Knowledge and awareness of harmful effect of substance abuse among users and non-users: a cross-sectional study from Bari Imam.

OBJECTIVES: To determine the prevalence of substance abuse among adult population of Nurpur Shahan and assess the participants' knowledge and awareness regarding substance abuse. METHODS: This was a cross-sectional study conducted in the households of Nurpur Shahaan, adjacent to Bari Imam on the outskirts of Islamabad, Pakistan, during January 2010. A structured questionnaire was used and 200 adults of ages 18 and above were assessed about their awareness of substance abuse, its social effects and health hazards. All collected data was entered into SPSS ver. 10. The independent variables in the study were age, gender, marital status, social class, education level and knowledge of substance abuse. The dependent variables were substance abuse, type of substance abuse, attitude towards using and attitude towards quitting. RESULTS: Out of the 200 adults consenting to participate in the survey, 65 (33%) were reported to suffer from substance abuse, while 135 (67%) claimed not to be in the habit. Awareness about the dangers of substance abuse was higher among non-users (59.4%) as compared to the users, but 40.6% users continued to use drugs despite knowing that adverse effects would follow. Non-user respondents were more aware of the risks involved (75.8%) than the users (23.4%). It remained unclear whether anxiety and depression were an outcome of addiction or a defence mechanism to perpetuate maladaptive behaviour of substance abuse. CONCLUSIONS: Substance abuse is prevalent among the lower and lower middle classes of Pakistan, with a propensity among male victims, to blame external circumstances, which they feel are beyond their control.

Attitudes and perceived barriers of tertiary level health professionals towards incident reporting in Pakistan.

BACKGROUND: A limited framework of incident reporting exists in most of the health care system in Pakistan. This poses a risk to the patient population and therefore there is a need to find the causes behind the lack of such a system in healthcare settings in Pakistan. AIMS: To determine the attitudes and perceived barriers towards incident reporting among tertiary care health professionals in Pakistan MATERIALS AND METHODS: The study was done in Shifa International Hospitals and consisted of a questionnaire given to 217 randomly selected doctors and nurses. Mean ± SD of continuous variables and frequency (percentage %) of categorical variables are presented. Chi square statistical analysis was used to test the significance of association among doctors and nurses with various outcome variables (motivators to report, perceived barriers, preferred person to report and patient's outcome that influence reporting behaviors). P value of <0.05 was considered significant. Student doctors and student nurses were not included in the study. RESULTS: Unlike consultant, registrars, medical officers and nurses (more than 95% are willing to report), only 20% of house officers will report the incident happened through them. Sixty nine percent of doctors and 67% of nurses perceive 'administration sanction' as a common barrier to incident reporting. Sixty percent of doctors and 80% of nurses would prefer reporting to the head of the department. CONCLUSIONS: By giving immunity from administrative sanction, providing prompt feedback and assurance that the incident reporting will be used to make changes in the system, there is considerable willingness of doctors and nurses to take time out of their busy schedules to submit reports.