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1.
Pan Afr Med J ; 38: 272, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34122699

RESUMO

Introduction: emergency obstetric care (EmOC) is a high-impact priority intervention strongly recommended for improving maternal health outcomes. The objectives of this study were to assess the availability, utilization, and quality of emergency obstetric care services in the Governorate of Sousse (Tunisia). Methods: a cross-sectional study was conducted among public health facilities which performed deliveries in Sousse in 2017. Data were collected by consulting clinical records and registers and interviewing staff using WHO EmOC tools. Emergency obstetric care (EmOC) indicators were calculated. Results: only the University maternity Unit functioned as full comprehensive EmOC facility. No other public facility provided all the 7 Basic EmOC signal functions 3 months prior to the survey. The unperformed signal functions were: administration of parenteral antibiotics, manual removal of placenta and assisted vaginal delivery. The number of EmOC facilities was 0.72 per 500,000 inhabitants. The met need for EmOC was 89.5%. The proportion of caesarean section was 24.2%. The direct obstetric case fatality rate was 0.159% and intrapartum and very early neonatal death rate was 0.65%. Conclusion: raising maternity facilities to a minimum level of basic EmOC status would be a major contributing step towards maternal mortality reduction.


Assuntos
Serviços Médicos de Emergência/organização & administração , Serviços de Saúde Materna/organização & administração , Obstetrícia/organização & administração , Qualidade da Assistência à Saúde , Cesárea/estatística & dados numéricos , Estudos Transversais , Parto Obstétrico/estatística & dados numéricos , Serviços Médicos de Emergência/normas , Feminino , Instalações de Saúde/normas , Instalações de Saúde/estatística & dados numéricos , Humanos , Recém-Nascido , Serviços de Saúde Materna/normas , Mortalidade Materna , Obstetrícia/normas , Morte Perinatal , Gravidez , Tunísia
2.
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.

3.
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.

4.
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
5.
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
6.
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
7.
Pan Afr Med J ; 36: 237, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33708328

RESUMO

Despite obstetric and pediatric progress, twin pregnancy still represents nowadays a high-risk situation for both pregnancy and childbirth. It still remains a distressing situation for the obstetric team. The aim of this study was to describe the practice of twin pregnancy deliveries in the obstetrics and gynecology department of Sousse, the maternal and fetal prognosis and to analyze the factors that may influence it. A descriptive, retrospective study of twin pregnancies births was conducted over a period of two years. We included twin pregnancies that have reached at least 28 weeks of amenorrhea (SA) and women having a twin pregnancy complicated by fetal death in utero. Women with a twin pregnancy who gave birth before 28 weeks were excluded. Bi-chorionic bi-amniotic pregnancies represented 67% of cases, compared with only 11.5% of mono-chorial bi-amniotic pregnancies and 3% of mono-chorial mono-amniotic pregnancies. A total of 52 patients have scheduled caesareans. Spontaneous labor was noticed in 304 cases, and was initiated in 43 cases. A total of 178 women gave birth by vaginal delivery (44.6%) and 215 by cesarean (53.9%). The cesarean rate for the second twin was 1.5%. When the delivery was vaginal, 19 cases of complications were observed (10.7%). We analyzed the Apgar score of both the first and the second twin according to the mode of delivery. There was no statistically significant difference in the Apgar score between the two delivery routes. Perinatal morbidity and mortality is higher for the second twin than for the first twin. Maternal morbidity was higher in vaginal delivery than cesarean delivery. There are no significant differences in the Apgar score according to whether the infants were born by vaginal delivery or by caesarean.


