Retrospective cross-sectional study of asthma severity in adult patients at the Jimma Medical Center, Ethiopia.

Asthma is one of the most prevalent chronic diseases and is a public health problem worldwide. It is a long-standing condition affecting the respiratory system. Thus this study aimed to assess the severity of asthma in patients at the adult emergency department of Jimma Medical Center (JMC), Southwest Ethiopia. A one year (1 May, 2020, to 1 May, 2021) retrospective cross-sectional study was conducted among 189 patients at the adult emergency department of JMC. Data were collected between 25 July, 2021 to 25 August, 2021 by two Bachelor of Science degree holders in nursing (BSC) nurses after providing proper training. We used structured checklist that was obtained from previous studies to collect the data. Finally, data were entered into EpiData version 3.1 then exported to Stata version 15.0 for further analysis. Multinomial analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association between risk factors and severity of asthma. Of 195 patients retrieved from the Health management information system (HMIS) logbook and patient profile, 189 fulfilled the eligibility criteria giving a response rate of 96.9%. The mean age of patients was 47.69 (± 19.02) years old ranging from 20 to 85. More than one third of the patients were age range of 20-39 years. Only more than half of the patients were women. Almost 46% of the patients had moderate asthma. Being male, merchant and government employees had lower odds of asthma than their counterparts whereas being daily laborers and smoking contributed to increased odds of moderate asthma. Patients' age and comorbidities had increased odds of severe asthma in relation to the participants of their reference category. Urban residents had decreased odds of severe asthma compared to their rural counterparts. This study highlights that majority of patients had moderate asthma. Health care providers should pay special attention to accurately diagnosing asthma according to its severity which is essential to the optimal management of asthma. This study calls JMC health care providers to give due attention while providing routine care for their patients in accordance to identified factors.

A Quantitative Study on Stigma and Statistically Correlated Factors Among Women Living with Genital Fistula in Oromia Region, Ethiopia. Identification of Urgent Corrective Strategies.

BACKGROUND: Two-to-three million women worldwide live with a genital fistula, with Asian and sub-Saharan African countries including Ethiopia accounting for the greatest percentage. Genital fistula is a devastating health problem due to the stigma associated with constant incontinence and bad-odor. Thus, this study aimed to determine the magnitude of the stigma towards women living with genital fistula in Oromia region, Ethiopia, and to highlight the factors associated with it, identifying potential strategies for corrective interventions. METHODS: This quantitative study was conducted among 422 women living with genital fistula in five fistula treatment centers of Oromia region using a cross-sectional study design from August 30, 2019 to February 28, 2020. Data were collected by face-to-face interview using a structured questionnaire, entered into Epi-data version 4.2, and analyzed by SPSS version 23. Bivariate and multivariable logistic regression analysis was done. P-value <0.05 was used to ascertain statistical significance with an adjusted odds ratio at 95% confidence interval (CI). The results were presented by text and tables. RESULTS: The response rate for this study was 100%. The magnitude of perceived high stigma related to genital fistula was 178 (42.2%). The factors associated with it were the respondents' father's educational level of being able to write and read compared to unknown fathers' educational level (AOR=0.09; 95% CI=0.03-0.34), and duration of living with a genital fistula of less than 2 years compared to living with a genital fistula for 5 years or more (AOR=0.52; 95% CI=0.31-0.86). CONCLUSION: The perceived level of stigma among women living with a genital fistula in Oromia region was significantly high. To reduce the perceived level of stigma and therefore to prevent the severe negative consequences of it, fathers, but also mothers, husbands, family members, and all the persons close to women living with genital fistulas should provide care and psychological support and all the necessary means to strongly encourage them to seek health care quickly, and to make them feel that they are beloved, and that there is hope for a healthy life in their near future.

COVID-19's Negative Impacts on Clinical Learning and Proposed Compensation Mechanisms Among Undergraduate Midwifery and Nursing Students of Jimma University.

