Pattern of Virtual Consultations in the Kingdom of Saudi Arabia: An Epidemiological Nationwide Study.

BACKGROUND: In the Kingdom of Saudi Arabia (KSA), little is known about the adoption of virtual consultations (VCs), with most studies being survey-based leading to varying results. This study aims to utilise secondary collected data on the use of both kinds of VCs currently available, and to epidemiologically describe the adoption of these consultations. METHODS: This retrospective study analysed data provided by the Ministry of Health between January 1st 2021 and June 30th 2022. For both the home-based and the hospital-based consultations, variables included the age and sex of patients, date of consultation, duration in minutes, closure status for the appointment and the governorate in which the patient is residing. A heat map was drawn to present patterns of utilisation across the country. RESULTS: The total number of VCs for both types were 1,008,228. For both types, females were higher adopters (54.73%). Of the total number of consultations, 751,156 were hospital-based. Of these consultations, family medicine consultations were the most common (20.42%), followed by internal medicine. Maternity follow-up clinics were higher in home-based clinics. The proportion of patient no-shows was high overall (48.30%). Utilisation was high in urban governorates, and low in rural ones. CONCLUSION: Findings have several implications on health policy. It provides further evidence of the importance of family medicine, where it was the most common speciality even in hospital-based settings. The high variability in the adoption of consultations across rural and urban areas as well as the extremely high number of patient-no-shows warrants further investigation.

The effect of transformation policies on healthcare providers' satisfaction in primary healthcare centers: the case of Eastern Saudi Arabia.

BACKGROUND: The Saudi Arabian Vision 2030 encompasses the Health Sector Transformation Program (HSTP), an initiative aimed at enhancing the accessibility, affordability, and quality of healthcare, with a strong emphasis on patient-centered care. To achieve this vision, the government has been providing training to Primary Healthcare (PHC) centers on patient-centered care, recognizing that spending quality time with patients is crucial for making informed clinical decisions. Therefore, it is essential to evaluate provider satisfaction with the quality of services they provide and assess the impact of organizational factors on care quality. This study represents the first comprehensive assessment of job satisfaction among PHC providers in the Eastern region of Saudi Arabia. It seeks to gauge job satisfaction among PHC providers and explore its associated impact on the quality of care they deliver. METHODS: This study employed a quantitative cross-sectional design. Data were collected using a modified version of the Job Satisfaction Survey (JSS), supplemented by three newly added dimensions. Additionally, questions addressing general characteristics were incorporated into the survey instrument. Data analysis involved calculating frequencies and percentages for univariate analysis, employing t-tests for comparisons between two groups, and utilizing ANOVA for comparisons among multiple groups (bivariate analysis). RESULTS: A total of 143 PHC providers took part in this study. Of these, 48% reported high satisfaction, while the rest were either dissatisfied or neutral. PHC providers were highly satisfied with supervision (17%, N=94). On the other hand, they were dissatisfied with contingent rewards (3%, N=15). There was a significant difference found between the intention to leave the job (yes, no) and job satisfaction scores (mean (SD)= 83.58 (16.174) vs. mean (SD)=101.64 (16.209), p-value < 0.001). There were also significant relationships between general characteristics and the dimensions such as co-workers, promotion, responsibility, nature of work, operating procedure, and communication (p-value< 0.05). CONCLUSION: The main findings of this study suggest that PHC providers working in PHC centers in the Eastern region were satisfied with their work, especially with supervision and patient care. However, the findings also revealed that there are many areas of the job of PHC providers that require planned reform, such as contingent reward and communication. Furthermore, intention to leave the job was significantly related to job satisfaction score and all the dimensions. The study findings will help policymakers and the Ministry of Health to develop an employee engagement and satisfaction program to track the PHC providers' levels of satisfaction.

The Incidence of Acute Peritonitis Secondary to Different Sites of Viscus Perforation.

