Cultural competence and associated factors among nurses working in public health institutions in the Assosa zone, Benishangul Gumuz regional state, Ethiopia, 2022

BACKGROUND

Cultural competence is one of the principal foundations of clinical nursing. In Ethiopia, nurses in nursing care still focus more on physical needs, the healing process, and treatment and less on the cultural aspects of the patient.

OBJECTIVE

This study aims to assess the cultural competence and associated factors among nurses working in public health institutions found in the Assosa Zone, West Ethiopia, in 2022.

METHODS

An institution-based cross-sectional study design was conducted on 362 nurses who were selected by simple random sampling. Data was collected using a structured, self-administered English version of the Nurse Cultural Competence Scale Questionnaire for Nurses. The data were entered into Epi Data version 3.1 and exported to SPSS version 25. Linear regression analysis was used to identify factors statistically significantly associated with the cultural competence of nurses at a p-value < 0.05.

RESULT

Overall The mean score of cultural competence of participants was 113 (CI, 111.7-115.7), with a mean item score of 3.2 (CI, 3.15-3.26). Nurse-to-patient ratio (B;.93, CI;.59_1.3), experience with previously working in a primary hospital than the current health institution (B; -11.1, CI; -18_-4.2), and experience with previously working in a health center than the current health institution (B; -11.5, C;-18.5_-4.8), being diploma education level (B; -23.2, CL;-32_-14.8), being BSC education level (B;-20.3, CI;-28_-12.3), and the presence of a feedback system in a health facility (B; 13.5, CI; 9.5_17.5) were identified as predicted factors of cultural competences.

CONCLUSION

The overall mean score of the cultural competencies of the participants was moderate. To improve the cultural competence of nurses, it is typically necessary to provide educational opportunities to raise their educational level and establish a feedback system in all health institutions across the nation.

Psychological distress and associated factors among asthmatic patients in Southern, Ethiopia, 2021

BACKGROUND

There is an increased prevalence of psychological distress in adults with asthma. Psychological distress describes unpleasant feelings or emotions that impact the level of functioning. It is a significant exacerbating factor in asthma control. Addressing factors that contribute to psychological distress in those asthma patients improves asthma outcomes. So, this study aimed to assess the prevalence of psychological distress and associated factors among asthmatic patients at Hawassa public hospitals, Ethiopia, 2021.

METHODS

Institution-based cross-sectional study design was used to select 394 asthma patients. Proportional allocation and systematic sampling techniques were used to select study participants. A logistic regression model was used to assess the predictors and psychological distress of the asthmatic patient. The association was interpreted using the odds ratio and 95% confidence interval.

RESULT

A total of 394 asthma patients participated in the study, giving a response rate of 93.4%. The prevalence of psychological distress among asthmatic patients was 51% [95%CI: 46%-56%]. Participants who had comorbid medical illness [AOR: 6.049, 95% CI (3.131-11.684)], experienced stigma [AOR: 3.587, 95%CI (1.914-6.723)], chewed khat [AOR: 7.268, 95%CI (3.468-15.231)], had poor social support and had uncontrolled asthma were significantly associated with psychological distress in asthmatic patients.

CONCLUSION

This study demonstrated that the prevalence of psychological distress was found to be high among asthmatic patients. Social support, stigma, chewing khat, comorbid medical illness, and poor asthmatic control had significantly associated with psychological distress in asthmatic patients.

The magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021

Introduction

Mental distress is a collection of mental health abnormalities characterized by symptoms of anxiety, depression, insomnia, fatigue, irritability, forgetfulness, difficulty in concentrating, and somatic symptoms. It affects society as a whole and no group is immune to mental distress; however, students have a significantly high level of mental distress than their community peers. The study is aimed to assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students.

Objective

To assess the magnitude of mental distress and associated factors among a school of medicine and college of health sciences students at Debre Markos University, 2021.

Methods

Institution-based cross-sectional study design was employed from March 15–29, 2021. A simple random sampling technique was used to select 475 study participants. A binary logistic regression model was used to identify factors associated with mental distress. Variables with a p-value less than 0.25 in the bivariable analysis were entered into multivariable logistic regression analysis and a P-Value of less than 0.05 was considered as having a statistically significant association.

