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Prevalence of Burnout among Doctors in Teaching Hospitals in Galle Sri Lanka
A. VD L. A. Vithanage,
P. V. De Silva,
J. D. V. C. Lekamwasam
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
1-4
Received:
30 December 2014
Accepted:
4 January 2015
Published:
22 January 2015
Abstract: Introduction: Burnout is a word used to assess the level of exhaustion or disengagement of a person involve in any particular profession. This topic has come to the light in recent years after the results of several studies showing that there are significant number of professionals is in the “Burnout” category. There are no published study results on this topic in Sri Lanka and it is high time to evaluate the issue in the Country. Method: We included all the professionals employed in the teaching hospitals both Karapitiya and Mahamodara. Data was collected using a self-administered questionnaire called Oldenburg Burnout Inventory (OLBI), well accepted and free to study tool. Results: 155 doctors had completed the questionnaire. Out of this the majority were males; 53.5%. Majority of the doctors were grade medical officers; 63.2%. Among them there were 24.8% doctors who were having more than 10 years’ experience. 24.2% doctors were engaged in private practice. A large number of doctors had satisfactory relationship with their Consultant; 94.7%, and with their colleagues; 98.6%. Most of the doctors had never consumed alcohol and never smoked. Out of all 36.1% found exhausted and 34.2% were disengaged with their work. The overall “Burnout” was 20.6%. Doctors involved in private practice are significantly burnout; P=0.04, compared to doctors not doing private practice. In addition the use of alcohol also showed the significant association; P=0.04 with the Burnout”. Conclusion: This study highlighted that there is a significant proportion of doctors; 20.6%, who are “Burnout”. Therefor further studies are recommended to identify the causes in detail.
Abstract: Introduction: Burnout is a word used to assess the level of exhaustion or disengagement of a person involve in any particular profession. This topic has come to the light in recent years after the results of several studies showing that there are significant number of professionals is in the “Burnout” category. There are no published study results ...
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Distribution of Diabetic Retinopathy among Diabetics in Southern Province of Sri Lanka
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
5-8
Received:
30 December 2014
Accepted:
4 January 2015
Published:
22 January 2015
Abstract: Diabetic Retinopathy (DR) refers to a group of pathologies found in the retina ofdiabetics that can lead to visual complications. Screening for DR is immensely useful in preventing blindness.Diabetic patients who were registered in the diabetic clinic of a leading hospital in the private sector over a period of one year were selected for this study. Total of 2603 diabetics were examined majority (97.0%) were Sinhala. They represented three districts of Southern province. Males were 64.3%. Majority belonged to the diabetic duration of 5 – 15 years. (72.9%). Total prevalence of DR was 7.53%. (Bilateral 5.5% and Unilateral 2.0%). Lowest prevalence value was shown in the age category of below 30yrs and the highest value of 10.9% in 51 – 60yrs group. The total prevalence of maculopathy was 0.6% with a higher age specific value in 51 – 60 group. Prevalence of pre proliferative and proliferative DR was only 0.12%. A steady increase was shown in the appearance of DR with the duration of diabetes. An obvious association with the occurrence of retinopathy and hypertension was shown than non hypertension patients.
Abstract: Diabetic Retinopathy (DR) refers to a group of pathologies found in the retina ofdiabetics that can lead to visual complications. Screening for DR is immensely useful in preventing blindness.Diabetic patients who were registered in the diabetic clinic of a leading hospital in the private sector over a period of one year were selected for this study...
