Pediatric Nursing

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    Assessent of Stress and Coping Strategies Among Women with Problem of Obstetric Fistula in Addis Ababa Ethiopia
    (Addis Ababa University, 2008-06) Mengesha, Mesfin; Murugan, Rajalakshmi (PhD)
    Background: An obstetric fistula is a hole in the wall of the vagina connecting to the bladder or rectum that is caused by prolonged and obstructed labor. As a result the girl or woman is left with uncontrollable leaking of urine and/or feces from her vagina, and constant and humiliating odor and wetness. Compounding this catastrophic physical trauma, in almost all cases, the woman suffers the loss of her baby. Without treatment women are frequently ostracized from their communities out of shame. Some are rejected or abandoned by husbands and families. Many are unable to work or earn a living, driving them deeper into poverty (21). Coping responses are a dynamic series of transactions between the individual and the environment, the purpose of which is to regulate internal states and/or alter the person-environment relations. The theory postulates that stressful emotions and coping are due to cognitions associated with the way a person appraises or perceives his/her relationship with the environment 22. This study is conducted to determine the levels of stress and coping mechanisms used by women living with obstetric fistula admitted at Fistula hospital in Addis Ababa. Objective: To determine the sources and levels of stress, and coping mechanisms of women living with obstetric fistula. Methodology: Institution based retrospective cross sectional study was conducted at Addis Ababa fistula hospital from April 2009 to June 2009. Valid and reliable questionnaire administered to all eligible women admitted to the facility during the study period. Participants were surveyed with a demographic data sheet, stress, and ways of coping questionnaire and in-depth semi-structured interviews and then processed and analyzed using SPSS software version 17. Results: Finding of this study showed that, the most frequently encountered sources of stress are internal stressors with highest mean and standard deviation 61.81(11.35) followed by external stressors 27.01 mean and 7.09 SD. The least sources of stressors among these women were, situational stressors having Mean and SD 26.280(8.06). The coping strategy used most frequently among these study subjects was Planful problem solving, Mean and SD 20.341(3.856) and escape- avoidance 15.522 Mean and 3.841 SD. The less common utilized coping strategy among theses women was Confrontive coping having 3.806 Mean and 1.503 standard deviation. Conclusions: Women with obstetric fistula are exposed to many stressful situations as a result of their problem, and these stressful situations are occurring with differing degree. Women utilize different coping mechanisms in order to avert their problem, identification of the type of stressor and it’s level and coping strategy has a paramount importance. Recommendation: The care that we provide to mothers must be an understanding and of holistic type which encompasses education, literacy training, the development of social networks, and the provision of skills with which to earn an adequate livelihood
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    Patient Satisfaction with Nursing Care in Medical and Surgical Wards of Government Hospitals, Addis Ababa, Ethiopia, May 2009
    (Addis Ababa University, 2009-05) Bekele, Solomon; Tachbele, Erdaw (PhD)
    Background: patient satisfaction with nursing care has been found to be the most important predictor of over all patients’ satisfaction with hospital care. Nursing practice is patient driven and patient centered. Accordingly, patient satisfaction has been strongly advocated by nursing professionals to be an important indictor of quality of nursing care delivery. Objective: The objective of this study was to assess patient’s satisfactions with nursing care provided in medical and surgical wards of government hospitals in Addis Ababa. Methods: A cross sectional study was conducted in three governments hospitals namely Back lion, St. Paul and Yekatit 12, in Addis Ababa, Ethiopia from July 2008 to June 2009, The study population was adult patients who were admitted to the medical and surgical words of the study hospitals and stayed for at least seven days. The data coactions tool was a modified Newcastle satisfaction with Nursing scale (NSNS). Data analysis was computed by SPSS. Ethical clearance was secured from medical faculty, IRB office A.A.U. and study hospitals. Participation in this study was voluntary and based on patient’s ability to given informed consent. Result: A total of 450 adult patients from medical and surgical wards were approached from the study hospitals and 435 of them participated in this study (non-response rare was (3.4%). Participants who were males, age group 18-30 years old, stayed in the ward of for 7-15 day and have no history of previous admission were more satisfied. The overall rating of satisfaction was 56.3%. The top aspects that patients scored highest for their satisfaction with nursing care were the amount of privacy nurses gave to patients, the amount of freedom given on the ward and nurses manner in going about their work. The aspects with which patients least scored were the amount of time nurses spent with patients’, nurses awareness of patient needs the amount and type of information nurses gave to patients about their condition and treatment. Income and having other disease in addition to cause of admission were the significant predictors of patient satisfaction with nursing care (P<0.05). Implementation of individual nursing care plan and improving therapeutic nurse-patient communication were recommended. JEY WORDS: Nursing care, patient satisfaction.
