Day 2 :
Keynote Forum
Muhammad Ajmal Zahid
Professor of Psychiatry, Faculty of Medicine, Kuwait University
Keynote: Mental and physical comorbidity in an Arab national primary health care setting
Biography:
Muhammad Ajmal Zahid is a Professor of Psychiatry, Faculty of Medicine, Kuwait University. He obtained his basic Medical degree from the King Edward Medical
College, Lahore, Pakistan in 1975 and membership from the Royal College of Psychiatrists, UK in 1985. His areas of interest include psychosocial correlates of
severe mental illness, workplace violence among the health care professionals, and psychiatric morbidity in general hospital medical outpatient and primary health
care settings. In addition, he has been involved in development of the Undergraduate Psychiatric Curriculum. His achievements include development of (A) a somatic
inventory to identify psychiatric morbidity in the physically ill patienets and (B) a violence scale to estimate the prevalence and the degree of violence among
the medical health professionals. He has authored 35 publications and is recepient of numerous research and academic awards.
Abstract:
Statement of the Problem: A considerable number of patients attending the primary health clinics suffer from co-morbid
psychiatric disorders.
Objectives: To estimate the prevalence of the comorbidity between common mental disorders (anxiety/depression/
somatization) and common chronic physical illnesses among primary health care attendees, and explore the relationship of
comorbidity with type of illness and socio-demographic characteristics.
Method: The Physical Health Questionnaires (PHQ-SADs) were administered to a randomized sample of 1046 primary
clinic attendees in all the five governorates of the country over a 5-month period. Physical diagnoses were ascertained by the
attending physicians based on ICD-10 criteria.
Results: Of 1046 respondents, 442 (42.25%) had at least one mental disorder, while 670 (64.1%) had a physical illness
diagnosis, viz: diabetes mellitus (37.01%), hypertension (34.18%), heart diseases (7.2%) and non-chronic physical illnesses
(9.4%). Physical comorbidity was significantly associated with older age, divorce, illiteracy, and poorer living conditions. Just
over one third 34.4% (360 out of 1046) of the patients had physical-mental comorbidity. 53.7% (360 out of 670) of those with
physical illness had mental comorbidity while 21.8% (82 out of 376) of those without physical illness had at least one mental
disorder (OR=4.1, P<0.001). The commonest comorbid mental disorders were somatization and the simultaneous presence
of all 3 mental disorders. There was an increase in the prevalence of mental disorders with increase in the number of physical
illnesses. Similarly, the severity of mental illnesses (higher psychopathology scores) was associated with the increasing number
of physical illneses. Subjects with heart diseases and asthma consistently had higher psychopathology scores.
Conclusion: The findings call for the primary care physicians to be sensitive to the psychosocial context of patients who
present primarily with physical conditions; more so for patients with multiple medical illnesses and social disadvantage.
- Primary Healthcare | Nursing | Mental Primary Healthcare Management | Dental Primary Care | Primary Womens Healthcare |Primary Healthcare Nursing | Primary Healthcare: Individualised Care | Primary Healthcare in Psychology
Location: PLAZA I
Chair
Muhammad Ajmal Zahid
Professor of Psychiatry, Faculty of Medicine, Kuwait University.
Co-Chair
Walter Eichendorf
Deputy Director General of the German Social Accident Insurance (DGUV) and Director of DGUV’s prevention division
Session Introduction
Walter Eichendorf
deputy director general of the German Social Accident Insurance (DGUV) and director of DGUV’s prevention division
Title: Vision Zero: A worldwide strategy
Biography:
Dr Walter Eichendorf studied physics and mathematics. He was the head of statistical department from 1983, director of public relations from 1989, deputy director
general since 1998. Since 2007, Eichendorf is deputy director general of the German Social Accident Insurance (DGUV) and director of DGUV’s prevention division.
In addition he is President of the German Road Safety Council (DVR). In the International Social Security Association (ISSA) Eichendorf is Vice President of both
the Research Section and the Prevention Culture Section.
