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Hassen AE, Agegnehu AF, Temesgen MM, Admassie BM, Abebe TA, Admass BA. Equipment preparedness for neonatal resuscitation in neonatal intensive care unit in resource limited setting: cross-sectional study. Ann Med Surg (Lond) 2024; 86:1915-1919. [PMID: 38576985 PMCID: PMC10990365 DOI: 10.1097/ms9.0000000000001801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/27/2024] [Indexed: 04/06/2024] Open
Abstract
Background Adverse healthcare's events are a critical issue worldwide, neonatal intensive care unit adverse events are a considerable issue. It is important that we recognize the basic equipment needed to address these circumstances. The aim of this study is to asses' equipment preparedness for neonatal resuscitation in the neonatal intensive care unit. Method A hospital-based, cross-sectional study was conducted on 210 neonates admitted to neonatal intensive care unit at comprehensive specialized hospital from 26/03/2022 to 26/05/2022. The data were collected using Checklist prepared from Neonatal resuscitation: current evidence and guidelines. The data obtained were summed up and presented as descriptive statistics using the Microsoft Excel and were analyzed using SPSS version 25. The result reported in text and table form. Result In this study there was 12.72% complete equipment preparation (without defect) in 210 cases. From the total, there was minor defect in 52.8% cases, and 34.45% cases had serious defect. Serious defects were more frequently detected in the equipment preparation (42.46%), resuscitation medications (12.5%), and radiant warmer set-up (40%). Conclusion and recommendation Overall equipment preparation for neonatal resuscitation was insufficient, and quality of equipment preparation for neonatal resuscitation and stabilization needs to be improved. To enhance equipment preparedness in the neonatal intensive care unit staff should establish uniform guidelines.
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Affiliation(s)
| | - Abatneh Feleke Agegnehu
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, North Gondar
| | - Mamaru Mollalign Temesgen
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, North Gondar
| | - Belete Muluadam Admassie
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, North Gondar
| | | | - Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, North Gondar
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Yaregal Melesse D, Teshale Tesema T, Ayinie Mekonnen Z, Chekol WB, Admass BA, Mengie Workie M. Predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia at Amhara Regional State Tertiary Hospitals: a multicenter prospective study. Front Pediatr 2024; 12:1348789. [PMID: 38523839 PMCID: PMC10957644 DOI: 10.3389/fped.2024.1348789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 02/23/2024] [Indexed: 03/26/2024] Open
Abstract
Introduction Postoperative delirium in paediatric patients is a recognised issue. Nevertheless, in low- and middle-income nations, researchers have had luck in determining its extent and predictors. Identifying predictors of postoperative delirium in paediatric patients having general anaesthesia at Tertiary Hospitals in Ethiopia was the aim of this study. Methods A multicenter, prospective follow up study was conducted from April 15 to June 15, 2023 at the study settings. During the study period a total of 424 paediatric surgical patients treated under general anaesthesia in all study locations, ranging in age from birth to sixteen were candidates for this study. Charts and direct observation of patient's with assessment tool [Cornell Assessment of Pediatric Delirium (CAPD)] were used from each available patient. Binary logistic regression analysis was performed to determine predictors of postoperative delirium in paediatric patients undergoing surgery under general anaesthesia. Results Postoperative delirium occurred in 160 of the 404 paediatric patients who underwent surgery under general anaesthesia. Ophthalmic surgery, corticosteroid use, anticholinergic use, severe postoperative pain, and preoperative anxiety were found to be predictors of postoperative delirium; whereas, sedative medication premedication and paracetamol used for analgesia were found to be protective against postoperative delirium. Inference and recommendation The postoperative delirium in paediatric patients undergoing surgery under general anaesthesia was higher compared to developed countries. Ophthalmic surgery, corticosteroids, anticholinergic medications, postoperative pain, and preoperative anxiety were found to be predictors. The impact of postoperative delirium might be lessened by concentrating on its screening and factor control.
