The relationship between job satisfaction and turnover intention among nurses in Axum comprehensive and specialized hospital Tigray, Ethiopia.

BACKGROUND: Nurses' turnover is a global concern which if not handled well can harm the productivity of an organization. The high turnover rate of health workers critically affects the health system, particularly in countries with limited resources. Hence, effective retention strategies require clear identification of the variables at the workplace that determines nurses' decision in staying in or leaving their employer organization. The aim of this study is to assess the relationship between job satisfaction and turnover intention among nurses in Axum Comprehensive and Specialized Hospital Tigray, Ethiopia. METHODS: The research was conducted using institution based cross-sectional study design. A total of 148 nurses were included in the study using a systematic random sampling technique. The study was conducted from January 2018 to June, 2019. Data were collected using semi-structured self-administered questionnaires. It was entered into Epidemiological information version 7 and then analyzed using Statistical Package for Social Sciences version 22. Bivariate logistic regression analysis was employed to examine the statistical association between the outcome variable and selected independent variables. All variables with P value < 0.05 in the bivariate analysis were included in the multivariable analysis. RESULT: Out of 148 nurses, more than half (64.9%) had the intention to leave the organization. The finding of this study showed that the level of job satisfaction was significantly associated with the overall intention. Nurses who were unsatisfied on their job autonomy were 2.55 (95% CI: 1.194, 5.466) more likely to intend to leave their workplace than nurses who reported to be satisfied. Nurses who were unsatisfied on training opportunity were also 2.55 (95% CI: 1.167, 5.571) times more likely to leave their job than nurses who reported to be satisfied. CONCLUSION: The overall turnover intention of nurses was found to be high and significantly associated with dissatisfaction on autonomy, and training opportunity. Therefore, continuous effort should be made by ward managers to enhance nurses' satisfaction onjob autonomy, and training opportunity.

Assessment of knowledge and attitude towards palliative care and associated factors among nurses working in selected Tigray hospitals, northern Ethiopia: a cross-sectional study.

INTRODUCTION: Palliative care is a multidisciplinary approach which is focused on both the patient and their family. Therefore the objectives of the study is to assess the knowledge and attitude towards palliative care and its associated factors among nurses in Tigray, Northern Ethiopia, 2018. METHODS: An institutional based cross-sectional quantitative study design was carried out using 355 nurses working in selected hospitals in Tigray region from February to March, 2018. Systematic random sampling was used to select six governmental hospitals. We used triangulation in the study method, making use of both Frommelt's Attitude Toward Care of the Dying (FATCOD) scale, and Palliative Care Quiz for Nursing (PCQN) knowledge. SPSS were applied for data entry and analysis. Statistical significance was declared at P<0.05. The goodness of fit the final logistic model was tested by using the Hosmer and Lemeshow test at a value of > 0.05. RESULTS: All the participants were able to respond. Out of the total study participants, 223 (62.8%) had good knowledge and 200 (56.3%) had a favorable attitude towards Palliative care. A medical ward had (AOR = 3.413, CI = 1.388-8.392, P = 0.019), trained Nurses [AOR = 3.488; CI = 1.735-7.015; P = 0.00) significant associated with nurses knowledge towards palliative care. Nurses working in the lemlem Karl (AOR=2.541; 95% CI; 0.013(1.106-5.835), nurses who had a 20-30 years ago had unfavorable attitude (AOR = 2.660; 95% CI; 0.002(1.386-5.106) were significant. CONCLUSION: The nurses had poor knowledge. However, their attitude towards palliative care (PC) was favorable.

Adherence to insulin therapy and associated factors among patients with diabetes mellitus in public hospitals of Central Zone of Tigray, Ethiopia, 2018: a cross-sectional study.