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    Assessment of Adult Diabetic Clients Perception About The Effect of Diabetic Related Education and Counseling in Yekatit 12 and Black Lion Specialized Hospitals, A Cross- Sectional Study; Addis Ababa, 2009
    (Addis Ababa University, 2009-06) Getahun, Meaza; Demisse, Asrat ( Assistant Professor)
    Background: The incidence of Type 2 Diabetes Mellitus (T2DM) is rapidly increasing on a global basis. Provision of proper educational session in health care facilities is believed as important in the management of T2DM. Objective: The aim of this study was to assess the perception of adult diabetic patients on diabetic related education and counseling. Method: This cross-sectional study was done in Addis Ababa Black Lion Specialized Hospital (BLSH) and Yekatit 12 Hospital Diabetic clinics from April 25 – May 22, 2009. The techniques for data collection were interview method and Focus Group Discussion (FGD). Six nurses were interviewers and the principal investigator supervised the over all process during an interview. FGD was conducted by the investigator with the aid of tape-recorder. A total of Four-hundred forty two participants with Type 2 Diabetes Mellitus and 25 patients were included in FGD. Data analysis was done using SPSS version 15.0 and results were presented by tables, figures and different statistical tests were done to indicate associations between variables. Result: Out of 442 study participants and 25 informants, nearly 56.6% of them were females and 60.7% of them aged above 40 years of age. Three- hundred ninety one (88.5%) of them were living with family and 225 (50.9%) of them had low monthly income (< 400 ETB). Mean BMI and FBS of study participants were 23.6 ± 3.81 kg/m2 and 164 ± 71.1 mg/dl respectively. Almost half of the study participants had FBS level between 120- 199 mg/ dl of blood. Around 63.6 – 97.7% of study participants had sufficient knowledge on what diabetes mellitus is, management options and related acute/ chronic complications. Perception about given diabetic education was strongly associated with age, education, income and duration of patient’s diagnosis with T2DM (P < o.oo1 and p < 0.005). Conclusions: Regular educational session for patients with adult onset diabetes mellitus is mandatory for empowering them with knowledge and skill. The result of this study will be used in those diabetic clinics as valuable information for improvement of patient education, which is essential for the betterment in quality of health. Keywords: Counseling, education, perception, Type 2 Diabetes Mellitus.
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    Risk Factors for Unsafe Sexual Behavior Among Preparatory Youth Students of Addis Ababa
    (Addis Ababa University, 2009-07) Dessie, Azeb; Abebe, Mesfin (PhD)
    Background: Youth’s sexual risk taking, which is recognized by involvement in premarital sexual activity, reluctance to use protective contraceptive, is observed to be the causes of various problems. As far as youths are exposed to high risk activities/ behavior is reported to be growing, it is obviously associated with Reproductive Health Risks (RHR), including the risk of HIV contraction, mainly acquiring the infection through unsafe sexual intercourse. Recognizing and addressing risk factors contributing to unsafe sexual behavior, and also understanding why they engage in risk behavior should be thought. Objective: The objective of this study is to assess the risks factors related to unsafe sexual behaviors Method: A cross-sectional study that employed quantitative data collection method supplemented by qualitative focus group discussion was used to assess risk factors for unsafe sexual behavior among preparatory youth students. The study was conducted from April to May 2009 in randomly selected 13 preparatory schools in A.A.on 461 samples of study subjects. Data entry, cleaning and analysis were done using SPSS version 13.0, bi- variate analysis was used to describe some of the socio-demographic variables, and logistic regression model was used to measure the association of outcome variables of different characteristics of the study subjects. Results were presented by tables and figures. Result: Out o 461 sample size 454 participated in the study making the response rate of 98.48%, 46.70% of the respondents were sexually active, the majority were males within the age group of 18-19 years. More than half of the sexually active students (60.84%),had their first sexual intercourse under the age of 18 years, the mean age of first sexual contact 16.4 years.60.85% of the respondents had multiple sexual partners, using condom consistently was practiced only by 40.6% of the sexually active respondents. Risks to unsafe sex like substances uses, peer pressure for doing sex, and loose family connectedness were found to be significantly associated (OR: 2.75, 95% CI: 1.633-4.636), (OR: 2.557,95% CI: 1.509-4.333), (OR:2.187, 95% CI: 1.172-4.084), respectively. Conclusion: The majority of youth students are at higher risk of acquiring unsafe sexual behavior which is related to risk factors or behaviors they are exhibited and obviously revealed with score on the AIDS risk behavior index. Considering the risk factors for youth unsafe sexual behavior preventive and promotive work should be strengthened through effective BCC and family life education.
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    Assessment of Factors Affecting Parents in Discussing Reproductive Health Issue with their Adolescent in Shambo town, Horo Guduru Wollega, Oromiya Region, Ethiopia, May 2009
    (Addis Ababa University, 2009-07) Assebe, Tesfaye; Gebrekidan, Berhane (Assistant Professor)
    Background: - even though sexual activity put adolescents at risk of various reproductive health (RH) challenges, many adolescent lack strong stable relation ships with parents or other adults with whom they talk to get information about their RH concern. Objectives: - The general objective of the study is to identify factors affecting parents in discussing reproductive health issues with their adolescent. Method: - Community based cross-sectional study was designed to determine factors affecting parents in discussing RH issue with their adolescents among families who had children aged 10 years and above living in Shambo town conducted in May 2009. A total of 262 house holds were selected using systematic sampling technique. Data was collected using structured questionnaire by six data collectors from resident of Shamboo town. Data was analyzed by SPSS soft ware version 15.0. Descriptive statistics was employed to describe the study population in relation to relevant variables. Odds ratio with 95% confidence intervals and regression was employed to describe the strength of association between the selected study variables by controlling for the effect of possible confounders Result and discussion: - The study showed that most respondent 84.6% were found to be knowledgeable about reproductive health and also the majority 90% had positive attitude towards discussing the RH issue with their adolescent. However, small proportions 38.2% have communicated to their adolescent on reproductive health issue. Educational level, knowledge, and attitude of parents had significant association with discussion of parents with their adolescents on RH issues. Conclusion and recommendation: - It can be concluded that, even though parents had basic information on RH, they did not practice in discussing RH issue with their adolescent. It is recommended that health workers in helping parents to become effective communicator to their adolescent as well as considering their role of educator should be considered
