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Abstract Background Deaths can be caused by terminal illnesses, accidents, or natural disasters. However, medically, death can be hastened by healthcare providers, patients themselves, or their relatives. In advanced cancers where the patient’s quality of life is compromised, Euthanasia can be used to hasten death. Inadequate medical resources and low socioeconomic status have been cited as factors influencing Euthanasia. This study sought to explore nurses’ and midwives’ knowledge and perspectives on Euthanasia in resource-constrained health facilities. Methods A qualitative exploratory, descriptive design was used to recruit 24 nurses and midwives from three major referral hospitals, two regional hospitals, and one district hospital. Data was collected through individual in-depth face-to-face and telephone interviews. Braun and Clarke’s (2006) thematic data analysis approach was used. Findings : Three main themes and eight subthemes were generated from the data: the main themes include Knowledge of Euthanasia, health system resource constraint-driven euthanasia and family resource constraint-motivated euthanasia. The findings indicate that nurses and midwives lack understanding of some terminologies related to the act. Strict policy decisions, inadequate resources, and misunderstanding of palliative care resulted in the practice of Euthanasia. Additionally, unbearable pains and financial constraints of families of critically ill patients made them request Euthanasia in the health facilities. Conclusion The study highlights the challenges of end-of-life care in resource-constrained settings, emphasizing the need for provider training, increased healthcare capacity, and clearer national guidelines for ethical decision-making.

Abstract Introduction Cervical cancer is one of the causes of female deaths worldwide. Cervical cancer incidence is rising with almost three thousand (2797) women in Ghana being diagnosed with the condition each year, with almost two thousand (1,699) of them dying from its complications Nurses caring for cervical cancer patients are exposed to emotional and psychological distress due to late presentation, the burden of care, patients’ suffering and the alarming number of deaths associated with it. Improving positive patient outcomes require identifying the challenges and support systems available to nursing staff so as to harness these support systems for improving care outcomes. Aim This study explored the challenges and support systems of nurses caring for women with advanced cervical cancer in Accra, Ghana. Method In this study, we adopted an exploratory qualitative design. The study was conducted among eleven (11) nurses and nine (9) midwives engaged at the national referral hospital in Ghana who were providing care for patients with advanced cervical cancer for over a year who were purposively sampled. The data was collected using in-depth interviews with a pre-tested semi-structure interview guide from the twenty participants. We recorded the interviews using an audio-tape. The audio files were transcribed verbatim and thematic analysis was undertaken with the aid of Nvivo 10.0. Results The challenges when rendering nursing care faced by participants of this study were exposure to frequent deaths, inadequate resources, and workload. Most participants lamented that they received absolutely no support from their workplace, hence their only form of support was from their family and friends. They also added that most of them were general nurses and midwives with no special training in oncology nursing or palliative nursing. Conclusion Nurses and midwives experience resource, knowledge and skill challenges when caring for patients with advanced cervical cancer. However, the nurses and midwives had emotional attachment to their jobs and their patients and were not distracted by their bad experiences. We recommend improving resource allocation for cervical cancer care through the National Health Insurance Authority (NHIA), Ghana and increased training of nurses in oncology and palliative nursing by the Ministry of Health, Ghana to improve knowledge and skills of the nurses and midwives caring for women with advanced cervical cancer to improve their quality of care. Further, hospitals must make it a priority to have more nurses and midwives trained in oncology and end of life care to improve the knowledge and skills of nurses and midwives caring for advanced cervical cancer patients. Also, these findings should trigger policy-level discussions at the Ministry of Health, Ghana on the training of specialized nurses and midwives in cancer and end of life care to help Ghana meet the sustainable development goal targets related to health.

