Connaissances, attitudes et pratiques des infirmiers des centres de santé primaires concernant les troubles de la déglutition chez les patients hémiplégiques dans les districts sanitaires urbains de la région des Hauts-Bassins au Burkina Faso

Post-stroke Complications and Mortality in Burkinabè Hospitals: Relationships with Deglutition Disorders and Nutritional Status

Stroke frequently causes deglutition disorders, leading to a decline in nutritional status and complications, and increasing mortality. Sub-Saharan data are scarce. The objectives of this study were to assess complications and mortality among hospitalized patients in Burkina Faso during the first two weeks after stroke, and to investigate associated factors. Patients with stroke were followed prospectively in Ouagadougou and Bobo-Dioulasso hospitals. Deglutition disorders and nutritional parameters were assessed at baseline (D0) and on Days 8 (D8) and 14 (D14). Complications and mortality were recorded up to D14. Factors associated with complications and mortality were investigated using multivariate analysis. Of the 222 patients included, 81.5% developed at least one complication, and mortality was 17.1%. At D0, D8, and D14, the rate of deglutition disorders was 37.4%, 28.4%, and 15.8%, respectively, and that of undernourishment 25.2%, 29.4%, and 31.0%, respectively. In multivariate analysis, only the presence of deglutition disorders was a risk factor for developing at least one complication (OR = 5.47, 95% CI 1.81-16.51). Factors predicting death were the presence of deglutition disorders at D0 (OR = 7.19, 95% CI 3.10-16.66), and at least one seizure during follow-up (OR = 3.69, 95% CI 1.63-8.36). After stroke, the rates of complications, death, and undernourishment were high compared to Western countries. Prevention and management of deglutition disorders, and specific follow-up of patients with seizures could reduce post-stroke mortality.

Primary health care: the experience of nurses

OBJECTIVE

to understand the meaning of nursing care in primary health care from the perspective of Chilean nurses.

METHOD

this was a qualitative study based on the social phenomenology of Alfred Schutz. Data was collected between January and April 2013, through interviews with 13 primary health care nurses in Chile.

RESULTS

the nurses perceived primary care as a gratifying experience, considering it an encounter of subjectivities. However, they felt burdened with multiple functions and by the hierarchical pressure to achieve targets. They strived to implement innovative care, expressed by the desire to go beyond traditional care practices, and improve the efficiency of management at the various levels of health care.

CONCLUSION

it is important to discuss the results of the present study in the context of health care and especially nursing education, with the goal of better preparing nurses who will deliver care at the primary health care level.