Search

Background The clinical learning environment is important to achieve the defined learning outcomes of the program, however nurse students face a multitude of challenges during their clinical placement. Objectives The objective of the study was to explore challenges experienced by nursing students during clinical placement with associated factors among highest institutions of Addis Ababa city, Ethiopia, 2020. Method A mixed method approach composed of cross sectional study and phenomenological method employed from February 15, to April 30, 2020 on 179 third- and fourth-year undergraduate nursing students selected using simple random sampling for the quantitative study and seven purposively selected students for qualitative study. Self-administered questionnaire and recording of telephone interview used to collect quantitative and qualitative data respectively. Logistic regression analysis carried out to identify the independent predictors, whereas the qualitative data analyzed using interpretation of the voice recorded during telephone interview, extracting significant statements, formulating meanings, and coding, categorizing into clusters of themes using the content analysis approach and using ATLAS ti.Version 7.5.16 software. Result the prevalence of challenge among nursing students was found to be 29 (16.9%).Consequently, in bivariate logistic regression, students’ religion, residence, entrance year, learning institution and substance use were found to have association with challenge among nursing student. However, in multivariable analysis only substance use and learning institution found to have significant association. Furthermore statistically significant negative moderate correlation between students total challenge score and their overall competency score were identified [r= -0.672, P value =

Introduction Malnutrition is a serious problem that causes high morbidity and mortality among cancer patients. There was no sufficient empirical evidence on the prevalence of malnutrition and associated factors among adult cancer hospitalized patients in Ethiopia. Objective This study aimed to assess the prevalence and risk factors of malnutrition among adult cancer patients receiving chemotherapy in cancer center, Ethiopia 2019. Methods A cross-sectional study was conducted among a sample of 281 patients selected using systematic sampling among cancer patients receiving chemotherapy. Data were collected by patient interviews and chart reviews using a structured questioner adapted from a subjective global assessment tool. Data were analyzed by SPSS version 24.0. Descriptive statistics such as frequency distribution, mean, median, and standard deviation were used to describe characteristics. Bivariate and multivariable analyses using logistic regression models were used. Result Of the 281 participating patients, 58.2% had malnutrition, which was higher among females (51.6%) than males (48.4%). The mean body mass index was 20.24 ± 3.6. Of all, 41.9% had moderate weight loss, 21.1% had severe weight loss and 52.3% had weight loss in the past two weeks. Stage four cancer (AOR = 7.2, 95% CI: 1.3–38.5), loss of appetite (AOR = 4.5, 95% CI; 1.5–17.2) and diarrhea (AOR = 7.8, 95% CI: 2.95–20.5) were significantly associated with malnutrition. Conclusion The prevalence of malnutrition among cancer patients who receive chemotherapy was high. Stage of cancer, appetite loss, and presence of diarrhea was found to be significant factors for malnutrition., Cancer; Malnutrition; Prevalence; Risk factors; Tikur Anbessa Specialized Hospital; Ethiopia.

Additional file 1.

Background and purpose Stroke is becoming the leading cause of morbidity and mortality throughout the Globe. Dysfunctions like anxiety, depression, sleep and sexual disorder; sensory, motor, cognitive and communication are prevalent alterations in stroke patients. These situations make them dependent on nursing interventions. The aim of this study is to determine the prevalence, nursing managements provided and stroke patient’s outcomes. Methodology Retrospective cross sectional study design was conducted among all new stroke patients admitted to Tikur Anbessa Specialized Hospital (TASH) from July1/2015 to Feb30/2018, Addis Ababa, Ethiopia. Results Stroke prevalence was 19.3%. Ischemic stroke was commonest of stroke which is 87 (51.2%) with an ischemic to hemorrhagic stroke ratio of 1.36:1.Ten-years increase in patients’ age leads to a 25% higher risk for ischemic stroke. Younger adults had 8.587 higher chances to improve free off complications than older adults did (OR = 8.6 95%CI (2.4, 30.5). Patients who early mobilized had 8.991times higher chance of outcome with improved without complications (OR = 8.991 95%CI (2.9, 27.0). Aspiration pneumonia was the leading cause of death accounting for 39% of all causes. Conclusion Stroke is on rising in Ethiopia, the occurrence rises with age (peak between 35 and 65 years). Younger adult patients (18–34 years) were 18.2% of patients, which is more dangerous in view of the early occurrences of stroke, which leads for a higher and prolonged disability adjusted life years.

