Evidence-based practice and the management of Archiritis in the Upper West Region of Ghana: Challenges in implementation and practice

This research was conducted to find out the problems faced in applying evidence-based practice (EBP) to manage arthritis. The relationship between arthritis and each of the following variables; gender, weight and age was determined. The study was also intended to determine the risk factor that is most related to arthritis. Chi-square was used to assess the relationship between arthritis and each risk factor. Test was found to be significant for all the three risk factors. Cramier’s V was used to compare the strength of the statistical relationship between arthritis and each risk factor. Cramier’s V value of 0.397 for age and arthritis was found to be greater than 0.236 each recorded for weight and arthritis, and gender and arthritis. The relationship between age and arthritis is therefore stronger and hence age posses the most risk of arthritis among the three risk factors (gender, age and weight). The average age and average weight of arthritis patients in the study area were found to be between 63 years and 66 years, and 63 kg and 67 kg respectively using 99 % confidence interval. Osteoarthritis is more common with 68.7 % of the cases whiles rheumatoid arthritis less common with 31.3 %. Arthritis affects women 58.7 % more than men. Knee joint is the most commonly affected joint followed by hip joint. Excessive riding of bicycle over long distances on daily bases could lead to an increase number of knee problems. Farming coupled with the practice of polygamy could result in an increase number of waist problems. Self assessment of nurses understanding of literature and literature search skills revealed that nurses have low confidence (below average) in their understanding of literature and literature search skills. Boxplot was used to show the age distribution of OA and RA patients. It was found that the average age of OA patients is higher than the average age of RA patients. Hence RA is more likely to affect people at an early age than OA. Boxplot was also used to compare the age distribution of OA and RA against gender. It was found that in both OA and RA, the average age of female patients is lower than the average age of male patients. Hence in both OA and RA, females are more likely to be affected at an early age than males. Also, boxplot comparism of the weights of patients with OA and RA shows that the average weight of RA patients is higher than that for OA patients. This shows that in general RA patients have more weight than OA patients. In addition, comparing the weight distribution of patients with OA and RA against gender using boxplot, it was found that in both OA and RA, the average weight of female patients is higher than that of their male counterpart. This shows that females are more likely to be affected by arthritis at an early age than their male counterpart. Furthermore, some problems that impede the successful implementation and practice of EBP were identified; CDSSs have not been implemented, there is no interdepartmental network for computers in the various departments, low patient awareness of CDSSs, electronic health records system has not been implemented, inadequate understanding of literature and literature search skills on the part of nurses, leadership styles that do not support EBP, quack herbal medicine practice, proliferation of licensed and unlicensed drug stores, and unqualified people prescribing at the drug stores.

Source: KNUST