Quality of Life in Patients Living with Stoma

BACKGROUND፡ Background and Objective: Quality of life of patients can be affected a treatment. A good quality of life is essential to achieve a goal in treating patients. This study aims to assess stoma related quality of life.METHODS: A cross-sectional study was done at St. Paul’s Hospital millennium Medical College from February 1 to July 31, 2019. A structured questionnaire was used to interview patients and review charts of patients to retrieve information on sociodemographic variables, type, and indications of the stoma. Data was collected using structured questionnaire adopted from the City of Hope and Beckman Research Institute after modifications to make it in line with the Ethiopian context.RESULTS: The mean score for the overall quality of life for stomata was 7.42 ± 0.53. Around 70% of patients have adjusted their dietary style due to stoma. More than half of them reported feelings of depression following stoma surgery. Only 34% of patients resumed sexual activity and only 11% were satisfied with it. None of them were enrolled in stoma association or support group. Factors such as type of ostomy (temporary/permanent), adjustment in dietary style due to stoma, depression, change in diet for not passing gas in public, and change in clothing style had significant effects on overall quality of life and its subscales (P < 0.05).CONCLUSIONS: This study demonstrated that living with stoma has a greater impact on the overall aspect of quality of life

Depressive Symptoms among Haramaya University Students in Ethiopia: A Cross-Sectional Study

Background. The prevalence of mental health problems including depression is increasing in severity and number among higher institution students, and it has a lot of negative consequences like poor academic performance and committing suicide. Identifying the prevalence and associated factors of mental illness among higher institution students is important in order to administer appropriate preventions and interventions. In Ethiopia, only a few studies tried to report associated factors of depression among university students. Objective. The objective of this study was to determine the prevalence and factors associated with depressive symptoms among Haramaya University students, Ethiopia. Methods. Institution-based, cross-sectional study design was conducted among 1040 students. A standard, self-administered questionnaire was used to get data from a sample of randomly selected 1040 undergraduate university students using a multistage systematic random sampling technique. The questionnaire used was the Beck Depression Inventory (BDI) scale which is a self-report 21-item scale that is used to assess the presence of depressive symptoms. All 21 items are rated on a three-point scale (0 to 3). Each question is scored on a 0 to 3 scale, and total scores range from 0 to 63, with higher scores reflecting greater levels of depressive symptoms. The questionnaire has been well validated as a measure of depressive symptomatology with scores 1-13 indicating minimal depressive symptoms, 14-19 showing mild depressive symptoms, 20-28 showing moderate depressive symptoms, and 29-63 indicating severe depressive symptoms. Logistic regression analysis was used to identify variables independently associated with depressive symptoms after we dichotomized the depressive symptoms screening tool to “yes/no” depressive symptoms. This means students who did not report any depressive symptoms were given “no” depressive symptoms and who reported at least one (≥1) depressive symptoms were given “yes” (depressive symptoms). Results. A total of 1022 (98.3%) out of 1040 students participated in this study. The mean age of participants was 20.9 years (SD±2.17), and the majority of them (76.0%) were male students. Prevalence of depressive symptoms among undergraduate students was 26.8% (95% CI: 24.84, 28.76). Among those who had reported depressive symptoms: 10%, 12%, 4%, and 1% of students reported minimal, mild, moderate, and severe depressive symptoms, respectively. Multivariable logistic regression analysis in the final model revealed that being a first-year student (AOR 6.99, 95% CI: 2.31, 21.15, p value < 0.001), being a second-year student (AOR 6.25, 95% CI: 2.05, 19.07, p value < 0.001), and being a third-year student (AOR 3.85, 95% CI: 1.26, 11.78, p value < 0.018) and being divorced/widowed (AOR 5.91, 95% CI: 1.31, 26.72, p value < 0.021), current drinking alcohol (AOR 2.53, 95% CI: 1.72,3.72, p value < 0.001), current smoking cigarettes (AOR 1.71, 95% CI: 1.02, 2.86, p value < 0.042), and current use of illicit substances (AOR 2.20, 95% CI: 1.26, 3.85, p value < 0.006) were independently associated with depressive symptoms. Having no religion and currently chewing Khat were statistically significantly associated with depressive symptoms in the binary logistic regression analysis but not in the final model. Conclusions. The prevalence of depressive symptoms among university students in this study is high relative to the general population. Sociodemographic factors year of study and current substance use were identified as associated factors of depressive symptoms. Recommendations. This finding suggests the need for the provision of mental health services at the university, including screening, counseling, and effective treatment. Families need to closely follow their students’ health status by having good communication with the universities, and they have to play their great role in preventing depression and providing appropriate treatment as needed. The governments and policy-makers should stand with universities by supporting and establishing matured policies which helps universities to have mental health service centers. Generally, the university and other stakeholders should consider these identified associated factors for prevention and control of mental health problems of university students

Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study

Objectives: Globally, twenty-three million adolescents aged 15–19 years have an unmet need for sexual and reproductive health services and are at risk of unintended pregnancy. In Sub-Saharan Africa, including Ethiopia, it might be difficult for adolescents to get access to sexual and reproductive health services that are acceptable to use. Privacy, a fear of sharing health concerns, a sociocultural environment, the unfriendliness of current services, and traditional taboos are some of the key reasons. This study aimed to explore the perspectives of service providers and adolescents on the use of sexual and reproductive health services. Methodology: A qualitative phenomenological study was conducted from January to February 2023 in the Tikur Anbessa specialized hospital. Purposive sampling was applied to select the study participants. A total of 17 in-depth interviews (with 7 adolescents and 10 health providers) were held. Instead of relying on the number of participants, data saturation was used. Thematic analysis was employed in analyzing the data. Result: The findings indicate that obstacles to the use of sexual and reproductive health services include challenges related to the availability of resources and accessibility; resistance from religious beliefs, cultural beliefs, and customs; quality and institutional-related challenges; and stigma and discrimination in sexual and reproductive health services, which pose the biggest barrier to health professionals providing standardized sexual and reproductive health services. Conclusion: A multi-pronged approach should be created to overcome these challenges, including community outreach for sexual and reproductive health and increasing awareness of the importance of early access to sexual and reproductive health through appropriate community forums. Existing sexual and reproductive health services are not promoted to adolescents and youth, and a lack of and difficulty getting resources for sexual and reproductive health services should be resolved

sj-pdf-2-smo-10.1177_20503121231223660 – Supplemental material for Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study

Supplemental material, sj-pdf-2-smo-10.1177_20503121231223660 for Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study by Befkad Derese Tilahun, Gizachew Yilak, Shewangizaw Amena, Gebremeskel Kibret Abebe and Mulat Ayele in SAGE Open Medicine</p

sj-pdf-1-smo-10.1177_20503121231223660 – Supplemental material for Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study

Supplemental material, sj-pdf-1-smo-10.1177_20503121231223660 for Exploring the perceptions of health service providers and adolescents on the utilization of adolescent sexual and reproductive health services in Tikur, 2023: A qualitative study by Befkad Derese Tilahun, Gizachew Yilak, Shewangizaw Amena, Gebremeskel Kibret Abebe and Mulat Ayele in SAGE Open Medicine</p

Electronic Medical Record System Use and Determinants in Ethiopia: Systematic Review and Meta-Analysis

BackgroundThe strategic plan of the Ethiopian Ministry of Health recommends an electronic medical record (EMR) system to enhance health care delivery and streamline data systems. However, only a few exhaustive systematic reviews and meta-analyses have been conducted on the degree of EMR use in Ethiopia and the factors influencing success. This will emphasize the factors that make EMR effective and increase awareness of its widespread use among future implementers in Ethiopia. ObjectiveThis study aims to determine the pooled estimate of EMR use and success determinants among health professionals in Ethiopia. MethodsWe developed a protocol and searched PubMed, Web of Sciences, African Journals OnLine, Embase, MEDLINE, and Scopus to identify relevant studies. To assess the quality of each included study, we used the Joanna Briggs Institute quality assessment tool using 9 criteria. The applicable data were extracted using Microsoft Excel 2019, and the data were then analyzed using Stata software (version 11; StataCorp). The presence of total heterogeneity across included studies was calculated using the index of heterogeneity I2 statistics. The pooled size of EMR use was estimated using a random effect model with a 95% CI. ResultsAfter reviewing 11,026 research papers, 5 papers with a combined total of 2439 health workers were included in the evaluation and meta-analysis. The pooled estimate of EMR usage in Ethiopia was 51.85% (95% CI 37.14%-66.55%). The subgroup study found that the northern Ethiopian region had the greatest EMR utilization rate (58.75%) and that higher (54.99%) utilization was also seen in publications published after 2016. Age groups <30 years, access to an EMR manual, EMR-related training, and managerial support were identified factors associated with EMR use among health workers. ConclusionsThe use of EMR systems in Ethiopia is relatively low. Belonging to a young age group, accessing an EMR manual, receiving EMR-related training, and managerial support were identified as factors associated with EMR use among health workers. As a result, to increase the use of EMRs by health care providers, it is essential to provide management support and an EMR training program and make the EMR manual accessible to health professionals

