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1.
J Spec Pediatr Nurs ; 26(2): e12324, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33421315

RESUMO

PURPOSE: In pediatric asthma, family empowerment education has been beneficial for the quality of life, pulmonary function, and family functioning. Few studies addressed the impact of a family empowerment program on asthma symptom control, acute healthcare use (AHCU), and medication use in children with asthma. This study aimed to assess the effect of a family empowerment intervention on asthma symptom control, AHCU, inhaler technique, and controller adherence in children with asthma. DESIGN AND METHODS: A single-center study using a randomized controlled design was conducted in a university hospital in the center of Tunisia from May 2018 to September 2019. Eighty-two families were randomly assigned to the intervention group (n = 41) of 8 weeks of group training sessions, or to the control group (n = 41) of usual care education. Thirty-seven families in the intervention group and 39 families in the control group received allocated intervention at baseline. Thirty-four families in each group completed the study at the 12-month follow-up. RESULTS: At baseline, the intervention and control groups were statistically comparable (p > .05). At follow-up, there were significant differences between the intervention and the control group in asthma symptom control, χ2 (1, N = 34) = 9.950, p = .002, and inhalation technique, χ2 (1, N = 34) = 5.916, p = .01. For AHCU and adherence to asthma controller, there was no significant difference between groups, χ2 (1, N = 34) = 3.219, p = .07, χ2 (1, N = 34) = 0.541, p = .46, respectively. The difference within time in asthma symptom control and inhalation technique was significant (p = 10-3 , p = .001; respectively). PRACTICE IMPLICATIONS: This study demonstrated that a family empowerment program significantly improved asthma symptom control and inhaler technique in children with asthma aged 7-17 years. This intervention could be clinically useful and time-saving for pediatric nurses.


Assuntos
Asma , Qualidade de Vida , Asma/tratamento farmacológico , Criança , Humanos
2.
Aust Crit Care ; 34(4): 363-369, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33121872

RESUMO

INTRODUCTION: Critical care nurses are considered the key to patient safety improvement and play a vital role in enhancing quality of care in intensive care units (ICUs) where adverse events are frequent and have severe consequences. Moreover, there is recognition of the importance of the assessment and the development of patient safety culture (PSC) as a strategic focus for the improvement of patient safety and healthcare quality, notably in critical care settings. OBJECTIVES: This study aimed to assess critical care nurses' perception of PSC and to determine its associated factors. METHODS: This cross-sectional study was conducted among nurses working in the ICUs of the Tunisian centre (six Tunisian governorates). The study instrument was the French validated version of the Hospital Survey on Patient Safety Culture questionnaire, comprising 10 dimensions and a total of 50 items. RESULTS: A total of 249 nurses from 18 ICUs participated in the study, with a participation rate of 87.36%. The dimensions scores ranged between 17.2% for the dimension "frequency of events reported" and 50.1% for the dimension "teamwork within units". Multivariable logistic regression indicated that respondents who worked in private hospitals were five times more likely to have a developed PSC (adjusted odds ratio [AOR]: 5.34; 95% confidence interval [CI], [2.28, 12.51]; p < 10-3). Similarly, participants who worked in a certified hospital were two times more likely to have a more developed PSC than respondents who work in noncertified hospitals (AOR: 2.51; 95% CI, [.92-6.82]; p = 0.041). In addition, an increased nurse-per-patient ratio (i.e., reduced workload) increased PSC (AOR: 1.10; 95% CI, [1.02-1.12]; p = 0.018). CONCLUSION: This study has shown that the state of critical care nurses' PSC is critically low and these baseline results can help to form a plan of actions for improvements.

