Search

Abstract Background Patient satisfaction is an important indicator of the quality of healthcare. Pain is one of the most common symptoms among cancer patients that needs optimal treatment; rather, it compromises the quality of life of patients. Objective To assess the levels and associated factors of satisfaction with cancer pain treatment among adult patients at cancer centers found in Northern Ethiopia in 2023. Methods After obtaining ethical approval, a multi-center cross-sectional study was conducted at four cancer care centers in northern Ethiopia. The data were collected using an interviewer-administered structured questionnaire that included the Lubeck Medication Satisfaction Questionnaire (LMSQ). The severity of pain was assessed by a numerical rating scale from 0 to 10 with a pain score of 0 = no pain, 1–3 = mild pain, 4–6 = moderate pain, and 7–10 = severe pain Binary logistic regression analysis was employed, and the strength of association was described in an adjusted odds ratio with a 95% confidence interval. Result A total of 397 cancer patients participated in this study, with a response rate of 98.3%. We found that 70.3% of patients were satisfied with their cancer pain treatment. Being married (AOR = 5.6, CI = 2.6–12, P

BackgroundBreakthrough cancer pain (BTCP) is a transient exacerbation of pain that affects the length of hospitalization and quality of life of patients. The objective of this study was to determine the prevalence and factors associated with BTCP among cancer patients at oncology units in Northern Ethiopia in 2022.MethodsA multi-center cross-sectional study was conducted from April to June 2022. After obtaining ethical approval, data were collected prospectively from 424 adult cancer patients admitted to oncology units. Breakthrough cancer pain was assessed by the numeric rating scale. Descriptive and binary logistic regression analyses were performed to determine the factors associated with BTCP. The strength of association was described in adjusted odds ratio (AOR) with 95% confidence intervals and variables with a P-value < 0.05 were considered to have a statistically significant association with BTCP.ResultThe prevalence of BTCP among cancer patients was 41.5%. The factors that were found to be associated with BTCP were colorectal cancer (AOR: 7.7, 95% CI: 1.8, 32.3), lung cancer (AOR: 6.9, 95% CI: 1.9, 26.0), metastasis (AOR: 9.3, 95% CI: 3.0, 29.1), mild background pain (AOR: 7.5, 95% CI: 2.5, 22.6), moderate background pain (AOR: 7.0, 95% CI: 2.2, 23.1), severe background pain (AOR: 7.1, 95% CI: 2.2, 22.8), no analgesics taken for background pain (AOR: 5.1, 95% CI: 2.8, 9.3) and uncontrolled background pain (AOR: 3.3, 95% CI: 1.8, 6.1).ConclusionThe prevalence of BTCP was high. Colorectal cancer, lung cancer, the presence of metastasis, the presence of background pain, not taking analgesics for background pain, and uncontrolled background pain were significantly associated with BTCP.

Abstract Background Effective communication is a fundamental step in providing best medical care and recognized as vital component of clinical anesthesia practice. Poor communication adversely affects patients’ safety and outcome. The objective of this study was to investigate the quality of anesthetist communication from patients’ perspectives at University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology A descriptive cross-sectional study was conducted on 423 surgical patients from April 1, – May 30, 2021. Perioperative patient-anesthetist communication (PPAC) was measured by using 15-items Communication Assessment Tool graded by 5-points Likert scale. Data collection was executed during postoperative time as the patients were optimally recovered from anesthesia. The collected data were cleaned and descriptive analysis was performed. Results A total of 400 (94.6% response rate) patients included and 226 (56.7%) were female. The median (IQR) age was 30 (25 – 40) years. Three-hundreds and sixty-one (90.3%) patients had reported good PPAC and 39 (9.8%) reported poor PPAC. The median (IQR) of PPAC scores was 53.0 (48.0 – 57.0) and range from 27 to 69. Highest mean score was observed for the item “Talked in terms I could understand” (4.3 ± 0.7). Lowest mean scores were observed for the item “Checked to be sure I understood everything” (1.9 ± 0.9). Patients who had underwent emergency surgery, no previous anesthetic exposure, had significant preoperative anxiety, no history of previous hospital admission, and moderate-severe preoperative pain were found to have poor PPAC compared to their counterparts in the proportions of 82.1%, 79.5%, 69.2%, 64.1%, and 59.0% respectively. Conclusions There was good PPAC in our hospital from patients’ perspective. However, there should be improvements in checking the degree of understanding of the delivered information, encouraging to question, disclosing next steps and involving in decision-making. Patients who underwent emergency surgery, had no previous anesthetic exposure, had clinically significant level of preoperative anxiety, had no history of previous hospital admission, and had moderate-severe preoperative pain were found to have poor PPAC.