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Prevalence of Burnout and Its Correlates among Female Primary School Teachers in the Southern Province of Sri Lanka
PV De Silva,
CG Hewage,
P. Fonseka
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
9-14
Received:
30 December 2014
Accepted:
4 January 2015
Published:
22 January 2015
Abstract: Introduction: Teaching is considered as one of the most important profession in the world today. In the past it was considered as a rather routine job without hard or hazardous work. However the present day school teachers have to play multiple roles in their day-to-day work with children, colleagues and administrators. Therefore teaching is now considered as a high stress profession. As a result there was a growing concern among researchers about teachers' mental health during last few decades. Several researchers have identified number of mental health problems of teachers including burnout. Burnout has not studied among teachers in Sri Lanka. Objective: The present study was planned to determine the prevalence and risk factors of burnout among female primary school teachers in the Southern Province of Sri Lanka. Methodology: Out of the female primary school teachers employed in the southern province of Sri Lanka, 660 teachers were selected using multi stage cluster sampling method. A self-administered questionnaire was used for the data collection. It consists with three broad sections: Socio-demographic characteristics, Occupational and life style factors and validated Sinhala version of Maslach Burnout Inventory- Educators Survey (MBI-ES-Sin). For identification of correlates of burnout, all the teachers identified as having burnout were selected as cases and double the number of cases was randomly selected from the teachers who were identified as not having burnout as controls. Results: Overall prevalence of burnout among female primary school teachers in the Southern Province was 115.6 per 1000 population. The prevalence rate for burnout was highest (157.8/1000 population) in the Hambanthota district. A stepwise increase in prevalence of burnout was observed from Galle (96/1000 population), Matara (105/1000 population) to Hambanthota district. Following the logistic regression analysis female primary school teachers more than 20 years in teaching profession, female primary school teachers who travel more than 10 kilometers daily to school, teachers doing home work more than 5 hours per week, teachers who participating in school activities during weekend, teachers who sleep less than 7 hours per day and teachers who are having one hour or less leisure time per day were identified as having significantly higher level of burnout. Conclusions: Burnout is a problem among female primary school teachers in Sri Lanka. Therefore, it is recommended that relevant authorities take necessary steps to address the factors contributing to the teacher burnout.
Abstract: Introduction: Teaching is considered as one of the most important profession in the world today. In the past it was considered as a rather routine job without hard or hazardous work. However the present day school teachers have to play multiple roles in their day-to-day work with children, colleagues and administrators. Therefore teaching is now co...
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Nutritional Status and Associated Feeding Practices among Children Aged 6-24 Months in a Selected Community in Sri Lanka: A Cross Sectional Study
Nishani H. Ubeysekara,
Renuka Jayathissa,
Champa J. Wijesinghe
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
15-23
Received:
6 December 2014
Accepted:
30 December 2014
Published:
12 February 2015
Abstract: Background: In Sri Lanka, nutritional indicators are static compared to other health indicators. Under nutrition among children less than five years remains a common public health problem. Poor nutritional status of children is associated with various factors which are preventable. Purpose of this study was to determine the nutritional status of children aged 6-24 months in a selected health unit area and to describe the associated feeding practices. Methods and materials: A cross sectional study was conducted among mothers of 428 children attending 24 randomly selected field weighing posts in Akuressa health division, for routine growth monitoring. Nutritional status of the children was assessed with anthropometric measurements and WHO growth charts. Other data were collected using an interviewer-administered questionnaire. Results: Prevalence of stunting, wasting and underweight in the sample was 17%, 17.1% and 21.3% respectively. Mean age of exclusive breast feeding was 5.8 months and prevalence of exclusive breast feeding for 6 months was 88.8%. Mean age of starting complimentary feeding was 6 months and majority (75.5%) started semisolids as the first food. A majority (75.8%) of the mothers practiced proper feeding during infections. Wasting was significantly associated with male gender (p<0.01), increasing age of the child (p<0.05) and late introduction of fat and oils into the diet (after 8 months of age) (p<0.001). Underweight was associated with male gender (p<0.001), increasing age (p<0.05) and late introduction of fat and oils into diet (after 8 months of age) (p<0.05). Stunting was only associated with male gender (p<0.05). Conclusion: Under nutrition among children is common in this age group. Some of the feeding practices are associated with poor nutritional status and these practices should be improved with effective interventions.
Abstract: Background: In Sri Lanka, nutritional indicators are static compared to other health indicators. Under nutrition among children less than five years remains a common public health problem. Poor nutritional status of children is associated with various factors which are preventable. Purpose of this study was to determine the nutritional status of ch...
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An Innovative Mental Health Outreach Program in Southern Sri Lanka: Successes and Lessons Learnt
Chandrasiri P. A. A.,
De Silva P. V.,
Karunarathne A. D. U.,
Ruban R.,
Madiwaka M. W. M. K.,
Suveendran T.