Abstract:
Vision Zero is the vision of a world without occupational accidents and work-related diseases. Its highest priority is to
prevent fatal and serious work accidents and occupational diseases. Vision Zero is the goal of a comprehensive culture
of prevention. The German Road Safety Council and the German Social Accident Insurance (DGUV) firmly embedded the
goal of shaping working and living environments in such a way in their prevention strategy that nobody is killed or so severely
injured or ill for work reasons that they suffer permanent damage. However, in order for Vision Zero to become a reality one
day, prevention must always be realigned to this goal. This broad and networked approach requires everyone in society to get
involved.The basic maxims are: Life is not negotiable; people make mistakes; tolerance limits are the physical load limits of
humans and people have a basic right to a safe working environment. If life is not negotiable and people make mistakes, then
it is ethically unacceptable to pay for a mistake with a loss of life or a serious injury. Vision Zero is a strategic, comprehensive
and qualitative approach where objectives are formulated and agreed upon; which is geared towards risks and hazards and;
which takes into consideration all the circumstances behind accidents at work and on the road, occupational diseases and
work-related health hazards. The goal of zero accidents might seem difficult, but it is the only ethically correct goal that we
must work on in the future. Vision Zero provides a strategy to achieve this. Under Vision Zero, safety and health at work are
values that companies, organizations and society appreciate and strive for.
Shirley Gutkowski
CEO and Primary Practitioner at Primal Air, LLC, USA
Title: Improving breathing with a novel use of Xylitol
Biography:
Shirley Gutkowski, RDH, BSDH practiced Clinical Dental Hygienist from 1986 to 2003 when she focused her energy on product research, writing and speaking. She
is the 2008 Alumna of the Year Marquette University School of Health Science in Dental Hygiene, a recipient of the Leadership Award from the World Congress of
Minimally Invasive Dentistry, and 2006 – 2007 President of the Wisconsin Dental Hygienists’ Association. Her podcast Cross Link Presentations highlights notables
such as Patrick McGowan (author of The Oxygen Advantage and premier Buteyko instructor), Dr. Kevin Boyd (Darwinian Dentist), Gill Rapley (author of Baby Led
Weaning), Dr. Allison Hazelbaker, Dr. Mike Nelson (metabolic flexibility) and others. As the science continues to point to correlations between oral and systemic
health, the function of the nasal airway is also under scrutiny. She has published extensively on these topics. She is a featured speaker on the upcoming The
Functional Oral Health Summit.
Abstract:
Epigenetic changes in the shape of the face have modified the airway leading to changes in breathing, like mouth breathing.
Mouth breathing in children has consequences leading to decreased nasal volume and dental malocclusions. Allergy
profiles have also increased over the last century topping 15 million Americans today improving the odds for mouth breathing
and its consequences. Allergy symptoms often include a sinus component that may be relieved, reduced, or eliminated using
a saline nasal spray complimented by xylitol. The mechanism of action, recommended usage, and safety profile of this novel
functional ingredient are discussed.
Yayehyirad Yemane Adinew
Lecturer at the Department of Midwifery College of Health Sciences, Mizan-Tepi University
Title: Assessment of the associated factors, management and complications of uterine rupture at mizan-tepi university teaching hospital, mizan-aman town, bench-maji zone, snnprs, south west ethiopia, 2016/17. A case control study
Biography:
Yayehyirad Yemane has completed his primary and secondary education in Jijiga town, Ethiopia. He has completed his Bachelor of Science in Midwifery from
University of Gondar, Ethiopia in July 12 -2012, and then started working as Head of the Department in Department of Midwifery College of Health Sciences,
Mizan-Tepi University for one year. Then, he joined his Master’s education at Mekelle University in September 2-2013. He graduated from Mekelle University with
the specialty of Master’s in Clinical Midwifery in February-03-2016. Currently, he is working as Lecturer at the Department of Midwifery College of Health Sciences,
Mizan-Tepi University.
Abstract:
Background: Uterine rupture is tearing of the uterine wall during labor or delivery and rupture of a previously or already
unscarred uterus is more often than not a catastrophic event resulting in death of the baby, extensive damage to the uterus and
sometimes even maternal death from blood loss. The overall incidence of uterine rupture is 1 in 2,000 deliveries. In developing
countries, uterine rupture is more prevalent or common and is a serious or common problem.
