Abstract:

Bladder cancer is the ninth most common cancer in the world and the 11^th most common cancer in Zambia. Bladder cancer is of three histological types, Squamous cell cancer, Transitional cell cancer, and Adenocarcinoma. The most common histological type in Zambia is Squamous cell cancer accounting for 60 percent of cases of muscle-invasive bladder cancer. The treatment of muscle-invasive bladder cancer is radical cystectomy, Lymph node dissection, and urinary diversion. Globally, radical cystectomy is associated with high morbidity and mortality. The most common diversion used was uretero-sigmoidostomy, accounting for 60 percent of cases. In our case series, the most common complications were wound dehiscence, hypo-proteinemia, bowel ileus, deep vein thrombosis, and electrolyte imbalance. Identification and prevention of complications associated with this procedure play a crucial role in improving survival for these patients. The role of nursing staff in the early recognition of these complications cannot be overemphasized.

References:

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[2] National Cancer Registry of Zambia, 2018, Zambia Global Cancer observatory, https://gco.iarc.fr/today/home.

[3] Mapulanga, V., Labib, M., & Bowa, K. 2012. Pattern of Bladder Cancer at University Teaching Hospital, Lusaka, Zambia in the era of HIV Epidemic. Medical Journal of Zambia, 39(1), 22-26.

[4] National Collaborating Centre for Cancer (UK).,2015, Bladder Cancer: Diagnosis and Management. London: National Institute for Health and Care Excellence (UK); 2015 Feb. (NICE Guideline, No. 2.) 5, Managing muscle-invasive bladder cancer.

[5] Bowa K, Mulele C, Kachimba J, Manda E, Mapulanga V, Mukosai S. ,2020, A review of bladder cancer in Sub-Saharan Africa: A different disease, with a distinct presentation, assessment, and treatment. Ann Afr Med. 2018;17(3):99-105. doi:
10.4103/aam.aam_48_17.

[6] Stein, R., Hohenfellner, M., Pahernik, S., Roth, S., Thüroff, J. W., & Rübben, H.,2012, Urinary diversion--approaches and consequences. Deutsches Arzteblatt international, 109(38), 617–622. https://doi.org/10.3238/arztebl.2012.0617.

[7] Anderson CB, McKiernan JM.,2018, Surgical Complications of Urinary Diversion. Urol Clin North Am. 2018 Feb;45(1):79-90.

[8] Nazmy M, Yuh B, Kawachi M, Lau CS, Linehan J, Ruel NH, Torrey RR, Yamzon J, Wilson TG, Chan KG.,2014, Early and late complications of robot-assisted radical cystectomy: a standardized analysis by urinary diversion type. J Urol. 2014 Mar;191(3):681-7.

[9] Hautmann RE, de Petriconi RC, Volkmer BG., 2010, Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol. 2010 Sep;184(3):990-4; quiz 1235.

[10] Schomburg J, Krishna S, Soubra A, Cotter K, Fan Y, Brown G, Konety B.,2018, Extended outpatient chemoprophylaxis reduces venous thromboembolism after radical cystectomy. Urol Oncol. 2018 Feb;36(2):77. e9-77. e13.

Abstract:

Pain is a common occurrence in children after surgery, but it has been neglected over the years. Management of pain is a fundamental human right for everyone who undergoes any surgical procedure. Pain assessment is the initial step of pain management and involves subjective and objective (behavioural and physiological) measures. This study aimed to describe the challenges of registered nurses in assessing post-operative pain among children (0- 3 years)). Descriptive phenomenology was adopted. Purposive sampling was used to recruit nine registered nurses with experience in nursing children after surgery in Effia Nkwanta Regional Hospital (Ghana). The researchers conducted an in-depth interview which was audio-recorded, transcribed verbatim and qualitatively analysed following Colaizzi’s approach to descriptive phenomenology analysis. The study findings revealed that nurses have experienced several challenges in assessing post-operative pain, including inadequate knowledge, inadequate resources, structural challenges, time constraints, and child-imposed factors. Given these results, nurses should make opportunities to enhance their skills and utilize evidence-based approaches to formally assess paediatric post-operative pain.

References:

[1] International Association for the Study of Pain (IASP). Pain: Clinical Updates. J Pain. 2015;23(6).

