RESUMO
BACKGROUND: Pain is the most common challenge that most hospitalized patients complain of and is influenced by several patients, nurses, and institutional-related factors. Most studies in Ethiopia on pain were focused on surgical illnesses only. OBJECTIVE: To assess nurses' pain management practice and associated factors for admitted patients at Comprehensive Specialized Hospitals. METHODS AND MATERIALS: A multi-center institution-based cross-sectional study was conducted at the five randomly selected Comprehensive Specialized Hospitals of the Amhara region from May 01 to June 01, 2022. A multi-stage sampling method was employed to select a total of 430 nurses and patients for whom the nurses were responsible. Data were collected using standard self-administered, structured, and checklist questionnaires from nurses, patients, and patients' charts respectively. The modified Bloom's criteria categorized the overall practice as good, moderate, and poor. Data were checked, coded, and entered into Epi-Data version 4.6 and exported to SPSS version 25. An ordinal logistic regression model was applied, and variables with a p-value < 0.05 with a 95% CI in the multivariable analysis were considered significant. RESULTS: The study evaluated the pain management practices of 430 nurses and only a quarter had good pain management practices. Those nurses with first degrees and above education level (AOR = 2.282) and who attended in-service training (AOR = 2.465) were found to have significantly higher pain management practice. Expected though patients with painful procedures (AOR = 5.648) and who had severe pain (AOR = 2.573) were receiving better pain management practices from their nurse care provider. Nurses working in the institutions with a pain-free initiative focal person (AOR = 6.339) had higher pain management practices. CONCLUSION AND RECOMMENDATION: Overall, the majority of nurses had poor pain management practices. Higher educational levels, in-service training, and assigning a pain-free focal person had an impact on pain management services. Patients with higher pain levels and painful procedures were getting better attention. Hospital administrations need to provide due attention to the pain management of hospitalized patients by providing in-service training and educational opportunities to improve the capacity of nurses. Patients would be benefited considerably if hospitals focus on assigning focal persons for advocating regular pain management for admitted patients regardless of their pain level.
RESUMO
BACKGROUND: The HIV/AIDS epidemic has been fuelled by gender inequality and disparity resulted in violation of women reproductive right. The "feminization" of the pandemic is more apparent in Sub-Saharan Africa where the larger numbers of HIV infected people are living. Although they carry the higher proportion of HIV cases; access to care and treatment is lower among women. In Ethiopia where HIV is prevalent and gender violence is common, the disparity may be higher. Therefore, this research aimed to assesses trends in gender disparity in the HIV/AIDS epidemic in Ethiopia to bring evidence for action. METHODS: This study was conducted using aggregates of HIV/AIDS indicator data from 1990 to 2016 of UNAIDS data bases. The data was compiled and analyzed with excel and STATA Version 11. The trend was assessed, gender difference was measured and rate of change was compared between genders and specific age groups. RESULT: Adult females (age 15+) accounted 61.5% of the HIV cases and new infection among adults. While, adolescent females (age 10-19) and young women (age 15-24) accounted 52.3 and 57.5% of prevalent cases and 74 and 68% of new infection in their age category respectively. HIV is 1.62 times more prevalent among adult women than men. Since 1990, HIV cases among adults has risen markedly in the first decade with 24 and 20%, then declined by 41.5% in the second decade and rose again by 5 and 8.7% among women and men respectively. The overall prevalence is declined by 72.4 and 71.5% from the maximum record. Women and men have equal access for ART; 62% of men and 61% of women from all adults living with HIV were on ART. While 61% of deaths were among adult women and the death rate is similar among adolescent women and men. AIDS- related death has been declined by 76% from the maximum record. CONCLUSION: HIV/AIDS prevalence, new infection and AIDS-related death are by far higher among adult women than men. While the coverage of treatment and HIV care is equal among both genders. Vulnerable age groups (adolescent females and young women) take the lion's share of the new infections and prevalent cases. Therefore due attention is needed to avert gender disparity with a particular emphasis for adolescents and young women.