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1.
BMC Health Serv Res ; 23(1): 96, 2023 Jan 28.
Artigo em Inglês | MEDLINE | ID: mdl-36709274

RESUMO

BACKGROUND: There is a sharp contradiction between the supply and demand of medical resources in the provincial capitals of China. Understanding the spatial patterns of medical resources and identifying their spatial association and heterogeneity is a prerequisite to ensuring that limited resources are allocated fairly and optimally, which, along with improvements to urban residents' quality of life, is a key aim of healthy city planning. However, the existing studies on medical resources pattern mainly focus on their spatial distribution and evolution characteristics, and lack the analyses of the spatial co-location between medical resources from the global and local perspectives. It is worth noting that the research on the spatial relationship between medical resources is an important way to realize the spatial equity and operation efficiency of urban medical resources. METHODS: Localized colocation quotient (LCLQ) analysis has been used successfully to measure directional spatial associations and heterogeneity between categorical point data. Using point of interest (POI) data and the LCLQ method, this paper presents the first analysis of spatial patterns and directional spatial associations between six medical resources across Wuhan city. RESULTS: (1) Pharmacies, clinics and community hospitals show "multicentre + multicircle", "centre + axis + dot" and "banded" distribution characteristics, respectively, but specialized hospitals and general hospitals present "single core" and "double core" modes. (2) Overall, medical resources show agglomeration characteristics. The degrees of spatial agglomeration of the five medical resources, are ranked from high to low as follows: pharmacy, clinic, community hospital, special hospital, general hospital and 3A hospital. (3) Although pharmacies, clinics, and community hospitals of basic medical resources are interdependent, specialized hospitals, general hospitals and 3A hospitals of professional medical resources are also interdependent; furthermore, basic medical resources and professional medical resources are mutually exclusive. CONCLUSIONS: Government and urban planners should pay great attention to the spatial distribution characteristics and association intensity of medical resources when formulating relevant policies. The findings of this study contribute to health equity and health policy discussions around basic medical services and professional medical services.


Assuntos
Hospitais Gerais , Qualidade de Vida , Humanos , Cidades , Hospitais Especializados , Hospitais Comunitários , China
2.
Artif Intell Med ; 135: 102456, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36628791

RESUMO

This study mainly aims to develop two effective and practical multi-criteria group decision-making approaches by taking advantage of the ground-breaking theory of PROMETHEE family of outranking methods. The presented variants of Preference Ranking Organization Method for Enrichment Evaluation (PROMETHEE) method are acknowledged to address the complex decision-making problems carrying the ambiguous information, expressible in terms of yes, no, abstinence and refusal, owing to the preeminent condition and wider structure of spherical fuzzy sets. Both of the proposed approaches seek help from the Shannon's entropy formula to evaluate the object weights of the decision criteria. The proposed techniques operate by taking into account the deviation between each pair of potential alternatives in accordance to different types of preference functions to determine the preference indices. The proposed technique of spherical fuzzy PROMETHEE I method carefully compares the positive and negative outranking flows of the alternative to get partial rankings. In contrast, the spherical fuzzy PROMETHEE II method has the edge to eliminate the incomparable pair by employing the net outranking flow to derive the final ranking. The application of proposed approaches is explained via a case study in the field of medical concerning the selection of appropriate site to establish Fangcang shelter hospital in Wuhan to treat COVID-19 patients. The convincing comparisons of the proposed methodologies with q-rung orthopair fuzzy PROMETHEE and spherical fuzzy TOPSIS methods are also included to verify the aptitude of the proposed methodology.


Assuntos
COVID-19 , Lógica Fuzzy , Humanos , Hospitais Especializados , Unidades Móveis de Saúde , Tomada de Decisões
3.
Front Public Health ; 10: 1038296, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36466516

RESUMO

Background: The COVID-19 pandemic had a major impact on people's mental health. As the SAS-Cov-2 evolves to become less virulent, the number of asymptomatic patients increases. It remains unclear if the mild symptoms are associated with mild perceived stress and mental illness, and the interventions to improve the mental health of the patients are rarely reported. Methods: This cross-sectional study investigated the level of depression, anxiety and perceived stress of 1,305 COVID-19 patients who received treatment in the Fangcang shelter hospitals in Shanghai, China. Network analysis was used to explore the relationship among depression, anxiety and perceived stress. Results: The prevalence of depression, anxiety and perceived stress in the patients with Omicron infection were 9.03, 4.60, and 17.03%, respectively, lower than the prevalence reported during the initial outbreak of COVID-19. "Restlessness (A5)," "Uncontrollable worry (A2)," "Trouble relaxing (A4)" and "Fatigue (D4)" had the highest expected influence values. "Irritability (A6)" and "Uncontrollable (S1)" were bridge symptoms in the network. Comparative analysis of the network identified differences in the network structures between symptomatic and asymptomatic patients. Conclusion: This study investigated the prevalence of depression, anxiety and perceived stress and the correlation among them in Omicron-infected patients in Fangcang shelter hospital, in Shanghai, China. The core symptoms identified in the study provide insight into targeted clinical prevention and intervention of mental health in non-severe Omicron-infected patients.