Abstract Background The complexity and demands of emergency healthcare service are continuously increasing, and it is important to regularly track the patterns of care at the emergency department (ED). Methodology A retrospective study was conducted at the ED of the University of Gondar Comprehensive Specialized Hospital (UoGCSH) from April 1 to June 30, 2021. Ethical approval was obtained from the Emergency and Critical Care Directorate of UoGCSH. Data was collected from the emergency registry and descriptive analysis was performed. Results A total of 5232 patients have visited and triaged at the ED. All patients who visited the ED have received triage service within 5 min of arrival. The average length of stay at the ED was 3 days. About 79.1% of patients have stayed at the ED beyond 24 h, and the unavailability of beds at admission areas was responsible for 62% of delays. Mortality rate at the ED was 1.4%, and male to female ratio of death was 1.2 to 1. Shock (all types combined), pneumonia with/without COVID-19, and poisoning were the leading causes of death at the ED which were responsible for 32.5%, 15.5%, and 12.7% of deaths respectively. Conclusions Triage has been done within the recommended time after patient arrival. However, many patients were staying at the ED for an unacceptably prolonged time. Unavailability of beds at the admission areas, waiting long for senior clinicians’ decisions, delays in investigation results, and lack of medical equipment were the causes of delayed discharge from the ED. Shock, pneumonia, and poisoning were the leading causes of death. Healthcare administrators should address the lack of medical resources, and clinicians should provide timely clinical decision and investigation results.

Abstract Background Pain is the most disturbing and annoying symptom experienced by children. However, it obtains poor attention in low- and middle-income countries particularly. The objective of this study was to assess knowledge, attitude and factors associated with pediatric pain management among nurses in tertiary hospitals in Northwest Ethiopia. Methodology : A multi-center cross-sectional study was conducted from March 1 to April 30, 2021. The knowledge and attitude of nurses were measured by using Nurses’ Knowledge and Attitudes Survey regarding Pain (P-NKAS). Descriptive and binary logistic regression analyses were performed to determine factors associated with knowledge and attitude. The strength of the association was presented by using adjusted odds ratio with 95% confidence interval and p-value

Objectives: To assess clinicians’ knowledge, attitude and associated factors towards patients’ early mobilization in intensive care units in the tertiary hospitals in Northwest Ethiopia. Methods: A multi-centre, cross-sectional study was conducted at the tertiary hospitals in Northwest Ethiopia from April to June, 2022. Data were collected by using self-administered, structured questionnaire; ordinal logistic regression analysis was performed and associations were described in adjusted odds ratios. Results: A total of 304 clinicians were included (response rate of 89.7%). The proportions of poor, fair and good knowledge towards early mobilization in intensive care unit among clinicians were 16.8%, 57.9% and 25.3%, respectively; while that of negative, fair and positive attitude were 16.4%, 60.2% and 23.4%, respectively. Factors associated with better knowledge were being a physiotherapist (adjusted odds ratio = 2.9, confidence interval = 1.2–6.7), having a total work experience >5 years (adjusted odds ratio = 4.6, confidence interval = 1.7–12.1), having an intensive care unit work experience >5 years (adjusted odds ratio = 2.8, confidence interval = 1.1–6.8), previous in-service training (adjusted odds ratio = 1.8, confidence interval = 1.1–3.0) and reading guidelines (adjusted odds ratio = 1.9, confidence interval = 1.1–3.2). Better attitude was associated with in-service training (adjusted odds ratio = 1.9, confidence interval = 1.2–3.1), attending early mobilization courses (adjusted odds ratio = 1.8, confidence interval = 1.1–3.0), presence of mobilization advocators (adjusted odds ratio = 1.7, confidence interval = 1.0–2.8), good knowledge (adjusted odds ratio = 2.6, confidence interval = 1.2–5.8) and fair knowledge (adjusted odds ratio = 2.5, confidence interval = 1.3–4.8). Conclusion: Most of the clinicians had demonstrated fair knowledge and attitude towards early mobilization in intensive care unit. However, there were significant proportion of clinicians who had poor knowledge and negative attitude. We recommended active engagement of physiotherapists and experienced clinicians in intensive care units. Clinicians need to have self-learning habits and attend regular training/courses related to early mobilization in intensive care unit.

IntroductionAnxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia.MethodologyA hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. Strength of association was described in adjusted odds ratio (AOR), and a p-value < 0.05 at 95% confidence interval was considered statistically significant.ResultsA total of 400 patients were included in this study with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40–56.7); age, ≥ 60 years (AOR: 5.7, CI: 1.6–20.4, P: 0.007); emergency surgery (AOR: 2.5, CI: 1.3–4.7, P: 0.005); preoperative pain (AOR: 2.6, CI: 1.2–5.4, P: 0.005); and rural residency (AOR: 1.8, CI: 1.1–2.9, P: 0.031) were found significantly associated with preoperative anxiety.ConclusionThe prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.

