Master of Science in Adult Health Nursing

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    KNOWLEDGE, PRACTICE AND ASSOCIATED FACTORS TOWARDS NEONATAL RESUSCITATION AMONG NURSES AND MIDWIVES WORKING IN GOVERNMENT HOSPITALS IN WEST SHOA, OROMIA, ETHIOPIA
    (hawassa universty, 2023-11) URGESSA CHALA IDATO
    Background: Neonatal resuscitation is a critical intervention for newborns difficulty to breathe or circulate blood. The first month of life is particularly vulnerable, and skilled nurses and midwives can prevent around 30% of preventable newborn deaths. So, it is crucial to assess the knowledge and practical skills of nurses and midwives in neonatal resuscitation to reduce neonatal deaths. Objective: The study aimed to assess knowledge, practice and associated factors towards neonatal resuscitation among nurses and midwives working in government hospitals in West Shoa. Methods: An institutional based cross-sectional study was conducted in West Shoa, from May 1 to July 20, 2023. A total of 235 nurses and midwives who are working in ten governmental hospitals were included. Data were collected using self-administered questionnaire and observation checklist of English version. Data was verified, coded and entered to Epi-data, then exported to Statistical Package for the Social Sciences version 26 Software for analysis. Descriptive statistics such as frequency with percentage distribution for categorized variables was used. Binary logistic regression analysis method was used to identify factors associated with the nurses’ and midwives’ knowledge and practice of neonatal resuscitation. Those variables that had P -value < 0.25 in logistic regression was taken to the multiple logistic regression models to adjust the possible confounder. Variables with p-value<0.05 in the multiple logistic regression analysis was considered statistically significant associations between covariates with knowledge and practice of nurses and midwives towards neonatal resuscitation at a 95% confidence interval. Results: This study was showed that only 40.3% and 27% had good knowledge and good practice on neonatal resuscitation respectively. Factors such as age (AOR=4.936), guidelines availability (AOR=0.178), supportive supervision (AOR=0.382), and in-service training (AOR=0.411) were associated with knowledge, while being female (AOR=0.296), being single (AOR=0.18), and in service training (AOR=0.431) were associated with practice. Conclusion: The knowledge and practice of neonatal intensive care unit nurses and midwives towards neonatal resuscitation are inadequate. Hospital managers should provide neonatal resuscitation guidelines, supportive supervision, and in-service training to reduce neonatal deaths.
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    PARENTS' KNOWLEDGE AND WILLINGNESS TO VACCINATE THEIR DAUGHTERS AGAINST HUMAN PAPILLOMAVIRUS AND THEIR ASSOCIATED FACTORS IN ALLE SPECIAL WEREDA, SOUTHERN ETHIOPIA 2023. MIXED STUDY
    (hawassa universty, 2023-11) SELEMAYE ZENEBE
    Introduction: Cervical cancer is the most deadly cancer worldwide. Although human papillomavirus vaccination is the primary prevention mechanism there was low awareness, uptake, and willingness among parents primarily in developing nations. Therefore assessing parents’ knowledge and willingness is necessary. Objective: This study aims to assess knowledge, willingness, and associated factors of the human papillomavirus vaccination parents of daughters aged 9-14 years, in Alle special Wereda, Southern Ethiopia, 2023. Materials and methods: A community-based cross-sectional study triangulated with the qualitative inquiry was employed among 418 parents in Alle Special Wereda, southern Ethiopia from April to May 2023. The data collected by interview were entered into Epi data 4.6 and exported to SPSS version 25 for analysis. Logistic regression analysis was employed to identify factors associated with human papillomavirus vaccine knowledge and willingness and the statistical significance of the association was asserted at a P-value of < 0.05. Manual thematic analysis was used to analyze qualitative findings. Result: Of the total participants in the study, 29.7% and 40.2% have good knowledge about and willingness for the human papillomavirus vaccination respectively. Educational status (AOR=0.755, 95%CI (0.150-0.3805), heard human papillomavirus vaccine (AOR=0.254, 95%CI (0.065-0.985), fear of sexually transmitted infections (AOR=0.194, 95%CI (0.049-0.774), and attitude (AOR=0.071, 95%CI (0.0150-0.338) were significantly associated with knowledge. knowledge (AOR=0.112, 95%CI (0.035-0.362), attitude (AOR=0.260, 95%CI (0.068-0.987), and readiness (AOR=0.169, 95%CI (0.056-0.509) were significantly associated with willingness of human papillomavirus vaccine. In addition, lack of trust, poor perception, fear of unknown side effects, and misunderstanding were identified as major factors by qualitative findings. Conclusion: Parents' knowledge and willingness to receive human papillomavirus vaccination was low. Knowledge was significantly associated with educational status, hearing human papillomavirus vaccine, fear of sexual infections, and attitude. Knowledge, attitude, and readiness were strongly associated with vaccination willingness. Therefore, to increase human papillomavirus vaccination, awareness, health education, and additional research are required.