Result

The magnitude of mental distress among students was found to be 35.4%, 95%CI (31%, 40%). Female sex [AOR = 1.95; 95%CI (1.24–3.06)], financial distress[AOR = 1.64; 95%CI (1.062.54)], feeling of insecurity [AOR = 2.49; 95% CI (1.13–3.54)], lack of interest to department [AOR = 2.00; 95%CI (1.75–4.36)] and cumulative grade point average less than expected [AOR = 2.63; 95%CI (1.59–4.37)]were significant variables with mental distress.

Conclusion

The magnitude of mental distress was high. Sex, financial distress, feeling of insecurity, lack of interest in the department, and cumulative grade point average less than expected were significant variables with mental distress, so special attention on mental health promotion is required from policymakers, college officials, parents, and other Non-Governmental organizations.

National burden of intestinal parasitic infections and its determinants among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia: A systematic review and meta-analysis

Objectives:

The aim of this systematic review and meta-analysis is designed to assess the pooled prevalence and determine risk factors of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy in Ethiopia.

Methods:

International databases: PubMed, Web of Science, Cochrane Library, Scopus, PsycINFO, African Journals Online, and Google Scholar were systematically searched. Publication bias was determined using the funnel plot and Egger’s regression tests. Heterogeneity between the studies included in this review was checked by I² statistic. The DerSimonian and Laird random-effects model was applied to estimate the pooled effect size. Sub-group, meta-regression, and sensitivity analysis were conducted. Overall, meta-analysis was done using Stata version 14 statistical software.

Results:

Twenty-seven studies with 8946 individuals were included, the estimated pooled prevalence of intestinal parasitic infections among people living with HIV/AIDS on anti-retroviral therapy was 40.24% (95% confidence interval = 33.8–46.6). Based on sub-group analysis, the highest prevalence was observed in the Tigray region 45.7% (95% confidence interval = 7.9–83.5), followed by Oromia region 42.2% (95% confidence interval = 28.8–55.6). Availability of latrine (odds ratio = 26.6, 95% confidence interval = 2.8–15.8), presence of animals at home (odds ratio = 2.7, 95% confidence interval = 1.2–5.8), and source of drinking water (odds ratio = 3.2, 95% confidence interval = 1.3–7.5) were significantly associated with intestinal parasitic infections.

Conclusion:

These findings indicated that the prevalence of intestinal parasites among people living with HIV/AIDS was high in Ethiopia.

Stigma and determinant factors among patients with mental disorders: Institution-based cross-sectional study

Objectives:

To assess prevalence and its associated factors of perceived stigma among patients with mental disorders who had appointment for treatment at Debre Markos, Finote Selam, and Felege Hiwot Hospitals, Ethiopia, 2019.

Methods:

At selected hospitals in the Amhara Region, an institution-based cross-sectional study was conducted from 1 February to 1 March 2019. Participants were selected using systematic random sampling technique and data were collected using a standardized questionnaire. The Internalized Stigma Scale was designed to examine the stigma associated with mental disorders. The data were coded and enter into Epi data version 4.4.2.1 before being exported to SPSS version 20 for analysis. Odds ratios and 95% confidence interval were used to show the strength of the association.

Results:

A total of 610 participants were participated, with a response rate of 98.6%, and 215 (35.2%) of them reported a high level of perceived stigma. Being single (adjusted odds ratio = 1.84, 95% confidence interval: 1.12, 3.02), accessing their medication freely (adjusted odds ratio = 1.70, 95% confidence interval: 1.08, 2.67), having suicidal thoughts (adjusted odds ratio = 1.95, 95% confidence interval: 1.25, 3.03), having low social support (adjusted odds ratio = 5.09, 95% confidence interval: 2.95, 8.76), age 25–34 years (adjusted odds ratio = 1.94, 95% confidence interval: 1.11, 3.40), age 35–44 years (adjusted odds ratio = 2.10, 95% confidence interval: 1.06–4.18), and age > 44 years (adjusted odds ratio = 3.48, 95% confidence interval: 1.67, 7.24) were revealed to be significantly associated with high perceived stigma after multivariable logistic regression analysis ( p < 0.05).