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    Assessment of Occupational Hazards Among Students of Nursing And Midwifery in Clinical Practice, in Addis Ababa, Ethiopia, 2009
    (Addis Ababa University, 2009-07) Fite, Teferi; Araya, Tekebash (PhD)
    Background: In their every day clinical practice, Nurses and Midwife students are at risk of occupational hazards especially risk of exposure to blood born pathogens potentially resulting to infections. The Nurse and Midwife students are prone to occupational health hazards and they are unrecognized group of health care providers. High levels of occupational hazards are believed to affect students’ health and academic functions. If the occupational hazards are not dealt with effectively, feeling of loneliness, sleeplessness and worrying may result. Effective coping strategies facilitate the return to a balanced state, reducing the negative effects of occupational hazards. Therefore, it is better to identify the occupational hazards that the Nurses and Midwife students face during their clinical practice and mechanisms of coping or preventing the occupational hazards. In order to have healthy and productive Nurses and Midwife graduates for the country, assessing the occupational hazards they face in their clinical practice and prompt intervention is very necessary. Objective: The objective of this study is to assess the occupational hazards faced by the Nurses and Midwife students during their clinical practice in all Degree program Nursing and Midwifery Schools in Addis Ababa. Methods: Cross-sectional descriptive survey was conducted from November 2008 to June 2009. 422 self administered questionnaire was distributed to 6 Health College Nurse and Midwife students who were systematically sampled and all have been filled and returned with much effort. The study populations were all of the systematically sampled of the regular Nurses and Midwifery day Degree program students of the six Nursing and Midwifery Schools excluding evening and 1st year students. Data was coded and analyzed using SPSS version 11 for computing frequency distributions. Greater number of responses and percentages were calculated. Result: The majority of the respondents (51.1%) knowledge of occupational hazards was gained from Nursing and Midwifery Schools, followed by books (16.6%) and Journals, (9. 2%). Majority of the study population (93.1%) indicated that they have got needle prick, blood splash and skin cuts during their clinical practice. The result confirms that all the factors mentioned in the work plan such as physical, biological, psychosocial and mechanical factors cause occupational hazards in the clinical practice. Conclusion and recommendation The study showed high rate of occupational hazards and the strongest predictor of needle prick injury, blood splash, and skin cuts, Nurse and Midwife students at risk for blood born pathogens. A safe and healthy practical area for Nurse and Midwife students is necessary for safe patient care and implementing control measures as well as preventive measures such as using universal precautions and managing shortage of preventive materials in clinical practical areas are recommended
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    The Desire to Have Children: Is Pmtct an Opportunity for Hiv Positive People? A Cross Sectional Study in Mekelle Health Institutions, Tigray/Ethiopia, 2009
    (Addis Ababa University, 2009-07) Desta, Amanuel; Cherie, Amsale (PhD)
    Back ground: The introduction of highly active antiretroviral therapy has changed the life prospect of PLWHA towards parenthood. However, little is known about the extent of PLWHA desire to have children. Objective: The aim of this study is to assess the desire to have children and identify factors associated with desire to have children among men and women living with HIV/AIDS at follow up of ARV treatment units. Method: A cross–sectional facility based study was conducted; using a pre tested structured questionnaires on sample of HIV–infected men and women attending at ARV treatment sites in Mekelle hospital and three health centers in Mekelle town. Total sample sizes of 367 respondents were selected using systematic random sampling technique. Respondents were selected proportional to the size of each facility serving ARV treatment. Data were analyzed using SPSS statistical soft ware version 15.0. Ethical clearance was obtained from the Medical Faculty of Addis Ababa University. Result: Data were obtained from 367 respondents, yielding a response rate 98.9%. One hundred forty four (39.2%) of respondents had desire to have children. Among men this proportion was 43.6% (n=61), in contrast to 36.6 (n=83) of women. Generally desire to have children was higher in the age group 20-29 years compared to elderly age group with OR 10.48 (95% CI: 5.07, 21.63). Respondents who disclosed their HIV status to their partners had significant association for desire to have children compared to those who do not disclosed with OR 1.67 (95% CI: 1.00, 2.80). Conclusion A significant proportion of HIV infected individuals have desire for children. Issues related to fertility desires need to be addressed more frequently by health care providers to their HIV-infected clients through counseling to facilitate informed decision- making about child bearing.
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    Assessment of Nurses’ Perception Towards Nursing Profession in Public Hospitals Under Addis Ababa Health Bureau, Ethiopia
    (Addis Ababa University, 2011-05) Wondwossen, Liya; Berhane, Emebet (PhD)
    Background: Whatever notion or idea best describes nursing and whatever set of activities it is defined, it is clear that there are different perceptions of nursing. Perception by itself is merely defied as an idea, belief, or an image you have as a result of how you see or understand something. The Perception of nursing may vary depending on age, educational level, social and professional experience. Objective: To assess Nurses’ Perception among Professional Nurses in public hospitals under Addis Ababa Health bureau, Ethiopia. Methods: Institution based cross sectional quantitative descriptive study with a cross sectional study design was used to assess the perception of nursing among professional nurses. The sample size was determined by using a formula for estimating a single population proportion. Sample size was 264. Data collection was carried out using structured questionnaire. The collected data were analyzed using EP Info version 3.5.1 and transformed to SPSS version 15.00 in the computer for further analysis. The analyses was verified using descriptive interpretation for demographic variables using frequencies and means, and comparative interpretation was employed for internal analyses using cross tabulation. The significance was checked using p value 0.05 and 95% confidence interval. Result: the response rate was 256 (96%). Majority (67.6%) were female nurses. More than half (56%) of nurses had good perception towards nursing. A significant association was seen between educational level and perception of nursing (P < 0.05). In addition education and perception of important aspects of nursing had shown association (P< 0.05).Conclusion & recommendation: Majority of nurses who participated in this study had good perception towards nursing. Occupational factors were identified as a leading factor which affects perception. Though this research lay down a base for the assessment of perception towards nursing by nurse professionals in our country, further researches are recommended.