3.
Compr Child Adolesc Nurs ; 44(2): 122-133, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32302238

RESUMO

Asthma is a leading cause of acute health care use (AHCU) as defined by hospitalization and emergency department visits (ED). Little was known about factors associated with asthma-related AHCU. This study aimed to identify factors determining AHCU in children and adolescents with asthma. A descriptive study was conducted among children with mild to severe asthma referred to the pediatric outpatient clinic of "Farhat Hached" University Hospital of Sousse (Tunisia) over a period of three months (April-June 2018). We collected data regarding clinical information, the number of hospitalizations and ED visits related to asthma in the past 12 months, asthma management behaviors, and quality of life of children. Multivariable logistic regression was performed using SPSS (20.0). A total of 90 children have participated in the study. The percentage of children aged 7 to 11 years was higher than the percentage of adolescents aged 12 to 17 years (67.8%; 32.2%, respectively). The final logistic regression model demonstrated that asthma severity and inhaler technique increased the odds of AHCU (OR a = 4.6; 95% CI: 1.1-18.1; p = .03, OR a = 2.9; 95% CI: 1.1-7.8; p = .02, respectively). Also, increased quality of life score reduced the odds of AHCU (OR a = 0.6; 95% CI: 0.4-0.9; p = .01). These results suggest that the organization of programs targeting the management of these factors can reduce the workload on hospital services and emergencies.

4.
Psychol Health Med ; 26(2): 212-220, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-32835517

RESUMO

Burnout is a major issue among healthcare students and a public health issue in general. Indeed, the consequences of student burnout are as complex as other mental distress factors, such as those concerned with smoking and alcohol consumption, or an unhealthy lifestyle.  This study aimed to determine the prevalence of burnout among health sciences students and to determine its associated factors. This is a cross-sectional descriptive study conducted among 368 students of a Tunisian institution using the French validated version of the MBI-SS. The prevalence of burnout was 64.4%. The presence of a diagnosed health problem, a diagnosed mental disorder or sleep problems were associated with burnout. Students who live alone are significantly the most emotionally exhausted (p=0.010) and the most cynical (p=0.033). Students who had a low socio-economic level are significantly more cynical than those who had a medium or high socio-economic level (p=0.032). Performing leisure activities and practicing physical activities were associated with emotional exhaustion (p=0.007, p= 0.008, respectively).In our study, burnout is prevalent among Tunisian health sciences students. Many factors were found to be associated with this syndrome. These findings reinforce the need to establish early preventive strategies to encounter this problem and its consequent risks.


Assuntos
Esgotamento Psicológico/epidemiologia , Estudantes de Ciências da Saúde/psicologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Estudantes de Ciências da Saúde/estatística & dados numéricos , Tunísia/epidemiologia , Adulto Jovem
5.
Int Emerg Nurs ; 54: 100941, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33341462

RESUMO

BACKGROUND: Emergency departments (EDs) are considered a high-risk environment because of the high frequency of adverse events that occur within. Measuring patient safety culture is an important step that assists healthcare facilities in planning actions to improve the quality of care provided to patients. This study aims to assess patient safety culture within EDs and to determine its associated factors. METHODS: A cross-sectional study conducted among professionals from all the EDs of public and private healthcare institutions in Tunisia. It spread from June to September 2017. We used the validated French version of the Hospital Survey on Patient Safety Culture questionnaire. RESULTS: In total, 11 EDs were included in the study, with 442 participants and a participation rate of 80.35%. All the ten dimensions of patient safety culture were in need of improvement. 'Teamwork within units' scored the highest with 46%, however, the lowest score was attributed to 'the frequency of adverse events reporting' (19.6%). Several factors have been found significantly related to safety culture. Private EDs have shown significantly higher scores regarding nine patient safety culture dimensions. CONCLUSION: This study showed a concerning perception held by participants about the lack of a patient safety culture in their EDs. Also, it provided baseline results giving a clearer vision of the aspects of safety that need improvement.


Assuntos
Serviço Hospitalar de Emergência , Gestão da Segurança , Estudos Transversais , Humanos , Equipe de Assistência ao Paciente/normas , Inquéritos e Questionários , Tunísia
6.
J Pediatr Nurs ; 54: e9-e16, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32616452

RESUMO

PURPOSE: Patient education is fundamental in asthma management, especially at pediatric age. It is increasingly recognized as effective in reducing the burden of the disease, but is less clear in improving the quality of life of children with asthma and their parents. This study assessed the effect of an asthma therapeutic education program on pulmonary function and quality of life in children with asthma and their parents. DESIGN AND METHODS: A monocentric randomized controlled trial conducted in Farhat Hached University Hospital of Sousse (Tunisia) from May 2018 to September 2019. Thirty-seven families in the experimental group and 39 families in the control group received allocated intervention at baseline. Thirty-four families in each group completed the study at the 12-month follow-up. RESULTS: The intervention significantly improved quality of life scores of children and their parents (all p < 0.05). Children in the experimental group had significantly better forced expiratory maneuver than children in the control group. Nonetheless, the FEV1/FVC ratio did not show any significant difference in the experimental and control group (p = 0.9; p = 0.14, respectively). CONCLUSIONS: This study demonstrated that a long-term family-based asthma education program resulted in better pulmonary function and QOL of children and parents enrolled in the intervention group, particularly children with non-allergic asthma. PRACTICE IMPLICATIONS: Family-based asthma education can reduce the burden of allergic and non-allergic asthma on children and their parents through improving their quality of life. Also, the pulmonary function of children with non-allergic asthma was improved due to My Asthma Therapeutic Education intervention.