Objective: To assess the associated factors, management and complications of uterine rupture in Mizan-Tepi University
Teaching Hospital, Mizan-Aman town, Bench-Maji Zone, SNNPRS, south west Ethiopia, 2016/17.
Methodology: A hospital based unmatched multi-factorial case-control study/consider was employed from 1st October - 30th
October 2016. The required sample size gave us a total of 352 delivery charts by considering case to control ratio of 1:4 of
these 71 were delivery charts with uterine rupture and 281 were delivery charts without uterine rupture which were selected
by using lottery method. Data was retrieved using pre-tested and structured data extraction format from operation notes,
delivery registers and patients cards documented from 2013-2015 G.C. Using SPSS version 20 software, descriptive statistics,
bivariate and multivariate logistic regression analysis was done and p-value <0.2 and <0.05 were considered as significant
during bivariate and multivariate logistic regression analysis respectively. AOR with 95% CI was used to control for possible
confounders and to interpret the results.
Result: From 1st January 2013 up to 31st December 2015 there were a total of 9878 deliveries from these 71 cases of uterine
rupture were recorded giving an incidence of 1 in 139 deliveries. Predisposing factors for uterine rupture were no antenatal care
(AOR 4.08 95% CI 1.924-8.651), labor duration > 18 hrs (OR 2.769; 95% CI 1.231-6.226), parity ≥ 5 (AOR 6.16; 95% CI 2.886-
13.148), having obstructed labor (AOR 2.714 95%; CI 1.228-5.720), no use of partograph (AOR 2.248, 95% CI 1.049-4.817).
There were 7 maternal deaths due to uterine rupture during the study period giving a mortality rate of ~ 0.07%.
Conclusion: Uterine rupture still remains one of the major causes of maternal and newborn morbidity and mortality. The
prenatal mortality for both case and controls is high in Mizan-Tepi University Teaching Hospital.
Biography:
Ermias Sahale finished MSc in clinical midwifery and working as Lecturer at Mizan-tepi university, Ethiopia.
Abstract:
Introduction: Labor pain is the most severe pain that a woman ever has to face. Pain relief in childbirth is subject to many
social and cultural modifiers, which continue to change. Delivery of the infant into the arms of a conscious and pain-free
mother is the most exciting and rewarding moment in maternal care services. Developed nation give emphasis on continuous
labor support, but in developing country pain is neglected especially managing labor pain. In a country like Ethiopia with low
institutional delivery managing labor pain can help as an incentive to enhance institutional delivery rate.
Objective: The main purpose of this study is to assess practice of labor pain management methods and associated factors
among skilled attendants in all Tigray region general hospitals.
Method: Institutional based cross sectional study design was carried out at all general hospitals in Tigray regional state from
October 01-30, 2016. All skilled attendants who were working at labor ward were included in the study. Data was collected by
interviewer-administered, pretested and structured questionnaire. The data were entered by Epi- info version 7 then analyzed
using SPSS for windows version 20. Descriptive analysis was done and logistic regression analyses were also used to see
the association of dependent and independent variables. Finally odds ratio and 95% confidence interval were computed to
determine the strength of association.
Result: This study found out that the practice of labor pain management methods was 43.3%, which is only non-pharmacologic
methods and practice of pharmacologic method was nil. Multivariate logistic regression showed professionals positive attitude
for labor pain management [AOR=2.242, 95% CI=(1.242-4.048)] and high level qualification [(AOR=2.876, 95% CI=(1.29-6.39)]
were statistically associated with practice of labor pain management methods.
Conclusion & Recommendation: This study revealed poor practice of labor pain management methods. Positive attitude and
highest qualification found to be significant predictor of practice of labor pain management methods. So there is a need to
build attitude and knowledge of skilled attendants towards good practice of labor pain management and further studies should
be done from mother satisfaction point of view.