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    PREVALENCE OF MALARIA AND ASSOCIATED FACTORS AMONG UNDER-FIVE CHILDREN IN ILU-GALAN DISTRICT, OROMIA REGION, WEST ETHIOPIA
    (hawassa universty, 2023-11) LELISA FIKADU
    Background: Malaria continues to impact the health of children in Ethiopia. Ilu Galan is an area of intense and prolonged, seasonal malaria transmission, and malaria is still the leading cause of morbidity and mortality among children under five years. This study aimed to determine malaria prevalence and associated risk factors among under-five children in the Ilu Galan district. Methods: A community-based cross-sectional study was conducted from April to June 2023 in the Ilu Galan district in West Shewa Zone, Ethiopia. A multi-stage sampling technique was carried out to select representative households. A systematic random sampling technique was applied to enroll 557 study participants. Malaria was determined using thick and thin blood film microscopy and a rapid diagnostic test kit. Furthermore, a pre-tested structured questionnaire was administered to collect the socio-demographic characteristics of the study participants who were associated with malaria infection. Data was cleaned and entered into Epi data version 3.1 and exported to SPSS version 26 for analysis. Bivariate and multivariable logistic regression analyses were done to identify risk factors associated with malaria. Adjusted odds ratios (AOR) with a 95% confidence interval (CI) were used to determine the strength of association of variables. P-value < 0.05 at 95% CI was considered statistically significant. Results: The overall prevalence of malaria among under-five children in the study area was 5.2%(28/542). P. falciparum, P. vivax, and mixed infection (both species) accounted for 71.4%, 25%, and 3.6% of the cases, respectively. Low parasitemia15/28 (53.6%)was more common, and high parasitemia13/28( 46.4%) with the proportion of parasite density respectively. Malaria infection was corelated to staying out door at night(AOR=3.09;95%CI:1.01-9.478),utilization of ITN(AOR=.261;95% CI:0.073-0.939), presence of eave on the house(AOR=4.081;95%CI:1.202 13.437),<1kmdistance of house hold from river(AOR=4.317;95%CI:1.194-15.618) and presence of stagnant water nearby house(AOR=11.399;95% CI:3.710-35.021). Conclusion: Malaria is still a common health problem in the study area, so the local government and other concerned bodies should focus on malaria prevention and control to minimize the burden.
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    IMMUNIZATION DROPOUT RATE AND ITS ASSOCIATED FACTORS AMONG CHILDREN AGED 15 – 23 MONTHS OLD AT SHASHAMENE CITY ADMINISTRATION, OROMIA, ETHIOPIA, 2023: A MIXED METHODS STUDY.