Assuntos
Cesárea/estatística & dados numéricos , Parto Obstétrico/estatística & dados numéricos , Resultado da Gravidez , Gravidez de Gêmeos , Adulto , Índice de Apgar , Feminino , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Mortalidade Perinatal , Gravidez , Prognóstico , Estudos Retrospectivos , Tunísia , Gêmeos , Adulto Jovem
8.
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
9.
Tunis Med ; 96(3): 209-218, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30325490

RESUMO

INTRODUCTION: Clopidogrel (clopi) is a prodrug widely prescribed in the management of coronary artery disease and requires the intervention of hepatic cytochrome P450 2C19 (CYP2C19) for its activation. However, there is interindividual variability in response to clopi despite the use of recommended doses. Thus, the studies have highlighted the effect of the CYP2C19 gene polymorphism or Cyp2C19 gene on the response to clopi and particularly Cyp2C19 * 2 which may be associated with an increased risk of major cardiovascular events or MACE. OBJECTIVE: To evaluate the effect of Cyp2C19 * 2 polymorphism on MACE occurrence and hemorrhagic complications in patients treated with clopi. METHODS: We carried out a descriptive longitudinal study including 71 patients placed under clopi for a minimum duration of one month. Genotyping of the Cyp2C19 allele was performed by conventional polymerase chain reaction (PCR). After a follow-up period of 495 ± 183 days, we performed a statistical analysis to evaluate the association between the Cyp2C19 * 2 polymorphism and the occurrence of MACE or hemorrhagic complications. RESULTS: Among our patients, 51% had an angioplasty, 42% medical treatment and 7% a coronary artery bypass surgery. In our study population, 52% were heterozygous (HTZ), 28% homozygous (HMZ) healthy * 1 / * 1 and 20% HMZ had the loss of function allele * 2 / * 2. The allelic frequency of Cyp2C19 * 2 was 46%. Follow-up mean duration was of 495 ± 183 days. During this period, the prevalence of MACE was 11% and that of hemorrhagic complications was 13%. In our study, we did not observe a significant association between the occurrence of MACE or hemorrhagic complications with the genotype carrying the Cyp2C19 * 2 allele. CONCLUSION: Among patients treated with clopi, wearing a Cyp2C19 * 2 function loss allele didn't seem to be associated with a significantly higher risk of MACE, nor a significantly lower risk of hemorragic complications. This suggests the necessity of larger studies.


Assuntos
Clopidogrel/uso terapêutico , Citocromo P-450 CYP2C19/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/genética , Clopidogrel/farmacocinética , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/metabolismo , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/genética , Feminino , Frequência do Gene , Predisposição Genética para Doença , Genótipo , Técnicas de Genotipagem , Hemorragia/induzido quimicamente , Hemorragia/epidemiologia , Heterozigoto , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Farmacogenômicos , Polimorfismo Genético , Tunísia/epidemiologia
10.
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
11.
Libyan J Med ; 13(1): 1433418, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29433385

RESUMO

The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). The depth of anesthesia was monitored using the Bispectral Index Scale (BIS), which is based on measurement of the patient's cerebral electrical activity. Primary outcome of the study was End-tidal of isoflurane concentration (Et-Iso) at BIS values of 40-60. Secondary outcomes include remifentanil consumption during the operation and time to extubation. Et-Iso was significantly lower in group L than in group C (0.63% ± 0.10% vs 0.92% ± 0.11%, p < 10-3). Mean remifentanil consumption of was significantly lower in group L than in group C (0.13 ± 0.04 µg/kg/min vs 0.18 ± 0.04 µg/kg/min, p < 10-3). Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10-3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.


Assuntos
Adjuvantes Anestésicos/administração & dosagem , Anestesia Geral , Anestésicos Inalatórios/administração & dosagem , Anestésicos Intravenosos/administração & dosagem , Anestésicos Locais/administração & dosagem , Isoflurano/administração & dosagem , Lidocaína/administração & dosagem , Piperidinas/administração & dosagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Extubação , Período de Recuperação da Anestesia , Anestésicos Inalatórios/análise , Monitores de Consciência , Método Duplo-Cego , Feminino , Humanos , Infusões Intravenosas , Isoflurano/análise , Rim/cirurgia , Masculino , Pessoa de Meia-Idade , Nefrectomia , Nefrotomia , Remifentanil , Volume de Ventilação Pulmonar , Fatores de Tempo , Adulto Jovem
12.
J Res Health Sci ; 18(1): e00403, 2018 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-29445049

