Psychosocial interventions for improving mental health and family functioning in families with parental cancer: A systematic review.

PURPOSE: Parental cancer significantly impacts both parents and children, necessitating psychosocial interventions to enhance family well-being. This systematic review aimed to assess the effectiveness of psychosocial interventions targeting parents with cancer on their mental health, quality of life, their children's well-being, and family functioning. METHODS: A comprehensive search was conducted in Ovid MEDLINE, PubMed, PsycINFO, and Cochrane Central Register of Controlled Trials databases for relevant articles published from 2006 to 2023. The methodological aspects of eleven studies from diverse countries were critically evaluated. RESULTS: The review included 496 parents, primarily female breast cancer patients, and their children. Narrative synthesis highlighted interventions that aimed to strengthen parent-child connection (Enhancing Connection (EC)), enhance family communication, improve psychological well-being of parents (Struggle for Life Intervention), and address children's mental health (Wonders and Worries (W&W)). Additionally, interventions like Cancer PEPSONE Program (CPP) aimed to expand social networks and support systems. These interventions demonstrated success in reducing depressive and anxiety symptoms, parenting stress, and mitigating children's externalizing and internalizing problems. However, they were not exempt from methodological limitations such as participant selection bias, lack of blinding, and low follow-up rates. CONCLUSIONS: Based on the review, psychological support for parents with cancer is an emerging field, predominantly explored in Western countries with a significant emphasis on maternal experiences. The early stage of this field and inherent methodological limitations warrant cautious interpretation of these findings and further research for comprehensive understanding and application.

Nurses' Documentation Practice and Associated Factors in Eight Public Hospitals, Amhara Region, Ethiopia: A Cross-Sectional Study.

Background: Nursing care documentation, which is the record of nursing care that is planned for and delivered to individual patients, can enhance patient outcomes while advancing the nursing profession. However, its practice and associated factors among Ethiopian nurses are not well investigated. Objective: To assess the level of nursing care documentation practice and associated factors among nurses working at public hospitals in Ethiopia. Methods: An institutional-based cross-sectional study was conducted from May 1 to 30, 2022. A total of 378 nurses and corresponding charts were randomly selected with a multistage sampling technique. Self-administered structured questionnaires and structured checklists were used to collect data about independent variables and nurses' documentation practice, respectively. Epi Data 4.6 was used for data entry and SPSS version 25 for analysis. Descriptive statistics and binary logistic regression analysis have been employed. The STROBE checklist was used to report the study. Results: In this study, 372 nurses participated, and 30.4% (95% confidence interval [CI]: 26%-35%) of them had good nursing care documentation practice. Adequate knowledge about nursing care documentation(adjusted odds ratio [AOR] = 4.16, 95% CI: [2.36-7.33]), favorable attitude toward nursing care documentation (AOR = 3.43, 95% CI: [1.85-6.36]), adequacy of documenting sheets (AOR = 2.02, 95% CI: [1.14-3.59]), adequacy of time (AOR = 3.85, 95% CI: [2.11-7.05]), nurse-to-patient ratio (AOR = 2.78, 95% CI: [1.13-6.84]), and caring patients who had no stress, anxiety, pain, and distress (AOR = 3.56, 95% CI: [1.69-7.52]) were significantly associated with proper nursing care documentation practices. Conclusion: Nursing documentation practice was poor in this study compared to the health sector transformation in quality standards due to the identified factors. Improving nurses' knowledge and attitude toward nursing care documentation and increasing access to documentation materials can contribute to improving documentation practice.

Nurses' pain management practices for admitted patients at the Comprehensive specialized hospitals and its associated factors, a multi-center study.

