Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

Prevalence and Predictors of Knowledge and Attitude on Optimal Nutrition and Health Among Pregnant Women in Their First Trimester of Pregnancy

Introduction

Evidence has demonstrated that knowledge and attitudes are indicators of nutrition and health modification among pregnant women. As a result, the objective of this study was to assess the prevalence and predictors of knowledge and attitudes about optimal nutrition and health among pregnant women in their first trimester of pregnancy.

Methods

A community-based cross-sectional study design was conducted between April 1 and June 1, 2018 among 750 pregnant women and sampled using the multi-stage sampling technique in the Ambo district of the West Shoa Zone, Ethiopia. Using a pre-tested, semi-structured questionnaire, data were gathered and analyzed using SPSS version 23. First, descriptive statistics were used, then bivariate and, finally, multivariable logistic regression analysis was used to assess the association of the predictors with the outcome variables.

Results

Overall, 33.3% and 31.3% of pregnant women had good knowledge and favorable attitudes about optimal nutrition and health, respectively. Residence, the woman's and her husband's educational status, having > five household members, being in rich households, taking distance to reach a health institution, being multiparous, having information, and receiving counseling were significantly associated with pregnant women's knowledge on optimal nutrition and health. Also, a favorable association was found between a woman's attitude toward optimal nutrition and health and her and her husband's educational status, household wealth status, and the distance traveled to a health facility.

Conclusion

The nutrition and health knowledge and attitudes of pregnant women in the study area were suboptimal. Improving knowledge and attitude during the first trimester of pregnancy is essential for suggesting nutrition and health-related behavior in the succeeding periods of pregnancy, which predominantly determine the pregnancy's outcomes.

Analysis of the Effect of Mindfulness Behavior Intervention Combined with Progressive Breathing Training on Pulmonary Function Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Purpose

Studies have shown that 50%-70% of patients with chronic obstructive pulmonary disease (COPD) have fatigue in addition to respiratory symptoms, so relieving respiratory symptoms and reducing fatigue are the main treatment objectives for COPD patients. This study focuses on the effect of positive behavioral intervention combined with progressive breathing training on pulmonary function rehabilitation in patients with COPD.

Methods

86 patients who underwent COPD treatment in our hospital between August 2020 and December 2021 were selected as study subjects and were divided into control (n = 43) and study groups (n = 43) using the random number table method. Patients in the control group were given conventional care, treatment, and health guidance, while patients in the study group were given positive behavioral intervention combined with progressive breathing training on this basis. Patients in both groups were compared on the basis of Multidimensional Fatigue Inventory 20 (MFI-20) score, the Medical Coping Questionnaire (MCMQ score), the Massive Attentional Awareness Scale (MAAS) score, and pulmonary function indicators (including the percentage of forced expiratory volume one second (FEV1%), peak expiratory flow (PEF), forced vital capacity (FVC), and 6-min walk distance (6MWD)) and quality of life (MCMQ) scores before and after 12 weeks of intervention.

Results

After 12 weeks of intervention, the study group had higher MFI-20 scores (comprehensive fatigue, physical fatigue, reduced activity, decreased power, and mental fatigue), confrontation scores on the MCMQ scale, MAAS scores (observation, description, nonjudgmental to intrinsic experience, nonresponsiveness to intrinsic experience, and perceived behavior), FEV1%, PEF, FVC, and 6MWD levels than the control group (P < 0.05). The scores of avoidance and submission on the MCMQ scale, and all scores of quality of life (cough, expectoration, shortness of breath, chest tightness, housework, going out, sleep, and energy) were lower than those of the control group (P < 0.05).

Conclusion

Positive behavioral interventions combined with progressive breathing training have a strengthening effect on the clinical treatment of COPD patients. Positive behavioral interventions combined with progressive breathing training are simple to implement as individual self-regulation methods and can be practiced on their own after being familiar with certain methods and techniques, and long-term adherence helps individuals cope with the stimulation of adverse events. Trail Registration. The clinical registration number for this research is L2020083.

Pregnant mothers' knowledge, attitude, practice and its predictors towards nutrition in public hospitals of Southern Ethiopia: A multicenter cross-sectional study

Objectives:

Insufficient nutrition can predisposes women to infection, pregnancy losses, preeclampsia and anaemia as well birth of underweight baby whose survival is threatened. Therefore, this study was aimed to assess pregnant mothers’ nutrition knowledge, attitude, practice and associated factors.

Methods:

A multicenter cross-sectional study was conducted among 378 participants who were selected using a systematic random sampling technique. Quantitative data were collected using a structured and interviewer-administered questionnaire, which consisted of questions on sociodemographic features, obstetrics characteristics and pregnant women’s nutrition knowledge, attitude and practice. Data entry and analysis were done using Statistical Package for the Social Sciences statistical version 23. Binary logistic regression analysis was done to identify associated factors. All variables with p-value of < 0.23 in bivariate analysis were included in multivariate analysis, and finally, statistical significance was declared at p-value < 0.05 with 95% confidence interval.

Result:

From 378 women participated, a total of 231 (61.1%) respondents were in age range of 25–34 years. About 148 (39.1%) of women were not knowledgeable, 153 (40.5%) had an unfavourable attitude, and 47.7% had poor dietary practice. Knowledge (adjusted odds ratio = 4.5; 95% confidence interval: 2.88, 10.06, p = 0.03), attitude (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.04) and practice (adjusted odds ratio = 3.6; 95% confidence interval: 2.43, 6.66, p = 0.036) were all significantly associated with maternal education. Regarding their occupation, merchant women were seven times (adjusted odds ratio = 7.02; 95% confidence interval: 2.88, 17.09, p = 0.01) more likely to have knowledge and government employees were six times (adjusted odds ratio = 6.05; 95% confidence interval: 3.58, 13.05, p = 0.04) more likely to be knowable than housewives. Moreover, multiparous women were 4.77 times (adjusted odds ratio = 4.77; 95% confidence interval: 1.15, 8.66, p = 0.002) more likely to be knowledgeable compared to primigravida women. Monthly income was also associated to attitude (adjusted odds ratio = 0.45, 95% confidence interval: 0.10, 1.66, p = 0.03). Women who had a favourable attitude were five times (adjusted odds ratio = 5.25; 95% confidence interval: 2.36, 9.62, p = 0.04) more likely to have good nutritional practices during pregnancy.

Conclusion:

Pregnant women’s knowledge, attitude and practice towards nutrition in this area were low. The educational status of women was associated with knowledge; attitude and practice. Likewise, occupation and parity were associated with knowledge; and attitude was also found to be a determinant factor of nutritional practice. Therefore, community nutritional education and antenatal nutritional counselling need to be strengthened in the area.