given to the women who participated in this project was fully understood. A sample size of 120 women (10%) who participated in the "Breast Week" was obtained through systematic sampling. A quantitative approach was adopted and a structured interview schedule guided the data collection process. The data were processed through use of SPSS and Microsoft Excel. Texts from open ended questions were categorized and frequency counts were applied to the data. It was found that the majority (96.6%) of the women had some knowledge of breast cancer. They linked breast cancer to the signs and symptoms associated with it and were able to describe the disease as one that kills women if not promptly detected and/or treated appropriately. Findings indicate that the majority of the women are aware of the dangers of the disease and had knowledge of someone who had died of breast cancer (59.2%). An assessment of the effectiveness of knowledge on breast cancer showed that these women could identify breast cancer as a disease that affects women and may cause death if not detected on time.     

Predictors of breast self-examination practice among elderly women

The purpose of the study presented in this article was to examine predictors of breast self-examination (BSE) practice among elderly female subjects in selected senior citizen centers. The health belief model served as the theoretical framework for the research study. Both the frequency of BSE performance and the technique subjects used to examine their breasts were measured by a questionnaire. Subjects who perceived few barriers to BSE had higher BSE technique scores. The findings also indicated that receiving instruction through a class on BSE was related to improved BSE technique. Perceived susceptibility to breast cancer and perceived benefits of BSE were not found to be significantly predictive of BSE practice.     

Factors related to practice of breast self-examination in rural women

The purpose of this study was to examine variables related to breast self-examination (BSE) in rural women. The sample of convenience consisted of 347 women who were members of selected county-extension homemaker clubs. Champion's Health Belief Model Scale was used to measure susceptibility, seriousness, benefits, barriers, health motivation, sociodemographics, and knowledge variables and frequency of BSE. Multiple regression analysis indicated that the Health Belief Model concepts accounted for 26% of the variance in BSE practice. Women who perceived more benefits of BSE in reducing the severity of breast cancer were more likely to report more frequent BSE. Women who perceived fewer barriers to performing BSE and those who scored high on health motivation were also more likely to report performing monthly BSE. Pearson product-moment correlation indicated a significant positive relationship between the variables of BSE knowledge and BSE practice (r = 0.1216; p = 0.023). The lambda statistics showed weak or no association between the demographic variables of age, race, marital status, religion, education, personal experience with breast disease, and friend's experience with breast disease and BSE practice. These findings suggest that perhaps educational programs emphasizing benefits of BSE may be implemented for women represented in this sample in an attempt to increase the number of women practicing BSE. Assessment of women's perceptions of potential barriers would allow nurses to plan appropriate strategies that could reduce the barriers. Finally, assessment of women's general health practices may identify women motivated toward good health. These women may be likely to complete monthly BSE if encouraged to do so.     

Knowledge, barriers, and facilitators of Korean women and their spouses in the contemplation stage of breast self-examination

The aim of this study was to identify the knowledge, barriers, and facilitators of breast self-examination (BSE) in Korean couples in the contemplation stage. The study design was based on assumptions from the Health Belief Model and Transtheoretical Model that contemplators perceiving benefits as greater than barriers are likely to move to the next stage. Participant couples, with wives having never practiced BSE but with an intention to do so, were drawn from churches. Qualitative research was conducted with focus group methodology including both husbands and wives in the groups. Data transcribed from audiotapes were analyzed to identify common themes. Knowledge of breast cancer and BSE included "perceiving risks of getting breast cancer," "behaviors used to stay healthy and detect breast cancer," and "skills in BSE"; barriers to BSE included "lack of sensitivity to breast cancer," "fear of getting bad news," "lack of information," and "shortage of time"; and facilitators of BSE included "making BSE a monthly routine," "continuous systematic interaction from healthcare professionals reaching out to the community," and "encouragement and help from husbands." To improve compliance with BSE, women in the contemplation stage need specific and correct knowledge delivered by diverse materials, reminders, and the inclusion of husbands as facilitators.     

Acculturation and breast self-examination among immigrant Latina women in the USA

This article is an extension of previous work, which identified acculturation as an important variable in predicting breast self-examination (BSE) in this sample of women. Here, acculturation is further examined as an intervening factor in predicting BSE. This paper presents the association between level of acculturation to mainstream culture in the USA and the practice of BSE among a population of low-income immigrant Mexican and Puerto Rican women (n = 111) in an urban area of the Midwest in the USA. The majority of women (84.7%) scored a low level of acculturation and 85% did not practice correct BSE. The crude odds ratio indicated that Latina women having a high level of acculturation (15.3%) were twice as likely to practice correct BSE than women with low acculturation. We would suggest that a clearer understanding of the variables that define the performance of BSE will assist in enabling nurses globally to incorporate assessments in their practice that will lead to more successful interventions.     

Pain in traumatic upper limb amputees in Sierra Leone

Data on 40 upper limb amputees (11 bilateral) with regard to stump pain, phantom sensation and phantom pain is presented. All the patients lost their limbs as a result of violent injuries intended to terrorise the population and were assessed 10-48 months after the injury. All amputees reported stump pain in the month prior to interview and ten of the 11 bilateral amputees had bilateral pain. Phantom sensation was common (92.5%), but phantom pain was only present in 32.5% of amputees. Problems in translation and explanation may have influenced the low incidence of phantom pain and high incidence of stump pain. In the bilateral amputees phantom sensation, phantom pain and telescoping all showed bilateral concordance, whereas stump pain and neuromas did not show concordance. About half the subjects (56%) had lost their limb at the time of injury (primary) while the remainder had an injury, then a subsequent amputation in hospital (secondary). There was no association between the incidence of phantom pain and amputation irrespective of being primary or secondary.     