INTRODUCTION: Adherence to insulin therapy is a critical factor for adequate control of diabetes mellitus. Despite the multiple well-known benefits of adherence to insulin therapy, poor adherence remains to be a common cause of diabetes mellitus-related complications. A better management of diabetes mellitus requires determining the level of patient adherence and identifying why non-adherence to insulin therapy occurs. Therefore, this study was designed to assess the level of adherence to insulin therapy and associated factors among diabetes mellitus patients. METHODS: The study was conducted from May 1 to July 1, 2018, using a cross-sectional study design. Interviewer-administered questionnaire was employed for data collection and systematic random sampling technique was used to select study participants. The collected data were entered using Epi data version 3.1.1 and exported to SPSS version 22 for analysis. Logistic analysis was carried out to check the level of association between adherence to insulin therapy and the independent variables with significance level of 0.05 at 95% confidence interval. RESULTS: 273 respondents were selected with a 100% response rate. Near to one-fourth (24.2%) of the respondents were adherent to their insulin therapy. The study revealed that good knowledge of diabetes mellitus [AOR=6.51; 95% CI [1.58, 26.71], age [>30 years] [AOR=2.63; 95% CI [1.27, 5.42], knowledge regarding insulin self-injection [AOR=4.21; 95%CI [1.06,16.65], favorable attitude towards insulin injection [AOR=2.14; 95% CI [1.04,4.41], free-of-cost insulin therapy [AOR= 4.62, 95% CI [1.06,16.65], having of glucometer at home [AOR= 2.82, 95% CI [1.12,7.09], and being a member of Ethiopian diabetic association [AOR= 5.41, 95% CI [2.31,12.64] were found to significantly affect adherence to insulin therapy. CONCLUSION: Nearly one-fourth of the study participants were adherent to their insulin therapy. Good knowledge and favorable attitude towards insulin injection, good knowledge regarding diabetes mellitus, being a member of the Ethiopian Diabetes Association, age greater than thirty years old, free-of-cost insulin therapy and having glucometer at home were found to be significant predictors of adherence to insulin therapy.

Risk factors of stillbirth among mothers delivered in public hospitals of Central Zone, Tigray, Ethiopia.

BACKGROUND: Stillbirth is a death before the complete expulsion or extraction from the mother. The burden is severe and high in developing countries. Risk factors for stillbirth are not yet studied in Ethiopia. OBJECTIVE: To identify risk factors of stillbirth among mothers delivered in public hospitals of Central Zone Tigray, Ethiopia. METHODS: A case-control study design was used. Data collection period was from January to April 2018. Study subjects 63 cases and 252 controls were selected using systematic random sampling technique from respective hospitals. The interviewer-administered questionnaire, observational, and chart analysis were used to collect the data. A binary logistic regression model was employed. Results were presented at significance level P-value <0.05. RESULTS: Maternal hypertension [AOR=12.83; 95% CI 3.38, 48.83], low birth weight [AOR=5.6; 95% CI 2.39, 13.38], pre-term [AOR=2.6;95%CI 1.12,6.16], alcohol intake [AOR=7.56; 95% CI 1.68, 34.04], polyhydramnios [AOR=13.43; 95% CI 3.63, 49.67], and meconium stained amniotic fluid [AOR=7.88; 95% CI 1.73, 8.18] were risk factors of stillbirth. CONCLUSION: The risk of stillbirth is increased with increasing maternal complication like maternal hypertension, alcohol consumption, polyhydramnios, and meconium-stained amniotic fluid. The occurrence of preterm and low birth weight of the fetus had an effect on the risk of stillbirth.

Nursing documentation practice and associated factors among nurses in public hospitals, Tigray, Ethiopia.

OBJECTIVE: The objective of this study was to investigate documentation practice and factors affecting documentation practice among nurses working in public hospital of Tigray region, Ethiopia. RESULTS: In this study, there were 317 participants with 99.7% response rate. The result of this study shows that practice nursing care documentation was inadequate (47.8%). Inadequacy of documenting sheets AOR = 3.271, 95% CI (1.125, 23.704), inadequacy of time AOR = 2.205, 95% CI (1.101, 3.413) and with operational standard of nursing documentation AOR = 2.015, 95% CI (1.205, 3.70) were significantly associated with practice of nursing care documentation. To conclude, more than half of nurses were not documented their nursing care. Employing institutions should provide training on documentation of nursing care to enhance knowledge and create awareness on nurses' documentation to nursing directors and chief executive officer to access adequate documenting supplies besides employing more nurses.

Determinants of hypertension among diabetic patients in Public Hospitals of the Central Zone, Tigray, Ethiopia 2018: unmatched case-control study.