Assuntos
COVID-19 , Saúde Mental , Humanos , COVID-19/epidemiologia , Estudos Transversais , Hospitais Especializados , Pandemias , China/epidemiologia , Unidades Móveis de Saúde
4.
PLoS One ; 17(12): e0279245, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36525442

RESUMO

BACKGROUND: The coexistence of diabetes mellitus and hypertension is a worldwide public health problem causing significant morbidity, mortality, and decreased quality of life. Despite the increasing burden of hypertension among patients with DM, data on determinants of hypertension among patients with DM in the Amhara region of Ethiopia is scarce. Hence, this study identified determinants of hypertension among people with diabetes attending chronic disease follow-up clinics in the Amhara region of comprehensive specialized hospitals in Ethiopia. METHOD AND MATERIALS: An institutional-based unmatched case-control study was conducted among 470 individuals with diabetes in the Amhara region's comprehensive specialized hospitals (Debre Berhan, Felege Hiwot, and Dessie Comprehensive specialized hospital). A multistage sampling technique was used to select participants for this study. We collected the data using standard questionnaires (short form of international physical activity questionnaire, Morisky medication adherence scale, patient health questionnaire, perceived dietary adherence scale, Oslo social support questionnaire, and alcohol use disorder identification test), physical measurements, and data extraction checklists. A multivariable binary logistic regression was fitted to identify determinants of hypertension, and we presented the findings using an adjusted odds ratio (AOR) with a 95% confidence interval (CI). RESULTS: 235 cases and 235 controls participated in this study. The median (IQR) age for the cases was 60 (52-66 = 14), and the mean age (± SD) for the controls was 51.72 (± 12.51). The significant determinants of hypertension with AOR [95% CI] were a lower level of physical activity: 1.82 [1.00, 3.31], depression: 2.00 [1.24, 3.21], family history of hypertension: 2.13 [1.34, 3.37], not having diabetic health education: 1.87 [1.18, 2.96], a longer duration of diabetes: 1.99 [1.05, 3.79], and poor glycemic control: 1.57 [1.01, 2.45]. CONCLUSION: In this study, determinants that increase the risk of hypertension among people with diabetes mellitus were older age, physical inactivity, depression, family history of hypertension, not having diabetic health education, a longer duration of diabetes, and poor glycemic control.


Assuntos
Diabetes Mellitus , Hipertensão , Humanos , Estudos de Casos e Controles , Etiópia/epidemiologia , Qualidade de Vida , Fatores de Risco , Hipertensão/complicações , Hipertensão/epidemiologia , Diabetes Mellitus/epidemiologia , Hospitais Especializados
5.
BMJ Open ; 12(11): e066215, 2022 11 18.
Artigo em Inglês | MEDLINE | ID: mdl-36400726

RESUMO

OBJECTIVE: The study was aimed to determine the prevalence and contributing factors of insomnia among patients with bronchial asthma. DESIGN: A multicentre cross-sectional survey was used. SETTING: This study was carried out from January to March 2022 in three university comprehensive specialised hospitals in Northwest Ethiopia. PARTICIPANTS: 422 patients with bronchial asthma were approached of which 93.8% completed the survey. OUTCOMES: The degree of asthma control and the severity of insomnia were evaluated using the Asthma Control Test and Insomnia Severity Index (ISI), respectively. The characteristics of the participants were presented, arranged and summarised using descriptive statistical analysis, and correlations between predictors and outcome variables were examined using logistic regression. The cut-off point was a p value of 0.05. RESULTS: Participants' ages ranged from 33.6 to 65.2 years on average. Just under three-fourths (71.4%) of the participants had at least one episode of insomnia as per the ISI measurement (score ≥10). The odds of insomnia episodes were about 5.4 and 1.93 times higher in patients with uncontrolled asthma and partially controlled asthma status, with adjusted OR (AOR)=5.4 (95% CI 4.4 to 6.79, p<0.001) and AOR=1.93 (95% CI 1.21 to 4.11, p<0.001), respectively. CONCLUSION: Insomnia episodes were substantially higher in bronchial patients with asthma. Insomnia is accompanied by asthma severity, and uncontrolled asthma and partially controlled asthma status are the two most determining factors for experiencing sleep disturbance. Furthermore, a prospective follow-up study must determine the real association found between insomnia and asthma control.