Assuntos
Asma , Qualidade de Vida , Asma/terapia , Criança , Humanos , Pais , Tunísia
7.
Compr Child Adolesc Nurs ; : 1-11, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32687718

RESUMO

Chronic childhood asthma is a leading cause of poor quality of life. Factors associated with this major asthma outcome were controversial. The aim of this study is to assess the quality of life of children and adolescents with mild to moderate asthma and to determine the factors associated with quality of life impairment in this population. This was a descriptive study carried out in the pediatric outpatient clinic of a University Hospital in the center of Tunisia over a period of 3 months (April-June 2018). Participants were children with mild to moderate asthma aged 7 to 17 years. The Pediatric Asthma Quality of Life Questionnaire was used to assess quality of life. Binary logistic regression was performed to identify predictors of asthma-related quality of life. A total of 90 children participated in the study. Almost 68% of children were aged 7 to 11, and nearly 32% were adolescents. The mean of PAQLQ total score was 4.7 ± 1.2. The final logistic regression model demonstrated that asthma symptoms control had the greatest impact on quality of life, followed by acute health care use in the past 12 months (p = .007; p = .01, respectively). The child gender and the parent's quality of life were also associated with the child's quality of life (p = .02; p = .008, respectively). This study revealed that children and adolescents with mild to moderate asthma had a moderate quality of life score. Asthma symptoms control, acute health care use, gender, and parent's quality of life determined the quality of life of children with asthma. Family-based asthma training programs that target family functioning and asthma outcomes are required.

8.
J Crit Care ; 56: 208-214, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31952015

RESUMO

PURPOSE: This study aimed to assess patient safety culture (PSC) in intensive care units (ICUs) and to determine the factors affecting it. MATERIALS AND METHODS: This is a cross-sectional study, conducted from October to November 2017 among professionals practicing in the ICUs of the Tunisian center. After obtaining institutional ethics committee's approval and administrative authorizations, an anonymous paper-based questionnaire was distributed to the participants after obtaining their consent to take part in the study. The measuring instrument used is the French validated version of the "Hospital Survey on Patient Safety Culture" questionnaire. RESULTS: A total of 402 professionals, from 18 ICUs and 10 hospitals, participated in the study with a participation rate of 82.37%. All dimensions were to be improved. The most developed dimension was teamwork within the unit (47.87%) and the least developed dimension was the non-punitive response to error (18.6%). Seven dimensions were significantly more developed in private institutions than in public ones. Results also show that when workload is reduced, the PSC was significantly increased. CONCLUSION: This study has shown that the PSC in ICUs needs improvement and provided a baseline results to get a clearer vision of the aspects of security that require special attention.


Assuntos
Cuidados Críticos/organização & administração , Unidades de Terapia Intensiva , Cultura Organizacional , Segurança do Paciente , Gestão da Segurança/organização & administração , Adulto , Estudos Transversais , Feminino , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Qualidade da Assistência à Saúde , Inquéritos e Questionários , Tunísia , Carga de Trabalho , Adulto Jovem
9.
Tunis Med ; 97(4): 519-524, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31729701

RESUMO

BACKGROUND: Student absenteeism is a major concern for higher education and especially for medical studies. AIM: This work was conducted to assess the extent of this phenomenon among undergraduate medical students at the Faculty of Medicine of Sousse and to determine whether certain student characteristics affect student absenteeism. METHODS: We conducted a descriptive cross-sectional study among first and second year of medical study students from the faculty of medicine of Sousse during the second semester of the 2015-2016 academic year using a pretested self-administered questionnaire. RESULTS: The response rate was 80.9%. Of the respondents, 9.6% reported never having attended the lectures. The reason that justified this absenteeism was the boring teaching. Absenteeism was significantly associated with gender (15.7% of male students never attended versus 7.1% of female students, p = 0.015), with the year of study (7.4% of first-year students versus 12.1% of second-year students, p = 0.0001) and the repetition of the year (9.1% of non-repeaters versus 21.1% of repeaters, p = 0.002). CONCLUSION: Various reasons for missing classes have been identified which suggesting the complexity of this decision. Knowledge of these factors could potentially help university medical teachers to develop innovative teaching strategies that would reduce the rate of absenteeism.