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Affiliation(s)
- Debas Yaregal Melesse
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Diress FT, Fentie DY, Endalew NS, Admass BA. Surgical team member's application of personal protective equipment: an observational study. Ann Med Surg (Lond) 2024; 86:1341-1345. [PMID: 38463072 PMCID: PMC10923328 DOI: 10.1097/ms9.0000000000001765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/16/2024] [Indexed: 03/12/2024] Open
Abstract
Background Personal protective equipment (PPE) is a term used to refer to clothing or equipment that creates a barrier to protect an individual from work-place hazards, thereby protecting the worker against work-related injuries and illnesses. This study was aimed at determining the compliance of application of personal protective equipment against the standards. Methods One hundred surgical personnel were included in this study from 21 March 2023 to 23 April 2023. Data were collected through direct observation. The standards were directly changed into question forms with two integral checking components, "Yes", and "No". Data were entered and analyzed by statistical package of social sciences (SPSS) version 25. Result A total of 100 surgical personnel involved in surgical procedures were assessed for how they applied PPE. Majority of healthcare workers, 61.2%, were compliant with the communicable disease control standard on the application of PPE. The highest compliance rate was observed for the put-on gloves over the gown, while the lowest compliance rate was observed for wearing eye protection. Conclusion and recommendation The practice of PPE usage by surgical personnel was suboptimal. Healthcare facilities can better protect their staff and patients from the spread of infections and other hazards through PPE use protocols. Donning and doffing must always be methodical and supervised by another staff member, especially during surgical emergencies. PPE should be used in accordance with infection prevention and control guidelines and the level of risk involved in the specific procedure.
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Affiliation(s)
- Fikadu Tadesse Diress
- Department of Anesthesia, College of Medicine & Health Sciences, Bahir Dar University, Bahir Dar
| | - Demeke Yilkal Fentie
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigussie Simeneh Endalew
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bitew A, Melesse DY, Admass BA. A 5-years results of the Ponseti method in the treatment of congenital clubfoot: a retrospective study. Eur J Orthop Surg Traumatol 2023; 33:1781-1787. [PMID: 35963923 PMCID: PMC10275805 DOI: 10.1007/s00590-022-03353-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Clubfoot is a common congenital deformity affecting mobility of children. It leads to pain and disability. The Ponseti treatment method is non-surgical method for the correction of clubfoot. There is variation from country to country in how the result of clubfoot management is measured and reported. This study aimed to assess the 5-years results of the Ponseti method in the treatment of congenital clubfoot which was performed for children aged under 2 years in western Amhara, Ethiopia. OBJECTIVES The objective of this study was to assess a 5-years results of the Ponseti method in the treatment of congenital clubfoot among under 2-years old children in Felege Hiwot Referral Hospital, Bahir-Dar, Ethiopia, from 2015 to 2019 G.C. METHODS A facility-based retrospective cross-sectional study was conducted. After receiving letter of ethical clearance from the University, IRB board, the data were collected from medical record/charts of patients' who received Ponseti treatment, and the collected data were entered and analyzed with Statistical Package for Social Sciences version 21. The results were presented with texts and tables. RESULTS A total of 200 children with 256 congenital clubfeet involved in the study. Among the total study subjects, 143 (71.5%) had unilateral clubfeet. The 5-years results of the Ponseti method in the treatment of congenital clubfoot conducted in 200 children with clubfeet were 187 (93.5%) with 95% (CI 90-99.5). Among the study participants, males were 66.5% (almost two times from females). CONCLUSIONS AND RECOMMENDATIONS According to the results from a 5-years data showed that the Ponseti method in the treatment of congenital clubfoot was successful with a success rate of 93.5%. We recommend that children with congenital clubfeet should be managed with Ponseti treatment method timely.
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Affiliation(s)
- Almaw Bitew
- Department of Orthopaedic Surgery, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Debas Yaregal Melesse
- Department of Anaesthesia, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anaesthesia, College of Medicine and Health Sciences, University of Gondar, P.O. Box 196, Gondar, Ethiopia
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Admassie BM, Admass BA, Yaregal Melesse D. Incidence and Associated Factors of Postoperative Undesirable Anesthetic Outcomes Among Surgical Patients at Referral Hospitals in Amhara Region, Ethiopia: A Multi-Center Study. Patient Relat Outcome Meas 2023; 14:137-152. [PMID: 37215184 PMCID: PMC10199704 DOI: 10.2147/prom.s403697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 05/12/2023] [Indexed: 05/24/2023] Open
Abstract
Background Patients undergoing surgery frequently experience unfavorable anesthetic outcomes. They may have an impact on body systems and result in more serious postoperative morbidities. This study was conducted to determine the incidence of postoperative undesirable anesthetic outcomes among surgical patients at referral hospitals in Amhara region, Ethiopia. Methods A total of 412 patients, who underwent surgical procedures between August 1 and October 30 of 2022, were included in this study. The Leiden Perioperative Care Patient Satisfaction Questionnaire's (LPPSq) dimension "discomfort and needs" was used to collect data on the first postoperative day. Data entry and analysis were performed using SPSS version 20. To assess how risk factors affected the outcome variable, logistic regression analysis was utilized. In multivariable logistic regression analysis, a variable with a P-value of less than 0.05 was statistically considered as significant. Results The proportion of those who had "at least a little bit" of unfavorable outcomes was calculated to estimate their overall prevalence, and the prevalence of those who had "more than moderate" levels of unfavorable outcomes was determined to appreciate how severe these outcomes were. The percentages of postoperative pain, the most common undesired result, for "at least a little bit" and "more than moderate" were 87.7% and 32.3%, respectively. In this study, postoperative cold was the least prevalent (51.4%) undesirable anesthetic outcome. The remaining undesirable postoperative outcomes were reported less frequently. Conclusion and Recommendation Undesirable postoperative anesthetic outcomes were still common. The most frequent unfavorable result was postoperative pain. Adequate postoperative patient follow-up and quality service are paramount.