    (hawassa universty, 2023-11) GEZAHEGN TILAHUN HAILU
    Introduction: Immunization – proven tool for controlling vaccine preventable diseases and save lives of millions of children. However, most children in developing countries are not fully immunized and dropout rate is high compared to national cut – off points. Despite the vast study by Ethiopians and other scholars on immunization dropout rate, little is known about vaccine dropout and reasons for it throughout all regions. There are also discrepancies in dropout rate in different studies. Therefore, the study aimed to identify immunization dropout rate and its associated factors among children age 15 – 23 month old in Shashamene City administration, Oromia, Ethiopia, 2023. Methods and Materials: A mixed methods community– based cross sectional study design was employed from May19 – June 28/2023. The sample size was calculated using single population proportion formula and with Epi-Info 7 software. Accordingly, a total of 434 study subjects were recruited to the study after considering a 10% non – response rate and 2 design effect. Four focus group discussions and 12 In-depth interviews were conducted for the qualitative study sampled purposively. The data were collected and entered into Epi-Data Version 4.6 and exported and analyzed using SPSS Version 25. A variable with P value less than 0.25 were transferred to multivariate logistic regression model and a P value less than 0.05 considered significant. The qualitative data collected, transcribed, coded, and analyzed using open code software and triangulation made accordingly. Results: The overall immunization dropout rate from completion in the current study setting was found to be 11.5% (95% CI = 0.084 – 0.154). Factors like missed vaccination schedule (AOR = 2.42; 95% CI = 1.110 - 5.296), availability of seat (AOR = 0.03; 95% CI = 0.011 - 0.068)), possession of immunization card (AOR = 0.43; 95% CI = 0.192 – 0.939) and accessibility of facility (AOR = 0.16; 95% CI = 0.057 – 0.430) were significantly associated with immunization dropout rate. The qualitative finding showed that load on vaccinators, shortage of antigens, loss of immunization card, and socio – economic routines contributed to high immunization dropout rate. Conclusion: The immunization dropout rate was higher compared with the national cut of point (< 5%) and WHO reference (< 10%). Staff workload, respondent’s forgetfulness, antigen shortages, lack of reminder systems, unavailability of seats and immunization card possession are main reasons contributed for vaccination dropout.
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    FLUID BALANCE MONITORING PRACTICE AND PREDICTORS AMONG NURSES WORKING AT PUBLIC HOSPITALS IN HAWASSA CITY, ETHIOPIA, 2023
    (hawassa universty, 2023-11) EYOB WONTE SHANKA
    Background: Fluid balance monitoring involves measuring input and output accurately. In order to treat patients effectively and shorten their hospital stays, accurate fluid balance monitoring is necessary. Recent studies have shown that the majority of fluid balance monitoring practices by nurses are unsatisfactory. There was an apparent gap in recording input and output and calculating 24-hour fluid balance by nurses. Although some studies on fluid balance monitoring have been conducted, fluid balance monitoring practice among nurses is still poorly understood. Objective: To assess fluid balance monitoring practice and predictors among nurses working at public hospitals in Hawassa city, Ethiopia, 2023. Methodology: A cross-sectional study was conducted from May 1 to June 30, 2023. A simple random sampling technique was used to select 270 nurses. A checklist for observations and a self-administered questionnaire were used to gather the data. The data was summarized using descriptive statistics. To find the predictors of fluid balance monitoring, bivariate and multivariable logistic regressions were employed. Results: Of all the nurses (n = 270) who participated in the study, 170 (63%) reported that they do not perform fluid balance monitoring. Sex was associated negatively (AOR = 0.153: 0.024, 0.981, p = 0.048), whereas knowledge was associated positively (AOR = 19.029: 3.053, 118.601, P = 0.002) with fluid balance monitoring practice and was found to be a predictor of fluid balance monitoring practice. Conclusion and recommendation: More than half of nurses assessed for fluid balance monitoring practice scored less than the mean score for practice-related questions. The knowledge of the respondent nurses was found to be a predictor of fluid balance monitoring practice. Provision of continuous and periodic training on the knowledge related to fluid balance monitoring practice for nurses working in public hospitals in Hawassa city has to be strengthened.
