Nurses' pain management practices for admitted patients at the Comprehensive specialized hospitals and its associated factors, a multi-center study.

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.

Psychosocial and clinical factors associated with depression among individuals with diabetes in Bahir Dar City Administrative, Northwest Ethiopia.

BACKGROUND: In a context of the potential epidemic nature of both diabetes mellitus (DM) and depression had negative effects in cases of disability and mortality. Coexisting depression had been linked to morbidity and mortality in people with diabetes. Therefore, this study aimed to identify psychosocial and clinical factors associated to develop depression symptoms in diabetes patients. METHODS: A systematic institution based cross-sectional study design was conducted from 1st March to 8th April 2016 among adult diabetes patent. Depression status was assessed by the Patient Health Questionnaire-9 (PHQ-9). Data were analyzed by logistic regression and at P < 0.05 with 95% CI was considered statistically significant. RESULT: A total of 416 patients were included in this studied. Based on PHQ-9, self- reported depression symptom was 29.3% [95% CI 25.2, 33.4]. In the performed statistical evaluation, patients whose age was between 45 and 54 years old (AOR = 3.88; 95% CI 1.36, 11.08); being female (AOR = 2.43; 95% CI 1.29, 4.58); who has poor social support (AOR = 6.08; 95% CI 2.98, 12.40); and who has high fear of kidney problems secondary to DM (AOR = 6.12; 95% CI 1.75, 21.23) were statistically associated with depressive symptoms in diabetes patients. CONCLUSION: This study demonstrated that complication fears, social support, being female and sexual dysfunction were found significantly associated with co-morbid depression in diabetes. Therefore, availed a social network of family and friends; providing diabetes education to address the patient's fear of complications; and considered a sexual function is an integral part of overall health in diabetic patients.

Assessment of prevalence of dental caries and the associated factors among patients attending dental clinic in Debre Tabor general hospital: a hospital-based cross-sectional study.

BACKGROUND: Dental caries is the most common dental health problem caused by the interaction of bacteria on tooth enamel. Risk factors for dental caries include salivary composition and inadequate fluoride. However, other factors, such as standard of living, behavior, hygiene, eating habits, social status and socio-demographic factors, also contribute to the evolution of caries. Therefore, this study aimed to determine the prevalence of dental caries and associated factors among patients attending the dental clinic in Debre Tabor General Hospital in North West Ethiopia. METHOD: An institution based cross-sectional study was conducted among 280 systematically selected patients attending Debre Tabor General Hospital dental clinic from May 8-20, 2017. The data were collected using pre-tested questionnaire and oral examination by a qualified dental professional. Basic hygienic procedures were observed during an oral examination. The teeth were examined for dental caries by the presence of decay, missing and filled teeth. The data were entered into Epi-Info version 3.5 and cleaned and analyzed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05. RESULTS: A total of 280 subjects participated in the study; among whom 129 (46.1%) were female and nearly two-thirds of the respondents 208 (74.3%) attended formal education. The study revealed k8that the overall prevalence of dental caries was 78.2%. Dental caries was lower among respondents who had good oral hygiene status (AOR = 0.05, 95% CI, 0.02, 0.81). Dental caries was higher among participants who earned less than 5000 Eth Birr per month (AOR = 8.43, 95% CI, 2.6, 27.2). Dental caries was lower among respondents who had good knowledge (AOR = 0.51, 95% CI, 0.03, 0.64). CONCLUSIONS: Prevalence of dental caries was high and found public health problem. Socioeconomic status, educational level, and poor oral hygiene practices were associated factors for dental caries. Health promotion about oral hygiene and integration of services are supremely important for the prevention of the problem of dental caries.

A systematic review and meta-analysis of the Ethiopian cohort of adult hypertensive people's adherence to healthy behaviors.

