Browsing by Author "Jayawardena, P.L."

Now showing 1 - 4 of 4

Effectiveness of an educational intervention on early detection of breast cancer in the district of Gampaha
(Sri Lanka Medical Association, 2012) Vithana, P.V.S.C.; Ariyarathne, M.A.Y.; Jayawardena, P.L.
INTRODUCTION AND AIMS: To assess the effectiveness of an educational intervention on improving knowledge, attitudes and practices (KAP) on early detection of breast cancer among Public Health Midwives (PHMs) and target group women (TGW) in the district of Gampaha. METHODS: A community-based intervention was conducted in Gampaha district using two Medical Officer of Health areas selected by random sampling as intervention (IA) and control (CA). The study participants were all PHMs in IA (n=38) and CA (n=47J and 260 TGW from each area. PHMs who were exposed to the educational intervention first, conducted the same among the TGW. For PHMs, post-intervention survey was conducted at one and six months and for TGW at six months after intervention. RESULTS: The overall median scores for KAP respectively were as follows: PHMs: Pre-intervention: IA: 58%[IQR: 53- 69%), 90%(IQR: 70-100%) and 62%(IQR: 57-70%). CA: 64%(IQR: 56-69%), 90%{IQR: 70-90%) and 62%( IQR: 50-77%). Post-intervention; six months IA: 93% (IQR: 91-93%), 100%(IQR: 90-100%), and 81%(IQR: 77-89%). CA: 67%(IQR: 58- 71%), 90%(IQR: 90-100%), and 62%( IQR: 58-73%). TGW: Pre-intervention: IA: 54%(IQR: 46-59%), 50%(IQR: 41-59%), and 0%(IQR: 0-20%). CA: 54%(IQR: 44- 59%), 50%(IQR: 36-59%), and 0%( IQR: 0-20%). Post-intervention: six months IA: 77%(IQR: 72-82%), 68%(IQR: 59- 76 %) and 40%(IQR: 20-60%). CA: 54%(1QR: 46- 59%), 50%(IQR: 36-64%), and 0%( IQR: 0-20%). All the post-intervention scores of PHMs and TGW in the IA were significantly higher in comparison to CA (p<0.001). CONCLUSIONS: This planned educational intervention had a significant impact on improving KAP of PHMs and TGW in the Gampaha district
Prevalence and correlates of postpartum depression in the puttalam district
(Sri Lanka College of Obstetricians and Gynaecologists, 2004) Rowel, D.D.S.; Jayawardena, P.L.; Fernando, N.
OBJECTIVES: To study the prevalence and the correlates of postpartum depression. METHODOLOGY: This was a community based prospective study, carried out in the District of Puttalam during the period of October 2003 to April 2004. The sample size computed was 1100. The validated Sinhala translation of the Edinburgh Postnatal Depression Scale (EPDS) was used to determine the prevalence of postpartum depression, at 6 weeks postpartum at home, where the cut off for depression was determined to be 9/10. In addition, the questionnaires on socio demographic data and reproductive health, the Maternity Social Support Scale, the Abuse Assessment Questionnaire, the Modified Life Events Inventory and the questionnaire on delivery and the index child were administered to identify the independent variables associated with postpartum depression. Multivariate logistic regression analysis was carried out and the results are expressed as Odds Ratios (OR) and 95% Confidence Intervals (95% CI). RESULTS: The prevalence of postpartum depression in the district of Puttalam was 32.1%. From multivariate analysis, unplanned pregnancy (OR=1.6; 95% CI= 1.1-2.3) , conflicts with the husband (OR=1.5; 95% CI= 1.1-2.0), physical abuse during pregnancy (OR=5-2; 95% CI= 1.6-16.1), death of a close friend (OR=2.2; 95% CI= 1.3-3.7), use of harsh words by the husband (OR=2.1; 95% CI= 1.2-3.1), normal vaginal delivery (OR=1.7; 95% CI= 1.1-2.6), low birth weight of the baby (OR=1.6; 95% CI= 1.01-2.4), illness in the baby (OR=2.1;95%CI= 1.2-3.4) and poor sleeping pattern of the baby at night (OR=1.6; 95% CI= 1.1-2.2), were the factors found to be significantly associated with postpartum depression. CONCLUSIONS: Postpartum depression which had a prevalence of 32.1% is considered a major public health problem in Sri Lanka. Therefore it is important to address the factors found to be associated with it, because of its negative impact on the mother, the child and the family.
Quality of breast cancer early detection services in the well women clinics in the district of Gampaha
(Sri Lanka Medical Association, 2012) Vithana, P.V.S.C.; Ariyarathne, M.A.Y.; Jayawardena, P.L.
AIMS: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. METHODS: Clinical breast-examination(CBE) coverage of target age group women(TGW) of 35-59 years was assessed in all the WWCs in Gampaha district from 2003-2007. Quality assessment of breast cancer early detection services was done using Lot Quality Assurance Sampling. The lot size and threshold value computed were twenty and six clinics respectively. Checklists were used in assessing coverage, physical facilities and clinic activities. Client-satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaires. RESULTS: CBE coverage in the Gampaha district increased from 1.1% (3389/318711) to 2.2% (7248/326271) from 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35% - 90%). Adequacy in relation to notice boards, stationery, furniture and linen, and cleanliness outside premises and toilets were identified as substandard. With regard to services, punctuality of staff arrival and in commencement of clinics, provision of healtheducation, availability of supervision and CBE and breast self-examination (BSE) services were observed as substandard in 7-20 clinics (35%-100%). Median satisfaction score among TGW was 45.2% (IQR: 38.7 - 54.8%). Only 11% had a score of >70%; the threshold for satisfaction. CONCLUSIONS: Coverage of breast cancer early detection service in the Gampaha district in 2007,11 years after commencing WWC services, was still very low (2.2%). All 20 clinics were substandard for overallCBEand BSE services.
Validation of the Sinhala translation of the Edinburgh Postnatal Depression Scale
(Sri Lanka Medical Association, 2005) Rowel, D.D.S.; Jayawardena, P.L.; Fernando, N.
OBJECTIVE: To validate the Sinhala translation of Edinburgh Postnatal Depression Scale (EPDS) to detect depression in antenatal and postnatal mothers. METHODOLOGY: Content validity of EPDS was checked by a panel of experts. Translation of the English questionnaire by bilingual experts to Sinhala by 'translation back translation1 method followed. Thereafter alternate form reliability of the instrument was checked. Criterion validity of the instrument was assessed against a 'gold standard', which was the clinical diagnosis by a consultant psychiatrist based on ICD 10 Research Diagnostic Criteria. This was done in field combine clinics of Medical Officer of Health area Kolonnawa. The antenatal mothers completing 34 weeks of period of amenorrhea and postnatal mothers 6 weeks after partus were administered the EPDS followed by the clinical psychiatric interview. The cut off scores for EPDS to identify depression in antenatal and postnatal mothers were determined using the Receiver Operator Characteristic (ROC) curves. RESULTS: The cut off score of 9/10 (sensitivity of 90.7% and a specificity of 86.8%) was the best cut off to screen for depression in antenatal mothers. In postnatal mothers a cut off score of 9/10 (sensitivity of 89.9% and a specificity of 78,9%) was the best cut off score to screen for postpartum depression.CONCLUSION: Sinhala translation of EPDS is a reliable and a valid instrument to detect depression in antenatal and postnatal mothers in Sri Lanka.