BACKGROUND: Pain is the most common challenge that most hospitalized patients complain of and is influenced by several patients, nurses, and institutional-related factors. Most studies in Ethiopia on pain were focused on surgical illnesses only. OBJECTIVE: To assess nurses' pain management practice and associated factors for admitted patients at Comprehensive Specialized Hospitals. METHODS AND MATERIALS: A multi-center institution-based cross-sectional study was conducted at the five randomly selected Comprehensive Specialized Hospitals of the Amhara region from May 01 to June 01, 2022. A multi-stage sampling method was employed to select a total of 430 nurses and patients for whom the nurses were responsible. Data were collected using standard self-administered, structured, and checklist questionnaires from nurses, patients, and patients' charts respectively. The modified Bloom's criteria categorized the overall practice as good, moderate, and poor. Data were checked, coded, and entered into Epi-Data version 4.6 and exported to SPSS version 25. An ordinal logistic regression model was applied, and variables with a p-value < 0.05 with a 95% CI in the multivariable analysis were considered significant. RESULTS: The study evaluated the pain management practices of 430 nurses and only a quarter had good pain management practices. Those nurses with first degrees and above education level (AOR = 2.282) and who attended in-service training (AOR = 2.465) were found to have significantly higher pain management practice. Expected though patients with painful procedures (AOR = 5.648) and who had severe pain (AOR = 2.573) were receiving better pain management practices from their nurse care provider. Nurses working in the institutions with a pain-free initiative focal person (AOR = 6.339) had higher pain management practices. CONCLUSION AND RECOMMENDATION: Overall, the majority of nurses had poor pain management practices. Higher educational levels, in-service training, and assigning a pain-free focal person had an impact on pain management services. Patients with higher pain levels and painful procedures were getting better attention. Hospital administrations need to provide due attention to the pain management of hospitalized patients by providing in-service training and educational opportunities to improve the capacity of nurses. Patients would be benefited considerably if hospitals focus on assigning focal persons for advocating regular pain management for admitted patients regardless of their pain level.

Service users' perceptions of recovery from recent-onset psychosis and their long journey to and through psychiatric treatment.

A growing body of evidence highlights that individuals' understanding of mental illness and recovery influences their mental health care preferences. Journeys to psychiatric care settings vary across regions with different socio-economic and developmental characteristics. However, these journeys in low-income African countries have not been well explored. This descriptive qualitative study aimed to describe service users' journeys to and through psychiatric treatment and explore their conceptualizations of recovery from recent-onset psychosis. Nineteen adults with recent-onset psychosis were recruited from three hospitals in Ethiopia for an individual semi-structured interview. Data from in-depth face-to-face interviews were transcribed and thematically analysed. Participants' conceptualizations of recovery are summarized into four themes; "domination over the disturbance of psychosis", "complete medical treatment course and stay normal", "stay active in life with optimal functioning", and "reconcile with the new reality and rebuild hope and life". These perceptions of recovery were reflected in their accounts of the long and hurdled journey to and through conventional psychiatric care settings. Participants' perceptions of psychotic illness, treatment, and recovery seemed to result in delayed or limited care in conventional treatment settings. Misunderstandings about only requiring a limited period/course of treatment for a full and permanent recovery should be addressed. Clinicians should work alongside traditional beliefs about psychosis to maximize engagement and promote recovery. Integrating conventional psychiatric treatment with spiritual/traditional healing services may make an important contribution to early treatment initiation and improving engagement.

Knowledge towards standard precautions among healthcare providers of hospitals in Amhara region, Ethiopia, 2017: a cross sectional study.

BACKGROUND: Literatures revealed that healthcare-associated infections are still a great concern in many developing countries including in Ethiopia. Despite the development of detailed guidelines for infection control, they remain as a critical challenge for the public health sectors and the knowledge of standard precautions among healthcare workers in many developing countries is low and not properly applied. Hence, the present study tried to determine the level of knowledge about standard precautions among healthcare workers of Amhara region, Ethiopia. METHODS: Institutional based cross-sectional study was conducted on a randomly selected public hospitals of Amhara region, Northwest Ethiopia from March 01-April 01/2017. A multistage sampling strategy was utilized to select 795 sampled healthcare workers. Data were collected using pretested self-administered questionnaire. The collected data entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. After using binary logistic regression, multivariable logistic regression analysis used to form the model. Variables which had statistically significant association with the outcome variable (P < 0.05) were identified as significant in the multivariable logistic regression analysis. RESULTS: Almost half (49.2%) of the study participants were female healthcare workers. Three-fourth (74.3%) of the healthcare workers involved in the current study had good knowledge towards standard precautions. Good knowledge towards standard precautions refers to scoring correct responses to > 60% of knowledge items from the survey. Year of service (AOR: 0.27, 95% CI: 0.16 to 0.44), educational status (AOR: 1.7, 95% CI: 1.13 to 2.56) were among the predictor variables. In addition, physicians were 6.97 times more likely to be knowledgeable (AOR: 6.97, 95% CI 2.42 to 20.12) than laboratory technician/technology counterparts. Study participants working in medical, Gyn/obs, pediatrics wards, and OPD were about 2.23, 4.27, 2.81 and 2.52 times more likely to be knowledgeable than study participants working in surgical ward. CONCLUSIONS: Overall, the majority of healthcare workers had good knowledge of standard precautions. But variation in knowledge was detected across healthcare workers by hospital type and ward/units. This may help to design a solution by prioritizing the problem.