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Affiliation(s)
- Belete Muluadam Admassie
- Department of Anesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Debas Yaregal Melesse
- Department of Anesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Admass BA, Ego BY, Tawye HY, Ahmed SA. Post-operative pulmonary complications after thoracic and upper abdominal procedures at referral hospitals in Amhara region, Ethiopia: a multi-center study. Front Surg 2023; 10:1177647. [PMID: 37255746 PMCID: PMC10225539 DOI: 10.3389/fsurg.2023.1177647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/25/2023] [Indexed: 06/01/2023] Open
Abstract
Background Thoraco-abdominal surgery cuts through muscle, disrupting the normal structure and function of the respiratory muscles, resulting in lower lung volumes and a higher risk of developing post-operative pulmonary complications (PPC). PPC remains an important cause of post-operative morbidity and mortality and impacts the long-term outcomes of patients after hospital discharge. This study was aimed at determining the incidence and factors associated with postoperative pulmonary complications among patients who underwent thoracic and upper abdominal surgery in the Amhara region of Ethiopia. Methods A multi-center follow-up study was conducted from April 1, 2022, to June 30, 2022, at comprehensive specialized hospitals in Amhara regional state, northwest Ethiopia. 424 patients were consecutively included in this study, with a response rate of 100%. A chart review and patient interview were used to collect data. A logistic regression analysis was performed to assess the strength of the association of independent variables with postoperative pulmonary complications.The crude odds ratio (COR) and adjusted odds ratio (AOR) with the corresponding 95% confidence interval were computed. Variables with a p-value of <0.05 were considered statistically significant predictors of the outcome variable. Results The incidence of postoperative pulmonary complication was 24.5%. Emergency procedures, preoperative SpO2 < 94%, duration of surgery >2 h, patients with a nasogastric tube, intraoperative blood loss >500 ml and post-operative albumin <3.5 g/dl were factors associated with pulmonary complications. The most common complications were pneumonia (9.9%) followed by respiratory infection (4.2%). Conclusion The incidence of postoperative pulmonary complication after thoracic and upper abdominal surgery remains high. Preoperative SpO2, duration of surgery, patients having a nasogastric tube, intraoperative blood loss and post-operative albumin were factors associated with post-operative pulmonary complications.
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Affiliation(s)
- Biruk Adie Admass
- Department of Anesthesia, College of medicine and health sciences, University of Gondar, Gondar
| | - Birhanu Yilma Ego
- Department of Anesthesia, College of medicine and health sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Hailu Yimer Tawye
- Department of Anesthesia, College of medicine and health sciences, University of Gondar, Gondar
| | - Seid Adem Ahmed
- Department of Anesthesia, College of medicine and health sciences, University of Gondar, Gondar
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Atnafu Gebeyehu N, Abebe Gelaw K, Asmare Adella G, Dagnaw Tegegne K, Adie Admass B, Mesele Gesese M. Incomplete immunization and its determinants among children in Africa: Systematic review and meta-analysis. Hum Vaccin Immunother 2023:2202125. [PMID: 37144686 DOI: 10.1080/21645515.2023.2202125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023] Open
Abstract
Immunization is one of the most cost-effective measures to prevent morbidity and mortality in children. Therefore, the purpose of this systematic review and meta-analysis was to determine the pooled prevalence of incomplete immunization among children in Africa as well as its determinants. PubMed, Google Scholar, Scopus, Science Direct, and online institutional repository homes were searched. Studies published within English language, with full text available for searching, and studies conducted in Africa were included in this meta-analysis. A pooled prevalence, Sub-group analysis, sensitivity analysis and meta-regression were conducted. Out of 1305 studies assessed, 26 met our criteria and were included in this study. The pooled prevalence of incomplete immunization was 35.5% (95% CI: 24.4, 42.7), I2 = 92.1%). Home birth (AOR=2.7; 95% CI: 1.5-4.9), rural residence (AOR = 4.6; 95% CI: 1.1-20.1), lack of antenatal care visit (AOR = 2.6; 95% CI: 1.4-5.1), lack of knowledge of immunizations (AOR=2.4; 95% CI: 1.3-4.6), and maternal illiteracy (AOR = 1.7: 95%CI: 1.3-2.0) were associated with incomplete immunization. In Africa, the prevalence of incomplete immunization is high. It is important to promote urban residency, knowledge of immunization and antenatal follow up care.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Kelemu Abebe Gelaw
