Adult Health Nursing

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    Factors Affecting Female Adolescent Sexual Reproductive Health Among In School Adolescents In Woreta Town, South Gonder
    (Addis Ababa university, 2007-07) Kelemework Abebe; Asnake Mengistu (PhD)
    Adolescents are alarmingly becomes sexually active at younger age. The socioeconomic, family atmosphere, peer pressure, individual life experience and other factors predisposed them to early onset of sexual activity. Premarital sexual activities of adolescent was accompanied with risk of unintended pregnancy, abortion, STDs including HIV/AIDS due to lack of factual information and knowledge of reproductive and sexual health issue. The major purpose of this study was to investigate factors which influence female adolescent sexuality among in school adolescents in Woreta town. In order to assess the objective of the study cross-sectional survey study design was used which includes quantitative method using a pre-tested written questionnaire and focus group discussion used to collect qualitative data as a supplement of quantitative. The sampling technique employed for this study was stratified sampling procedure. Data were collected from 660 females adolescents aged 12-19 years who are considered as adolescent in this study. The statistical tools that used to analyze the data include uni-variate, bivariate and multivariate analysis. Univariate used to describe the adolescents and parents variables. The chi-square test (bivariate) was used to establish the association between the independent variables and sexual behavior (dependent variable). Binary logistic regression model was used to analyze the effects of the explanatory variables on the female adolescent sexuality. The study revealed that 36.1 percent of unmarried female students ever had sex. As reported by respondents the main reason for having sex for the first time was the desire to marry and love affairs. 28.9 per cent of sexually experienced female adolescents were ever use of contraceptive and 21.8 percent used condom at first sexual intercourse. The finding of the study showed that age, education level, religiosity, living arrangement, mother education and occupation, father education, peer pressure, self efficacy, mother-adolescent communication and respondent attitude toward premarital sex were associated to female adolescent ever had sex. At multivariate level, the finding of the study depicted that adolescents discussed with their mother about sexual related issues were less likely to be sexually active than those who had never discussed with their mother about sexual related issue. Female adolescents who have no sexually experienced friends were 15.2 percent less likely to have had sexual intercourse relative to those who have sexually experienced friends. Adolescents in this study were found to involve in sex at early ages and most of whom do not use contraceptive. Thus, the need to initiate comprehensive sexual and reproductive health programs targeting adolescents and strong information education communication and intervention programs by all concerned bodies will be recommended. It also further noted that the neefor parental empowerment have to be emphasized to enable them to cope with the challenge ofadolescent life.
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    Assessment of the Reproductive Health Needs of High School Students in Hossana, Ethiopia.
    (Addis Ababa University, 2010-06) Kegnu Tadele; ArayaTekebash(B.Sc)
    Background Sexual and Reproductive Health problems that the young people are facing are not localized to onegeographic location or one part of the world. Worldwide, 15 million adolescents experience pregnancy each year. Since most of these pregnancies are unwanted, young women tend to have induced abortions, whether legal or not. Moreover, half of new HIV infections are observed in the15-24 age groups. On top of this, studies about STI in adolescents show that the incidence is increasing. Today, each year, one in 20 adolescents suffers from an STI other than HIV (1). Objectives and methods A cross sectional institution based study was conducted to assess the reproductive health needs of high school students in Hossana Town. 422 study subjects were identified by using multi stage sampling method. Data was collected using structured questionnaire, entered and analyzed using EPI info and SPSS statistical program respectively. ResultsAbout 35.8%, of the respondents had experienced penetrative sexual intercourse and 59.5% of the respondents reported that their first sexual intercourse had been unplanned. About 16.9% of the respondents have more than one sexual partner. Among sexually active students, 45.7 % had used condom during their first sexual intercourse as a means of preventing pregnancy and/or STIs including HIV/AIDS. Majority (70.4%) of sexually active female respondents have ever been pregnant out of which 52.9% of them had induced abortion. Conclusion In spite of the students need to get SRH services, the school clinics are not providing theirservices adequately. The health service delivery system should consider the special needs of youth and work out comprehensive and effective policies and strategies to provide young people with the services appropriate to their needs.
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    Determinants of Nurses’ Job Satisfaction in Government Hospitals, Addis Ababa, Ethiopia, June 2010.
    (Addis Ababa University, 2010-06) Yimam Wondwossen; Mekonnen Bazie(Msc)
    Introduction: Nurse‟s job sat isfact ion is a cornerstone for improving the qualit y of health care, patient satisfaction, staff morale, job competence, patient compliance, positive patient outcomes and its continuity of care; however, dissatisfaction leads to decreased productivity, efficiency, and the quality of care, each of which raises costs to the health care system. Objective: The main objective of this survey was to assess levels and determinants of nurses‟ job satisfact ion by using Herzberg‟s job motivator and hygiene factors in Addis Ababa government hospitals. Methods: Institution based cross-sectional study was conducted from Nov to May 2010 on 300 nurses working in Addis Ababa government hospitals. Pre-tested and self administered questionnaire was used to collect data from six hospitals. Simple random and systematic sampling technique was employed in this study. The data was entered, cleaned and analyzed using SPSS version 15. Associations between dependent and independent variables assessed and presented using frequency, mean, standard deviation, student t-test, ANOVA, & Pearson‟s correlation test. Statistical significance was set at p-value < 0.05. Results: Three hundred nurses responded from the sampled 314 respondents and composed a response rate of 95.5%.The majority 188 (63%) of nurses were dissatisfied with their job. Advanced age and work experience were related with nurses‟ job sat isfact ion. The overall mean satisfaction score of hygiene and motivation factors were 3.54 (+0.96SD) and 3.35 (+0.09SD) respectively. Almost all determinants were positively and moderately correlated with job satisfaction, whereas compensation was negatively and strongly correlated with job satisfaction. Conclusions: The majority of nurses were dissatisfied with their job. Advanced age and work experience were statist ically significant and associated with nurses‟ job sat isfaction. Almost all hygiene and motivation factors were positively and moderately correlated with nurses‟ job satisfaction. Hygiene factors were more important predictors of job satisfaction than motivation factors in this study subjects. The study subjects were not satisfied with the compensation (salary) that they received for their work that they do. Recommendations: Managers can use both hygienic & motivation determinants as a strategic tool to increase nurses‟ job sat isfact ion and they should also give priorit y and design appropriate mechanism to their young and low experienced nurses to improve level of their job satisfaction. The factors contributing to nurses‟ dissat isfact ion with compensation (salary) should be further investigated and depending on the findings, alternative methods of reward need to be considered.