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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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    LEVEL OF NURSE PRACTICE AND PERCEIVED BARRIERS TOWARDS DEEP VEIN THROMBOSIS PREVENTION IN SELECTED ETHIOPIA ARMED FORCE HOSPITALS IN 2023
    (hawassa universty, 2023-11) ANDUALEM TESHOME
    Background: Deep vein thrombosis is a preventable and treatable cause of death among hospitalized patients. Nurse deep vein thrombosis prevention practice plays a major role in improving prevention care. But there have been few studies on nurse’s deep vein thrombosis prevention practice in Ethiopia that have revealed a low level. Objective: To assess level of Nurses practice and perceived barriers to deep vein thrombosis prevention in selected Ethiopian armed forces hospitals. Methods and Materials: An institutional-based mixed study design conducted from March 1 to 2 May 2023. For the quantitative study a simple random sampling technique was used to select 245 participants. Observational checklist adapted from National Institution for Health and Care Excellence guideline and different literature. Data was entered in Epi-Data version 3.1 software and exported to SPSS version 26.0. For analyses, bivariate and multivariate methods were used. For the qualitative study, eight participants who had work experience of at least six months in patient care were selected by using purposive sampling and semi-structured interview questions conducted in Amharic. Thematic analysis was applied using ATLAS.ti version 7. Finally triangulated with quantitative data. Results: A total of 245 participant were involved in this study, with a 100% respondent rate. The result showed that 40.8%, with a 95% CI (34.6, 47.3) had good practice about deep vein thrombosis prevention. Age between 26 and 30 years [AOR=0.31; 95% CI (0.10, 0.99)], work experience ≤ 5 years [AOR=0.16; 95% CI (0.05, 0.51)], not having training [AOR=0.09; 95% CI (0.03, 0.33)], nurses who had poor knowledge [AOR= 0.30; 95% CI (0.13, 0.70)], and nurses who had a negative attitude [AOR=0.09; 95% CI (0.03, 0.28)] were significantly associated with deep vein thrombosis prevention practice. In the qualitative study, lack of training, lack of knowledge, work load, absence of supervision, and patient refusal are some barriers Conclusion and Recommendation: This study reveals that more than half of the participants had poor practice in deep vein thrombosis prevention. Work experience, lack of training, poor knowledge, and a negative attitude are factors that affect prevention practice. Absence of guidelines, work load, absence of supervision, and patient refusal are perceived barriers. So, we recommend that to improve the quality of care, it requires a continuous education program and routine supervision.
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    IMPLEMENTATION OF INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESS (IMNCI) GUIDELINE AND ITS BARRIERS IN PUBLIC HEALTH FACILITIES OF GAMO ZONE, SOUTH ETHIOPIA, 2023: INSTITUTIONAL BASED MIXED CROSS SECTIONAL STUDY
    (hawassa universty, 2023-11) AMANUEL ELIAS BILATE
    Introduction: The Integrated Management of Neonatal and Childhood Illness (IMNCI) is a comprehensive approach to children's health that prioritizes the overall well-being of the child. Ethiopia is a country with high under-five mortality rates, and about 75% of mortality is caused by IMNCI target diseases. Despite this, IMNCI guideline implementation is low at the country level and unknown in the study area. Also, the barriers to IMNCI have not yet been adequately assessed. Objective: to assess the implementation of the IMNCI guideline and its barriers in the public health facilities of the Gamo zone, South Ethiopia region, 2023. Method: A facility-based mixed cross-sectional study was conducted in May 2023. From 57 health centers in the Gamo Zone, 17 were selected randomly. A total of 572 samples were taken from 2679 cases. Then the total sample was allocated proportionally to each selected health center based on their under-five case flow. Finally, data was collected by document review of the IMNCI register book using a systematic random sampling method. Two IMNCI-trained data collectors and one supervisor were recruited for quantitative data, while the principal investigator collected qualitative data. Data was coded, entered, and cleaned using Epi Data version 4.6 and exported to SPSS version 25 for analysis. Descriptive statistics were used to determine the level of IMNCI implementation. While qualitative data was collected through in-depth interviews with key informants of the study, it was also transcribed, coded, and thematically analyzed. Result: The proportion of IMNCI implementation in the study area was 63.3%. 446 (78%) cases were correctly classified, and 86 (15%) were incorrectly classified. Similarly, 385 (67.3%) cases were correctly treated, whereas 187 (32.7%) cases were not correctly treated. 477 (783.4%) cases took counseling, while 95 (16.6%) cases did not. Only 125 (21.9%) were appointed correctly. The possible identified barriers to IMNCI implementation were a shortage of trained staff, a shortage of supply and equipment, a physical layout problem, staff negligence and turnover, and the nature of the guidelines. Conclusion and recommendation: The IMNCI implementation was low in the study area compared to WHO standards. So from the federal government to the facility level, responsible bodies and local NGOs should emphasize the solution to the identified barriers.