Introduction Significant number of women present with advanced-stage breast cancer in Ghana. These women usually depend on family caregivers for their multi-dimensional needs. Yet, there are gaps in research about what motivates family caregivers to assume the caring role and their experiences with caregiving within the Ghanaian context. Aim To explore and describe the caregiving motivations and experiences among family caregivers of patients living with advanced breast cancer. Methods In-depth, semi-structured qualitative interviews were conducted with 15 family caregivers who were providing unpaid care for women living with advanced breast cancer. Colaizzi's thematic analysis was used to analyze the data. Results Family relationship normally prescribed the caregiving role among family caregivers. Due to the lack of home-based palliative services in Ghana, findings suggest that family caregivers are the main managers of advanced breast cancer-related symptoms in the home. These findings are discussed under three major themes: (i) motivation for assuming the caregiving role; (ii) meeting self-care and psychosocial needs of the patient; and (iii) symptom management and monitoring. Conclusion Socio-cultural values influence the role of family caregivers in Ghana. This presents opportunities for health professionals and relevant stakeholders to develop a culturally-PLOS ONE

Introduction: Caregivers of women with breast cancer in low-and-middle-income countries experience significant physical and economic burdens. The review aimed to map the evidence of studies that had reported on the experiences of family caregivers of women diagnosed with breast cancer. Methods: A systematic literature search was conducted in CINAHL, PubMed, PsycINFO, Scopus, and Web of Science databases using a combination of key search terms and medical subject heading terms such as "family caregiver," "breast cancer," "home care," "low-and-middle-income countries," "experience," "effect," and "coping mechanism." A total of 1781 articles were retrieved and screened. Nineteen studies addressing caregiving experiences were included in the final review based on the inclusion and exclusion criteria. Results: The systematic review yielded 19 studies that focused on caregivers' motivation, needs of caregivers, intervention for caregivers, and consequences of caregiving. The most significant correlates of the quality of life among caregivers were disease severity, functional status of patients, and family income. The challenges encountered by caregivers were mostly psychosocial. Conclusions: Caregivers play a crucial role in the management of women with breast cancer. However, they are faced with increasing challenges in their caregiving roles. Understanding the nature and extent of the burden experienced by family caregivers in developing countries will facilitate the development of appropriate interventions that can help improve caregivers' quality of life. Gaps in recent studies were identified, and suggestions for future research were also addressed in this review. Systematic review registration: PROSPERO CRD42019118391

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Objective Cancer caregiving can result in increased psychosocial distress and poor health‐related quality of life (QOL). Psychoeducation has been shown to be effective in enhancing caregiving‐oriented outcomes. A systematic assessment of the overall effect of psychoeducational intervention (PEI) and identification of individual intervention characteristics that may contribute to the effectiveness of PEI is needed. Methods For this meta‐analysis, relevant articles were identified through electronic databases using key search terms and their medical subject heading such as “family caregiver,” “cancer,” and “psychoeducational intervention.” Results Twenty‐eight controlled trials with 3876 participants were included. PEIs had beneficial effect on depression (Standardized Mean Difference [SMD] −0.26; 95% CI = −0.50 to −0.01, p < 0.04), anxiety (SMD −0.41; 95% CI = −0.82 to 0.01, p < 0.05), caregiver burden (SMD −0.84; 95% CI = −1.22 to −0.46, p < 0.0001) and QOL (SMD 0.59, 95% CI 0.24–0.93; p < 0.0009) at the immediate post‐intervention period. At longer‐term follow‐up, the effectiveness of PEI was maintained on QOL (SMD 0.39, 95% CI = −0.00 to −0.77, p < 0.05), and anxiety (SMD −0.57; 95% CI = −1.09 to −0.06, p < 0.03). Moderation analysis showed that intervention characteristics such as studies conducted in high‐income countries, group intervention and studies that focused on specific and mixed cancers explain some of the high variations observed among the included studies. Conclusions PEI may benefit caregivers of cancer patients through the significant effects on caregiver burden, QOL, anxiety, and depression. The findings from the moderation analysis may be important for the design of future interventions.

Background: Children’s nurses’ knowledge of pain affects their pain management practices. Even though poor knowledge and attitudes have been reported in several studies, most were carried out in developed settings. However, little has been reported on the management of paediatric pain by nurses in resource-limited settings such as in sub-Saharan Africa.Purpose: This study sought to assess the knowledge and perceptions of children’s nurses regarding paediatric pain in a Ghanaian context.Methodology: A descriptive cross-sectional survey was carried out among 65 nurses at eight hospitals at various levels of healthcare in Ghana. Over three months, participants’ demographic data and responses on the Pediatric Nurses Knowledge and Attitude Survey Regarding Pain (PNKAS) instrument were collected. Data were analyzed and presented using descriptive and inferential statistics.Results: Participants’ average (SD) knowledge and attitudes regarding paeditric pain was 36.7% (6.9%) and ranged from 21.4% to 57.1%. Pediatric pain knowledge and attitudes (PPKA) of the nurses differed based on working years in the children’s unit and the hospital type they worked in (p<0.05). Nevertheless, the type of hospital facility was the only independent predictor of their PPKA (R2=0.181, p<0.001).Conclusion: Children nurses in this setting generally had insufficient knowledge and attitudes on paediatric pain. They should be motivated to undertake self-directed learning and regular continuing professional education to update their knowledge, attitude and skills on evidence-based pediatric pain assessment and management.

Background: Available empirical evidence shows increasing rates of stoma surgeries (i.e., colostomy) among persons in sub-Saharan Africa, particularly Ghana. Compared to developed countries, the management of colostomy is considered more stressful due to the absence of a homecare management model after discharge from the hospital. Yet, there exist a paucity of evidence on the experiences, challenges and coping strategies of persons living with colostomy after being discharged, within a resource constrained setting such as Ghana. Aims: The experiences and challenges as well as coping strategies of colostomy patients were explored and described in this study. Methods: Using a descriptive phenomenological design, semi-structured face-to-face interviews were conducted with a purposive sample of 15 patients with colostomy. Colaizzi’s analytical framework and a deductive process was employed to thematically analyse the data. Results: Themes that characterised participants’ experiences and challenges with colostomy comprised: social stigmatisation, social isolation/withdrawal, sex-related challenges, psychological experiences and challenges, suicidal ideation, physiological experiences and challenges, dietary/eating challenges, difficulties caring for colostomy, skin disorders, cost of colostomy accessories, and work restrictions. Amidst these experiences and challenges, participants were shown to promote their resilience in the face of adversity through assets and resources: social support, spirituality and religion, lifestyle modifications, nutritional and pharmacological strategies, and improvised stoma accessories.Conclusion: Persons living with colostomy experience numerous challenges that threatens their health and wellbeing. Yet, they rely on assets and resources to remain resilient in the face of these challenges. Findings have implications for policy interventions on public education, expansion of health insurance scheme, stoma nurse recruitment and training, and patients’ resilience healthcare strategies of colostomy in Ghana.