Larry Lumor Gotah
Head of Department of the St. Karols School of Nursing in Ghana
Title: Perceptions of male infertility among men in the Accra metropolis, Ghana
Biography:
Larry Lumor Gotah has completed his Mphil Nursing degree at the University of Ghana Legon and has 12 years of Nursing experience. He is the current Head of
Department of the St. Karols School of Nursing in Ghana. He has made his first oral presentation at the first MDS LANCET student conference and yet to publish
a paper on his Master’s thesis.
Abstract:
The concept of male infertility appears to be shrouded in secrecy. This study explored the perceptions of male infertility
among men in the Accra metropolis. The Common Sense Model of illness representation (CSM) was used as an organizing
framework. Purposive sampling was used to recruit 14 men. The men were interviewed for 30 to 45 minutes. All interviews
were audio- taped and transcribed verbatim and thematic content analysis was conducted. Four main themes emerged from
the data (illness representation, coping, health outcomes and unmet needs of men with infertility). Out of these, three themes
were consistent with the CSM while one new theme emerged from content analysis. Findings revealed, men with infertility are
perceived to experience stigmatization, divorce and financial crisis with infertility treatment. The men perceived that Ghanaian
men are pressured to marry and produce children. Failure to conform to the society’s expectation was perceived to result in
stigmatization and in some instances, infertile men are perceived to commit suicide if they fail to respond to this obligation.
Men with infertility are also perceived to engage in risky habits like alcoholism and multiple sexual partners as strategies to cope
with infertility. Child adoption as an option for coping with male infertility is perceived to be a stigmatized concept in Ghana.
Poor health outcomes such as hypertension and madness are beliefs associated with male infertility. In conclusion, nurses need
to understand the perceptions the society hold about men with infertility and pay attention to how these perceptions influence
health service accessibility.
Addisu Alehegn Alemu
Lecturer in Mizan Tepi university, Ethiopia
Title: Magnitude and associated factors of primary cesarean section among mothers who gave birth between September and August, 2016 G.C in Suhul general hospital, Tigray, Ethiopia
Biography:
Addisu Alehegn Alemu has completed his Msc from Mekelle University College of Medicine and Health Sciences. He is a Researcher and Lecturer in Mizan Tepi
university, Ethiopia. He has published more than 3 papers in reputed journals
Abstract:
Background: Cesarean section is a lifesaving medical intervention. Its share in decreasing maternal mortality and morbidity
rates are immense, it is also an indicator of maternal health services quality of a country. However it is associated with many
complications compared with vaginal deliveries. The rising rate of CS is a global concern and it ranges between 12 and 86% in
developed and middle-income countries and between 2 and 39% in developing countries. Unjustified prior caesarean section
and decreasing trial of labor after caesarean section are among the reasons for its increment. A woman after a primary cesarean
has only 10% chance of a vaginal birth for sub sequent deliveries. In Ethiopia rate of caesarean section is increasing ranging
from 8 to 37% in the urbanized region. However, rate and factors leading to primary caesarian section are not addressed well.
Objectives: To asses magnitude and associated factors of primary cesarean section among mothers who gave birth between
September and August 2008 E C in Suhul general hospital, Tigray, Ethiopia.
Methodology: Retrospective cross sectional study from September 19 to October 20, 2009 E C(Ethiopian calendar)was
conducted in Suhul general Hospital. The data entered into EPI-Info version 7 and exported to SPSS version 20 for cleaning,
editing and analyzing. Logistic (bi-variable and multi-variables) logistic regressions were used to examine associations between
outcome and independent variables.
Result: The rate of primary CS in this study was 20.2%.Fetal distress 26 (32.2%), cephalopelvic disproportion 15 (17.3%).
Mothers who had been augmented were 3.14 times more likely to undergone primary CS than who hadn’t been AOR(95%CI)=
3.14(1.497,6.571) and mothers who had pregnancy induced hypertension were 3.10 times more likely to undergone primary
CS than those who hadn’t AOR, 95%CI =3.10(1.230,7.829).