Assuntos
Asma , Distúrbios do Início e da Manutenção do Sono , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/complicações , Estudos Transversais , Prevalência , Etiópia/epidemiologia , Universidades , Seguimentos , Estudos Prospectivos , Asma/complicações , Asma/epidemiologia , Hospitais Especializados
6.
PLoS One ; 17(11): e0277254, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36346804

RESUMO

BACKGROUND: More than one-third of reproductive aged women in Ethiopia use hormonal contraceptives to prevent conception. The present study aimed to compare the hematological parameters of reproductive-age women taking hormonal contraceptives at the University of Gondar Comprehensive Specialized Referral Hospital, Northwest Ethiopia in 2021. METHODS: A comparative cross-sectional study was conducted from April to June 2021. A total of 240 study participants were recruited by using a consecutive sampling technique. Data on socio-demographic variables and clinical data were collected through face-to-face interviews using a structured questionnaire and medical record reviews, respectively. Three milliliter venous blood was collected for complete blood count analysis using Unicel DxH 800 coulter hematology analyzer. Data was entered into Epi-data 4.4.3.1 version then exported to IBM SPSS v25 for analysis. Kruskal-Wallis H, Dunn-Bonferroni pairwise comparison test, and Spearman's correlation analysis were used for inferential statistics. P<0.05 were considered statistically significant. RESULT: The median and interquartile range of platelet count among combined oral contraceptive users was 285(238-332) which is significantly higher than that of depot medroxyprogesterone acetate users 246(220-226) (p = 0.010), implant user 247(221-297) (p = 0.034), and controls 256(224-278) (p = 0.015). The result also showed long-term use of implant negatively correlated with red blood cell count (p = 0.033). CONCLUSION: This finding concludes that combined oral contraceptive users had a higher platelet counts than controls while long-term use of implants can result in low red blood cells count. Therefore, a baseline evaluation of complete blood count in women desiring contraceptive methods would also be recommended.


Assuntos
Anticoncepcionais Orais Combinados , Hospitais Especializados , Humanos , Feminino , Adulto , Estudos Transversais , Etiópia , Encaminhamento e Consulta
7.
BMC Public Health ; 22(1): 2203, 2022 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-36443723

RESUMO

OBJECTIVE: To explore the psychological experience of Juvenile patient's parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic. METHODS: A qualitative study was conducted by using a phenomenological research method. Sixteen parents of juvenile patients with COVID-19 were recruited from National Exhibition and Convention Center (Shanghai, China) Fangcang shelter hospital (FSH) using purposive sampling. Data were collected by face-to-face in-depth interviews over 27 days, from April 9 to May 6, 2022. The interview data were analyzed using Colaizzi seven-step analysis method. RESULTS: The psychological experiences of the parents of juvenile patients in the Fangcang shelter hospital were summarized into three themes: "perception regarding the FSH", "worried about the unmet needs of juvenile patients ", and "the psychological burden after discharge". These themes were classified into 9 sub-themes, including the acceptance of FSH, adaptability to FSH, concerns about cross-infection in the FSH, special needs of infants and young children, psychological needs of preschool children, the learning demands of school-age children, concern about re-positive, fear of sequelae, worry about social acceptance. CONCLUSION: Juvenile patients and their parents in the Fangcang shelter hospitals have both positive and negative experiences. It is suggested that facilities for minors should be planned in advance. Humanistic care for adolescent patients and health education for the public are also critical.


Assuntos
COVID-19 , Adolescente , Lactente , Pré-Escolar , Humanos , COVID-19/epidemiologia , Hospitais Especializados , Pandemias , China/epidemiologia , Unidades Móveis de Saúde , Hospitais , Pais , Hormônio Foliculoestimulante
8.
Front Public Health ; 10: 1054313, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36438303

RESUMO

Background: The global health has been affected by the COVID-19 pandemic persistently, of which Omicron is currently the predominant variant. However, the impact of vaccination on Omicron remained uncertain. Objective: This study sought to explore the effect of vaccination on patients infected with Omicron. Methods: A retrospective observational cohort was conducted in the largest Fangcang shelter hospital in Shanghai from April 1 to May 30, 2022. The demographics, length of hospital stay, clinical symptoms, the comorbidities and vaccination status were recorded. Clinical outcomes of the vaccinated and non-vaccinated groups were compared and analyzed. Results: Of the 3,119 patients who fulfilled the eligibility criteria and were enrolled in the study, 2,226 (71.4%) patients had received nCoV-19 vaccine while 893 (28.6%) patients had not received it before admission. Patients in the vaccinated group had significantly shorter length of hospital stay than those in the unvaccinated group (15.48 ± 2.708 vs. 15.85 ± 3.102, p < 0.001). More asymptomatic patients were observed in the vaccinated group than the non-vaccinated (70.4 vs. 64.5%, p < 0.001). Further subgroup analysis demonstrated that the older the age, the more significant the difference was (p < 0.005). Conclusions: Vaccination was associated with a significant reduction in the severity of Omicron infection compared with no vaccination. Vaccination appears to make Omicron-infected people with milder symptoms than unvaccinated people. This suggests the potential effectiveness of current vaccines against Omicron.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Estudos Retrospectivos , Pandemias , Hospitais Especializados , Unidades Móveis de Saúde , China/epidemiologia
9.
PLoS One ; 17(10): e0275366, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36240137