Assuntos
Absenteísmo , Estudantes de Medicina , Estudos Transversais , Feminino , Humanos , Masculino , Fatores Sexuais , Inquéritos e Questionários , Tunísia , Adulto Jovem
10.
Tunis Med ; 96(2): 122-128, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30324977

RESUMO

BACKGROUND: Tobacco use among teenagers in an increasing concern for the international community, especially with the fact that early experimentation is now identified as a risk factor for durable consumption and addiction. AIM: To study Tobacco use and its determinants amongteenagers in the city of Sousse. METHODS: A descriptive cross-sectionalstudy was carried out among a sample of teenagers enrolled in the city of Sousse (Tunisia) in 2016-2017. A two-stage sampling was conducted for the selection of adolescents. Data were collected using a self-administered questionnaire in Arabic language. RESULTS: The sample consisted of 330 students. The prevalence of smoking was 9.7%(95% CI6,7% ;13%), with a male predominance (14.4% vs 6.3%). The mean age of onset of tobacco was 14.65 ± 1.38 years. 44.8% of parents ignore their children's smoking. The mean dependence score was 4.77 ± 3.6 (HONC test).  Factors significantly associated with smoking were gender, age, educational level, repeating school years, relationship with parents and teachers, presence of smokers in the environment, knowledge about the health risks of tobacco. CONCLUSION: Sensitizationactions should be strengthened within schools, starting even in primary schools, in collaboration with teachers, family and health professionals. In addition, more effective and rigorous enforcement of legislation is essential.


Assuntos
Instituições Acadêmicas/estatística & dados numéricos , Fumar/epidemiologia , Estudantes/estatística & dados numéricos , Adolescente , Comportamento do Adolescente/fisiologia , Fatores Etários , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Fatores de Risco , Inquéritos e Questionários , Tunísia/epidemiologia , Urbanização , Adulto Jovem
11.
J Res Health Sci ; 18(2): e00414, 2018 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-29784895

RESUMO

BACKGROUND: Bullying is a serious public health concern remarkably common among youth. Involvement in bullying can lead to deleterious effect on the emotional well-being of pupils. The aim of this study was to assess the prevalence of bullying, its psychosocial associated factors and the perceived involvement of parents, teachers, and classmates to counteract this behavior. STUDY DESIGN: A cross-sectional study. METHODS: We conducted this study in 2015 among a representative multistage sample of 1584 students enrolled in middle schools in the Region of Sousse using the revised Olweus Bully/Victim Questionnaire. It assesses the prevalence of bullying and covers qualitative details of bullying including psychosocial factors and perceived efforts of others to counteract bullying. RESULTS: 11.7% of respondents were classified as pure victims, 7.8% as pure bullies, 3.2% as bully-victims and 75.5% as bystanders. Compared to other groups, the bully-victims were less likely to report a feeling of empathy and liking school. They were more likely to be afraid of being bullied, aggressive and to have fewer friends in the class. Only 30.3% of the victims indicated that they told someone about being bullied. The majority of the middle school students perceived that classmates (54.1%) and teachers (39.5%) did nothing to counteract bullying. CONCLUSIONS: Information about bullying is critical and must be gathered before effective intervention is planned. Parents, teachers and students should learn effective ways to handle the bullying problem since the most effective programs are comprehensive targeting students, schools, families and the community.