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    Assessment of Factors Affecting Contraceptive use Among Preparatory School Adolesents in Addis Ababa, 2010.
    (Addis Ababa University, 2010-06) Demas Tangute; Tachbele Erdaw
    Background: Adolescents in Ethiopia are exposed to various risks, such as human immunodeficiency virus (HIV), other sexually transmitted infections (STIs), unwanted pregnancy and unsafe abortion due to unprotected sex while they have high knowledge of contraceptive use. Objective: To asses the factors affecting modern contraceptives utilization among preparatory school adolescents Methods: A cross sectional school based study was conducted on April to May 2010 in Addis Ababa Administration using multistage stage sampling technique .A total of 830 students in five government and three non government schools were included in the study. A pre tested structured questionnaire complemented with focus group discussion were used for data collection. The data entered cleaned and analyzed using SPSS version 15 software. Frequencies, cross- tabulations and logistic regression were used Result Overall from 830preparatory school adolescents 159(19.2) % were sexually active .Of which 69(43.4 %) had used modern contraceptive methods. Most of the respondents used condom 52 (75.4%). Significantly higher proportion of male adolescents 55(79.7%) than females 14(20.3%) used contraceptives. In the binary logistic regression sex, living with friends, living alone, having pocket money, discuss sexual related issue with friends, condom, shops and affordable service were found to be significant predictors of contraceptive use. Conclusion The prevalence of contraceptive use was low this showed that sexually active adolescents are highly exposed to the consequences of unprotected sex Adolescents who discus sexual related issues with their close friends were more likely to use contraceptive than who don‟t Adolescents who had pocket money were more likely to use contraceptives than who had no Religious prohibition, ashamed to buy, emotional and unplanned sexual practice, fear of being seen by some one who knows them and trust their partner were the most frequently reported reasons for not to use contraceptives by school adolescents The most preferred method for future use was condom and the most preferred source for future use was shop Recommendation Establish Parents- teachers - students relationship to have free discussion time in order to decrease their fear and ashamed about sexuality to bring behavioral change Since the most affecting factor to use contraceptive by sexually active school adolescents were ashamed to buy and emotional unplanned sexual practice, other strategies like getting the service every where when they need by using modern technology should be considered Most of the adolescents preferred to use condom with affordable service from the shop, considering this training to the shopkeepers about the storage and supplying of condom is mandatory since condom can be easily affected by heat
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    Perception of Nurses and Physicians towards Barriers to Nurse-Physician Communication and its Impact on patients ‘outcomes at Hawassa Referral and Teaching Hospital, SNNPRS, Ethiopia
    (Addis Ababa University, 2011-06) Yatasa Yavello ; Cherie, Amsale(BA)
    Background: Effective communication between nurses and physicians is essential in providing safe and effective care. Even if high-quality patient care is the goal of medicine and nursing, patients are dying and experiencing preventable complications because of poor nurse physician relationship. Objectives: The main objective of this study was to assess perception of nurses & physicians towards barriers to nurse-physician communication and its impact on patients’ outcome at Hawassa referral and teaching hospital. Methodology: An institution based cross sectional study was carried out. All nurses and physicians who were working at Hawassa referral and teaching hospital during the data collection time and willing to participate in the study were participated in the study. Data was collected using a self administered questionnaire while data analysis was done using SPSS version 15. To explain the study population in relation to relevant variables, frequencies, and percents were calculated. Pearson correlation tests were run to test degree and direction of relationship between factors that affect nurse-physician communication and patient outcomes. Ethical approval and clearances were obtained from department of nursing and midwifery institutional review board, College of Health Sciences, Addis Ababa University. Results: All identified factors have been found to have effect on nurse-physician communication with different degrees of impact. The three leading factors with priority of effect as perceived by nurses were unfavorable management decision perceived by 88 (77.2%) nurses, information gap as perceived by 83 (72.8%) and uncooperativeness at work perceived by 83(72.8%) nurses where as poor interpersonal communication skill perceived by 31(86.1%), information gap perceived by 29 (80.6%) physicians, and poor attitude to work perceived 28(77.8%) were priority for physicians. 98% of the total respondents; 111 (97.4%) nurses and all 36 (100.0%) physicians perceive that effective nurse-physician communication can improve patient care quality. In addition, 140 (93.3%) respondents; 104 (91.2%) nurses and all physicians (100.0%) perceive that effective nurse physician communication can reduce patient length of stay and 143 (95.3%) respondents; 109(95.6%) nurse and 34 (94.4%) physicians perceive that effective nurse-physician communication can increase patient satisfaction. Pearson correlations testes revealed that there is an inverse relationship between factors affecting nurse-physician communication and patient outcomes. Large proportion of nurses 44(38.6%) expressed their overall perception as “poor”; whereas the majority of physicians 16 (44.4%) expressed their overall perception as “good”. Conclusion: The study showed that all identified factors have been found to haveeffect on nurse-physician communication with different degrees of impact. Bothnurses and physicians have perceived that effective nurse-physiciancommunication have positive impact on patient outcomes. Negative correlationswere existed between factors affecting nurse physician communication and patientoutcomes. Nurses were not satisfied with their relation with physicians where asphysicians were relatively satisfied with their relation with nurses. Interventionssuggested by nurses and physicians to improve nurse-physician communicatio include respect for other & others’ profession, trainings on interpersonal &professional communication, accountability and responsibility for ones professional duties and others.
