Browsing by Author "Masika, Golden Mwakibo"

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    Defining compassionate nursing care
    (SAGE Publications, 2020) Su, Jing Jing; Masika, Golden Mwakibo; Paguio, Jenniffer Torralba; Redding, Sharon R
    Background: Compassion has long been advocated as a fundamental element in nursing practice and education. However, defining and translating compassion into caring practice by nursing students who are new to the clinical practice environment as part of their educational journey remain unclear. Objectives: The aim of this study was to explore how Chinese baccalaureate nursing students define and characterize compassionate care as they participate in their clinical practice. Methods: A descriptive qualitative study design was used involving a semi-structured in-depth interview method and qualitative content analysis. Twenty senior year baccalaureate nursing students were interviewed during their clinical practicum experience at four teaching hospitals. Ethical considerations: Permission to conduct the study was received from the Institutional Review Boards and the participating hospitals. Results: Baccalaureate nursing students defined and characterized compassionate care as a union of “empathy” related to a nurse’s desire to “alleviate patients’ suffering,” “address individualized care needs,” “use therapeutic communication,” and “promote mutual benefits with patients.” Students recognized that the “practice environment” was characterized by nurse leaders’ interpersonal relations, role modeling by nurses and workloads which influenced the practice of compassionate care by nursing personnel. Conclusion: Compassionate care is crucial for patients, nurses, and students in their professional development as well as the development of the nursing profession. In order to provide compassionate care, a positive practice environment promoted by hospital administrators is needed. This also includes having an adequate workforce of nurses who can role model compassionate care to students in their preceptor role while meeting the needs of their patients.
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    The effectiveness of non‐pharmacological interventions targeting neuropsychiatric symptoms among persons with preclinical and mild dementia: a systematic review and network meta‐analysis
    (Wiley, 2021) Lin, Rose Sin Yi; Yu, Doris Sau Fang; Lin, Polly Wai Chi; Masika, Golden Mwakibo
    To conduct a systematic review and network meta‐analysis examining the effects of non‐pharmacological interventions on neuropsychiatric symptoms (NPS) in a community‐dwelling population with preclinical and mild dementia to identify the design characteristics of more effective interventions. A comprehensive search was conducted in 10 electronic databases. Two reviewers independently appraised the methodological quality of studies using the Risk of Bias 2.0 tool. A pairwise meta‐analysis was performed to estimate the standardized mean differences (SMD) with 95% confidence intervals. Network meta‐analysis was then used to estimate the relative effects and rankings of different interventions. Twenty‐one studies involving 1773 participants were included. Seven studies focused on preclinical dementia, and 14 studies focused on mild dementia. The majority of studies reported a single domain of NPS (depression, anxiety, apathy or agitation) rather than overall NPS. Data on depression were pooled. Pairwise analysis and network meta‐analysis indicated that multimodal interventions (SMD = −0.47, p = 0.01) were superior to psycho‐behavioral educative interventions (SMD = −0.04; p = 0.65), cognitive training (SMD = −0.27, p = 0.10), and art‐based interventions for improving depression. The more crucial design characteristics included those that emphasized skill transferal into daily life, psycho‐behavioral content to encourage a positive outlook and self‐identity, and disease‐specific educational content to improve symptom management. This review indicated that multimodal interventions with cognitive, psycho‐behavioral and educative components were the most effective approaches for improving depression in patients with preclinical and mild dementia. More comprehensive evaluations using standardized and robust measures of NPS in patients with preclinical dementia are warranted.
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    Historical overview of critical care nursing in Tanzania culminating in its first inaugural conference in Tandem with the sixth conference of the African Federation of Critical Care Nurses
    (World Federation of Critical Care Nurses., 2022) Manji, Zainab Karim; Masika, Golden Mwakibo; Ramadhani, Fatina B.; Kalinga, Erasto; Safari, Sixtus Ruyumbu; Ndile, Menti; Mkoka, Dickson
    Critical care nursing is an emerging and growing facet of healthcare in Africa. This article provides a historical overview of critical care nursing in Africa, specifically in Tanzania. This includes the founding of the African Federation of Critical Care Nurses in 2017 and the Tanzania Critical Care Nurses Association in October 2022.
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    Integrative review of factors affecting cognitive health among older adults: perspectives on focus for prevention of dementia in developing countries
    (ELSEVIER, 2018) Masika, Golden Mwakibo; Yu, Doris S.F.
    Background: Cognitive impairment is a prominent public health issue among older adults. Different factors are believed to be associated with different stages of cognitive impairment. Knowledge of these factors are important in programming for preventive measures and to reduce worsening of impairment to more debilitating states. The aim of this integrative review and meta-analysis was to examine the modifiable risk factors impacting at different stages of cognitive impairment trajectory and their magnitude. Methods: A systematic search of literature was conducted in 6 databases: Medline, Embase, Global Health, Food Science and Technology Abstracts (FSTA), Co- chrane Central Register of Controlled Trials (CCRCT) and CI-NAHL complete, for current studies published within 10 years by November 2017. Prospective cohort, case control and cross sectional studied were included. Results: A total of 506 items were retrieved from the databases and 57 articles met the inclu- sion criteria for this review. Six groups of modifiable factors were identified including: vascular factors, co-morbidity and medical interventions, biological and nutritional factors, genetic and environmental interaction, psychological factors, life style factors and social factors. Vascular factors, particularly history of stroke presented the highest risk of dementia compared to the rest of other exposures, with odd ratios (OR) of ¼3.80 [95%CI, 1.92, 7.51]), and MCI (OR ¼1.82 [95% CI, 1.57, 2.11]), while engaging in physical activity at least 2 or more times per week was associated with a reduced risk of dementia (OR¼0.67 [95%CI, 0.48, 0.93]). Conclusions: Despite of some of vascular factors identified in this review are clinical conditions by themselves, their preventive measures are available in the developing countries. Culturally sensitive interventions focusing on vascular factors, as well as nutritional and life style factors may have dual positive effects in preventing both vascular condition and cognitive decline among elderly.
