Prevalence and correlates of job loss among schizophrenia outpatients at St. AmanuelMental Specialized Hospital, Addis Ababa, Ethiopia; cross sectional study.

BACKGROUND: Job loss in patient with chronic illness like schizophrenia is the most serious public concern in the clinical and socio-economic terms worldwide. Patients with schizophrenia usually have unsatisfactory job termination like quitting or getting fired which results well-established negative outcomes. The complex interplay between one another has made job and mental illness the focus areas. In the developing nations, there is limited study on these areas in spite of higher rates of job loss. OBJECTIVES: This study aimed to assess the prevalence and correlates of job loss among schizophrenia outpatient units in Addis Ababa, Ethiopia. METHODS: Institutional based cross-sectional study was conducted at Saint Amanuel Mental Specialized Hospital among schizophrenia outpatient units in Addis Ababa from May to June 2018. A total of 421 study subjects were interviewed using Positive and Negative Syndrome Scale and Perceived devaluation and discrimination scale. Out of the total study participants, female populations were slightly higher (50.4%) and the majorities (38.6%) were orthodox religion followers. Study characteristics was summarized using descriptive statistics and bi-variable and multivariable analysis was performed using Statistical Package for Social Science version 24. Furthermore, those factors at p value ≤ 0.05 were considered as statistically significant. RESULTS: The prevalence of job loss among patients with schizophrenia was 37.3%. Factors including unmarried [AOR = 2.42:95% CI (1.28, 4.54)], divorced [AOR = 2.34: 95% CI (1.16, 4.71)], severe positive symptoms [AOR = 2.03: 95% CI (1.15, 3.60)], severe general psychopathology [AOR = 1.76: 95% CI (1.01, 3.08)], and poor level of social and occupational functioning [AOR = 5.05: 95% CI (2.81, 9.09)] were significantly associated with job loss among schizophrenia people. CONCLUSION: This study suggested that job loss among schizophrenia outpatients was high. There was significant association among people with unmarried, divorced, severe positive symptoms, poor functionality and higher general psychopathology. Therefore, clinical and psychosocial factors were responsible for job loss which warrant further attention and investigation.

Pathways through homelessness among women in Addis Ababa, Ethiopia: A qualitative study.

BACKGROUND: There has been a paradigm shift in understanding homelessness. The shift is from the belief that homelessness results from lack of secure housing towards the view which explains homelessness in terms of the complex interactions of factors which determine the pathways into and out of homelessness. The evidence base for women's homelessness is less robust than men's homelessness. The effect of gender and its relationship with homelessness has been neglected. Addis Ababa, the capital city of Ethiopia, is estimated to be home for around 50,000 homeless people. This study aims to explore pathways through homelessness in women who were sheltered in a facility for the homeless in Addis Ababa. METHODS: In-depth interviews were conducted in 2019 with 14 women who were 'roofless', and were gathered for support in a temporary shelter in Addis Ababa, Ethiopia. The shelter was one of the eight such facilities established in Addis Ababa few months earlier than the study. For data analysis the QDA Miner 5.0.30 software was used and data was analyzed using thematic analysis approach. RESULTS: The analysis revealed that determinant factors for pathways into homelessness among women occurred on the background of predisposing factors, such as poverty, being raised by caregivers other than biological parents, child marriage, unstable employment history. On top of the predisposing factors listed above the occurrence of precipitating factors such as problems with marriage, migration, death of parents, deception, became the immediate cause of homelessness. Despite mentions of positive experiences of homelessness such as mutual support and good social life within network of homeless people, the net effect of the interaction between negative and positive experiences of the homeless life, together with the effectiveness of coping strategies by the participants resulted in the participants' decision of whether homelessness is tolerable. Finally, the presence of perpetuating factors such as lack of affordable house, feeling of shame to go back home, and unfavorable situation at home discouraged participants from exiting the homeless situation. CONCLUSION: From the findings of the study we conclude that the predisposing factors and the precipitating factors resulted in the occurrence of onset of homelessness among the participants. Once homeless, the experiences of life as homeless, and the availability of the means to exit from it determined whether the participants would stay homeless or exit from it.

Prevalence and determinants of test anxiety among medical students in Addis Ababa Ethiopia.

BACKGROUND: Worldwide, problematic test anxiety is a common health problem among medical students. The magnitude of problematic test anxiety ranges from 25 to 40% in undergraduate medical students and has a detrimental effect on academic achievement and success of students. However, data on the prevalence of test anxiety among medical students is limited. Thus, the study aimed to assess the prevalence and associated factors of test anxiety among medical students. METHODS: In this cross-sectional study, a stratified random sampling technique was used to select the participants. The level of test anxiety was determined by the Westside Test Anxiety Inventory (WTAI). We utilized logistic regression to explore the association between test anxiety and the potential sociodemographic/student-related characteristics among medical students. RESULTS: The study included 423 medical students. Our study resulted the prevalence of problematic test anxiety among medical students to be 52.30% (95% CI 47.40-57.30). The prevalence of test anxiety was remarkably higher in women (79.75%) than in men (33.62%) students. Female sex [AOR = 3.25, 95% CI: (1.54, 6.89)], having low grade [AOR = 0.11,95% CI: (0.044,0.288)], being first year [AOR = 10.55,95% CI: (1.4,76.7)], excessive course load [AOR = 6.128,95% CI: (2.675,14.039)], and taking oral examination [AOR = 2.89,95% CI: (1.42,5.84)] were determined as some of the predicting factors of test anxiety among medical students. Additionally, lack of systemic study plan [AOR = 2.4, 95% CI: (1.25, 4.59)], poor social support [AOR = 3.6, 95% CI: (1.56, 8.29)], moderate social support [AOR = 3.39, 95% CI: (1.56, 7.4)], psychologically distressed [AOR = 2.68, 95% CI: (1.37, 5.27)] independently predicts test anxiety among medical students. CONCLUSION: Findings suggest that a substantial percentage of medical students had problematic test anxiety in Ethiopia (52.30%). This study also showed a significant association between test anxiety and female sex, having poor grade point average, being the first year, excessive course load, oral examination, lack of study plan, poor social support, moderate social support, and having psychological distress. Problematic test anxiety, which is found to be common among medical students, deserves more attention.