[2] Ball RW, Bindler RC, Cowen KJ, Shaw MR. Child Health Nursing. 3rd ed. New Jersey: Pearson Prentice Hall; 2018.

[3] Mbugua B, Chemoiywa A. Non-pharmacological pain management in paediatric nursing. Turku University of Applied Sciences; 2017.

[4] Pasero C. Challenges in Pain Assessment. J PeriAnesthesia Nurs. 2009; 24:50–4.

[5] Pasero C, McCaffery M. No self-report means no pain-intensity rating. Am J Nurs. 2011; 105:50–3.

[6] Kliegman RM, Stanton BF, Schor NF, St. Geme JW, Behrman RE. Nelson Textbook of Pediatrics. 19th ed. Philadelphia: Elsevier Saunders; 2011.

[7] Chou R, Gordon DB, Leon-Casasola O, Rosenberg JM, Bickler S, Brennan T, et al. Management of Postoperative Pain: A Clinical Practice Guideline from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists’ Committee on Regional Anesthesia, Executive Comm. J Pain [Internet]. 2016;17(2):131–57. Available from: http://dx.doi.org/10.1016/j.jpain.2015.12.008.

[8] Royal College of Nursing. Clinical practice guidelines: The recognition and assessment of acute pain in children. London: Royal College of Nursing; 2009.

[9] Stapelkamp C, Carter B, Gordon J, Watts C. Assessment of acute pain in children: development of evidence- based guidelines. Int J Evidence- Based Healthc. 2011; 9:39–50.

[10] Srouji R, Ratnapalan S, Schneeweiss S. Pain in Children: Assessment and Nonpharmacological Management. Int J Pediatr. 2010;1–11.

[11] Kahsay H. Assessment and treatment of pain in pediatric patients. Curr Pediatr Res. 2017;21(1):148–57.

[12] James S, Nelson K, Ashwill J. Nursing care of children: principles and practice. 4th Editio. St Louis: Elsevier; 2013.

[13] Kholowa ET, Chimwaza AF, Majamanda MD, Maluwa AO. Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi. J Biosci Med. 2017; 5:46–59.

[14] Christie OO, Oluseyi OA, Olunfunke OD. Factors Associated with Utilization of Pain Assessment Tools in Pain Management among Nurses in Selected Hospitals in Ekiti State. Int J Caring Sci. 2018;11(1):164.

[15] Hall RW, Kanwaljeet JS. Pain Management in Newborns Analgesia Sedation Pain Stress NICU Infant-newborn. Clin Perinatol [Internet]. 2014;41(4):895–924. Available from: http://dx.doi.org/10.1016/j.clp.2014.08.010.

[16] Zamzmi G, Zhi R, Kasturi R, Goldgof D, Ashmeade T, Sun Y. A Review of Automated Pain Assessment in Infants: IEEE Rev Biomed Eng. 2019; 3:1–21.

[17] Aziato L, Adejumo O. Developing a context-appropriate clinical guideline for post-operative pain management in Ghana: A participatory approach. Int J Africa Nurs Sci. 2015; 2:26–33.

[18] Aziato L, Dedey F, Marfo K, Avoka J, Nat J. Validation of three pain scales among adult postoperative patients in Ghana. BMC Nurs. 2015;14(42).

[19] Menlah A, Garti I, Amoo C, Agyare FD. Knowledge, attitudes, and practices of post-operative pain management by nurses in selected district hospitals in Ghana. Sage Open Nurs. 2018; 4:1–11.

[20] Anim- Boamah O, Aziato L, Adabayeri VM. Ghanaian nurses’ knowledge of invasive procedural pain and its effect on children, parents, and nurses. Nurs Child Young People. 2017;24(7):26–31.

[21] Hammond CK, Dogbe J, Painstil V, Osei- Tutu L. Pain description and presentation in children admitted to a teaching hospital in Ghana. J Cancer Prev Curr Res. 2015;2(4):1–10.

[22] Anim- Boamah O&, Aziato L. Ghanaian nurses’ knowledge of invasive procedural pain and its effect on children, parents, and nurses. Nurs Child Young People. 2017;29(7):26–31.