Conclusion & Recommendation: The magnitude of primary cesarean section in this study is high. Gestational age and
augmentations, pregnancy induced hypertension and birth weights were associated factors. Objective decision for nonreassuring
fetal heart beat pattern should be practiced to reduce the magnitude of primary caesarean section
Cris Renata Grou Volpe
Teacher at the University of Brasilia -UNB, Master of Health Sciences University of Sao Paulo
Title: Nursing diagnoses associated of depression indices and capacity mental in elderly people in a geriatric ambulatory clinic of Brazil
Biography:
Cris Renata Grou Volpe is currently working as a Teacher at the University of Brasilia -UNB, Master of Health Sciences University of Sao Paulo. She has completed
her PhD in Nursing at the Graduate Nursing Program (UNB). She has experience in nursing, with emphasis on fundamental nursing, medical and gerontology
acting on the following topics: nursing in adult health and elderly, medicine, nursing in public health, semiotics and nursing process.
Abstract:
The present study aimed to identify the most prevalent nursing diagnoses in elderly patients in a geriatric outpatient clinic in
the Federal district, Brazil, according to NANDA Taxonomy II relating them to the depression and mental scales. This is a
descriptive, observational study of 40 elderly people over 65 years attended at the geriatric clinic. Data collection took place in
March 2010 for 60 days. The scales of EDG and MEEM were used. The Pearson's chi-square was used for associations and the
significance level of p<0.05. The Geriatric Depression Scale (EDG) and the Mental State Mini Exam (MMSE) were used. This
study was approved by the Ethics Committee of the Health Department of the Federal District. The most prevalent nursing
diagnoses were: Disturbed sensory perception; decreased cardiac output; impaired dentition; impaired memory; risk of falls
and insomnia. The indexes of depressive symptoms by EDG were 35% and the cognitive alterations by the MEEM were 60%.
There is a significant association between social isolation, risk of loneliness, chronic sadness and hopelessness in relation to
the depression indexes demonstrated by the scale. SDs significantly associated with cognitive impairment by MMSE were poor
knowledge and impaired memory. Older people tend to have cognitive deficits and depressive symptoms, especially older ones,
and dependence on how much wings activities of daily living. The most prevalent related factor with impaired memory was
excessive environmental changes and poor cognition was cognitive.
Miho Tonai
professor from Nursing Assessment Division, Department of Basic Nursing, Oita university of Nursing and Health Sciences, Japan
Title: Perceptions of nursing students and nurses assessed using an eye movement observation device
Biography:
Miho Tonai is working as professor from Nursing Assessment Division, Department of Basic Nursing, Oita university of Nursing and Health Sciences, Japan
Abstract:
Aim: The present study aimed to determine the ways to improve observation and assessment abilities during basic nursing
education by defining differences in the perceptions of symptoms and subsequent actions between nursing students and nurses
at the bedside.
Methods: Ten junior and 10 senior students at a nursing school and nine qualified nurses wore a device that tracks eye
movement. The nurses and students assessed symptoms in a simulation of a patient complaining of fatigue and perspiration in
a mock hospital room. They were then questioned about what they perceived as the most important issue and how they would
deal with it.
Analysis: The main areas observed included the face, a drip injection device, the bed surroundings, the feet and the areas of the
body that were perspiring. The ratio of the amount of time taken to assess each item to the total duration of observation was
calculated. Responses to the questions were classified as observations, impressions, hypotheses, verification and judgments.
Results: Among the participants, 43.9%, 50.9% and 57.6% of junior and senior nursing students and qualified nurses,
respectively, spent most of the time observing the face. Significantly more nurses than students observed the feet, whereas
significantly more junior students spent time observing other areas (p=0.02). The answers to the questions indicated that other
than the face, most participants in all groups paid more attention to other areas. Significantly more qualified nurses than junior
students included responses classified as judgments (p=0.01), and the nurses reached conclusions based on their observations.
Discussion: The objectives of the visual assessment of the patient was not clear to the nursing students, whereas the qualified
nurses considered various possible causes of the symptoms, actively observed them, consistently judged the level of urgency
and prioritized the need for assistance.
Naoko Arakawa
Assistant Professor at the College of Life and Health Sciences at Chubu University.