Conclusion:

The prevalence of high perceived stigma was 35.2%, which is found to be high among people who have mental disorders in this study. Being single, accessing their medication freely, having suicidal thoughts, having low social support, and being within the age of (25–34), (35–44), > 44 were all found to be significantly associated with high perceived stigma ( p < 0.05). But married, access medication by fee, have no suicidal thought, having moderate and strong social support, and young age were significantly associated with low perceived stigma.

Economic valuation of attributes of Lake Tana: random parameter model

The general objective of the study is estimating economic value of Lake Tana attributes using stated preference method of valuation in general and choice experiment method in particular. The target population was households who live around Lake Tana. The study has identified four attributes of Lake Tana (Water quality, fishery, irrigation, and recreation). The study has formulated three alternatives in which two of them were improved whereas the one is the status quo. Each attribute has three levels. The study has surveyed 238 households which were selected using multistage sampling method. Each respondent was presented with eight choice sets. Each choice set has three alternatives including opt option. The study has employed random parameter logit model for data analysis. In line with this model the study has conducted the extended random parameter logit model. The status quo (ASC0) is negative and significant both in random parameter logit model but positive and insignificant in extended random parameter logit model. This means that households have preferred the improved situation of the Lake Tana. This indicates that households are willing to pay to improve the current situation of the lake. Random parameter logit model shows that all improved attributes have positive sign and significant at 1% significance level. This means that improved situation of attributes that are identified by this study improve utility of households. Government should protect Lake Tana from any problem by raising funds from households since households are willing to pay to improve Lake Tana's attributes.

Antiseizure medication nonadherence and its associated factors among Epileptic patients in Ethiopia, a systematic review and meta-analysis

BACKGROUND

The majority of patients with epilepsy in resource-poor countries never receive proper treatment, and those who are started on anti-seizure medications quickly discontinue them. Medication noncompliance is extremely common, with estimates ranging from 26 to 79 percent. Non-adherence to antiseizure medications is associated with poor seizure control, increased morbidity, increased hospitalization time, poor quality of life, increased health care costs, and increased mortality in adults.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guideline was used for this systematic review and meta-analysis. The databases Pub Med, Cochrane Library, Scopus Online, and Google Scholar were all searched. STATA™ version 11 software was used for the meta-analysis. The I² test and Egger's tests were used to assess heterogeneity and publication bias. The random-effects method was used to estimate the pooled adherence level with a 95 percent confidence interval.

RESULTS

This meta-analysis included twelve Ethiopian studies involving a total of 3416 epileptic patients. The national pooled prevalence of antiseizure medication non-adherence was 41.96%. Patients who paid for their medications, took them for more than a year, had co-morbidity, and felt stigmatized were more likely to be non-adherent than their counterparts.

CONCLUSION

According to this systematic review and meta-analysis, more than two out of every five epileptic patients did not take their antiseizure medications as prescribed. Clinicians must educate epileptic patients about the importance of medication adherence.

SYSTEMATIC REVIEW REGISTRATION

The review has been registered on an International Prospective Register of Systematic Review with registration number CRD42019142905.

Behavioral Response to HIV/AIDS Prevention Messages Among Students in Selected Universities of Amhara Region, Northwest Ethiopia: An Extended Parallel Process Model

Background

HIV/AIDS is a global pandemic. Sub-Saharan Africa accounts for two-thirds of the newly HIV-infected cases in the world. Similarly, the prevalence of HIV infections among Ethiopian university students has also increased as HIV prevention was not sufficiently prioritized. In order to decrease the surge of the HIV pandemic, prevention messages that encourage individuals to reduce sexual and risk behaviors still remain a key intervention strategy. Besides this, the behavioral response to HIV prevention messages among Ethiopian universities is not well studied.

