Objective This study aims to assess the magnitude and associated factors of poor medication adherence among diabetic and hypertensive patients visiting public health facilities in Addis Ababa, Ethiopia during the COVID-19 pandemic. Methods A multi-site cross-sectional design was conducted from 1st through 30th of August 2020 at public health facilities of the study area. Adult outpatients with T2DM and hypertension visiting hospitals and health centers were included in the study. A proportion to size allocation method was used to determine the required sample size per facility. Data was collected using the 8-item Morisky medication adherence scale. Descriptive statistics and binary logistic regression were used to analyze data. A 95% confidence interval and p≤0.05 statistical significance was considered to determine factors associated with poor medication adherence. Results A total of 409 patients were included in the present study. About 57% of the patients reported that the COVID-19 pandemic has posed negative impacts on either of their follow-up visits, availability of medications, or affordability of prices. And, 21% have reported that they have been affected in all aspects. The overall magnitude of poor medication adherence was 72%. Patients with extreme poverty were more likely to have good medication adherence (AOR: 0.59; 95%C.I: 0.36–0.97), whereas attendance to a health center (AOR: 1.71; 95%C.I: 1.02–2.85), presence of comorbidity (AOR: 2.05; 95%C.I: 1.13–3.71), and current substance use history (AOR: 11.57; 95%C.I: 1.52–88.05) predicted high odds of poor adherence. Conclusion Over a three-fourth of the patients, in the study setting, have poor adherence to their anti-diabetic and antihypertensive medications. Health facility type, income level, comorbidity, and current substance use history showed a statistically significant association with poor adherence to medication. Stakeholders should set alternative strategies as perceived impacts of the COVID-19 pandemic on medication adherence are high in the study area.

Background Coronavirus disease 2019 (COVID-19) has resulted in unprecedented morbidity, mortality, and health system crisis leading to a significant psychological destress on healthcare workers (HCWs). The study aimed to determine the prevalence of symptoms of common mental disorders among HCWs during the COVID-19 pandemic at St. Paul's Hospital, Ethiopia. Methods A self-administered cross-sectional study was conducted to collect socio-demographic information and symptoms of mental disorders using validated measurement tools. Accordingly, PHQ-9, GAD-7, ISI, and IES-R were used to assess the presence of symptoms of depression, anxiety, insomnia, and distress, respectively. Chi-square test, non-parametric, and logistic regression analysis were used to detect risk factors for common mental disorders. Results A total of 420 healthcare workers participated in the survey. The prevalence of symptoms of depression, anxiety, insomnia, and psychological distress was 20.2%, 21.9%, 12.4%, and 15.5% respectively. Frontline HCWs had higher scores of mental health symptoms than non-frontline healthcare workers. Binary logistic regression analysis showed that being married was associated with a high level of depression. Furthermore, working in a frontline position was an independent risk factor associated with a high-level of symptoms of depression, anxiety, and psychological distress. Limitations It is a single-center cross-sectional study and the findings may not be nationally representative or reveal causality. Conclusions A significant proportion of healthcare workers are suffering from symptoms of mental disorders. Frontline HCWs were at a greater risk of severe symptoms. Therefore, psychological interventions should be implemented to support health professionals, especially frontline workers.

