Abnormal lipid profiles are a major risk factor for atherosclerosis and cardiovascular diseases andrepresent a growing public health concern influenced by socioeconomic, cultural, and ethnic factors. inethiopia, where chronic illnesses are increasingly prevalent, dyslipidemia poses a significant healthburden. this systematic review and meta-analysis aimed to estimate the pooled prevalence of abnormallipid profiles and identify associated risk factors among chronically ill patients in ethiopia. Relevantstudies were systematically retrieved from multiple databases, and data were extracted and analyzedusing StAtA/MP 17.0. A weighted inverse variance random-effects model was employed to compute thepooled estimates. the analysis revealed a pooled prevalence of abnormal lipid profiles of 54.14%, withthe highest burden found among diabetic patients (75.75%) and in the Southern Nations, Nationalities,and Peoples Region (69.28%). the likelihood of abnormal lipid profiles was significantly higher amongfemales, individuals older than 40 years, and those with hypertension. these findings highlight theurgent need for routine lipid screening and targeted interventions for high-risk populations to addressthe rising burden of dyslipidemia among chronically ill patients in ethiopia.
Keywords: Lipid profile, dyslipidemia, chronic disease, hypertension, systematic review, meta-analysis, Ethiopia

Background: Managing chronic illness requires navigating a complex trajectory from diagnosis to end-of-life, with each phase necessitating specific nursing approaches. Effective management throughout these phases is vital for improving patient outcomes and quality of life.
Objective: This study aims to explore nursing approaches in managing chronic illness across its trajectory, from diagnosis to end-of-life care, focusing on phase-specific care, emotional support, education, interdisciplinary collaboration, and the challenges faced by nurses.
Methods: A qualitative research design using a grounded theory approach was employed to construct a theoretical framework grounded with the insights and experience of nurses' approaches across the chronic illness trajectory within Western Amhara, Ethiopia. The study comprised 24 nurses who were selected through the process of purposeful and theoretical sampling methods. Data was collected via in-depth interviews. Data analysis followed a constant comparative method, involving open, axial, and selective coding to identify key strategies and challenges across the illness trajectory.
Results: The primary finding of this study emphasizes the evolving and adaptive role of nurses in chronic illness management, highlighting their ability to provide personalized care, emotional support, and education throughout the illness trajectory. Central to the investigation is the theory of nurses' evolving and adaptive role in chronic illness management, where they adjust their strategies to address the physical, emotional, and psychological needs of patients and families, from pre-diagnosis to end-of-life care. The study identifies key adaptive strategies, including fostering resilience, facilitating interdisciplinary collaboration, and managing fluctuating symptoms. Despite challenges such as heavy workloads and emotional strain, nurses require training for continuous professional development, technological integration, and collaborative platforms to reinforce their critical role in optimizing patient outcomes in chronic illness management.
Conclusion: This study highlights nurses' adaptive role in chronic illness care, focusing on phase-specific interventions, emotional support, interdisciplinary collaboration, and education across entire illness trajectory to meet diverse needs of patients and their families. Despite challenges such as heavy workloads and emotional strain, the study recommends ongoing professional development and technological integration to optimize patient outcomes.

Keywords: chronic illness trajectory; diagnosis; end-of-life; grounded theory; nursing approaches.