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Getachew Asmare Adella
- Department of Reproductive Health, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Kirubel Dagnaw Tegegne
- Department of Comprehensive Nursing, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Science, Gondar University, Gondar, Ethiopia
| | - Molalegn Mesele Gesese
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
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Hassen AE, Agegnehu AF, Admass BA, Temesgen MM. Preoperative anemia and associated factors in women undergoing cesarean section at a comprehensive specialized referral hospital in Ethiopia. Front Med (Lausanne) 2023; 10:1056001. [PMID: 37081836 PMCID: PMC10110839 DOI: 10.3389/fmed.2023.1056001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/21/2023] [Indexed: 04/07/2023] Open
Abstract
BackgroundAnemia is a common public health burden during pregnancy. Severe maternal and fetal complications have been associated with anemia. Despite many studies on anemia during pregnancy have been conducted in Ethiopia at any time of antenatal care visits, the prevalence of preoperative anemia among women awaiting cesarean delivery and its contributing factors have not been determined. The aim of this study was to determine the prevalence and associated factors of preoperative anemia in women awaiting cesarean section at a comprehensive specialized hospital in Ethiopia.MethodsAn institution-based cross-sectional study was done from April to June 2022 to determine preoperative anemia in women undergoing cesarean delivery. Data were obtained using a standardized questionnaire that included the women’s background characteristics. Bi-variable and multi-variable logistic regression analyses were performed to identify variables related to preoperative anemia. With a 95% confidence level, the estimated crude odds ratio and adjusted odds ratio were calculated. In a multivariate analysis, variables were considered statistically significant if their p-value was less than 0.05.ResultsA total of 424 pregnant women with a 100% response rate were included in this study. The prevalence of preoperative anemia among women awaiting cesarean delivery was 28.3% (95% CI: 23.8–32.5%). Previous history of abortion, lack of iron supplementation, human immunodeficiency virus infection, previous cesarean section, and American Society of Anesthesiology class III were significantly associated with preoperative anemia among women awaiting cesarean section.Conclusion and recommendationPreoperative anemia was diagnosed in a significant proportion of women awaiting cesarean-delivery. Anemia was linked to a lack of iron supplementation, American Society of Anesthesiology class III, previous history of abortion, human immunodeficiency virus infection, and previous cesarean section. Therefore, early detection of high-risk pregnancies, iron supplementation, prevention of HIV infection and due attention to people living with HIV/AIDs are paramount.
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Affiliation(s)
| | - Abatneh Feleke Agegnehu
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Biruk Adie Admass,
| | - Mamaru Mollalign Temesgen
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Admass BA, Ego BY, Tawye HY, Ahmed SA. Preoperative investigations for elective surgical patients in a resource limited setting: Systematic review. Ann Med Surg (Lond) 2022; 82:104777. [PMID: 36268455 PMCID: PMC9577970 DOI: 10.1016/j.amsu.2022.104777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/27/2022] Open
Abstract
Background Methods Results Conclusion Ordering preoperative investigation is a common practice. Routine laboratory tests has significant burden on health care costs. Preoperative tests should be guided by the patient's clinical history, co-morbidities, and physical examination. Ordering preoperative investigations based on recommendation of guidelines is very essential.
