Validation of Tunisian Arabic version of Pittsburgh Sleep Quality Index in non-clinical adolescents.

INTRODUCTION: Sleep quality is a complex phenomenon with quantitative and subjective aspects that vary during adolescence. The prevalence of sleep disorders is not known in Tunisia due to the lack of validated tools. AIM: To translate and validate the questionnaire Pittsburgh Sleep Quality Index (PSQI) into Tunisian Arabic in middle school students. METHODS: We translated the PSQI into Tunisian Arabic based on the translation back-translation method. We conducted a cross-sectional study on a sample of 560 adolescents. Exploratory factor analysis was performed to study construct validity. To test reliability, the global internal consistency of the scale was computed. RESULTS: The construct validity was verified by factor analysis, proving that a single factor explained 30.3% of the overall variance. This model produced a good factor load for all the components. The analysis of the reliability showed an acceptable internal consistency (Cronbach's alpha=0.6). CONCLUSION: The Arabic Tunisian version of the PSQI is a psychometrically valid measure. The PSQI could be useful for the detection and evaluation of symptoms of sleep disorders, as well as for further studies and researches about associated factors with poor sleep quality in adolescent and youth.

The path to Family Medicine in Tunisia. Strategic analysis.

BACKGROUND: Health system reforms in many countries have shown that the delivery of integrated primary health care services according to family medicine is the most efficient approach to achieve universal health coverage. In Tunisia, the issue is therefore the capacity of our health system to integrate a care approach based on family practice. AIM: To assess the preparedness to implement family medicine in our country Methodology: this is a qualitative study carried out over a period of 9 months during the year 2017.Based on a WHO protocol addressing the 13 pillars of family practice, our study explores health policy context, actors (using interviews with key informants at national, regional and local level) and health content. RESULTS: Family practice model is a strategic priority in Tunisia. However, this political recognition suffers from a lack of operationalization, in relation with continuing medical training, registration of patients and families by doctors, referral system, minimum package of essential care/ essential drugs and quality of care monitoring as well as community involvement.. CONCLUSION: Our situation analysis reveals that the delivery of integrated care based on family practice model; enforce to adopt a comprehensive and operational health policy that goes beyond the academic aspects.