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    Assessment of Knowledge, Attitude and Intension of Health Science Students Toward Safe Abortion Care Provision in Debre Markose University, Ethiopia, May 2011
    (Addis Ababa University, 2011-05) Asmamaw, Tarekegn; Assefa, Yeshi (PhD)
    Background: Negative attitudes toward abortion among professionals providing abortion services could be an obstacle even under a law which permits abortion on request. The shortage of health care providers who are willing or trained to perform abortions undermines the provisions of safe abortion services, by limiting the availability of safe, legal abortion, and has serious implications for women's access to abortion services and health service planning. Objective: The aim of this study is to assess knowledge, attitudes and intension of DMU Health Science student toward safe abortion provision. Methods: A quantitative cross-sectional institution based study was conducted to examine knowledge, attitude and intension of health science students (n=190) to provide safe abortion care services using pretested standard questionnaire at Debre Markose University. Result : Respondents were asked whether unsafe abortion is one of the major health problems in their country. Out of all respondents, 94.2% said that it was a major health problem. 65.3% agreed that they are more comfortable with medical abortion than with surgical abortion. Large majority of respondents 89.0% reported that they were not plan to perform abortion for their patients regardless of their reason for terminating a pregnancy. Discussion: More intension to provide medical abortion and surgical abortion in this study might have been the perception of students considering that higher magnitude of the problem of unsafe abortion in our country and the need of safe abortion care providers to solve maternal morbidity and mortality from unsafe abortion. Conclusion and recommendation: Very surprisingly majority of students in this study have willingness to seek abortion care training. Although it may not be possible or desirable to require abortion training for every future health care provider separately, making safe abortion care training a standard part of the curriculum will open avenues for both future nurses and health officer who are in favor of providing safe abortion care services. More important, expanding abortion training in the allied health professions will likely alleviate the abortion provider shortage throughout Ethiopia. Key word: Attitude, Intension, safe abortion provision, medical abortion, surgical abortion.
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    A Comparative Study on Nurses and Midwives Job Satisfaction Between Functional and Business Processing Re-Engineering (BPR) Method of Organization in Hawassa University Teaching Hospitals, Snnpr, Ethiopia
    (Addis Ababa University, 2011-05) Kassa, Abdu; Mandesh, Alemnesh(PhD)
    Background: Job satisfaction is the affective orientation that an employee has towards their work. What makes a job satisfying or unsatisfying does not depend only on the nature of the job, but also on the expectations that individuals have of what their job should provide. Objectives: The main objective of this study is to compare levels of professional nurses and midwives job satisfaction and its determinants between functional and business processing re- engineering (BPR) method of organization in Hawassa university teaching hospitals, SNNPR, Ethiopia. Methods: Institutional based cross- sectional descriptive data was collected by using self- administered questioners complimented by focus group discussions from 122 nurses and midwives full time workers who were randomly selected via simple random sampling technique. Results: The analysis and interpretation of data was made using simple percentage count, mean score, and crude and adjusted odds ratio. Narrations of some qualitative data were also used. Concerning the findings of overall job satisfaction on both methods of organization almost half by half result were found, means the new method (BPR) couldn’t bring a significant change on nurses and midwives job satisfaction. Also half of the respondents were planned to learn out of nursing science in the coming five years because of hate of organizational affiliation towards nurses. This may cause shortage of experienced nurses and midwives which is a global problem nowadays. Conclusion: The study in this regard showed that a lot has to be done in the future to avert this situation. To this end, it should receive special managerial attention by finding out possible strategies, to strengthen predictors of intention to remain employed and upgrading their knowledge in nursing sciences, like employment practices that reflect moral integrity, incorporate clear communication systems, maximize employee involvement in decision-making, cohesive working relationships (cooperation with medical staff), appropriateness of the system for nursing, promote praise and recognition, and establish a shared vision and goals
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    Prevalence of Suboptimal Child Spacing Practice and its Associated Factors Among Women of Child Bearing Age in Serbo Town,Jimma Zone Southwest Ethiopia, 2017
    (Addis Ababa University, 2011-06) Bacha, Girma; Wondwesson, Kalkidan (PhD)
    Introduction: Birth spacing is the time gaps between two consecutive life births. Optimal spacing until the next pregnancy is generally understood to refer to resting period that allows the mother time to recover from pregnancy, and labor. Family planning programs have advocated three and more year’s intervals between births for infant and child health and survival. Recent research found that the health of mothers and infants with the birth interval of 3 to 5yrs is safer than 2 yrs or less. Objectives: To assess Prevalence Of Suboptimal Child Spacing Practice And Its Associated Factors Among Women Of Child Bearing Age In Serbo Town,Jimma Zone Southwest Ethiopia, 2017 Ethiopia, from March to April 2017. Methods: Community based cross sectional study design was used. Samples of 314 women were selected using simple random sampling. Semi structured and pretested questionnaire was used in a face to face interview to collect the data. Data was checked for completeness and analyzed using SPSS V.20. Bi-variable logistic regression and multi- variable regression were done for predictor variables associated at p-value <0.05 with the outcome variable. Finlay the