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Shift work sleep disorder is a circadian rhythm sleep-wake disorder characterised by insomnia and/or excessive sleepiness associated with a shift work schedule that overlaps with habitual sleep time. This study aimed to assess the prevalence of shift work sleep disorders and associated factors among healthcare professionals working at Jimma University Medical Center, Southwest Ethiopia.
Institutional-based cross-sectional study.
Tertiary hospital in Southwest Ethiopia.
The data were collected using a self-administered questionnaire from health professionals recruited using a simple random sampling technique.
Shift work-sleep disorder was assessed by the International Classification of Sleep Disorders, the Insomnia Severity Index and/or the Epworth Sleepiness Scale. A logistic regression analysis was conducted to determine the association between the predictor and the outcome variable. The ORs and 95% CIs were determined. Variables with a p value
370 participants were involved in the study, yielding a response rate of 97.6%. The prevalence of shift work sleep disorder was 35.9% (n=133). Working in three shifts (Adjusted OR (AOR) 3.25, 95% CI=1.92 to 5.57), more than 11-night shifts per month (AOR 2.83, 95% CI=1.49 to 5.37), absence of nap (AOR 2, 95% CI=1.14 to 3.52), stress (AOR 4.4, 95% CI=2.36 to 8.2), fatigue (AOR 2.7, 95% CI=1.26 to 3.73), alcohol (AOR 3.9, 95% CI=1.79 to 8.47) and khat (AOR 4.40, 95% CI=1.76 to 10.96) use in the last 3 months was significantly associated with shift work sleep disorder.
One in three healthcare professionals working at Jimma University Medical Center had a sleep disorder related to shift work. Working in three shifts per day, having more than 11-night shifts per month, lack of naps, presence of stress, fatigue and substance use were found to be associated with shift work sleep disorder.
by Mekuriaw Nibret Aweke, Muluken Chanie Agimas, Moges Tadesse Abebe, Tigabu Kidie Tesfie, Meron Asmamaw Alemayehu, Werkneh Melkie Tilahun, Gebrie Getu Alemu, Worku Necho Asferie
BackgroundMixed milk feeding is defined as providing formula and/or animal milk along with breast milk to infants under six months old which is prevalent in many countries. However, this practice is generally not recommended as it can reduce the intake of breast milk, depriving the infant of its optimal nutritional and immunological benefits. Unlike formula, breast milk contains complex bioactive constituents that promote intestinal and pancreatic growth and develop mucosal defenses. The aim of this study was to analyze the spatial distribution and predictors of MMF practices in Ethiopia.
MethodsThis study utilized data from the 2019 Mini-Ethiopian Demographic and Health Survey (MiniEDHS), a nationally representative cross-sectional survey conducted from March to June 2019. The total weighted sample size derived from the data examined in this study amounted to 524 infants. The data analysis used Global Moran’s I for spatial autocorrelation and the Getis-Ord Gi * statistic for local cluster analysis to assess the spatial distribution of mixed milk feeding prevalence across Ethiopia’s administrative regions and cities. Empirical Bayesian Kriging was used for spatial interpolation to estimate mixed milk feeding prevalence in unsampled areas. The analysis utilized a maximum spatial cluster size threshold of 50% of the population to detect clusters of varying sizes. Ordinary least squares regression analysis identified significant spatial predictors. In geographically weighted regression analysis, the effect of predictor variables on the spatial variation of mixed milk feeding was detected using local coefficients.
ResultsThe overall weighted prevalence of Mixed Milk Feeding (MMF) in Ethiopia was 10.12% (95% CI: 7.8, 13.01). This prevalence shows significant regional variations across the country emphasizing regional disparities in prevalence and distribution. The Global Moran’s I statistic was 0.14, with a Z-score of 3.18 and a p-value of Conclusion
The study found significant regional variations in mixed milk feeding practices in Ethiopia. Households with middle wealth index and baby without postnatal check were significant spatial predictors of mixed milk feeding. To reduce mixed milk feeding prevalence, targeted interventions should engage community leaders, enhance breastfeeding education in maternal health services, and integrate counseling into routine healthcare to support informed maternal choices and improve child health outcomes nationwide.
To explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting.
Understanding collaborative practice in diabetes care in developing countries helps to design and provide patient-centred and cost-effective care.
An exploratory qualitative study.
Interviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration.
Most participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking.
Perceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies.
The findings in this study inform development of tailored and patient-centred diabetes care in tertiary care settings in sub-Saharan Africa.
The study was reported in accordance with the COREQ checklist.
Patients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback.
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