Master of Science in Adult Health Nursing

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    KNOWLEDGE AND PRACTICE OF HYPOGLYCEMIA PREVENTION AND ITS ASSOCIATED FACTORS AMONG ADULTS WITH DIABETES IN WEST SHEWA, ETHIOPIA, 2023
    (hawassa universty, 2023-11) DABA WOGI GEBISA
    Background: Hypoglycemia is a medical emergency that causes hospital admission and emergency department visit. Knowledge of hypoglycemia prevention is very essential due to the fact knowledgeable patient is more likely to practice hypoglycemia prevention. Despite this fact, the knowledge and practice of hypoglycemia prevention and its associated factors among patients with diabetes insufficiently studied in Oromia. Objective: To assess knowledge and practice of hypoglycemia prevention and its associated factors among patients with diabetes in West Shewa, Ethiopia, 2023 Methods: Institutional based cross-sectional study design conducted from May 01 to June 01, 2023. A systematic random sampling technique used to select 393 participants with proportional allocation. A pre-tested, structured and interviewer administered questionnaire was used to collect data. The data entered using Epi-data version 4.6 and then exported to SPSS software version 25 for further processing. A binary logistic regression model performed to determine the association between dependent and independent variable. Factors with p-value <0.25 on bivariate analysis were taken to multivariate analysis. The strength of association was determined by AOR. The level of significance declared at p-value <0.05 with 95% CI. Result: Among the total respondents, 273(70.9%) live with Type2 DM and 131(34.0%) used insulin. Generally, 59.7% and 47% of respondents had good knowledge and practice of hypoglycemia prevention respectively. The educational level, using insulin, and monthly income were associated with good knowledge. Whereas educational level, having a glucometer, and knowledge were associated with good practice of hypoglycemia prevention Conclusion and recommendation: The study shows there is a knowledge and practice gap regarding hypoglycemia prevention. Health care provider should give hypoglycemia-oriented health education.
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    INTENTION AND PREDICTORS TOWARD CERVICAL CANCER SCREENING AMONG WOMEN ATTENDING ANTIRETROVIRAL THERAPY SERVICES IN SIDAMA REGION, ETHIOPIA 2023.
    (hawassa universty, 2023-11) DERIBE ADISU ARARSO
    Background: Cervical cancer continues to be a serious public health problem in developing countries. In Ethiopia, the proportion of women with human immunodeficiency virus (HIV) who receive cervical cancer screening services remains low. To promote screening behavior, it is important to understand the predictors of women’s intention to receive cervical cancer screening. Objective: To assess intention and predictors toward cervical cancer screening among women attending antiretroviral therapy services in the Sidama region, Ethiopia, 2023. Methods: An institutional-based mixed-method study was conducted from June 6 to July 4, 2023. Using systematic random sampling, a total of 422 women on antiretroviral therapy services were involved in the study, whereas a purposively selected 10 women were included in an in-depth interview. Data collection tools adapted from Theory of planned behavior for both qualitative and quantitative measure. Quantitative data was collected by Kobo Collector and analyzed using SPSS version 25. Linear regression analyses were done to identify statistically significant independent variables with the intention of cervical cancer screening. The qualitative data were analyzed using ATLAS.ti7 through thematic analysis. The study obtained ethical approval from Hawassa University of college of medicine and health science. Result: A total of 415 patients participated in this study with making a response rate of 98%. The mean age of respondents was 35.96±8.79 years. Theory of planned behaviors variables explained 72.2% of the variance in intention to receive cervical cancer screening among women on antiretroviral therapy. The mean score of intention was 3.92±0.92. About three-fourths 314 (72.5%) of the participants who scored above the mean were intended to be screened for cervical cancer in the next three months. Attitude towards cervical cancer screening (β=0.456, p<0.05), social influence (β=0.207, p<0.05), perceived easiness and difficulty towards intention to screen cervical cancer (β=0.156, p<0.05), past screening experience (β=0.110, p<0.05), and comorbidities (β=0.065, p<0.05) were significant predictors of intention to receive screening for cervical cancer. Qualitative findings revealed that a negative attitude towards screening, community disapproval, and cervical cancer treatment costs were barriers to cervical cancer screening intention. Conclusion: Nearly three-fourth of women was found to have the intention to receive cervical cancer screening. Attitude towards screening, social influence, perceived easiness and difficulty of the intention to screen, past screening experience, and comorbidities were factors affecting women’s intention to screen cervical cancer. So, we recommend interventions aimed at enhancing HIV-positive women’s cervical cancer screening behavior by targeting attitudinal change and creating positive social pressure toward screening. Further research is recommended using a prospective cohort study design to see how much intention is transformed into behavior.
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    DETERMINANTS OF CERVICAL CANCER SCREENING UTILIZATION AMONG WOMEN AGED 30-49 YEARS OLD IN NORTH ARI DISTRICT, ARI ZONE, SOUTHERN ETHIOPIA, 2023.