INTRODUCTION: Hypertension, among diabetic patients, is a worldwide public-health challenge and a leading modifiable risk factor for other cardiovascular diseases. The main purpose of this study was to identify determinants of hypertension among diabetic patients. METHODS: Data were collected from January to March 2018 using an interviewer-administered structured questionnaire. Data collectors and supervisors were trained before the period of data collection. The questionnaire was pretested on 5% of the sample at Suhul hospital. Bivariable logistic regression was employed to examine the crude associations between the outcome variable and determinant variables. This was followed by multivariable analysis to examine the determinants of hypertension among diabetic patients by selecting variables which had p value ≤0.2 in the bivariable analysis. RESULTS: The age range of the respondents was 18-80 years, with the median age of 51.56±14.92 years. Not attending diabetes mellitus education sessions (AOR=2.61, 95% CI (1.12,6.1), duration since diagnosis with diabetes (AOR=8.52; 95% CI (1.97, 36.84), poor glycemic control (AOR=22.99, 95CI (5.92,89.28), overweight (AOR=4.84, 95%CI (1.42,16.51), and non-adherence to diabetes medication (AOR=4.66, 95% CI (2.22,9.79), diet (AOR=9.70,95% CI (3.34,28.22), exercise (AOR= 5.47, 95% CI (2.35,12.75), and self-monitoring blood glucose (AOR=6.62, 95% CI (3.16, 13.86) were found to be the determinants of hypertension among diabetic patients. CONCLUSION: This research concludes that longer duration with diabetes, nonattendance of diabetes education sessions, poor glycemic control, and not-adherence to antidiabetic medications, diet, exercise and self-monitoring blood glucose were found to be the determinants of hypertension among diabetic patients.

Prevalence and associated factors of chronic kidney disease among adult hypertensive patients in Tigray teaching hospitals: a cross-sectional study.

OBJECTIVE: The aim of this study was to assess the prevalence of chronic kidney disease and to identify associated factors of chronic kidney disease among hypertensive patients. A cross-sectional study was conducted among selected 578 hypertensive patients. Data were collected using face to face interviewing questionnaires and from medical chart review. Binary logistic regression analyses were performed and analyzed using SPSS version 23.0. RESULT: Of the total 578 hypertensive patients the prevalence of chronic kidney disease was found to be 128 (22.1%). Of these hypertensive patients, patients with uncontrolled blood pressure, overweight/obesity, dyslipidemia and diabetic mellitus, 43.3%, 33.7%, 27.3% and 28.2 respectively. After adjustment, the independent variables the significant associated factors of chronic kidney disease among hypertensive patients were age [AOR (95% CI 1.43 (1.07-1.81)], uncontrolled hypertension 4.434 [AOR (95% CI 9.45 (1.34, 14.73)], overweight/obese [AOR (95% CI 7.422 (2.72, 20.28)], dyslipidemia [AOR (95% CI) 13.749 (5.69, 33.215)], diabetic mellitus [AOR (95% CI) 2.137 (1.07, 4.26)]. In conclusion, the prevalence of chronic kidney disease was considerably high. The major associated factors of chronic kidney disease were age, uncontrolled hypertension, overweight/obese, diabetic mellitus and dyslipidemia.

Intimate partner physical violence and associated factors in reproductive age married women in Aksum Town, Tigray, Ethiopia 2018, and community based study.

OBJECTIVE: As reports indicated about 1 in 3 of women worldwide have experienced physical violence but there is no enough reports on the current status of the act in Aksum town so this study intended to identify the prevalence and factors associated with physical violence of reproductive age married women in Aksum town Tigray Ethiopia. RESULT: A total of 398 women were enrolled in the study and making a response rate of 100%. 112 (28.1%) women had physical violence in their lifetime. Educational level of women (AOR = 2.2; 95% CI 1.28, 6.7), Occupation of women's (AOR = 3.8; 95% CI 2.32, 12.8), age of husband (AOR = 5.2; 95% CI 2.3, 11.5), husbands having other wife (AOR = 7.8; 95% CI 4.2, 18.9) and husbands having alcohol habits (AOR = 3.8; 95% CI 1.74, 14.7) had significant association with physical violence.

Immediate newborn care of knowledge, practice and associated factors among health care providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018.

OBJECTIVE: The aim of this study was to assess the immediate newborn care of knowledge, practice and associated factors among healthcare providers in Northwestern Zonal health facilities Tigray, Ethiopia, 2018. RESULTS: Among the total healthcare providers, who participated in this study, 64.8% had good knowledge and 59.8% of the respondents had a good level of essential newborn care practice. Unavailability of adequate materials (like guidelines, drug, etc.) and training status were significant variables with knowledge and practice of newborn care.

Effect of ketofol versus propofol as an induction agent on ease of laryngeal mask airway insertion conditions and hemodynamic stability in pediatrics: an observational prospective cohort study.