IntroductionPerioperative respiratory adverse events (PRAEs) are frequent among pediatrics surgical patients and are accountable for 3/4th of perioperative critical incidents and 1/3rd of cardiac arrests.ObjectiveAssess the prevalence and factors associated with PRAEs among pediatric surgical patients in University Hospitals in Northwest Ethiopia, 2020.MethodologyAfter ethical approval obtained prospective observational study was conducted among 210 pediatric surgical patients. Perioperative respiratory adverse events were defined as the occurrence of any episode of single/combination of coughing, breath holding, hypoxemia, laryngospasm and bronchospasm. Bivariate and multivariate binary logistic regression analyses were performed and variables with p < 0.05 at 95% confidence interval were considered as statistically significant.ResultsThe prevalence of PRAEs was 26.2% (CI: 20.5–30.9%). A total of 129 episodes of PRAEs were occurred and of them, 89 (69.0%) were occurred in the postoperative period. Desaturation was the predominant adverse event which was observed 61 (47.3%) times. Age

Background: Anemia is the most common hematological finding in surgical patients. One-third of surgical patients were anemic during preoperative assessment. The presence of preoperative anemia was found to be related with increased morbidity, mortality, length of hospital stay, intensive care unit admissions and postoperative infections. Objective: To determine the prevalence and factors associated with preoperative anemia among adult patients scheduled for major elective surgery at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia, 2020. Methods: After obtaining an ethical approval, hospital-based cross-sectional quantitative study was conducted from June to August 2020 in University of Gondar Hospital. Full blood count within two weeks of preoperative period was considered valid if there were no any factors that affect the hematologic system Descriptive statistics, cross-tabulations and binary logistic regression analysis were performed to identify factors associated withpreoperative anemia. The strength of the association was presented using AOR with 95% confidence interval and p-value < 0.05 was considered as statistically significant. Result: A total of 185 patients enrolled with 100% response rate. We observed preoperative anemia in 36.8% patients. The multi-variable binary logistic analysis showed that ASA II and III [AOR: 3.8, CI: 1.6–9.2], recent prior surgery [AOR: 3.3, CI: 1.3–8.5], history of malignancy [AOR: 9.4, CI: 2.0–43.4], orthopedic procedure [AOR: 11.2, CI: 4.0–31.6] and gynecologic procedure [AOR: 5.2, CI: 1.7–14.5] were significantly associated with preoperative anemia. Conclusion: The prevalence of preoperative anemia was high and ASA ≥2, recent prior surgery, history of malignancy, orthopedic surgery and gynecologic procedure were significantly associated with preoperative anemia. We recommend to clinicians to aim prevention, early detection and treatment of preoperative anemia among adult patients scheduled for major elective surgery to reduce risk of anemia and related adverse outcomes.

Objective. We aimed to assess the level of patient’s satisfaction and associated factors regarding postoperative pain management. Methods. An institution-based cross-sectional study was conducted from April to May 2018 at the University of Gondar, and comprehensive specialized hospital data were collected through semistructured questionnaire and chart review. Level of satisfaction was measured using five-point Likert scale. Statistical analysis was done using SPSS software version 23. Both bivariable and multivariable logistic regression analyses were done. Variables of P value ≤0.2 in the bivariable analysis were a candidate for multivariable logistic regression. A P value ≤0.05 was considered as significantly associated with patient’s level of satisfaction at 95% CI. Results. A total of 418 patients were included in this study with a response rate of 98.58%. The overall proportion of patients who were satisfied with pain management services was 72.2% (95% CI: 67.7–76.6). ASA1 (AOR = 3.55: 95% CI = 1.20–10.55) and ASA2 patients (AOR = 3.72: 95% CI = 1.04–13.28), absence of postoperative pain (AOR = 1.86: 95% CI = 1.02–3.39), peripheral nerve block done (AOR = 9.14: 95% CI = 3.93 20.86), received analgesic before request (AOR = 6.90: 95% CI = 3.72–12.83), and received systemic analgesics (AOR = 6.10: 95% CI = 1.17–33.91) were significantly associated with the level of satisfaction. Conclusion. The level of patient satisfaction with postoperative pain management was considerably low. Hence, it is vital to implement time-interval pain assessment method during the first 24 hours of postoperative period and treat accordingly based on the WHO pain ladder. Moreover, we suggested that all patients who underwent major surgery should receive peripheral nerve block as part of multimodal analgesia to decrease the incidence and severity of post op pain.