findings were presented using tables, pie charts and graphs accordingly. Result: The prevalence of short birth interval in this study was 59.9%. Independent predictors like age at first marriage (AOR: 2.10, 95%CI=1.19, 3.69), sex of index child (AOR: 1.964, 95%CI= 1.05 3.96), educational status (AOR: 3.05,95 %CI=1.68, 3.83), duration of breastfeeding (AOR: 3.09, 95%CI=1.38, 6.96) and use of modern contraceptives (AOR: 1.94, 95%CI=1.09, 3.45) were found to be statistically associated with short birth interval. Conclusion and Recommendation: Majority of the study respondents were practicing short birth interval. Education level, age at first marriage, having female child, short duration of breastfeeding and not using of modern contraceptives were some of the factors associated with the outcome variable. The Woreda Health bureau and Educational bureau should work in collaboration to create awareness so as to minimize the problems accordingly. Key words: Suboptimal, birth interval, Women of Child Bearing Age, Serbo town
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    Assessment of Cognitive Status of Patients With Type 2 Diabetes Through the Minimental State Examination Among Outpatient Attendants in Tikur Anebessa Specialized Hospital, Addis Ababa
    (Addis Ababa University, 2011-06) Mulugeta, Tefera; Tsige, Yosief (PhD)
    Background: Although it has been suspected from the early 1970s that there is a risk of impairment of cognitive function associated with type 2 diabetes mellitus, it is only more recently that interest has increased in research on possible mechanisms of this association and cognitive function of a patient with type 2 diabetes is not usually evaluated in routine clinical care. Aim: To assess the cognitive status of patients with type 2 diabetes and identify factors associated with it detected by MMSE. Methods: Institution based crossectional quantitative study carried out on 384 clients with type 2 diabetes mellitus who were selected by convenient sampling. The data was collected by interview using minimental state examination form. Data entry was done in Epi Info version 3.5.1 and then the data exported to SPSS version 16.0 for analysis purpose. Prior to actual data collection, ethical clearance was taken from Addis Ababa University; School of Medicine Department of Nursing and Midwifery and Tikur Anebessa Hospital. Result: A total of 384 type 2 diabetes mellitus outpatient respondents were participated in this study. The total MMSE score was 24.32 ± 3.510 points, with a range from 13 to 30. When the interpretation of this row score modified with educational level, 96(25%) respondents were cognitively impaired. Male respondents were found to be significantly, however; negatively associated with impaired cognitive status. Clients with less than grade 8 education were a highest increase in odds of poor cognition than higher education of their complements. Moreover, respondents having lower income were 2.6 times positively associated with impaired cognitive status than respondents with high income. Study subjects aged 41-50 and 50-60 were shown to have less cognitive impairment than aged 61 and above of their counterparts respectively. In addition, respondents who have been using insulin therapy were presented as impaired cognitive status as compared to those OHA users when analyzed with binary logistic regression. Conclusion and recommendation: Patients with type 2 diabetes should be regularly evaluated for their cognitive function, because duration and severity of disease could be associated with decline in cognition. The early implementation of mini-mental, which is a simple method of execution, can be done to detect early stages of cognitive impairment. Future studies will be important to better identify risk factors for cognitive dysfunction and lighten its relationship with diabetes.
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    Assessment of Knowledge, Attitude, and Practice Towards Emergency Contraceptives Among Female College Students at Mekelle Town, Tigray Region, Ethiopia, 2011
    (Addis Ababa University, 2011-06) G/hiwot, Haftom; G/Kidan, Berhane (Assistant Professor)
    Background: Death related to unintended pregnancy associated events is a series public health concern in Ethiopia. This is very common in young adolescents for whom life is full of adventure and temptation with very little knowledge about the consequences of their reckless activities. Emergency contraceptives are the only method that can be used within short time after sexual intercourse, offering a second chance to prevent unwanted pregnancy. Emergency contraceptive will have contribution in decreasing maternal mortality and morbidity due to unwanted Pregnancy & its sequel. Objectives: To assess the knowledge, attitude and practice of emergency contraceptives among female college students at Mekelle town, Ethiopia. Methods: An institutional based cross-sectional survey was conducted among 616 female college students at Mekelle town from January to May, 2011. Multistage sampling technique with Probabilities proportional to size was used. Data were analyzed by SPSS window version 16.0 soft ware package and presented using frequencies, percentages, crude odds Ratio, 95% Confidence Intervals and multiple logistic-regressions to adjust for possible confounding variables. Results: Of the total respondents, 393(67.3%) of them replied that they have heard about emergency contraceptives. Among those who have ever heard of emergency contraceptives, 224 (57%) mentioned pills only, 9 (2.3%) mentioned intrauterine contraceptive devices (IUCDs) only and 154(39.2%) mentioned both pill & IUCDs. 263(45%) of the respondents were knowledgeable towards ECs, and about 271(46.4%) of the students had positive attitude towards emergency contraceptives Of the sexually active respondents 70(24.2%) only reported that they had used emergency contraceptive methods previously. Whereas, 219(75.8%) were not used emergency contraceptives; some of the reasons were lack of knowledge about ECs (42.9%); no desire to use (22.8%) and inaccessibility toward emergency contraceptives (16.4%). Conclusion: The study indicated low level of knowledge; very low practice and majority showed negative attitude towards emergency contraceptives
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    Assessment of the Feasibility Of Objective Structured Practical Examination Among Final Year Diploma Nursing Students in Government and Private Colleges in Addis Ababa, Ethiopia.