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Abebe MM, Arefayne NR, Temesgen MM, Admass BA. Evidence-based perioperative pain management protocol for day case surgery in a resource limited setting: Systematic review. Ann Med Surg (Lond) 2022; 80:104322. [PMID: 36045767 PMCID: PMC9422356 DOI: 10.1016/j.amsu.2022.104322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background Worldwide, there is an increasing trend of performing more complex operations in a day care setting, usually driven by economic considerations. Provision of appropriate pain relief is still inadequate in this setting. Poor pain control and adverse effects of opioids provided for pain control are common reasons for readmission, with human and economic consequences. The aim of this review was to develop evidence-based protocol for pain management of day surgery in a resource limited setting. Method After formulating the key questions, scope, and eligibility criteria for the articles to be included, advanced search strategy of electronic sources from data bases and websites was conducted. Screening of literatures was conducted with proper appraisal checklist. This review was reported in accordance with preferred reporting items for systematic reviews and meta-analysis (PRISMA) 2020 statement. Results A total of 333 articles were identified from data bases and websites using an electronic search. 45 articles were removed for duplication and 87 studies were excluded after reviewing titles and abstracts. At the screening stage, 73 articles were retrieved and evaluated for eligibility. Finally, 40 studies met the eligibility criteria and were included in this systematic review. Conclusion Day surgery encourages patients to mobilize soon after surgery and empowers them to manage their own pain. Thus, preoperative patient education and high-quality perioperative pain management are paramount. With increasing healthcare demands for more day-case procedures, multi-modal analgesic techniques in the perioperative period with good extension of analgesia into the postoperative discharge period are essential. Nearly one-third of patients experience moderate-to-severe pain after day surgery. Standardized pain evaluation, protocols, and multi-modal analgesia are keys to effective pain control. Patient education and preparation will improve patient compliance of analgesia. Alternatives to opioids should be promoted in day surgery. Local anesthetic techniques facilitate early and safe discharge of patients after day surgery.
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Admass BA, Endalew NS, Tawye HY, Melesse DY, Workie MM, Filatie TD. Evidence-based airway management protocol for a critical ill patient in medical intensive care unit: Systematic review. Ann Med Surg (Lond) 2022; 80:104284. [PMID: 36045781 PMCID: PMC9422313 DOI: 10.1016/j.amsu.2022.104284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 11/24/2022] Open
Abstract
Background Airway management outside the theatre is performed either to resuscitate a physiologically unstable critically ill patients or to secure an emergency airway in the absence of essential equipments. It is a life saving procedure for critically ill and injured patients. Delaying in securing airway or awaking the patient is not an option in case of difficult airway in intensive care unit. Therefore, developing and implementation of an evidence-based airway management protocol is important. Objective This review was conducted to develop a clear airway management protocol for a critical ill patient in medical intensive care unit. Methods After formulating the key questions, scope, and eligibility criteria for the evidences to be included, a comprehensive search strategy of electronic sources was conducted. The literatures were searched using advanced searching methods from data bases and websites to get evidences on airway management of a critical ill patient. Duplication of literatures was avoided by endnote. Screening of literatures was conducted based on the level of significance with proper appraisal. This review was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement. Results A total of 626 articles were identified from data bases and websites using an electronic search. Of these articles, 95 were removed for duplication and 305 studies were excluded after reviewing their titles and abstracts. At the screening stage, 79 articles were retrieved and evaluated for the eligibility. Finally, 40 studies related to airway management of a critical ill patient in medical ICU were included in this systematic review. Conclusion A critical ill patient needs oxygenation and ventilation support. A focused and rapid assessment, with special attention of the airway and hemodynamic status of the critical ill patient is paramount. An appropriate airway management option should be employed to resuscitate or to control an emergency airway of a critical ill patent. This could be non invasive ventilation or invasive airway intervention. Airway management outside operating theatre is a common practice. A critical ill patient needs oxygenation and ventilation support. A focused airway assessment even in the most urgent situation is mandatory. Usage of appropriate airway management intervention is paramount.
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Gebeyehu NA, Gelaw KA, Azeze GA, Admass BA, Lake EA, Adela GA. Knowledge, attitude and practice towards kangaroo mother care among postnatal women in Ethiopia: Systematic review and meta-analysis. PLoS One 2022; 17:e0265411. [PMID: 35522657 PMCID: PMC9075620 DOI: 10.1371/journal.pone.0265411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 03/01/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Kangaroo mother care is a key procedure in reducing neonatal mortality and morbidity associated with preterm birth. In Ethiopia, neonatal death remains a serious problem, and this study aims to determine the prevalence of the knowledge, attitudes and practice of kangaroo mother care among Ethiopia women. METHODS PubMed, Web of Science, Google Scholar, EMBASE and the Ethiopian University online library were searched. Data were extracted using Microsoft Excel and analysed using STATA statistical software (v. 11). Publication bias was checked by forest plot, Begg's rank test and Egger's regression test. To look for heterogeneity, I2 were computed and an overall estimated analysis carried out. Subgroup analysis was done by region, study setting, publication, gestational age, birth weight and component of kangaroo care. The Joanna Briggs Institute risk of bias assessment tool was used. We carried out a leave one out sensitivity analysis. RESULTS Out of 273 articles retrieved, 16 studies met the eligibility criteria and are thus included in this study. Those 16 studies had a total of 12,345 respondents who reported kangaroo mother practice, with five (comprising 1,232 participants combined) reporting that both knowledge and attitude were used to determine the overall estimation. The pooled estimates of good knowledge, positive attitude and poor practice of kangaroo mother care were found to be 64.62% (95% CI: 47.15%-82.09%; I2 = 97.8%), 61.55% (49.73%-73.38%; I2 = 94.8%) and 45.7% (95% CI: 37.23%-54.09%; I2 = 98.5%), respectively. This study is limited to postnatal women and does not take account their domestic partners or health providers. CONCLUSION The findings revealed significant gaps in the knowledge, attitudes and practice of kangaroo mother care in Ethiopia when compared with other developing countries. Therefore, kangaroo mother care training to women, along with further studies on domestic partners and health providers.
