ABSTRACT
Background: Worldwide, quality education is one of the important tools to improve healthcare quality. Healthcare practitioners must be competent in their clinical judgement to meet clients' need. However, poor clinical judgment skill accounts for almost one-third of all patient problems in health care. Expert patient simulation has been used as a training method for clinical judgement skill. However, according to empirical studies, using expert patients to develop clinical judgement skill is unclear. The method is effective in one situation but not in another. Objective: To examine the effect of expert patient simulation on the clinical judgment skill of health science students of Mizan-Tepi University. Methods: A pre-test/post-test quasi-experimental design was used on 92 randomly selected samples from the graduating cohort of midwifery students. The research subjects who took part in the experiment were picked at random. Tools included the Creighton Competency Evaluation Instrument (C-CEI®), the Learning Satisfaction and Self-Confidence Questionnaire, and the Kolb Learning Style Inventory (LSI). The Wilcoxon-signed rank test was utilized to compare the self-confidence scores among intervention and control group of students, and the paired sample test was used to compare clinical judgment scores. Cohen's d was used to assess the effect size, and Spearman correlation was used to explore the association. Results: Clinical decision-making ability and self-confidence measures revealed statistical and practical differences between before and after simulation. There was a mean difference of 2.28 (95% CI, 1.78, 2.79), t (45)=9.13, p 0.001, and an effect size of 1.3, p 0.001. A pre-and post-simulation self-confidence measure showed statistically significant improvement after simulation (W = 1, Z = -3.57, P 0.001). A moderately significant positive connection (r = 0.419, p 0.004) was also discovered. Conclusion: The study found that human expert patient simulation is a tremendous clinical training technique for improving students' clinical decision-making skill competency and self-confidence.
ABSTRACT
Background: Undernutrition in pregnant women, expressed as low mid-upper arm circumference, is responsible for maternal mortality and morbidity, adverse birth outcomes, subsequent childhood malnutrition, and mortality. As a result, the purpose of this study was to determine the prevalence of maternal undernutrition and associated factors during pregnancy in public hospitals in the Bench-Sheko and Kaffa zones of southwest Ethiopia. Methods: A facility-based cross-sectional study design was employed among 566 women who received antenatal care from March-May 2021 at the public hospitals of the Bench-Sheko and Kaffa zones, Southwest Ethiopia. A systematic random sampling technique was used to select the research unit. Undernutrition was measured by mid-upper arm circumference. The data were entered into Epi- Data version 3.1 and then exported to Statistical Package for Social Science (SPSS) version 21 software for analysis. Multivariate logistic regression models were constructed using variables with a P-value <0.25 in bivariate logistic regression analysis. Finally, in multivariate logistic regression analysis, the variable with a (P-value < 0.05) is considered statistically significant. Results: A total of 566 pregnant women participated in our study with a response rate of 98.3%. The overall prevalence of undernutrition among pregnant women was 42.4% (95% CI: 38.3, 46.5). In multivariate logistic regression, the age of mothers between 16-24 years old (AOR = 3.9, 95% CI: 1.60, 9.70), household food insecurity (AOR = 1.81, 95% CI: 1.04, 3.15), and poor dietary knowledge (AOR = 3.25, 95% CI: 1.94, 5.47) were the factors significantly associated with undernutrition among pregnant women. Conclusion: According to this study finding, the prevalence of undernutrition was very much high in the study area, which was significantly associated with the age groups of 16-24 years older women, poor dietary knowledge, and household food insecurity. Therefore, the strategies and programs targeted towards reducing and preventing undernutrition among pregnant mothers should be made at all levels to improve their nutritional status, and also health information, nutrition counseling, and food assistant should be provided.
