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      Patient satisfaction with nursing care in Ethiopia: a systematic review and meta-analysis

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          Abstract

          Background

          Patient satisfaction with nursing care has been considered as the most important predictor of the overall patient satisfaction with hospital service and quality of health care service at large. However, the national level of patient satisfaction with nursing care remains unknown in Ethiopia. Hence, the objective of this systematic review and meta-analysis was to estimate the level of patient satisfaction with nursing care and its associated factors in Ethiopia.

          Methods

          Studies were accessed through an electronic web-based search strategy from PubMed, Cochrane Library, Google Scholar, Embase, PsycINFO, and CINAHL by using a combination of search terms. The quality of each included article was assessed using a modified version of the Newcastle-Ottawa Scale for cross-sectional studies. All statistical analyses were done using STATA version 14 software for windows, and meta-analysis was carried out using a random-effects method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed for reporting results.

          Results

          Of 1166 records screened, 15 studies with 6091 patients fulfilled the inclusion criteria and were included in the meta-analysis. The estimated pooled level of patient satisfaction with nursing care in Ethiopia was 55.15% (95% CI (47.35, 62.95)). Patients who have one nurse in charge (OR: 1.08, 95% CI: 0.45–2.62, I 2: 77.7%), with no history of previous hospitalization (OR: 1.37, 95% CI: 0.82–2.31, I 2: 91.3%), living in the urban area (OR: 1.07, 95% CI: 0.70–1.65, I 2: 62.2%), and those who have no comorbid disease (OR: 1.08, 95% CI: 0.48–2.39, I 2: 91.9%) were more likely to be satisfied with nursing care compared with their counterparts although it was not statistically significant.

          Conclusion

          About one in two patients were not satisfied with the nursing care provided in Ethiopia and may be attributed to several factors. Therefore, the Ministry of Health should give more emphasis to the quality of nursing care in order to increase patient satisfaction and improve the overall quality of healthcare service in Ethiopia.

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          Most cited references39

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          Meta-analysis of probiotics for the prevention of antibiotic associated diarrhea and the treatment of Clostridium difficile disease.

          Antibiotic-associated diarrhea (AAD) is a common complication of most antibiotics and Clostridium difficile disease (CDD), which also is incited by antibiotics, is a leading cause of nosocomial outbreaks of diarrhea and colitis. The use of probiotics for these two related diseases remains controversial. To compare the efficacy of probiotics for the prevention of AAD and the treatment of CDD based on the published randomized, controlled clinical trials. PubMed, Medline, Google Scholar, NIH registry of clinical trials, metaRegister, and Cochrane Central Register of Controlled Trials were searched from 1977 to 2005, unrestricted by language. Secondary searches of reference lists, authors, reviews, commentaries, associated diseases, books, and meeting abstracts. Trials were included in which specific probiotics given to either prevent or treat the diseases of interest. Trials were required to be randomized, controlled, blinded efficacy trials in humans published in peer-reviewed journals. Trials that were excluded were pre-clinical, safety, Phase 1 studies in volunteers, reviews, duplicate reports, trials of unspecified probiotics, trials of prebiotics, not the disease being studied, or inconsistent outcome measures. Thirty-one of 180 screened studies (totally 3,164 subjects) met the inclusion and exclusion criteria. One reviewer identified studies and abstracted data on sample size, population characteristics, treatments, and outcomes. From 25 randomized controlled trials (RCTs), probiotics significantly reduced the relative risk of AAD (RR = 0.43, 95% CI 0.31, 0.58, p < 0.001). From six randomized trials, probiotics had significant efficacy for CDD (RR = 0.59, 95% CI 0.41, 0.85, p = 0.005). A variety of different types of probiotics show promise as effective therapies for these two diseases. Using meta-analyses, three types of probiotics (Saccharomyces boulardii, Lactobacillus rhamnosus GG, and probiotic mixtures) significantly reduced the development of antibiotic-associated diarrhea. Only S. boulardii was effective for CDD.
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            The measurement of patient satisfaction.

