ABSTRACT
Background: Clinical practice is the means by which nursing students learn to apply the theory, facilitating integration of theoretical knowledge and practical skill in the clinical setting which becomes arts and science of profession. This correlation of theory and practice, and the building of meaningful experience, take place during clinical practice in the health care service. Even though, nursing students need to have clinical competency during practical setting, there were little available evidences regarding to their competency status in Ethiopia. Therefore, this study was aimed to assess magnitude of clinical competency and its predictors among undergraduate nursing students studying in universities of Southern regional state of Ethiopia in 2021 G C. Methods: Multi-centered institutional based cross-sectional study was conducted among 414 undergraduate nursing students studying in eight universities of Southern regional state of Ethiopia in 2021 academic year. Systematic random sampling technique after proportional allocation to each selected university was used to select the study participants. Data were collected using pretested structured questionnaire by face to face interview after written informed consent was obtained from each participant. Data were cleaned, coded and entered into Epidata version 3.01 and analyzed using statistical package for social science (SPSS) software version 26. Descriptive statistic for all variables and bi-variable and multi-variables logistic regression analysis to identify factors associated with clinical competency was computed and expressed in odds ratio. The result was presented in the form of text, tables and figures and those variables with P-value of <0.05 in multivariable analysis were declared as statistically significant. Result: From 423 total calculated sample sizes, 414 of them were participated in this study giving a response rate of 97.8%. From those participants, 248 (59.9%) of them has clinical competency [95% CI: (55.18%, 64.62%)]. In multivariable analysis, studying in post basic program [AOR: 5.58], conducive clinical learning environment [AOR: 4.10], good staff-student interaction [AOR: 7.44], satisfaction [AOR: 20.66] and positive attitude towards clinical practice [AOR: 2.49] were factors significantly associated with clinical competency. Conclusion: In this study, the overall magnitude of clinical competency was found to be unsatisfactory (59.9%). Studying in private program, non-conducive clinical learning environment, poor staff-student interaction, low satisfaction and negative attitude towards clinical practice were identified as factors associated with clinical incompetency. Policy makers, universities and teaching health facilities need to work collaboratively to create nurses with clinical competency by focusing on proper screening to select candidates for studying in private program, creating conducive clinical learning environment, integrating students with clinical staffs to facilitate learning and positive attitude change of students towards their profession to increase level of satisfaction.
ABSTRACT
Background: Tuberculosis remains the most important global health problem. Worldwide, tuberculosis is the cause of a single infectious agent and the ninth leading cause of death, ranking above human immunodeficiency virus. In high-burden settings, one of the mechanisms to control tuberculosis is to identify patients' problems during treatment. Nevertheless, the problem is still a countrywide issue, and there is a shortage of research to show treatment outcomes and associated factors of tuberculosis in Southern Nations, Nationalities, and People's Regions in the Gurage Zone. Methods: An institution-based, cross-sectional study was conducted to collect data from 347 medical records of tuberculosis patients from 20 July 2016 to 30 July 2021 at Gurage Zone Public Hospitals. The tool includes data about socio-demographic characteristics, as well as tuberculosis-related, and tuberculosis treatment outcome status. Data were analyzed using SPSS version 26, and multivariable logistic regression analyses were conducted to identify significantly associated variables with successful tuberculosis treatment outcomes. The adjusted odds ratio (AOR) with its 95% confidence interval (CI) at a p-value of < 0.05 was used to claim statistical association. Results: In this study, the overall prevalence of successful tuberculosis treatment outcomes was 79.3%. HIV-negative tuberculosis patients (AOR = 4.33; 95% CI: 1.91, 9.79), patients aged < 20 years (AOR = 0.16; 95% CI: 0.04, 0.74), and married participants (AOR = 0.29; 95% CI: 0.10, 0.88) were significantly associated with successful tuberculosis treatment outcomes. Conclusion and recommendations: The prevalence of successful tuberculosis treatment outcomes was low. HIV-TB co-infection, single marital status, and age >20 years negatively affected the treatment outcomes of tuberculosis, thus more effort and better attention should be given to better outcomes of tuberculosis patients, especially for HIV-TB co-infected participants.
ABSTRACT
OBJECTIVES: Tuberculosis (TB) is common in children with human immunodeficiency virus (HIV), but its effect on the survival of HIV-infected children is not well understood. Therefore, the aim of this study was to assess the incidence and predictors of active TB among HIV-positive children at Adama Referral Hospital and Medical College, Oromia, Ethiopia. METHODS: A retrospective study was conducted over 5 years using a checklist to gather data from 428 randomly selected pediatric patient charts. The checklist was adapted from the standardized antiretroviral therapy (ART) follow-up form currently used by the institution's ART clinic. Data were analyzed by bivariate and multivariable analysis using Cox regression proportional hazards models, as appropriate. Survival was calculated and compared using the Kaplan-Meier and log-rank tests. RESULTS: Of the 466 charts reviewed, 428 patient records were included in the analysis. A total of 67 new TB cases were observed during the follow-up period. Hence, the incidence rate in this cohort was found to be 6.03 per 100 child-years of observation. A baseline hemoglobin level <10 g/dL (adjusted hazard ratio [aHR], 7.04; 95% confidence interval [CI], 1.03 to 48.15), moderate wasting (aHR, 2.86; 95% CI, 1.02 to 7.99), and not receiving isoniazid preventive therapy (aHR, 8.23; 95% CI, 2.11 to 32.06) were among the independent predictors of TB occurrence. CONCLUSIONS: The incidence of TB was high, particularly in pre-ART patients receiving chronic care for HIV. Close followup of HIV-positive children is crucial to protect them against the development of TB. Initiating isoniazid preventive therapy, averting malnutrition, and managing anemia are also of significant importance.