BACKGROUND: Even though lockdown measures contributed to reducing the rate of COVID-19 transmission, it resulted in great distraction in clinical learning. Thus, the aim of this study was to assess COVID-19's negative impacts on clinical learning, and proposed compensation mechanisms among midwifery and nursing undergraduate students of Jimma University, southwest Ethiopia. METHODS: This study was conducted among 147 midwifery and nursing students of Jimma University in March 2021 using cross-sectional study design. The respondents were selected by simple random sampling method. Data were collected by using a self-administered questionnaire and analyzed descriptively by SPSS v.23. The results were presented in tables, and narrated. RESULTS: Three fifths (88 (59.9%)) of the study participants perceived high negative impacts of COVID-19 on their recent clinical learning. The proposed compensation mechanisms to be implemented before and during the next clinical practice include: using teacher-facilitated skill demonstration laboratory, case scenarios, clinical teaching videos, and clinical conferences. Students' effort to understand the objectives of their clinical learning and using multi-media to achieve it was another proposed compensation mechanism. Also, providing pre-placement training and in-service training with priority for students graduating during COVID-19 pandemic were proposed compensation mechanisms. CONCLUSION: COVID-19's negative impacts on clinical learning were great among the participants of this study. The proposed compensation mechanisms should be applied by all concerned bodies with great emphasis to end the long-term negative impact of the pandemic, thereby ensuring the production of competent midwives and nurses.

Attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia.

BACKGROUND: Good attitude on collaborative care between nurses and midwives with physicians is crucial for better team working. This further enables those vital health care professionals to provide quality and improved care for their clients. OBJECTIVE: To assess the attitude of nurses and midwives towards collaborative care with physicians in Jimma University medical center, Jimma, South West Ethiopia. METHODOLOGY: The institution-based cross-sectional study was conducted from March 20 to April 8, 2019, using a semi-structured and standardized questionnaire. Study units were selected by simple random sampling using the lottery method. A total of 410 participants were included in the study. Data were entered into Epi data version 4.2 and exported to statistical packages for social sciences version 23 for cleaning and further analysis. Descriptive statistics were presented with tables, figures, and narratives. The level of significance was set at a p value of less than 0.05 in multivariable logistic regression. RESULTS AND CONCLUSION: More than five out of ten, 234 (57.2%) of participants had a good (good attitude is defined in the operational definition section of methodology) attitude towards collaborative care with physicians, and the rest 175 (42.8%) poor attitude toward it. Participants had the highest median score in the shared education and teamwork (26.0) subscale and midwives were found to have higher mean rank scores compared to nurses. It was only in the nurse's/midwife's autonomy subscale that a statistically significant difference was found (Z = - 2.92, p value = 0.003). More generally, more than have of the participants had a good attitude on providing care collaboratively with physicians, though a significant proportion of nurses and midwives also rate collaborative care provision with physicians as poor. RECOMMENDATIONS: The findings of this study suggested that interventions are needed to be taken to improve nurse's and midwife's attitudes on the provision of collaborative care with physicians. Enhancement of shared education, cooperation rather than dominance and caring attitude are all vital. These all could in turn enhance the quality of care provided for clients.

Inter-professional collaboration of nurses and midwives with physicians and associated factors in Jimma University specialized teaching hospital, Jimma, south West Ethiopia, 2019: cross sectional study.

BACKGROUND: Inter-professional collaboration between professionals is crucial in health care where most of the activities are undertaken in a team. One of these collaborations is the collaboration of nurses and midwives with physicians. The main objective of this study was to assess interprofessional collaboration of nurses and midwives with physicians and associated factors at Jimma University specialized teaching hospital from March 20 to April 8, 2019. METHODS: An institution-based cross-sectional study was conducted among 358 nurses and 52 midwives who are working in Jimma University Specialized teaching hospital using a structured self-administered questionnaire. Study units were selected by simple random sampling using the lottery method. The result was summarized using descriptive statistics and statements. The level of significance was set at a p < 0.05. RESULT: The overall response rate was 99.76%. Around two-third, 66.7% (n = 273) of participants had a satisfactory inter-professional collaboration with physicians and 238 (58.2%) had good relationship with physicians. Again 234 (57.2%) of participants had a favorable attitude towards interprofessional collaboration with physicians. Moreover, statistical significance was obtained on the relationship of participants with physicians (p = 0.000), the experience of disruptive behavior (p = 0.000), attitude towards interprofessional collaboration with physicians (p = 0.000) and occupational status (p = 0.001). CONCLUSION: The majority of the participants had a satisfactory inter-professional collaboration with physicians and four of the many possible factors under consideration were finally found statistically significant. Again, it was revealed that nurses and midwives did not significantly differ in their inter-professional collaboration with physicians.