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Antimicrobial resistance (AMR) is one of the most urgent global health threats, responsible for an estimated 4.95 million deaths annually, including 1.27 million directly linked to drug-resistant infections. Nigeria is particularly affected, ranking 19th globally in AMR-related mortality, with an estimated 64 500 attributable and 263 400 associated deaths in 2019. These estimates are likely conservative due to limited surveillance. Economically, AMR could cost Nigeria 5%–7% of its GDP by 2050.
Despite this burden, antibiotic misuse remains widespread, with 42% of adults and over 46% of children under 5 receiving antibiotics without prescriptions. At the primary healthcare (PHC) level, where most antibiotics are prescribed, challenges such as limited diagnostics, inconsistent prescription and poor access to digital tools hinder effective antimicrobial stewardship (AMS).
The primary objective of this study is to assess the knowledge, attitudes and practices regarding antimicrobial resistance (AMR) among PHC prescribers in Imo State, Nigeria. A secondary objective is to explore preliminary indicators of their digital readiness to inform future technological interventions for AMS.
A cross-sectional study using an online questionnaire.
PHC facilities across all 27 local government areas of Imo State, Nigeria.
A purposive sample of 547 facility-based public PHC prescribers included 84% of all facility Officers-in-Charge of health facilities in the state and 16% of other PHC workers who were involved in prescription.
The primary outcome measures were composite scores for knowledge (adequate/inadequate), attitude (positive/negative) and prescribing practice (good/poor), derived from a validated questionnaire. Secondary measures included sources of AMR information and indicators of digital readiness.
While 77.1% demonstrated adequate knowledge, only 32.7% exhibited positive attitudes and 88.5% reported poor prescribing practices. Attitude was the strongest predictor of good practice (OR=17.585, p
These findings underscore a critical gap between knowledge and practice, driven in part by limited access to digital decision-support tools. To address the documented gaps in tool access and training, strengthening digital inclusion through context-adapted e-learning, offline-compatible AMS tools and simplified digital antibiograms is a necessary implication for improving antibiotic stewardship and clinical outcomes at the PHC level.
Osteoporosis requires long-term self-care engagement, yet little is known about how individuals experience and manage self-care in everyday life. Understanding these experiences is essential to inform tailored nursing interventions. The objective of the study was to explore and describe the experience of self-care maintenance, monitoring, and management in people with osteoporosis.
A qualitative descriptive study.
We conducted semi-structured interviews. Data were analyzed using Mayring's qualitative content analysis with a deductive approach based on Riegel's theory of self-care. We reported data in accordance with the Consolidated Criteria for Reporting Qualitative Studies (COREQ) checklist.
Participants (1 Male, 19 Females; Aged 55–80) Identified Four Themes of self-care: maintenance (e.g., Medication Adherence, Physical Activity), monitoring (e.g., Symptom Recognition, Test Interpretation), management (e.g., Lifestyle Reflections, Prevention), and general self-care. Key factors included motivation, trust in healthcare professionals, and integration of health behaviors into daily life. Barriers were low self-efficacy, poor symptom recognition, and inconsistent adherence.
Self-care in osteoporosis is a multidimensional and dynamic process influenced by individual beliefs, contextual factors, and support from healthcare professionals. Recognizing the variability in patients' self-care behaviors is essential to develop personalized education and support. Strengthening general health behaviors may enhance disease-specific self-care. This understanding can guide healthcare professionals in designing more effective, tailored care strategies.
Introducción. La punción arterial para el análisis gasométrico provoca dolor de intensidad variable. Este dolor podría alterar la dinámica ventilatoria y, por tanto, los parámetros respiratorios de la muestra sanguínea. Objetivos. Determinar la posible relación entre el dolor inducido por la punción arterial y los parámetros obtenidos del análisis gasométrico de estas muestras de sangre. Como objetivos secundarios, obtener la prevalencia del dolor provocado en la muestra estudiada y la posible asociación con el número de intentos. Metodología. Estudio transversal que incluyó 100 muestras arteriales de 61 pacientes durante el primer semestre de 2024. La intensidad del dolor, reportada mediante la escala NRS-11, fue la variable principal de estudio. Se analizó la asociación de esta variable con variables gasométricas (por ejemplo, pH, pO2, pCO2 y lactato) y con otras variables sociodemográficas y relacionadas con punción arterial. Resultados. La edad fue de 69,43 ± 13,07 y el 68% eran hombres. Respecto a la variable principal de resultado, la puntuación media del dolor fue de 4,03 ± 2,61. La intensidad del dolor no mostró asociación con ninguna variable gasométrica. Sin embargo, el número de intentos de obtener con éxito una muestra arterial mostró significación. Tras ajustar por otras variables, cada intento adicional aumentaba el dolor en 1,14 puntos. Discusión. No se encontró asociación entre el dolor de la punción arterial y los parámetros del análisis gasométrico, por lo que los resultados pueden interpretarse de forma robusta en situaciones en las que no es posible un manejo adecuado del dolor.
ABSTRACT
Introduction. Arterial puncture for gasometrical analysis causes pain of varying intensity. This pain could alter the ventilatory dynamics and therefore the respiratory parameters of the blood sample. Objectives. To determine the possible relationship between the pain induced by arterial puncture and the parameters obtained from the gasometrical analysis of these blood samples. As secondary objectives, to obtain the prevalence of pain caused in the sample studied and the possible association with the number of attempts. Methodology. Cross-sectional study involving 100 arterial samples from 61 patients during the first half of 2024. Pain intensity reported by the NRS-11 was the main study variable. The association of this variable with gasometrical variables (for example: pH, pO2, pCO2, lactate) and with other variables of different nature (sociodemographic and related to the arterial puncture itself) was analyzed. Results. The age was 69,43 ± 13,07 and 68% were men. Regarding the main outcome variable, the mean pain score was 4.03 ± 2.61. Pain intensity showed no association with any of the gasometric variables. However, the number of attempts to successfully obtain an arterial sample showed significance. After adjustment for other variables, each additional attempt increased pain by 1.14 points. Discussion. No association was found between arterial puncture pain and gasometric analysis parameters, so the results can be robustly interpreted in situations where adequate pain management is not possible.
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