Objective

To assess students’ behavioral response to HIV/AIDS prevention messages in selected universities of the Amhara region using an extended parallel process model (EPPM), in 2019.

Methods

A facility-based cross-sectional study was employed among 423 eligible students from January to February, 2019 using a stratified sampling technique. The dependent variable is response to HIV/AIDS prevention messages (danger control and fear control) which is addressed by EPPM. The model explains the components of threat (perceived susceptibility and perceived severity) and efficacy (response efficacy and self-efficacy). Subtracting wings of threat component score from efficacy wings score gives the critical value. If the critical value had positive scores, it showed responses of danger control; if the critical value was negative, it showed response of fear control. A logistic regression model was fitted to assess the association between the dependent and independent variables.

Results

The response rate of this study was 94.6%. Among 400 respondents, 263 (65.8%; 95%CI: 61–70) of them were in the danger control response whereas 137 (34.2%; 95%CI: 30– 39) were in fear control response. Moreover, 200 (50%) of the participants had adequate knowledge and 180 (45%) had a favorable attitude towards HIV/AIDS prevention messages. Danger control response for HIV prevention messages was higher among first-year students (AOR=5.5; 95%CI: 1.5–19) and third-year students (AOR=3.9; 95%CI: 2–14) compared with fifth-year students. Similarly, those students who reside on the campus were 60% times less likely to develop danger control when compared with students who live with their family (AOR=0.4; 95%CI: 0.2–0.9). Besides this, students who had adequate knowledge (AOR=2.6; 95%CI: 1.5–4.5) and students who receive fear-inducer messages (AOR=4.5; 95%CI: 3–25] were more likely to develop danger control responses.

Conclusion and Recommendation

Nearly two-thirds of the participants were in the danger control response. Year of study, with whom students currently live, type of message they received, and the knowledge level of respondents were the factors associated with students’ response to HIV/AIDS prevention messages. Therefore, the messages must aim at enhancing threat component perception with appropriate efficacy messages to control danger and promote behavioral change.

Suicidal behavior among people with epilepsy in Northwest Ethiopia: A comparative cross-sectional study

INTRODUCTION

Premature mortality is common in people with epilepsy, but the causes vary where suicide is considered as one of the commonest.

OBJECTIVE

The objective of this study was to compare suicidal behavior between people with epilepsy and the general population and identify associated factors in Northwest Ethiopia.

METHODS

We have conducted a comparative cross-sectional study in Northwest Ethiopia. We have selected people with epilepsy from outpatient departments and the comparisons from the general population. Suicidal behavior was assessed by the revised version of Suicidal Behaviors Questionnaire (SBQ-R). Logistic regression was implemented to look for associations between factors and the dependent variable.

RESULTS

The prevalence of suicidal behavior in people with epilepsy was 18.2%, significantly higher than the community sample, which was 9.8% (p-value = .001). This difference persists in the multivariable logistic regression model by which the odds of suicidal behavior in people with epilepsy was two times more as compared to the community sample. Other variables positively associated with suicidal behavior for the overall sample were depressive symptoms, no formal education, divorced/widowed marital status, and higher perceived criticism. Better social support was protective factor for suicidal behavior.

CONCLUSION

The proportion of suicidal behavior is twofold higher in people with epilepsy than the general population. Routine screening for suicide risk should be an integral part of epilepsy treatment.

Help seeking behavior for problematic substance uses in north-West Ethiopia

Background

Substance miss use and neuro-psychiatric conditions are a growing public health challenges, but 76 to 85% of people with those disorders in low and middle-income countries did not receive treatment. The aim of this study was to see help seeking behavior and determinant factors in residents with problematic substance uses.

Methods

A total of 2400 participants had screened for problematic substance uses and 548 participants were found positive for problematic substance uses. Then, we had interviewed 548 participants for help seeking behavior by pre-tested modified General Help Seeking Questionnaire. Logistic regression with its corresponding p-value < 0.05; Adjusted odds ratios (AOR) and 95% confidence intervals (CI) have been used.

