ABSTRACT
Background: Anxiety before surgery is one of the most challenging aspects of preoperative care. Preoperative anxiety has a number of postoperative complications. There are only a few studies that report on preoperative anxiety in surgical patients in Ethiopia, and their prevalence differs from one study to the next. Objective: The aim of this study was to assess the level of preoperative anxiety and associated factors among surgical patients admitted at public hospitals in southern Ethiopia. Methods: From July to August 2022, a facility-based cross-sectional study was conducted among patients admitted to surgical wards at public hospitals. Data collection was conducted using a pretested, structured questionnaire administered by an interviewer. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory scale. The data were coded and entered in Epi Data Version 4.6, then exported to Statistical Package for Social Sciences version 25 for analysis. To describe the study variables, descriptive statistics were used. The associated factors were then identified using bivariate and multivariate logistic regression analyses. Results were declared at a p-value of less than 0.05 based on an adjusted odds ratio with a 95% confidence interval. Result: A total of 220 patients were enrolled, with a 99.5% response rate. The observed preoperative anxiety level was 57.5% (95%CI: 54.63-62.35). High preoperative anxiety was associated with no formal educational status (AOR: 3.75; 95%CI = 1.36, 10.39), fear of death (AOR =2.01; 95%CI = 1.09, 3.73), fear of waking up in middle of surgery (AOR =3.42; 95%CI =1.19, 9.77), fear of postoperative pain (AOR = 2.56; 95%CI = 1.15, 5.74). Conclusion: This study found that five out of ten patients scheduled for surgery in public hospitals had high levels of preoperative anxiety. Anxiety levels were associated with factors such as the educational status of respondents, fear of death, fear of waking up in the middle of surgery, and fear of postoperative pain. Preoperative anxiety assessments should be conducted regularly in each hospital, and appropriate anxiety-reducing methods must be implemented.
ABSTRACT
Introduction: Postpartum depression (PPD) is a nonpsychotic depressive state that begins after childbirth. In Ethiopia, there was limited evidence about the prevalence and factors associated with PPD in terms of residence. Objective: To assess disparities in PPD among urban and rural mothers in the Shashogo district, Hadiya zone southern Ethiopia 2022. Methods: Community-based comparative cross-sectional study design was employed from May 3 to July 3, 2022. A sample size of 556 (185 from urban and 371 from rural) was calculated using a double population proportion approach and mothers in the postpartum period were randomly selected from both urban and rural settings using stratification followed by single stage and the systematic random sampling method. Data were gathered by trained data collectors using an interviewer-administered questionnaire and analyzed using SPSS Version 25. Statistical significance was declared at a P value of < .05. Results: One hundred forty-four (26.6%) mothers in the postpartum period with 95%CI [23-30] were depressed, of which 37 (19.8%) with 95% CI [14-26] in urban and 107 (30%) with 95% CI [25-35] found in a rural setting. Unplanned pregnancy, low maternal social support, assisted delivery, no antenatal care (ANC) follow-up, no postnatal care (PNC) follow-up, and low household income were independent predictors of PPD in rural residence whereas unplanned pregnancy, low maternal social support, assisted delivery, and antenatal depression were independent predictor of PPD in urban. Conclusion: PPD was found to be high in the study area as compared to national/global burden. Unplanned pregnancy, low maternal social support, and assisted delivery were predictors for both urban and rural. Low income, no ANC, and PNC follow-up were associated with PPD in rural settings only whereas antenatal depression is a predictor of PPD in urban settings.
ABSTRACT
BACKGROUND: Procedures to treat intestinal obstruction range from minimally invasive laparoscopic surgery to more complicated open surgical procedures. It may end with high morbidity and mortality because of different reasons. It is very important to know about the determinants of favorable outcome of surgical management for intestinal obstruction however, little is known about this problem at public hospitals of Southern Ethiopia. METHODS: Facility based cross sectional study was conducted. A total of 230 medical records which fulfill the inclusion criteria were used for this study. Variables with p value of less than 0.25 in the bivariate analysis were entered in multivariable logistic regression to control confounding. Finally, odds ratio with 95% confidence interval was used to identify variables which were significantly associated with dependent variable. RESULTS: According to this study the magnitude of favorable surgical management outcome of intestinal obstruction was 177(77.0%) [95% CI, 71.4, 82.4]. Having small bowel obstruction (AOR = 2.49) [95% CI 1.91, 5.12], having simple bowel obstruction (AOR = 4.32) [95% CI, 2.00, 9.35], early presentation of patients (AOR = 4.44) [95% CI, 1.99, 9.92] and intraoperative procedure other than resection and anastomosis was performed (AOR = 0.45) [95% CI, 0.21, 0.96] were significantly associated with favorable outcome among surgically treated patients. CONCLUSION: The overall magnitude of favorable surgical management outcome of intestinal obstruction was moderate compared to other study. Having small bowel obstruction, having simple bowel obstruction, other procedure other than resection and anastomosis done, and early presentation of patients were significant predictors. Physicians should diagnose intestinal obstruction early and appropriate interventions should be taken on time before the complication happened. On time consultation and decision at the hospital setting is also recommended.