Objective The incidence of peritonitis secondary to viscus perforation will be examined to determine the most common sites of perforation and associated comorbidities. Methods This is a retrospective observational study based on data collected from the King Fahad Hospital of the University (KFUH). This research targeted patients who had viscus organ perforation and the relation of peritonitis secondary to it. The sample was taken from patients under the care of the General Surgery Department from the first of Feb 2016 to the 12th of Sep 2022. The final sample consisted of 450 patients. The method of diagnosis of peritonitis was mainly clinical, and the surgical approach was either through an exploratory laparotomy or a diagnostic laparoscopy. Incidental findings of viscus organ perforation were noted in addition to certain postoperative complications (e.g., adhesions) and hospital stay. Results Analysis of the results showed a significant relation (p<0.001) between viscus organ perforation and peritonitis. The most common comorbidities associated with secondary peritonitis were hypertension (12, 24.5%), diabetes mellitus (10, 20.4%), any abdominal mass (3, 6.1%), and inflammatory bowel disease (1, 2%). However, a chi-square analysis has shown no significant association between peritonitis and the targeted associated comorbidities. Conclusion Perforation of the small intestine carries the biggest association with peritonitis incidence, in addition to comorbidities such as hypertension and diabetes mellitus. Further study to establish the value of these factors might contribute to decreasing the morbidity and mortality of secondary peritonitis.

Factors associated with anxiety symptoms among medical laboratory professionals in Khobar: Single institution study.

Background: A clinical professional has a challenging role during the coronavirus disease (COVID-19) pandemic in providing timely and accurate results with limited resources and a rapid increase in the number of samples to be tested. However, during the ongoing pandemic, the anxiety level of Medical Laboratory Professionals (MLT) has not been studied in Saudi Arabia within the hospital environment. Aim: To determine the associated factors related with anxiety level of MLT at King Fahd Hospital of the University (KFHU) during the COVID-19 pandemic. Methods: The study design was a cross-sectional quantitative study. Data were collected by administering a paper-based questionnaire that was distributed among MLT at KFHU. The questionnaire consisted of three sections. The first two sections were prepared by the researchers and included participant demographics and questions related to COVID-19. The third section used the Hamilton Anxiety Scale to assess anxiety levels. Result: The study revealed that 70.4% of MLT showed no signs of anxiety, while 19.2% showed mild/moderate anxiety levels, and approximately 10.4% showed severe to extreme anxiety levels. In addition, a significant association between the anxiety level and difficulty breathing among MLT wearing personal protective equipment was observed. Moreover, a significant association between sex and anxiety level was identified. Females MLT had higher percentages of severe anxiety (12.8% vs. 5.1%) and mild/moderate anxiety (24.4 vs. 7.7%) than males. Conclusions: Protecting the mental health status of MLT is an essential part of public health measures to fight the COVID-19 pandemic.

Healthcare Providers' Satisfaction with Implementation of Telemedicine in Ambulatory Care during COVID-19.

INTRODUCTION: Telemedicine has become a critical aspect of healthcare provision during the coronavirus pandemic (COVID-19). However, healthcare providers' utilization of and satisfaction with telemedicine technologies could have a significant impact on the quality of care provided to patients during COVID-19. The current study explores the key factors that could affect healthcare providers' satisfaction with telemedicine in ambulatory care during the pandemic. OBJECTIVES: This research study aims at identifying the factors that could influence the healthcare providers' satisfaction level with the use of telemedicine in ambulatory care services in Saudi Arabia during COVID 19. METHODS: This is a descriptive quantitative cross-sectional study. The research team has utilized the Service Quality Model (SERVQUAL) to assess the healthcare providers' satisfaction with telemedicine in ambulatory care through a questionnaire that was adapted from previous studies. This questionnaire includes the following dimensions: tangibility, reliability, responsiveness, assurance, and empathy. It was distributed to all ambulatory care physicians in a public hospital-based ambulatory health center in Eastern Region, Saudi Arabia. RESULTS: The study findings showed that Saudis are significantly more satisfied with telemedicine compared to non-Saudis. Age, gender, experience, medical specialty, and computer literacy skills were not found to have any significant effects on the level of the provider's satisfaction. CONCLUSION: This research provides new insight and understanding of the relationship between the frequent use of the health information system and the level of physician satisfaction. This major finding puts more emphasis on the importance of education and training when it comes to the adoption of telemedicine through the frequent use of health information systems and applications. These encouraging findings provide a vital piece of information for healthcare organizations interested in a further adoption of telemedicinal practices and applications.

Patient Acceptance and Intention to Use e-Consultations During the COVID-19 Pandemic in the Eastern Province of Saudi Arabia.