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    Seroprevalence of Helicobacter Pylori Infection and its Risk Factors Among Adult Patients With Dyspepsia in Hawassa Teaching and Referral Hospital, South Ethiopia
    (Addis Ababa university, 2011-06) Alemayehu Alem; Mihret Adane(PhD)
    Background: Helicobacter pylori is a curved gram-negative bacteria which causes gastritis and peptic ulcer disease. It is also an important risk factor for the development of gastric cancer and mucosal associated lymphoid tissue lymphoma. Many studies revealed that the prevalence of Helicobacter pylori infection varies with geographical region, socio demographic characteristics and environmental conditions of the studied population. In addition, it is more frequent in dyspeptic patients than normal individuals and dyspeptic symptoms accounts 10% of hospital admission in Ethiopia. Objective: The main objective was to determine the seroprevalence of Helicobacter pylori infection and its risk factors in adult patients with dyspepsia. Methods: A case control study was conducted between December 2010 and February 2011 on a total of 106 patients at Hawassa Teaching and Referral Hospital, South Ethiopia. The presence of antibody against Helicobacter pylori was determined serologically and a face to face interview was taken to assess the contributing factors for the infection. Ethical clearance and informed consents were obtained before data collection. Logistic regression was used to estimate odds ratio (crude and adjusted with 95% confidence interval) of positive responses to the different risk factors. Comparison between groups was compared with Chi-square and a P-value of <0.05 was considered significant. Results: Of the total 106 participants, 54 (51%) were male and 52(49%) female with mean age 32 years, range 18-75 years. Of these the seropositivity for Helicobacter pylori infection was found in 37(70%) of 53 dyspeptic patients (95% CI, 55.7% - 81.7%) and 29(54%) of 53 non dyspeptic participants (95% CI, 40.4% - 68.4%) p >0.05). The seroprevalence in participants that have family size > 5 was 71.4 %( 45/63) and 48.8 %( 21/43) for family size < 5 (AOR=2.6 (3.97- 7.127) p<0.05). Conclusion: There was a considerable increase of Helicobacter pylori seroprevalence in dyspeptic patients than the non dyspeptics i.e. 70% versus 54%. Among all variables, over crowding was positively associated Helicobacter pylori infection.
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    A Cross-sectional Study on Knowledge and Preventive Practice of Female Nurses’ towards Cervical Cancer in the Selected Government Hospitals in Addis Ababa, Ethiopia, 2011.
    (Addis Ababa University, 2011-06) Hailu Mignote; Mesfin Abebe(BSC)
    Introduction: Cervical cancer is the first most common cancer in women in sub-Saharan Africa. In Ethiopia, the incidence of cervical cancer is high, 35.9 per 100,000 women. Low level of awareness, lack of effective screening programs to detect precancerous conditions, overshadowed by other health problems (such as acquired immune deficiency syndrome, tuberculosis and malaria) and insufficient attention to women‟s healt h are the possible factors for the observed higher incidence rate of cervical cancer in the country. Objective: To explore the knowledge of cervical cancer, its preventive practice and associated factors among nurses in government hospitals. Methods: A cross-sectional descriptive study was conducted on knowledge and preventive practice of female nurses towards cervical cancer, from October 2010 to May 2011 in Addis Ababa, Ethiopia. The study was conducted in 4 randomly selected government hospitals. The study subject from each hospital was selected by proportional to size allocation. A total of 275 female nurses were selected to complete self administered questionnaire by six trained data collectors and two supervisors. Data was collected on March, 2011. The questionnaires were checked for completeness, cleaned manually and entered in to SPSS windows version 16.0 for analysis. Results: The finding of the study has indicated that hundred fifty eight (60.8%) nurses had knowledge of cervical cancer but only 57 (21.9%) reported practicing prevention of cervical cancer. Among the socio demographic and profession related factors, marital status and training has a strong and positive association on the knowledge of cervical cancer. In addition, other variables like education, family history, unit of work and ever cared patient with cervical cancer were shown to be significant and positive predictors of knowledge of cervical cancer. Variables like age, experience, being diagnosed with cervical cancer, ever cared patient with cervical cancer and ever visited to health institution were revealed to be significant and positive predictors of preventive practice of cervical cancer. Conclusion and recommendation: From this finding it is possible to conclude that; more than half of the respondents were Knowledgeable but preventive practice of Nurse‟s for cervical cancer was very poor. Consistent and frequent upgrading programs should be implemented; further research has to be done and the policy makers has to pay attention in designing strategies to strengthen nurses awareness on preventive measures.
