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IntroductionCervical cancer has been identified as the fourth most common form of malignancy affecting and killing women globally. Nurses caring for cervical cancer patients are exposed to emotional and psychological distress due to late presentation and the burden of care. Resilience has been identified as one of the effective ways of helping nurses to cope well with the stress of oncology nursing, but this remains undetermined in Ghana.AimThis study explored personal and workplace factors influencing the resilience of nurses caring for women diagnosed with advanced cervical cancer (stage III and IV) in a resource-constrained setting in Ghana.MethodUsing a qualitative approach, we recruited twenty nurses and midwives who had worked for a year and above caring for advanced-stage cervical cancer patients at the national referral hospital in Ghana. We conducted in-depth interviews between July, 2022 to September, 2022 which were audio-taped with participants' consent. Transcription was done verbatim, and analysis conducted using thematic analysis approach with the aid of NVivo 10.0.ResultsThe results revealed experience as a safety toolkit, inherent desire to help/care for the patient, emotional numbness and maintaining professional outlook as personal factors influencing resilience among the participants. Regarding the workplace factors influencing resilience, we identified the main theme of demands of caregiving for advanced cervical cancer patients with the following sub-themes; severity of cases managed, nature of care rendered, activities of care given, reshuffling, schedules and gender mirroring as an exacerbator of psychological suffering.ConclusionResilience among nurses and midwives caring for terminally ill cervical cancer patients is influenced by longer years of service, intrinsic motivation to work as a nurse, and the defense strategy of emotional numbness and professionalism at the individual level. Also, the huge demand of caregiving serves as a major workplace factor affecting the resilience of nurses and midwives. We recommend strategies such as regular ward conferences and in-service trainings aimed at enhancing job-experience, inherent desire to render care and professionalism be adopted in resource-constrained settings to improve nurses' resilience. In addition, political actors and management of hospitals must prioritize allocation of resources for advanced cervical cancer care with particular focus on providing more specialized nurses and midwives.

Managing postoperative pain require good understanding of the bio-ethical principles in order to preserve patients’ rights. Bio-ethical principles in health care include autonomy, beneficence, justice and nonmaleficence. It is important that health care professionals understand that patients in pain have the right to satisfactory management. Good insight on ethical principles and how they relate to pain management places the nurse on a better pedestal to manage postoperative pain effectively. However, there is scanty literature on the level of Ghanaian nurses’ knowledge and application of bio-ethical principles in postoperative pain management. Therefore, the study objectives were to: explore nurses’ understanding of the bio-ethical principles in postoperative pain management; explore how nurses apply bioethical principles in postoperative pain management. The study employed qualitative exploratory descriptive design. Purposive sampling technique was used to recruit participants from the surgical wards. Semi-structured interview guide was designed for data collection. Data saturation was reached at the fourteenth participant. Thematic analysis method was used and themes emerged inductively. Three main themes identified through inductive content analysis of data were: beneficence, autonomy and justice. Findings showed that nurses had some appreciable level of knowledge of the fundamental principles related to ethics and applied them in postoperative pain management. Nurses knew their duties in advocating for patients. Patients rights to refuse treatment was also appreciated by some nurses. Nurses also demonstrated humanity by helping patients financially to settle hospital debts which explicitly shows the empathetic characteristics of nurses. The study concluded that nurses are knowledgeable in bioethical principles underpinning post operative pain management and also applied these principles when caring for surgical patients.

Adherence to antiretroviral therapy (ART) is essential to achieving an improved cluster of differentiation-4 (CD4) count, viral load, and quality of life while preventing drug resistance. Medication adherence among people living with Human Immunodeficiency Virus (HIV) is influenced by different factors. Several studies have identified adherence promoters and inhibitors that emanate from the internal and external environment. We conducted six (6) individual in-depth interviews and three (3) focus group discussions to explore adherence behaviour among patients diagnosed with HIV in a teaching hospital in Accra, Ghana. Participants were drawn from the intervention arm of a mobile phone adherence intervention program. They had been enrolled in the study for at least six (6) months before the interviews are conducted. Results revealed that participants adhered to treatment irrespective of prompts from significant others. Adherence promoters included perception of ART as part of daily routines, benefits of the ART, awareness of regimen, access to food, and transparency. Adherence inhibitors were forgetfulness, secrecy, waiting time, religious beliefs, and sleep. People living with HIV (PLWHIV) have the personal motivation to take medication; however, negative perceptions about HIV must be addressed to ensure optimum adherence behaviour.