Title: Validity and usability of templates for a tablet-type database system created for community health nurses in Thailand
Biography:
Naoko Arakawa is a Registered Nurse and a Public Health Nurse who currently works as an Assistant Professor at the College of Life and Health Sciences at Chubu
University. She is also pursuing her PhD on Fundamentals and Clinical Nursing at the Nagoya University Graduate School of Medicine. The research theme of
her Doctoral thesis is to promote work efficiency and effective use of data by developing a database system for community health nurses in developing countries.
She has acquired a Grant-in-Aid for Young Scientists from the Japanese government for her work on the research theme. She is interested in Nursing Informatics,
particularly practical work using the Nursing minimum data set and the development of database systems.
Abstract:
Background: Community Health Nurses (CHNs) in Thailand are the key players in the health promotion and follow-up for
rural residents with chronic diseases. Our previous study showed there were major six target groups: diabetes, hypertension,
stroke, maternity, neonate and tuberculosis among them. However, because CHNs were recording residents’ information using
paper-based formats, they could not well utilize data collected from the residents.
Purpose: The purpose of the study is to develop an easy to use database system that could directly input data from residents
using a tablet device and examine its validity and usability.
Methods: Through five rounds of reciprocal development processes with CHNs who worked at a health-promoting hospital
in rural Northern-east Thailand, we revised designs, structures and data-entry format of a tablet-type database system for the
six target groups. In the final study, we asked four CHNs to use our system in their daily activities for five months to evaluate
the usability.
Results: Four CHNs who participated in this trial, collected data from 101 patients. Most of the data were collected from
diabetes patients (n=64) and 65% had suffered nerve damage in the peripheral nervous system. CHNs provided education to
patients on diet (94%), exercise (91%), curative medicine (78%), self-control (45%), sleep (42%) and stress management (35%).
CHNs could notice the detailed statistical trends for the first time, whereas previously they had just impressions through their
activities.
Conclusion: Our system can provide better information easily that could show the attributes of residents with chronic disease.
Further, it would help to describe the daily community health activities, which were not described before this system was used.
We also expect this system to help CHNs’ decision making to improve quality of community health.
Natsuki Nakayama
Associate Professor in the Nagoya University Graduate School of Medicine.
Title: Daily activity improves heart rate variability and sleep quality in patients with mild hypertension and/or stable angina pectoris
Biography:
Natsuki Nakayama has graduated from Nagoya University, Nagoya Japan. She is a registered Nurse, who currently works as an Associate Professor in the Nagoya
University Graduate School of Medicine. Her research interest includes preventions of diseases such as cardiovascular disease, gastrointestinal motility and
autonomic nervous activity.
Abstract:
Some studies have evaluated that sleep and physical activity are involved in cardiovascular prognosis. The objective of
this study was to evaluate the potential role of daily activity in heart rate variability (HRV) at sleep periods and clarify
relationships between daily activities and sympathovagal balance. We conducted this study as a nonrandomized, prospective,
six-month study in 42 patients with hypertension and/or stable angina pectoris. Daily activity was measured by the active
meter and HRV was evaluated by the Holter 24-hour ambulatory electrocardiogram at the start of the study (BASE) and after
6 months (6MoA). Heart rate, HRV parameters, such as low-frequency (LF), high-frequency (HF) and LF/HF ratio were
calculated 1 hour (1After), 3 hours after sleep onset (3After) and 1 hour before awaking (1Awake). The active mass at 6MoA
increased in 26 patients (active group), while it decreased in 16 patients (inactive group). LF/HF ratio of 1Awake was higher the
inactive group than active group at BASE. LF/HF ratio during sleep, 1After, 3After and 1Awake in inactive group were higher
than active group at 6MoA. LF and HF were significantly increased at 1Awake in active group from BASE to 6MoA. There
was significant increase in HF at 3After in active group, and in LF/HF ratio at 1After in inactive group. There was significant
increase in LF at 1Awake in inactive group. The decrease in active mass changed HRV outcomes with increased LF/HF ratio at
all sleep periods. These findings suggest that the increase of daily activity improves sleep quality.