Background: Adherence to healthy behavior has become increasingly important in recent years for better blood pressure management. For the management and prevention of hypertension, it is a strong recommendation. But there have been a number of observational studies conducted in Ethiopia on hypertensive people's healthy lifestyle choices. An extensive review, however, that would have provided even a sliver of supporting data for developing an intervention, is missing. The purpose of this review and meta-analysis was to fill in this gap. Methods: The meta-analysis of an observational study was followed by a systematic review. Searches and extracts from the databases CINAHL (EBSCO), MEDLINE (via Ovid), PubMed, EmCare, and Google Scholar have been conducted by three reviewers. Only studies with low and moderate risk were included in the analysis after the quality of the articles was evaluated by two independent reviewers using the Newcastle-Ottawa Scale. After accounting for heterogeneity and publication bias, this study presented the estimated overall and six major domains of adherence to healthy behaviors among hypertensive adult individuals. The PROSPERO database had this systematic review registered under protocol number CRD 42020206150. Results: The overall estimated adherence to healthy lifestyle habits among Ethiopian hypertensive adult individuals was 42.45% (95% CI: 33.51-51.38, I2 = 95.2%). We also investigate the adherence of major domains of healthy behaviors, such as the estimated healthy dietary adherence: 50.86% (95% CI: 39.61-62.11%), the estimated adherence to physical activity: 48.74% (95% CI: 36.60-60.96), and the estimated adherence to sodium intake: 51.79% (95% CI: 36.77-66.8). The following variables were statistically significant predictors of adherence to the overall health behavior: education level (Pooled Odds Ratio (POR): 2.8; 95% CI: 1.98-3.63, I2 = 0.0%), duration of hypertension (POR: 3.1; 95% CI: 1.80-4.32, I2 = 0.0%), and hypertensive people who was knowledgeable of hypertension (POR: 6.8; 95% CI: 1.05-12.58, I2 = 89.3%). Conclusions: Less than half of the hypertension population in Ethiopia had healthy lifestyle behaviors. A low percentage of hypertensive adults also had adhered to salt (sodium) intake, physical activity, and weight management. So, intervention programs should focus on the health faithfulness of the specific section of adherence to healthy lifestyle practice according to recommended lifestyle practice guidelines.

Level of dietary adherence and determinants among type 2 diabetes population in Ethiopian: A systemic review with meta-analysis.

BACKGROUND: The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is not well-implemented in Ethiopia. Up to now, in the nation, several primary observational studies have been done on dietary adherence level and its determinants among type 2 diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. METHODS: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization- Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion dietary adherence among type2 diabetes and the odds ratios of risk factors favor to dietary adherence after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42020149475. RESULTS: We included 19 primary studies (with 6, 308 participants) in this meta-analysis. The pooled proportion of dietary adherence in the type 2 diabetes population was 41.05% (95% CI: 34.86-47.24, I2 = 93.1%). Educational level (Pooled Odds Ratio (POR): 3.29; 95%CI: 1.41-5.16; I2 = 91.1%), monthly income (POR: 2.50; 95%CI: 1.41-3.52; I2 = 0.0%), and who had dietary knowledge (POR: 2.19; 95%CI: 1.59-2.79; I2 = 0.0%) were statistically significant factors of dietary adherence. CONCLUSION: The overall pooled proportion of dietary adherence among type 2 diabetes in Ethiopia was below half. Further works would be needed to improve dietary adherence in the type 2 diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and dietary education according to diabetes recommended dietary guideline.

Hand washing practice among health care workers in Ethiopia: systemic review and meta-analysis, 2020.

OBJECTIVE: Hand washing with soap and water is the single most weapon against infectious agents. Proper hand washing is not only reduces nosocomial infection, but also prevents the spread of current global concern Novel Corona viruses (COVID-19) and other viral illnesses like cold and flu. Therefore, the aim of this study is to assess hand washing practice among health care workers in Ethiopia. METHODS: In the current meta-analysis, the target variables search from different databases, like Google Scholar, African Journals OnLine, PubMed, and Scopus. All necessary data extracted by using a standardized data extraction format. Heterogeneity across the studies was evaluated using the I2 index and Cochran's Q test. A random effect model computes to estimate the pooled proportion of hand washing practice among health care workers. RESULTS: In this meta-analysis, we included fifteen observational studies summarize the proportional of hand washing practice among health care workers. In the current study, the pooled hand washing practices among Ethiopian was 57.87% (95% CI: 44.14-71.61). Subgroup analysis conduct to identifying the sources of heterogeneity. CONCLUSION: The overall pooled proportion of hand washing practice among health care workers was low. Hand washing with water and soap is recommended at least for 20 s to prevent contagious disease like Corona viruses.