BACKGROUND The global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. The period of child's diagnosis negatively influences parents socially and psychologically leading to depression. OBJECTIVES The aim of the study was to assess the prevalence of depression, its associated factors and parent's experience towards care of their cancer diagnosed child. METHODS A mixed approach quantitative and qualitative cross-sectional study was employed between 15 March and 1 April 2017. Systematic random sampling involving 275 participants in the quantitative and 20 conveniently selected participants for qualitative study were included in the study. Beck's depression inventory scale was used to collect data. Logistic regression including bivariate and multivariate analysis considering 95% confidence interval (CI) was utilized to examine association between dependent and independent variables. P-value

Objectives:Postpartum Depression (PPD) is a serious public health problem that leads to high maternal morbidity and mortality, enormously affecting the infant, family and society. Thus, the aim of this study was to assess the prevalence and factors associated with postpartum depression among postpartum mothers attending public health centers in Addis Ababa, Ethiopia, 2016.Methods:Facility-based cross-sectional study was conducted from March 2016-April 2016 among 633 postpartum women. Four sub cities were identified through simple random sampling technique among 10 sub cities in Addis Ababa, Ethiopia. Furthermore, the study participants were determined by systematic random sampling after 10 health centers were selected by lottery method and the number of participants in each health center was proportionally allocated. In order to determine postpartum depression, participants were rated using the Edinburgh Postnatal Depression Scale (EPDS) and the findings were analyzed using bivariate and multivariate logistic regression. P-value less than 0.05 with 95% confidence interval was used to state the association.Results:The study revealed prevalence of postpartum depression among mothers was 23.3%. Moreover, women who were unmarried, had unplanned pregnancy, delivered without presence of any relatives in health institutions, had previous history of child health, had history of substance use and had low income were found to more often display postpartum depression.Conclusion:For optimal maternal health care provision in regards to postpartum depression, integration of mental health service in addition to inter sectoral collaboration of women’s affair with health institutions is crucial.

Back Ground: Risky sexual behavior among orphans and vulnerable children and its associated physical, psychological and social consequences is becoming a major public health concern globally. Objectives: To assess the prevalence of risky sexual behavior and its determinants among orphan and vulnerable children in Addis Ababa. Methodology: A community based cross sectional study was conducted on three support and care giving organizations for orphans and vulnerable children in Addis Ababa, Ethiopia from March to June 2014. A total of 422 orphan and vulnerable children were selected using systematic sampling. Data were collected using pre tested self-administered questionnaire. Logistic regression was used to analyze the data. Result: A total of 407 (96.4%) respondents participated in this study. Among them 112 (27.5%) had sexual intercourse in their life time, of these 50 (44.6%) started sex before the age of 15, 94 (83.9%) had forced sex, 84 (75.0%) had multiple sexual partners, only 16 (14.3%) used condom the first time they had sex and 96 (85.7%) participated in transactional sex. Females were about 3.25 (2.67 - 7.3) times more likely to engage in risky sexual behavior than male respondents, double orphans had 4.32 (2.45 - 9.54) odds of risky sexual behavior compared to their counterparts. Those respondents who had knowledge of HIV transmission and prevention were less likely to be involved in risky sexual behavior 0.58 (0.41 - 0.93). Conclusion: Orphan and vulnerable children are at a higher likelihood of risky sexual behavior. Intervention targeted at multilevel such as orphan survival training, assertive communication skills, sexuality education and education about HIV risk perception, physical, psychological and human right protection, social support, and economic access for basic needs need to be given consideration.