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Affiliation(s)
- Natnael Atnafu Gebeyehu
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kelemu Abebe Gelaw
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Gedion Asnake Azeze
- School of Midwifery, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Health Science and Medicine, University of Gondar, Gondar, Ethiopia
| | - Eyasu Alem Lake
- School of Nursing, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Getachew Asmare Adela
- School of Public Health, College of Health Science and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Admass BA, Tawye HY, Endalew NS, Mersha AT, Melesse DY, Workie MM, Gashaw M, Ferede YA. Assessment of post-operative nausea and vomiting prophylaxis usage for cesarean section, 2021: A cross sectional study. Ann Med Surg (Lond) 2022; 75:103399. [PMID: 35386765 PMCID: PMC8977925 DOI: 10.1016/j.amsu.2022.103399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Objective Methods Results Conclusions PONV is the most common morbidity after surgery and anesthesia. Untreated PONV is associated with complications. Appropriate anti emetic prophylactic agents can reduce PONV. Practice of PONV prophylactic usage is low.
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Molla Kiflie A, Tarekegn Mersha A, Mengie Workie M, Adie Admass B. Assessment of venous thromboembolism prophylaxis practice in medical-surgical adult ICU: A cross sectional study. International Journal of Surgery Open 2022. [DOI: 10.1016/j.ijso.2021.100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Abebe MM, Arefayne NR, Temesgen MM, Admass BA. Incidence and predictive factors associated with hemodynamic instability among adult surgical patients in the post-anesthesia care unit, 2021: A prospective follow up study. Ann Med Surg (Lond) 2022; 74:103321. [PMID: 35145680 PMCID: PMC8818524 DOI: 10.1016/j.amsu.2022.103321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/23/2022] [Accepted: 01/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Hemodynamic instability, which is an independent predictor of long-term patient morbidity and duration of stay in the hospital, is a risk for patients in the post-anesthesia care unit. Multiple factors contribute to the development of postoperative hemodynamic instability. Prevention and treatment of these factors may reduce patients' hemodynamic instability, and its associated morbidity and mortality. Objective The aim of this study was to determine the incidence and factors associated with hemodynamic instability among adult surgical patients in the post-anesthesia care unit. Method An institution-based prospective follow up study was conducted from April 20, 2021 to June 28, 2021. Four hundred and seventeen (417) adult surgical patients were involved in this study. Descriptive and analytic statistics were used to describe our results. Both the bivariable and multivariable logistic regression with crude odds ratio and adjusted odds ratio were used with a 95% confidence interval to evaluate the strength of association. In multivariable regression, a p-value < 0.05 was considered as statistically significant. Result The overall incidence of hemodynamic instability was 59.47% (CI: 0.55, 0.64). The incidence of tachycardia, bradycardia, hypotension, and hypertension were 27.34%, 21.82%, 13.67%, and 15.35% respectively. Preoperative use of beta-blockers, ASA class III, procedure longer than 4 h, intraoperative hemodynamic instability, and regional anesthesia were significantly associated with hemodynamic instability in the post-anesthesia care unit. Conclusion and recommendation The incidence of hemodynamic instability in the post anesthesia care unit was high. Preoperative use of beta-blockers, intraoperative hemodynamic instability, and prolonged duration of procedures were predictors of hemodynamic instability after operation. Early detection and management of these perioperative risk factors is necessary to reduce hemodynamic instability in the post-anesthesia care unit. HDI is a common complication after surgery and anaesthesia It results in severe morbidity and mortality HDI is associated with multiple predictive factors Early detection and intervention of HDI improves outcome after surgery
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Affiliation(s)
- Melkam Mulugeta Abebe
- Department of Anesthesia, College of Medicine &health Sciences, Debre Berhan University, Ethiopia
| | - Nurhusen Riskey Arefayne
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O. Box: 196, Ethiopia
| | - Mamaru Mollalign Temesgen
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O. Box: 196, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, P.O. Box: 196, Ethiopia
- Corresponding author.