BACKGROUND: Laryngeal mask airway is a supraglottic airway device which has led to a fundamental change in the management of modern general anesthesia. In the present study; we evaluated the laryngeal mask airway insertion conditions and hemodynamic changes comparing ketamine-propofol mixture (ketofol) with propofol. The study was to compare the ketamine-propofol mixture (ketofol) with propofolon the ease of laryngeal mask airway insertion conditions and hemodynamic effects for induction of general anesthesia. METHODS: One hundred twenty pediatric patients were recruited and assigned to two groups (60 each). Group KP = ketofol, group P = propofol. Insertion conditions were compared using a Chi-square test while hemodynamic variables were compared using the independentt-test. Statistical significance was stated at p-value< 0.05. RESULTS: Laryngeal mask airway insertion summed score was nearly similar between the two groups. Mean blood pressure and heart rate were maintained higher in ketofol group while a significant drop was observed in the propofol group. The time from the Laryngeal mask airway placement to the return of spontaneous ventilation was significantly longer in propofol group (240 s [range = 60-360 s]) compared with ketofol group (180 s [range = 30-320 s]) (p = 0.005). CONCLUSIONS: Laryngeal mask airway insertion condition summed score was comparable in both ketofol and propofol group. Ketofol provided equivalent laryngeal mask airway insertion conditions while maximizing hemodynamics and minimizing apnea time. Ketofol can be used as an alternative to propofol for laryngeal mask airway insertion in pediatrics.

Determinants of hypothermia on neonates admitted to the intensive care unit of public hospitals of Central Zone, Tigray, Ethiopia 2017: unmatched case-control study.

OBJECTIVE: This study aims to identify determinants of hypothermia in neonates in neonatal intensive care unit of public hospitals of Central Zone Tigray, Ethiopia in 2017. RESULTS: A total of 88 cases and 176 controls were included in this study. Ninety-one percent cases and 86.4% controls were in the 1st week of neonate age. Multivariable logistic regression analysis showed that delayed initiation of breastfeeding [AOR = 7.23; 95% CI (2.75, 18.99)], low birth weight [AOR = 8.51; 95% CI (2.71, 26.73)], preterm [AOR = 3.689; 95% CI (1.359, 10.012)], low APGAR score at 5th min [AOR = 3.71; 95% CI (1.57, 8.79)], skin to skin contact [AOR = 6.23; 95% CI (2.523, 15.358)], night time delivery [AOR = 6.25; 95% CI (2.58, 15.12)] and bathed within 24 h [AOR = 10.06; 95% CI (3.86, 26.22)] were independent risk factors of neonatal hypothermia.

Risk factors of preterm birth among mothers who gave birth in public hospitals of central zone, Tigray, Ethiopia: unmatched case-control study 2017/2018.

OBJECTIVE: The aim of the study was to identify the risk factors for preterm birth in public hospitals of the central zone, Tigray, Ethiopia 2017/2018. RESULT: A total of 88 neonates who born preterm (cases) and 176 neonates who born term (controls) with their index mothers were included making a response rate of 100%. About 84/88 (95.5%) mothers in cases and 173/176 (98.3%) in control had antenatal care follow up. Among them, 33 (39.3%) cases and 102 (58%) controls were had antenatal care follow up four times and above. In multiple logistic regression at P-value < 0.05, mothers with ANC follow up less than four [AOR 95% CI 2.15 (1.19, 3.85)], mothers with pregnancy-induced hypertension [AOR 3.245; 95% CI (1.58, 6.67)], multiple pregnancy [AOR 2.47; 95% CI (1.14, 5.33)], fetal distress [AOR 4.0; 95% CI (1.9, 8.2)] and birth defect [AOR 3.19; 95% CI (1.22, 8.34)] were independent risk factors of preterm delivery.

The magnitude of anemia and associated factors among pregnant women attending public institutions of Shire Town, Shire, Tigray, Northern Ethiopia, 2018.

OBJECTIVE: Anemia is a widespread health problem among pregnant women causing maternal/infant morbidity and mortality mainly in low-income countries. Understanding of the magnitude of anemia and related socio-demographic variables in a specific setting would help scale-up preventive and therapeutic measures in a locality. So that this study focuses on the magnitude of anemia and its associated factor among pregnant women attending antenatal care in public hospitals of shire town and using institution based cross-sectional study design on 480 randomly selected study subjects. RESULT: The overall prevalence of anemia was 16.3%. Majority of the participants (52%) have mild anemia (10-10.9 gm/dl). Pregnant mothers with human immunodeficiency virus, intestinal parasitic infection and having lower inter-pregnancy gap were significant predictors of anemia. Preventing infection of the mother during pregnancy and making the gap between pregnancies are necessary.