Results

Among five hundred and forty-eight participants with problematic substance use, only one hundred and sixty-eight (30.7%) with 95% CI (27, 35%) had sought help. Age above 35 years [AOR = .47 95% CI (.25, .90)], who had common mental disorders [AOR = 4.12, 95% CI (2.7, 6.3)], who had comorbid medical condition [AOR = 3.0, 95% CI (1.7, 5.3)], and grand-families’ history of substance use [AOR = 2.18, 95% CI (1.4, 3.4)] were significantly associated with help seeking behavior.

Conclusion

Help-seeking behavior was infrequent in people with problematic substance use. Advanced age was a barrier to seek help while medical illnesses, common mental disorders and history of substance use in grand families were found to enforce to seek help.

Health care seeking behavior for depression in Northeast Ethiopia: depression is not considered as illness by more than half of the participants

BACKGROUND

Depression is one of the most disabling and chronic mental illnesses. Despite its high burden, many people suffering from depression did not perceive that they had a treatable illness and consequently most of them did not seek professional help. The aim of this study was to assess the level of professional help-seeking behavior and associated factors among individuals with depression.

METHODS AND MATERIALS

The community-based cross-sectional study was conducted among residents of Dessie, Northeast Ethiopia. First, 1165 residents were screened for depression using patient health questionnaire and then 226 individuals who were screened positive for probable depression were interviewed with General Help-Seeking Questionnaire to assess the professional help-seeking behavior of participants with depression. Major associated variables were identified using logistic regression with 95% confidence interval (CI), and variables with a p value less than 0.05 were considered statistically significant.

RESULTS

Among the total participants with depressive symptoms, only 25.66% of them did seek professional help. Being female [adjusted odds ratio (AOR) = 2.769, 95% CI (1.280, 5.99)], current alcohol drinking [AOR = 2.74, 95% CI (1.265, 5.940)], co-morbid medical-surgical illness [AOR = 4.49, 95% CI (1.823, 11.071)], perceiving depression as illness [AOR = 2.44, 95% CI (1.264, 4.928)], having moderate depressive symptoms [AOR = 2.54, 95% CI (1.086, 5.928)] and moderately severe depressive symptoms [AOR = 7.67, 95% CI (2.699, 21.814)] were significantly associated with help seeking behavior of participants.

CONCLUSIONS

Level of professional help-seeking behavior is as low as previous studies in different countries. The severity of depressive symptoms, co-morbidity of medical-surgical illness, current drinking of alcohol, being female, and perceiving depression as illness were significantly associated with professional help-seeking behavior for depressive symptoms. Working on mental health literacy in the community is important to increase help-seeking behavior.

Satisfaction and associated factors of outpatient psychiatric service consumers in Ethiopia

PURPOSE

The purpose of this study was to assess the level of patient satisfaction and associated factors with psychiatric outpatient services in Ethiopia.

PATIENTS AND METHODS

A cross-sectional study was performed from May 2015 to June 2015. A total of 454 participants selected by systematic random sampling were included in this study. Pretested and interviewer-administered questionnaire was used to collect the data. Patient satisfaction was measured using Charleston Psychiatric Outpatient Satisfaction Scale, and other validated tools were used to assess the associated variables. Multivariate logistic regressions with 95% confidence interval (CI) were used to assess the strength, and P-value <0.05 was used to indicate significance of association.

RESULTS

A total of 441 respondents were enrolled, with a response rate of 97.1% and magnitude of satisfaction of 61.2%. Being male (adjusted odds ratio [AOR] =0.612, 95% CI: 0.39, 0.94), being widowed (AOR =0.13, 95% CI: 0.05, 0.36), urban residence (AOR =0.49, 95% CI: 0.31, 0.78), diagnosed with schizophrenia (AOR =0.48, 95% CI: 0.28, 0.81), unfavorable attitude (AOR =0.49, 95% CI: 0.28, 0.86), and poor social functioning (AOR =0.52, 95% CI: 0.34, 0.80) were significantly associated with satisfaction.

CONCLUSION

More than one-third of psychiatric service consumers were dissatisfied with the service they received. Integrating patients to their own treatment plan and regular service evaluation are important to improve satisfaction.