Predictors of work-related stress among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia

Work-related stress [WRS] is an insidious and persistent part of everyday life related to the response of people to work environment. Nursing is a strenuous job and WRS is prevalent among nurses. The aim of this study was to estimate the prevalence of WRS among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. A cross-sectional epidemiological study was conducted in 17 primary health care centers [PHCCs] representing the primary level of health care and Medical Tower Complex [MTC] representing the secondary health care level in Dammam city. The total number of nurses included in the study was 637 nurses [144 in PHCCs] and [493 MTC]. Data were collected using a self-administered questionnaire, which was developed based on the pertinent literature. It included two main parts: Sociodemographic and job characteristics of nurses and 31 WRS questions. The overall prevalence of WRS among all studied nurses was 45.5%; 43.1% and 46.2% in primary and secondary levels, respectively. In the primary level, there was a statistical significant association between WRS and being married [85.5%], and having living three children and more [53.2%]. Moreover, younger age group 20-<30 years [79.4%], Saudi nationality [86.8%], being married [74.6%], having nonbachelor degree [83.3%], work shifts [89.5%], and working in surgical department [46.5%] were the significant associating factors with the occurrence of WRS among nurses in secondary levels. Young age was the only predicting factor for WRS in primary care level. While being female, Saudi, married, with work shifts, and working in surgical department were found to predict WRS in the secondary level. Appropriate strategy in health care organization to investigate stress in health care settings is recommended. Moreover, interventional programs to identify, and relieve sources and effects of stress should be developed

"Foot care practices among type 2 diabetics attending a primary care military hospital, Taif, Saudi Arabia"

To determine foot care practices among type 2 diabetic patients without previous history of foot problems attending primary care clinics in Prince Mansour Military Community Hospital [PMMCH], Taif, Saudi Arabia. A Cross-sectional descriptive study using a convenient non probability sample was done during August and September 2010. 188 type 2 diabetic patients were questioned using a predesigned questionnaire sheet after reviewing their medical files. Collected data included: socio-demographic features, medical condition, diabetes control and foot care practices, which was later judged using a scoring system to show its quality. Among the studied sample: 112/188 [59.6%] were males; mean age was 56.5 years +/- 14.5 SD. Illiteracy was prevalent in 47.9% of them. Poorglycemic control [HbA[1]c>/= 7 mmol] was reported in 75% of the patients. Regular foot checkup has never been performed in 30.3% of the sample, 65.4% never seek medical advice for their foot problems, 61.2% never used special medical shoes and 46.3% never checked inside the shoe before wearing it. Using our scoring system, 63.3% of the studied patients were considered poor in their foot care practices. Educational level was the only factor predicting the level of good foot care practices, those with higher level were found to have better practices [OR=2.179, 95% CI=1.074-4.423 and p<0.05]. Health education programs integrated in comprehensive foot care clinics are crucial to limit foot complications among the growing number of diabetic patients

Water pipe [shisha] smoking among male students of medical colleges in the eastern region of Saudi Arabia

Shisha smoking, one of the commonest methods of smoking tobacco among Arabs, increases the risk of cardiovascular and respiratory diseases. The objective of this study was to determine the prevalence of shisha smoking among male students of three colleges and to identify factors associated with shisha smoking. This cross-sectional study included 500 male students of three colleges [medicine, applied medical sciences and dentistry]. Data were collected from 371 students using a self-administered questionnaire. The overall prevalence of shisha smoking was 12.6% [8.6% shisha only and 4.0% both shisha and cigarettes]. Thirty students [63.8%] started shisha smoking at ages of 16 to 18 years. Seven students [15%] smoked shisha daily. Cafes or restaurants were the favorite places for smoking [70.2% of students]. There was a high prevalence of shisha smoking among students whose mothers had a secondary [19.1%] and higher [53.3%] education. There was a high prevalence of shisha smoking among university students. The majority of students started shisha smoking at a young age. Public health measures, including the banning of smoking in public places are recommended

Attention deficit hyperactivity disorder [ADHD]: Is it a health problem among male primary school children