Low back pain among nurses working in clinical settings of Africa: systematic review and meta-analysis of 19 years of studies.

BACKGROUND: Nurses in Africa are arguably the most important frontline healthcare workers available in most healthcare facilities, performing a broad range of tasks. Such tasks are considerably presumed in the causation of workload. Nursing is listed among the highly risky professions for developing low back pain. The nursing profession is ranked within the top ten professions which have a great risk of low back pain. Hence, this review aimed to ascertain whether low back pain is a significant concern for nurses in African healthcare facilities. METHODS: A comprehensive literature search of different databases with no date limit was conducted from September to November 2018 using the PRISMA guideline. The quality of the included studies was assessed using a 12-item rating system. Subgroup and sensitivity analyses were performed. Cochran's Q and the I2 test were used to assess heterogeneity. The presence of publication bias was evaluated by using Egger's test and visual inspection of the symmetry in funnel plots. RESULT: In this review, 19 studies from different African regions with a total sample size of 6110 nurses were included. All the studies were carried out between 2000 and 2018. Among these, the lowest and the highest prevalence were found to be 44.1 and 82.7% respectively. The estimation of the prevalence rate of low back pain among nurses using the random-effects model was found to be 64.07% (95% CI: 58.68-69.46; P-value < 0.0001). Heterogeneity of the reviewed studies was I2 = 94.2% and heterogeneity Chi-squared = 310.06 (d.f = 18), P-value < 0.0001. The subgroup analyses showed that the highest prevalence of LBP among nurses was from West African region with prevalence rates of 68.46% (95% CI: 54.94-81.97; P-value < 0.0001) and followed by North Africa region with prevalence rate of 67.95% (95% CI: 55.96-79.94; P-value < 0.0001). CONCLUSION: Even though the overall prevalence of the present study is lower when compared to the Western and Asian studies, it indicated that the prevalence of low back pain among nurses is substantial.

Predictors of subjective recovery from recent-onset psychosis in a developing country: a mixed-methods study.

PURPOSE: This study was conducted to: (a) investigate the levels and progress of subjective recovery from recent-onset psychosis; (b) examine its predictive factors and; (c) describe perceived challenges and opportunities affecting recovery. The findings were expected to help inform recovery-oriented psychiatric care in low-income, particularly African, countries. METHODS: This sequential explanatory mixed-methods study involved 263 service users with recent-onset psychosis from Northwestern Ethiopia. For the quantitative part, a 9-month longitudinal study approach was employed with three time point measurements over 9 months. Predictor variables for subjective recovery from recent-onset psychosis were identified by hierarchical multiple linear regression tests. Following the quantitative survey, individual qualitative interviews were conducted with 19 participants. Interview data were transcribed and thematically analysed. RESULTS: High mean subjective recovery scores were recorded throughout the study (Questionnaire about the Process of Recovery score ranging from 44.17 to 44.65). Quality of life, internalized stigma, disability, hopelessness, satisfaction with social support, and central obesity were significant predictors of subjective recovery across the three time points. Participants' perceived challenges and opportunities affecting their recovery were categorized into four themes. CONCLUSION: In Ethiopia, a low percentage of individuals with SMIs initiate psychiatric treatment and many discontinue this to attend spiritual healing. In this study, the Ethiopian SMI patients engaged consistently in psychiatric treatment indicated high mean subjective recovery scores. Devising mechanisms to integrate the psychiatric treatment and spiritual healing sectors are suggested. Approaches to improve quality of life, functioning, hope, internalized stigma and provide need-based social support are suggested.

Factors influencing subjective recovery of people with recent-onset psychosis: A cross-sectional study in a low-income sub-Saharan country.

People with psychosis were traditionally believed to have a chronic deteriorating condition with no hope of recovery. Recent studies have shown varied levels of recovery across countries. However, evidence from low-income, particularly African countries is scant. This study aimed to investigate levels of subjective recovery of people with recent-onset psychosis and identify its influencing factors. A cross-sectional study was conducted among 263 outpatients with recent-onset psychosis in a low-income country, Ethiopia. Psychiatric outpatients were randomly selected, and assessed by a set of questionnaires measuring their psychosocial, clinical and physical health conditions. Hierarchical multiple regression tests were used to identify factors influencing subjective recovery. The level of subjective recovery was found to be high, with a mean Questionnaire about the Process of Recovery score of 44.17. Individuals with higher quality of life were found to have significantly better subjective recovery level. Hopeless and centrally obese individuals were found to have significantly lower level of subjective recovery. Despite the limitations associated with a cross sectional study design, the results suggest that individuals with recent-onset psychosis in Ethiopia may have a better level of subjective recovery than those in high-income countries and their recovery is influenced by quality of life, hopelessness and central obesity.