BACKGROUND፡ Discussing potentially bad outcomes is a standard communication task in clinical care. Physicians’ awareness on ways to communicate bad news is considered low. SPIKES protocol is the most popular strategy used by physicians, but its practice and patients' perception are not known. This study attempted to fill the knowledge gap on protocol implementation, patient preference and physician effects.METHODS: Hospital-based descriptive cross-sectional study was conducted at SPHMMC from May 1 to June 30 using structured interviews administered to patients and physicians. Three hundred and sixty patients and 111 physicians were included. Assessment of SPIKES performance, patient satisfaction, patient preference, and physician awareness, attitude and effects were studied.RESULTS: Performance of SPIKES protocol was setting (74.5%), perception (51.1%), invitation (56.3%), knowledge (15.9%), emotion (22.3%) and summary (10.1%). Only 30.6% of the patients were entirely satisfied with the interaction, and 19.2% with knowledge attained. Patient satisfaction was associated with physician asking how much information they like (P=0.025). Patient desire and report showed variation. Eighty-two percent of the physicians were not aware of the protocol, and 83.8% had no training. Half of the physicians feel depressed after disclosure.CONCLUSIONS: Patient satisfaction with communication process and knowledge is poor, as is performance of SPIKES components. Satisfaction is related to being asked how much patients want to know. Patients’ desires on how to be told news is different from how it is done. Breaking bad news increases feeling of depression. Awareness and training on the protocol are deficient; medical schools should incorporate it into their studies and implement proper follow-up.

BackgroundThe Coronavirus pandemic is presenting several challenges in Ethiopia on an unprecedented scale. It is affecting the country in different ways ranging from a significant impact on the economy to a disrupted public health delivery of both curative and preventive services. The aim of this study was to assess health related quality of life of patients with chronic non-communicable diseases during the Coronavirus pandemic in Addis Ababa, Ethiopia.MethodsA multi-facility based cross sectional study design was conducted in August 2020 among public health institutions in Addis Ababa. Health facilities were chosen purposively based on high number of patient flow. Participants from each health facility were drawn after proportional to size allocation. A translated EQ-5D-3L VAS instrument was used to collect data. Analysis was done using SPSS v.26.0. Descriptive statistics, Mann Whitney U test, Kruskal Wallis test, Spearman’s rank correlation test and Binary logistic regression were applied. ResultsOf the 409 participants included in the study, majority were in the age group of 46-60 (36%), females (56%), from hospitals (54.8%), jobless (25.4%), married (63.3%) and orthodox Christian (71.4%). Above two third of the patients reported no problems for self-care, usual activity and depression/anxiety. All dimensions showed an increasing proportion of moderate to severe problems in the age group beyond 45. Facility type (U=16651, P=0.001), comorbid condition (U=13248.00, P=0.000) and age (rs=-0.27, p=0.000) were found to show statistically significant score difference for GQoL. An overall prevalence of any problem was 59%. Education level, visit to a health center and marriage were associated with less odds of an affected HRQoL unlike lower monthly income and presence of comorbidities which were opposite.ConclusionsHRQoL of patients in the study settings was found to be suboptimal and below the general population. Education and arrangement of safe and quality health services to such group of patients is warranted especially during the COVID-19 pandemic.

Introduction:The learning environment is an important determinant of the quality of medical education. Having a good learning climate leads to improved learning process, satisfaction with education, and helps achieve the goals of the curriculum. Assessment of the quality of learning environment helps with the identification of areas that need improvement. The aim of this study was to assess the learning environment of internal medicine training program in Ethiopia. Methods: A mixed methods study using a cross-sectional survey using Postgraduate Hospital Educational Environment Measure and a qualitative study using a focus group discussion was done on internal medicine residents from December 2020 to May 2021. Comparison of quantitative data was done using Mann-Whitney U-Test and Kruskal-Wallis H-test. P-value <0.05 was considered statistically significant. Results: A total of 100 residents participated in the study. The overall total mean score of the responses of the participants was 70.87 (±19.8) with mean perceptions of role autonomy, perceptions of teaching and perceptions of social support of 25.9 (±7.1), 27.1 (10.2) and 17.9 (±5.1), respectively. These values suggest the presence of plenty of problems in the program. Higher mean scores were reported by males and by earlier years of residency. Ten residents participated in the focus group discussion. Four recurring themes that negatively affect learning environment were identified and included excessive workload, inadequate teaching activity, nonconducive hospital physical environment and lack of diagnostic and therapeutic modalities. Conclusion:The internal medicine residency learning environment has many challenges that need immediate attention and follow-up.