塞拉利昂埃博拉病毒病流行特征分析

目的 分析塞拉利昂埃博拉病毒病(Ebola virus disease,EVD)疫情流行特征,总结该国疫情未能及时控制原因,为今后我国新发和输入性传染病防控工作提供借鉴。 方法 收集世界卫生组织和塞拉利昂卫生部官方网站公布的疫情资料,采用描述性流行病学方法进行分析。 结果 至2015年3月1日,塞拉利昂共报告EVD病例11 446例,死亡3546人,发病率为180.6/10万,死亡率为55.9/10万。塞拉利昂疫情时间分布可分为五个阶段:悄然而缓慢传播阶段、暴发阶段、快速上升阶段、快速下降阶段、波动式缓慢下降阶段。疫情首发地区为西南部的凯拉洪,之后输入至西北部的坡特洛科,继而蔓延至全国。有登记信息的病例(10 903例)数据显示,女性发病率高于男性(P=0.01),年龄越大发病率越高(2=2136.07,P0.001)。医务人员发病率高于全国,有统计学意义 (P0.001)。 结论 塞拉利昂疫情未能及时控制的原因主要有:经济水平落后、文化习俗、防控资源不足、早期防控措施落实不到位等。该国疫情应对经验对我国今后新发和输入性传染病防控有重要的借鉴意义。     

援塞抗击埃博拉出血热护理队伍的建设

目的探讨执行援塞抗击埃博拉出血热等应急援外任务时护理队伍的建设方案。方法通过分析解放军第302医院第二批援塞医疗队护理人员结构的合理性、出发前集中培训考核及效果评价、援塞完成任务情况,总结护理队伍建设的经验和取得的初步成效。结果援塞抗击埃博拉出血热医疗队护理队伍应选择年轻化、经验丰富、能力较全面的队员,使护理队伍结构更加合理,以便能够更出色地完成应急救援任务。结论针对援塞医疗队护理队伍的任务,建立一套完善的选拔、培训、考核及管理模式至关重要,同时要注重优化护理人才结构与强化应急保障能力的综合培训。     

Marginalization of girl mothers during reintegration from armed groups in Sierra Leone

BACKGROUND: Although the widespread presence of girls who participate in fighting forces is increasingly recognized, they remain a highly marginalized group globally, receiving little attention either during or after armed conflict. This is especially true for "girl mothers," girls who return to communities with children born while members of fighting forces. AIM: The concept of marginalization (Hall et al. 1994) is used to examine what happens to girl soldiers, especially girl mothers, in the aftermath of armed conflict when they seek to reintegrate back into their communities. METHODS: This analysis, as part of a larger study of reintegration of girl mothers, is based on field work with girls who were in fighting forces in northwest Sierra Leone, especially those who returned with children. FINDINGS: The type and level of marginalization these girls experience is consistent with the conceptualization of marginalization; however, they lack voice and experience shame and vulnerability. Moreover, economics were fundamentally related to their marginalization. The girls' access to resources was significantly constrained because the area was heavily impacted by the war and because of widespread poverty throughout Sierra Leone. DISCUSSION: The findings raise important questions about marginalization of girls affected by war. Girls and girl mothers experience an extremely high level of marginalization; however, some aspects are not consistent with the original conceptualization of marginalization. Theory development in nursing needs to incorporate multiple voices, especially those of the very marginalized and be done in such a manner that benefits and empowers.     

Emergency care capacity in Freetown,Sierra Leone: a service evaluation

Background

There is an increasing global recognition of the role of emergency medical services in improving population health. Emergency medical services remain underdeveloped in many low income countries, particularly in sub-Saharan Africa. There have been no previous evaluations of specialist emergency and critical care services in Sierra Leone.

Methods

Emergency care capacity was evaluated at a sample of seven public and private hospitals in Freetown, the capital of Sierra Leone. A structured set of minimum standards necessary to deliver emergency and critical care in the low-income setting was used to evaluate capacity. The key dimensions of capacity evaluated were infrastructure, human resources, drug and equipment availability, training, systems, guidelines and diagnostics. A score for each dimension of capacity was calculated based on the availability of a list of specified indicators within each dimension. In addition, an Emergency Care Capacity Score was calculated to demonstrate a composite measure of capacity based on the various indicator scores. This method has been used by the World Health Organisation in evaluating the availability and readiness of healthcare systems in low- and middle-income countries.

Results

Substantial deficiencies in capacity were demonstrated across the range of indicators and predominantly affecting publically funded facilities. Capacity was weakest in the domain of infrastructure, with an average score of 43%, while the strongest areas of capacity overall were in drug availability, 82%, and human resources, 79%. A marked disparity was noted between public and private healthcare facilities with consistently lower capacity in the former. The overall Emergency Care Capacity Score was 66%.

Conclusion

There are substantial deficiencies in emergency care systems in public hospitals in Freetown which are likely to compromise effective care. This represents a serious barrier to access to emergency healthcare. Emergency care systems have an important role in improving population health and as such should a priority for local policy makers.

Electronic supplementary material

The online version of this article (doi:10.1186/s12873-015-0027-4) contains supplementary material, which is available to authorized users.     

乳腺自检价值的再评价

介绍了乳腺自检在筛查乳腺癌中的价值 ,重点对乳腺自检价值的研究现状及结果、国际上对乳腺自检价值的再评价、乳腺自检在我国乳腺癌普查中的价值进行了综述。