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    Assessment of Diabetic Aelf Care Practices and Associated Factors Among Type II Diabetic Patients in Tikur Anbessa Specialized Hospital Endocrinology Unit, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2012-05) Kidanu Kalayou; Demissie Asrat(RN, BS.N, MSN, )
    Background: Diabetes is a general term for a group of metabolic disorders that affect the body’s ability to process and use sugar (glucose) for energy. The three most common forms of diabetes are type I diabetes, type II diabetes, and gestational diabetes. Type II diabetes mellitus resulting from the combination of resistance to insulin action and inadequate insulin secretion. It is a serious public health problem that threatens the quality of life, the success of long-term maintenance therapy for diabetes depends largely on the patients’ adherence with self-care practices. Objective: Was to assess diabetic self care practices and associated factors among type II diabetic patients in Tikur Anbessa Specialized Hospital, Addis Ababa City. Method: institutional based cross sectional study design was utilized, 323 study subjects were selected using systematic random sampling technique and the data was collected using interviewer administered structured questioner, data was entered in to EPI-INFO version 3.5.1 and analyzed using SPSS version 16. Frequencies and other descriptive statistics were computed. Bivariate and Multivariate logistic regression were computed to assess statistical association between the outcome variable and selected independent variables using Odds ratio, significance of statistical association was assured or tested using 95%CI and P-value (<0.05). Scoring method was employed to classify patients’ self-care practice level as adhered or not adhered. Results: The response rate was 99.1%, of all respondents 167(52.2%) and 153(47.8%) were Female and Male respectively. The majority of the study participants 232 (72.5%) were in the age group of 30 to 60 years. Most of the respondents were orthodox Christian 257 (80.3%) by religion and Amara184 (57.2%) by ethnicity. Of the total respondents 182(57%), 246(77%), 211(66%) and 139(43%) were attended formal education, married, unemployed and had very low monthly income respectively Respondents’ self-care practices were, the majority 270 (84.4%) respondents were not adhered to SMBG practice. A total of 311(97.2%) respondents were adhered to anti-diabetic medication. The majority 252 (78.8%) respondents were not adhered to recommended diet management practices. one hundred seventy (53.1%) were reported adhered to physical activity that meet the recommended guidelines .Of all study participants, 213(66.6) respondents were adhered to the recommended diabetic foot care practices. Overall self-care practices (SDSCA) were reported as adhered in 178 (55.6%) participants. There was a significant association between level of education, monthly income, Presence of glucometry at home, marital status, diabetic complication, age and gender and self-care practices. But there was no a significant association between duration of diabetes, Occupation and family history of diabetic and self-care practices. Conclusion: Despite the important role of self-care practices in management of diabetes were recognized to be useful and effective in achieving diabetes control and preventing its serious complication, findings of this study were indicated that most patients had no adherence to self-care practices especially in SMBG and diet management. Generally adherence to self-care practice was suboptimal among type II diabetic patients in TASH Endocrinology unit. Hence healthcare personnel must increase patients’ awareness on the importance of all domains of self-care practice and strongly promote the practice through effective IEC programme.
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    Assessment of Premarital Sexual Initiation and Associated Factors Among Mersa Town, Preparatory and High School Students, North Wollo, Amhara Regional State
    (Addis Ababa University, 2012-05) Endris Kedir; Shimeles Tsehay
    Background: Adolescence is a period of dynamic change representing the transition from childhood to adulthood and is marked by emotional, physical, and sexual maturation. Habits that are formed during adolescence had major effects in adulthood health and welfare ranges from 10-19 years and young people or youth is in the age ranges of 15 to 24 years old Objective: The aim of this study was to assess prevalence of premarital sexual initiation and associated factors among Mersa Preparatory and High school students, North Wollo, Amhara National Regional State, March 10-30, 2012. Methods: A school based quantitative cross sectional survey was conducted from March 10 to 30, 2012. Stratified random sampling technique proportional to size was applied. Pretested, structured and close ended questions prepared in English and translated to the local Amharic language and self administered type of questionnaire was used. Data was entered using EPI INFO .version 3.5.1 and exported and analyzed using SPSS version 16.0 windows and multiple logistic regression models were used to identify predictors of premarital sexual initiation. Results: A total of 356 respondents were involved in the study. The prevalence of premarital sex was 31.7%. The mean age of sexual initiation in the study population was 16.46 ± 2.3 for males, 16.6 ± 1.4 for females and 16.5± 1.9 years for both sex. Being male by gender [COR 2.053 (1.278, 3.300) and AOR 1.703 (1.997, 2.910)], age greater than 15 years [COR 2.333 (1.075, 5.063) and AOR 1.572(1.627, 3.941)], having pocket money [COR 0.446 (0.277, 0.720) and AOR 2.102(1.244, 3.552)] were found to be significantly associated with premarital sex Conclusion and recommendation: This study has revealed that early sexual initiation before marriage was high and school adolescents started sexual intercourse very early and are involved with high-risk sexual practices which were unplanned and unprotected. Consistent Provision of information about adolescent reproductive health in general and per-marital sexual practices and factors related to it in particular should be provided to the school adolescents by the concerned governmental and non-governmental bodies.
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    Assessment of Adherence to Hypertension Managements and its Associated Factors Among Hypertensive Patients Attending Black Lion Hospital Chronic Follow up Unit Addis Ababa, Ethiopia.
    (Addis Ababa University, 2012-05) Abera Habtamu; Abebe Mesfin
    Background: Hypertension is one of the most important preventable causes of premature mortality worldwide and it is one of the primary risk factors for heart disease and stroke. In Ethiopia 10.6% and Addis Ababa, 30% of the population has been estimated to have hypertension. Adherence to medication therapy and lifestyle change is an aspect of patients’ care that is often overlooked and should be evaluated as a crucial part of cardiovascular management. Therefore, this study aimed to assess adherence and associated factors of adherence to hypertensive management among hypertensive patients in Black Lion Hospital chronic follow up unit. Methods: A cross-sectional study was conducted. Systematic sampling technique was used to select 286 study subjects. A structured standard questionnaire was used after some modifications. Analysis was done using SPSS software. The descriptive analysis such as percentage, proportion, frequency distribution and appropriate graphic presentation were used. Bivariate and multivariate logistic regressions were employed. P-value <0.05 was considered statistically significant association. Results: Of 286 subjects included in the study, 165 (57.7%) were female and mean age was 52(22-83) years. The adherence level of respondents to medication, diet, substance and exercise were 69.2%, 64.7%, 87.4% and 43.7% respectively. On regression analysis, married respondents were two times more likely to adhere to anti-hypertensive medication compared to divorced (AOR=2.00, 95%CI: 1.330-6.744, P=0.008). Very well informed respondents were 2 times(COR=1.94,95%CI:1.042-3.622,P=0.037), 4 times(AOR=4.17,95%CI:1.862-.340,P=0.001) and 7 times(AOR=6.47,95% CI:2.514-16.664,P<0.001) were more likely to adhere to medication, diet and recommended substance management than their counterparts respectively. Respondents with the duration of diagnosis of five or more years were 89 %( AOR=0.11, 95% CI: 0.013-0.955, P=0.045) and 90 %( AOR=0.10, 95% CI: 0.026-0.340, P<0.001) were less likely to adhere to medication and substance recommendation than their counterparts. Conclusion and recommendation: The rates of adherence to medicine and life-style changes were generally found to be low in these study participants. The cause of non-adherence is different according to the type of adherence. Each recommendation should be assessed individually in terms of adherence.