Assuntos
Bullying/prevenção & controle , Bullying/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Adolescente , Agressão/psicologia , Criança , Estudos Transversais , Docentes , Feminino , Humanos , Masculino , Pais , Grupo Associado , Prevalência , Estudantes/psicologia , Tunísia/epidemiologia
12.
Sante Publique ; 29(2): 255-262, 2017 Apr 27.
Artigo em Francês | MEDLINE | ID: mdl-28737344

RESUMO

Aim: This study was designed to assess the prevalence of alcohol consumption and factors associated with alcohol consumption among students of the Sousse region of Tunisia. Methods: This was a cross-sectional study conducted among 556 students of Sousse universities during the 2012-2013 academic year, using an anonymous self-report questionnaire. Data capture and statistical analysis were performed with SPSS software 18.0. Results: Our study population was composed of 268 males (48.2%) with a mean age of 21.8 ± 2.1 years. Eighty-four students (15.1%) had consumed alcohol at least once. On multivariate analysis, male gender (OR = 6.94; 95%CI = [2.32-20.72]), smoking (OR = 13.21; 95%CI = [6.20-27.78]), drug use (OR = 32.22; 95%CI = [6.73-154.26]) and parental alcohol consumption (OR = 4.31; 95%CI = [1.70-10.91]) were the factors significantly associated with alcohol consumption among students. Conclusion: This study was designed to determine the characteristics of alcohol consumption among Tunisian students. Alcohol consumption levels were comparable to those reported in the general population and were significantly related to smoking and drug use. The next step of this study will consist of developing strategies to prevent risk behaviours in the student population.


Assuntos
Consumo de Álcool na Faculdade , Consumo de Bebidas Alcoólicas/epidemiologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Prevalência , Tunísia/epidemiologia , Adulto Jovem
13.
Int J Adolesc Med Health ; 31(4)2017 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-28632496

RESUMO

Background The objective of the study was to evaluate the effectiveness of a school-based physical activity and nutritional behavior intervention, on the reduction of clustering of chronic diseases risk factors among school children. Materials and methods A quasi-experimental school-based intervention was conducted with an intervention group and a control group in the region of Sousse in Tunisia. The intervention was implemented between 2010 and 2013, with data collected at pre and at post intervention. Studied risk factors were: smoking, sedentary behavior, low fruit and vegetable intake and obesity. Odds ratios (ORs) were used to calculate the clustering of two risk factors. We calculated ORs in each group before and after the intervention. Results In the intervention group, the prevalence of adolescents that had no risk factors has significantly increased (p = 0.004). In the control group the prevalence of adolescents carrying two or more risk factors has increased (p = 0.06). The results showed that all risk factors tended to cluster together in both groups. In the intervention group, the calculated OR for smoking and sedentary behavior decreased after assessment (OR = 5.93) as well as the OR for smoking and low fruit and vegetable intake (OR = 3.26). In the control group, all ORs increased, showing an enhancement of the association. Conclusion This study showed the effectiveness of a school-based intervention in reducing the clustering of chronic diseases risk factors.

14.
Int J Adolesc Med Health ; 29(2)2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-26360490

RESUMO

BACKGROUND: Obesity is a serious health issue and predisposes individuals to an increased risk of morbidity and mortality. Its prevalence in children has increased worldwide. OBJECTIVE: To demonstrate the feasibility and effectiveness of a school-based management program based on healthy lifestyle promotion for obese and overweight adolescents in Sousse, Tunisia. METHODS: We conducted a quasi-experimental study among overweight and obese school children enrolled in 7th and 8th grades in Sousse, Tunisia with two groups, intervention and control. The 1-year intervention was based on promoting healthy eating and physical activity through a collective intervention for all recruited children and an individual intervention only for obese children who require intensive managing. Data collection was done before, at the end and at a 4-month follow up of the intervention, both in intervention and control groups. RESULTS: The body mass index Z score decreased significantly from pre-intervention to post-intervention (1.89±0.57 to 1.76±0.63, p<0.001) and from post-intervention to the follow-up (1.76±0.63 to 1.55±0.68, p<0.001) in the intervention group. In the control group, it decreased significantly from pre-intervention to post-intervention but not significantly from post-intervention to follow-up assessment. Calorie intake decreased significantly both in intervention and control groups. CONCLUSION: This project began with introducing a new culture of health management in schools on one side and with increasing awareness of the importance of obesity prevention and treatment. The support of authorities for this type of action is very important to guarantee its sustainability.