Background Spontaneous preterm birth is commencement of labor with intact or pre labor rapture of membrane and birth before 37 weeks of gestation. The aim of this study was to identify common factors associated with spontaneous preterm birth in Addis Ababa public hospitals. Methods After random selection of three hospitals from the six Addis Ababa’s Public hospitals having Neonatal intensive care unit, systematic sampling was employed to select study units from admission log book of the neonates. Data were collected using structured checklist. Finally, data entered to EpiData 3.1 and transported to SPSS 22 for analysis. Bivariate and multivariate logistic regression analysis was done for the variables. Result The mean gestational age of preterm birth was 32.45 (±2.903 SD). Majority (66.1%) of preterm births were spontaneous and 33.9% were induced preterm births. Hypertension during pregnancy [P = 0.001, AOR = 0.182, 95% CI: (0.067, 0.493)] and maternal HIV infection [P = 0.041, AOR = 3.408 95% CI: (1.048, 11.079)] significantly associated with spontaneous preterm birth. Conclusion Those mothers who were diagnosed with hypertension during pregnancy less likely gave spontaneous preterm birth than who had no history of hypertension during pregnancy and HIV positive mothers gave spontaneous preterm more likely than HIV negative mothers. Thus, giving emphasis to these factors with appropriate care during pregnancy is important to reduce spontaneous preterm birth.

Background Midwives are the primary source of care and support for mothers and newborns at the most vulnerable time in their lives.The Ethiopian National Reproductive Health Strategy targeted reduction of Maternal Mortality rate to 267/100,000 live births in the years 2006–2015. Midwives play a crucial role in the care of pregnant women, from the first antenatal visit right through to the delivery and the postpartum period. Methodology Institution based cross-sectional study was carried out from March 2015 to April 2015 in Addis Ababa city, Ethiopia to assess job satisfaction and its determinants among midwives working at government health facilities. A total of 234 midwives were involved from 84 health centers and 8 governmental hospitals proportional to the size of health centers and hospitals using simple random sampling method. A total of 175 and 59 midwives were taken from health centers and government hospitals respectively. Different variables like Socio demographic, Job related domain and Organizational domain were collected using pre structured questionnaire after getting written consent. Data entry and analysis were done using SPSS 21.00. Binary logistic regression was used to determine factors affecting job satisfaction. P-values less than 0.05 were considered statistically significant. Result From 234 eligible respondents 221 midwives participated in this study which makes a response rate of 94.44%. The overall mean job satisfaction was 52.9%. Independent predictors of job satisfaction includes Sex [AOR = 4.07 (95%CI: 1.36–12.37)], working unit [AOR = 0.04 (95%CI:(0.001–0.45)], Educational status [AOR = 5.74(95%CI: 1.48–40.47)], Marital status [AOR = 3.48 [1.01–11.97)], supervision [AOR = 4.33 (95%CI: 1.53–20.22)], standard of care[AOR 4.80, (3.38–50.10)] and work load [AOR 8.94, (95%CI 2.37–22.65)]. Midwives were least satisfied from salary, extrinsic reward and professional opportunity subscales while they were most satisfied from coworker relation and the standard of care they provided to clients. Conclusion Half of study subjects were satisfied with their job. Governmental and Nongovernmental organizations should consider the factors that contribute to job dissatisfaction in order to improve service provision.

Background: Unsafe abortions resulting from unintended pregnancies denote an important public health challenge throughout the world. Although various strategies have been used to address this problem unsafe abortion from unwanted pregnancy remained the cause for a significant number of maternal morbidity and mortality. Objective: To assess the prevalence of unwanted pregnancies and factors associated with unwanted pregnancies. Methodology: A facility based cross-sectional study was conducted to select randomly 349 women of reproductive age from five hospitals providing antenatal care in Addis Ababa. Data were collected using standardized pretested interviewer administered questionnaire. Logistic regression was used to analyze the association between the dependent and independent variables. Result: A total of 333 reproductive age group females participated in the study making the response rate 95.4%. A total of 126 (37.8%) and 50 (39.6%) respondents had unwanted pregnancy and induced abortion at some point in their lives. Marital status and number of sexual partner were significantly associated with unwanted pregnancy with AOR [1.783 (1.036, 3.068), 11.355 (5.106, 25.253)] respectively. Conclusion: The prevalence of unwanted pregnancy and induced abortion were high, and most of the induced abortion was the result of unwanted pregnancy. This study has implication that comprehensive approaches should be emphasized to increase awareness, access and use of family planning methods.

