Amen Bawazir

Patients? Satisfaction with Health Education Services at Primary Health Care Centers in Riyadh, KSA

Objectives: The purpose of the study is to assess different aspects of patients’ satisfaction in relation to the health education services provided in Primary Health Care centers at a Major Medical Center in Riyadh, Kingdom of Saudi Arabia. Research design and methods: This is a cross-sectional survey targeting attendees of PHC centers at Prince Sultan Military Medical City in Riyadh. A total number of 400 participants were enrolled in this study. Data was collected over a 5 months period (Dec 2012 to April 2013). Results: The overall satisfaction reported with health education services was 68%. One to one education clinic was the most preferred method for delivery of health education. The majority of participants preferred the physician as a health education provider. Conclusions: Findings from this study showed that our participants expressed a positive evaluation of the distinct dimensions of the health education services provided. However, services of health education were poorly attended in this institution. Barriers causing poor attendance were attributed to the shortage of trained health education staff, lack of time for the providers, cost, and misunderstanding for the role of the health educator.

Patterns of childhood cancer incidence in Saudi Arabia (1999- 2008).

BACKGROUND Although childhood cancer is a rare disease, 100,000 children younger than 15 years of age die from cancer each year, the majority of them in developing countries. More data need to be gathered and published particularly in developing countries to better understand the scale of the problem. AIMS This study aimed to describe the patterns of childhood cancers in Saudi Arabia over a period of ten years (1999-2008). MATERIALS AND METHODS This descriptive retrospective study was based on secondary data from the Saudi Cancer Registry from 1999 to 2008. All Saudi cases (both genders), under the age of 15 years, who were diagnosed with cancer during the study period, were included in this study. RESULTS Childhood cancer in Saudi Arabia, in the period between 1999 and 2008, accounted for about 8% of total cancer cases. The most common encountered cancers were leukemia (34.1%), followed by lymphoma (15.2%), brain (12.4%), and kidney cancers (5.3%). The overall incidence of childhood cancers increased from 8.8 per 100,000 in 1999 to 9.8 per 100,000 in 2008. The incidence rates of cancers per 100,000 in the years 1999 and 2008 were generally higher among males, (9.4 and 11.5 in males vs. 8.3 and 8.1 in females). The highest incidence rate in the surveyed years was apparent in the birth to age 4 years group. CONCLUSIONS Cancer is an important public health problem in Saudi Arabia and a major ascending contributor to mortality and morbidity in children. More studies are required to describe the patterns of childhood cancers and related risk factors in Saudi Arabia.

MERS-CoV infection: Mind the public knowledge gap

Abstract In August 2015, the Corona outbreak caused by Middle East respiratory syndrome coronavirus (MERS-CoV) was the 9th episode since June 2012 in Saudi Arabia. Little is known about the public awareness toward the nature or prevention of the disease. The aim of this work was to assess the knowledge of the adult population in Riyadh toward the MERS-CoV. In this cross-sectional survey, a self-administrated questionnaire was distributed to randomly selected participants visiting malls in Riyadh. The questionnaire contained measurable epidemiological and clinical MERS-CoV knowledge level variables and relevant source of information. The study included 676 participants. Mean age was 32.5 (±SD 8.6) years and 353 (47.8%) were males. Almost all participants heard about the corona disease and causative agent. The study showed a fair overall knowledge (66.0%), less knowledge on epidemiological features of the disease (58.3%), and good knowledge (90.7%) on the clinical manifestation of the MERS-CoV. Internet was the major (89.0%) source of disease information, and other sources including health care providers, SMS, television, magazines and books were low rated (all <25%). In a multivariate logistic regression analysis age ≤30 years (Odds Ratio (OR)=1.647, 95%CI 1.048–2.584, P =0.030), male gender (OR=1.536, 95%CI 1.105–2.134, P =0.01), and no tertiary education (OR=1.957, 95%CI 1.264–3.030, P =0.003) were independent significant predictors of poor epidemiological knowledge. This study concludes that there was inadequate epidemiological knowledge received by the public and the reliance mostly on the clinical manifestations to recognizing the MERS-CoV disease. Comprehensive public health education programs is important to increase awareness of simple epidemiological determinants of the disease is warranted.

Antenatal Education: An Assessment of Pregnant Women Knowledge and Preferences in Saudi Arabia

Introduction: Antenatal educational programs are delivered during the childbearing years to expecting mothers. These interventions are considered preparatory strategies for physiological and psychological changes during pregnancy. Aim: To assess the antenatal knowledge and describe the learning needs and preferred information seeking behavior of expecting and/or new Saudi mothers. Methods: A cross-sectional study was conducted at multiple primary health care centers in Riyadh city, Saudi Arabia. A questionnaire was used to assess levels of antenatal knowledge, educational preferences, and information Results: The mean antenatal knowledge score was low (34.8/100). Educational material in written format was preferred by 39.8% of the sample, followed by a preference for one to one education (18.8%). Physicians were the preferred source of information by 2/3 of the participants. Preferred educational strategies were motivation and support, guidance, problem solving, and dos and don’ts. Selected content ranged from identifying pregnancy symptoms, to post-partum care. Conclusion: Antenatal knowledge scores were low with no variation with age or educational level among this population. Reform in antenatal educational content, channels, and formats should be adapted according to the preferences of the target population. Further research is recommended on the evaluation of the content of antenatal education and its cultural relevance.