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
24-30
Received:
20 December 2014
Accepted:
10 January 2015
Published:
14 February 2015
Abstract: Psychiatric illnesses has emerged as an important disease category as prevalence of mental disorders is being rising sharply. The disease burden due to mental illnesses is rising in Sri Lanka as well. Provision of care for those who are psychiatrically ill poses a significant challenge to health care systems. In this circumstances a community based our reach program becomes an important and effective strategy to improve psychiatric services provided for patients. Community support officers (CSO) program was launched in 2006 in district of Hambantota, Southern Sri Lanka to serve this purpose. Objective of this article is to describe the program in relation to its objectives, initiation, main activities, coordination, technical guidance, funding, monitoring and evaluation. Then we intended to evaluate the success by analyzing performance data and impact made. Finally we critically analyzed the program to discuss strengths and weaknesses in view of providing a guidance to replicate it in other settings. Program documents were reviewed and key informant interviews were done with leading characters of the program. Periodical progress reports and reports on performance review meetings also retrieved. Recruitment of CSO’s was done according to set criteria. They were given a special training and skills were developed on identification of common psychiatric illnesses at field level, communication skills and crisis intervention. Lecture discussions and role plays were used as teaching methods and consultant psychiatrists conducted the program. Organizational structure of the program was laid down within the existing administrative framework of primary health care system in the country. Main functions of CSO’s were Surveying the community to detect mentally ill people, Guiding and directing patients to seek psychiatric care, following up those patients, Conducting, contributing and participating in community mental health promotion programs. Supervision and monitoring was done at various levels and periodical progress review meetings were held. It was based on inbuilt information system. This program was concluded by the end of 2010. Follow up responsibilities were handed over to primary health staff at MOH offices. CSO program is a classic example for how community level workers can be empowered and utilized as an effective workforce to deliver mental health services at grass root level where existing system can’t penetrate. Carefully planned recruitment criteria, training given by technical experts, linking with existing primary health care system and monitoring done by regional health authorities were responsible for the success of this program.
Abstract: Psychiatric illnesses has emerged as an important disease category as prevalence of mental disorders is being rising sharply. The disease burden due to mental illnesses is rising in Sri Lanka as well. Provision of care for those who are psychiatrically ill poses a significant challenge to health care systems. In this circumstances a community based...
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Nutritional Status of Preschool Children and Its Associates: A Sri Lankan Experience of a Fishing Community
Chandrasekara Karunamuni Pushpika Sudarshini De Silva,
De Silva Hiranthi,
Indrapala Waldeniyage Kolitha Prasanna
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
31-35
Received:
24 December 2014
Accepted:
16 January 2015
Published:
2 March 2015
Abstract: Introduction: Childhood malnutrition remains one of the most challenging global public health problems. To combat this problem, it is essential to reveal the magnitude of malnutrition and underlying socio- cultural factors influencing child feeding and raring. Despite satisfactory income levels, fishing families have low standards of living due to their different life styles and behavioral attitudes which can contribute to poor nutritional status among their children. Methodology: A cross sectional study was conducted among a group of marine fishing families in MOH area Ambalangoda. Study population consisted of all children (189) aged 1-5 years. Height and weight and nutritional status were assessed. Pre tested interviewer administered questionnaire was used to evaluate the selected socio-demographic and cultural factors of these families affecting the nutritional status. Results: Prevalence of different forms of malnutrition reported was underweight-31%, stunting-23% and wasting-11.2%. Prevalence of alcoholism was 37.9% while smoking was 45.5%. Parental level of education, mother’s employment status was not significantly related to the nutritional status. Significant association was found between maternal literacy with underweight and wasting while literacy of father with stunting. Father being an alcoholic was significantly related to wasting, stunting and underweight. Father’s state of smoking has also being identified as a significant associate of underweight and stunting. Method adopted to dispose excreta of children also found to be significantly associated factor with underweight of their preschool children. Conclusions and recommendations: Parental literacy, father’s substance abuse was identified as associated factors for malnutrition in this community and health educational and promotional programmes should be targeted towards these factors using audio visual aids considering the levels of literacy of parents.