Introduction Functional disability in older adults refers to difficulties in performing daily activities. It is usuallyevaluated based on an individual’s ability to carry out basic activities of daily living and instrumental activities of dailyliving. Although existing studies provide valuable insights, comprehensive global data on functional disability inbasic and instrumental activities of daily living among older adults remain limited. This study aims to review existingresearch worldwide to estimate the overall pooled prevalence of functional disability in these areas.Methods Systematic searches were conducted across EMBASE, Scopus, PubMed/MEDLINE, and Google Scholar fromMay 5 to July 11, 2024. Cross-sectional studies worldwide on functional disability in basic and instrumental activitiesof daily living among adults aged 60 and older, published in English up to July 11, 2024 were included. Studies wereexcluded if they did not report the outcomes of interest, were inaccessible, case reports, low quality, review articles,or published in languages other than English. Data extraction and cleaning were performed using Microsoft Excel,and STATA version 17 was used to compute the pooled effect size with 95% confidence intervals (CIs) for functionaldisability in both basic activities of daily living and instrumental activities of daily living among older adults. Toderive these estimates, we used weighted averages, where each study’s prevalence was weighted by the inverse ofits variance. Study heterogeneity was assessed using the Cochrane I² statistic and its associated p-value. Subgroupanalysis and meta-regression were conducted to identify sources of heterogeneity. Sensitivity analysis was used toevaluate the impact of individual studies on the overall results. Publication bias was assessed with Egger’s test andfunnel plots, and was addressed through trim-and-fill analysis.Results This review includes 35 studies with a total of 133,827 participants. The pooled prevalence of functionaldisability in basic activities of daily living was estimated at 26.07% (95% CI: 19.04–32.74), while on instrumentalactivities of daily living, it was estimated at 45.15% (95% CI: 36.02–54.29). After applying the trim-and-fill method,the adjusted overall prevalence of disability in basic activities of daily living was 15.12%, (a 95% CI: 11.25–19.13%).
subgroup analysis showed highest prevalence in Africa (BADL: 42.91%, IADL: 69.34%) and lowest in Asia (BADL:19.15%, IADL: 32.66%). Participants aged 65 and above, those in institutional settings, and studies with smaller samplesizes tended to report higher levels of functional disability.Conclusions Nearly one-fourth of the study participants had functional disability related to basic activities of dailyliving, while about half experienced disability in instrumental activities of daily living. This emphasizes the needfor continued effort in improving the quality of life and support systems for individuals facing functional disability,particularly in instrumental activities.Keywords Basic activities of daily living, Functional disability, Instrumental activities of daily living, Older adults.

ntroduction: Cognitive impairment is a medical condition caused by neurodegeneration, marked by a gradualdecline in neurological, motor, psychological, and cognitive domain functions, as well as daily activities. Itprimarily affects individuals with conditions such as Alzheimer’s disease, stroke, HIV/AIDS, diabetes mellitus,cancer, epilepsy, dementia, and other chronic illnesses, as well as older adults. While some individual studieshave explored the effects of cognitive impairment, there is a lack of nationwide research to provide a compre-hensive understanding of its burden among individuals with chronic diseases.Objective: To assess the pooled prevalence of cognitive impairment and its associated factors among individualswith chronic diseases in Ethiopia.Methods: Several databases were examined to find available articles. The data were extracted and sorted inMicrosoft Excel before being exported to STATA/MP 17.0 for analysis. A random-effects Der Simonian-Lairdmodel with a 95 % confidence interval was used to pool the data. Cochrane I2 statistics and Egger’s test wereused to evaluate heterogeneity and publication bias, respectively. To determine the cause of heterogeneity,subgroup analysis was performed. A log-odds ratio was utilized to illustrate the association between cognitiveimpairment and its associated factors. P-values less than 0.05 were considered statistically significant.Result: This study included 22 individual articles comprising a total of 6818 participants. The overall prevalenceof cognitive impairment among individuals with chronic diseases was 44.43 % (95 % CI: 37.76–51.10). Studiesconducted in Addis Ababa reported a higher prevalence of 50.89 % (95 % CI: 34.59–67.19). Similarly, researchfocusing on older adults indicated the highest prevalence, at 57.58 % (95 % CI: 28.78–86.39). Participants whoare unable to read and write were 3.82 times more likely to experience cognitive impairment compared to thosewho had completed primary education (AOR = 3.82; 95 % CI: 2.97–4.91).Conclusion: This review found a high prevalence of cognitive impairment among Ethiopians with chronic dis-eases, especially in older adults and those in Addis Ababa. Illiteracy significantly increased the risk. Thesefindings highlight the need for targeted cognitive screening and integration of cognitive care into chronic diseasemanagement.
Keywords: Cognition, Cognitive impairment, Associated factors, Ethiopia