Background: Understanding ecological factors that influence risky sexual behavior of adolescents is vital in designing and implementing sexual risk reduction interventions in specific contexts. Interventions undertaken without understanding the critical factors may not produce the desired results. Objective: The objective of this study was to identify the factors associated with adolescent risky sexual behavior among school adolescents in Addis Ababa, Ethiopia. Methods: This cross-sectional study was done among randomly selected school adolescents in Addis Ababa, Ethiopia. Data were collected by an anonymous self administered questionnaire. Risky sexual behavior was assessed by asking question about sexual activity, consistent condom use and faithfulness to a single partner. Logistic regression analysis was done to identify factors related to sexual behavior using the ecological framework. Result: Overall 377(10.6%) of the 723 sexually active students were involved in risky sexual practices. Risky sexual behavior was significantly and very strongly associated with perception of peers' involvement in sexual intercourse [AOR = 11.68 (95% CI: 8.76 - 15.58)]. Conclusion: This study demonstrated that peer pressure is the most important factor associated with risky sexual behavior among school adolescents in Addis Ababa. Interventions aimed at reducing sexual behavior among school adolescents should target adolescents as a group rather than individually.

Introduction: Success of antiretroviral therapy (ART) requires that individuals maintain nearly one hundred percent adherence to the prescribed regimen. Lack of optimal adherence to ART is associated with a high risk of developing mutant HIV strains, and increased risk of HIV transmission. Psychosocial adaptation is associated with positive health behaviors in HIV. In this study, we determined the correlation between psychosocial adaptation to living with HIV and adherence to ART, and determined the factors associated with psychosocial adaptation. Methods: In this cross sectional study, we interviewed 235 HIV-infected adults that receive ART from the infectious Diseases Institute (IDI) clinic and used the Health Related Hardiness Scale (HRHS) to measure psychosocial adaptation. Adherence to ART was determined by self-report of the number of doses missed in the previous 7 days. Pearson correlation was used to determine the relationship between psychosocial adaptation and adherence to ART. Logistic regression was used to determine the factors associated with psychosocial adaptation. Results: Most (60.4%) were females, married or staying with a partner (46.4%) and had some form of employment (74.4%). Participants had a mean age of 38 ± 9 years, had been registered in the HIV clinic for a median period of 6 years, with a mean duration on ART of 4 ± 3 years. A majority (86%) were adherent to ART. HRHS is found to be reliable (Cronbach’s alpha=0.83) and participants had a percentage mean adaptation of 85.9%. There was a significant correlation (r=0.159, p=0.015) between psychosocial adaptation and adherence to ART. Excellent perception of health status (OR=2.36, 95% CI=1.22-4.53, P=0.01), very good self-rating of ART adherence (OR=3.35, 95% CI=1.74-6.50, P=

In 2005, Ethiopia liberalized its abortion law and subsequently authorized midwives to offer abortion services. Using a 2013 survey of 188 midwives and 12 interviews with third-year midwifery students, this cross-sectional research examines midwives' attitudes toward abortion to understand their decisions about service provision. Most midwives were willing to provide abortion services. This willingness was positively and significantly related to clinical experience with abortion, but negatively and significantly related to religiosity, belief that providers have the right to refuse to provide services, and care of patients from periurban as opposed to rural areas. No significant relationship was found with perceptions of abortion stigma, years of work as a midwife, or knowledge of the law. Interview data suggest complex dynamics underlying midwives' willingness to offer services, including conflicts between professional norms and religious beliefs. Findings can inform Ethiopia's efforts to reduce maternal mortality through task-shifting to midwives and can aid other countries that are confronting provider shortages and high levels of maternal mortality and morbidity, particularly due to unsafe abortion.

Background: Healthy sexuality is a developmental process which needs investments from parents. Nonetheless, little is known about the effect of parenting practices and styles on the sexual risk behavior of young people. Objectives: to assess the effect of different parenting styles and parenting practices on the sexual behavior of adolescents. Methods: A cross-sectional study was conducted among 3840 randomly selected high school adolescents using three stage sampling in Addis Ababa, Ethiopia. Data were collected by a self-administered anonymous pre tested questionnaire. Logistic regression analysis was done to identify parental factors associated with sexual behavior. Results: From the 3543 students participated in this study 723(20.4%) respondents reported ever having sexual intercourse and nearly three -quarter of those who initiated sex were involved in risky sexual practices. Respondents who live with both parents [AOR= 0.48 (95%CI: 0.21-0.83)] and perceived connected to their parents [AOR= 0.51(95%CI: 0.22-0.96)] were less likely to experience risky sexual behavior. Similarly, students from authoritarian and authoritative parents were more likely to have safe sexual practices [AOR = 0.38(95%CI: 0.23-0.86)] and [AOR = 0.41(95%CI: 0.24-0.93)] respectively compared to children from permissive parenting styles. In addition, parent child communication about sexual issues [AOR =0.56 (95%CI: 0.31-0.94)] and parental monitoring were protective from risky sexual behavior [AOR =0.52(95%CI: 0.32-0.92)]. Conclusion: Appropriate parenting practices have a shielding effect from adolescent sexual risk behavior. Interventions that enable parents to build proper parenting practices, skills and styles have paramount importance.

