Therapeutic communication and its associated factors among nurses working in public hospitals of Gamo zone, southern Ethiopia: application of Hildegard Peplau's nursing theory of interpersonal relations.

BACKGROUND: Therapeutic communication can assist nurses in achieving their goals. Effective nurse-patient communication can improve clinical outcomes and boosts patient satisfaction. But, there is an arming gap in therapeutic communication between nurses and patients in Ethiopia, which hinders the quality of nursing care. Some studies have been done on therapeutic and its barriers. Nevertheless, those studies did not fully address factors from different perspectives and were supported by nursing theories or models. Therefore, this study aimed to fill these gaps in the study setting. METHODS: Institution-based cross-sectional study was conducted among 408 nurses working in public hospitals of Gamo zone from December 1, 2021, to January 30, 2022. Out of the six hospitals in the Gamo zone, three were selected by simple random sampling method. The data were collected by an interview-administered Open Data Kit survey tool and analyzed by SAS version 9.4. Descriptive statistics were computed and a generalized linear model was used to identify associated factors. RESULTS: In this study, a standardized percentage of the maximum scale of therapeutic communication was 52.32%. Of the participants, 40.4% had high, 25.0% moderate, and 34.6% had low levels of therapeutic communication. Age, marital status, and qualification showed significant and positive relationships with the overall therapeutic communication. However, sex, working unit, nurse burnout, lack of empathy from nurses, challenging nursing tasks, lack of privacy, use of technical terms by nurses, lack of confidence in nurses, stress, unfamiliarity with the nursing job description, shortage of nurses, insufficient knowledge, lack of participation in decision making, and having contagious disease showed a significant and negative relationship with overall therapeutic communication. CONCLUSIONS: This finding indicates a gap in therapeutic communication between nurses and patients, and modifiable factors are identified. Therefore, giving opportunities for nurses to improve their qualifications, a special attention to nurses working in stressful areas, sharing the burden of nurses, involving nurses and patients in decision-making, and motivating and creating a positive working environment is vital to improving therapeutic communication.

Perceived Utilization of Leadership Styles Among Nurses.

Background: Nurses´ perceptions of leaders´ leadership styles has a significant impact on their well-being. Effective leadership in health care is crucial for improving and enhancing the effectiveness of health care systems. This study aimed to assess the perceived utilization of leadership styles among nurses at Jimma town public health facilities, Ethiopia. Methods: This facility-based cross-sectional study was conducted with 403 nurses. Data were collected through a self-administered structured questionnaire. Data were entered into Epi-Data version 4.6 and then exported to SPSS version 25. The strength of association was described using unstandardized adjusted ß with a 95% confidence interval (CI) and p-value <0.05. Results: Of the 422 participants, 403 completed and returned the questionnaire correctly, thus achieving a response rate of 95.5%. Staff nurses perceived that their head nurses fairly often or commonly used transformational leadership styles, with a mean of 2.77±0.60. The multivariable linear regression analysis model indicated that there was a positive relationship between perceived leadership style and gender, overall organizational commitment, overall job-related stress, overall innovative work behavior, and overall leadership practice. However, there was a negative relationship between perceived leadership style and nurses who had not received previous training on leadership. Conclusion: This study highlights that transformational leadership is a commonly utilized leadership style by leader nurses. Effective and balanced use of various leadership styles requires knowledge (training), organizational commitment, and innovative work behavior from both leaders and staff nurses. Therefore, a transformational leadership style is key to achieving organizational goals and increasing staff nurses' productivity.

Pattern of Perioperative Surgical Patient Care, Equipment Handling and Operating Room Management During COVID-19 Pandemic at Jimma Medical Center.

