School of Nursing

Determinants of High Blood Pressure Management among Patients Experiencing Stroke:

2026-04-14T15:19:35Z

Determinants of High Blood Pressure Management among Patients Experiencing Stroke: Mathiu, Purity Kathambi Non-communicable diseases (NCDs) are a leading global health concern, with77%ofrelated deaths occurring in low- and middle-income countries. In Kenya, hypertension is a major contributor to cardiovascular diseases and a leading cause of morbidity and mortality. The risk of stroke continues to rise, with 1 in 4 individuals expected to experience one in their lifetime (World Stroke Day 2022). This study examined the determinants of blood pressure management among hypertensive patients who developed stroke at Meru Teaching and Referral Hospital (MeTRH), and evaluated current management practices. Using a mixed-methods convergent design, data was collected from80 patients with stroke records (via systematic random sampling), 42 healthcare workers (stratified random sampling), and 10 hypertensive stroke patients (purposive sampling). Tools included medical checklists, structured questionnaires, and in-depth interviews. The study was conducted across MeTRH’s outpatient, medical wards, and non-communicable disease clinics. The results revealed a higher prevalence of hypertension with a complication of stroke among females and older adults (mean age 58.6). Nearly half (47.4%) of healthcare workers (nurses, clinical officer, medical officers, physicians) had under five years of hypertension management experience, and only 18.4% correctly identified the current definition of hypertension, indicating significant knowledge gaps. While 94.7%reportedconducting regular blood pressure screenings and providing lifestyle counselling, patient non-adherence remained a significant barrier—often due to work-related challenges and financial constraints that limited self-care. There was no statistically significant association between healthcare delivery and blood pressure control (p = 0.308). The integration and people centricity of care was outstanding in convergence. Despite consistent screening and counselling efforts, effective blood pressure control remains hindered by limited healthcare provider experience and patient adherence issues. Addressing these gaps is essential for reducing stroke risk and improving hypertension outcomes. The study recommends strengthening clinical practice by introducing structured hypertension counselling at every clinic visit and developing standardized management guidelines. Policymakers should ensure access to essential diagnostics (e.g., ECG, lipid panels) and affordable medications. Follow-up tracking systems for adherence and lifestyle education are also necessary. Community-based support programs or peer-led hypertension clubs are encouraged to promote long-term self-care. Future research should investigate gender-specific and cultural barriers affecting hypertension control.

Assessment of Pain Management Competencies among Healthcare Professionals in Meru Teaching and Referral Hospital and St Theresa Mission Hospital Kiirua in Meru County

2026-04-14T15:07:30Z

Assessment of Pain Management Competencies among Healthcare Professionals in Meru Teaching and Referral Hospital and St Theresa Mission Hospital Kiirua in Meru County Wanzallah, Paulyne Truphena Pain is a public health problem and affects millions of people globally. Analysed medical literature reveals a concerning gap of up to 30% of healthcare professionals lack training in pain assessment and management. Effective pain management is essential and possible through comprehensive pain management guidelines, trained healthcare professionals and adequate facilities. It helps ensure patient recovery, comfort and overall quality of life. However, studies suggest that health care professionals often demonstrate varying levels of competency in pain assessment and management. The objective of this study is to assess the healthcare professionals’ competency in pain management in Meru Teaching and Referral hospital and St Teresa mission hospital Kiirua. Design was a Cross-sectional study (Mar 23– May 5, 2025). Participants were 154 Health Care Professionals (22 doctors, 31clinical officers, 101 nurses). Tool Used was Adapted KASRP questionnaire. The practice questions and observation checklist questions were developed from literature review. Ethics approval from MIRERC, NACOSTI, Meru County Research office, MeTRH and STAMHK administration and a consent from participants were sought. Analysis was by descriptive, Chi-square, logistic regression, and multinomial logistic regression at a Significance set at p< 0.05. N= 135. The Mean Knowledge on pain assessment total scores obtained by doctor, clinical officers and nurses were (32.7222, N=18), 28.4333, N=30), (30.4419, N=86) respectively. 17(89.5%) out of 19 questions assessing the HCPs skills in pain management were answered correctly. (41.5%) healthcare professionals use the pain assessment tool every time they meet the patients. Clinical officers used it more frequently as compared to doctors and nurses. A significant difference between the KASRP score, sample characteristics and the observation checklist result where (p<0.001) was noted. 48 (100%) of the sampled patient files had a prescription of pain medication, only 11(22.9%) of the files had pain classification and only 2 (4.2%) had finding according to assessment scale documented. Variation of practice exists among healthcare professionals in the utilization of pain assessment tools. Majority participants reported having and following pain management guidelines but only a small percentage use pain assessment tools and document the pain assessment findings. This study highlights the need of improvement in knowledge in order to improve the skills in Pain management among healthcare professionals at MeTRH and STMHK. Competency is contributed to by knowledge, skills and attitudes equally. With these findings, HCP had good knowledge practice and attitude in pain management but poor documentation practices.

Determinants of Health Outcomes in Traumatic Brain Injury among Patients Attending Meru Teaching and Referral Hospital

2026-04-14T14:50:00Z

Determinants of Health Outcomes in Traumatic Brain Injury among Patients Attending Meru Teaching and Referral Hospital Mukindu, Faith Kinya Traumatic brain injury is the disruption of the brain structure caused by external force, characterized by confusion, loss of consciousness, coma, or seizure. TBI is a public health concern globally and the leading cause of admissions, increased morbidity, mortality, and disability. The objective of the study was to assess the determinants of health outcomes of TBI patients at MeTRH. A cross-sectional study design was used. The study population included adult TBI patients, and healthcare providers. A sample size of 36 TBI patients, and 74 healthcare workers. Medical record files were used as data source to collect data on prevalence and types of TBI. Data was collected using checklist, interview-guided questionnaires, disability rating scale tool, and self-administered questionnaires. Data management involved cleaning, codding, entering numerical data into SPSSv27. The study identified a wide spectrum of TBIs, epidural hematoma (21.4%, n=18), skull fractures (20.2%, n=17), subdural hematoma (16.7%, n=14) being most prevalent. RTA leading cause (70.2%, n=59), assaults (22.6%, n=19). Inferential analysis showed a significant association between type of TBI and health outcomes (χ²=12.47, p=0.002), subdural hematoma and severe TBI linked to higher mortality. Overall, 16.7% (n=6) of patients died, within two weeks, 52.8% (n=19)regained functional independence by Week 6. Recovery trajectories revealed physical improvement compared to cognitive and psychosocial recovery, with 38.9%(n=14)employable without restrictions. Patient-related factors older age (≥50 years), male sex, history of prior TBIs (11.9%, n=10), low admission GCS,(≤8), delayed hospital arrival (>6 hours) were significantly associated with poor outcomes (χ²=15.36, p=0.001Healthcare-related factors influenced recovery, timely access to CT scans (97.6%, n=82)surgical interventions (44.0%, n=37) ,limited ICU space, inadequate rehabilitationservices constrained recovery. The severity distribution revealed 44%(n=37) mild, 32%(n=27) moderate, and 24% (n=20) severe TBIs, with outcome differences statisticallysignificant across severity levels (ANOVA, F=9.21, p<0.001). Findings; high prevalence of TBI in young males (75%, n=63) caused by RTAs, good neurological and physical recovery, cognitive, psychosocial, and employment outcomes remained suboptimal. Strengthening road safety, pre-hospital emergency care, neuroimaging, surgical capacity, and comprehensive rehabilitation programs, with standardized use of outcome tools such as the DRS, `are critical to improving long-term TBI health outcomes.