RESUMO

BACKGROUND: Internet represents a revolution in the world of technology and communication all over the world including Tunisia. However, this technology has also introduced problematic use, especially among students. The current study aimed to determine the prevalence of Internet addiction among college students and its predictors in the region of Sousse, Tunisia. STUDY DESIGN: A cross-sectional study. METHODS: The current study was conducted in the colleges of Sousse, Tunisia in 2012-2013. A self-administrated questionnaire was used to collect data from 556 students in 5 randomly selected colleges from the region. Collected data concerned socio-demographic characteristics, substances use and internet addiction using the Young Internet Addiction Test. RESULTS: The response rate was 96%. The mean age of participants was 21.8±2.2 yr. Females represented 51.8% of them. Poor control of internet use was found among 280 (54.0%; CI95%: 49.7, 58.3%) participants. Low education levels among parents, the young age, lifetime tobacco use and lifetime illicit drugs use were significantly associated with poor control of internet use among students (P<0.001). While, the most influential factor on internet use among them was under-graduation with an adjusted odds ratio of 2.4 (CI95%: 1.7, 3.6). CONCLUSIONS: Poor control of internet use is highly prevalent among the college students of Sousse especially those under graduate. A national intervention program is required to reduce this problem among youth. A national study among both in-school and out-of-school adolescents and young people would identify at-risk groups and determine the most efficient time to intervene and prevent internet addiction.


Assuntos
Comportamento Aditivo/etiologia , Internet , Estudantes , Universidades , Adulto , Fatores Etários , Comportamento Aditivo/epidemiologia , Estudos Transversais , Escolaridade , Feminino , Humanos , Drogas Ilícitas , Masculino , Pais , Prevalência , Fatores de Risco , Fumar , Transtornos Relacionados ao Uso de Substâncias , Inquéritos e Questionários , Tunísia/epidemiologia , Adulto Jovem
13.
Sante Publique ; 29(1): 71-79, 2017 Mar 06.
Artigo em Francês | MEDLINE | ID: mdl-28737329

RESUMO

Objective: This study was designed to assess the quality of the Gabès (Tunisia) mobile emergency care medical records and propose corrective actions.Materials and methods: A clinical audit was performed at the Gabès mobile emergency care unit (SMUR). Records of day, night and weekend primary and secondary interventions during the first half of 2014 were analysed according to a data collection grid comprising 56 criteria based on the SMUR guidelines and the 2013 French Society of Emergency Medicine evaluation guide. A non-conformance score was calculated for each section.Results: 415 medical records were analysed. The highest non-conformance rates (48.5%) concerned the "specificities of the emergency medical record" section. The lowest non-conformance rates concerned the surveillance data section (23.4%). The non-conformance score for the medical data audit was 24%.Conclusion: This audit identified minor dysfunctions that could be due to the absence of local guidelines concerning medical records in general and more specifically SMUR. Corrective measures were set up in the context of a short-term and intermediate-term action plan.


Assuntos
Ambulâncias , Guias como Assunto , Registros Médicos/normas , Unidades Móveis de Saúde , Humanos , Auditoria Médica , Estudos Retrospectivos , Tunísia
14.
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
15.
Int J Qual Health Care ; 29(2): 176-182, 2017 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-28073903

RESUMO

Objective: To assess the patient safety culture (PSC) in operating rooms (ORs) and to determine influencing factors. Design: A cross-sectional descriptive multicenter study which was conducted over a period of 7 months (October 2014-April 2015) using the French validated version of the Hospital Survey On Patient Safety Culture questionnaire. Setting: Of the note, 15 ORs of public and private healthcare institutions. Participants: In total, there were 368 participants including surgeons, anesthesiologists, surgical and anesthesia technicians, nurses and caregivers, divided into 316 professionals exercising in public sector and 52 working in private one. Main Outcome Measure(s): A self-administrated questionnaire investigating 10 dimensions of PSC (including 45 items), two items examining the staff perception of patient safety quality and reporting events, and five items regarding demographic characteristics of respondents. Results: The participation rate in the study was 70.8%. All 10 dimensions were to be improved. The overall perception of patient safety had a score of 34.9%. The dimension that had the lowest score (20.5%) was the non-punitive response to error, and the one that had the highest score (41.67%) was teamwork in the ORs. Three dimensions were developed in private sector, and none in public hospitals. Conclusion: This study showed that the level of the PSC needs to be improved not only in public hospitals but also in private ones. The obtained results highlight the importance of implementing quality management systems and developing PSC.