RESUMO

BACKGROUND: Respiratory distress syndrome (RDS) is caused by a deficiency of a molecule called surfactant. It occurs in newborns born before 37 weeks of gestation. It is a main cause of morbidity and mortality in the early neonatal period. Therefore, this study aims to assess median time to recovery and predictors of preterm neonates with respiratory distress syndrome admitted in University of Gondar comprehensive specialized hospital Northwest Ethiopia 2020. METHODS: Institution based retrospective follow up study was conducted on 386 preterm neonates with hyaline membrane disease who were admitted in the neonatal intensive care unit from January, 2016 to December 2018. The data were entered in to EPI info version 7.0 and transferred to Stata version 14.0 for analysis. Both bi-variable and multi variable Weibull parametric model were fitted to identify predictors with 95% confidence interval of hazard ratio (HR) and p-value. P-value less than 0.05 in the multivariable model showed the presence of significant association between covariates and the dependent variable. RESULTS: The overall median length of recovery were 11 day with an interquartile range of (7, 16) neonate-days. Being a product of multiple pregnancy (AHR 1.67; 95%CI (1.25, 2.23)), vaginal mode of delivery (AHR 1.6; 95%CI (1.13, 2.26)), and neonatal hypothermia at admission (AHR 1.6; 95%CI (1.13, 2.26)) were found to be significant predictors of time to recovery. CONCLUSION: In this study the median time to recovery of preterm neonates with respiratory distress syndrome was slower than the clinical recommendations. Receiving bag and mask ventilation and hypothermia decreased the recovery whereas, vaginal delivery gestational age at birth, being multiple pregnancy, birth weight ≥2000grams were enhance the recovery of preterm neonates with RDS.


Assuntos
Hipotermia , Síndrome do Desconforto Respiratório do Recém-Nascido , Etiópia/epidemiologia , Feminino , Seguimentos , Hospitais Especializados , Humanos , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Estudos Retrospectivos , Tensoativos
10.
PLoS One ; 17(10): e0275171, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36201488

RESUMO

BACKGROUND: Breast cancer is the leading cancer among women with an annual crude incidence of 27.4 per 100,000 in Ethiopia. The aims of this study were to (a) estimate the unit cost of breast cancer treatment for the standard Ethiopian patient, (b) identify the cost drivers, (c) project the total cost of breast cancer treatment for the next five years, and (d) estimate the economic burden of the disease in the main specialized tertiary hospital-Tikur Anbessa Specialized Hospital (TASH) Addis Ababa. METHODS: Primary data were collected from health and non-health professionals. Secondary data were collected from patient`s charts and official reports from various national and international organisations including data from TASH. To establish work-time estimates, we asked professionals on their time usage. RESULT: A total of US$ 33,261 was incurred to treat 52 Addis Ababa resident female breast cancer patients in TASH between July 2017 and June 2019. The unit cost of treatment for a hypothetical breast cancer patient to complete her treatment was US$ 536 for stage I and US$ 705 for stage II and III using the existing infrastructure. This cost increased to US$ 955 for stage I and US$ 1157 for stage II and III when infrastructure amortization was considered. The projected total costs of breast cancer treatment in TASH is between US$ 540,000 and US$ 1.48million. However, this will increase to US$ 870,000 and US$ 2.29 million when the existing fixed assets are changed. CONCLUSION: The economic burden of breast cancer treatment is high compared to the economic status of the country. Thus, it is recommended that TASH should revise its charges and breast cancer should be included in the Social and Community based health insurance scheme. JEL classification: H51, H75, I18, P46.


Assuntos
Neoplasias da Mama , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/terapia , Etiópia/epidemiologia , Feminino , Custos de Cuidados de Saúde , Hospitais Especializados , Humanos , Fatores Socioeconômicos
11.
PLoS One ; 17(10): e0274464, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36201533