Abstract: Introduction: Childhood malnutrition remains one of the most challenging global public health problems. To combat this problem, it is essential to reveal the magnitude of malnutrition and underlying socio- cultural factors influencing child feeding and raring. Despite satisfactory income levels, fishing families have low standards of living due to ...
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Functional Amblyopia; A Blinding Disease in a Normal Eye
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
36-46
Received:
12 March 2015
Accepted:
12 March 2015
Published:
20 March 2015
Abstract: Amblyopia is reduction of vision with the proper optical correction either in one or both eyes.. The diagnosis of Amblyopia requires both the demonstration of visual acuity loss and the absence of an organic cause. A visual defect screening program was conducted on children aged 3-14 years of Bope-Poddala health unit area of the city of Galle Sri Lanka. Children aged 5-14 years were examined at each respective school. Children aged 3-5 years were examined at the pre schools .Children not attending to pre schools were examined in the community. All possitives and difficult to handle cases with a 10% of normal were referred to the ophthalmology clinic for secondary screening, investigation and diagnosis. Cases of diagnosed Amblyopia were called after one year for re-assessment. A total of 6685 school children and 934 preschool children were enrolled for this study. After exclusion, 5649 children were screened.Out of the total of 5649 children who were screened 439 (7.8%) were found to have eye diseases with or without visual defects giving a prevalence of 78/1000 children. Of those with such diseases, 88.8% had visual defects. The prevalence of visual defect was 6.9% (69/1000 children). Of the children with visual defects 90.0% (351) were due to refractive errors. The prevalence of refractive errors was 6.2% (62/1000 children).The analysis of the prevalence of different types of refractive errors showed that the prevalence of myopic astigmatism was 52.3%, Simple myopia was 24.6%, simple hypermetropia was 12.5%. Myopic astigmatism was the commonest type of refractive error in unilateral or bilateral involvement. The second commonest was simple myopia. It was found that out of 223 children with bilateral refractive errors 11.6% had unilateral Amblyopia and 17.5% had bilateral Amblyopia giving a total of 29.1%. Of all children with unilateral refractive errors 39.8% had Amblyopia. The development of Amblyopia among unilateral refractive errors was higher than bilateral refractive errors (p<0.05).The total prevalence of refractive Amblyopia was 2.1% of the population. Of them 1.4% had unilateral Amblyopia and 0.7% had bilateral Amblyopia. This difference was statistically significant. (P<0.05) Highest prevalence was observed in the age group of six and seven years (3.4% and 3.0%.). Distribution of Amblyopia among males and females were almost equal. The total prevalence of Amblyopia among children was 2.3%. Refractive Amblyopia calculated was 2.1% that consisted of 1.9% of Anisometropic Amblyopia.The strabismic Amblyopia was 0.2%. Deprivation Amblyopia was 0.2%. There were no Amblyopes found in the group of strabismic Amblyopia without refractive errors.
Abstract: Amblyopia is reduction of vision with the proper optical correction either in one or both eyes.. The diagnosis of Amblyopia requires both the demonstration of visual acuity loss and the absence of an organic cause. A visual defect screening program was conducted on children aged 3-14 years of Bope-Poddala health unit area of the city of Galle Sri L...
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Comparison of Quality of Life of Patients with Hydrocele and Quality of Life of Patients with Inguinal Hernia
Seneviratne R. W.,
Kumara M. M. A. J.,
Abewickrama R.,
Kumarasinghe J. P. M.,
Somasiri K. G.,
De Silva P. V.