[23] Kusi Amponsah A, Oduro E, Bam V, Kyei-Dompim J, Ahoto CK. Nursing students and nurses’ knowledge and attitudes regarding children’s pain: A comparative cross-sectional study. PLoS One. 2019;14(10): e0223730.

[24] Kusi Amponsah A, Frimpong Kyei E, Agyemang JB, Boakye H, Kyei- Dompim J, Ahoto CK, et al. Nursing-Related Barriers to Children’s Pain Management at Selected Hospitals in Ghana: A Descriptive Qualitative Study. Pain Res Manag. 2020;1–7.

[25] Ofosu Dwamena SO, Druye AA, Asamoah Ampofo E. Experience of Registered Nurses of Postoperative Pain Assessment Using Objective Measures among Children at Effia Nkwanta Regional Hospital in Ghana. J Caring Sci. 2020;9(3):125–32.

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[28] Aranha PR, Dsouza RP, Umarani J, Shilpa GS. Assessment and Management of Pain in Children: Knowledge and Attitude of Staff Nurses. Int J Nurs Educ Res. 2015;3(2):1–4.

[29] Mediani HS, Nurhidayah I, Mardhiyah A, Hendrawati S. Nurses Journey of Postoperative Pediatric Pain Care: A Qualitative Study Using Participation Observation in Indonesia. Glob J Health Sci. 2019;11(4):93–103.

Abstract:

Cooperative learning is an effective teaching strategy that maximizes student’s learning. A descriptive study involving 219 nursing students and 27 teachers used a self-administered questionnaire to determine the approaches of cooperative learning and perceptions of nursing students and teachers in Bamenda. The study set to assess the use of cooperative learning in Bamenda-Cameroon, identify the techniques implemented, highlight its achievements, challenges and describe students’ and teachers’ perceptions. The table of random numbers was used to obtain a probability sample of students while teachers were conveniently sampled. Data were collected using a modified Cooperative Learning Implementation Questionnaire and analysed using SPSS version 20.0 at an alpha level of 0.05. Descriptive statistics was used to summarise numerical data, Correlation analysis through the Pearson Product Moment correlation test was used to test the relationship between cooperative learning and students’ achievement, while t-test was used to compare the perceptions of students and teachers on cooperative learning. The margin of error was set at P  0.05. Eventually, cooperative learning was noted to be occasionally used in Bamenda, with learning together, think-pair-share, group investigation and peer instruction identified as the methods often used.. The achievements of cooperative learning were affirmed with almost no disadvantage as the use of cooperative learning was observed to always improve students’ achievement. Both groups of respondents indicated their love for cooperative learning and willingness to implement it but did not really agree on how it was implemented. Within the perspectives of this study, it was observed that cooperative learning existed as an informal technique of education in Bamenda.

References:

[1] Johnson, DW., Johnson, RT. (2009). An Educational Psychology Success Story: Social Interdependence Theory and Cooperative Learning. Educational Researcher. 38(5), 365-379.

[2] Levit M, (2016). Teaching teamwork and cooperation: Critical skills in healthcare today, retrieved on 16/08/2019 http://edtheory.blogspot.com/2016/05/teaching-team-work-and-cooperation.html.

[3] Johnson, DW., Johnson, RT., & Smith, K. (1991). Active learning: Cooperation in the College Classroom. Edina, MN: Interaction Book Company

[4] Slavin, R.E. (1995). Cooperative learning: Theory, research, and practice (2nd Ed.). Boston: Allyn & Bacon.

[5] Slavin. RE (2010). The nature of learning. Chapter Seven: Co-operative learning: what makes group work? Doi: 10.1787/1789264086487-9-en accessed 05/01/2020 from https://books.google.cm/books?id=306PApBeLTwC&pg=PA161&lp.

[6] Johnson DW, Johnson RT. (2018). Cooperative Learning: The Foundation for Active learning Chapter 5. accessed from http://dx.doi.org/10.5772/intechopen.81086.

[7] Li, M. P. & Lam, B. H. (2013) The active classroom. The Hong Kong Institute of Education. Retrieved from https://www.eduhk.hk/.../cooperativelearningcoursewriting_LBH%. (Coop learning (EDUHK) 07/20/2019.