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    Challenges and Coping Mechanisms of Nurses Working in Intensive Care units of Governmental and Non Governmental Hospitals of Addis Ababa City from 2011-May2012.
    (Addis Ababa University, 2012-05) Kassie Amare ; Tachbele Erdaw(PhD)
    Introduction: The interplay of high technology and high acuity in critical care makes the intensive careunit (ICU) environment one of the most complicated for healthcare facilities. Most hospitalized patientswith critical conditions are cared for in ICUs. Nurses with limited ICU experience consider caring for highly dependent patients more challenging than experienced nurses and may perceive that ICU setting isa more strenuous and stressful environment in which to work. Objective: The aim of this study was to assess the challenges and coping mechanisms of nurses workingin intensive care unit in caring for patients in governmental and non-governmental Hospitals of AddisAbaba, Ethiopia, 2012. Methods: Descriptive cross sectional study was conducted to assess the challenges and coping mechanisms of nurses working in intensive care units in caring for patients in governmental and nongovernmental Hospitals in Addis Ababa. A total of 207 intensive care unit nurses were involved in thestudy. Result: A total number of 207 nurses who were working in intensive care units of both governmental andnongovernmental hospitals were participated in the study, of which 102 (49.3 %) were working government hospitals in neonate, pediatrics, medical and surgical intensive care units, where as the rest105 (50.7 %) were working in nongovernmental hospitals in neonate, pediatrics, medical, surgical,emergency and cardiac intensive care units. Among all respondents 85 (41.1 %) didn’t get adequate information from physicians about the patient’s over all condition. Majority 156 (75.4%) of nurses were assigned in intensive care units without their choice. The result shows that majority 136 (65.7 %) of nurses feels demoralization when they were unable to perform procedure for their patients in their respective working units followed by feeling of inferiority which accounts 18.4 %. Conclusion and recommendation: Nurses in intensive care units have no adequate supplies to provide care for their patients and also there is poor team sprite in the intensive care units of both governmental and nongovernmental hospitals. Nurse- patient- ratio in the study site indicates that nurses are highly overloaded. Therefore there should be proper staffing policy in each hospital to maintain quality health care service.
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    Assessment of Factors Influencing Professionalism in Nursing in Mekelle Zone Public Hospitals,Tigray,Northern Ethiopia,2012.
    (Addis Abeba University, 2012-05) Fantahun Atsede; Demissie,Asrat(Ass Prof)
    Background Professionalism is defined as the conceptualization of obligations, attributes, interactions, attitudes, and role behaviors required of professionals in relationship to individual clients and to society as a whole. Professionalism attributes include knowledge, spirit of inquiry, accountability, autonomy, advocacy, innovation and visionary, collaboration and collegiality, and ethics. These all may be influenced by age, sex, work experience, salary, ethnicity, religion, marital status, educational status, work setting, and professional organization. Objective The aim of the study was to assess factors influencing professionalism in nursing among nurses in Mekelle zone Public hospitals. Methods A quantitative cross sectional study design supplemented by qualitative were employed. Arandom sample of clinical nurses (N =210) from September 2011 to May 2012.The techniques for data collection were self administered questionnaire and focus group discussion (FGD). Data analysis was done using SPSS version 16.0 and logistic regression analysis was done to assess significant association between dependent and independent variables. Qualitative of data was analyzed manually and results were presented descriptively. Result Out of 210 respondents 58.57% were females and the mean age of the respondents was 32.40 years (SD= 8.42; range, 20-59 y).The mean of nursing experience 10.35(SD=9.154) and (51.43%) possessed BSc in Nursing. Respondents belonged to a professional organization was only 48%. The mean monthly salary of participants was 2168.39 EB (SD=573.281).The finding also showed that age and work experience had significant correlated with total professionalism (r= .122, P< .1); and (r = .120, P< .1) respectively. Work setting in Mekelle hospital was significantly associated [AOR (95%CI) = 4.090(1.359, 12.309)] with professionalism. Depending on FGD, the major factors were workload, had no vision, FMOH did not focused nursing as a profession, Weakness of the Ethiopian Nursing Association , lack of life insurance as well as the Health professionals and society’s views of the profession. Conclusion and Recommendation Respondents who score high attitude toward professionalism were 12.9%. After further statistical analysis using logistic regression, work setting in Mekelle Hospital had significantly associated with professionalism. Age and work experience had correlated with total professionalism.ENA and FMOH should focus on developing the level of professionalism in nursing. There were additional factors raised in FGD: such as lack of life insurance, weak ENA. Key words: professionalism, attributes of professionalism, Mekelle public hospital nurses.
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    Assessment of Stress and Coping Among Nurses Who Work at Gondar University and Felege Hiwot Referral Hospitals, Amhara Region, Ethiopia.