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
47-49
Received:
16 March 2015
Accepted:
17 March 2015
Published:
23 March 2015
Abstract: Introduction: Quality of life (QOL) is one measure of how much a disease has affected the life of a patient from his or her perspective. WHOQL 100 assesses QOL under six domains and 24 facets along with overall quality of life. It was translated to Sinhala and was validated. QOL of hydrocele patients as well as inguinal hernia patients is expected to be lower than normal. Method: Ethical clearance was obtained from the ethical review committee of the Faculty of Medicine, University of Ruhuna, WHOQOL 100 was self administered to patients admitted for hydrocelectomy or herniotomy before surgery and by-standers in surgical ward as the control. Results: There were 23 males subjects in each category. The mean ages and SDs were 43.8±12.9 (Hydrocele), 44.4±14.0 (Control) and 43.7±11.9 (Hernia). QOL score of physical capacity (66.4±9.7 and 78.0±12.1; p=0.001), psychological (65.5±15.4 and 78.0±9.5; p=0.002) and level of independence (67.7±14.3 and 76.5±12.7; p=0.033) domains of hydrocele patients were significantly lower than those of the control. QOL scores of social relation were significantly lower in hydrocele patients than in hernia patients (60.1±15.5 and 71.5±14.4; p=0.014). Conclusions: QOL of hydrocele patients were lower than normal. Physical, psychological and level of independence are more affected than the other aspects of QOL. Psychological aspects of the QOL are lower in hydrocele patients than in patients with hernia. Assessment of QOL using WHOQOL 100 can be considered as a valid tool to find out the impact of hydrocele on different aspects health.
Abstract: Introduction: Quality of life (QOL) is one measure of how much a disease has affected the life of a patient from his or her perspective. WHOQL 100 assesses QOL under six domains and 24 facets along with overall quality of life. It was translated to Sinhala and was validated. QOL of hydrocele patients as well as inguinal hernia patients is expected ...
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A Use of New Questionnaire Based Tool for Evaluation of Medical Student’s Satisfaction Regarding Their Final Professorial Surgical Appointment at Faculty of Medicine, University of Ruhuna, Sri Lanka
Kumara M. M. A. J.,
Seneviratne R. W.,
Abewickrama R.,
Kumarasingha J. P. M.,
De Silva P. V.
Issue:
Volume 3, Issue 2-1, March 2015
Pages:
50-53
Received:
17 March 2015
Accepted:
17 March 2015
Published:
23 March 2015
Abstract: Introduction: Faculty of Medicine University of Ruhuna, Located in southern coastal town of Galle is one of 10 state owned medical faculties in Sri Lanka. . Surgical curriculum consist of lectures, Tutorials, ward classes as well as clinical appointments scattered through last 3 years. The Final year two-month professorial surgical appointment is meant to ensure that Graduates have acquired rounded knowledge and key skills in surgery to pass out to become safe and competent intern house officers. No formal study has been conducted to assess the student perspectives regarding this appointment. Methodology: Purpose of this study is to evaluate the student component of the 360 degree assessment regarding the effectiveness of teaching programme of professorial surgical clinical appointment using a questionnaire consist of five components. Results: Vast majority of students answered the questionnaire (range 130-136 except concerning requirement to modify end appointment assessment method when responding number fell to 118). Components A is aimed to evaluate students view of professorial appointment and its usefulness for different components of final MBBS examination .Over 84% marked generally useful and above for all the components of final MBBS examination. Highest was for short cases at 96.1% while lowest figures were for long cases (84.4%). Component B is to assess view of different modalities of clinical teaching encounters during professorial appointment and its usefulness for improving surgical knowledge and a good pass at final mbbs. 97.8% thought elective ward rounds were generally useful or above while lowest was obtained by emergency theatre teaching (84%). Component C has six questions aimed to assess student satisfaction of quantity of particular sessions. 89.3% were satisfied about number of clinic teaching sessions which fell towards short case practice sessions (73.8%), theatre teaching sessions (59.2%) and endoscopy sessions (58.9%). D is a single question about their satisfaction of end appointment assessment method and any modifications required.46.5% thought continuous assessment method require modifications. Component E assesses the overall effectiveness of the surgery appointment in functioning as an intern medical officer effectively. 81.8% marked generally useful and above. Conclusions: Significant majority of students were satisfied in most of the components of final year professorial appointment while certain drawbacks became apparent such as insufficient number of endoscopic and Operating Theatre sessions. The designed Performa appears to be a satisfactory tool to assess student satisfaction about a final year professorial clinical appointment and more studies and further modifications may result in its validation even for other clinical appointments.
Abstract: Introduction: Faculty of Medicine University of Ruhuna, Located in southern coastal town of Galle is one of 10 state owned medical faculties in Sri Lanka. . Surgical curriculum consist of lectures, Tutorials, ward classes as well as clinical appointments scattered through last 3 years. The Final year two-month professorial surgical appointment is m...
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