No abstract

Introduction: Patient satisfaction is an important and commonly used valid indicator for themeasurement of service quality. Patient responses to healthcare services are one of the bestways to obtain information about patient views regarding the quality of healthcare. The mainaim of the study was to find out the patient’s satisfaction level in the tertiary care center. Methods: A descriptive cross-sectional study was conducted among 94 outpatients at a tertiary carecenter. Data were collected after obtaining ethical clearance from the institutional review committee.Patients were selected conveniently who visited any four of the major department. We collecteddemographic data and the patient satisfaction towards outpatient clinic experience was studied. Weused the Patient Satisfaction Questionnaire–18 to assess patient satisfaction. Data were entered andanalyzed in Statistical Package for the Social Sciences version 23. The mean score and the standarddeviation were calculated. Results: Overall satisfaction was 74.78% with a mean value of 3.7394±0.40128. The highest satisfactionscore was found in regards to the interpersonal manner of health personnel (4.2872±0.61561) followedby communication (3.9628±0.40982) and the lowest was seen in accessibility and convenience(3.2394±0.81478). Conclusions: The mean score and percentage of patient satisfaction were high in the hospital.However, the accessibility and availability of medical personnel were only a matter of concern.

Background: Depression is a common public health problem among elders worldwide and is associated with high morbidity and disability. This study aims to assess depression and its associated factors among elderly in old-age homes and a community of Kathmandu district.Method: A comparative cross-sectional study recruited 122 elderly from old-age homes and a community of Kathmandu district. Depression was measured using the Geriatric Depression Scale-short scale (GDS-15). Socio-demographic and medical history was collected using semi-structured questionnaire. We utilized bivariate logistic regression to assess the association of depression with each variable. Results: The prevalence of depression among elderly in old-age homes was 74.6% and in community was 41.8%. The study found that elderly residing at old age homes were four (OR=4.087; 95% CI=2.373-7.038) times more likely to have depression than those residing in the community. Age was found to be associated with depression among the respondent of both settings. In old-age homes, not receiving old-age allowance, bad perception of life, bad social relation, having a chronic disease, lack of care from family, stress and weeping as stress coping strategy were associated with depression. In the community, stress, non-involvement in family decision making, feeling of neglect, dysfunctional capability, bad social relation, lesser monthly income had positive relation with depression.Conclusion: Depression is highly prevalent among Nepalese elderly, with higher burden in those living in old-age homes. This emphasizes the need for screening of depression among elderly, to initiate early intervention measures.

No abstract

Introduction: Postpartum Depression is an important public health problem in developing country like Nepal. Although prevalence of postpartum depression is high in our setting, it is most neglected area of mental health. These have negative consequences not only to mother but also to infant. Data related to postpartum depression in Nepal are limited, research in this particular field will contribute in knowing the gravity of the situation and helps to formulate the factor association to upcoming researchers. This research is done in order to find out the prevalence of postpartum depression. Methods: A descriptive cross-sectional study was carried out in Paropakar Maternity and Women’s Hospital, among total 348 postnatal mothers who were selected through convenient sampling technique. Validated Nepalese version of Edinburg Postnatal Depression Scale was used to screen depressive symptoms. Data was collected after receiving ethical approval letter. Data entry was done using SPSS version 20. Results: Out of total mothers, the prevalence of Postpartum Depression (PPD) was seen among 51 mothers (14.7%). Conclusions: Postpartum Depression being a common yet neglected area of maternal health in Nepal, should be detected in early stage. As, the study showed that about one sixth of mothers had postpartum depression, more focus should be given to maternal mental health.

Introduction:  For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme. Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables. Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981). Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.

Background: There seems to be huge differences in availability and utilization of Sexual and Reproductive Health information and services despite of taking decisive step by Government of Nepal. The main aim of the study is to access the utilization and factors associated with SRH services among adolescents.  Methods: This cross-sectional descriptive study was carried out among 406 adolescent students of grade 11 and 12 which were taken as census in selected higher secondary schools of Kathmandu District through simple random sampling technique. The utilization of SRH services was assessed by semi-structured validated and pretested questionnaire which includes socio-demographic, utilization of sexual health and reproductive health (SRH) services and sexual behaviours. Data were entered and analyzed in SPSS version 20 where Chi-square tests is done to identify the associated factors with utilization SRH services utilization.Results: Overall utilization in last 12 months was 17.2% and was found to be strongly associated with availability of services within 30 minutes of walking distance (p value=0.001), interaction with parents (p-value: 0.02) and with sexually being active within 12 months (p value=0.001). Utilization of SRH services was slightly higher among females (19.8%) compared to males (15.3%). Most utilized services were services related to menstrual problems and family planning including ECP. This study concludes that fear of family and society hinders the utilization of SRH services.Conclusions: As adolescent fear to talk and seek for the services, due to the social cultural norms and stigma attached to SRH services, utilization among adolescent of selected colleges in Kathmandu is low.

Introduction: Hypertension is now becoming an increasingly important cause of morbidity and mortality in developing countries which leads to a major public health problem. It is necessary for an assessment of an individual’s hypertension self-care behavior and its associated factors in order to provide clinicians about important information regarding how to better control hypertension. Thus, the objective of this study was to assess the self-care practices among hypertensive patients of all age group and to understand the factors associate with it. Methods: A community-based cross-sectional study was conducted in Tsum-Nubri Rural Municipality of Gorkha district among 68 hypertensive patients. Self-care activities were measured using a semi-structured questionnaire with the H-hypertension self-care activity level effects (H-SCALE) and the data was entered and analyzed in SPSS version 16. Uni-variate analysis was done and was presented through frequency and percentage whereas, bivariate analysis was by using chi-square test where P value <0.05 was considered to be association between dependent and independent variables Results: Adherence to the recommended levels of medication was reported to 25%; only 8.8% followed the physical activity level guidelines. None of the participants showed adherence to weight management and low- salt diet recommendation. 51.5% of them were adherence to non-smoking and alcohol abstinence. Marital status (0.005), education level (0.003) and monthly household income (0.003) were significantly associated with adherence to non-smoking. Also, body mass index (0.001) was significantly associated with the physical activity. Conclusions: Based on study findings, life style modification and regular monitoring must be considered in order to increase good self-care practice