Background: The nature of COVID-19 transmission creates significant risks in surgical departments owing to the close contact of medical staff with patients, the limited physical environment of the operating room and recovery room, the possibility of shared surgical equipment and challenges in the delivery of surgical care in all surgical departments. Globally, studies have reported that the effects of the pandemic on surgical departments are profound, potentially long-lasting and extensive. To manage these effects, different local guidelines and recommendations have been developed, with potential differences in their effectiveness and implementation. Therefore, harmonized and effective national/international guidelines for specific surgical departments during perioperative periods are pertinent to curtail the infection, and will inevitably need to be adapted for consistent and sustainable implementation by all medical staff. The pattern of surgical patient care during the COVID-19 pandemic at Jimma Medical Center (JMC), Ethiopia, has not been explored yet. The present study aimed to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC. Methods: A cross-sectional study was conducted to describe the pattern of perioperative surgical patient care, equipment handling and operating room management during the COVID-19 pandemic at JMC, using five-point Likert scales (0, not at all; 1, rarely; 2, sometimes; 3, most of the time; 4, frequently). A total of 90 respondents [35 patients (five patients from each of seven surgical departments) and 55 healthcare providers (six professionals from each of nine units, including the center of sterility room and anesthesia)] who were available during the study period, selected by a convenience sampling technique with multistage clustering, participated in the study. Data were collected using a structured questionnaire via direct observation and face-to-face interviews with patients undergoing surgery, healthcare providers and hospital administrators, against the standard surgical patient care guidelines. The collected data were manually checked for missing values and outliers, cleared, entered into EpiData (v4.3.1) and exported to SPSS (v22) for analysis. The mean score of practice was compared among different disciplines by applying the unpaired t-test. The findings of the study were reported using tables and narration. A p-value of less than 0.05 was declared as statistically significant. Results: Despite the surgical care practice having changed during the COVID-19 pandemic in all service domains, it is not implemented consistently among different surgical departments owing to different barriers (lack of training on the updated guidelines and financial constraints). The majority of surgical staff were implementing the use of preventive measures against COVID-19, while they were practiced less among patients. The guidelines for surgical practice during the preoperative phase were well applied, especially screening patients by different methods and the application of telemedicine to reduce physical contacts. But, against guidelines, elective patients were planned and underwent surgery, especially in the general surgery department. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. The extent of practice for anesthesia care, operating room management and postoperative care in the recovery room also changed, and the guidelines were sometimes applied. Conclusion and Recommendations: Although perioperative surgical care practice differed before and during the pandemic, the standard guidelines were inconsistently implemented among surgical departments. The implementation of recommended guidelines in the center of sterility room in handling surgical equipment was not very different before and during the pandemic. Thus, the authors developed safe surgical care guidelines throughout the different domains (infection prevention and PPE use; preoperative care, intraoperative care, operating room management, anesthesia care, equipment handling process and postoperative care) for all disciplines and shared them with all staff. We recommend that all surgical staff should access these guidelines and strictly adhere to them for surgical service during the pandemic.

Compliance to antenatal psychosocial assessment practice among midwives: a best practice implementation project.

INTRODUCTION AND AIMS: As directed by the WHO, antenatal care providers have good opportunities to identify and refer mothers who are struggling with psychosocial problems. In Ethiopia, the pooled prevalence of perinatal depression is 25.8%, which is almost two-fold of the pooled global prevalence. Though this is an indication of the need for prompt interventions, there is no assessment targeted to this population. Therefore, the aim of this project was to promote an antenatal psychosocial assessment practice among midwives. METHODS: Using the Joanna Briggs Institute Practical Application of Evidence System, 66 first visit antenatal care assessment opportunities were observed in both baseline and follow-up audit using three audit criteria. Fourteen midwives were interviewed for the first criterion. On the basis of the results, the gaps and barriers were analyzed using Getting Research into Practice strategies. RESULT: The baseline audit result revealed a 0% compliance rate for all evidence-based antenatal psychosocial assessment audit criteria. This scenario disclosed that there had not been psychosocial problem assessment practice at antenatal clinic. However, the postimplementation result showed that an average 91.5% practice of evidence-based antenatal psychosocial assessment was applied as per standards. CONCLUSION: Carrying out discussions on evidence summary with providers, on-the-job training, using local leaders' opinions, and involving relevant stakeholders appeared to be the key methods in improving compliance to best available evidence in antenatal psychosocial assessment.