RESUMO

BACKGROUND: Immune hemolytic anemia commonly affects human immune deficiency infected individuals. Among anemic HIV patients in Africa, the burden of IHA due to autoantibody was ranged from 2.34 to 3.06 due to drug was 43.4%. IHA due to autoimmune is potentially a fatal complication of HIV which accompanies the greatest percent from acquired hemolytic anemia. OBJECTIVE: The main aim of this study was to determine the magnitude and associated factors of immune hemolytic anemia among human immuno deficiency virus infected adults at university of Gondar comprehensive specialized hospital north west Ethiopia from March to April 2021. METHODS: An institution-based cross-sectional study was conducted on 358 human immunodeficiency virus-infected adults selected by systematic random sampling at the University of Gondar comprehensive specialized hospital from March to April 2021. Data for socio-demography, dietary and clinical data were collected by structured pretested questionnaire. Five ml of venous blood was drawn from each participant and analyzed by Unicel DHX 800 hematology analyzer, blood film examination and antihuman globulin test were performed to diagnosis of immune hemolytic anemia. Data was entered into Epidata version 4.6 and analyzed by STATA version 14. Descriptive statistics were computed and firth penalized logistic regression was used to identify predictors. P value less than 0.005 interpreted as significant. RESULT: The overall prevalence of immune hemolytic anemia was 2.8% (10 of 358 participants). Of these 5 were males and 7 were in the 31 to 50 year age group. Among individuals with immune hemolytic anemia, 40% mild and 60% moderate anemia. The factors that showed association were family history of anemia (AOR 8.30 at 95% CI 1.56, 44.12), not eating meat (AOR 7.39 at 95% CI 1.25, 45.0), and high viral load 6.94 at 95% CI (1.13, 42.6). CONCLUSION AND RECOMMENDATION: Immune hemolytic anemia is less frequent condition in human immunodeficiency virus infected adults, and moderate anemia was common in this population. The prevalence was increased with a high viral load, a family history of anemia, and not eating meat. In these patients, early detection and treatment of immune hemolytic anemia is necessary.


Assuntos
Anemia Hemolítica , Globulinas , Infecções por HIV , Adulto , Estudos Transversais , Etiópia/epidemiologia , Feminino , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Hospitais Especializados , Humanos , Masculino , Pessoa de Meia-Idade
12.
Artigo em Inglês | MEDLINE | ID: mdl-36141996

RESUMO

Most presentations of conjunctivitis are acute. Studies show that uncomplicated cases resolve within 14 days without medication. However, antibiotic prescription remains standard practice. With antimicrobial resistance becoming a public health concern, we undertook this study to assess antibiotic prescription patterns in managing acute conjunctivitis in an eye hospital in Ghana. We recorded 3708 conjunctivitis cases; 201 were entered as acute conjunctivitis in the electronic medical records (January to December 2021). Of these, 44% were males, 56% were females, 39% were under 5 years, 21% were children and adolescents (5-17 years) and 40% were adults (≥18 years). A total of 111 (55.2%) patients received antibiotics, of which 71.2% were appropriately prescribed. The use of antibiotics was more frequent in children under 17 years compared to adults (p < 0.0001). Of the prescribed antibiotics, 44% belonged to the AWaRe "Access" category (Gentamycin, Tetracycline ointment), while 56% received antibiotics in the "Watch" category (Ciprofloxacin, Tobramycin). Although most of the antibiotic prescribing were appropriate, the preponderance of use of the Watch category warrants stewardship to encompass topical antibiotics. The rational use of topical antibiotics in managing acute conjunctivitis will help prevent antimicrobial resistance, ensure effective health care delivery, and contain costs for patients and the health system.


Assuntos
Antibacterianos , Conjuntivite , Doença Aguda , Adolescente , Adulto , Antibacterianos/uso terapêutico , Criança , Ciprofloxacina , Estudos Transversais , Feminino , Gentamicinas , Gana , Hospitais Especializados , Humanos , Masculino , Pomadas , Padrões de Prática Médica , Tetraciclinas , Tobramicina
13.
BMJ Open ; 12(9): e065799, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-36104127

RESUMO

OBJECTIVES: This study aimed to examine COVID-19 patients' experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks. DESIGN: This study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis. SETTING: This study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China's response to the first wave of the COVID-19 pandemic. PARTICIPANTS: A total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients; (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties. RESULTS: Three themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients' evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient-healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients. CONCLUSIONS: Our findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients' perspectives into healthcare service appraisal in emergency shelter hospitals.


Assuntos
COVID-19 , COVID-19/epidemiologia , Hospitais , Hospitais Especializados , Humanos , Unidades Móveis de Saúde , Pandemias
14.
Cancer Control ; 29: 10732748221127156, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36113140

