Predictors of Perceived Stress among Medical and Nonmedical College Students, Minia, Egypt.

BACKGROUND: Nowadays, stress has been tagged a global phenomenon. Many undergraduate students undergo considerable stress, and a variety of sources of stress have been identified among university students. The aim of this study is to identify the level of perceived stress and its predictors among medical and nonmedical Minia University students. METHODS: This was a cross-sectional study comparing between medical and nonmedical students in Minia University, conducted during the period from March to April 2017. The sample consisted of 314 medical and 291 nonmedical students chosen through cluster random sampling as a section was chosen randomly from each academic year and collectively form the final sample. Data were collected through interview by a questionnaire inquiring about sociodemographic data, common stressors as academic, financial, family, and transportation stressors and Cohen Perceived Stress Scale 10. RESULTS: The prevalence of perceived stress was slightly higher (88.9%) among medical students than among nonmedical students (83.5%). Severe stress was found among (18.8%) of medical students compared to (12.4%) among nonmedical students (P < 0.05). The significant predictors of perceived stress were academic stressors, no exercise and being female among medical students, and were academic and financial stressors among nonmedical students. CONCLUSIONS: Medical students perceived more stress than nonmedical students. The academic stressors were significant predictors among all students; hence, there is a need for the establishment of students counseling unit, to facilitate coping with the stress of study and examination.

Awareness and practice of patient rights from a patient perspective: an insight from Upper Egypt.

OBJECTIVES: To assess the patients' awareness of their rights, the predictors of knowledge of patients' rights and the degree of adherence to these rights by the medical team from the patients' perspective. DESIGN: A cross-sectional study. SETTING: Minia University Hospital, Minia, Egypt. PARTICIPANTS: Hospitalized patients in Minia University Hospital, from 1 January to 1 February 2017. METHODS: In total, 514 patients were interviewed during their hospital stay. Data were collected using a structured questionnaire that inquired about their knowledge of the patient rights and the level of practicing these rights from their point of view. MAIN OUTCOME MEASURES: The awareness about different aspects of the patient rights was assessed by a mean knowledge score. Factors affecting the patients' awareness about their rights were evaluated. The extent to which physicians and nurses apply the patient rights from the patients' point of view was measured. RESULTS: About 76% of patients did not know that there is a charter of patient rights. The mean knowledge score of patient rights in this study was 7.2 ± 2.71 out of 14. Patients' education associated significantly with their knowledge score. The majority (98.1%) of interviewed patients stated that the medical team did not inform them about the available treatment choices. CONCLUSIONS: The greater part of the patients was not aware of their rights at a satisfactory level. Health care providers should place more emphasis on increasing the patients' awareness about their rights and involve them in making decisions regarding their treatment choices. The Ministry of Health needs to be more sensitive to this issue.

The Palliative Performance Scale Predicts Survival among Emergency Department Patients, Minia, Egypt.

BACKGROUND: Emergency department (ED) physicians provide care to patients with a wide range of prognoses, and must develop care plans that anticipate patient's survival. However, the tools available to guide care planning had limited data to support their use. There is a new concern to understand if palliative care (PC) should be offered in the ED and the Palliative Performance Scale (PPS), a screening tool used in other settings in PC, has been little used in the ED. AIM: The aim of this study is to assess the prognostic value of the PPS in predicting 1, 3 and 6 months survival in patients admitted through the ED. DESIGN: This was a prospective, cohort study. SUBJECTS AND METHODS: We evaluated 147 patients at the age of 35 years and more admitted through the ED of Minia University hospital from May 1, 2016 to June 31, 2016. Each patient's PPS score was evaluated initially in the ED, with follow-up assessments of survival at 1, 3, and 6 months. RESULTS: Baseline PPS for the 147 patients was 50. The PPS score was a strong predictor of survival (Log-rank test of Kaplan-Meir P < 0.0001). Patients with an initial PPS score of 40 or less were less likely to survive at 6 months. CONCLUSION: The PPS score may predict survival in patients admitted to the hospital through the ED. The ease of use holds promise that the use of the PPS in the ED may help ED physicians predict survival and plan for a better decision.