Nurses' intention to leave their job in sub-Saharan Africa: A systematic review and meta-analysis.

INTRODUCTION: Nurses' intention to leave their job is a worldwide concern. Internal and external brain drain factors are the main reason for nurses' intention to leave their job. So far, in Sub Sahara Africa, several observational studies have been done on nurses' intention to leave their job. However, a comprehensive review that would have a lot of evidence for designing an intervention is lacking. Hence, this study aimed to the pooled status of nurses' intention to leave their job. METHODS: In the current meta-analysis, the target variables were searched from different electronic databases. These electronic databases are Pub Med, Google Scholar, Science Direct, African Index Medicus, African Journal Online, EMB ASE, and the Cochran Library. To determine the pooled proportion of intention to leave their job in Sub- Saharan Africa, all the necessary data was extracted by using a standardized data extraction format. We analyzed the data by using Stata 15 statistical software. Heterogeneity between the primary studies assessed by Cochran Q and I-square tests. A random-effect model computes to estimate the pooled nurses' intention to leave their job. RESULT: We included fifteen full-text studies in the current meta-analysis. The findings of this meta-analysis revealed that the pooled proportion of nurses' intention to leave their job in sub-Saharan Africa was 50.74% (95% CI; 41.33, 60.14; I2 = 95.80%). The subgroup analysis showed that the highest pooled proportion of intention to leave their job (58.03% (95% CI: 47.93, 68.12)) in East Africa. The lowest pooled estimation to leave their job among nurses showed that South Africa (33.04% (95%CI: 20.45, 45.63)). CONCLUSION: In the current study, there was a high proportion of nurses indentation to leave their job. Nurses' intention to leave their job also varied from region to region in the study area. Therefore, health managers and stakeholders focus on design sufficient development and career opportunities, positive working atmosphere, and secure their autonomy.

Level of nurses' knowledge on pressure ulcer prevention: A systematic review and meta-analysis study in Ethiopia.

OBJECTIVE: Pressure ulcers (PU) are injuries to the skin and underlying tissue because of prolonged pressure. It affects millions of people in the world. One of the major nursing roles is to prevent patients from developing PU. Inadequate knowledge of nurses' toward PU can have a significant effect on preventive care strategies. Therefore, the aim of this meta-analysis study was to assess the overall level of nurses' knowledge about the prevention of pressure ulcers. METHODS: A systemic review of primary research was undertaken and nurses' knowledge on pressure ulcer prevention was evaluated. All original cross-sectional studies conducted only in Ethiopia in the English language were included in this meta-analysis. After extraction, the data analysis was done using STATA version 11 statistical software. Based on heterogeneity between the studies, the data were analyzed using a random effects model. RESULTS: In this systematic review and meta-analysis, all the studies on nurses' knowledge on the prevention of PU were reviewed based on the PRISMA statement. The overall knowledge of nurses' on pressure ulcer prevention was 46.24 % (95 % CI: 26.63-65.85). CONCLUSION: The overall knowledge of nurses' on pressure ulcer prevention was low in this meta-analysis study. Sustainable training about the prevention of PU is very important for all nurses.

Non-adherence to self-care and associated factors among diabetes adult population in Ethiopian: A systemic review with meta-analysis.

