Art Therapy in Burn Cases: A Review and Case Examples.

ABSTRACT: In this article, we provide an overview of the literature on contributions of art making and medical art therapy for patients with burn injuries. The potential value of art therapy in addressing the complex physical and psychosocial needs of burn patients is discussed through examination of 7 peer-reviewed articles. Two case examples of burn survivors, 1 pediatric and 1 adult, are included to demonstrate the use of art therapy in an inpatient and outpatient setting, respectively. Art therapy and other intervention strategies for overall psychosocial adjustment of burn patients are often underutilized. Further research in art therapy is needed to examine the psychosocial aspects of burns patients and the potential role that medical art therapy may have in a burn care center.

Magnitude of postpartum depression and associated factors among women in Mizan Aman town, Bench Maji zone, Southwest Ethiopia.

BACKGROUND: The first 12 months after childbirth may represent a high-risk time for depression. In Ethiopia there is a paucity of evidence about its magnitude and associated factors during that period. So, the aim of this study was to assess the magnitude of depression and associated factors among postpartum women in Mizan Aman town, Bench Maji Zone, Southwest Ethiopia 2017. METHODS: A community based cross- sectional study design was employed from March 15 to April 15, 2017. Four hundred sixty women were selected using multistage random sampling technique. Face to face interview were conducted using structured questionnaires and standardized scales. Bivariate logistic regression analysis was done to see crude association between each independent variable and outcome variable. Variables with p value < 0.25 in bivariate analysis were entered to multivariable logistic regression analysis to control for confounding. Adjusted odd ratios with 95%CI were calculated to identify independent predictors of postpartum depression. RESULT: Four hundred fifty-six postpartum women participated in the study giving a response rate of 99%. The magnitude of postpartum depression among the study population was 102 (22.4%, 95% CI: 19.84-24.96). Postpartum depression is relatively higher in the first 6 weeks after birth. Postpartum depression is higher among mothers with age range between 18 and 23 years (aOR 3.89 95%CI: 1.53-9.90), unplanned pregnancy (aOR 3.35 95% CI: 1.701-6.58), child having sleeping problems (aOR 3.72 95%CI: 1.79-7.72), domestic violence (aOR 2.86 95%CI 1.72-8.79), unsatisfied marital relation (aOR 2.72 95% CI 1.32-5.62), poor social support (aOR 4.30 95% CI 1.79-10.30), history of previous depression (aOR 7.38 95% CI 3.12-17.35) and substance use (aOR 5.16 95% CI 2.52-10.60). CONCLUSION: The magnitude of postpartum depression was high. This underlines health care planners' needs to incorporate screening strategies for depression following childbirth.

Knowledge and attitude of health extension workers regarding mental health problems in Jimma Zone, Ethiopia: a cross-sectional study.

OBJECTIVE: Health extension workers' (HEWs') knowledge and attitude regarding mental health problems are vital for integrating mental healthcare into primary healthcare services. However, information in this context is scarce in Ethiopia. So, this study aimed to assess HEWs' knowledge and attitude towards mental health problems in Jimma, Ethiopia. DESIGN: A cross-sectional study. SETTING: Five districts in Jimma Zone, Ethiopia, 2020. PARTICIPANTS: A total of 259 HEWs working in selected five districts were included in the study. OUTCOME: The knowledge and attitude status of HEWs towards mental health problems. RESULTS: Nearly half of the respondents had inadequate knowledge (122,47.1%) and an unfavourable attitude (125, 48.3%). Most (139, 53.7%) described mental illness as due to evil spirits' possession. Almost all (240, 92.7%) of the respondents reported talking or laughing alone as a manifestation of mental illness. Almost two-thirds (157, 60.6%) of the respondents reported people with mental illness are dangerous. About a quarter (63, 24.3%) of the participants stated witch doctors should manage mental illnesses. CONCLUSIONS: A significant proportion of the study respondents had poor knowledge and attitude towards mental health problems. Short-term and long-term mental health training is needed to improve their perception level and to provide effective community mental health services.