    (Addis Ababa University, 2011-06) Gebru, Asefash; Cherie, Amsale (PhD)
    Background The way clinical performance is assessed is one of the determinants affecting clinical skill training of nurses. The conventional method of clinical assessment is found to be subjective. Objective Structured Practical Examination (OSPE) has been introduced in many countries as a valid and reliable assessment tool. In Ethiopia, there is no experience in regard to the feasibility of OSPE and its use to assess clinical performance of students. Objective The main objective of this study was to assess the feasibility and the clinical performance of final year diploma nurse students using OSPE. Methods and Materials The study was done in Menlik II Health Science College and Central University located in Addis Ababa. The study populations were final year diploma nurse students. The design of study was descriptive cross-sectional. A total of 36 students 16 from Menilik II and 20 from Central University were enrolled. In Central out of 3 campuses, Lanchia Campus was selected randomly. Out of 35 students in Lanchia Campus 20 were chosen using simple random sampling. Data were collected through a structured questionnaire, checklist, focus group discussion and observation. The variables collected were age, clinical performance score, feasibility of OSPE, perception of study subjects and barriers to skill training. Result The mean age of the 36 students was 21.7 years. Out of 6 clinical competencies assessed managing 3rd stage of labor, clean wound dressing, managing airway obstruction and administering IM injection were poorly performed while that of measuring blood pressure was good. Of the expected 1872 tasks to be performed by the 36 students in the 6 clinical procedures 886(47.3%) were correctly performed. In addition, out of 52 steps expected to be performed by a student in the 6 procedures, the maximum steps performed by a student correctly were 35(67.3%). Among major deficiencies observed in the management of 3rd stage of labor was inability to palpate the abdomen to rule out the presence of another baby 35 (97.2). In addition, 31(86.1%) and 27(75.0%) of the students were unable to read the growth monitoring chart and interpret temperature of a patient respectively. Furthermore, instructors and students attitude towards OSPE was highly positive. Feasibility study showed in each demonstration room a maximum of 10 stations could be organized. The amount of time to conduct OSPE in each site was 290 minutes. OSPE was found feasible in a small set up with few numbers of students. The result also showed the main barriers to clinical training were instructors’ competency, coaching process, close supervision and inadequate learning facilities. Conclusion Objective Structured Practical Examination is feasible in a small setup where the numbers of students to be assessed are few. When the numbers of students are many, additional resource is required. OSPE has demonstrated the clinical performance of the students to be weak. Recommendation Objective Structured Practical Examination was found feasible and should be introduced as an additional clinical assessment tool
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    Assessment on Factors Affecting Implementation of Nursing Process Among Nurses in Selected Governmental Hospitals, Addis Ababa, Ethiopia.
    (Addis Ababa University, 2011-06) Aseratie, Mulugeta; Murugan, Rajalakshmi (PhD)
    Background: Nursing Process is a systematic problem-solving approach used to identify, prevent and treat actual or potential health problems and promote wellness. It has five steps- assessment, diagnosis, planning, implementation, and evaluation. Objective: To assess factors affecting implementation of nursing process among nurses in selected governmental hospitals of Addis Ababa. Method: A cross-sectional study was conducted on selected governmental hospitals in Addis Ababa from February-April, 2011. Both quantitative and qualitative methods were used. Purposive sampling was used for selection of hospitals. Black Lion, St. Paul, Ras Desta Damitew Memorial, and Yekatit 12 hospitals were convenient for the study. The participants were selected using simple random sampling technique. The minimum sample size was 202. Tools were given to nurse expatriate to check for its validity and adjustment was made according to the feedback obtained before pre test. Data was collected using self-administered questionnaire and in-depth interview. Data was analyzed using SPSS 16th version. Result: Out of 202 sampled respondents 192 agreed to participate in the study and the response rate was 95%. One hundred two (53.1%) were females and 90(46.9%) were males. One hundred forty (72.9%) of the total respondents were working in a stressful working environment where as 31(16.1%) were working in a disorganized working environment, the remaining 21(10.9%) respondents explained their work place was negligent at a time. Thirty one (16.1%) of respondents were highly knowledgeable. From the total respondents 89(46.4%) were highly skillful. One hundred (52.1%) of respondents have implemented nursing process. From binary logistic regression model analysis those who have implemented nursing process were nurses working in a stressful working environment were 2.8(adjusted OR: 0.357, 95%CI: (0.157-0.814) times less likely to implement nursing process than disorganized working environment adjusting for facility accessibility, knowledge, and sex. Accessibility of facilities needed for nursing care were 2.248(Adjusted OR: 2.248, 95%CI: (1.079-4.684))times more likely to implement nursing process than nurses working in an inferior facility controlling for working environment, knowledge, and sex. Highly knowledgeable respondents were 38.913(Adjusted OR: 38.913, 95%CI: (10.3-147.006))times more likely to implement nursing process than low knowledge group nurses adjusted for working environment, facility, and sex. Conclusion: Nursing process implementation is affected by various factors. The study has identified organizational factors, patient related factors, and level of knowledge and skill were among those factors highly influenced nursing process implementation. This factors cause poor quality of nursing care, disorganized caring system, conflicting role, medication error and readmission with similar problem, dissatisfaction with the care patients have received, and increased mortality.
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    Assessment of Determinants of Induced Abortion Among Child Bearing Age Women Attending Maternal and Child Health Clinic in Mekelle Town, Tigray, Ethiopia.