Abstract Background The need for primary care physicians to be heavily involved in the provision of palliative care is growing. International agencies and practice standards advocate for early palliative care and the use of specialized palliative care services for patients with life-threatening illnesses. This study was conducted to investigate physicians’ referral practices and perceived barriers to timely referral at the Korle Bu Teaching Hospital. Methods A cross-sectional study design was employed using a convenience sampling technique to recruit 153 physicians for the study. Data on socio-demography, referral practices, timing and perceived barriers were collected using a structured questionnaire. Binary Logistic regression using crude and adjusted odds was performed to determine the factors associated with late referral. Significance was set at p

Abstract Background Nurses and midwives have been stretched by the COVID-19 pandemic amidst the heroic roles they have played during the peak of the COVID-19 pandemic. Nurses stood tall among their peers in the healthcare industry saving lives. The pandemic has had a toll on nurses physically, psychologically, and socio-economically. The numerous deaths have traumatized nurses coupled with the fear of possible infection. Nurses have seen their colleagues and loved ones lose their lives to the pandemic, nevertheless, they still render care to patients no matter the circumstances. Due to that, it is imperative to ascertain the extent to which nurses who are much needed in healthcare delivery have been affected by this pandemic. This scoping review used Arksey and O’Malley’s review methodology to investigate the nature of work-related psychosocial challenges nurses encountered during the peak of the pandemic, noting the major contributors to the challenges and the coping strategies used to address them. Methods We performed a scoping review and searched for articles from five databases including PUBMED, CINAHL, SCOPUS, Google Scholar, and Grey literature from December 2019 to December 2021. A total of 7,334 articles were retrieved for the study but 45 met the inclusion criteria. Results Work-related psychosocial challenges identified included stress, burnout (emotional exhaustion and depersonalization), Post-Traumatic Stress Disorder, depression, sleeplessness, and anxiety. Factors that accounted for the challenges were inadequate personal protective equipment (PPEs), discomfort using the PPEs, extreme workload, and fatigue. Nurses experienced job insecurity, business closure, and separation from family and loved ones, and these contributed to their challenges. Strategies used to deal with the challenges centred on emotion-focused and problem-focused coping. Conclusions The study recommends regular counselling and support for all nurses working at the frontline to help them better cope with the devastating effects of the pandemic so that they could build resilience towards future pandemics.

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.

With the increasing cancer incidence in Ghana especially breast cancer among women, its diagnosis and prognosis present enormous fear and worry for women and their families. Thus, breaking the news of breast cancer diagnosis to patients presents enormous difficulty to healthcare professionals. Aim: This study sought to explore the preferences of people living with breast cancer regarding the disclosure of their diagnosis. Methods: The study used an exploratory-descriptive qualitative design to recruit and interviewed 17 women diagnosed with breast cancer and receiving treatment in a National Radiotherapy and Nuclear Medicine Center of a major Teaching Hospital in Ghana. Data were analyzed using Braun and Clarke’s 2006 thematic analysis approach. Findings: Two major themes, six subthemes, and five sub-subthemes were generated from the data. The study found that patients preferred detailed information on the stage of their cancer diagnosis, treatment options, and the lifestyle necessary to enhance their health. The participants preferred that the news of their diagnosis be broken to them gradually in the form of a conversation with consolatory gestures, without any hidden information. From the study, clinicians do not follow any specific systematic method in the disclosure process, clinicians used a conversation approach involving consolation, encouragement, comic words, and pampering mostly in disclosing cancer diagnosis which was found relieving.In conclusion, People living with breast cancer prefer full gradual disclosure of diagnosis in a conducive environment in the presence of loved ones in a humane manner.

Abstract Aim This study was undertaken to discover the socioeconomic impact of breast cancer on young women in Ghana. Methods A qualitative exploratory and descriptive design was used to recruit 12 young women from the University of Ghana hospital, 37 Military hospital and Ridge hospital. Individual interviews were conducted face to face and data transcribed verbatim and analysed using content analysis. Results Three themes emerged: perceptions and beliefs; economic concerns; and secrecy. Participants perceived that breast cancer was a test of faith, a spiritual disease that is contagious and disgraceful. Mostly, participants stopped work to cater for themselves, and as a result, they encountered financial challenges. Their challenges were compounded with conscious efforts to keep diagnosis secret to avoid being stigmatized. Conclusion Young women living with breast cancer need support physically, economically and socially from healthcare providers, their families and the society at large.