Risk factors of birth asphyxia among newborns in public hospitals of Central Zone, Tigray, Ethiopia 2018.

OBJECTIVE: The aim of study was to identify risk factors of birth asphyxia among newborns in public hospitals of Central Zone Tigray, Ethiopia 2018. RESULTS: A total of 88 cases and 176 controls were included in the study. Thirty (34.1%) cases and 28 (15.9%) of controls were not able to read and write. Twenty-one (23.9%) cases and 9 (5.1%) controls were had meconium stained on pelvic examination. Multivariable logistic regression analysis showed that maternal illiteracy [AOR = 6; 95% CI (1.51, 23.80)], low birth weight [AOR = 6.9; 95% CI (3.01, 15.81)], preterm [AOR = 2.2; 95% CI (1.022, 4.76)], prim parous [AOR = 3.1; 95% CI (1.51, 6.38)], antepartum hemorrhage [AOR = 12; 95% CI (2.29, 63.11)] and meconium stained amniotic fluid [AOR = 7.88; 95% CI (2.92, 21.29)] were independent risk factors of birth asphyxia.

Consistency of Integrated Management of Newborn and Childhood Illness (IMNCI) in Shire Governmental Health Institution in 2017.

OBJECTIVE: In an effort to reduce infant mortality and morbidity, the World Health Organization and other technical partners developed the Integrated Management of Newborn and Childhood Illness (IMNCI). This study focuses on assessment of consistency and completeness of integrated management of neonatal and child hood illness in primary health care units. RESULTS: A total of 384 cases were taken from 3562 cases both from young infant registration (under-2 month old) and child registration (2 months-5 year old). Out of 384 cases, 241 (62.8%) cases were correctly classified and 143 (37.2%) were incorrect classifications. Similarly 164 (42.7%) cases were treated correctly where as 220 (57.3%) treated incorrectly. Only 95 (24.7%) cases have given appropriate appointments where as 289 (75.3%) cases were appointed incorrectly. The overall consistency of IMNCI management is poor. Unless continuous follow up of and training was given, children are not treated as expected. More over using electronic method of IMNCI may alleviate the problem.

Prevalence of intestinal helminths and associated factors among school children of Medebay Zana wereda; North Western Tigray, Ethiopia 2017.

OBJECTIVE: To assess the prevalence of intestinal helminth infections and associated factors among primary school children of Medebay Zana wereda, a northwestern zone of Tigray, northern Ethiopia from March to April 2017. RESULT: The prevalence of intestinal helminths was 12.7%. The highest prevalence of intestinal helminth infections was observed in the age group of 11-14 years old and the most prevalent helminths species were Schistosoma mansoni. Mothers' level of education [AOR = 0.27 [0.13-0.58]], place of defecation [AOR = 2.63, 95% CI 1.14-6.02]], hand wash before meals [AOR = 9.0, 95% CI 3.72-21.74]], hand wash after defecation [AOR = 5.77 [1.78-18.63]] and eating unwashed vegetables [AOR = 5.67 [2.19-14.73]] were associated with higher risk of having intestinal helminths detected in stool. In the study area the risk of detecting intestinal helminths in their stool were more associated the improper personal hygiene of the children.

Magnitude of diabetes self-care practice and associated factors among type two adult diabetic patients following at public Hospitals in central zone, Tigray Region, Ethiopia, 2017.

OBJECTIVE: Self-care practice in type two diabetes is a critical factor to keep the disease under control. Despite the important role of self-care practices in management of diabetes were recognized to be useful and effective in achieving diabetes control and preventing its complication, findings of previous studies in Ethiopia were confirmed that, aspects of self-care practices were more problematic. So that this study focus on magnitude of self-care practice and associated factors among diabetic patients. RESULTS: Among the total 284 respondents, their mean age was 52.19 years and about 178 (62.7%) had poor diabetic self-care practice. Having glucometer at home (AOR = 3. 719 [1.700, 8.139]), knowing fasting glucose level (AOR = 2. 709 [1.481, 4.957]), attending diabetic education (AOR = 2. 487 [2.027, 6.020]), perceived benefit (AOR = 2. 422 [1.374, 4.269]), perceived barrier (AOR = 0. 471 [0.265, 0.394]), and self-employment (AOR = 5. 936 [1.965, 17.936]) were significantly associated with good self-care practice.