Factors influencing subjective recovery of people with recent-onset psychosis: A cross-sectional study in a low-income Sub-Saharan country.

People with psychosis were traditionally believed to have a chronic deteriorating condition with no hope of recovery. Recent studies have shown varied levels of recovery across countries. However, evidence from low-income, particularly African countries is scant. This study aimed to investigate levels of subjective recovery of people with recent-onset psychosis and identify its influencing factors. A cross-sectional study was conducted among 263 outpatients with recent-onset psychosis in a low-income country, Ethiopia. Psychiatric outpatients were randomly selected, and assessed by a set of questionnaires measuring their psychosocial, clinical and physical health conditions. Hierarchical multiple regression tests were used to identify factors influencing subjective recovery. The level of subjective recovery was found to be high, with a mean Questionnaire about the Process of Recovery score of 44.17. Individuals with higher quality of life were found to have significantly better subjective recovery level. Hopeless and centrally obese individuals were found to have significantly lower level of subjective recovery. Despite the limitations associated with a cross sectional study design, the results suggest that individuals with recent-onset psychosis in Ethiopia may have a better level of subjective recovery than those in high-income countries and their recovery is influenced by quality of life, hopelessness and central obesity.

Prevalence and associated factors of hypertension in Amhara regional state city and its' surrounding rural districts: a community-based cross-sectional study.

BACKGROUND: Nowadays, among non-communicable diseases hypertension is a growing public health important disease both in developed and developing nations. OBJECTIVE: The aim of this study was to determine the prevalence and associated factors of hypertension in Amhara Regional State city and its' surrounding rural districts, Ethiopia. METHOD: Community-based cross-sectional study was conducted in the urban and rural communities living in Amhara Regional State city and its' surrounding rural districts administrations in 2015. The WHO Stepwise approach was used for data collection. RESULT: A total of 1405 subjects participated and the response rate was 95.5%. The overall prevalence of hypertension was 11.4% either previously diagnosed or undiagnosed and was higher in older ages. Whereas the prevalence of hypertension was 13% for urban and 10% for rural residents. Nearly half of them (46.3%) were newly diagnosed. A family history of hypertension, being underweight, overweight, obese, and raised fasting blood sugar were found to be significantly associated with raised blood pressure. CONCLUSION: One among every three (37.4 %) and one among every nine study participants were found to have pre-hypertension and hypertension respectively.

Compliance to Iron-Folic Acid Supplementation and Its Association with the Number of ANC Visits in Ethiopia: Systematic Review and Meta-Analysis.

BACKGROUND: The World Health Organization recommended that 80% of communities in all countries should receive the standard dose of iron folic acid. But, in Ethiopia, this target was not yet achieved. The compliance of iron folic acid was also variable across each district. Therefore, the aim of this study was to assess women compliance with iron-folic acid supplementation and its association with a number of antenatal care visits in Ethiopia using systematic review and meta-analysis, 2018. METHODS: In the current meta-analysis, the target variables were searched from different electronic database system like PubMed, Google Scholar, Science Direct, and Cochrane Library. To predict the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia, all original studies were considered. All necessary data were extracted by using a standardized data extraction format. The data were analyzed by using STATA 14 statistical software. Heterogeneity between the studies was assessed by Cochrane Q and I 2 tests. A random effect model was computed to estimate the pooled compliance with iron-folic acid supplementation. RESULTS: Twelve full-text studies were included in the meta-analysis. The findings of this meta-analysis revealed that the pooled prevalence of compliance with iron-folic acid supplementation in Ethiopia was 43.63% (CI: 28.00, 59.25%). The women from the city administration had a high rate of compliance as compared with other regions of Ethiopia. The odds of having four or more antenatal care visit were the independent pooled predictor of compliance with iron-folic acid supplementation. CONCLUSION: Current compliance with iron-folic supplementation was lower than the World health organization recommendation. Mothers from the city administration who utilized the antenatal care four and above times, had high level compliance with iron-folic acid supplementation. Therefore, we recommended that women should visit the antenatal clinic four times to compliance with the iron folic acid supplementation.