    (Addis Ababa University, 2012-05) Zewdu Fissiha; Tacbele Erdaw(M.sc, PhD )
    Background: A survey of literatures on nurses reveals that although a great deal of research has been carried out relating to stress and coping in nurses internationally, the information in Ethiopia is yet limited. Objective: This study was designed to determine Sources of occupational stress and coping strategies among nurses who are working at Gondar University and Felege Hiwot Referral Hospitals, Amhara Region, Ethiopia. Methodology: An institution based cross- sectional study was conducted from January to February, 2012 G.C among nurses who work at Gondar University and Felege Hiwot referral hospitals. For the purpose, a total of 268 Nurses were involved in the study. Sstandardized self administered questionnaires including Nursing Stress Scale and Ways of Coping Checklist were distributed among the nurses. In order to check the clarity of the questionnaires, a pilot pre test was conducted on nurses in Debark Hospital, Debark Town. Then the survey was conducted immediately after amending the questioners based on the feedback from the pre test. Statistical analysis of the data were conducted using Statistical Package(SPSS 20) for the demographic profile of the participants, the frequency of the adopted coping strategies and the mean scores (and standard deviation) of sources of stress. Analytical statistics were done to compare relationship among variables. Result: The greatest proportion of respondents was women (59.7%), Orthodox (97.4%), age between 23-35(63.1%) years, had less than 5 years of experience (44%). The following stressors were identified: death and dying, work load, uncertainty regarding treatment of a patient, work load. The most common strategy used by nurses was problem-solving and Seeking social support and Accepting responsibility and the strategy least used were escape avoidance. In this study large proportion of nurses used Problem-focused approaches but an emotion-focused strategy were generally less used. Conclusion It was concluded that sampled nurses are stressed. They should be sent for courses on human behaviour, resource management, interpersonal relation, stress management and crisis interventions .
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    Assessment of Treatment Compliance Among Cervical Cancer Patients in Tikur Anbessa Specialized Hospital, Oncology Unit.
    (Addis Ababa University, 2012-06) Yitayih Gebre; Aga Fekadu(RN, MSC)
    Background: Cancer of the cervix is the second most common form of cancer amongst SouthAfrican women. Cervical cancer ranks as the 2nd most frequent cancer among women inEthiopia, and the 2nd most frequent cancer among women between 15 and 44 years of age.Compliance has been defined as “the extent to which a person’s behavior coincides withhealthcare advice” or as when patients do what health professional’srecommend.Noncompliance is typically cited as occurring in from 50% to 75% of patients. Objective: The purpose of the study was to assess compliance to treatment services and associated factors with treatment compliance of cervical cancer patients in TASH, oncology unit. Materials and methods: Institutional based cross sectional quantitative study was conducted from February, 8-April, 22/2012. A total 314 cervical cancer patients were the study participants. Data was collected using structured questionnaire based interview and secondary data collection also used. After clearing and checking for consistency data were coded and entered in to EPI-INFO(version-5.3.1) and transported into SPSS version 16.00 software to determine frequency, OR and association tests were examined through Binary and multivariate logistic regression . Result: Out of 314 interviewed cervical cancer patients 219(69.7%) were compliant but 95(30.3%) were non compliant to the treatment services. The reason as identified by 39(41.0%)of the respondents with non compliant to the treatment services was long duration of appointment time and 20(20.0%) of the participants due to medication side effect on the body was examined in the study area. There is a significant difference between the participants 121(78.6%) who had missed their appointment time with, OR=2.32(1.408, 3.882) and pvalue=0.001 than the respondents 98(61.2%) of cervical cancer patient of treatment compliance. Conclusion: the findings of the study about the treatment service were partially non compliant to radiotherapy and cheomradations services and patients missed their appointment were 2.3 times non compliant than who were not missed the appointment time. Factors in low income level, missing appointment, medication side effect, prolonged treatment, poor understanding of treatment advantages were significantly affects treatment compliance based on binary and multivariate logistic regression analysis .
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    Coping Mechanism used by Breast Cancer Patients in Tikur Anbessa Specialized Hospital ,Addis Ababa,Ethiopia,2012.
    (Addis Ababa University, 2012-06) Amare Meron; Kalku Yemesirach
    BACKGROUND INFORMATION: Breast cancer is the leading cause of cancer related death among women worldwide .Many women adapt differently to having breast cancer and use different coping strategies to deal with the physical and psychological challenges of the disease. A review of the literature showed several factors that could influence the coping strategies of women with cancer, including demographic characteristics, educational level, positive thinking, and psychosocial support. OBJECTIVE: To assess coping mechanisms used by breast cancer patients in Tikur Anbassa Specialized Hospital,Addis Ababa, Ethiopia from October to May 2012. METHOD: The study was conducted in Tikur Anbassa Specialized Hospital from October to May 2012. Aninstitutional based cross-sectional study was implemented. All breast cancer patients in the study hospital were enrolled. The total of 234 breast cancer patients obtained for interview by convenient non probability sampling technique. The data was collected using pretested structured questionnaire which was piloted on 10% of patients with the same hospital prior to data collection time. The final result of this study will be submitted to the concerned bodies. Data was entered into the computer, cleared, edited and coded before analysis. The data was analyzed by using SPSS 16.0 version. The results were presented by frequency tables, charts and figures. Moreover, cross tabulation made between selected variables and p<0.05 was considered significant. RESULTS: From a total of 234 breast cancer patients involved in the study area, 101 (43.2%) were at age range of40-54 years. The majority of subjects 214 (91.5%) were ever married while 20 (8.5%) were never married. Among the study subjects 152 (65.0%) of the respondents were unemployed and the others 82 (35.0%) were engaged in some occupation. Among the educational status of the study population 90(38.5%) had no formal education. Among the respondents 109 (46.6%) had no income. Among 234 respondents 59.13% of them did not use seeking social support coping activities. The majority of the respondents 67.01% did not use planful problem solving coping activities. From a totalof 234 respondents 68.3% did not use positive reappraisal coping activities. After controlling for confounding variables educational level was found to be the main predictor, independently and negatively associated with isolation with (OR=0.199,95%CI(0.102,0.211). Illiterates use isolation compared to literates. CONCLUSIONS AND RECOMMENDATIONS: Breast cancer disease indeed affects quality of life and the clients` coping in a dominant ways.Therefore, we need to encourage positive coping activities and discourage negative coping activities.Moreover, we need to incorporate social and psychological support in addition to the physical care. It is recommended that educators must design programs and curricula to provide information inclusive ofboth patients and caregivers. More research in field will help to solve existing as well as new problem.