Barriers and Facilitators for Implementing Mental Health Services into the Ethiopian Health Extension Program: A Qualitative Study.

PURPOSE: The Ethiopian Ministry of Health has integrated mental health services into the community health service, but it has not yet been implemented. Therefore, this study aimed to explore the barriers and facilitators of mental health service implementation in the Ethiopian community health program. METHODS: A qualitative case study was conducted in the Ethiopian primary health care system in 2019. We have conducted about eight key informant interviews with policymakers, service managers, and service providers. The interviews were tape-recorded, transcribed, translated, and analyzed manually using the World Health Organization building blocks framework. RESULTS: The Health Ministry of Ethiopia has recently included mental health services into the health extension package but not yet implemented as part of integrated services. The identified barriers were low political commitment, shortage of resources, non-functional referral system, lack of interest from private health service organizations, attitudinal problems from both the society and service providers, and lack of consistent reporting system of the mental health problems. However, the well-designed primary health care system, trained health extension workers, changing political commitment and attitude of the community could facilitate the mental health service implementation. CONCLUSION: A series of activities are expected, especially from the healthcare system managers to implement, follow, and evaluate mental health services implementation at the health extension programs.

Knowledge of the community regarding mental health problems: a cross-sectional study.

BACKGROUND: Knowledge of the community regarding mental health problems has a remarkable impact on the attitude, the help-seeking path, and prevention of stigma and discrimination against patients with mental health problems. It is also the cornerstone for designing evidence-based community mental health interventions. However, the evidence is scarce in developing countries like Ethiopia. This study aimed to assess the knowledge regarding mental health problems and associated factors among communities of Jimma Zone, Oromia, Ethiopia. METHODS: A community-based cross-sectional study was conducted in the Jimma zone from March 1 to 22, 2020. A structured, pretested, and interviewer-administered questionnaire was used to collect data from 420 study participants selected through a systematic sampling technique. The knowledge about mental health was measured by the adapted version of the Mental Health Knowledge Schedule tool. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Multivariate logistic regression analysis was done, and p-value < 0.05 and 95% CI were used to determine the predictors of the outcome variable. RESULTS: The overall knowledge score showed (188, 44.8%) of the respondents had inadequate knowledge. Moreover, (75, 17.9%) of the respondents reported psychiatric disorders are contagious, and (138, 32.9%) mentioned leaving alone is the treatment for mental illness. Talking or laughing alone and showing strange or unusual behaviors were described as symptoms of mental illness by the majority (407, 96.9%) and (403, 96.0%) of respondents, respectively. Brain dysfunction was attributed to the cause of mental illness by most (390, 92.9%) of the study participants. Similarly, the percentage of responses that attributed the causes of mental illness to possession by an evil spirit, God's punishment, and witchcraft were significantly high (368, 87.6%), (321, 76.4%) and (259, 67.1%), respectively. Furthermore, regression analysis showed that respondents who were able to read and write were 64% less likely to have adequate knowledge than those in secondary school and above educational status (AOR = 0.34, 95% CI (0.16-0.69)). CONCLUSION: Knowledge of mental illness among the general public was relatively poor and higher levels of education were associated with good knowledge of mental health problems; this suggests the need for due emphasis on public education to improve the mental health literacy status of the community.

Mood Symptoms, Suicide, and Associated Factors Among Jimma Community. A Cross-Sectional Study.