Background: Over the last decade, the use of digital technology has increased immeasurably and transformed both our personal and professional lives. The medical profession quickly embraced this development, especially after the spread of the COVID-19 pandemic. Medical consultations were transitioned to online settings as a substitute for face-to-face consultations. This exponential acceleration of the use of remote online consultations (e-consultations) was deemed necessary to respond to the impact of the global pandemic. This study identifies the factors that influence actual patient use and the intention to use e-consultations in Saudi Arabia. Methods: A cross-sectional survey was distributed online via social media platforms targeting the population living in Saudi Arabia from August to December 2020. The questionnaire measured patient perceptions of and attitudes toward utilizing e-consultations using a validated questionnaire informed by the technology acceptance model (TAM). Analyses were performed in SPSS to identify the external factors that influence patients' actual use of e-consultations and to assess the TAM factors (usefulness, social influence, and ease of use) that influence the intention to use e-consultations across both actual users and never-users. Results: A total of 150 participants completed the questionnaire; the average age was 38 years old, 85% of the participants were females, and 67% reported never using e-consultations. Additionally, motivation, trust, attitude, and social influence were significantly related to participants' intention to use e-consultations. Conclusion: Participants' trust in and perception of the usefulness of e-consultations were significant factors in their intention to use e-consultation services. Policymakers' attention to those factors could play a role in increasing public acceptance and the use of e-consultations to improve distance medical care.

Factors affecting compliance with national accreditation essential safety standards in the Kingdom of Saudi Arabia.

Accreditation is a widespread culture internationally and nationally. The effectiveness of compliance with accreditation standards was positively correlated with health care settings' performance in multiple aspects: leadership, professional performance, patient safety and organizational culture. There is limited knowledge of the national compliance rate with accreditation standards. Therefore, it is important to assess the hospital compliance with accreditation rate in the Kingdom Saudi Arabia (KSA) and its related factors. This paper presents a quantitative cross-sectional study. Data were extracted from the annual Essential Safety Requirement (ESR) survey database from the Central Board for Accreditation of Health care Institutions (CBAHI) research center during the period 2016 to 2018. Hospitals that started their operation after the first ESR survey round in 2016 or shut down during the study period were excluded. The hospital scoring was on a scale of 0 to 100 and classified as follows: score 2 if the hospital satisfactory compliance (Fully Met) was ≥ 80% and score 1 if particular compliance (Partially Met) was ≥ 50% to < 80%. Then, a score of 0 indicated insufficient compliance (Not Met) when < 50% and a score of not applicable (NA) if the standard does not apply to the hospital. A total of 437 hospitals were surveyed in 20 regions in the KSA and had an overall compliance rate on average that was higher among private hospitals than among public hospitals (77% vs. 66%). Overall, private hospitals had a significantly better compliance rate than public hospitals (mean rate = 84% vs. 68%, respectively, P = 0.019). Large hospitals had more compliance with some standards than smaller hospitals. After adjusting for the year of the survey report, the private hospital type was more compliant than the public hospital. This study supports mandatory accreditation programs for both public and private health sectors, with increased monitoring by the concerned parties (i.e., CBAHI and the Ministry of Health). The authors encourage the application of accreditation for specialized and independent health services.

Impact of the COVID-19 Pandemic on Oncology Patients' Mental Health and Treatment Plans.

The COVID-19 pandemic has disrupted cancer care to a certain degree. There is objective evidence that COVID-19 outbreaks are causing substantial emotional distress among cancer patients regardless of their disease severity. This study aims to measure the levels of psychological distress, depression, and pandemic anxiety among cancer patients in Saudi Arabia during the outbreak of COVID-19 and their impact on patients' cancer treatment plans. Methods: This was a cross-sectional study conducted among oncology patients in Saudi Arabia in November of 2020. The levels of stress, depression, and anxiety symptoms during the COVID-19 outbreak were measured using the Questionnaire for Depression and Anxiety (PHQ-4), and patients were classified as depressed/distressed if the total score was 6 and above and classified as not depressed/distressed if they scored less than 6. Results: Among the sampled population, anxiety symptoms and depression were detected in 61.5% and 70.2%, respectively. Statistical analyses revealed that feeling more isolated was significant for anxiety symptoms (p = 0.005), while patients who used institutions as a source of COVID-19 information had significant depression (p = 0.010) compared to patients who accessed information from other sources. In the binary regression model, feeling more isolated than before was 3.208 times more likely to be associated with anxiety symptoms (OR = 3.208; 95% CI = 1.391-7.396; p = 0.006), while those patients who had a support institution as a source of COVID-19 information were 4.2 times more likely to be associated with depression (OR = 4.200; 95% CI = 1.328-13.280; p = 0.015). Conclusion: The COVID-19 pandemic has added to the burden on cancer patients. The increased risk of anxiety symptoms and depression was clearly demonstrated in this study. Feeling isolated had a greater impact on anxiety symptoms, while obtaining COVID-19 information from a patient support institution negatively affected depression.