    (hawassa universty, 2023-11) AYALEW BELAYNEH
    Background: In Ethiopia, an estimated 7445 women are diagnosed with cervical cancer, and 5338 die from the disease. But early screening has a vital role in reducing morbidity and mortality. However, the utilization of cervical cancer screening is very low in Ethiopia, and there is still no scientific evidence on determinant factors in the study area. OBJECTIVE: To identify determinants of cervical cancer screening utilization among women aged 30-49 years old in the north Ari district, Ari zone, Southern Ethiopia, 2023. METHODS: A community-based unmatched case-control study was conducted among 30-49 year-old women in the north Ari district from April 15/2023 to May 15/2023. A simple random sampling technique was used to select cases and control a total selected women were 219 for the study. A pre-tested, interviewer based, structured questionnaire was used to collect data. Data were entered using Epidata 3.1 and exported to SPSS (Statistical Package for Social Science) version 25 for data analysis. Variables with a p-value of less than 0.25 in the bivariable analysis were included in the multivariable logistic regression, and a final p-value of < 0.05 with a 95% confidence interval for the adjusted odds ratio to determine the level of significance. RESULT: A total 216 women were participated in this study making a response rate of (98.7%). This study showed that no polygamy (AOR 0.23, 95%CI 0.12-0.44) a moderate level of knowledge about cervical cancer (AOR 6.75, 95%CI 1.9, 22.8), a high level of knowledge about cervical cancer (AOR 4.17, 95%CI 1.2, 14.1) and a positive attitude toward cervical cancer screening (AOR 3.57, 95%CI: 1.03, 12.30) were determinants of the utilization of cervical cancer screening. CONCLUSION: Being polygamous, having knowledge about cervical cancer, and having a positive attitude toward cervical cancer screening were determinants of the utilization of cervical cancer screening. Therefore, this study recommended that North Ari health services could increase health education for people with monogamous, poor knowledge about cervical cancer and a negative attitude toward cervical cancer screening through health campaigns in communities to enhance the utilization of cervical cancer screening.
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    SCREENING ATTENDANCE, INTENTION TO ATTEND,HEALTH LITERACY AND ASSOCIATED FACTORS OF BREAST OR CERVICAL CANCERS AMONG WOMEN IN GEDIO ZONE, ETHIOPIA, 2023: BASED ON PROTECTION MOTIVATION THEORY
    (hawassa universty, 2023-11) ABEL DESALEGN DEMEKE
    Introduction: Breast and cervical cancers are the most frequent and fatal cancers among women. Early detection has a significant impact on the success of the treatment. However, a limited study was available that assessed both cancers simultaneously and involved health literacy in relation to cancer screening behaviors. This study is the first critical step in designing interventions that improve cancer early detection. Objective: Aim to assess the magnitude of screening attendance, intention to attend, health literacy of breast or cervical cancers, and their predictors among women aged 30-49 years old in Gedeo Zone, South Ethiopia, in 2023 based on protection motivation theory. Method: A community-based cross-sectional study design was conducted from April 30 to May 30 on 594 women's by employing a multi-stage cluster sampling technique. Data collection was performed using pretested, structured interviewer-administered questionnaires via the kobo Collect app. IBM SPSS version 25 was used for statistical analyses and the characteristics of participants were described by frequencies and percentages for categorical variables. A binary logistic regression model was used to identify factors associated with outcomes. In bi-variable analysis variables with a p-value ≤ 0.25 were candidates for multivariable analysis. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p value < 0.05 were declared statistically significant. Result: A total of 554 women were included in the study, yielding a response rate of 93.2%. Of them, 120 (21.7%), 95% CI: [18%, 25%] were screened for cervical cancer, 30(5.4%) 95% CI: [4%, 7%] for breast cancers and 132 (23.8%) 95% CI: [20%, 27%] for two-female cancers (screened either for breast or cervical or both). In this study’s, 342 (61.7%) 95% CI: [58%, 66%] were had the intention to attend screening and 216(39%) 95% CI: [35%, 43%] adequate health literacy of breast and cervical cancers. Age of 45-49 [AOR = 4.18, 95% CI (1.59, 10.9)], college and above educational status [AOR = 5.49, 95% CI (2.01, 13.1)], having family or friend history of breast or cervical cancer [AOR = 5.55, 95% CI (2.47, 12.5)] ,short anticipated time to seek help [AOR 4.66(1.31, 11.7), adequate health literacy AOR = 6.98, 95% CI (2.82, 13.3) ], high self-efficacy [AOR 2.32, 95% CI (1.08, 4.96)], were positive factors; while high response cost [AOR 0.19, 95% CI (0.08, 0.50)] were negative factors associated with screening attendance. Having a family or friend history of breast or cervical cancer [AOR = 7.18, 95%CI (3.59, 14.4)], short anticipated time to seek help [AOR = 4.75, 95% CI (2.41, 9.39)], adequate health literacy [AOR = 2.26, 95%CI (1.15, 4.48)], high perceived severity [AOR = 2.96, 95% CI (1.64, 5.37)], high self-efficacy [AOR = 3.93, (1.76, 8.77)] were positive factors associated with screening intention to attend. Urban residence [AOR 1.96(1.19, 3.22), short anticipated time to seek help [AOR = 4.01, 95% CI (2.15, 7.49)], good knowledge [AOR = 4.51, 95% CI (1.14, 13.9)], ever used contraceptives [AOR = 2.51, 95% CI (1.24, 5.11)] were positive factors associated with health literacy. Conclusion and Recommendation: This study found that screening attendance and health literacy of breast and cervical cancers among women were low. Further, more women in this study were found to have had cervical cancer screening compared to women who had ever been screened for breast cancer. More than half of women had the intention of attending screenings in the future. Therefore, to improve screening attendance and intention to attend designing health literacy-focused screening policies and provision of factors should have to be addressed at each level of health care. Also, to enhance health literacy emphasis should be given to rural residents and providing health education to enhance their awareness.