BACKGROUND: Self-care practice among people with diabetes is not well-implemented in Ethiopia. So far, in Ethiopia, several observational studies have been done on self-care practice and its determinants in people with diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap. METHODS: A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization's Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion of non-adherence to self-care practice in people with diabetes and the odds ratios of risk factors hindering to self-care practice after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD 42020149478. RESULTS: We included 21 primary studies (with 7,134 participants) in this meta-analysis. The pooled proportion of non-adherence to self-care in the diabetes population was 49.91 (95% CI: 44.73-55.08, I2 = 89.8%). Male (Pooled Odds Ratio (POR): 1.84 95%CI; 1.04-2.64, I2 = 15.0%), having private glucometer (POR: 2.71; 95%CI: 1.46-3.95, I2 = 0.0%), short-term Diabetes Mellitus (DM) duration (POR: 3.69; 95%CI: 1.86-5.52, I2 = 0.0%), DM complication (POR: 2.22; 95%CI: 1.48-2.95, I2 = 0.0%), treatment satisfaction (POR: 1.8; 95% CI: 1.15-2.44, I2 = 0.0%), received diabetes self-management education (POR: 2.71; 95% CI: 1.46-3.95, I2 = 0.0%) and poor self-efficacy (POR: 3.09; 95% CI: 1.70-4.48, I2 = 0.0%) were statistically significant factors of non-adherence to self-care practice. CONCLUSIONS: The overall pooled proportion of non-adherence to self-care among adult diabetes in Ethiopia was high. Further works would be needed to improve self-care practice in the diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and each domain of self-care practice according to diabetes self-management guideline.

Assessment of Knowledge, Attitude, and Practice of Sunlight Exposure of Infants among Mothers Attending in Governmental Health Facilities in Farta District, South Gondar Zone, North West Ethiopia, 2018.

BACKGROUND: Sunlight exposure serves an important purpose in human bodies. It promotes good health and plays a major role in the production of the very essential vitamin, vitamin D. Vitamin D is important for the growth of healthy, normal bones. Research conducted in different areas suggested that daily exposure to sunshine remains the cheapest, safest, and most effective method of preventing rickets. OBJECTIVE: To assess knowledge, attitude, and practice of infants to sunlight exposure among lactating women in Farta district, in 2018. METHOD: Institution based cross sectional study design was conducted among mothers attending the selected health center. Systematic sampling method was used to select individual respondents. Data were entered and analyzed by using SPSS version 20. RESULT: Among 357 respondents identified for the study, 95% (n = 339) was responding to the interview. Of the total respondents, 49.9%, 46%, and 45.7% of them had poor knowledge, unfavorable attitude, and poor practice about sunlight exposure, respectively. CONCLUSION AND RECOMMENDATION: The results of this study showed that almost half of the mothers had inadequate knowledge, attitude, and inadequate practice about sunlight exposure. Therefore, mothers need to be educated about the importance of sunlight exposure.

The Prevalence of Traditional Malpractice during Pregnancy, Child Birth, and Postnatal Period among Women of Childbearing Age in Meshenti Town, 2016.

BACKGROUND: Cultural practices, beliefs, and taboos are often implicated in determining the care received by mothers during pregnancy and child birth which is an important determinant of maternal mortality. OBJECTIVE: To assess prevalence of cultural malpractice during pregnancy, child birth, and postnatal period among women of childbearing age in Meshenti town, Amhara region, northwest Ethiopia, in 2016. METHODS: Community based cross-sectional study was conducted among women of reproductive age group interviewed during the study period from May 10 to June 17, 2016. Total sample size was 318 women of reproductive age group. Systematic sampling technique was conducted. RESULT: Overall, 50.9% of the respondents had cultural malpractices during their pregnancy. Out of 318 women, 62 (19.5%) practiced nutrition taboo, 78 (24.5%) practiced abdominal massage, 87 (29.7%) delivered their babies at home, 96 (32.8%) avoided colostrums, 132 (45.2%) washed their baby before 24 hr after delivery, and 6 (6.9%) cut the cord by unclean blade. CONCLUSION AND RECOMMENDATION: The findings of this study show that different traditional malpractice during perinatal period is still persisting in spite of modern developments in the world. Health education and promoting formal female education are important to decrease or avoid these cultural malpractices.