Background: The global burden of mental health problems is high and is predicted to rise. At present, mood symptoms are the foremost common psychological problems worldwide, yet little is known regarding their magnitude and associated factors in developing countries. Therefore, this study aimed to assess the magnitude and associated factors of anxiety, depressive, manic symptoms, and suicidal behavior among the rural Jimma community, Ethiopia. Methods: A community-based quantitative cross-sectional survey was employed on 423 households selected through systematic random sampling. An adapted version of the Mini International Neuropsychiatric Interview tool was used for the structured face-to-face interview. The collected data were checked for completeness, coded, and inserted into Epi Data version 3.1 and exported to SPSS version 23 for analysis. Variables with P < g0.05 and odds ratio (OR) [95% confidence interval (CI)] on multivariate logistic regression analysis were considered as factors associated with the outcome variable. Results: Overall, 185 (44.0%), 55 (13.1%), 44 (10.5%), and 23 (5.5%) of the respondents had anxiety, depressive, manic symptom, and suicide behavior, respectively. The odds of having anxiety symptoms were nearly 5 times higher among those who had perceived discrimination and racism experience compared to their counterpart [adjusted OR (AOR), 5.02; 95% CI, 1.90-13.26]. Likewise, recently bereaved participants had 4-fold higher odds of reporting depressive symptoms (AOR, 3.9; 95% CI, 1.4-10.4) than the non-bereaved ones. Furthermore, respondents who had depressive symptoms were almost four and a half times more likely to have manic symptoms compared to those who did not (AOR, 4.3; 95% CI, 1.71-11.02). Conclusion: Anxiety, depressive, manic symptoms, and suicidal behavior were prevalent in the community and positively associated with multiple psychosocial factors. Implementing accessible and affordable community-based mental health services is recommended to mitigate the problems.

Prevalence and Factors Associated with Depression among HIV/AIDS-Infected Patients Attending ART Clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia.

BACKGROUND: HIV is a chronic life-threatening illness and, like other similar chronic and stigmatizing illnesses, can be stressful to manage. Depression is a common mental health problem that deteriorates the quality of life of people with HIV/AIDS and found to be a strong predictor for noncompliance to antiretroviral therapy treatment. Therefore, epidemiological evidence on the factors associated with depression among patients with HIV/AIDS can contribute towards effective and efficient preventive health care strategies for this population. OBJECTIVES: To assess the prevalence and factors associated with depression among HIV/AIDS-infected patients attending ART clinic at Jimma University Medical Center, Jimma, Southwest Ethiopia, in 2018. METHODS: This study followed an institution-based cross-sectional quantitative study design. A simple random sampling method yielded 303 participants who were interviewed from April to May 2018, using a pretested questionnaire, followed by their card review. The SPSS version 23 was used for bivariate analysis which was used to find out the significance of association. Variables that showed association in bivariate analysis at p value < 0.25 were entered to multivariable logistic regressions to control for confounders, and the significance of association was determined by 95% confidence interval and p value < 0.05. RESULTS: The point prevalence of depression was 94 (31%). Variables like sex (AOR = 0.510 (95%CI = 0.264-0.986)), marital status (AOR = 3.610 (95%CI = 1.649-7.901)), opportunistic infection (AOR = 3.122 (95%CI = 1.700-5.733)), and medication adherence (AOR = 0.470 (95%CI = 0.266-0.831)) were significantly associated with depression. Conclusion and Recommendation. From the findings of this study, it is possible to conclude that depression was highly prevalent among people living with HIV/ADS. Sex, marital status, opportunistic infection, and medication adherence were found to be associated with depression and need attention from the health professional working in the ART clinic.

Attitude and help-seeking behavior of the community towards mental health problems.