Introduction Nurse burnout negatively impacts patient care quality, safety, and outcomes, while harming nurses’mental health, job satisfaction, and retention. It also imposes financial burdens on healthcare organizations throughabsenteeism, reduced productivity, and higher turnover costs, highlighting the need for research to address thesechallenges. The umbrella review methodology was selected to integrate evidence from multiple systematic reviewsand meta-analyses, offering a broad and in-depth summary of existing research to guide practice and policy. Thisapproach equips stakeholders with a holistic understanding of the multifaceted impacts of nurse burnout, facilitatingthe design of effective interventions that support nurses, enhance healthcare delivery, and optimize patientoutcomes. Consequently, this umbrella review aims to evaluate the global prevalence and contributing factors ofnurse burnout.Methods This umbrella review included 14 systematic reviews and meta-analyses identified from various databases.The quality of each study was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR II). Data wereextracted using Microsoft Excel and analyzed with STATA 17.0. Heterogeneity was measured using Higgin’s I2 Statistics,and summary prevalence estimates were calculated with the Der Simonian-Laird random-effects model. Meta-regression and subgroup analyses were conducted to identify the source of high heterogeneity. Publication bias wasassessed using funnel plots and Egger’s regression test, with the former providing a visual assessment of bias and thelatter offering a statistical method to detect asymmetry.Results The global prevalence of nurse burnout was evaluated in three areas: emotional exhaustion (33.45%, 95%CI 27.31–39.59), depersonalization (25.0%, 95% CI 17.17-33.00), and low personal accomplishment (33.49%, 95% CI28.43–38.55). Emotional exhaustion was most common among nurses working during the COVID-19 pandemic(39.23%, 95% CI 16.22–94.68). Oncology nurses experienced the highest rate of depersonalization (42%, 95% CI16.71–77.30), while nurses in intensive care units reported the highest rate of low personal accomplishment (46.02%,95% CI 43.83–48.28).
Conclusions Nurse burnout is prevalent worldwide, often marked by a sense of low personal accomplishment.Several factors contribute to this issue, including role conflict, negative emotions, family problems, moral distress,stress, commuting distance, predictability of work tasks, and workplace advancement.Keywords Nurse, Burnout, Determinant factors, And umbrella review

Introduction: The magnitude of poor sleep quality among people with asthma is widespread and has detrimental consequences, including a higher chance of having poor work performance, an increase in the frequency of asthma attacks, an increase in the need for overnight hospitalization, and a worse health related quality of life. However, it has not been well studied, especially in low-income countries like Ethiopia. This study's objective was to assess the degree of sleep quality and related factors among people with asthma who had follow-up visits at public hospitals in the East Gojjam Zone.
Methods: An institutional-based cross-sectional study design was conducted among 406 people with asthma through consecutive sampling techniques at public hospitals in East Gojjam Zone from June 6 to July 1, 2022. Sleep quality was measured by the Pittsburgh Sleep Quality Index through a face-to-face interview, and the collected data were entered into Epi Data version 4.4.2 and exported to SPSS version 25 for analysis. Logistic regression was fitted to assess the association between dependent and independent variables. Variables with a P-value