Sachiko Deguchi
currently she is teaching at Kitasato University.
Title: Status and issues of Japanese psychiatric hospitals; Based on the hearing from nursing directors
Biography:
Sachiko Deguchi has her expertise in Mental Health and Psychiatric Nursing. She has completed her PhD in Psychiatric Nursing and currently she is teaching at
Kitasato University. For the past 20 years, she has conducted the hearing on the Japanese people concerning their war-time experiences on how their experiences
affected their lives after the war. Now she and her colleague are working research activities to form the effective support system for nursing staff of continuing
education of psychiatric hospitals.
Abstract:
In Japan, over 90% of the psychiatric hospitals are private hospitals where there are long stayed patients and have problems of
social hospitalization and revolving door etc. The psychiatric nursing staff has various educational background and many of
them are mid- career recruited workers and the employee turn-over rate is higher than general practice nurses. So the directors
of nursing have been facing difficulties of career education. To clarify the difficulty of continuous learning, the needs of nurses,
learning and to give some suggestions on the continuing education, we interviewed five directors of nursing service department
at five different private psychiatric hospitals. As a result, we have found out they understand that the base of nursing care’s
quality depends on the continuing education supported by staff. So, they have been working together with the back office on a
trial -and –error bases. They are looking for the way to succeed in continuing education, while experiencing difficulties. On the
other hand, due to the various social backgrounds of nursing staff at private psychiatric hospitals, there is the limit to conduct
conventional top-down education. They should rather have the bottom –up type learning-support programs. Moreover, it was
suggested that it is important to support the directors of nursing as well as to maintain effective tie -up between the specialists.
Kefyalew D Gizachew
Lecturer in Debre Berhan University, Ethiopia
Title: Prevalence and associated factors of common mental disorders among pregnant women in Debre Birhan Town, North Showa Zone, Amhara region, Ethiopia, 2014
Biography:
Kefyalew D Gizachew has his expertise in evaluation and treatment in improving the mental health wellbeing. He serves as a Lecturer in Debre Berhan University,
Ethiopia since October, 2015. He previously worked as a Midwife in primary health care settings and in Debre Berhan Referral Hospital, Ethiopia. He served as a
Mental Health Professional Specialist in Debre Berhan Referal Hospital.
Abstract:
Introduction: In low- and lower-middle income countries about one in six pregnant women are experiencing antenatal
common mental disorders (CMD).
Objective: To assess prevalence and associated factors of common mental disorders among pregnant women in Debrebirhan
Town, North Showa Zone, Amhara region, Ethiopia, 2014.
Methods: Community based cross-sectional study was employed among 569 study subjects. Data was collected using faceto-
face interviews with Amharic version of Self Reporting Questionnaire (SRQ-20) from seven selected kebeles. Kebeles
were selected by simple random sampling and individuals were selected using cluster sampling. Crude Odds Ratio (COR)
and adjusted Odds Ratio (AOR) was analyzed using bivariate and multivariable logistic regression analysis and the level of
significance for association was determined with 95% CI and at P- value < 0.05.
Result: A total 557 study participants were completed the interview and the prevalence of antenatal common mental disorder
was found to be 45.2%. Loss of loved one (AOR=1.97; 95% CI: 1.19-3.27), history of chronic medical illness (AOR=6.57; 95%
CI: 2.17-19.94), Unwanted pregnancy (AOR=2.13; 95% CI: 1.15-3.95), nulliparity (AOR=8.71; 95% CI: 1.58-47.94), one or less
ANC consultations (AOR=0.22; 95% CI: 0.08-0.64), two-three ANC consultations (AOR=0.30; 95% CI: 0.11-0.83) and current
obstetric complications (AOR=4.45; 95% CI: 2.21-8.99) were important factors significantly associated with antenatal common
mental disorder.
Conclusion: The prevalence of antenatal common mental disorder (CMD) was high in this study that shows antenatal CMD
is significant public health issue that requires a great emphasis. So, early screening and intervention for antenatal CMD should
be integrated in primary health care and antenatal care service settings.