Shared Decision-Making: A Cross-Sectional Study Assessing Patients Awareness and Preferences in Saudi Arabia.

Background and Aim: Shared decision-making (SDM) has become broadly accepted during the consultation, especially when there are many options of treatment. This study aims to assess patients' levels of awareness and preferences of SDM in Saudi Arabia. Methods: This is a cross-sectional study targeting patients in Saudi Arabia. Two validated questionnaires were used, the first validated questionnaire focuses on measuring knowledge, attitude and experiences of shared-decision making. The second questionnaire is the the Autonomy-Preference-Index focusing on patients' preferences for being involved in SDM. Relevant items to the study aim were chosen and translated into Arabic. Psychometric testing was conducted for Arabic and English versions and tested for content and face validity. The questionnaire administered online via social media channels, between February 2021 and May 2021. A total of 411 respondents completed the questionnaire. Results: The findings showed a positive association between awareness and preferences of SDM among patients in Saudi Arabia. In the awareness of the SDM domain, females reported higher scores than male participants (t = -4.504, P < 0.001). Saudis reported higher scores in their awareness of SDM than non-Saudis (t = 2.569, P = 0.011). Participants without health insurance reported higher scores in their awareness of SDM than those insured (t = -2.130, P = 0.034). Participants with degree have higher knowledge levels than participants with no degree (f = 10.034, P < 0.001). Females reported higher scores in their preferences of SDM than the male (t = -2.099, P = 0.036). Participants who visited private health-care settings in their last clinical encounter reported higher preferences of SDM than participants who received care in other settings (f = 2.653, P = 0.048). Conclusion: The study concludes that the more aware a patient is, the more likely they prefer SDM practice. This finding can support health-care policymakers in developing SDM policies that enhance patient-centered care.

Sociodemographic and Occupational Factors Associated With Burnout: A Study Among Frontline Healthcare Workers During the COVID-19 Pandemic.

Purpose: To describe the prevalence of burnout among frontline healthcare workers (HCWs) during the COVID-19 pandemic and the associated sociodemographic and occupational factors. Methods: A cross sectional survey study was carried out to study HCWs burnout using the 19-item Full Copenhagen Burnout Inventory (CBI) that includes personal, work, and patient-related burnout subscales. Bivariate analysis was used to test for associations and p < 0.05 was considered statistically significant. Results: A total of 207 responses received; where the mean score of personal burnout was 67.23, the mean of work-related burnout was 61.38, and the mean of patient-related burnout was 54.55. Significant associations were found; where female HCWs, those working in rotating day-and-night shifts, working more than 55-h per week, and who had their shift time and hours changed during the pandemic, had higher levels of personal and work-related burnout (P < 0.05). Patient-related burnout was higher among those who were single (divorced or separated), nurses, non-Citizens, those with fewer years of experience, and who were infected by COVID-19 and have been quarantined (P < 0.05). Age was not a significant factor of burnout in any of the CBI subscales. Conclusions: There is a prevalent level of burnout among frontline HCWs during the COVID-19 pandemic. Findings highlight key sociodemographic and occupational factors affecting burnout; which can help planning for psychological support strategies. Furthermore, effective administrative control is important to institute policies and mechanisms to identify, and freely report burnout symptoms among HCWs to promote their wellbeing.

Evaluation of the Mawid mobile healthcare application in delivering services during the COVID-19 pandemic in Saudi Arabia.

PURPOSE: The purpose of this study is to evaluate MAWID mobile application developed by the Ministry of Health, Saudi Arabia, which is used for primary care hospitals appointments management and for tracking and tracing COVID-19. PARTICIPANTS AND METHODS: An online questionnaire-based survey was used for collecting data related to three major factors including Ease of Use, Satisfaction, and Benefits of MAWID application among its users. Out of total 2542 participants, 345 participants completed only a part of the survey, and 204 participants did not use the application. After removing, 549 invalid responses, a final sample of 1993 was included for the data analysis. RESULTS: 82.1% of the participants referred MAWID as easy to use application, 79.8% were highly satisfied with the application, and majority of the participants reflected potential benefits of using the application. T-test results have revealed that significant differences existed between males and females, and young and older participants in relation to the Ease of Use and Satisfaction levels associated with MAWID application. CONCLUSION: Mobile applications can be very effective in delivering the healthcare services during pandemics. However, there is a need for regular evaluation and assessment to trach the change in users' needs and update the app according to the changing requirements.