BackgroundPost-intensive Care Syndrome (PICS) is defined as various physical, psycho-logical, and cognitive, impairments that can arise during an ICU stay, continueafter leaving the ICU, or even persist following hospital discharge. It impactsboth patients and their family’s quality of life. Various primary studies worldwidehave reported prevalence of PICS among ICU survivors. However, these studiesexhibit inconsistency and wide variations. Therefore, this systematic review andmeta-analysis aimed to estimate the pooled prevalence of post intensive caresyndrome among intensive care unit survivors along with its association with ICUlength of stay.MethodsWe used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA) 2020 checklist for this review. We searched PubMed/Medline, CINHAL,Embase, and Google scholar to retrieve articles. The Newcastle Ottawa Scale (NOS)was used for quality assessment of articles. The random effects model with I-squaredtest was used to estimate the prevalence of PICS and its association with ICU lengthof stay. To identify the source of heterogeneity within the included studies, meta-regression and subgroup analysis were used. We employed Egger’s regression testand funnel plots for assessing publication bias. STATA version 17.0 software wasused for all statistical analyses. A p-value of < 0.05 with 95% confidence interval wasused declare statistically significant.
ResultsA total of 19 articles with a population of 10179 ICU-survivors were included in thisreview. The pooled prevalence of PICS was found to be 54.35% (95% CI = 45.54,63.15). In sub-group analysis by region, the highest prevalence was observed instudies done in south and north America with overall prevalence of 61.95% (95%CI = 28.33, 95.62). Among the three domains of PICS (physical, cognitive and mentaldomains), the highest prevalence score was observed in the physical domain withoverall prevalence of 45.99% (95% CI = 34.66, 57.31). In this meta-analysis, thosepatients who stayed more than four days in the ICU were 1.207 [95% CI = 1.119,1.295] times more likely to develop at least one among the three domains of PICS inthe post-intensive care period than their counterparts.ConclusionThis systematic review and meta-analysis demonstrate a high prevalence of PICSamong ICU survivors, and highlight the significant association between ICU lengthof stay and the development of PICS. These findings underscore the need for tar-geted interventions to mitigate the long-term effects of critical illness, particularly forpatients with prolonged ICU stays.

Introduction
Dyslipidemia is a major risk factor for cardiovascular disease, with its prevalence steadily rising in both developed and developing nations. An unhealthy lifestyle significantly contributes to the development of dyslipidemia, with smoking being a well-known risk factor.
Methods
A comprehensive search was conducted across several databases, including Google Scholar, Web of Science, African Journals Online (AJOL), HINARI, and PubMed/MEDLINE. Articles published up until June 24, 2024, were considered for inclusion. Data extraction and organization were carried out using Microsoft Excel, while analysis was performed using STATA/MP 17.0. The quality of the included studies was evaluated using the Newcastle–Ottawa Scale (NOS). To analyze the pooled data, a weighted inverse variance random effects model with a 95% confidence interval was applied. Heterogeneity among studies was assessed using Cochrane’s I2 statistics, and Egger’s test was conducted to detect potential publication bias. The association between dyslipidemia and its associated factors was examined using the log odds ratio, with a p-value of less than 0.05 considered statistically significant.
Results
A total of 44 articles involving 12,395 participants were included. The overall pooled prevalence of dyslipidemia in Ethiopia was 56.60% (95% CI 50.40–62.80). Dyslipidemia was observed across various population groups, with notable prevalence rates associated with different risk factors. Among individuals with insufficient physical activity, the prevalence was 30.12% (95% CI 22.53–37.70). In those who smoked cigarettes, it was observed in 6.81% (95% CI 4.27–9.34). Among chronic alcohol consumers, the prevalence of dyslipidemia was 15.75% (95% CI 9.65–21.86). Furthermore, 30.12% (95% CI 22.53–37.70) of dyslipidemia was reported among individuals with inadequate physical exercise.
Conclusions
The prevalence of dyslipidemia in Ethiopia was 56.60%, indicating a significant public health concern. The condition is particularly prevalent among individuals with insufficient physical activity, smoking habits, and chronic alcohol consumption, suggesting strong associations with these modifiable risk factors. To reduce dyslipidemia, public health initiatives should focus on promoting physical activity, anti-smoking campaigns, and educating on the risks of excessive alcohol use. Health professionals should also prioritize early detection and management in high-risk groups to reduce long-term cardiovascular risks.