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Ferede YA, Bizuneh YB, Workie MM, Admass BA. "Prevalence and associated factors of preoperative anxiety among obstetric patients who underwent cesarean section": A cross-sectional study. Ann Med Surg (Lond) 2022; 74:103272. [PMID: 35198163 PMCID: PMC8844776 DOI: 10.1016/j.amsu.2022.103272] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 01/26/2023] Open
Abstract
Background Anxiety is the most common problem in the preoperative period. This anxiety increases postoperative pain, delay healing, and prolong the hospital stay. Among the surgical population, a higher level of preoperative anxiety has been seen in obstetric patients. Objective The aim of this study was to assess the prevalence and associated factors of preoperative anxiety among obstetric patients undergoing cesarean section. Methods An institutional-based cross-sectional study was conducted from January 01, 2021, to May 30, 2021. A total of 376 obstetric patients who underwent cesarean sections were included. Descriptive statistics, cross-tabs, and binary logistic regression analysis were performed to identify the association shivering and independent variables. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and a p-value<0.05 was considered as statistically significant state versions of state-trait anxiety inventory scale (S-STAI) were used for this study. Results The overall prevalence rate of preoperative anxiety was 63% (95% CI: 58.2, 68.1). The patient's preoperative mean anxiety score of STAI was (43.81 ± 8.81). There was a high level of preoperative anxiety in patients undergoing emergency cesarean section as compared to elective patients. Patients' age less than 30 years, level of education, and previous anesthesia and surgery exposure were also highly associated with the dependent variable. Conclusion In this study, fear of complications and fear of death result of operation were the most common factors responsible for preoperative anxiety while few patients were anxious about financial loss and osmotic issues. The prevalence rate of preoperative anxiety was 63% among obstetric patients. Preoperative anxiety was highly related to fear of complications and fear of death. Age, Level of education were significantly associated with preoperative anxiety. Previous anesthesia exposure was also significantly associated with anxiety. Preoperative anesthesia visits are important to reduce anxiety.
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Affiliation(s)
- Yonas Admasu Ferede
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Yosef Belay Bizuneh
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Misganaw Mengie Workie
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Admass BA, Hailemariam AS, Agegnehu AF, Getahun AB. Parental Satisfaction and Associated Factors Toward Their Child's Anesthesia Service at a Comprehensive Specialized Referral Hospital in Ethiopia, 2021: A Cross-Sectional Study. Front Pediatr 2022; 10:849969. [PMID: 35733814 PMCID: PMC9207345 DOI: 10.3389/fped.2022.849969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Parental satisfaction is a key measure of the quality of a child's anesthetic care. Understanding of parents' opinions and satisfaction about their child's anesthesia service in the hospital is vital for hospital funding and parent experience. OBJECTIVE The purpose of this study was to determine the level of parental satisfaction with their child's anesthetic care and the factors that contributed to that satisfaction. METHODS An institution-based cross-sectional study was undertaken between March and June 2021. A structured questionnaire with the background characteristics of parents and children was used to collect data. A total of 238 parents were included in the study. To find parameters linked to parental satisfaction with their child's anesthetic service, bi-variable, and multi-variable logistic regression analyses were used. Crude odds ratio and adjusted odds ratio with a 95% confidence interval (CI) were estimated. Variables with a p-value < 0.05 were considered statistically significant in multivariable analysis. RESULT The proportion of parental satisfaction toward their child's anesthesia service was 77.7% (95% CI: 72.3, 82.4%). Non-anxious, male, employed, and urban resident parents and parents of pre-medicated children were associated with high satisfaction scores. CONCLUSION AND RECOMMENDATION Overall, parents' satisfaction with their child's anesthesia service was promising. Parents who were non-anxious, male, employed, and lived in an urban area and whose child had received sedative premedication had high rates of parental satisfaction with their child's anesthetic care.Parents from rural areas, as well as worried and female parents, should receive extra care. Preoperative anxiety is reduced when parents are given enough and understandable information. Thus, the provision of comprehensive information on their child's anesthesia care process and psychological or emotional support to parents are necessary to boost their satisfaction.