RESUMO

BACKGROUND: Common mental disorders (CMD) are the most usual reactions following cancer diagnosis causing significant psychological sufferings. Even though research-based evidence is necessary for mental health promotion and intervention activities, there is a scarcity of evidence in Ethiopia to assist policy makers' efforts in reforming mental health care particularly that of cancer patients. OBJECTIVE: The main objective of this research is to assess the magnitude of common mental disorders and associated factors among cancer patients who have a follow-up treatment at Black Lion Specialized Hospital, Addis Ababa, Ethiopia. METHOD: Institutional-based cross-sectional study was conducted from August 1 to September 30, 2020. A systematic random sampling technique was used to select 396 study participants. A Self-Reporting Questionnaire (SRQ-20) and interviewer-administered structured questionnaire were employed to collect data. Data were analyzed using descriptive statistics and logistic regression. Odds ratios with 95% confidence intervals was used to report the findings. RESULT: A total of 396(230 men and 160 women) participants took part in the study. The overall magnitude of CMD among cancer patients was found to be 70.3%, of which the rate was 73.5% among women and 67.8% among men, in the last 4 weeks. Being women (AOR = 1.74; 95%CI: 1.00, 3.02), unemployed (AOR = 3.035, 95% CI: 1.37, 6.72), average monthly income of less than 1600 Ethiopian Birr (AOR = 2.838; 95%CI: 1.58, 5.08), being on cancer treatment for more than 5 years (AOR = 2.653, 95% CI: 1.39, 5.03), poor social support (AOR = 3.618, 95% CI: 1.33, 9.80), and current use of substances (AOR = 6.852; 95% CI: 2.038, 23.034) were the factors significantly associated with CMD. CONCLUSION AND RECOMMENDATION: Common mental disorders are one of the major health concerns among cancer patients. Common mental disorders were found to be more common in females and among current users of a psychoactive substance. Therefore, cancer patients need special attention of not only physicians but also that of mental health professionals for possible detection and early treatment of mental disorders. Rendering social and economic support may reduce the negative effects of the illness.


Assuntos
Transtornos Mentais , Neoplasias , Estudos Transversais , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Masculino , Transtornos Mentais/epidemiologia , Neoplasias/epidemiologia , Prevalência
15.
BMJ Open ; 12(9): e061061, 2022 09 26.
Artigo em Inglês | MEDLINE | ID: mdl-36167381

RESUMO

OBJECTIVE: To develop and validate a risk prediction model for the prediction of preterm birth using maternal characteristics. DESIGN: This was a retrospective follow-up study. Data were coded and entered into EpiData, V.3.02, and were analysed using R statistical programming language V.4.0.4 for further processing and analysis. Bivariable logistic regression was used to identify the relationship between each predictor and preterm birth. Variables with p≤0.25 from the bivariable analysis were entered into a backward stepwise multivariable logistic regression model, and significant variables (p<0.05) were retained in the multivariable model. Model accuracy and goodness of fit were assessed by computing the area under the receiver operating characteristic curve (discrimination) and calibration plot (calibration), respectively. SETTING AND PARTICIPANTS: This retrospective study was conducted among 1260 pregnant women who did prenatal care and finally delivered at Felege Hiwot Comprehensive Specialised Hospital, Bahir Dar city, north-west Ethiopia, from 30 January 2019 to 30 January 2021. RESULTS: Residence, gravidity, haemoglobin <11 mg/dL, early rupture of membranes, antepartum haemorrhage and pregnancy-induced hypertension remained in the final multivariable prediction model. The area under the curve of the model was 0.816 (95% CI 0.779 to 0.856). CONCLUSION: This study showed the possibility of predicting preterm birth using maternal characteristics during pregnancy. Thus, use of this model could help identify pregnant women at a higher risk of having a preterm birth to be linked to a centre.


Assuntos
Nascimento Prematuro , Etiópia/epidemiologia , Feminino , Seguimentos , Hospitais Especializados , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Estudos Retrospectivos
16.
PLoS One ; 17(8): e0271895, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35939445

RESUMO

BACKGROUND: Breast cancer is the most frequent and fatal cancer type globally. The fatality rate of breast cancer is mostly due to disease complications like hematological alterations. Therefore, this study aimed to assess the hematological abnormalities before, during, and after the initiation of cancer treatment in breast cancer patients at the University of Gondar comprehensive specialized hospital. METHODOLOGY: Hematological profiles were collected from 267 breast cancer patients who attended the cancer treatment center from September 2017 to August 2021. A data extraction sheet was used to extract data from the patient's medical chart, including sociodemography, clinical, and hematological profiles. EPI info version 3.5.1 and SPSS Version 25 softwares were used for data entrance and analysis, respectively. Descriptive statistics were summarized using frequency and percentage. The Friedman test followed by a Wilcoxon signed rank test was used to compare the mean difference between the hematological profiles at zero and after the 4th and 8th cycles of treatment. RESULT: Of the total participants, 91% were females, and the median age of the study participants was 45 (IQR = 36, 55) years. Red blood cell, white blood cell, and lymphocyte counts, as well as hematocrit and hemoglobin values, were significantly reduced after the initiation of cancer treatment, while the platelet count and red cell distribution width were significantly increased. The prevalence of anemia was 21.7% (95% CI: 16.6, 26.8), 22.7% (95% CI: 17.6, 27.8), and 26.4% (95% CI: 21.3, 31.5) before, during, and after the initiation of cancer treatment, respectively. The prevalence of leukopenia before, during, and after treatment was 9.7%, 18.8%, and 15.1%, respectively. Finally the prevalence of thrombocytopenia was 6.3%, 3.4%, and 8% at before, during, and after treatment, respectively. CONCLUSION: This study concluded that many hematological parameters were significantly affected by the breast cancer treatment. Therefore, proper patient follow-up and provide appropriate interventions related to their hematological abnormalities is crucial. It is also important to conduct further prospective studies to confirm the findings of this study.


