Background Measuring patient satisfaction has become an important parameter of the continuous quality assessment and improvement in anaesthesia services. The aim of this study was to assess the level of patient satisfaction with perioperative anaesthesia care and to determine the factors that influence satisfaction. Method This study is an cross sectional design, conducted on 470 patients who underwent different types of surgeries at two National Referral Hospitals in Asmara, Eritrea between January and March of 2018. Patients were interviewed 24 h after the operation using a Tigrigna translated Leiden Perioperative Care Patient Satisfaction questionnaire (LPPSq). Descriptive and inferential analysis were made using SPSS (version 22). Statistical significance level was set at P < 0.05. Results The overall satisfaction score was 68.8%. Less fear and concern was observed among patients with satisfaction scores of 87.5%. Staff-patient relationship satisfaction score was 75%. Patients were least satisfied with information provision (45%). Multivariable analysis revealed that satisfaction of patients who did surgery at Halibet hospital is significantly higher (p < 0.001) than those patients who did at Orotta hospital. Moreover, those patients who did elective surgery had higher level of satisfaction that those who did emergency surgery (p < 0.001). Conclusion Moderate level of satisfaction was observed among the patients. Generally, the study emphasized that the information provision about anesthesia and surgery was low. Patients described better staff-patient relationship and low fear and concern related to anesthesia and surgery was observed.

Background. Postoperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the postoperative period. Method. A cross-sectional study design was applied on 470 patients who underwent different types of surgeries within a three-month period. Patients were interviewed 24 hours after operation (POD 1) using the Leiden Perioperative care Patient Satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered, and the measurements of that dimension are presented in this report. Items of the dimension were standardized and measured using a five-point Likert scale from “Not at all” to “Extremely.” Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Results. The prevalence were computed in two manners, prevalence of those with ‘at least a little bit’ outcomes, which was computed to see the total occurrence of these outcomes, and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, postoperative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6%, respectively. The rest of the postoperative undesirable outcomes were less frequently reported. Conclusion. Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed.

Background Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and reducing the need for medication. This study aimed to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals. Methods This was a descriptive cross sectional study conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses’ utilization of selected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVA were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were mostly used while, cognitive-behavioral (5.9%) and physical methods (5.8%) were hardly used. The results also showed that, characteristics such as, age (p = 0.013), level of education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals were the only determinants of the non-pharmacological methods at multivariable level with a statistical significance of (p < 0.001). On the perceived barriers; heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%), nurse’s lack of knowledge (50%) and experience (40.3%) were identified. Conclusion The use of non-pharmacological methods in the studied hospitals varied greatly due to knowledge and experience of the nurses. Therefore, it is recommended that exposure and training for all health care providers at all level is a paramount importance in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.

Background Postoperative pain remains a concern to both patients and health care professionals. Non-pharmacological pain relief methods have the potential to complement pharmacological interventions and may offer alternative treatment options. The aim of the study was to assess nurses’ utilization of postoperative nurses’ non-pharmacological pain relief methods and the perceived barriers for their implementation in the National Hospitals. Methods Descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation of those methods were used to collect data. Descriptive statistics for the demographic data, independent samples t-test and one way ANOVA for the nurses’ utilization of the non-pharmacological methods and perceived barriers were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were reported to be the most frequently used methods, whereas the cognitive-behavioral (5.9%) and physical methods (5.8%) were found with less frequency. The results also show that characteristics, such as the nurses' age (p = 0.013), education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods. Among the various perceived barriers, health care system related barriers such as heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), lack of administrative support (76.6%) followed by patient related barriers such as patients uncooperative behavior (57.1%) were identified. Conclusion Only few of the non-pharmacological methods were found to be utilized by the nurses as pain relieving strategies and various perceived barriers are existing among the nurses towards the utilization of these methods. Nurses in these settings need training and education on non-pharmacological pain relief methods, particularly on methods that are utilized less often.

Background Triage starts at the front door of the Emergency Department (ED), and repeatedly performed by the responsible duty nurses with the aim of facilitating a timely and appropriate treatment of patients. A triage system called the Orotta Triage System was implemented in the emergency settings of the selected hospitals in 2006, with the emergency nurses trained to triage using the system. Since the introduction, a majority of nurses have been replaced by new untrained nurses. This study was conducted to assess the impact of an educational intervention on the triage nurses knowledge and performance. Methods A single group pre-posttest study design was performed in the adult EDs of the National Referral Eritrean Referral Hospitals, from January to July of 2018. All staff members in the ED were involved. Data collection tools utilized were, a self-administered knowledge assessing questionnaire and a practice observation checklist. Analysis was done in SPSS (version 22) using repeated measures ANOVA. Statistical significance level was set at P < 0.05. Results The mean knowledge scores at Time 1(prior to the intervention), Time 2 (following the intervention) and Time 3 (three month follow up) were 6.23 (SD = 2.29), 10.55 (SD = 1.79), and 9.39(SD = 2.67) respectively. During the pre-intervention phase, only one (3%) nurse was determined to have adequate knowledge. Two days post training (immediate post-intervention), the percentage possessing adequate knowledge increased to 39% but dropped back to 19% three months later. Mean knowledge difference scores (95% CI) of immediate post and pre-intervention (Diff. = 4.32, 1 95%CI: 3.08–5.56), three months later and pre-intervention (Diff. = 3.16, 95%CI: 1.71–4.62) and immediate post and three months later (Diff. = 1.16, 95%CI: 0.12–2.20) were found to be statistically significant. The median score of appropriate triage practice at pre-intervention (Md = 6, IQR = 3) was not significantly different (p = 0.053) from that at post-intervention (Md = 8, IQR = 5). Conclusion The level of triage knowledge and appropriate application was low among the emergency nurses prior to training. The training provided an initial improvement in knowledge, but no significant improvement in triage nursing performance. To optimize ED triage performance, appropriate, timely in-service training is required to ensure new staff are educated and experienced staff have their knowledge and skills refreshed.