Assuntos
Atitude Frente a Saúde , Aconselhamento/métodos , Promoção da Saúde/métodos , Sobrepeso/prevenção & controle , Estudantes/psicologia , Adolescente , Índice de Massa Corporal , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Pessoal de Saúde , Humanos , Masculino , Sobrepeso/epidemiologia , Serviços de Saúde Escolar , Instituições Acadêmicas , Estudantes/estatística & dados numéricos , Tunísia/epidemiologia
15.
Pan Afr Med J ; 23: 30, 2016.
Artigo em Francês | MEDLINE | ID: mdl-27200135

RESUMO

INTRODUCTION: Nowadays, the circuit of drugs is a plague. This situation may cause serious harm to patients. In this context, we conducted a study with the aim to describe and evaluate the circuit of anticancer drugs in a Tunisian regional hospital. METHODS: This is an evaluative study of the risk of anticancer drugs, conducted over a period of 15 days during the year 2014 in the Department of Cancer Research of the Regional Hospital of Gafsa (Tunisia). The evaluation method is based on that conducted by the project "SECURIMED" and developed by the Coordination Committee of the Clinical Evaluation and Quality in Aquitaine (CCECQA) in France. RESULTS: In our study, the observation of anticancer drugs circuit has revealed some deficiencies. We noted that the roles of the various actors are subject sometimes to tasks shifting, which may sometimes be dangerous. The study also revealed a lack and an inadequacy with the standards in terms of the necessary equipment for the preparation of the anticancer drugs. CONCLUSION: Securing drugs circuit should be a priority included in all national processes and shared by all stakeholders to achieve a premium goal: the quality of care and patient safety.


Assuntos
Antineoplásicos/efeitos adversos , Composição de Medicamentos/métodos , Exposição Ocupacional/análise , Desenho de Equipamento , Feminino , Hospitais , Humanos , Masculino , Tunísia
16.
Glob Heart ; 11(1): 131-7, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27102030

RESUMO

BACKGROUND: High blood pressure is preventable and is directly related to lifestyle habits such as an unbalanced diet, low levels of physical activity, and tobacco use. OBJECTIVES: This quasiexperimental study aimed to assess the effectiveness of a 3-year community intervention targeting healthy lifestyle promotion in reducing hypertension prevalence among adults. METHODS: A quasiexperimental design was used to evaluate the effectiveness of a 3-year intervention for healthy lifestyle that was implemented between 2010 and 2013 in a community of adults in the region of Sousse in Tunisia. The population study was randomly selected in both intervention and control groups at pre-assessment and post-assessment. After considering a type 1 error α of 5%, a type 2 error ß of 20%, and a change in the prevalence of various risk factors of 6% between pre-intervention and post-intervention, the sample size was fixed to 2,000 adults in intervention and control areas. RESULTS: The intervention group was composed of 940 and 1,001 adults, and the control group was composed of 940 and 976, respectively, at pre-assessment and post-assessment. The prevalence of hypertension decreased in the intervention group globally from 37.3% to 33.7% but not significantly (p = 0.1). In the control group, this proportion increased from 31.1% to 33.4% without significant difference (p = 0.28). In the intervention group, after stratification for age, a significant decrease (p = 0.007) in the prevalence of hypertension was observed for participants younger than 40 years old: it decreased from 22.8% to 16.2%. In the control group, it increased from 14% to 15.4% (p = 0.52). In intervention group, a significant decrease of the hypertension from 31.4% to 26% (p = 0.03) was observed among nonobese participants after stratification for weight status. No significant change was observed in the control group. CONCLUSIONS: This study showed the feasibility and effectiveness of a community-based intervention to reduce the prevalence of hypertension in the context of a developing country.


Assuntos
Dieta Saudável , Exercício Físico , Promoção da Saúde/métodos , Hipertensão/prevenção & controle , Atenção Primária à Saúde , Abandono do Hábito de Fumar , Adulto , Serviços de Saúde Comunitária , Estudos de Viabilidade , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Meios de Comunicação de Massa , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador , Prevalência , Características de Residência , Serviços de Saúde Escolar , Tunísia/epidemiologia , Adulto Jovem
17.
Arch Iran Med ; 19(3): 179-85, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26923889