Does fasting in Ramadan increase the risk of developing urinary stones

Objectives To explore the frequency of renal colic (RC) secondary to urinary stones in Ramadan compared to other months and seasons of the year. Methods Retrospective cross-sectional study using medical records of 237 patients admitted through the emergency room (ER) with a diagnosis of RC secondary to urinary stones over a 10-year period at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Results Patients fasting in Ramadan are 2 times more likely to present with a calculus of ureter as opposed to calculus in another location in the urinary tract, particularly when the holy month of Ramadan falls in the summer season. There was no significant difference in the frequency of urinary stones between Ramadan and non-Ramadan months. Conclusion Fasting in Ramadan does not increase the risk for developing urinary stones compared to non-fasting months. However, fasting in Ramadan during the summer may increase the risk of developing ureter stones compared to fasting in Ramadan during the winter.

Breast Cancer Screening Awareness and Practices among Women Attending Primary Health Care Centers in the Ghail- Bawazir District of Yemen

Micro‐Abstract This cross‐sectional study aimed to assess breast cancer screening awareness and practices among women attending primary health care centers in the Ghail‐Bawazir district of Yemen. A significant association between marital status, level of education, working status, and level of knowledge and breast screening practice was reported. Health care providers play a very limited role in providing awareness to their patients. Introduction: Women with from breast cancer often present to health care facilities with an advanced stage of disease. This study assessed the breast cancer screening awareness and practices among women presenting to primary health care centers in the Ghail‐Bawazir district of Yemen. Material and Methods: A cross‐sectional descriptive study was carried out from November 1, 2016 through January 31, 2017. A total of 317 women who attended primary health care centers in the Ghail‐Bawazir district during the study period were randomly selected for inclusion in the study. Data analysis was carried out using the Statistical Package for the Social Sciences (SPSS) Version 20. Descriptive statistics and χ2 analysis were used to present the frequency distributions and associations that existed in the data. The data was displayed in tables and graphs. Results: Very limited information on breast cancer was obtained from health care providers (14%). Around one‐half of the respondents had satisfactory levels of breast cancer knowledge and awareness, whereas 30.3% were practicing self‐breast examination, and only 1.6% had ever been exposed to a mammogram test. A significant association between marital status, level of education, working status, and level of knowledge and breast screening practice was reported (P = .01). By regression analysis, age and limited level of knowledge on self‐breast examination were found determinant (P < .015) in factors associated with the use of clinical breast examination. Conclusion: The study reveals the satisfactory knowledge of women about breast cancer along with inadequate awareness of breast cancer screening and screening practices.

Validation of a diabetes numeracy test in Arabic

Background The prevalence of diabetes Mellitus in Saudi Arabia is 24%, ranking it among the top ten Worldwide. Diabetes education focuses on self-management and relies on numeracy skills. Poor numeracy may go unrecognized and it is important to have an assessment tool in Arabic to measure such a skill in diabetes care. Objectives To validate a 15-item Diabetes Numeracy Test (DNT-15) in the Arabic Language as a tool to assess the numeracy skills of patients with diabetes and to test its properties among Saudi patients with diabetes. Methods A 15-question Arabic-language test to assess diabetes numeracy among patients with diabetes on the basis of the diabetes numeracy test (DNT-15) was validated among a sample Arabic speaking Saudi patients with diabetes. Data collection included patients’ demographics, long-term glycemic control, diabetes type, duration, co-morbidities, and diabetes related knowledge questions. Internal reliability was assessed using Kuder-Richardson Formula 20 (KR-20). Results The average score of Arabic DNT-15 was 53.3% and took an average of 30 minutes to complete. The scores significantly correlated with education, income, HbA1c, and diabetes knowledge (p<0.05). Content Validity Ratio (CVR) of 0.75 and Content Validity Index (CVI) of 0.89 supported good content validity. The Arabic DNT-15 also had good internal reliability (KR20 = 0.90). Conclusion Patients with diabetes need numeracy skills to manage their disease. Level of education does not reflect level of numeracy, and low numeracy skills might be unnoticed by health care providers. The Arabic DNT-15 is a valid and reliable scale to identify Arabic speaking patients with difficulties in certain diabetes-related numeracy skills.

Five-year comparison of diabetic control between community diabetic center and primary health-care centers

Context: Hyperglycemia is the most important factor for development of complications. A high level of hemoglobin A1c (HbA1c) is linked with such complications of diabetes. Aims: The aim of this study was to compare diabetic care between community diabetic center (CDC) and primary health centers. Settings and Design: This was a retrospective cohort study conducted at King Abdulaziz Medical City for National Guard Health Affairs at Riyadh, Saudi Arabia. Subjects and Methods: Data were retrieved from electronic medical records for diabetes mellitus Type 2 patients who were treated at two settings: CDCs and primary healthcare. Statistical Analysis Used: SPSS (V21) was used to analyze the univariate and bivariate analysis, Student′s t-test for continuous variables and Chi-square test for binary variables were used. P value was set as statistically significant if it is <0.05. Results: The mean difference for HbA1c from first to last visits increased significantly +0.2 ± 1.67 with P = 0.002 while the low-density lipoprotein (LDL) on the other way around improved by decrease of -0.159 ± 0.74 and P < 0.000. Body mass index (BMI) among the sample increased by +0.134 ± 1.57 with no significant, P = 0.078. Among the sample, 39.5% improved their HbA1c while 56.8% deteriorated and 3.6% of the samples′ readings remain the same. 55.3% of the sample improved in LDL and 52.4% in the high-density lipoprotein while 53.7% improved in triglycerides. The BMI was improved among 43.4% of diabetic patients. Conclusions: The 5-year management of diabetic patients failed to improve the A1c or BMI, at both CDC and primary health-care centers.