Determinants of diabetic retinopathy in Tikur Anbessa Hospital, Ethiopia: a case-control study.

BACKGROUND: Diabetic retinopathy is the most frequent complication of Diabetes Mellitus and remains the leading cause of preventable blindness. However, there are limited studies on the determinants of diabetic retinopathy in the study area as well in Ethiopia. Hence, this study aimed to assess the determinants of diabetic retinopathy among diabetic patients at Tikur Anbessa Hospital. METHODS: An institution-based unmatched case-control study design was conducted at Tikur Anbessa Hospital from May 11 to June 26, 2020. Diabetic patients who developed retinopathy within 2 years were cases in the study. Patients who were free of retinopathy were controls in this study. Data were collected using a pretested interviewer-administered questionnaire, Topcon retinal examination, and a record review. The collected data were entered into Epi Data version 3.1 software, and analyzed using SPSS version 25. Binary logistic regression analysis was used to assess the determinants of diabetic retinopathy. RESULTS: A total of 282 patients (142 cases and 140 controls) were included in the study. The mean age (± Standard deviation) for the cases and the controls were 50.6 (SD: ± 18.7) and 44.9 (SD: ± 17.65) respectively. Patients who had a glucometer at home (AOR = 0.048; 95% CI: 0.005-0.492), exercise adherence (AOR = 0.075; 95% CI: 0.007-0.84), diabetes duration < 5 years (AOR = 0.005; 95% CI: 0.00-0.10) and 5-10 years (AOR = 0.041; 95% CI: 0.003-0.57), health information on diabetic complications (AOR = 0.002; 95% CI: 0.00-0.042) and appointments every month (AOR = 0.004; 95% CI: 0.00-0.073) and every 3 months (AOR = 0.022; 95% CI: 0.002-0.23) were less likely to develop diabetic retinopathy. Participants who had poor glycemic control (AOR = 19.9; 95% CI: 2.34-168.69), systolic hypertension (AOR = 23.4; 95% CI: 2.56-215.36) and nephropathy (AOR = 17.85; 95% CI: 2.01-158.1), had a higher risk of developing diabetic retinopathy. CONCLUSIONS: Patients who had a glucometer at home, exercise adherence, diabetes duration < 10 years, health information on diabetic complications, and frequent follow-up had a preventive role. However, poor glycemic control, systolic hypertension, and nephropathy increase the risk of diabetic retinopathy. A concerted effort should be made to improve the health status of patients with Diabetes Mellitus, with particular emphasis on lifestyle modification practices to prevent diabetic retinopathy.

Determinants of Quality of Work Life among Nurses Working in Hawassa Town Public Health Facilities, South Ethiopia: A Cross-Sectional Study.

BACKGROUND: A high quality of work life (QWL) is a crucial issue for health care facilities to have qualified, dedicated, and inspired employees. Among different specialties in health care settings, nurses have a major share among other health care providers. So, they should experience a better QWL to deliver high-quality holistic care to those who need help. OBJECTIVE: To assess the level of quality of work life and its predictors among nurses working in Hawassa town public health facilities, South Ethiopia. METHODS: A facility based cross-sectional study was conducted on 253 nurses of two hospitals and nine health centers. The total sample size was allocated to each facility based on the number of nurses in each facility. Data were collected using a structured questionnaire. The interitem consistency of the scale used to measure QWL had Cronbach's alpha value of 0.86. A multinomial logistic regression model was fitted to identify significant predictors of quality of work life using SPSS version 20. RESULTS: The study showed that 67.2% of the nurses were dissatisfied with the quality of their work life. We found that educational status, monthly income, working unit, and work environment were strong predictors of quality of work life among nurses (p < 0.05). CONCLUSION: Significant proportions of the nurses were dissatisfied with the quality of their work life. The findings in this study and studies reported from elsewhere pinpoint that perception of nurses about the quality of their work life can be modified if health care managers are considerate of the key issues surrounding QWL.