Aims: To synthesize quantitative evidence on levels of dignity during acute hospital admission and identify barriers and facilitators to patients' dignity or dignified care from the perspective of hospitalized patients. The secondary aim was to examine the relationship between dignity and demographic, clinical and psychological characteristics of patients.Design: A systematic review based on the protocol of the Preferred Reporting Items for Systematic reviews and Meta-Analyses guideline for reporting systematic reviews.Data Sources: Five electronic databases (PubMed, CINAHL, Embase, PsycINFO, AgeLine) were searched in February 2021, followed by backward-forward searching using Web of Science and Scopus databases.Review Methods: Potentially eligible articles were scrutinized by two reviewers.Articles that met the eligibility criteria were appraised for quality using the Critical Appraisal Tool for Cross-Sectional Studies. Two reviewers extracted data for the review and resolved differences by consensus.Results: Out of 3052 potentially eligible studies, 25 met the inclusion criteria. Levels of dignity for hospitalized patients vary widely across geographic locations. Patients' dignity is upheld when healthcare professionals communicate effectively, maintain their privacy, and provide dignity therapy. Patients' perceptions of dignity were, in some studies, reported to be associated with demographic (e.g. age, marital status, gender, employment, educational status), clinical (e.g. hospitalization, functional impairment, physical symptoms) and psychological (e.g. depression, anxiety, demoralization, coping mechanisms) variables whilst other studies did not observe such associations. Conclusion:Patients in acute care settings experience mild to a severe loss of dignity across different geographic locations. Patients' dignity is influenced by several demographic, clinical and psychological characteristics of patients. Impact:The findings of the review support impetus for improvement in dignified care for hospitalized patients, addressing factors that facilitate or impede patients' dignity.

Study aimConsidering the alarming rate at which young people abuse tramadol, as evidenced by the numerous media reports on the subject, this qualitative study was conducted to explore the facilitators to the abuse of tramadol by young people.Design and methodsA qualitative exploratory descriptive design was employed in conducting the study. A total of 18 participants were purposively sampled. Data for the study were collected through two focused group discussions and three in‐depth‐interviews. Thematic analysis was used to analyse the data.ResultsThe findings of the study revealed four main themes. These themes were initiating factors of abuse; desirable physical effects; desirable psychological effects; and undesirable effects. It was revealed that many young people initially get into tramadol abuse because of peer pressure, curiosity or post‐traumatic addiction. However, they often continue the practice for various physical and psychological gratifications including euphoria, attentiveness, high energy levels, pain relief and improved sexual performance. The study also revealed some unpleasant side effects of tramadol abuse such as severe vomiting, loss of appetite, seizures, emotional aloofness and irritability. Many of the participants in this study also expressed willingness to quit tramadol abuse because of social discrimination and the enormous side effects that come with the abuse of the drug.

Background. Efforts to reduce under-five mortality across the globe are being hindered by a disproportionately high rate of neonatal deaths. About a quarter of these neonatal deaths are caused by birth asphyxia. Available evidence shows that effective neonatal resuscitation delivered by providers skilled in and knowledgeable about neonatal resuscitation can significantly reduce neonatal mortality rates. Objectives. This cross-sectional study was conducted to determine knowledge and experience in neonatal resuscitation among midwives in Tamale, and the factors associated with their knowledge on neonatal resuscitation. Methods. This was a cross-sectional study involving all midwives practicing in three large hospitals in Tamale. We developed a questionnaire to collect data on demographic characteristics of participants, and their knowledge and experience in neonatal resuscitation. We used the Statistical Package for Social Sciences (SPSS), version 21, to analyse the data. Demographic characteristics of participants were summarized using descriptive statistics. Pearson's correlation was used to determine associations between knowledge and some selected demographic features, while the one-way ANOVA was conducted to determine differences in level of knowledge based on the demographic features. Results. 98.1% of the participants in this study had insufficient knowledge on neonatal resuscitation. Midwives at the Tamale Central Hospital demonstrated a statistically significantly higher level of knowledge (24.67 ± 2.79, p = .014), compared to those at the Tamale Teaching Hospital (22.92 ± 4.56, p = .028) and Tamale West Hospital (21.50 ± 6.24, p = .021). Those who had a first-degree qualification in midwifery and those with a Post-NAC/NAP midwifery certificate had a statistically significantly higher knowledge than those with a diploma in midwifery. Training in neonatal resuscitation was associated with more knowledge in neonatal resuscitation (r(158) = .195, p = .013). In terms of experience, 55% of the participants in this study were not experienced in performing neonatal resuscitation. There were no differences in their level of experience based on their academic qualification, work place, and years of practice as a midwife. Conclusion. Considering the generally low level of knowledge and experience of midwives in neonatal resuscitation as discovered in this study, there is an urgent need for government to provide more opportunities for all practicing midwives to be trained in this important lifesaving skill.

Background Although several studies have been conducted on the lived experiences of persons with spinal cord injury (SCI) in high income countries, there is no published data on such experiences in Ghana. The purpose of this study was to explore the lived experiences of persons with SCI in the Tamale Metropolis of the Northern Region of Ghana. Material and Methods A qualitative descriptive design involving thirteen participants was conducted at the Tamale Metropolis-Ghana. A purposive sampling technique was used to recruit participants, using the Neurosurgical Unit of the Tamale Teaching Hospital as an outlet for recruitment of the sample. Data was gathered mainly through face-to-face in-depth interviews. The data was analyzed concurrently with data collection, using thematic content analysis. Ethical approval was obtained for the study from the Noguchi Memorial Institute for Medical Research and the research unit of the Tamale Teaching Hospital. Results The three main themes that emerged from the data during analysis were “physical effects,” “psychological effects,” and “social issues.” Conclusion. The findings from the study suggest that SCI is a life threatening condition and that persons with SCI grapple with a myriad of physical symptoms that range from chronic pain and paralysis of lower and/or upper limbs, to bladder and bowel incontinence. These physical symptoms have significant psychological and social effects on the functioning of the affected persons.

Aims and objectives:The aim of this study was to explore older adults' perspectives about dignity and dignified nursing care during acute hospitalisation in Ghana. Background: Maintaining hospitalised older adults' dignity is an essential component of nursing care and one of the most important determinants of wellbeing. To date, no study has been published on older adults' perspectives of dignified nursing care in the African context. Study design: A qualitative descriptive research design. Methods: Twenty hospitalised older adults were purposively selected from the medical and surgical wards of a teaching hospital in Ghana. Data were gathered through semi-structured interviews between April and August, 2021, and analysed using reflexive thematic analysis techniques. The SRQR checklist was used to document reporting of the study. Results: The following four themes were identified: Effective nurse-patient communication, Maintaining patients' privacy, Respectful and compassionate care provision and Providing quality and safe care. Dignity was preserved when patients were treated with respect and compassion, provided privacy, and had close family members involved in physical care. Identified barriers to dignity included inadequate information about their health condition, poor communication by the nurses, lack of autonomy, poorly designed healthcare infrastructure and inadequate privacy. Conclusions: Several enablers and barriers to dignified nursing care have been identified that have been discussed in previous studies. The unique factors identified in the Ghanaian context were family members' involvement in physical care influenced by cultural and religious beliefs, environmental barriers to privacy and dignity and inadequate involvement in decision making. Relevance to clinical practice: Nurses must treat older patients with respect, educate them about the health condition, involve them in care decisions, and identify their This is an open access article under the terms of the Creat ive Commo ns Attri bution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.