Assuntos
Anemia , Neoplasias da Mama , Neoplasias da Mama/complicações , Neoplasias da Mama/tratamento farmacológico , Estudos Transversais , Índices de Eritrócitos , Etiópia/epidemiologia , Feminino , Hospitais Especializados , Humanos , Masculino , Estudos Prospectivos
17.
BMC Health Serv Res ; 22(1): 1058, 2022 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-35982435

RESUMO

BACKGROUND: Measuring the caregivers' satisfaction is vital for the effectiveness of childcare. Children admitted to pediatric wards require special hospital situations, a bespoke approach from the medical team, and the participation of caregivers. It is important to give attention to the caregivers while planning for child services. The purpose of this study was to assess the caregiver's satisfaction with the services provided in pediatric wards of Jimma University Medical Center and identify its associated factors. METHODS: Facility-based cross-sectional study design was done at Jimma University Medical Center. Participants in the study were primary caregivers who spent two or more days in the pediatric ward with their admitted children. Data were collected from 400 selected caregivers. A consecutive sampling method was employed. Principal component analysis was done for all Likert scale instruments to extract factor (s) representing each of the scales and to have factor scores. Variables with the Likert scale were treated as continuous after principal component analysis was employed. Using these factor scores, a multiple linear regression analysis was carried out to identify factors associated with caregivers' satisfaction with service in pediatric wards. A significance level of less than 0.05 was used in the final model to determine statistical significance. RESULT: This study showed that caregivers' satisfaction with the services in the pediatric ward was 68%. Level of education (ß = -0.24, (95% CI; -.411, -.070)), availability of basic facilities (ß = 0.163, (95% CI; .063, .263)), patience to listen to patients' problem (ß = 0.431, (95% CI; .324, .537, staff communication with client (ß = 0.163, (95% CI; -4.839, -1.610)), availability of laboratory tests and its service (ß = -0.964, (95% CI; -1.435, -.493)), availability of drug, imaging and service at radiology (ß = 2.907, (95% CI; 1.470, 4.344)) and availability of pathology and its service (ß = 1.869, (95% CI; .993, 2.746)) were significant factors associated with caregivers satisfaction with health service in pediatrics ward. CONCLUSION: Caregivers were moderately satisfied. Education level, availability of basic facilities communication with client, and the availability of laboratory tests and drugs were factors that significantly associated with caregiver satisfaction. Hospital should avail laboratory tests and drugs in order to maintain high levels of caregiver satisfaction.


Assuntos
Satisfação do Paciente , Pediatria , Centros Médicos Acadêmicos , Cuidadores , Criança , Estudos Transversais , Etiópia , Hospitais Especializados , Humanos , Satisfação Pessoal , Inquéritos e Questionários
18.
Ethiop J Health Sci ; 32(4): 773-780, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35950074

RESUMO

Background: Developmental delay is a major health problem throughout the world causing significant individual disability. Even though physical examination and patient history are the most important and basic evaluations of patients with developmental delay, additional investigations are usually required in supporting or reaching a diagnosis among which is neuroimaging. This study aims to assess brain Magnetic resonance imaging (MRI) patterns in patients presented with developmental delay. Method: A retrospective analysis of 164 patients who had undergone brain Magnetic Resonance Imaging (MRI) evaluation for the developmental delay was done. The study was conducted between March to November 2021 G.C at Tikur Anbessa Specialized Hospital (TASH). The patients' clinical history and magnetic resonance imaging reports were reviewed from their medical records. All patients with developmental delay who had brain MRI evaluation at TASH and at one private diagnostic center in Addis Ababa were included in the study. Results: A total of 164 patients were included in this study of which 95(57.9%) were male and 69(42.1%) female patients were seen. A total of 120 patients (73.2%) showed abnormal brain MRI studies. Previous neurovascular insults were the most common abnormalities seen in 75(45.7%) patients followed by imaging findings of congenital and developmental abnormalities seen in 20(12.2%) patients. Conclusion: Brain MRI is an important input in the evaluation of patients with developmental delay. It can give evidence for the cause of developmental delay, especially in the diagnosis of perinatal/hypoxic-ischemic insults, and congenital and developmental malformations.