RESUMO

BACKGROUND: Nosocomial infections are public health issues that are associated with high mortality in intensive care units. This study aimed to determine nosocomial infection-associated mortality in Tunisian intensive care units and identify its risk factors. METHODS: A prospective cohort study was carried out in intensive care units of a Tunisian University Hospital. The ICUs-wide active surveillance of nosocomial infections has been performed between 1 July 2010 and 30 June 2011. Data collection was based on Rea-Raisin protocol 2009 of "Institut National de Veille Sanitaire" (InVS, Saint Maurice - France). We used Kaplan Meier survival analysis and Cox Proportional Hazard regression to identify independent risk factors of nosocomial infection-associated mortality. RESULTS: Sixty-seven patients presented nosocomial infection in the end of the surveillance. The mean age of patients was 44.71 ± 21.2 years. Of them, 67.2% were male and 32.8% female. Nosocomial bacteremia was the most frequent infection (68.6%). Nosocomial infection-associated mortality rate was 35.8% (24/67). Bacteremia (Hazard Ratio (HR)) = 3.03, 95% Confidential Interval (95% CI): [1.23 - 7.45], P = 0.016) and trauma (HR = 3.6, 95% CI: [1.16 - 11.2], P = 0.026) were identified by Cox regression as independent risk factors for NI-associated mortality. CONCLUSIONS: Our rate was relatively high. We need to improve the care of trauma patients and intensify the fight against nosocomial infections especially bacteremia.


Assuntos
Bacteriemia/epidemiologia , Infecção Hospitalar/mortalidade , Unidades de Terapia Intensiva/estatística & dados numéricos , Adulto , Idoso , Feminino , Hospitais Universitários , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Tunísia , Adulto Jovem
18.
Int J Adolesc Med Health ; 28(2): 211-6, 2016 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-26360487

RESUMO

INTRODUCTION: Tobacco use, which begins in adolescence and childhood and continues in later life, is the major avoidable risk for non-communicable diseases and death in the world. Self-reports have frequently been used to estimate smoking prevalence and health consequences. This study explores the validity of self-reports of smoking behavior among schoolchildren in Tunisia. MATERIALS AND METHODS: This study was conducted in March 2014 among a sample of 147 schoolchildren randomly selected. Data concerning the smoking habit were collected by a questionnaire designed for the purposes of this work. Then, exhaled CO, a biochemical marker of smoke exposure, was measured using piCO+ Smokerlyzer® breath CO monitor among participants. Sensitivity and specificity of self-reports were calculated. RESULTS: The prevalence of reported smoking was 9.5% with 16.7% and 1.7% respectively among boys and girls. Their mean age was 14.5±1.28 years old. When considering 4 ppm as the cut-off level of breath CO, sensitivity and specificity of self-reports were 100% and 93.7%, respectively. But at a breath CO cut-off of 3 ppm, self-reporting was 62.5% sensitive and 93.5% specific. CONCLUSION: According to our findings, we suggest that self-reports can be considered as a good tool to be used with a reasonable confidence to assess the smoking status.


Assuntos
Autorrelato/normas , Fumar/epidemiologia , Inquéritos e Questionários/normas , Adolescente , Biomarcadores/análise , Monóxido de Carbono/análise , Criança , Feminino , Humanos , Masculino , Prevalência , Instituições Acadêmicas , Estudantes , Tunísia/epidemiologia
20.
Health Serv Res Manag Epidemiol ; 2: 2333392815601841, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-28462262

RESUMO

AIM: To investigate differences in attitude toward physical activity in normal-weight, overweight, and obese adolescents. MATERIALS AND METHODS: We conducted a cross-sectional survey carried out in 2009/2010. It concerned randomly selected schoolchildren of colleges of Sousse in seventh and ninth grade. The sample was composed of 4003 schoolchildren. A questionnaire was used to evaluate habits and perception of physical activity, and we took anthropometric measurements of height and weight. RESULTS: Among schoolchildren who performed a recommended level of physical activity, there was no significant difference in perceptions according to weight status. However, among those who did not practice physical activity, obese participants had significantly less positive perception. Overweight and obesity significantly increase the risk of negative perception of physical activity practice among participants who do not do the recommended level of physical activity. However, this association becomes non significant among those who practice recommended level of physical activity. The same findings were observed after adjustment by age and sex. CONCLUSION: Negative attitudes among inactive children may favor the development of a vicious circle perpetuating physical inactivity among normal-weight and overweight children.

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