Background Disclosure of HIV status has become an entry criterion for prevention of mother to child transmission programs in resource-constrained countries. However, little has been explored about the prevalence of, barriers to, outcomes and factors associated with HIV status disclosure among HIV positive pregnant women in Ethiopia. Method Cross- sectional study was conducted among 107 pregnant women who were attending antenatal care in public centers from April to June 2011 in Addis Ababa capital city of Ethiopia. Data was collected using interviewer administered pretested structured questionnaire and entered and was analyzed using SPSS- 15 version. Results presented in tables. Result Seventy three percent of women had disclosed their HIV status to their partner. Discussion about testing and a smooth relationship with the partner were independently associated with their disclosure. Women who disclosed to their partners were almost five times more likely to participate in Prevention of Mother to Child Transmission programs than their counterparts (AOR = 4.74; 95% CI 1.24-18.14). Conclusions Although most participants disclosed their HIV sero-positive status, lack of disclosure by some women might result in a limited ability to participate in PMTCT programs. Thus, assertiveness and improved communication skills training should be offered to HIV positive pregnant mothers and be reinforced during on-going counseling.

This article was migrated. The article was marked as recommended. A 2010 Lancet Commission on global higher education for the health professions called for institutional and instructional reforms worldwide in order to keep pace with pressing global health care needs. Among their many recommendations is an awareness of the value of international collaboration to enhance educational quality. In this article, we reflect on our experience of building such a collaboration in nursing. Using the concept of counterparts as articulated by DeSantis (1993; 1995), we describe the highlights as well as the lessons of our work together in developing the research component of the Masters of Science in Nursing (MScN) at Addis Ababa University in Ethiopia. We extend DeSantis' (1995) emphasis on roles in the relationship for understanding what constitutes success in international collaborations. Beyond identifying roles and responsibilities, our story calls attention to the value of cultivating relationships in which interdependence, mutuality, and issues of reciprocity are at the fore.

Background Understanding the full range of sexual behaviors of young people is crucial in developing appropriate interventions to prevent and control sexually transmitted infections including HIV. However, such information is meager in developing countries. The objective of this study was to describe oral and anal sex practices and identify associated factors among high school youth. Methods A cross-sectional study was conducted among high school youth in Addis Ababa, Ethiopia. A multi-stage sampling procedure was followed to select a representative sample of school youth. The total sample size for this study was 3840. Data were collected using a self-administered questionnaire. Data analysis was guided by the ecological framework. Results The overall proportion of people who reported ever having oral sex was 5.4% (190) and that of anal sex was 4.3% (154). Of these 51.6% (98) had oral sex and 57.1% (87) had anal sex in the past 12 months. Multiple partnerships were reported by 61.2% of the respondents who had oral sex and 51.1% of students practicing anal sex. Consistent condom use was reported by 12.2% of those practicing oral sex and 26.1% of anal sex. Reasons for oral and anal sex included prevention of pregnancy, preserving virginity, and reduction of HIV and STIs transmission. Oral sex practice was strongly and significantly associated with perception of best friends engagement in oral sex (AOR = 5.7; 95% CI 3.6-11.2) and having illiterate mothers (AOR = 11.5; 95%CI 6.4-18.5). Similarly, anal sex practice was strongly and significantly associated with favorable attitude towards anal sex (AOR = 6.2; 95%CI 3.8-12.4), and perceived best friends engagement in anal sex (AOR = 9.7; 95%CI 5.4-17.7). Conclusion Considerable proportion of adolescents had engaged in oral and anal sex practices. Multiple sexual partnerships were common while consistent condom use was low. Sexual health education and behavior change communication strategies need to cover a full range of sexual practices.

