Employee Recognition Programs and Employee Output as Moderated by Workers’ union Activities: Evidence from Kenyatta National Hospital (KNH), Kenya

e12552 Background: Breast cancer is the commonest cancer among women in Kenya. We wanted to examine breast cancer seen at the Kenyatta National Hospital in relation to local factors that influence prognosis and quality of life, local variations in treatment and outcomes; describe the clinical care patterns, monitor the safety of the therapies provided to patients in a routine clinic setting. Methods: A prospective study of patients with breast cancer between 11.08.2011 and 11.09.2014 inclusive. Data included demographic details, diagnostic and staging procedures, stage, treatment and outcome. Estimates of relative survival used period approach. hi-square tests and analysis of variance (ANOVA) were utilised to make comparisons. Cross sectional data are presented in proportions, means and medians. Results: Four hundred patients were included, age range 20 to 83, median 49 years. Out 312, 65 (20.8%) were obese. Eight of 397 (2%) were smokers and 22(5.5%) took alcohol. Early disease was diagnosed in 269 out of 354 (76%) and metastatic disease in 85(24%). Breast lump presented in 388 out of 400 (97%), breast pain in 104 out of 388 (26.8%). Fifteen of 394 (3.8%) had second breast cancer, 4 (1%) had had ovarian cancer and 9 (2.3%) had had had other malignancy. History of breast cancer in first and second-degree relative was elicited in 41 out of 394 (10.4%). Ductal carcinoma NOS was commonest in 343 (88.2%), lobular carcinoma in 9(2.5%). Cases by T stage were T1 - 25(7.2%), T2 -130(37.4%), T3 - 96(27.6%), T4 - 87(25%). Of 322 cases, 187(58.1%) were ER positive and 175 (54.4%) PR positive. Her2 positive cases were 78 out of 322 (24.2%). Neo adjuvant and adjuvant chemotherapy mainly consisted of combinations of cyclophosphamide and doxorubicin [AC] +/- a taxane[AC→T] ( mainly by medical oncologists) or AC+ 5-FU [CAF] (mainly by clinical oncologists). Of 305 cases 272 (89.2%) completed adjuvant therapy, 8(2.6%) died during treatment. Median overall survival was 57.1 months (95% CI; 55.6 to 59.5 months). For metastatic disease, median PFS was worse for patients < 40 years. Conclusions: Pathology and biology mirrored global situation, over 75% of patients had non metastatic disease. A significant proportion of early disease patients did not complete treatment.

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HEALTHCARE PROVIDER PATIENT VERBAL LANGUAGE USE ON DIABETES MELLITUS MANAGEMENT PRACTICES IN SELECTED HOSPITALS IN KENYA

Journal of Health, Medicine and Nursing ◽

10.47604/jhmn.1391 ◽

2021 ◽

Vol 7 (2) ◽

pp. 61-98

Author(s):

Geoffrey Ungaya ◽

Hellen Mberia ◽

Kyalo Wa Ngula ◽

William Sigilai ◽

Saira Sokwalla

Keyword(s):

Diabetes Mellitus ◽

Linear Regression ◽

Healthcare Provider ◽

Language Use ◽

Management Practices ◽

Categorical Variables ◽

National Hospital ◽

Verbal Language ◽

Kenyatta National Hospital ◽

Diabetes Mellitus Management

Purpose: To establish the effect of healthcare provider patient verbal language use on diabetes mellitus management practices in selected hospital in Kenya. Methodology: This was a causal comparative research study design with application of quantitative and qualitative methodology. The study was carried out at the outpatient diabetic clinics of Kenyatta National Hospital and MP Shah Hospital. 400 patient participants were involved in the study and comprised of 313 patients at Kenyatta National Hospital (KNH) and 87 patients at MP Shah respectively studied between the months of February 2019 and November 2019. A researcher administered questionnaire was used to collect data. The results were summarized using percentages and means or medians for categorical and continuous data respectively. Comparisons were done using chi square test of association of categorical variables and independent t-test for comparison of means. Linear regression and ANOVA were used to test for associations and hypothesis between healthcare provider patient verbal language use (VLU) and diabetes mellitus management practices (DMMPs). Results: Patients at MP Shah Hospital rated the verbal language use significantly higher than the patients at KNH (p< 0.001). However, linear regression analysis showed that verbal language use was not statistically significant overall in Kenya [β=0.04, (95% CI -0.09, 0.17), p=0.552], at KNH [β=0.05, (95% CI -0.10, 0.19), p=0.513] and MP Shah Hospital [β=0.09, (95% CI -0.21, 0.39), p=0.552]; (P > 0.05), hence the failure to reject the null hypothesis. Therefore, there was no significant effect of verbal language use by the healthcare provider and the patient on diabetes mellitus management practices in selected hospitals Kenya. Unique contribution to theory, practice and policy: Verbal language use though important in healthcare provider patient interactions was not responsible for improvement in the diabetes mellitus management practices among the patients. Therefore, verbal language use by the healthcare providers in their communication interaction with patients need to be reinforced in healthcare practice to ensure improved DMMPs. Strategies should be developed to enhance verbal language use through educational curriculum development and implementation at the medical training institutions.

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