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    Assessment of Utilization of Youth Friendly Reproductive Health Services Among College Youth in Asela Town,Oromia Regional State, Ethiopia.
    (Addis Ababa University, 2014-04) Bedho Tolessa Kebede; Aga Fekadu(BSc, MSc)
    Background The reproductive and sexual health of the youth remains a relatively new and sensitive area mainly due to restrictive norms and policies guiding the services and also the access and utilization of YFRHS among the college youth are dependent on many factors which include demographic, economic, college, socio-cultural and health system factors. This study was conducted to assess the utilization of youth friendly reproductive health services (YFRHS)among college youth in Asella town. Methods The study used quantitative approaches to collect data. The study was utilize survey research adapting descriptive cross sectional design and a questionnaire to interview 423 college youth in Asella town. Quantitative data was analyzed using Epi Info & Statistical Package for Social Sciences (SPSS). Descriptive statistics and chi-square tests were performed to determine significant associations. The study was performed for a total of six months starting from December 2014 up to May 2014. Result The study establish that sex, age, level of education, and youth’s awareness about existence of reproductive health facility and services. Age, sex, knowledge had no significant influence on utilization of almost all YFRHS such as family planning, voluntary counseling and treatment of STI. As indicated by the test result of family planning (χ2= 17.915, p = 0.593), VCT (χ2= 17.84,P = 0.598) and treatment for STIs (χ2= 24.336, p = 0.228) they had no significant association toutilization of the service. Again age was not also significant association with knowledge of YFRHS and their utilization χ2= 38.968, P = 0.472. On sex and utilization, significance was not seen in sex and utilization of family planning because (χ2= 4.53, P=0.104). Conclusion and Recommendation The recommendations arising from this study are: this study recommends active sensitization of the youth in college through different activities that creates an opportunity where such information can be shared to scale up their knowledge on the YFRHS and the facilities that are available, this will in turn increase utilization of the services.
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    Assessment of Adherence to Insulin Self Administration and Associated Factors Among Diabetes Mellitus Patients at Endocrinology unit of Tikur Anbessa Specialized Hospital.
    (Addis Ababa University, 2014-06) Haji Yusuf ; Mengistu Zuriyash(MSC)
    Background: Diabetes is a significant and growing health problem worldwide. The goals of diabetes treatment are to keep blood glucose levels as near normal as possible while avoiding acute and chronic complications and diabetes mellitus requires continual intensive treatment in order to reduce the risk and progression of chronic micro- and macro-vascular complications. A key dimension of healthcare quality is adherence to prescribed medications. Non-adherence with insulin regimens is associated with worse glucose control and with higher rates of diabetes-related complications. Objectives: To determine the pattern of adherence to insulin selfadministration and associated factors among adult patients with diabetes mellitus at endocrinology unit of Tikur Anbessa Specialized Hospital. Methods: A cross-sectional study was conducted from December to June 2014, on a total of 378 diabetic patients on insulin self administration using convenience sampling method until the required sample size achieved. The data were collected using structured questionnaires after ethical approval and informed signed consent have been taken. The data entry and analysis was conducted using Epi info version 3.5.4 and SPSS version 21. Results: One hundred twenty five (33.1%) of the respondents were found to be non-adherent to insulin self injection. Multivariate analysis identified who stopped taking insulin when they feel better, who have Heart disease and those not taking insulin when they were out of home for long time as independent factors for non adherence of insulin self administration. Conclusion: One third of the respondents are found to be non-adherent to insulin injection. The most common reason for non adherence to insulin self administration were forgetting time of injection, deliberately, feeling better and feeling worse. Almost all participants have been using one needle for two or more days, only 4 (1.1 %) participants have been using single needle once as recommended. Recommendation: There is a need to design a means for patients to understand risk and complication of non adherence to insulin self administration, patients should be encouraged to discuss their injection related concerns and providing them leaflet to avoid poor recall of instructions and improve consequent clinical outcomes. For those patients who do reuse insulin needle, nurses should check frequently injection sites as reusing needle causes infection.