    (Addis Ababa University, 2011-06) Buruh, Gerezgiher; Berhanu, Balcha (PhD)
    Background: Different studies imply that post-abortion care was not only traumatic for women and men but also a costly and time consuming endeavor for health care facilities, providers and families. Nationally cross sectional study on women aged 15 to 49 was carried out at northwest Ethiopia, implies that abortion rate was 19%. Limited access to contraceptives for all groups of women has been clearly identified as a determinant of induced and spontaneous abortion in some studies in Ethiopia. Objectives: To assess determinants of induced abortion among child bearing age women attending maternal and child health clinic in Mekelle town, Tigray, 2011. Methods: Institution based cross sectional study on assessment of determinants of induced abortion was conducted in February 2011. Study subjects were the women in childbearing age, attending maternal and child health clinic in Mekelle town, among induced abortion survivors by convenience sampling. The data was collected by interview using structured questionnaire, and cleaned and analyzed using SPSS V 16.0. Crude and adjusted odds ratio was used to see the association with p value < = 0.05 as significant. Results were interpreted and presented in the form of figures, tables and texts. The result will be disseminated timely and contributes to the control of induced abortion. Results: A total of 260 women of reproductive age group were interviewed. The main determinants of induced abortion were health problem 56 (21.5%) and child spacing39 (15%). The younger the women, the higher the risk of induced abortion. The mean age of health institution based induced abortion was 25.19 years. Contraceptive failure was also substantial determinant among the respondents. Marital status and occupation were some of the influential demographic factors. Conclusions and recommendations: Majority of women who experience induced abortion 120(46.1%) were less than 25 years age. The most frequent determinant of induced abortion reported was health problems 56 (121.5%). When educational level and economy of the women increases, their interest to induce in health institution also increased. It was recommended that health professional, policy makers and leaders should create awareness in the community that the unwanted pregnancy would have cultural, economical and psychological impacts secondary to induced abortion. Key words: number of induced abortion and order of pregnancy aborted
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    Assessment of Ethical Beliefs Towards Hiv/Aids Patients Among Nursing Students in Addis Ababa University, Ethiopia
    (Addis Ababa University, 2011-06) Chala, Dereje; Feleke, Atsede (PhD)
    Background: Ethical issues associated with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome are challenging and complex because of beliefs about disease, stigma surrounding the epidemic, lack of knowledge and fear of human immunodeficiency virus/Acquired immunodeficiency syndrome. Pillars of ethical principles; autonomy, beneficence, non maleficence and justice guide the delivery of health care. No nursing students in the United States and 11.5 % of South Africa held beliefs that were fully supportive of the ethical standards of practice in the context of human immunodeficiency virus/Acquired immunodeficiency syndrome. Objective: To assess the ethical beliefs of nursing students towards HIV/ AIDS patients in Addis Ababa, Ethiopia from October 2010 to April 2011. Methods and materials: An institution based cross sectional study design was used from October 2010 to April 2011. Samples of 210 of nursing students were recruited by proportionate systematic random sampling technique. Questions were pretested and collected by self administration method. The collected data was controlled and cleaned properly for consistency and entered into Epi info version 3.5.1 software and transferred to SPSS version 15.0 for analysis. Results were presented using frequency table and appropriate graphs. Finally, binary and multinomial logistic regression was used to predict the outcome variables and control the confounding factors. Results: 11.9% of respondents were fully supportive, 22.9% were partially supportive and 65.2% were non supportive of the ethical standards of nursing practice towards human immunodeficiency virus/Acquired immunodeficiency syndrome patient. There was significant association between history of care at non-clinical setting (Crude odds ratio=2.07) and having family died of AIDS, and support on ethical standards. Conclusions: A staggering proportion of nursing students in Addis Ababa University had beliefs about human immunodeficiency virus/Acquired immunodeficiency syndrome patient‘s care that do not reflect the inherent ethical standards of nursing practice. History of giving care for HIV/AIDS at non-clinical setting, respondents from rural area, having history family died of HIV/AIDS, and who didn‘t belief admission of Acquired Immunodeficiency Syndrome patients to separate room affects the support of ethical standards Recommendation: Mentoring experiences about complex ethical issues related to HIV/AIDS patient care should be given by clinical instructors; so that they can be committed to the ethical standard beliefs related to HIV/AIDS patient care. Key words: ethical beliefs, HIV/AIDS, nursing students
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    Assessment of Knowledge and Practice on Birth Preparedness and Complication Readiness Among Antenatal Clients in Selected Health Centers in Addis Ababa, Ethiopia
    (Addis Ababa University, 2011-06) Araya, Luchia; Tachbele, Erdaw (PhD)
    Background- Birth preparedness and complication readiness is a strategy to promote the timely use of skilled maternal and neonatal care, especially during childbirth. Based on the theory that preparing for childbirth, and being ready for complications reduces delays in obtaining this care. Lack of advance planning for use of a skilled birth attendant for normal births, and particularly inadequate preparation for rapid action in the event of obstetric complications, are well documented factors contributing to delay in receiving skilled obstetric care. Birth preparedness has been globally endorsed as an essential component of safe motherhood programs to reduce delays for care, so reduced maternal mortality rate and neonatal mortality rate. Objective: To assess knowledge and practices with respect to birth preparedness and complication readiness among antenatal clients in selected Addis Ababa Health Centers. Methods: A cross-sectional institution based study was conducted to examine knowledge and practice of birth preparedness and complication readiness among clients at five selected health centers by using pretested standard questioner in Addis Ababa. The sampling technique was systematic sampling and the sample size was 290. Results: Data were obtained from 290 mothers, yielding a response rate 100%.Taking into account identifying danger sign during pregnancy, labor and during postnatal, and place of delivery identification, means of transportation and saving money. About 42%, 17.2%, 27.7% of the respondents were knowledgeable about danger sign during pregnancy, delivery, and postpartum period respectively. Regarding to knowledge to birth preparedness 46% of the respondents were knowledgeable and 68.0% stated that they were prepared for birth and its complication. In this study educational status of mothers and their knowledge about danger sign during pregnancy was associated. Illiterate mothers were 0.48 times less knowledgeable about danger sign during pregnancy as compared to those who were secondary and above (OR=0.42(95%CI=0.21, 0.82). Mothers with the income of 500-1000 Birr per month were 2.86 times more likely to have knowledge about danger sign during pregnancy as compared to those who were with no income(COR=2.86 (95% CI=1.41,5.78)) but the significant association between educational status, income and danger sign during pregnancy was not retained in the multivariate analysis. Conclusion and recommendation-The study identified poor comprehensive knowledge and practices on preparation for birth and its complication in the study area. Community education about preparation for birth and its complication and empowerment of women through expansion of educational opportunities are recommended for improving birth preparedness and consequently the effects of pregnancy related complications. The individual woman, her family and the community as a whole should have to be well informed on birth preparedness and complication readiness.