Background: Community-based health insurance (CBHI) is an emerging form of microhealth insurance that relies on theprinciple of solidarity, with community members pooling money to help with medical expenses. The level of household heads’satisfaction with CBHI schemes is more likely to affect their decision to remain enrolled and the entrance of new members.However, studies regarding household heads’ satisfaction with the CBHI schemes are scarce in Ethiopia. Therefore, this studyaimed to determine the level of satisfaction with CBHI schemes and associated factors among heads of households inNorthwest Ethiopia.Methods: A community-based cross-sectional study was conducted from March 1–30, 2022. A stratified random samplingtechnique with multistage sampling was used to select 604 study participants. A face-to-face interview was conducted using apretested structured questionnaire. Both bivariable and multivariable logistic regression analyses were conducted. An adjustedodds ratio (AOR) with 95% confidence intervals (CIs) was computed to evaluate the strength of the association, and variableswith a p value < 0 05 at a 95% CI were considered statistically significant.Results: This study found that about 56.1% of household heads were satisfied with the CBHI schemes. Being older age(AOR = 1 85; 95% CI: 1.17, 2.94), rural residence (AOR = 4 13; 95% CI: 2.24, 7.62), visited only health center (AOR = 0 34;95% CI: 0.20, 0.55), distance from a health facility (AOR = 3 18; 95% CI: 1.82, 5.55), agreement with prescribed drugs(AOR = 2 31; 95% CI: 1.36, 3.92), friendliness with healthcare provider (AOR = 3 65; 95% CI: 2.18, 6.10), and had a goodknowledge of benefit packages (AOR = 3 00; 95% CI: 1.93, 4.67) were significantly associated with household head satisfaction.Conclusion: The overall satisfaction of household heads with the CBHI schemes was good. The type of health facility visited,residence, age, distance from health facilities, relationship with healthcare providers, agreement with prescribed medications,and knowledge of community based health insurance were significantly associated with participants’ satisfaction. Thus, thesefindings suggest that improving access to healthcare services, fostering better relationships between healthcare providers andbeneficiaries, and enhancing awareness of CBHI benefits could further increase satisfaction levels among households.Keywords: community-based health insurance (CBHI); Ethiopia; household; satisfaction

Background: In any field, professionalism is essential. A profession can fulfill itsresponsibilities when professionals develop their knowledge in various ways, suchas continuing professional development, expanding their skill levels, adhering tothe norms of the profession, and demonstrating high levels of commitment.Developing professionalism in nurses is a key strategy for improving the qualityof nursing care and healthcare. However, no study has shown a comprehensiveoverview of professionalism in nursing in Ethiopia. Thus, this systematic reviewand meta-analysis aim to present a comprehensive assessment of the overalllevel of professionalism in nursing in Ethiopia.Methods: The Preferred Reporting Items for Systematic Review and Meta-Analysis standard was followed in the reporting of this systematic review andmeta-analysis. An extensive exploration of digital repositories, including PubMed(MEDLINE), EMBASE, Cochrane, Africa Journal of Online, Google Scholar, and anadvanced Google search, was conducted to obtain published studies detailingprofessionalism in nursing in Ethiopia. STATA version 17 commands created thepooled estimate with a 95% confidence interval. The I2 test and Egger’s test wereused to identify the presence of heterogeneity and publication bias, respectively.To manage heterogeneity, a subgroup analysis and random effect model wereused.Results: A total of 11 articles with a total of 3,581 participants were includedin the final systematic review and meta-analysis. The pooled estimate ofprofessionalism in nursing in Ethiopia was 54% (95% CI: 44, 66%). In thesubgroup analysis, the highest pooled estimate of professionalism in nursingwas observed in South Ethiopia, which is 64% (95% CI: 43–86%).Conclusion: The level of professionalism in nursing in Ethiopia is suboptimal.Being female, having a higher educational level, having long years of experience,having a low workload, having favorable job satisfaction, being a member ofa nursing organization, having a good working environment, working in non-stressful units, and having a good organizational culture were the major factorsthat had a positive association with professionalism in nursing. Therefore,healthcare professionals, the Ministry of Health, and other stakeholders shouldfocus on interventions to enhance the organizational culture, job satisfaction,working unit, and working schedule for nurses.KEYWORDSnursing, nurses, Ethiopia, caring behavior, factors, professionalism in nursing