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    Prevalence and Associated Risk Factors of Hepatitis B and C Virus among Volunteer Blood Donors in Arbaminch Blood Bank SNNPR, Ethiopia
    (Addis Ababa university, 2015-11) Adato Ayele; Mulugeta Gebru
    Background: Hepatitis B virus (HBV) and Hepatitis C virus (HCV) is major public health problems that affect million people worldwide and people who are infected assumed to develop liver cirrhosis or hepatocelular carcinoma. Infected peoples are at latent stage before clinical sign and symptom, screening of blood donors is very important for healthy and safe blood donation. Objective: To assess prevalence and associated risk factor of HBV and HCV among volunteer blood donors in Arbaminch blood bank. Method: A cross sectional study design was conducted among blood donors in Arbaminch blood bank from Feb 2015-Aug 2015. A total of 359 volunteer blood donors who came to Arbaminch blood Bank were interviewed face to face, then data was collected by using structured and pretested questionnaire, and finally blood sample drown and tested for HBV and HCV by using ELISA (enzyme linked immunosorbent assay) technique. Descriptive statistics was calculated for most variables in the study. OR and 95% CI was used to assess the association. Result: Prevalence of HBV and HCV among study participant was 4.7% and 0% respectively.From 17 participants tested positive for HBV, 8 (47%) were males. The test positivity among male was 8/197 (4.1%) while among females was 9/162 (5.6%) and more than three forth participants tested positive were age less than 25. After multivariate analysis, when positivity was compared among study participants grouped based on average monthly income, participants earning 581-1,300 were 32.2% less likely to have infection than participants earning below 580 birr per month. (AOR= 0.322, 95%CI =0.108-0.961). Volunteer donors who exposed to unsafe therapeutic drug injection was 8(2.2%) and from those 3(37.5%) was positive for HBV. When compare to volunteers who did not exposed 14(4%), exposed donors 11 times increased risk of HBV infection. This was statistically significant (AOR=11.090, p=2.258-54.475). Conclusion: Prevalence HBV of among volunteer blood donors in Arbaminch Blood Bank was4.7%. Low monthly income and using unsafe therapeutic injection were related to HBVinfection. Recommendation: Improve community awareness, infection control and post counseling will be done to control infection. Key words: hepatitis B virus, hepatitis C virus, volunteer blood
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    Treatment Outcome and Associated Factors Among Cervical Cancer Patients Treated at Tikur Anbesa Specializsed Hospital Addis Ababa, Ethiopia a Retrospective Study
    (Addis Ababa University, 2018-01) Tarik Fikeraddis; Gebreyohannis Tigistu (MSc)
    INTRODUCTION: Cervical cancer is a common cancer of the female reproductive system,specifically the cervix of the uterus. Based on the global burden of cancer 2008 estimates, about 12.7million cancer cases and 7.6 million cancer deaths are estimated to have occurred. Among these 56% of the cases and 64% of the deaths occurred in the economically developing world. Ethiopia is one of the developing countries with 42 million female populations and 7000 new cases of cervical cancer with 5000 deaths every year. Despite this high prevalence of disease there is only one cancer treatment center at TikurAnbesa specialized hospital which provides surgery, chemotherapy and radiotherapy. The facility serve as a national referral facility for all regions associated with this most of the time it is congested with many patients waiting to be treated. OBJECTIVES: to asses treatment outcome of cervical cancer patients and associated factor among patients treated at Tikur Anbesa specialized hospital oncology unit. Methods and analysis: retrospective quantitative cross sectional study design was conducted using questions to collect data from medical chart of patient who were treated for the past 5 years. Data was analyzed by bivariate, multivariate logistic regressions using SPSS version 22computer software. Result: In this study the treatment outcome of cervical cancer patients was cured for 3.6% patients and recurrence occurred among 26.2 % of cervical patients and 70.2% were lost from follow up. In multi logistic regression cervical patients those with stage 3b were 0.021 times {AOR=0.012; 95% CI (0.001-0.23)}, less likely to be cured compared to those have clinical stage 2A. Cancer patients those have positive result of pelvic node were 0.03times {AOR=0.001; 95% CI (0.001-0.92)} less likely to be cured compared to those have negative result of pelvic node. Cervical cancer patients with sero -positive HIV status were 2.8 times {AOR=2.8; 95% CI (2.14- 7.65)} more likely to have recurrence of disease compared to those with sero -negative HIV status. Conclusion and recommendation: The study revealed that there were a relatively low number patients cured from cervical cancer, slightly high number of recurrence of disease occurred and high number patients lost to follow up. There is a need to design treatment outcome improving intervention plan and implementation.
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    Assessment of Job Related Stress and Its Predictors Among Nurses Working in Government Hospitals of West Shoa Zone, Oromia Region, Ethiopia, 2018
    (Addis Ababa University, 2018-03) Nemera Amsalu; Cherie Amsale (PhD)
    Background: Job stress is prevalent problem among nurses working in public Hospitals as they deal with large number of patients with variety conditions and work over load. Therefore, if it is not properly managed stress leads to high levels of employee, illness, absenteeism, high turnover, and decreased productivity that compromise provision of quality service to clients. However little has been addressed job related stress and its predicting factors in the study area Objective: To assess the level of job related stress, and predicting factors among Nurses working in Public hospitals of West Shoa Zone, Oromia Region, Ethiopia, 2018. Method: Institutional based Cross-sectional study design supplemented with qualitative study design was used. A structured self-administered questionnaire was use to collect data from study participants from February 30,to march 30,2018. Study population was all nurses who are working in randomly selected in Public Hospitals in West Shoa Zone and sample size was 180 nurses from the six hospitals. The data were entered into info.3. and analyzed by SPSS window software 21 version. Descriptive statistics such as frequency distribution and measure of central tendency and variability were computed. Univariate and multiple logistic regressions were used to identify the association between dependent and independent variables. Results: A total of 180 nurses working in West Zone public hospitals were given the questionnaire, and the response rate was 98.3 % (177).The study indicated that 87(49.2%);95%CI:,42.4%-56.5%) of nurses were occupationally stressful. Death and dying, uncertainty regarding patient treatment, conflict with supervisor and work load was the most sources of stress for nurses with mean scores of 2.76, 2.55, 2.5 and 2.4 respectively. Individual factors like respondents‟ work experience of less than five years (AOR=12.300,95% ,CI:2.59858.245), diploma holders; married (A OR=, 11.323,95 %,CI:4.213-30.434)and nurses who were work in emergency units (AOR=10.291,95%, CI:1.98-53.48).was significantly associated with overall job related stress score. Conclusion and Recommendations .In this cross sectional study almost half of the nurses were occupationally stressful. Individual factors like respondents work experience of less than five years, diploma holders; married and nurses who were work in emergency units was significantly associated with overall job related stress score. To prevent occupational stress among nurses, policy makers and different stake holders should come up with strategies and Programs that will help to develop stress reduction management for hospital based nurses