            Many applied health service researchers launch into patient satisfaction surveys without realizing the complexity of the task. This paper identifies the difficulties involved in executing patient satisfaction surveys. The recent revival of interest in 'satisfaction' and disagreements over the meaningfulness of a unitary concept itself are outlined, and the various perspectives and definitions of the components of satisfaction are explored. The difficulties of developing a comprehensive conceptual model are considered, and the issues involved in designing patient satisfaction surveys--and the disasters that occur when these issues are ignored--are then set out. The potential cost-effectiveness of qualitative techniques is discussed, and the paper concludes by discussing how health care management systems could more effectively absorb the findings of patient satisfaction surveys.
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              The effect of health facility delivery on neonatal mortality: systematic review and meta-analysis

              Background Though promising progress has been made towards achieving the Millennium Development Goal four through substantial reduction in under-five mortality, the decline in neonatal mortality remains stagnant, mainly in the middle and low-income countries. As an option, health facility delivery is assumed to reduce this problem significantly. However, the existing evidences show contradicting conclusions about this fact, particularly in areas where enabling environments are constraint. Thus, this review was conducted with the aim of determining the pooled effect of health facility delivery on neonatal mortality. Methods The reviewed studies were accessed through electronic web-based search strategy from PUBMED, Cochrane Library and Advanced Google Scholar by using combination key terms. The analysis was done by using STATA-11. I2 test statistic was used to assess heterogeneity. Funnel plot, Begg’s test and Egger’s test were used to check for publication bias. Pooled effect size was determined in the form of relative risk in the random-effects model using DerSimonian and Laird's estimator. Results A total of 2,216 studies conducted on the review topic were identified. During screening, 37 studies found to be relevant for data abstraction. From these, only 19 studies fulfilled the preset criteria and included in the analysis. In 10 of the 19 studies included in the analysis, facility delivery had significant association with neonatal mortality; while in 9 studies the association was not significant. Based on the random effects model, the final pooled effect size in the form of relative risk was 0.71 (95% CI: 0.54, 0.87) for health facility delivery as compared to home delivery. Conclusion Health facility delivery is found to reduce the risk of neonatal mortality by 29% in low and middle income countries. Expansion of health facilities, fulfilling the enabling environments and promoting their utilization during childbirth are essential in areas where home delivery is a common practice.
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                Author and article information

                Contributors
                mulugetahenok68@gmail.com
                fasilw.n@gmail.com
                ayalew.d16@gmail.com
                henok22@ymail.com
                tesfadej2003@gmail.com
                Journal
                BMC Nurs
                BMC Nurs
                BMC Nursing
                BioMed Central (London )
                1472-6955
                8 July 2019
                8 July 2019
                2019
                : 18
                : 27
                Affiliations
                [1 ]GRID grid.449044.9, Lecturer of Nursing, Department of Nursing, , College of Health Science, Debre Markos University, ; P.O. Box 269, Debre Markos, Ethiopia
                [2 ]ISNI 0000 0004 0439 5951, GRID grid.442845.b, Lecturer of Nursing, Department of Nursing, School of Health Science, , College of Medicine and Health Science, Bahir Dar University, ; P.O. Box 79, Bahir Dar, Ethiopia
                [3 ]ISNI 0000 0000 8539 4635, GRID grid.59547.3a, Lecturer of Nursing, Department of Nursing, College of Health Science, , University of Gondar, ; P.O. Box 196, Gondar, Ethiopia
                [4 ]ISNI 0000 0000 9558 4598, GRID grid.4494.d, Department of Epidemiology, University of Groningen, University Medical Center Groningen, ; Groningen, the Netherlands
                Author information
                http://orcid.org/0000-0001-7330-3609
                Article
                348
                10.1186/s12912-019-0348-9
                6615179
                31320836
                4b1dbd7f-b8f8-4d16-addc-a4278f2ce5f7
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 July 2018
                : 16 June 2019
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2019

                Nursing
                nursing care,patient satisfaction,systematic review,meta-analysis,ethiopia
                Nursing
                nursing care, patient satisfaction, systematic review, meta-analysis, ethiopia

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