Use of social media for the improvement of radiation safety knowledge among Saudi Arabian radiographers.

BACKGROUND: Radiographers have used social media networks for education, research, professional development and other purposes. However, in Saudi Arabia, there are no studies on the use of social media by radiographers. Therefore, the objective of this research was to evaluate the use of social media for the improvement of radiation safety knowledge among Saudi Arabian radiographers. METHODS: A questionnaire was designed to collect the data from Saudi Arabian radiographers. The questionnaire was created using Google Forms and was sent to 530 radiographers using WhatsApp. In total, 159 participants completed and returned the questionnaire through WhatsApp. The response rate was 30%. Basic descriptive statistics were employed to analyse the data. RESULTS: Most of the participants (79.9%) thought that social media could be used as a tool for the improvement of radiation safety knowledge. Also, almost half of participants (49.7%) employed social media when they needed to obtain information about radiation protection. Similarly, a majority of respondents (69.2%) used social media when they required information related to radiation safety. In addition, 81.7% of participants observed on video the existing information on radiation safety. Also, 71.7% of them were disposed to expand the use of social media to obtain information for radiation protection in their professional activities. CONCLUSION: The results indicate that social media can help to improve radiation safety knowledge among Saudi Arabian radiographers. Consequently, participants were willing to increase the use of these tools in their professional work.

Handwashing Knowledge, Attitudes, and Practices among Students in Eastern Province Schools, Saudi Arabia.

Background. Lack of knowledge about appropriate handwashing practices has caused great concerns for human health, especially in the risk of many communicable diseases. The objective of the current study is to determine the level of handwashing knowledge, attitudes, and practices among school students in Eastern Province Schools, Saudi Arabia. A cross-sectional survey was recruited from November 2019 to March 2020 to assess the level of the students' handwashing knowledge. A reliable questionnaire was prepared (Cronbach's alpha = 0.608) and conducted using a two-stage sampling technique. A total of 271 students participated in the study from primary, middle, and high schools; 80% were boys, most of whom displayed an acceptable level of knowledge on hand hygiene. Nearly 75% and 74% of boys and girls, respectively, gained knowledge about hand hygiene practices from their parents. Only 46% of the students thought that handwashing is a potential protective measure against diseases, whereas 34% thought it only removes dirt. Prevalence of handwashing with soap after using the toilet was recognized among 52% of the students. Additionally, 93% of the students used water and soap to wash their hands (p value < 0.001) and 97% suggested that soap and water are the best methods to wash their hands (p value < 0.001). There was a positive correlation between the mother's education and hand hygiene practices (p value = 0.044). Results collectively indicated that handwashing knowledge and practices among school students in the Eastern Province are acceptable interventions in preventing the transmission of infectious diseases such as COVID-19. Indeed, further improvement conducted through specific health education programs to emphasize the role of handwashing in health hygiene is highly recommended.

Virtual Reality: Is It Helping Children Cope with Fear and Pain During Vaccination?

BACKGROUND: Virtual reality (VR) is an innovative distraction technology in health care, but little is known about this topic in Saudi Arabia. The aim of this study was to assess the effectiveness of using VR to reduce pain and fear among children during vaccination. METHODS: It is a cross-sectional study design. A total of 104 children (ages 4-6 years) receiving routine vaccinations in a single primary health care in Eastern Region, Saudi Arabia, participated in the study and grouped to a VR technology intervention group or vaccination as usual without VR distraction. The primary outcome is the difference in the child's self-rated fear and pain scores between those who have been vaccinated with or without VR distraction, measured by the two validated international facial expressions scales Wong-Baker FACES Pain Scale and Children's Fear Scale. RESULTS: In the two-month study period, 53 children were vaccinated using the VR technology and 50 children were vaccinated without VR. Bivariate analysis showed a significantly lower pain score among the VR group (=1.36, SD 2.06) compared with the group without VR (=6.90, SD 3.47) (P-value < 0.001). Similarly, fear score was lower in the VR group (=0.64, SD 0.92) compared with the group without VR (=2.88, SD1.55) (P < 0.001). In multivariable regression models adjusted for age and gender, children vaccinated using the VR technology had significantly lower pain and fear scores compared with those who were vaccinated as usual without VR distraction. CONCLUSION: VR technology showed a positive impact on reducing pain and fear among children aged 4-6 years during vaccination. Policymakers are encouraged to expand the use of this distraction tool in primary health centers to improve the vaccination experience among children.

