Introduction: Clinical education is an essential element in a baccalaureate nursing program, providing nursing students with the required knowledge, skills, abilities, and attitudes that are required to deliver professional nursing care after graduation. Objective: The purpose of this study was to identify the student perceived challenges associated with nursing instruction in the clinical environment. Methods: A cross-sectional descriptive design was used to identify the challenges associated with clinical instruction from the nursing students’ perspective. Convenience sampling was used to recruit 187 nursing students from three universities in Jordan, including one public and two private. Results: The major challenges to clinical education were fear of committing mistakes; lack of facilities for students; lack of knowledge among community and patients about the nursing profession; fear of infection; lack of availability of equipment in the clinical setting; students’ lack of preparedness and skills in planning care; and lack of collaboration from clinical staff. Conclusion: Identifying the challenges is necessary to formulate strategies to address them, to improve curriculum designed and clinical education for nursing students accordingly.
Objectives: To evaluate the usefulness of combined oral contraceptives (ethinyl estradiol and levonorgestrel) in resolving menstrual pattern disorder in reproductive-age women with a functional ovarian cyst in Iraq. Method: A longitudinal (before and after) , interventional study was used. Data were collected at a single obstetrics and gynaecology outpatient clinic in Mosul City, Iraq. Participants: A sample of 96 women aged between 15 and 45 years participated in the study. Participants diagnosed with ovarian cysts were treated using an oral administration of contraceptive pills (combination of ethinyl estradiol, 0.03 mg, and levonorgestrel, 0.15 mg) on a daily basis for a treatment duration of 2 months. The Outcome Measures are Menstrual pattern disorders (dysmenorrhea, irregular menstrual cycle, and amenorrhea) and cyst dimensions were recorded. Results: After one therapy cycle, a statistically significant disappearance of menstrual pattern disorder was observed (p=0.000). Cyst resolution was observed in 89.58% of the patients (n=86), while mean ovarian cyst size fell from 4.452 ± 1.0603 cm at the start of therapy to 0 .451 ± 1.5613 cm(p = 0.000). 5 of the 10 persistent cysts disappeared after the second cycle (2 months after the start of therapy) and complete cyst resolution was 94.8% (n = 91) after two cycles. This indicated a further significant reduction of mean ovarian cyst size to 0.335 ± 1.4684 cm. However, no significant difference was observed between mean cyst size in the first and second months of treatment (p=0.329). Conclusion: Combined oral contraceptives (ethinyl estradiol and levonorgestrel pills) are effective in relieving dysmenorrhea, irregular menstrual cycle, and amenorrhea. They also hasten the disappearance of functional ovarian cysts, and are associated with high rates of success in patients with functional ovarian cysts.
The Coronavirus pandemic (COVID-19) presents an unprecedented impact on healthcare facilities and health professionals globally, especially in resource-poor settings, including Africa. This article aims to highlight the challenges of providing palliative care in Africa and to forecast what this means in light of the public health issues surrounding COVID-19. According to the Coronavirus in Africa tracker (BBC News, 2020), there are 925,369 confirmed cases of COVID-19 reported in Africa, out of which 19,605 are confirmed deaths as of 31 st July 2020. While 577,947 cases are reported to have recovered, there remains a high number of active confirmed cases of 327, 818 in the continent. These numbers could be higher, but are underreported, due to ineffective reporting systems, the capacity to diagnose on a large scale, and people not recognising the symptoms of COVID-19. With the anticipation that COVID-19 will have devastating effects on Africa (Hopman et al, 2020; Nkengasong and Mankoula, 2020), this will cause a surge in the need for palliative care and medical supplies. The World Health Organization (2018) defines palliative care as any support that improves the quality of life of patients and their families experiencing life-threatening illnesses, through the prevention and relief of suffering, whether physical, psychosocial or spiritual care. In this context, palliative care will mean the care for COVID-19 patients, particularly for those cases where conventional treatment is ineffective and/or life-supporting measures are unsuccessful; that is, the patients whose health conditions have declined to the extent that any life-supporting treatment is failing, and the persons become labelled as terminally ill. Universal health coverage goals consider Palliative care as a critical component; however, palliative care has not been given the needed attention in African countries, and this disproportionate attention results in significant health-related suffering at the end of life (
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