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    Montreal cognitive assessment 5‐minute protocol is accurate in screening for mild cognitive impairment in the rural African population, neuropsychology: cognitive and functional assessment in diverse populations
    (Alzheimer's Association Publication, 2020) Masika, Golden Mwakibo; Wong, Adrian; Lin, Rose S.Y.; Lee, Diana T. F.; Yu, Doris S. F.; Li, Polly W. C.
    The prevalence of dementia in Tanzania, as in other developing countries is progressively increasing.1 Yet the screening instruments for the pre‐clinical stage of the diseases are lacking. This study examined the diagnostic accuracy of the Montreal Cognitive Assessment‐5‐minutes protocol (MoCA‐5‐min) among older adult in the rural Tanzania. After cultural adaptation following Brislins approach,2 the MoCA‐5‐min and the IDEA cognitive screening were concurrently administered to community‐dwelling older adults (n=202) in Chamwino district and 40 re‐evaluated at 6 weeks. Exploratory factor analysis (EFA) using principal component method and oblique rotation was performed to determine the underlying factor structure of the scale. The concurrent and the diagnostic accuracy of the MoCA‐5‐min were examined by comparing its score with IDEA cognitive screening and the psychiatrist’s diagnosis using DSM‐V criteria respectively. The EFA found that all the MoCA‐5‐min items highly loaded into one component, with factor loading ranging from 0.550 to 0.879. The intraclass correlation coefficient for 6 weeks test‐retest reliability was 0.85. Its strong significant correlation with the IDEA screening (Pearson's r = 0.614, p < 0.001) demonstrated a good concurrent validity. Using the psychiatrists rating as a gold standard, the area under the curve (AUC) was 0.861, (95% CI = 0.799 – 0.922) (Figure 1). With the optimal cut‐off score for MCI at 22, the sensitivity was 80% and specificity was 74%. As for dementia, at a score of 16 the sensitivity was 90% and specificity was 80%, whereas the AUC was 0.910, (95%CI = 0.852 – 0.967) (Figure 2). Upon stratifying the sample into different age groups, the optimal cut‐off scores tended to decrease with the increase in age (Table 1). The MoCA‐5‐min is reliable and provides a valid and accurate measure of cognitive decline among older population in the rural settings of Tanzania. The use of varying cut‐off scores across age groups may ensure a more precise discriminatory power of the MoCA‐5‐min.
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    P2‐452: Applicability of the kiswahili version of montreal cognitive assessment among older adults with very little and no education in rural Tanzania: a validation survey
    (Alzheimer's Association Publication, 2019) Masika, Golden Mwakibo; Yu, Doris S. F.; Li, Polly W. C.
    The incidence of dementia in the low and middle‐income countries, particularly sub‐Saharan Africa is rising [1,2]. The Montreal Cognitive Assessment (MoCA) has been widely used to screen for pre‐clinical and clinical stage of this dementia. However, its use in Tanzania is very limited. The aim of this study was to investigate the applicability and psychometrics of the Kiswahili version of MoCA (K‐MoCA) among older adult in the rural Tanzania. The K‐MoCA was administered to 259 community living older adults in Chamwino district, together with the IDEA cognitive screening, IDEA‐Instrumental Activities of Daily Living, and Mental Health Inventory as referencing instruments to examine its concurrent and construct validity. The IDEA was a more validated cognitive test for the Tanzanian population [3]. A subsample (n = 86) were diagnosed by a psychiatrist as 19 having normal cognition, 42 having MCI and 25 having dementia for examining its sensitivity and specificity. The reliability, and correlation of the K‐MoCA with IDEA cognitive screen were also investigated. K‐MoCA demonstrated an acceptable reliability (Cronbach alpha= 0.78) and was significantly correlated with the IDEA cognitive screen (r = 0.651, p < 0.001). Referencing to IDEA scores and psychiatrist rating, the K‐MoCA total and the domain scores except abstraction and delayed recall, were significantly different between subjects with normal cognition, MCI and dementia; which indicated satisfactory discriminant validity (Table 1). Table 2 shows the construct validity of K‐MoCA where the cognitive scores converges with the predicted relationship with age, education and instrumental ADL ability. However, the screening ability (Figure 1 and Figure 2), using the psychiatrist's rating as the golden standard, Receiver Operating Curve analysis, indicated that the recommended cut‐off scores of 26 and 18 did not give acceptable specificities for detecting MCI (Sensitivity: 92%; specificity: 11) and dementia (Sensitivity: 92%; specificity: 55) respectively. The results may be related to the fact that some of the items were less culturally relevant to the Tanzanian population. Overall, the utility of K‐MoCA for detecting MCI and dementia in this population was low due to less cultural relevance of some items. Modification to those items are recommended to improve its utility. its utility