Physical inactivity is a serious epidemic that affects one's health and there's evidence that exercise can improve quality of life and health. The healthcare setting has been recognized as an appropriate and promising venue for counseling and prescribing physical activity to increase activity index of the population. An exercise prescription from a healthcare professional will remind the patient that physical activity is part of their treatment plan and should be adhered to with the same diligence with which their medication is taken. However, limited research on the topic suggests that many healthcare professionals are not incorporating exercise into treatment, and many lack the confidence to do so. The purpose of this study was to evaluate current exercise prescription trends among practicing healthcare professionals in Kakamega County, Kenya. A cross-sectional study was carried out in public health facilities in Kakamega County. The target population was nurses, medical officers and clinical officers. Data was collected using self-administered questionnaires and a total of 280 healthcare professionals from 7 government hospitals in Kakamega county participated in the study. From these hospitals 221 healthcare professionals (medical officers=11,5%, nurses= 165,75% and clinical officers=71,32%) completed the questionnaire. Healthcare professionals (HCPs) reported that, they occasionally (n=75, 33.9%) referred patients to other professionals for fitness assessment or appraisal, they occasionally (n=78, 35.3%) provided patients with verbal directions for a physical activity program, they very rarely (n=73, 33%) provided patients with written directions for a physical activity program, they frequently (n=71 32.1%) counselled PA (verbal or written prescription) for purposes of preventing chronic disease, they occasionally (n=76, 34.4%) discussed about physical activity with their patients and 59 (26.7%) very rarely participated in exercise session at least three times a week. The independent between-group ANOVA yielded a non-statistically significantly effect, F (2, 218) = 1.132, p = .324, ƞ p 2 = .01. Statistical power was not adequate and was equal to .248. Thus, the null hypothesis of no significant differences in knowledge of exercise prescription in health professionals at public health facilities in Kakamega was accepted. In conclusion these findings lend support for further training, increased incorporation, and further growth needed in healthcare professionals' self-efficacy in the prescription of exercise.
Despite diagnosis being an important part of clinical or medical consultations, the diagnosis might fail leading to adverse effects. This is a global problem, where developed and developing countries go through. In sub-Saharan Africa, variations between initial diagnosis and final diagnosis lead to diagnostic errors with high maternal mortalities. In Kenya, a lot of measures have been put in place but still, variation in diagnosis appear to have become rampant. Bungoma county is one of the counties with a high mortality ratio, especially for pregnant women attributed to the variation between initial and final diagnosis. Therefore, it was crucial to investigate the variation between initial and final diagnosis in relation to obstetric outcomes at hospitals in Bungoma County. The cross-sectional research design was used (Bungoma and Webuye hospitals). Systematic sampling was used to obtain 384 respondents after proportionate allocation to each hospital, and purposive sampling to select 8 health care workers as key informants. Data was collected using a structured questionnaire and an interview guide. The pre-test was done with validity established through crosschecking and reliability calculated using the Cronbach method (0.89). Using a statistical package for social sciences version 25, descriptive and inferential statistics was run where chi-square and odds ratio was used to determine the influence between variables, significance and prediction. The study revealed a variation between initial diagnosis and the final diagnosis was 20.8% while diagnostic errors were significant predictors of obstetric outcomes among post-natal mothers at level five with a p-value of 0.045 at a significance of 5%(P=0.045). Demographic characteristics showed no relationship with obstetric outcomes (P=0.54>0.05). Matched diagnostic had no variations (N=327, M=1.00, SD=0.000); while unmatched diagnostic had variations (N=327, M=1.82, SD=.384). There was a relationship between diagnostic errors and obstetric outcome (ꭓ2 (1) = 251.86, p< .001). An association between diagnostic error with unsafe obstetric outcomes was significant at the odds ratio of 2.03(OR 2.03, 95% CI 1.31–2.16). The study demonstrates that a correct diagnosis is a viable strategy in preventing unsafe obstetric outcomes and by extension minimizing morbidity and mortality among pregnant women. The study concluded that there was a variation between initial diagnosis and final diagnosis which had an adverse obstetric outcome. it was recommended to build capacities for the health workers in order to address increased diagnostic errors.
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