Vaccination coverage and associated factors among children aged 12 - 23 months in Northwest Ethiopia.

BACKGROUND: Full vaccination coverage has been identified as the foundation for the prevention of morbidity and mortality from the childhood illnesses. However, a significant number of children do not get recommended vaccinations. The problem is much worse in low-income countries with varied figures and evidence gap. Therefore, this study was conducted to assess vaccination coverage and its predicting factors in one of the low-income country Ethiopia, particularly in northwest Ethiopia. METHODS: A community-based cross-sectional study was conducted in Northwest Ethiopia in 2016 on 846 children aged 12 to 23 completed months. Cluster sampling method was used. Mothers or caretakers were interviewed. SPSS version 20 was used for analysis. RESULTS: In Northwest Ethiopia, full-vaccination coverage for the children aged 12-23 months was 58.4%, while 17% and 24.6% were partially vaccinated and not vaccinated at all respectively. Child full vaccination status has a positive association with urban residence, having antenatal care visit, institutional delivery for the study child, vaccination site at health institutions, mothers who knows vaccination schedule of a catchment area, and mothers taking a child for vaccination even if the child is sick. However, mothers who ever-married and their travel time to the nearest vaccination site ≤ 30 minutes were negatively associated with child full-vaccination status. CONCLUSION: Vaccination coverage in Northwest Ethiopia, East Gojam, is better than the national coverage. Yet, it is far below the plan. Encouraging antenatal care utilization, delivery at health institutions, and providing adequate information on child vaccination (including when to start, return and finish) for mothers would increase full-vaccination coverage.

Knowledge, attitude and practice towards cervical cancer among women in Finote Selam city administration, West Gojjam Zone, Amhara Region, North West Ethiopia, 2017.

INTRODUCTION: Cancer of the cervix is the leading cause of cancer-related death among women, especially in developing countries affecting women at a time of life when they are critical to social and economic stability. METHOD: The study was conducted at Finote Selam City Administration from February 01 to March 01, 2017 using a community-based cross-sectional study design. The representative sample size was selected using multistage sampling technique. The data were collected using an interviewer-administered questionnaire adapted from the previous study. Data were entered using EpiData Version 3.1 statistical software and analyzed using SPSS version 20 statistical package. RESULT: One hundred seventy (23.1%) were knowledgeable about cervical cancer whereas 63% of participants had a negative attitude and only 7.3% had ever screened for the disease. Logistic regression analysis showed that age, marital status, religion, experienced sexual intercourse and age at 1st sexual intercourse were found to be significantly associated with the knowledge of cancer of the cervix. CONCLUSION: Ministry of health in collaboration with other concerned bodies should design a strategy to give education about cervical cancer including information on risk factors, signs and symptoms; and availability of screening should be provided for women and as well as for the public.

Patients' attitude towards medical students involvement in their health care at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2010.

BACKGROUND: Patients' willingness to the involvement of medical students in their health care is the mandatory input to medical education. Admitted patients' willingness level should be known and factors affecting willingness should be identified and it is necessary to act upon them for better medical care. METHODOLOGY: A cross-sectional hospital based survey was conducted to assess the admitted patients' attitude towards medical students' involvement in their health care at Tikur Anbesa Specialized Hospital in 2010. Data were collected from 422 adult patients admitted in Tikur Anbesa Specialized Hospital from April to May 2010 using structured questionnaire and by interview method. The data gathered in this way were then processed using SPSS version 15. RESULT: Three hundred and ninety-two participants had responded to all questions they were asked (response rate = 92.8%). One hundred and five (26.8%) patients had negative attitude to medical students' involvement in their health care. The proportion of patients' having positive attitude towards students was slightly reduced from medical to surgical and to gynecology wards 77.4%, 72.0%, 69.2% respectively. Patients who had previous interactions with students were more likely to have negative attitude (AOR (95% CI) = 1.72(1.03, 2.87). The odds patients admitted in gynecology and obstetrics ward to prefer female students to care for them was higher (AOR (95% CI) =1.93(1.13, 3.30). CONCLUSION: Almost half of the patients admitted to Tikur Anbessa Specialized Hospital objected to clinical procedures on them even physical examination, hence developing clinical skills in TASH might be challenging for the majority of students. The challenge might be worsened for male students in gynecology wards.