[8] Laal M, & Ghodsi SM, (2012) benefits of collaborative learning. Procedia - Social and Behavioral Sciences 31 (2012) 486 – 490. Available online at www.sciencedirect.com.

[9] IT learning and development Centre of Penn State University (2017). Benefits of cooperative learning. Available at http://tutorials.istudy.psu.edu/cooperativelearning/coopertivelearning6.html.

[10] Laal. M, Khattami-Kermanshahi, Z. & Laal. M (2014). 5th World Conference on Educational Sciences - WCES 2013 Teaching and education; collaborative style. Procedia - Social and Behavioural Sciences 116 (2014) 4057 – 4061 Available online at www.sciencedirect.com.

[11] Sonthara, K. & Vanna, S. (2009) Cooperative learning: theory & practice. A new guide for teachers. USAID. BOSTON and Cambodia.

[12] Goyak, AM (2009). The Effects of Cooperative Learning Techniques on Perceived Classroom Environment and Critical Thinking Skills of Preservice Teachers. A PhD Dissertation, from https://digitalcommons.liberty.edu/ on 05/01/2020.

[13] Molla E. & Muche M. (2018). Impact of Cooperative Learning Approaches on Students’ Academic Achievement and Laboratory Proficiency in Biology Subject in Selected Rural Schools, Ethiopia. Hindawi Education Research International Volume 2018, Article ID 6202484, accessed from https://doi.org/10.1155/2018/6202484 Accessed from https://www.tandfonline.com/doi/full/10.1080/0305764X.2016.1259389.

[14] Cornelius-Ukpepi, BU, Aglazor, GN & Odey, CO (2016): Cooperative Learning Strategy as Tool for Classroom Management. Advances in Multidisciplinary Research Journal. Vol 2, No.2 Pp 67-76.

[15] Cloud T, (2014) Cooperative learning in the classroom, Journal on Best Teaching Practices pp7- 8

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[16] Kaufman. D, Sutow. E, & Dunn. K (1997). Three approaches to cooperative learning in higher education. The Canadian Journal of Higher Education Volume XXVII, Nos. 2, 3, 1997 pages 37–66.

[17] Xuan. L, (2015) Application of cooperative learning approach: teachers’ and students’ perceptions towards cooperative learning. A Master’s Thesis/Capstone Project; accessed on 05/01/2020 from https://dspace.sunyconnect.suny.edu/handle.

[18] Boyle M & Gillies RM 2010). Teachers' reflections on cooperative learning: Issues of implementation. Teaching and Teacher Education 26: 933-940 accessed from www.ScienceDirect.com.

[19] Mahmoud HG. (2017). The Effect of Cooperative Learning Strategy on Undergraduate Nursing Students Enrolled in Nursing Administration Course. International Journal of Learning and Development Vol. 7, No. 1 accessed from http://dx.doi.org/10.5296/ijld.v7i1.11021.

[20] Uno, M. & Katayama, Y. (2017) Learning Outcomes Using Cooperative Learning in Communication Classes: Evaluation Using Text Analysis. Open Journal of Nursing, 7, 1058-1068. https://doi.org/10.4236/ojn.2017.79077.

[21] Kritpracha. C, Sae-Sia. W, Nukaew. O, Jittanoon. P, Chunuan. S, & Kaosaiyaporn. O (2018). The Development of Cooperative Learning Using Jigsaw Activities for Learning Achievement and Self-directed Learning Behaviours of Master
Nursing Students. International Journal of Information and Education Technology, Vol. 8, No. 12, December 2018. doi: 10.18178/ijiet.2018.8.12.1162.

[22] Ha L, Jeroen J & Theo W (2018) Collaborative learning practices: teacher and student perceived obstacles to effective student collaboration, Cambridge Journal of Education, 48:1, 103-122, DOI: 10.1080/0305764X.2016.1259389.

[23] Jecklin KS. (2007). The impact of active and cooperative instruction on the preferences of beginning nursing students’ learning strategy. Nurse Education Today 27, pp. 474–480. doi: 10.1016/j.nedt.2006.08.006.

[24] https://www.concordia.ca/content/dam/artsci/research/cslp/docs/cliq.pdf.