Background: Adolescent reproductive health problems are a great threat to adolescent’s warfare and such problems are associated with inadequate knowledge. In Eritrea, as adolescent reproductive health is not given much attention the knowledge is expected to be poor, which could lead adolescents to become victims of adolescence related reproductive health problems and limit their opportunity to build a better future. Therefore, this study was carried out with the aim of investigating the reproductive health knowledge, attitude and practice among secondary school students in Asmara, the capital of Eritrea. Methods: A cross sectional study design was conducted on 428 adolescent high school students with the age range of 14 to 19 years. Sample size was determined by using a single population proportion formula. Initially, population size of each school and each grade was taken and proportional sample size was determined from each school and then from each grade. The list of students was used and participants were selected using simple random sampling. Data was collected through a structured self-administered questionnaire. Descriptive and inferential analysis were made using SPSS (version 22). Statistical significance level was set at P<0.005.Results: The median age of the study participants was 15 (IQR=2), in which 88.8% were between age of 14 to 16 years with 53% of them being females. The level of knowledge of the students regarding RH was low, with moderate to good attitude. Sexual practice was very low (3.5%) with usage of 86.7% of contraceptive use. Meanwhile, the usage of sexually explicit material was relatively higher (53%). Conclusions: Reproductive health knowledge was low almost in all variables. Meanwhile, significant number of students are already engaged in heterosexual romantic relationships and use of sexually explicit material. Adolescents need to be knowledgeable about themselves and the people they relate to, need sound information about the physical, psychological and social changes that take place through childhood to adolescence.

Background: Pharmacological methods are widely used for postoperative pain management however, poorly controlled pain continues to pose a significant challenge. Non pharmacological methods could contribute to the unresolved postoperative pain management in assisting nurses’ routine care and minimizing the need formedication. The aim of the study was to assess nurses’ utilization of non-pharmacological methods in postoperative pain and the perceived barriers for their implementation at the National Hospitals.Methods: A descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization ofselected non-pharmacological methods and the perceived barriers for the implementation was used to collect data. Descriptive statistics for the demographic data, independent samples t-test, one way ANOVA and factorial ANOVAwere used to analyze the data. Statistical significance level was set at P < 0.05. Results: The study found out that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were the most frequently used methods, while cognitive-behavioral (5.9%) and physical methods (5.8%) had less frequency. The results also showed , such as the nurses' age (p=0.013), education (p=0.012), work experience (p=0.001) and place of work (p=0.001), were significantly related to the use of non-pharmacological methods at bivariate level. However, hospitals had a statistical significance of (p<0.001) and were the only determinants of the non-pharmacological methods at multivariable level. On the perceived barriers;heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), patient’s uncooperative behavior (57.1%), language difference (64.4%),nurse’s lack of knowledge (50%) and experience (40.3%) wereidentified.Conclusion: Non-pharmacological methods on postoperative patients in the studied hospitals varied greatly due to experience and knowledge. The study recommends exposure and training for all health care providers at all level in order to appreciate the benefits of non-pharmacological methods applicable to postoperative pain management among patients. This could be achieved through on job training, seminars, scientific conferences and other brainstorming forums.

Background: Perioperative undesirable anesthesia outcomes are common among patients undergoing surgery. They may affect body systems and lead into more serious intraoperative and postoperative problems. This research is conducted in the Eritrean National Referral Hospitals with the aim of assessing the prevalence of undesirable anesthesia outcomes during the perioperative period. Method: A cross sectional study design was applied on 470 patient who underwent different types of surgeries with in a three month period. Patients were interviewed 24 hours after operation using the Leiden preoperative care patient satisfaction questionnaire (LPPSq). This study reports one component of a large study conducted. The dimension “Discomfort and needs” of the LPPSq was considered and the measurement of that dimension are presented in this report. Items of the dimension were standardized and measured using a five point Likert scale from “Not at all” to “Extremely”. Multivariable logistic regression was used to look for the association of the outcomes with the types of surgery and types of anesthesia using SPSS (Version 22). Statistical significance level was set at p< 0.05. Results: The prevalence of undesirable anesthesia outcomes were computed in two manners; prevalence of those with ‘at least a little bit’ outcomes which was computed to see the total occurrence of these outcomes and prevalence of those having ‘more than moderate’ outcomes to see the severe experience of these outcomes. Prevalence of the predominant undesirable outcome, post-operative pain, for ‘at least a little bit’ and ‘more than moderate’ were 82.6% and 43.6% respectively. The rest post-operative undesirable outcomes were less frequently reported. Conclusion: Postoperative pain was found to be the most prevalent undesirable outcome. Enhancement of the proper assessment and management of postoperative pain through the development and implementation of specific pain management modalities is needed. Local guidelines should also be available in these settings for the treatment of acute postoperative pain or other outcomes. Keywords: Leiden preoperative care patient satisfaction questionnaire (LPPSq), Perioperative care, Surgery, Undesirable anesthesia outcomes.