Perceived Barriers to Primary Care Services Utilization and its Associations with Overall Satisfaction of Patients in Saudi Arabia: A Cross-Sectional Questionnaire-Based Study.

INTRODUCTION: Primary care plays an integral role in modern healthcare systems. More so in a country that is currently undergoing a reform of its health system. Their remains barriers that hinder patients from seeking medical assistance from primary physicians. This study aims to examine the overall satisfaction of patients toward Primary Healthcare Centers (PHCs) in Saudi Arabia, as well as its association with potential barriers from a sample of patients who presented at the emergency department (ED) for non-urgent cases. METHODS: This cross-sectional study sampled 403 patients from King Fahd Hospital of the University. A piloted questionnaire was utilized that included questions on sociodemographics, satisfaction of PHCs, as well as organizational, socioeconomic, access, and patient-doctor relationship barriers using a Likert-scale item response. Chi-squared and Fisher's Exact tests were used to compare categorical variables, and multivariable logistic regression was used to assess the association between overall satisfaction and all factors and barriers. RESULTS: The sample consisted of 48.1% males and 51.9% females. Only 5.2% of the patients were hospitalized. Of the total sample, 28.3% reported being always satisfied with PHC services. The most reported barriers were organizational barriers and socioeconomic barriers. The regression analysis found that being a female, highly educated, have high organizational, and patient-doctor relationship were independent predictors for low overall satisfaction with PHCs. CONCLUSION: Findings from this study should allow healthcare planners and policy makers to reduce the impact of these barriers by finding solutions that would target them. This may include strictly implementing policies such as proper implementing of triaging in EDs as well as promoting services that are being provided free of charge at these centers.

Awareness, Attitudes, Practices, and Perceived Barriers to Medical Error Incident Reporting Among Faculty and Health Care Practitioners (HCPs) in a Dental Clinic.

BACKGROUND: Good Catch programs are being increasingly embraced by the Saudi healthcare system to improve incidence reporting rates and patient safety. However, dental health care is at a critical stage of promoting a safety culture; there is insufficient use of incident reporting systems (IRS) in several dental schools. Therefore, in this study, we evaluated the level of awareness, attitudes, practices, and perceived barriers to incident reporting among faculty and health care practitioners (HCPs) working in a university dental clinic. METHODS: It is a cross-sectional study design where participants have been recruited from faculty working in a dental clinic at Imam Abdulrahman bin Faisal University during the year 2019. A self-administered questionnaire was distributed including domains of awareness, attitude, practice, and barriers to use. RESULTS: A total of 199 completed questionnaires were received. HCPs differed with respect to their levels of awareness, attitudes, and practices of incident reporting when compared with non-Saudi HCPs. Nurses showed high awareness scores (X= 4.4, p <0.001), practice scores (X= 3.61, p <0.001), and attitudes (X= 3.9, p <0.001) in comparison with dentists and interns. The respondents agreed that the most common factor that influenced the rate of their incident reporting was "possible negative effect on the relationship with employees.". CONCLUSION: Nurses showed higher levels of awareness, attitude, and practice regarding IRS than did dentists and interns. We uncovered key factors influencing incident reporting among the faculty and HCPs in a university dental clinic. These findings could aid policymakers to focus on these factors so as to frame appropriate strategies to encourage incident reporting and to improve the effective use of the IRS.

A comparative study of strategies for containing the COVID-19 pandemic in Gulf Cooperation Council countries and the European Union.