Abstract Background Young women diagnosed with breast cancer face challenges that interfere with their entire life with psychological and physical effects. Method We employed a qualitative exploratory descriptive design, and recruited twelve participants through purposive and snowball sampling methods to conduct 12 face to face individual interviews. A reputable review board in Ghana; Noguchi Memorial Institute for Medical Research, gave ethical clearance for data collection. Data were transcribed verbatim and analysed using thematic content analysis. Results Three themes emerged from the data; physical effects of breast cancer, effects of treatment on body image, and emotional effects of breast cancer diagnosis and treatment. The negative effects of treatment incapacitated most of the women and limited their activities of daily living. Some experienced severe bodily weakness and stayed indoors for days. Most participants felt they looked unattractive because they have had a mastectomy done, and used pieces of rags and handkerchiefs as breast prostheses. Those who had hair loss through chemotherapy used different kinds of wigs to cover their baldness. Almost all the participants cried, felt depressed, and became emotionally unstable when they were told their diagnosis. Some denied their diagnoses and displaced their anger on healthcare personnel. A few of them felt they had brought disgrace to their families because breast cancer is perceived, a disgraceful disease. Conclusion Young women diagnosed with breast cancer require psychological interventions and physical support from healthcare personnel and their families.

Background: COVID-19 has impacted negatively on people physically, psychologically, spiritually, and socioeconomically worldwide. Nurses’ ability to prepare towards case management is imperative because the potential of one coming across the virus at the hospital is inevitable. This study intended to explore and describe nurses’ perspectives on preparation towards fighting COVID 19 in Ghana. Methods: A qualitative exploratory descriptive design was adopted. Nine major health facilities designated for COVID-19 treatment centres in four regions in Ghana were involved in the study. A semi structured interview guide was used to interview twenty-nine nurses via telephone based on data saturation. Ethics approval was obtained from the Ethics Review Committee of the Nursing and Midwifery Council of Ghana. Result: data yielded two major themes and four subthemes. The two main themes were 1. Health facilities’ preparation of nurses towards COVID-19, with its subthemes; targeted training, and selection of experienced staff. 2. Nurses’ individual preparedness towards COVID-19 with the subthemes; information sourcing and sharing. Nurses in Ghana prepared for combating COVID-19 by going through training on infection prevention and control, and case management using demonstrations and simulations. Experienced nurses in Ghana volunteered to be at the frontline managing cases. Continuous updates on the virus and its management through information tracking sharing played a key role. Conclusion: Nurses in Ghana need to have more specialty training targeted at diseases of public health importance. Key words: Nurse; preparedness; covid-19.

Aim: This study sought to identify ways of coping with breast cancer diagnosis and its treatment challenges among young Ghanaian women living in the Accra metropolis. Methodology: The study used an exploratory descriptive qualitative approach to recruit twelve participants aged 28–45 years through purposive and snowball sampling methods from three hospitals in the Accra metropolis. Participants were interviewed using a face to face approach and interviews were audio recorded with participants’ permission. Verbatim transcription was done and data were analyzed using content analysis procedures. Findings: Participants believed God is the ultimate healer. They prayed and read the Bible. Some believed God could replace their breasts, they voided sinful acts and used religious artefacts such as the Rosary, special oil prepared by pastors, pictures of pastors. They obtained physical and emotional support from their families, partners and significant others. They compared themselves with others who had worse health challenges such as those with end-stage breast cancers who were on admission and those who have died. Participants also listened to music, read storybooks, took a walk in flower gardens to cope with breast cancer diagnosis and treatment. Conclusions: Young women living with breast cancer rely more on God and support from their families, friends and the church in coping with their condition. These young women need to be attended to by multidisciplinary healthcare team the clinical psychologist and a spiritual leader to enable meet their physical, psychosocial and spiritual needs. Keywords: Breast cancer, Coping, Ghana, Spirituality, Social support, Young women