Performance of Essential Practices and Self Efficacy in Stroke Care Among Nurses and Midwives at The Adult University Teaching Hospital, Lusaka, Zambia
Abstract:
Background: Stroke is among the leading causes of disability and mortality worldwide, necessitating effective multidisciplinary care practices to optimize patient outcomes. Nurses play a critical role in the provision of stroke care, requiring not only technical proficiency but also a high level of self-efficacy to motivate their delivery of optimal care. This study therefore investigated the essential practices and self-efficacy in stroke care among nurses and midwives at the Adult University Teaching Hospital in Lusaka, Zambia.
Methods: The study employed a descriptive cross-sectional approach that involved use of a structured self-administered questionnaire to collect data from a randomly selected sample of 163 nurses working in various units at the Adult University Teaching Hospital in Lusaka. Univariate and multivariable logistic regression analysis was used to identify predictors of the essential practices performed by nurses in the management of stroke patients at 95% confidence level. Normality of data was tested using the Shapiro-Wilk test as well as inspection of histograms.
Results: Half (50.9%) of the participants reported having never performed essential practices in caring for patients with stroke, while the majority (90.8%) reported high self-efficacy for stroke care. Some of the essential practices that were only performed by a minority of participants included continuous cardiac monitoring of patients (33.8%), administering recombined tissue Plasminogen Activator in divided doses (34.0%), using the Braden Scale in the prediction of stroke patients at high risk of developing pressure ulcers (36.1%), and performing a bedside swallow screen in the first 24 hours after stroke (27.6%). Univariate and multivariable logistic regression analysis revealed no significant predictive effect of various factors, including self-efficacy (P = 0.811, cOR = 0.91, CI = 0.40–2.05) on reported performance of stroke care practices.
Conclusion: Despite the central position occupied by nurses in the management of patients with stroke, their reported performance of essential stroke care practices was low. Despite an overall high self-efficacy, nurses also reported low self-efficacy in performing a few yet critical stroke care practices, such as performing a bedside swallow screening test. This heralds a need for in-house training and for large-scale studies that can investigate the performance of essential stroke care practices using observational approaches to help enhance validity.