BACKGROUND: Community attitude towards mental health problems and help-seeking behavior plays a major role in designing effective community based mental health interventions. This study aimed to assess the attitude, help-seeking behavior, and associated factors of the Jimma zone community towards mental health and mental health problems. METHODS: A community-based cross-sectional study design was employed. A respondent from each of the 423 systematically selected households was interviewed using a pretested, structured, and interviewer-administered questionnaire. Accordingly, a community's attitude towards mental health problems was measured by the adapted version of the "Community Attitude towards Mentally Ill questionnaire (CAMI)" and help-seeking behavior was measured by a general help-seeking questionnaire. Data were entered into Epi-data version 3.1 and exported to SPSS version 23.0 for analysis. Bivariate and multivariate logistic regression analysis was done to determine the independent predictors of the outcome variable. RESULTS: Among the total 420 study participants (197,46.9%) of them had an overall unfavorable attitude towards mental illness. The majority (153,36.4%) of the study participants agreed on avoidance of anyone who has mental health problems and (150,35.7%) participants described marrying a person with a mental health problem or recovered from the problem is foolishness. Moreover, regression analysis showed family monthly income (AOR = 0.24, 95%CI:0.06-0.91) and occupational status (AOR = 0.57, 95%CI:0.34-0.96) were found to be the predictors of community attitude towards mental health problems. The study finding also revealed a significant number of the respondents preferred non- medical treatment approaches. CONCLUSION: Almost half of the respondents had an unfavorable attitude towards mental health problems and the traditional and religious help-seeking intention was high. This suggests the need for designing effective community based mental health interventions to improve the general public attitude and help-seeking behavior towards mental health problems.

Is There Association between Risky Sexual Behaviors and Depression Symptoms among Youth? A Case of Jimma University Students, Ethiopia.

BACKGROUND: Risky Sexual Behaviors (RSB) and Depression symptoms expose young people to various reproductive health problems including sexually transmitted infections and HIV/AIDS. To date the link between these two major public health problems lacks empirical evidence in the context of higher education institutions in Ethiopia. OBJECTIVE: The aim of this study was to assess association between risky sexual behavior and depression symptoms among Jimma University main campus students, Jimma, Ethiopia, 2016. METHODS: An institution based quantitative cross sectional study was conducted. A pre-tested questionnaire and modified Beck Depression Inventory II were administered to 700 students, selected by multi-stage stratified sampling, from the main campus of Jimma University. Descriptive statistics, simple and multiple logistic regression models were used to analyze possible confounders. Presence of crude association between the dependent and independent variables was detected by bivariate logistic regression analysis. Variables with p value < 0.25 in bivariate analysis were analyzed by multivariable logistic regression to exclude the confounders. Adjusted odd ratios with 95%CI were computed to examine depression symptoms and other independent variables as predictors of RSB. RESULTS: RSB were reported by 30.2% students. Out of 222 (33.6%) students with depression symptoms 105 (47.3%) reported RSB. Students with moderate depression symptoms are nearly two times more likely to experience risky sexual behavior than students with no depression symptoms (AOR 1.9, 95% CI: 1-3.1). Students with severe depression symptoms are nearly two and half times more likely to experience RSB than students with no depression symptoms counterparts (AOR 2.6, 95%CI: 1.3- 5.1). CONCLUSION: RSB were high among students with depression symptoms in the main campus of Jimma University. To help students overcome the challenges, recommendation was given for concerted action from the University, governmental and NGO, and the surrounding community to establish support services and various reproductive and mental health awareness programs within the campus.

Evaluation of a multistate faith-based program for children affected by natural disaster.

OBJECTIVES: To systematically evaluate Camp Noah, a faith-based intervention for children affected by natural disaster: to assess the extent to which the camps were carried out according to the program design, to describe how the Camp Noah program was implemented, and to explore Camp Noah program effects on children. DESIGN: Qualitative survey. SAMPLE: Twenty-eight local, state, and national stakeholders. MEASUREMENT: Open-ended interviews. RESULTS: Although camps adhered to the curriculum, many implementation weaknesses resulted from a lack of clear program structure and written procedures. Stakeholders observed that children generally were able to process their disaster experiences in the camp, and some children exhibited increased understanding of God's role in their disaster experience. Stakeholders also described parent reports of increased coping skills related to weather among some children. Lastly, stakeholders both observed positive effects of Camp Noah on children's behaviors and symptoms and described changes reported to them by parents. CONCLUSIONS: Every year, thousands of children suffer emotionally as a result of natural disaster in the United States. With public health nursing support and improvements in infrastructure, Camp Noah may be a promising intervention to address this important public health problem.