Background: Insufficient knowledge about Sexually Transmitted Infections (STI) and issues around accessing health services are among the major impediments to successfully prevent STIs among adolescent populations in developing countries. Objectives: To assess knowledge of adolescents about STIs and identify the barriers to seeking reproductive health service among high school adolescents. Methods: A cross sectional design complemented with a qualitative inquiry was the method used to collect relevant data among high school students in Addis Ababa, Ethiopia. A multistage sampling procedure was used to randomly select students across the city. The quantitative data were collected using a pre tested self administered questionnaire. Qualitative data were collected by conducting focus group discussions with purposively selected students. The analysis produced the proportion of adolescents who knew at least two symptoms of STI and associated factors. The qualitative information offers contextual understanding of the issues. Results: In total, only 634(17.9%) adolescents had knowledge of at least two symptoms of STIs. The reported knowledge was better among male students [AOR=1.47 (95%CI: 1.13-2.91)] and students who had mothers with formal education [AOR=1.48 (95%CI: 1.09-2.94)] compared to their counterparts. Overall 175(4.9%) of the students reported having symptoms of STIs 12 months prior to the survey, of which 58(33.1%) did not receive treatment. Among those reported treated, 50(42.7%) took self medication. Major barriers for not seeking treatment for STIs were perception of unavailability, unaffordability and inaccessibility of STI services in the existing health institutions. Adolescents prefer obtaining user friendly STIs services in schools. Conclusion: Adolescents are not aware of the symptoms of STI. Proper treatment for STI is not sought by the majority of students that reported STI symptoms. Inclusion of specific information and facts about STI in the school curriculum and providing user friendly STIs services at school can greatly reduce the risk of STIs among school adolescents.

This study was conducted to assess the perceived sufficiency and usefulness of HIV/AIDS information, education and communication (IEC) messages and materials as well as to identify preferences for IEC sources and methods. Data were collected using a self-administered questionnaire and focus group discussions. A total of 901 students in Addis Ababa, Ethiopia, participated in the study. Over three quarters of the respondents believed in the usefulness of IEC. IEC materials were perceived to be useful in increasing knowledge about HIV/AIDS by 456 (51%), to influence attitude by 357 (40%) and to acquire safer sexual practices by 382 (42%) of the respondents. None of the information sources and messages available for high school students highly satisfied the sufficiency indicators. Even though no single information source was highly preferred, radio and television ranked top. Life skills training was the most desired intervention by the students. IEC on HIV/AIDS was able to acquaint students with the disease rather than equipping them with knowledge and skill needed in their daily life. Therefore, appropriate and mutually reinforcing IEC messages with emphasis on life skill training are recommended. RÉSUMÉ Cette étude a été menée pour évaluer la suffisance perçue et l'utilité des messages et des matériels de l'information, l'éducation et la communication (IEC) du VIH/SIDA ainsi que pour identifier les préférences pour les sources et les méthodes d'IEC. Les données ont été recueillies à l'aide d'un questionnaire auto-administré et des discussions à groupe cible. Au total, 901 étudiants à Addis Abeba, Ethiopie, ont participé à l'étude. Plus de trois quarts des repondants avaient confiance en l'utilité de l'IEC. On a perçu les matériels de l'IEC comme étant utiles quant il s'agit d'augmenter de 456(51%) la connaissance sur VIH/SIDA, pour influencer de 357(40%) l'attitude et pour acquérir de 382(42%) des répondents des pratiques sexuelles moins dangereuses. Aucune des sources d'information et des messgaes disponibles pour les étudiants des secondaires n'a bien satisfait les indices de la suffisance. Bien qu'aucune source d'information n'a été bien préférée, la radio et la télévision ont occupé la première place. La formation de technique de vie a été l'intervention la plus désirée par les étudiants sur la maladie plutôt que de les munir de la connaissance et la technique nécessaires dans leur vie quotidience. En conséquence, on préconise les messages de l'IEC appropriés et mutuellement renforçants, qui mettent l'accent sur la formation de technique de vie. Afr J Reprod Health Vol.9 (1) 2005: 66–77