Assuntos
Hospitais Especializados , Imageamento por Ressonância Magnética , Encéfalo/diagnóstico por imagem , Etiópia , Feminino , Humanos , Masculino , Gravidez , Estudos Retrospectivos
19.
PLoS One ; 17(8): e0268558, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35972926

RESUMO

BACKGROUND: At birth, continuous flow of nutrients to the fetus in utero interrupted due to cut of the route /umbilical cord/. Instead of the cord, breast-mouth connection will be the next route in the extra uterine life. Nevertheless, limited data in our locality show the duration for how long immediate newborns are fasting. OBJECTIVE: This study aimed to assess time to initiation of breastfeeding and its predictors among postnatal mothers within 12 hours of birth in Debre Markos Comprehensive Specialized Hospital, North West Ethiopia, 2020. METHODS: A Facility based prospective follow-up study was conducted among 475 participants who were selected using systematic random sampling techniques. To collect the data, techniques including interview, chart review and observation were used. Data was entered to Epi-data version 3.1 and analyzed by STATA 14 software. A cox proportional hazards regression model was fitted to identify predictors for survival time. Results of the final model were expressed in terms of adjusted hazard ratio (AHR) with 95% confidence interval, statistical significance was declared with P-value is less than 0.05. RESULTS: Newborns were fasting breast-milk for the median time of 2 hours. In this study, 25% of participants initiated breastfeeding within 1 hour, pre-lacteal while 75% initiated within 3 hours. Gave birth to multiple babies (AHR 0.37, 95% CI (0.19, 0.69)), operative delivery (AHR 0.77, 95% CI (0.62, 0.96)), got advice on timely initiation of breastfeeding immediately after delivery (AHR 0.79, 95% CI (0.63, 0.97)), pre-lacteal feeding initiation (AHR 10.41, 95% CI (2.82, 38.47)) and neonatal sickness (AHR 0.08, 95% CI (0.03-0.19)) were statistically significant predictors for time to initiation of breastfeeding. CONCLUSION: Fifty percent of mothers initiated breastfeeding within 2 hours. Most of them didn't initiate breastfeeding based on world health organization's recommendation, within one hour after delivery. Multiple birth, operative delivery, getting advice on timely initiation of breastfeeding immediately after delivery, giving pre-lacteal feeding and neonatal sickness were found to be predictors of time to initiation of breastfeeding.


Assuntos
Jejum , Hospitais Especializados , Etiópia , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Estudos Prospectivos
20.
BMC Pregnancy Childbirth ; 22(1): 665, 2022 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-36028804

RESUMO

BACKGROUND: Apgar score is used to evaluate the neonates' overall status and response to resuscitation, as well as its prognosis beyond the neonatal period. Low fifth minute Apgar scores is more frequent and is associated with markedly increased risks of neonatal mortality and morbidity. In Ethiopia, the prevalence of birth asphyxia is high (22.52%). Birth asphyxia contributes to significant neonatal morbidities and mortalities due to severe hypoxic-ischemic multi-organ damage, mainly brain damage. Therefore, this study was aimed to identify determinants of low fifth minute Apgar score among newborns delivered by cesarean section. METHODS: An unmatched case control study design was conducted. The Apgar score is based on measures of heart rate, respiratory effort, skin color, muscle tone, and reflex irritability. The data collection tool or checklist was adapted from previous study done at Addis Ababa, Ethiopia. In this study, cases were all newborns with Apgar score < 7 whereas controls were all newborns with Apgar score > = 7. The study participants were selected by simple random sampling technique. Data was into Epidata version 4.6 and exported to SPSS software version 24. Multivariable logistic regression was used to identify the independent effect of different factors at P < 0.05. RESULT: Factors associated with low Apgar score were fetal birth weight < 2.5 kg [adjusted odds ratio (AOR) = 8.17, 95% confidence interval (CI): 1.03 ‒ 64.59] P = 0.046, skin incision to delivery time (AOR = 5.27; 95% CI: 2.20 ‒ 12.60) P = 0.001, pregnancy induced hypertension (AOR = 4.58, 95% CI: 1.75 ‒ 11.92) P = 0.002, antepartum hemorrhage (AOR = 3.96; 95% CI: 1.75 ‒ 8.94) 0.001, general anesthesia (AOR = 3.37, 95% CI: 1.72 ‒ 6.62) P = 0.001, meconium stained amniotic fluid (AOR = 3.07, 95% CI: 1.32 ‒ 7.12) P = 0.009 and emergency cesarean section (AOR = 2.17, 95% CI: 1.13 ‒ 4.15) P = 0.019. CONCLUSIONS: Fetal birth weight < 2.5 kg, skin incision to delivery time, pregnancy induced hypertension, antepartum hemorrhage, type of anesthesia, meconium stained amniotic fluid and type of cesarean section were factors independently associated with Apgar score. Therefore, it is important to work on identified risk factors to reduce the impacts low fifth minute Apgar score in the in early adulthood..


Assuntos
Asfixia Neonatal , Hipertensão Induzida pela Gravidez , Complicações do Trabalho de Parto , Complicações na Gravidez , Adulto , Índice de Apgar , Asfixia , Peso ao Nascer , Estudos de Casos e Controles , Cesárea , Etiópia , Feminino , Hemorragia , Hospitais Especializados , Humanos , Recém-Nascido , Gravidez , Universidades
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