Intention to use wearable health devices and its predictors among diabetes mellitus patients in Amhara region referral hospitals, Ethiopia: Using modified UTAUT-2 model

Introduction: The burden of diabetes mellitus is increasing in Africa. Wearables have a proven track record of combating chronic diseases. However, little is known about patients’ intentions to use such technologies in resource-limited settings. Therefore, this study aimed to assess DM patients' intentions to use wearable health devices and its predictors in Ethiopia. Methods: An institutional-based cross-sectional study was conducted among 924 diabetes mellitus patients from May 19 to June 23, 2022, at referral hospitals in the Amhara regional state of Ethiopia. An interviewer-administered questionnaire was used to collect the data using the Kobo Collect app. A systematic random sampling technique was used to select the study participants. Descriptive statistics were done using SPSS version 25 software and presented using tables and pie charts. Structural equation modeling analysis with SPSS AMOS version 26 software was employed to identify predictors associated with the intention to use wearable health devices in Ethiopia. Results: A total of 883 diabetes mellitus patients, with a 95.56% response rate, participated in the study. The proportion of intention to use wearable health devices was 47.1%, 95% CI (43.7–50.5). Effort expectancy (β = 0.543, P < 0.01), performance expectancy (β = 0.306, P < 0.01), facilitating condition (β = 0.131, P < 0.05), and habit (β = 0.093, P < 0.05) had a positive direct relationship with intention to use wearable health devices. Age (β = 0.439, p < 0.001) was moderate performance expectancy, while gender (β = 0.780, p < 0.001) had moderate effort expectancy to the intention to use wearable health devices. Conclusions: Overall, diabetes mellitus patients’ intentions to use wearable health devices were promising. The intention to use wearables was positively related to effort expectancy, performance expectancy, facilitating conditions, and habit. Thus, increasing patient intention to utilize it could be achieved through capacity building, access to technology, and technical support. In addition, implementers should prioritize improving the availability of devices, patients' abilities, encouraging customers, to utilize the product on a regular basis by actively fostering their relationship with them, and create awareness about usefulness of wearable health devices

Readiness to use electronic medical record systems and its associated factors among health care professionals in Ethiopia: A systematic review and meta-analysis

Background: Electronic medical record systems (EMRs) are being incorporated into the healthcare system to modernize it, but it is also intended to save lives by promoting communication and evidence-based decision-making. Ethiopia is one of the developing nations with the lowest acceptance and utilization of EMRs, even though they are a crucial instrument for the delivery of healthcare. The pooled prevalence of readiness to use electronic medical record systems is unknown. As a result, this study assesses systematic review and meta-analysis to identify the pooled levels of readiness to use EMRs and associated factors among health professionals in Ethiopia. Method: Search engines were used to locate studies that adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols in Medline, PubMed, Scopus, EMBASE, African Journal Online (AJOL), HINARI, Science direct, and Web-Science (PRISMA). The STATA version 11 program was used to carry out the investigation. The heterogeneity among the included papers was evaluated using the indicator of heterogeneity (I2). A visual examination of the funnel plot was employed to investigate potential publication bias. A random-effect model meta-analysis is used to assess the pooled effect size of each study with a 95% confidence interval. Result: Three studies in total were utilized to evaluate the relationship between readiness to use an electronic medical record system and attitude. The systematic and meta-analysis revealed that the pooled prevalence of readiness to use electronic medical record systems was 51.31% (95% CI: 40.54–62.07). Furthermore, participants with a positive attitude (Adjusted OR (AOR) = 2.26 (95% CI: 1.36–3.75, having computer literacy (Adjusted OR (AOR) = 2.98 (95% CI: 1.60–5.58) and having good knowledge (Adjusted OR (AOR) = 2.54 (95% CI: 1.67–3.46) were significant factors associated with readiness to use electronic medical record system among health care professionals in Ethiopia. Conclusion and recommendations: The overall pooled level of readiness of health professionals for the implementation of the EMR was found to be low. Raising the level of knowledge, attitude, and computer skills among health professionals requires comprehensive capacity-building packages for the sustainable improvement of readiness to use EMRs