Awareness about Breast Cancer and Its Screening among Rural Egyptian Women, Minia District: a Population-Based Study

Background: Recent global cancer statistics indicate rising global incidence of breast cancer and the increase is occurring at a faster rate in developing countries. Training women how to carry out breast self-examination (BSE) can help them to be alert to any abnormalities in their breasts to speedily seek medical consultation. Health behavior may be influenced by level of awareness about breast cancer. Methods: A cross-sectional community- based study aimed to assess the level of knowledge about breast cancer risk factors, early warning signs, screening approaches and related predictors. Also, to determine the extent of practice of breast self- examination (BSE) among rural women, Minia in the period from February to May 2016. A total of 600 women were randomly included in the study. A questionnaire included socio-demographic characteristics and information related to their knowledge about breast cancer. Data analysis was carried out using SPSS version 19. Results: Moderate and high knowledge scores were presented by 46.9 %. Nearly 40% of participants had the knowledge that smoking increased the likelihood of cancer breast and almost 30% of them affirmed that being obese or having a positive family history of cancer breast made them vulnerable to cancer breast. It was found that 28.7% and 18.2% of them knew that aging and nulliparity increased the likelihood of breast cancer. Participants with better knowledge score were 4.8 times more likely to practice BSE. Conclusion: This study revealed poor knowledge among rural women regarding cancer breast. BSE and clinical breast examination were not well practiced. It is recommended to create awareness programs about breast cancer and regular patterns of BSE.

Predictors of Delay in Seeking Health Care among Myocardial Infarction Patients, Minia District, Egypt.

Objectives. To determine the barriers that hinder early seeking of medical care among Minia's myocardial infarction patients. Methods. The study was based on individual interviews with 207 men and women with a first confirmed myocardial infarction (MI), admitted to the coronary care units of hospitals in Minia city in the period from April 1 to August 30, 2014. Data was collected via structured questionnaire and patient medical charts. The delay was evaluated by assisting patients to triangulate time of symptom onset and time of professional health care by placing both times in context of daily activities that participants could easily remember. Results. The median (25th, 75th percentiles) delay time was 4 (2, 10) h. Only 32.8% of patients arrived within 2 hours of symptoms onset. Variables that significantly predicted prehospital delay time were patient's misinterpretation of nature of pain with OR 8.98 (95% CI) (3.97-20.32), illiteracy 7.98 (2.77-22.95), age (>65) 5.07 (1.57-16.29), and pain resistance behavior 4.61 (2.04-10.41). Conclusions. Interventions to decrease prehospital delay must focus on improving public awareness of acute myocardial infarction symptoms and increasing their knowledge on early treatment benefits.

Factors affecting survival of women diagnosed with breast cancer in El-Minia Governorate, Egypt.

OBJECTIVES: This study was conducted to determine breast cancer survival time and the association between breast cancer survival and socio-demographic and pathologic factors among women, in El-Minia, Egypt. While there has been much researches regarding prognostic factors for breast cancer but the majority of these studies were from developed countries. El-Minia has a population of approximately 4 million. To date, no research has been performed to determine breast cancer survival and the factors affecting it in El-minia. METHODS: This retrospective study used data obtained from the cancer registry in the National Institute of Oncology in El-Minia and included 1207 women diagnosed with first primary breast cancer between 1(st) January 2005 and 31(st) December 2009 and followed to 30(th) June 2010. The association between survival and sociodemographic and pathological factors and distant metastasis at diagnosis, and treatment options was investigated using unifactorial chi-square test and multi-factorial (Cox regression) analyses. Kaplan-Meier analysis was used to compare survival time among different groups. RESULTS: Median survival time was 83.8 ± 3.2. Cox regression showed that high vs low educational level (Hazard ratio (HR)= 0.35, 95% CI; 0.27-0.46), metastases to bone (HR = 3.22, 95% CI: 1.71-6.05), metastases to lung (HR= 2.314, 95% CI: 1.225-4.373), tumor size (≤ 2 cm vs ≥ 5 cm: HR = 1.4, 95% CI: 1.1-1.8) and number of involved nodes (1 vs > 10 HR = 5.21, 95%CI: 3.1-9.01) were significantly related to survival. CONCLUSIONS: The results showed the need to develop screening programs and standardized treatment regimens in a tax-funded health care system.