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Affiliation(s)
- Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Abatneh Feleke Agegnehu
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Belete Getahun
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alemu WM, Ashagrie HE, Agegnehu AF, Admass BA. Comparing the analgesic efficacy of transversus abdominis plane block versus wound infiltration for post cesarean section pain management: A prospective cohort study. International Journal of Surgery Open 2021. [DOI: 10.1016/j.ijso.2021.100377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Getahun AB, Endalew NS, Mersha AT, Admass BA. Magnitude and Factors Associated with Preoperative Anxiety Among Pediatric Patients: Cross-Sectional Study. Pediatric Health Med Ther 2020; 11:485-494. [PMID: 33364873 PMCID: PMC7751437 DOI: 10.2147/phmt.s288077] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/10/2020] [Indexed: 12/22/2022]
Abstract
Background Anesthesia and surgery are common sources of anxiety and stressful experiences in children. This unpleasant sensation depends on several factors. This study aimed to determine the magnitude of preoperative anxiety and associated factors in pediatrics patients at the University of Gondar Comprehensive Specialized Hospital North West Ethiopia 2020. Methods An institutional-based cross-sectional observational study was conducted from March to September 2020 at the University of Gondar Comprehensive Specialized Hospital. After obtaining ethical approval from the institutional review board. All consecutive ASA physical status I & II boys and girls with the age of 2–12 years scheduled for a variety of elective (general, urologic, ENT, ophthalmic and other surgical) operations were included. The level of anxiety was measured using the Modified Yale Preoperative Anxiety Scale short form (m-YPAS-SF) observational tool. Parental anxiety was assessed using Spielberger’s short version of state-trait anxiety. Binary logistic regression analysis was performed to identify the association between preoperative children’s anxiety and independent variables. The strength of the association was present by adjusted odds ratios. Results The magnitude of preoperative anxiety in children in the operation room was 75.44% (95% confidence interval (CI): 68.36, 81.34). Age (AOR: 3.83; 95% CI: 1.58, 9.30), previous surgery and anesthesia (AOR: 6.73, 95% CI: 1.25, 36.19), outpatient surgery (AOR: 5.16, 95% CI: 1.32, 20.23) and parental anxiety (AOR: 3.26, 95% CI: 1.30, 20.23) were significantly associated with preoperative children anxiety. Conclusion The magnitude of preoperative anxiety in pediatric patients was considerably high in our setup. Younger age, previous surgery and anesthesia, outpatient surgical setting, and parental anxiety were the independent risk factors for preoperative anxiety. Therefore, the operating staff should assess the child’s anxiety and should consider appropriate anxiety reduction methods during the preoperative visit of pediatric patients and their families.
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Affiliation(s)
- Amare Belete Getahun
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Nigussie Simeneh Endalew
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Abraham Tarekegn Mersha
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Admass BA, Endalew NS, Tawuye HY, Mersha AT. Knowledge and Attitude of Ethiopian Oncology Nurses About Cancer Pain Management: National Survey. Cancer Manag Res 2020; 12:9045-9055. [PMID: 33061599 PMCID: PMC7524177 DOI: 10.2147/cmar.s261172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Cancer is becoming a leading cause of death worldwide. Pain is a common and devastating symptom of cancer patients that can significantly affect the patient's quality of life. Optimal cancer pain control requires adequate knowledge and positive attitudes of nurses. Little is known about the knowledge and attitudes of oncology nurses towards cancer pain management in Ethiopia. The current study aimed to assess the knowledge and attitude of nurses and determinants of cancer pain management in all oncology centers in Ethiopia. METHODS A nationwide cross-sectional survey was conducted on 138 nurses in all oncology centers in Ethiopia. Self-completed survey questionnaires were distributed using the 'Knowledge and Attitudes Survey Regarding Pain (KASRP)' tool. Both bivariable and multivariable logistic regression analyses were used. Both crude odds ratio and adjusted odds ratio with the corresponding 95% CI were calculated to show the strength of association. Variables with a p-value of <0.05 were considered as statistically significant. RESULTS Only 7.2% (95% CI: 2.9, 11.6) of oncology nurses had good knowledge and attitude about cancer pain management. Among 41 items, the mean number of correctly answered questions was 20.4 (SD = 5.13). Nurses who had a master's degree in nursing were positively associated with good knowledge and attitude about cancer pain management. CONCLUSION In this nationwide study, the overall knowledge and attitude level of oncology nurses towards cancer pain management were poor. Nurses who had a master's degree in nursing were significantly associated with good knowledge and attitude towards cancer pain management. Regular training and revision of the contents of pain management education in the academic curriculum of nursing education are recommended.
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Affiliation(s)
- Biruk Adie Admass
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Nigussie Simeneh Endalew
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Hailu Yimer Tawuye
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
| | - Abraham Tarekegn Mersha
- Department of Anaesthesia, School of Medicine, College of Medicine and Health Science University of Gondar, Gondar, Ethiopia
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