Users' attitudes to an electronic medical record system and its correlates: a multivariate analysis.

Implementation of an electronic medical record (EMR) system increases efficiency of health services, quality of care and patient satisfaction. Successful implementation depends on many factors, one of which is how users respond to the new system. We studied medical receptionists' appraisal of the newly implemented EMR system in primary healthcare centres in Kuwait. Four hundred receptionists were selected randomly from different healthcare centres and asked to complete a user interaction satisfaction questionnaire relating to their experience of the new system. The response rate was 80.5%. A large majority of the respondents considered the system to be flexible (83%), easy (89%), and satisfying (81%). However, more than one third of the respondents (36%) found the system inadequate. Bivariate and multivariate analyses found age, typing ability, ease of data entry and computer error as significant correlates with overall user response. These findings relating to users' reactions to various aspects of the EMR should assist policymakers to recognise the causes of dissatisfaction with the EMR among medical receptionists at health centre clinics that may adversely affect its successful implementation and regular use, as well as the quality of care provided by the clinics. In addition, the findings provide information to assist the development of guidelines for future implementation of the EMR system at the secondary healthcare level.

Job satisfaction of nurses with multicultural backgrounds: a questionnaire survey in Kuwait.

BACKGROUND: Nurses working in Ministry of Health hospitals in Kuwait come from 35 countries, and only 12% of them are Kuwaitis. This study explores factors that influence the job satisfaction of nurses of multicultural background working in five general hospitals in Kuwait. OBJECTIVES: This study aims to identify factors related to the job satisfaction of nurses and the effect of selected background characteristics (e.g., age, gender, nationality, educational qualification, marital status, monthly salary, experience in other countries, and years of experience) on the global satisfaction scale by using the McCloskey-Mueller Satisfaction Scale. METHODS: A stratified random sample size of 500 subjects was selected, and a questionnaire was distributed among them. Four hundred thirty-six completed questionnaires were returned, resulting in a response rate of 87.2%. RESULTS: Factor analysis identified five factors: satisfaction with (a) professional opportunities; (b) praise and recognition; (c) scheduling of duty; (d) control and responsibility, and (e) extrinsic rewards. These together explained 59.5% of the total variance. Nurses were found to be dissatisfied with two of five factors: professional opportunities and extrinsic rewards. Nurses were satisfied with the remaining three factors, although levels of satisfaction were not very high. The relationship of job satisfaction with nationality and marital status was positive and significant. However, a higher level of educational qualification showed an inverse relationship with job satisfaction. CONCLUSIONS: Two issues identified here concerned aspects of nurses' professional development and extrinsic rewards, which have to be addressed as prerequisites to any improvement in the quality of nursing care in Kuwait. Based on our findings, we recommend a concerted action in developing a strategy to improve various aspects of nurses' professional development and extrinsic rewards. This will have a positive impact on the quality of health care of the Kuwaiti population.

Prevalence of viral markers among first-time Arab blood donors in Kuwait.

BACKGROUND: The aim of this study was to assess the effect of blood donation modes on the prevalence of viral markers among Arab first-time blood donors in Kuwait. STUDY DESIGN AND METHODS: Donor ethnic background was classified as Kuwaiti nationals and non-Kuwaiti Arabs. A total of 26,874 donors were screened in 2002 for the following viral markers: hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), anti-hepatitis B core antigen (HBc), human immunodeficiency virus-1 and -2 antibody (anti-HIV-1 and -2), HIV p24, and human T lymphotropic virus-I and -II antibody (anti-HTLVI/II). All samples positive for the presence of anti-HBc were tested for anti-HBs. Among these donors, 12,798 were first-time donors of which 74 percent were replacement and 26 percent were volunteers. RESULTS: The prevalence of HCV among replacement donors was significantly higher than the volunteer group. The difference between the two modes of blood donations, however, was not significant for HBsAg. The prevalence of anti-HCV among Kuwaiti national and non-Kuwaiti Arab first-time donors was 0.8 and 5.4 percent, respectively, whereas the prevalence of HBsAg was 1.1 and 3.5 percent, respectively, with the difference being significant at a p level of <0.0001. The difference observed for prevalence of anti-HBc among Kuwaiti national and non-Kuwaiti Arab donors (17 and 33.3%, respectively) was significant (p < 0.0001). Among first-time donors, 13.7 percent were positive for the presence of anti-HBs, indicating that 13.7 percent of the total Arab donor population might have had a previous infection and possible immunity to hepatitis B virus (HBV). CONCLUSION: A high prevalence of HBV and HCV was found among non-Kuwaiti Arab donors. The prevalence of anti-HCV was only significantly higher among replacement versus volunteer first-time donors. Therefore, there is a need to develop a strategic plan that incorporates the diverse background of the blood donors living in Kuwait.

Determinants of job satisfaction among nurses in Kuwait.

OBJECTIVE: Job satisfaction among nurses working in five general hospitals in Kuwait was analysed using a global scale based on the McClosky Mueller Satisfaction Scale (MMSS) in relation to selected background characteristics (eg age, gender, nationality, educational qualification, monthly salary and the departments in which they worked. DESIGN: The questionnaire was distributed to 500 nurses using a stratified random sample. The response rate was 87.2%. RESULTS: Age, nationality and the department worked in had a positive significant relationship with job satisfaction. However, a higher level of educational qualification and previous work experience in other countries showed an inverse relationship with job satisfaction. CONCLUSION: Based on our findings, we recommend that expatriate staff should be provided with an understanding of cultural differences and how to cope with them. Special attention should be paid to the norms regarding interaction among males and females and social interaction among professionals from the opposite gender. Intensive courses in the languages to be used in the care provision process should be provided to impart requisite language competency.

RBC alloimmunization and autoimmunization among transfusion-dependent Arab thalassemia patients.

BACKGROUND: Thalassemia major is a common hemoglobinopathy in the Arabian Gulf region. However, limited data are available on the frequency of RBC alloimmunization and autoimmunization in transfusion-dependent Arab thalassemia patients. STUDY DESIGN AND METHODS: A total of 190 thalassemia major patients were classified as Kuwaiti Arab and non-Kuwaiti Arab. Pretransfusion investigation records were reviewed for the presence of RBC alloantibody and autoantibody, and the age at which RBC alloantibody was developed. RESULTS: Fifty-seven (30%) patients developed RBC alloantibodies. The most common clinically significant alloantibodies were directed against antigens in the Kell and Rh systems. Anti-K developed in 41 (72%) patients followed by anti-E in 26 (45.6%). RBC autoantibodies developed in 21 (11%) patients with and without underlying RBC alloantibodies. Sixty-six (49.6%) RBC alloantibodies developed between the ages of 2 and 10 years. CONCLUSION: Several factors might have contributed to the high alloimmunization and autoimmunization rate observed in this study, including the heterogeneity of the population living in Kuwait, lack of better-matched donors for those patients, and the use of poststorage leukodepleted blood. It is recommended that thalassemia patients receive blood matched for Rh and Kell antigens and prestorage leukodepleted RBCs.