Browsing by Author "Nwosu, Chinemerem"

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    Evaluating the Influence of Patient Caretakers’ Health Literacy on Delays in Care for Traumatic Brain Injury Patients at Mulago National Referral Hospital, Uganda.
    (2019-04-24) Nwosu, Chinemerem
    Background Caretakers take on caregiving tasks such as feeding and administering oral medication for patients at Mulago National Referral Hospital (MNRH), Uganda and many Low-Middle Income Countries (LMICs) where nurse shortages are prevalent. They shoulder the burden of caretaking responsibilities with little or no knowledge of the patient care. Studies have shown that caretaker’s ability to navigate the healthcare system, find, and use health information to support their patients throughout the care continuum can impact the three delays in care: seeking, reaching and receiving care. With the life-threatening nature of Traumatic Brain Injuries (TBI) in Uganda, caretakers’ play an important role in ensuring patients access care in a timely manner. This study seeks to determine the factors that impact TBI patient caretakers’ health literacy in MNRH and examine how these factors influence the three delays in care. Methods This qualitative research study was carried out in the neurosurgical ward at MNRH, in northern Kampala. The study participants were 27 adult caretakers. Semi-structured in-depth qualitative interviews, outlined through “The Three Delay Framework”, was utilized to understand participants’ experiences with delays in seeking, reaching and receiving care for moderate to severe TBI patients. Thematic content analysis and manual coding was used to analyze interview transcripts and identify overarching themes in the participant responses. Results This study identified three main caretaker health literacy factors, each with three sub-factors, that impact the three delays to care. The main themes identified were Extrinsic, Intrinsic and Health System Factors. The nine sub-themes were Government Support, Community Support, Financial Burdens, Lack of Medical Resources, Access to Health Information, Physician Support, Emotional Challenges, Navigational Skills and Understanding of Health Information. These components were found to influence the delays to care to varying degrees. More importantly, Financial Burdens, Government Support, Emotional Challenges, Physician Support and Lack of Medical Resources were recurring health literacy factors across the three delays. Conclusion The health literacy factors identified in this study work to influence caretakers’ functional health literacy and the delays to care in a co-dependent manner. A better understanding of how these factors impact patient outcomes is necessary for the development of context and culturally relevant interventions targeted at improving a caretaker’s ability to maneuver the healthcare system and support patients in resource-poor settings. There is a strong need for the state and policy makers to invest in improving health education and communication strategies to support caretakers’ health literacy needs and mitigate the delays to care for TBI patients.
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    Influence of Caretakers' Health Literacy on Delays to Traumatic Brain Injury Care in Uganda.
    (Annals of global health, 2020-10) Nwosu, Chinemerem; Spears, Charis A; Pate, Charles; Gold, Deborah T; Bennett, Gary; Haglund, Michael; Fuller, Anthony

    Background

    Traumatic brain injury (TBI) is a life-altering condition, and delays to care can significantly impact outcomes. In Uganda, where nurse shortages are prevalent, patients' family members are the primary caretakers of these patients and play an important role in ensuring patients' access to timely care. However, caretakers often have little or no knowledge of appropriate patient care. Caretakers' ability to navigate the healthcare system and find and use health information to support their patients can impact delays in seeking, reaching, and receiving care.

    Objectives

    This study seeks to determine the factors that impact TBI patient caretakers' health literacy and examine how these factors influence delays in care.

    Methods

    This study was carried out in the Mulago National Referral Hospital neurosurgical ward, where 27 adult caretakers were interviewed using semi-structured, in-depth, qualitative interviews. "The Three Delay Framework" was utilized to understand participants' experiences in seeking, reaching, and receiving care for TBI patients. Thematic content analysis and manual coding was used to analyze interview transcripts and identify overarching themes in participant responses.

    Findings

    The main health literacy themes identified were Extrinsic, Intrinsic and Health System Factors. Nine sub-themes were identified: Government Support, Community Support, Financial Burdens, Lack of Medical Resources, Access to Health Information, Physician Support, Emotional Challenges, Navigational Skills, and Understanding of Health Information. These components were found to influence the delays to care to varying degrees. Financial Burdens, Government Support, Emotional Challenges, Physician Support and Lack of Medical Resources were recurring factors across the three delays.

    Conclusion

    The health literacy factors identified in this study influence caretakers' functional health literacy and delays to care in a co-dependent manner. A better understanding of how these factors impact patient outcomes is necessary for the development of interventions targeted at improving a caretaker's ability to maneuver the healthcare system and support patients in resource-poor settings.
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    Representation of Female Speakers at the American Academy of Orthopaedic Surgeons Annual Meetings Over Time.
    (The Journal of the American Academy of Orthopaedic Surgeons, 2023-03) Nwosu, Chinemerem; Wittstein, Jocelyn R; Erickson, Melissa M; Schroeder, Nicole; Santiesteban, Lauren; Klifto, Christopher; Jiang, Yue; Shapiro, Lauren

    Background

    In the United States, women comprise 16% of orthopaedic surgery residents, 4% of fellows, and 6% of practicing orthopaedic surgeons. The underrepresentation of women in surgical subspecialties may be because of lack of early exposure to female mentors. Conference speaker roles are important for visibility. This study aims to evaluate the representation of women in speaker roles and responsibilities at the American Academy of Orthopaedic Surgeons (AAOS) meetings over time.

    Methods

    The names of speakers and session titles at the annual AAOS meetings were obtained from conference programs for the years 2009, 2014, and 2019. Each speaker was classified based on sex and role. Sessions discussing scientific or surgical topics were classified as technical and those that did not were classified as nontechnical. Descriptive statistics are provided, as well as individual-year odds ratios (ORs) and confidence intervals (CIs) examining sex versus technical session status and sex versus speaker role; combined results controlling for year are calculated using the Cochran-Mantel-Haenszel method.

    Results

    Overall, 3,980 speaking sessions were analyzed; 6.8% of speaking sessions were assigned to women. Women were more likely than men to participate in nontechnical speaking roles (OR 3.85; 95% CI, 2.79 to 4.78). Among talks given by women, the percentage that were nontechnical increased (25.5% in 2009, 24.3% in 2014, and 44.1% in 2019). Among moderator roles, the percentage assigned to women increased (4.5% in 2009, 6.0% in 2014, 14.5% in 2019).

    Discussion

    Our findings demonstrate an increase in female speakers at AAOS meetings from 2009 to 2019. The percentage of female moderators and nontechnical sessions given by women increased since 2009. A need for a shift in the distribution of speaker role exists, which promotes inclusivity and prevents professional marginalization. Representation of women as role models increases visibility and may address the leaky pipeline phenomenon and paucity of women in orthopaedics.