The aim of this study was to determine the prevalence of Attention Deficit Hyperactivity Disorder [ADHD] among male primary school children. Cross-sectional study. Male primary schools, Dammam, Saudi Arabia. One thousand two hundred and eighty-seven students, aged 6-13 years, in 67 government and 10 private primary schools were selected by multistage systematic random sampling. Data were collected using two types of questionnaires: the modified Arabic version of the Attention Deficit Disorders Evaluation Scale [ADDES] school version, and Parents' questionnaire to diagnose the three main subtypes of ADHD namely: inattention, hyperactivity-impulsivity, and combined ADHD. It was found that the majority of the boys were from government schools [83.0%], aged 6-<9 years [40.5%] and of Saudi nationality [80.7%]. One thousand two hundred and sixty-eight out of 1287 completed all parts of the questionnaire concerned with diagnosing all the three types of ADHD. The overall prevalence of combined ADHD was 16.4% [208], 12.4% [157] hyperactivity-impulsivity and 16.3% [207] inattention disorders respectively. The study also revealed a variety of socioeconomic factors to be significantly associated with the development of ADHD. These included parents' low level of education, mother's occupation, and low socioeconomic status. In this study, the overall prevalence of ADHD was higher than previous studies in Saudi population. ADHD prevention and control should be an integral part of the primary health care [family medicine] system. Education and training programs for parents, school teachers, and caregivers regarding different aspects of ADHD should be established

Handicapping conditions among children under six years in family medicine centers in Alexandria. Part I: screening and detection

Early identification of children with developmental delays is important in the primary health care [PHC] setting. The PHC practitioner's office is mostly the place where the majority of children younger than 5 years of age are seen and is ideal for developmental and behavioral screening by the use of age-appropriate developmental checklists to record milestones during preventive care visits as a part of developmental surveillance. The aim of the present study was to screen children under 6 years in 5 family medicine [FM] facilities in Alexandria, Egypt for the early detection of some handicapping conditions [visual, hearing, speech, and orthopedic] and to review the family files of the screened children to assess the number of suspicious cases missed by the family physicians. Data were collected using a pre-designed screening sheet for the early detection of the above mentioned handicapping conditions among 550 children attending the study FM facilities and by family file review of the screened children. Screening of children under 6 years old had yielded the following results: orthopedic abnormalities represented 14.2%, followed by visual abnormalities [9.3%], speech abnormalities [8.9%], hearing abnormalities [6.2%], and mental retardation [2%]. Risk factors found to affect the occurrence of the study handicapping conditions were found to be mostly positive family history, consanguinity between parents, maternal age at the time of pregnancy, and complications during pregnancy; labour; and in the post natal period. Recording was incomplete as only 11.6% of the screened children had both complete files including growth and development charts. Poor performance of the family physicians in the study facilities was evident regarding detection and referral of handicapped cases in children as only 75 handicapped cases [46.3%] could be detected by the family physicians in the study facilities out of the 162 handicapped cases detected by the researcher. Family physicians in the study facilities referred only 57.3% of the detected. Therefore, screening for risk factors of handicap should be performed by the family physicians during routine daily activity as well as during the well baby clinic schedules. This is best achieved by proper development and application of guidelines and protocols for screening, follow up, and management of handicapping conditions including proper recording and referral

Handicapping conditions among children under six years in family medicine centers in Alexandria. Part II: assessment of resources

Handicap means the disadvantage or restriction of activity caused by disability. It is the practical consequence of disability and impairment. It is estimated that 5% of the world's children population suffer from severe handicaps and an additional 10-15%, may need special attention to overcome less severe handicaps. The aim of the present study was to assess the quality of human and non-human resources necessary for the prevention and control of handicapping conditions among children under 6 years in 5 family medicine [FM] facilities in Alexandria, Egypt. Data were collected using 2 different questionnaires: a checklist was designed to assess the availability of resources required for the early detection of visual, hearing, speech, and orthopedic causes of handicap among children under six in the study family medicine facilities. A self-administered questionnaire was designed to assess the knowledge, attitude, and practice [KAP] of 34 family physicians working in the study FM facilities about the early detection of the previously mentioned handicapping conditions in children. The percentage of registered to the total population was highest at Gohn FM unit [68.8%] and lowest at El-Seiouf FM center [24.6%]. Most of the equipment required for handicap screening was available in the study FM facilities. Child health records, daily registration records, and well baby clinic records were available, but no specific records or reports for handicapping conditions in children were present. About half of the physicians [47%] had no postgraduate studies at all, only 23.5% and 3% of the family physicians were trained about detection of mental retardation, and genetic causes of handicap, respectively and 14.7% did not attend any training course at all. The majority of family physicians had fair knowledge [76.5%], positive attitude [61.8%], and partial practice [70.6%]. The difference in KAP levels between the different study facilities was statistically insignificant. There was a statistically significant direct proportionate relation between the knowledge of the physicians and their practice; i.e., the higher is the knowledge the better is the practice. Therefore, handicap prevention and control should be properly integrated within PHC [Family medicine] services with continuous, proper training of all health team members