Pediatric Nursing

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Browsing Pediatric Nursing by Subject "Adherence"

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    Adherence to Self Management and Associated Factors Among Hypertensive Patients Attending Chronic Follow Up Units of Public Health Hospitals in Addis Ababa, Ethiopia, 2016
    (Addis Ababa University, 2016-06) Tibebu, Abel; Mengistu, Daniel (Assistant Professor)
    Background - One of the most prevalent non communicable diseases is hypertension. The availability of effective antihypertensive medications didn‟t bring the expected outcomes in terms of controlling blood pressure. The rationale for these and other findings of uncontrolled hypertension direct towards poor adherence. The most neglected causes of uncontrolled hypertension are unhealthy lifestyles. Few studies are conducted to show the gap and magnitude of self-management adherence. Objectives – This study tried to assess the self-management adherence of hypertensive patients attending follow up at chronic follow up units of public health hospitals in Addis Ababa, Ethiopia,2016. Method – Institutional based cross sectional study was conducted in four public health hospitals which were selected by lottery method. The final calculated sample size was 416 which were proportionally allocated to each of the institutions and systematic random sampling was used. Data was checked, cleaned and entered in to Epidata software version 3.1, and was imported to SPSS version 21 software for analysis. The results of the descriptive statistics were expressed as percentages and frequencies. Associations between independent variables and dependent variables were analyzed using bivariate and multivariate analysis. The study was conducted from February 15 – April 15, 2016. Results – The study included 404 respondents with 97% response rate. 210(52%) were male and mean age was 54±10.77 years. The respondents‟ adherence to lifestyle modifications and anti- hypertensive medications were 23% and 66.8% respectively. The lifestyle and medication related adherences were found to be better in females, patients who had comorbidities and have been knowledgeable about the disease and was poor among young adult respondents. Conclusion and Recommendations – The rates of adherence to medication and life-style changes were generally found to be low. Educational sessions that especially focus on lifestyle modifications and ongoing support for patients should be designed and studies which assess all the components of self-management should be conducted for comparison among different subgroups. Keywords – Self management, Adherence, Hypertension, Lifestyle modifications, Anti- hypertensive medications
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    Assessment of Self Care Practices and Associated Factors Among Type 2 Diabetic Patients at Tikur Anbessa Specialized Hospital Addis Ababa, Ethiopia
    (Addis Ababa University, 2014-06) Lemessa, Feyissa; Demisse, Asrat ( Assistant Professor)
    Background: Diabetes is a general term for a group of metabolic disorder that affects the body’s ability to process and use sugar (glucose) for energy. The three most important forms of diabetes are type I, type II and gestational diabetes. Type 1 diabetes results from cell destruction usually leading to absolute insulin deficiency. Type 2 diabetes results from a progressive insulin secretary defect on the background of insulin resistance. Diabetes is a serious public health problem that threatens the quality of life, the success of long term maintenance therapy for diabetes depends largely on patients’ adherence with self care practice. Objectives: To assess diabetes self care practices and associated factors among diabetic patients in Tikur Anbessa Specialized Hospital, Addis Ababa. Methods: Institutional based cross sectional study design was utilized, 328 study subjects were selected using systematic random sampling technique and the data was collected using interviewer administered structured questionnaires, data was entered in to EPI INFO version 3.5.4 and analyzed using SPSS version 20. Frequencies and cross tab was computed. Bivariate and multivariate logistic regression was computed to assess statistical association between the outcome variable using Odds Ratio, significant of statistical association was assured or tested using 95% 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 98.8% of all respondents 174(53.7%) and 150(46.3%) were female and male respectively. The majority of study subjects 221(68.2%) were in the age group of 30 to 60 years. Most of respondents were orthodox Christian 259(79.9%) by religion and Amhara 170(52.5%) by ethnicity. About 243(75%), 238(73.5%), 187(57.7%), 72(22.2%) wer attended formal education, married, unemployed and had very low monthly income respectively. Majority 207(63.9%) respondents were not adhered to SMBG practice. A total of 204(63%) respondents were adhered to anti-diabetic medications. The majority 191(58.9%) were not adhered to recommended diet management practices, one hundred fifty nine (49.1%) were reported adhered to physical activity that meet the recommended guidelines. Of all study participants about 172(53.1%) respondents were adhered to the recommended diabetic foot care practices. Over all self care practices (SDSCA) were reported as adhered in 167(51.5%) participants. There was a significant association between level of education, monthly income, presence of glucometry at home, marital status, age and gender and self care practices. But there was no 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 complications, finding of this study were indicated that most patients had no adherence to self care practice especially in SMBG and diet management. Generally, adherence to self care practice was suboptimal among type II diabetic patients in TASH Endocrinology unit. Recommendation: Health care personnel must increase patient’s awareness on the importance of all domains of self care practices and strongly promote the practice through effective IEC program. Keywords: adherence, self care, self care practice, diabetic complications, associated factor
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    Level of Adherence and Associated Factors to Option B+ Pmtct Programme Among Pregnant & Lactating Mothers in Selected Government Health Facilities of South Wollo Zone, Amhara Region, North East Ethiopia, 2016
    (Addis Ababa University, 2016-06) Tsegaye, Delelegn; Derbie, Leul (PhD)
    Introduction፡ Adherence to ART among HIV positive pregnant & lactating mothers is a central component in PMTCT to reduce viral loads & achieve elimination of mother to child transmission of HIV. Option B+ PMTCT programme is a recently introduced approach to eliminate new HIV infection among children. This approach is based on treatment as prevention to mean starting lifelong ART for all HIV positive pregnant & lactating mothers without considering CD4 count or clinical stage of HIV/AIDS disease. Objectives: The aim of this study was to measure the level of adherence and identify factors associated with adherence to option B+ PMTCT programme among pregnant & lactating mothers in selected government health facilities of south wollo zone, Amhara region, north east Ethiopia Method: An institution based cross sectional quantitative study design was used. The study was conducted in two hospitals & five health centers found in south Wollo zone, Amhara region. The sample size required for this study was 191 HIV+ pregnant & lactating mothers who were on PMTCT follow up. The study subjects were taken consecutively until the sample size was met from March 1 to April 14, 2016. Standard structured data collection instrument was used & it was collected by using face to face interviewing. The data were entered in to EpiData 3.1 then exported to statistical package for social science (SPSS) window version 21 for analysis. Entered data were explored for errors & missing values then it was cleaned before analysis. Bivariate and multivariate logistic regression analyses were employed to identify associated factors for adherence. P-value less than 0.05 with 95 % confidence interval was used to state the association between independent predictors and the outcome variable. Result: A total of 190 HIV+ pregnant & lactating mothers were included in this study. The level of adherence on option B+ PMTCT drug was 87.9 %. Factors such as those who attend in Hospital(AOR 0.3,95% CI(0.11-0.82), rural residence (AOR 0.26, 95%CI (0.1-0.73) and those who faced challenges in the same day diagnosis of HIV and initiating lifelong option B+ treatment (AOR 0.08, 95%CI (0.02-0.37) were associated factors for adherence Conclusion & recommendation: mothers who attended for option B+ drugs in health centers, those who lived in urban area and who had no any challenges in same day diagnosing & initiating option B+ drugs were significantly associated factors for better adherence to option B+drugs. Therefore, the ability to effectively handle these factors is crucial in the success of option B+ programme. Key words: adherence, Option B+, HIV+ pregnant & lactating mothers, north east Ethiopia