Assuntos
Atitude do Pessoal de Saúde , Salas Cirúrgicas/organização & administração , Cultura Organizacional , Segurança do Paciente/normas , Adulto , Estudos Transversais , Feminino , Hospitais Privados/normas , Hospitais Públicos/normas , Humanos , Masculino , Salas Cirúrgicas/normas , Qualidade da Assistência à Saúde/normas , Gestão da Segurança/organização & administração , Inquéritos e Questionários , Tunísia
16.
Sante Publique ; 29(5): 685-691, 2017 Dec 05.
Artigo em Francês | MEDLINE | ID: mdl-29384302

RESUMO

AIMS: To assess safety culture in primary healthcare centres and to explore its associated factors. METHODS: This multicentre cross-sectional descriptive study was conducted in the 30 primary healthcare centres in central Tunisia and used the validated French version of the Hospital Survey on Patient Safety Culture questionnaire' (HSOPSC). RESULTS: A total of 214 professionals participated, corresponding to a response rate of 85%. The ?Teamwork within centres? dimension had the highest score (71.5%). However, two safety dimensions had very low scores: ?Frequency of event reporting?, ?Non-punitive response to errors? with percentages of 31.4% and 35.4%, respectively. Among the associated factors, the ?Frequency of reported events? dimension was significantly higher among professionals involved in risk management committees (p = 0.01). CONCLUSION: This study demonstrates that the level of safety culture needs to be improved in primary healthcare centres in Tunisia and also highlights the need to implement a quality management system in primary healthcare centres.


Assuntos
Cultura Organizacional , Segurança do Paciente , Atenção Primária à Saúde , Gestão da Segurança/organização & administração , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Inquéritos e Questionários , Tunísia
17.
Tunis Med ; 95(2): 120-125, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29424871

RESUMO

BACKGROUND: Fetal macrosomia is associated with an increased risk of adverse outcomes to both the mother and the infant. AIM: To determine maternal and neonatal outcomes associated to fetal macrosomia in diabetic and non- diabetic mothers. METHODS: It is a descriptive retrospective study conducted in Tunisia. We included in this study all patients who delivered newborns having a birth weight above 4kg during 2013. Multivariate analysis was performed using binary logistic regression to identify the complications associated to macrosomic pregnancies with diabetes. RESULTS: Among the 10186 deliveries registered during the study period, 821 mothers gave birth to macrosomic newborns. The prevalence of macrosomia was 8.1%, and macrosomic newborns who had a birth weight of 4500 g or greater were 1.06%. Macrosomia was significantly higher in males (p <10-3). The rate of cesarean delivery was 47.9%. The most frequent adverse maternal and neonatal outcomes were perineal tears (3.6%), post-partum hemorrhage (0.6%), shoulder dystocia (4.9%) and neonatal intensive care unit admission (7.6%).The proportion of maternal diabetes was 9.3%. Macrosomic pregnancies with diabetes appear to be significantly associated with cesarean delivery (OR=2.22), postpartum hemorrhage (OR=6.69) and neonatal intensive care unit admission (OR=4.18). CONCLUSION: Macrosomia increases the risk of maternal and perinatal morbidity particularly when it was associated to maternal diabetes.