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OBJECTIVE: To identify dietary diversity and its associated factors among lactating women in the Debub Bench district. METHODS: Cross-sectional study design was conducted among 836 lactating women from January 1st to March 31st, 2019, in Debub Bench district. The outcome variable of the study was determined based on the proportion of lactating mothers who fed less than five major food groups to mothers who fed more than five major food groups out of nine (9) food groups. Lactating mothers who fed less than five of the major food groups were categorized under unacceptable dietary diversity. Data were first collected through face-to-face interviews by validated structured questionerers and then entered in Epi-data version 4.6.0.2 software. A bivariate and multivariate logistic regression analysis were later conducted using IBM SPSS version 26 software. During the analysis, multicollinearity was check by using the tolerance test and variance inflation factors (VIF), Hosmer-Lemeshow goodness of fit test was used to see model fitness, and adjusted odds ratios and their 95% confidence interval at P values ≤0.05 were considered to determine statistically significant factors. RESULT: A total of 836 lactating mothers had participated in the study. The response rate was 91.26%. The mean age of the participants was 29 years (SD ± 6.7). The study found that the magnitude of unacceptable dietary diversity score was 72.4% (95% CI: 69.5-75.5). The study also found that factors such as nutrition information (OR = 4, 95% CI: 2.64-6.08), absence of garden (OR = 2.35, 95% CI: 1.19-4.61), absence of latrine (OR = 6.86, 95% CI: 3.26-14.56) and household food insecurity (OR = 5.23, 95% CI: 3.64-7.46) were significantly associated with unacceptable dietary diversity. CONCLUSION: The finding of this study showed that information about nutrition, absence of latrine, absence of garden, and household food insecurity were significantly associated with dietary diversity. Based on the finding of the study, the following recommendations are made. First, strategies and programs targeted towards promoting dietary diversity and good health among lactating women should be made at all levels. Second, lactating mothers should be adequately provided with nutritional information. Three, mothers should be empowered to alleviate household food insecurity by leveraging their premises for gardening diversified and nutritious vegetables.
ABSTRACT
BACKGROUND: Malnutrition is a term used to refer a condition of both excessive and under-nutrition. Even in the 21st c, it is yet among the major public health challenges that affect the health, growth, and development of millions of children across continents. Studies show that malnutrition during early childhood could result in devastating long-term effects such as poor school performance, weak immune system, and growth and development. Unfortunately, Ethiopia is among the developing countries hard hit by the problem of malnutrition (under-nutrition). OBJECTIVE: To assess the magnitude of stunting, wasting, and underweight and risk factors associated with them; among Children aged between 6- 36 months. METHODS: A community-based cross-sectional study design was conducted on 700 study participants from April to May 2020. Nutritional status of children aged between 6-36 months was determined based on the WHO reference population with Z score ≤ -2 SD (HAZ, WHZ and WAZ) was looked upon for stunting, wasting and underweight accordingly. Data were collected through structured and measuring anthropometric of the eligible sample unit. The questionnaire data were first entered into Epi-data and later analyzed following binary and multiple logistic regression analysis procedures with the help of IBM SPSS 26. Adjusted odds ratios, with 95% CI of the association and statistical significance declared at P-values ≤ 0.05 in this study. RESULTS: In the present study, the response rate of the respondent was 100%. Factors significantly associated with undernutrition: stunting, Mothers who have no formal education (AOR = 2.58, 95% CI; 1.44-4.63), food insecure (AOR = 1.9, 95% CI; 1.23-2.9) and children had no feeding plate (AOR = 1.53, 95% CI; 1.07-2.19). FOR UNDERWEIGHT: have not individual feeding plate (AOR = 2.39, 95% CI; 1.42-4.03), poor dietary diversity (AOR = 1.82, 95% CI; 1.23-2.69) and food insecurity (AOR = 4.24, 95% CI; 2.68-6.71).We have also identified age between 6-11 months (AOR = 6.81, 95% CI; 2.93-15.79), 12-23 months (AOR = 2.28, 95% CI; 1.03-5.06), food insecure (AOR = 10.34, 95% CI; 5.22-20.45) and poor dietary diversity (AOR = 5.58, 95% CI; 2.36-13.19) as risk factors associated with wasting. CONCLUSION: This study relived that six variables significantly associate with undernutrition. These are: children have not his/her own feeding plate, household food insecurity, mother who had no formal education, poor dietary diversity and children aged between 6-11months and children age 6-23 months. Based on the findings of this study, the following recommendations are made. First, strategies and programs targeted towards the reduction and prevention of undernutrition among 6-36-month children should be made at all level to improve childhood nutritional status. Second, provide health information to families regarding the importance of separating children's feeding plate. Three, provide nutritional counselling about feeding practice and dietary diversity for mothers who have no formal education.