BACKGROUND: The COVID-19 pandemic has impacted every aspect of human lives including health, businesses, and lifestyles. In spite of governments implementing various strategies across the globe, the pandemic is still expanding with increasing numbers of positive cases. In addition, countries are reopening and easing lockdown restrictions in order to get their economies back on track, and this has led to an increase in the transmission of novel coronavirus. Therefore, it is essential to regularly review the containment strategies employed in different regions in order to understand the characteristics of COVID-19 transmission and to formulate a future course of actions. OBJECTIVE: The objective of this study is to review the COVID-19 transmission statistics in Gulf Cooperation Council (GCC) and European Union (EU) countries, and to compare these data with the various containment strategies implemented for containing the spread of the virus. METHODS: A review method was adopted along with different statistical methods for comparing and analyzing COVID-19 data and containment strategies. Transmission types and the Case Fatality Rate (CFR) in the countries in both regions are used to present the current state of the pandemic. In addition, changes in the number of COVID-19 cases are compared with the mitigation and suppression strategies implemented in both regions and their impact is analyzed. RESULTS: Countries in the EU were slow in reacting to the pandemic, as delays are observed in the implementation of mitigation strategies. However, suppression strategies were implemented soon after mitigation strategies. GCC countries, on the other hand, were quick to react, and they implemented both mitigation and suppression strategies simultaneously, as soon as the pandemic emerged. The CFR was found to be low among GCC countries compared to EU countries. In addition, a second wave of transmission was observed in the EU, whereas in GCC countries there has been no second wave, although a gradual increase in the number of cases is observed. Community transmission was observed among the majority of countries in both GCC and EU countries. CONCLUSIONS: With the reopening of markets, the focus of governments should be on developing integrated user-centric preventive strategies, with a blend of awareness creation, motivation, and support.

Measuring Patient Trust in Public versus Private Physicians in the Kingdom of Saudi Arabia (KSA).

BACKGROUND: This study aims to assess and compare patient trust in public vs private physicians and to determine the factors that can affect the level of trust in the context of the KSA. METHODS: A cross-sectional study was carried out in the KSA to assess patient trust in physicians. A questionnaire was administered in both Arabic and English to patients above 18 years of age via online channels. RESULTS: A statistically significant difference was found between the level of trust in public vs private physicians, where the public physicians showed higher patients' trust scores compared to private physicians, where the mean was 2.51 (SD=0.60) and 2.29 (SD=0.56), respectively, P-value<0.001. A statistically significant difference was also found between self-assessment health status (SAHS) groups (F(3)=11.429, P=0.010). Other factors were not significantly associated. CONCLUSION: This study found that public physicians engender a higher level of patient trust than private physicians. A further qualitative study should be conducted in the future to investigate the reasons behind the high trust in public physicians in the KSA. PRACTICE IMPLICATIONS: The results of this study open doors for new investigations that might result in the implementation of new interventions to promote patient trust in the healthcare journey in KSA.

The Effects of Ambulance Response Time on Survival Following Out-of-Hospital Cardiac Arrest.

BACKGROUND: Patients who suffer cardiac arrest outside medical facilities are at greater risk of death and adverse medical outcomes. Cardiopulmonary resuscitation affects the survival rates of such patients, which suggests that response time may be vital to patient outcomes. OBJECTIVE: The aim of this study was to investigate the role of response time, whether more or less than 8 minutes, on the survival of patients who have suffered out-of-hospital cardiac arrest. METHODS: Data were collected from emergency cases handled by a secondary hospital in Jubail, Saudi Arabia, between January 2017 and October 2019. There were 108 out-of-hospital cardiac arrest cases, 85 of which resulted in death. RESULTS: Bivariate analysis showed no significant association between response time and patient outcomes; however, the odds of having a negative outcome (death) if the response time is more than 8 minutes is double the odds of dying if the response time is less than 8 minutes. CONCLUSION: Ambulance response time to out-of-hospital cardiac arrest does not significantly influence the patient survival rate in the current study hospital. Other variables may have a more significant effect.

Mobile Ambulatory Application Asafny and Traditional Phone Request 997: A Comparative Cross-Sectional Study.

PURPOSE: This study aimed to determine whether there was a time difference between the ambulatory application Asafny and traditional type 997 in reaching people in need and interacting appropriately. MATERIALS AND METHODS: This study was conducted using retrospective cross-sectional study. A total of 2120 ambulance requests was extracted from Saudi Red Crescent Authority servers in Eastern Province, Kingdom of Saudi Arabia. The requests were extracted between 2017 and 2019. RESULTS: There were no significant differences between the two methods of request. In 2019, the shortest times for all phases of requests were recorded. "Ordinary patient" was the most common cause for requests. CONCLUSION: Over the years, efforts by the Saudi Red Crescent Authority facilitated improvements in ambulatory services by adapting new technology and services. This has helped reduce times for all phases of emergency requests.