Assuntos
Macrossomia Fetal/diagnóstico , Macrossomia Fetal/epidemiologia , Resultado da Gravidez/epidemiologia , Gravidez em Diabéticas/epidemiologia , Adolescente , Adulto , Parto Obstétrico/métodos , Parto Obstétrico/estatística & dados numéricos , Distocia/epidemiologia , Distocia/etiologia , Feminino , Macrossomia Fetal/complicações , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/etiologia , Masculino , Pessoa de Meia-Idade , Complicações do Trabalho de Parto/diagnóstico , Complicações do Trabalho de Parto/epidemiologia , Hemorragia Pós-Parto/epidemiologia , Hemorragia Pós-Parto/etiologia , Gravidez , Complicações na Gravidez/diagnóstico , Complicações na Gravidez/epidemiologia , Gravidez em Diabéticas/diagnóstico , Prevalência , Prognóstico , Estudos Retrospectivos , Tunísia/epidemiologia , Adulto Jovem
18.
Tunis Med ; 94(4): 398-304, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27704514

RESUMO

Background Overweight in schools is a worrisome public health problem because they increase medium and long term risks of morbidity and mortality especially with an increased risk of persistence of obesity in adulthood. Aim To estimate the prevalence of overweight among school children and to identify its associated risk factors. Methods this is a descriptive cross-sectional study conducted among school students aged less than 18 years in the area of "Hazoua" (Tozeur). The references of BMI used for overweight and obesity are those of IOTF. The French BMI references are used to establish the prevalence of underweight. Data entry and analysis was performed using SPSS 20. Results Our sample included 445 students. The average BMI was 18.73±3.4 kg/m2. The prevalence of Underweight was 9.7%, while overweight and obesity have been reported among 6.7% of students. Overweight was significantly associated to gender and the practice of sport outside school. Conclusion Obesity in schools in the community of Hazoua is now lower than that reported in other studies. In contrast, we detected a problem of underweight, which deserves as much attention. Intervention programs should be established and whose objectives are to improve students' skills in terms of eating behavior and physical activity, these actions require collaboration at all levels.

19.
Sante Publique ; 28(5): 613-622, 2016 Nov 25.
Artigo em Francês | MEDLINE | ID: mdl-28155737

RESUMO

The results of this study will help guide public hospital human resource managers in the choice of measures designed to increase the motivation of their employees in order to ensure staff satisfaction as well as quality health care services..


Assuntos
Pessoal Técnico de Saúde/psicologia , Satisfação no Emprego , Motivação , Adulto , Estudos Transversais , Feminino , Hospitais Públicos , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade da Assistência à Saúde , Tunísia , Recursos Humanos
20.
Afr J Reprod Health ; 20(4): 44-50, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29566318

RESUMO

This study aimed to determine the frequency and the nature of maternal near miss (NM) events in a population of women attending a tertiary level maternity hospital in Tunisia and to evaluate the care level of this institution according to indicators proposed by the World Health Organization (WHO). We opted for a retrospective medical chart review of cases of NM and maternal mortality that occurred in the year 2010 at the Farhat Hached Maternity University Hospital. NM cases were defined based on the WHO criteria 2009. There were 9957 deliveries, 58 NM events and one case of maternal death. Haemorrhagic (74.1%) and hypertensive disorders (20.7%) were the leading causes of NM. The study showed a low Maternal NM Ratio of 5.86/1000 live births, a relatively low mortality index of 1.7 % and Severe Maternal Outcome Ratio of 5.96/1000 live births. This was the first study to document NM in a Tunisian public maternity. The WHO approach allowed a systematic monitoring of quality of maternal health care. There is a low frequency of maternal morbidity and mortality at the level of this facility. But, more efforts are still needed to document NM events in other types of care facilities in Tunisia.


Assuntos
Cuidados Críticos/estatística & dados numéricos , Complicações do Trabalho de Parto/epidemiologia , Qualidade da Assistência à Saúde , Adulto , Cuidados Críticos/normas , Parto Obstétrico/métodos , Parto Obstétrico/normas , Emergências/epidemiologia , Feminino , Maternidades , Humanos , Recém-Nascido , Mortalidade Materna , Gravidez , Complicações na Gravidez/epidemiologia , Taxa de Gravidez , Estudos Retrospectivos , Centros de Atenção Terciária , Tunísia/epidemiologia , Adulto Jovem
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