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    Determi a Ts of Breastfeedi G Practice Amo G Mothers of Childre Aged Less Tha 24 Mo ths Atte Di G Gover Me Tal Mater Al A D Child Health Cli Ics I Mekelle Tow , Orther Ethiopia
    (Addis Ababa University, 2011-06) Berhe, Hailemariam; Mekonnen, Bazie (PhD)
    Background- Breastfeeding and good nutrition for children are essential for achieving the Millennium Development Goals, particularly the goals relating to child survival. Even though most mothers in Ethiopia breastfeed their babies, they do not always follow the recommendations of the "National Strategy for Infant and Young Child Feeding,". Mothers do not initiate breastfeeding within one hour after delivery, majority of them provide pre-lacteal feed and they do not exclusively breast feed to six months. Although the implementation of the national infant and young child feeding guideline has been in place since 2004, there is limited study which evaluated breastfeeding practices in the study area in this regard. Objective- The aim of this study was to assess determinants of breast feeding practice among mothers’ of children aged less than 24 months attending governmental maternal and child health clinics in Mekelle town. Methods- Institution based cross sectional study was carried out among five health facilities selected using simple random sampling technique. Data was collected by interviewer administered structured questionnaire and it was entered, cleaned and analyzed by using SPSS for windows version 16.0. Proportion was used to describe the results and it was presented in the form of figures, tables and texts. Binary logistic regression model was used to test association between dependent and independent variables. Result- A total of 361 mothers with their index child were interviewed. The ever breastfeeding rate in this study was 98.9%. The timely initiation rate of breastfeeding and exclusive breastfeeding were 77.9% and 60.8%, respectively. Eighty five percent of mothers reported on demand breastfeeding. The continued breast feeding rate at one year and at two years was 95.7% and 65.6% respectively. Home delivery (AOR=3.7[95%CI= 1.81, 9.33]), Vaginal delivery (AOR=14.4[95%CI=4.8, 43.7]) and non health professional as a birth attendant (AOR=3.5[95%CI=1.21, 8.53]) were found to be positively statistically associated with timely initiation of breastfeeding (P<0.05). Employment status (AOR=4.81(95%CI=2.27, 10.16]) and Child’s age (AOR=3.42[95%CI1.36, 8.59]) were associated with exclusive breastfeeding practice for the first 6 months. Conclusion and recommendation-: A range of characteristics affect the practice of timely initiation of breastfeeding and exclusive breastfeeding such as socio-demographic, obstetric and health service related practices/factors. Coordination, strengthening and sustaining of the existing strategies, and approaches for further improvement of optimal breastfeeding practice is recommended Key words: Timely initiation, exclusive breastfeeding
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    Assessment of Adult Cancer Patients’ Opinion Towards Cancer Chemotherapy Related Information Needs in Tikur Anbessa Specialized Referral Hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2011-06) Belay, Mulugeta; Murugan, Rajalakshmi (PhD)
    Background: Many people have some type of altered cell growth such as moles and skin tag. Most of altered cell growth are harmless (benign) and do not require intervention. Malignant cell growth or cancer, however, is serious and, without intervention, leads to death. Even though, providing care to clients and families experiencing cancer is complex and challenging, giving patients with adequate information, advice and support around treatment is an important component of care in which nurses play an important role. Patients desire different types and amounts of information depending on their type of cancer, the extent of disease progression, and their unique personal life circumstances. Method: Institution based cross-sectional qualitative and quantitative descriptive study designs were employed on 395 patients in Tikur Anbessa Specialized Referral Hospital from February 2011 to March 2011 with convenience sampling technique to explore cancer patients’ opinion towards cancer chemotherapy related information needs. Data was collected by face-to-face and through an in-depth interviews using structured and semi structured questionnaires. Cleaned and coded data were entered to epi-info software and then exported into a Statistical Package for Social Science Version 16 software for analysis purpose. Calculations of proportions were recorded on frequency tables and cross tabulation were done for selected variables. Also Pearson’s chi square test was calculated in order to show association between selected variables. Qualitative data obtained through an in-depth interview was transcribed by arranging the record according to forwarded questions and analyzed manually by identifying common themes. Result: In this study, 395 study participants were involved; 385 for quantitative and 10 for qualitative. Out of which 290 (73.42%) were females and 107(27.08%) were males. As a qualitative result the majority of the participants had negative opinions towards cance chemotherapy related information and quantitatively 144 (37.4%) study participants had neutral opinions and 135 (35.1%) had negative opinions. Whereas, Only 106 (27.5%) of them had reported positive opinions towards cancer chemotherapy related information. Majority of the participants were believed that “unless age difference should be considered health education should not be successful. Participants were also got insufficient information while they had favorable attitude towards cancer chemotherapy related detailed information in the form of booklets. Patients’ economic status and their specific diagnosis were found to have statistically significant association with their level of opinion at p-value of .014 and .000 respectively. Conclusion and Recommendation: The study showed that majority of the study participants got less information related to cancer chemotherapy. To this reason, most of them did not know what chemotherapy they have taken or currently taking. Regarding to this, nurses should get communication training and trainings which helps them to show empathetic behavior to patients. Key words: Cancer patients, Opinion, Chemotherapy, Information needs.