Monique Chaaya

Demographic and Psychosocial Profile of Smoking Among Pregnant Women in Lebanon: Public Health Implications

Objectives: To assess the prevalence and determinants of smoking prior to and during pregnancy in Lebanon. Methods: A cross-sectional study using two structured instruments. One instrument included information on demographic characteristics, smoking patterns in the index pregnancy and previous pregnancies, use of prenatal health services, stressful life events, and social support during pregnancy. The second was the Arabic General Health Questionnaire (GHQ-12). Women who delivered in 11 randomly selected hospitals in Beirut and its suburbs within 24 hours were asked to consent to participate in the study. The total sample interviewed was 576 women. Results: The prevalence of pre-pregnancy smoking was 32% and 20% for smoking in pregnancy. Considering argileh smoking, the prevalence of tobacco use in pregnancy increased to 27% in Beirut and 25% in the suburbs. Pre-pregnancy smoking was associated with older maternal age [OR = 1.08, 95% CI (1.03, 1.14)], low and medium education [OR = 2.22, 95% CI (1.22, 4.04)], increased psychiatric distress [OR = 3.11, 95% CI (1.77, 5.46)], and a husband who smoked [OR = 5.00, 95% CI (2.98, 8.39)]. Continued smoking during pregnancy was associated with low and medium education [OR = 3.77, 95% CI (1.31, 10.8)], younger age [OR = 1.11, 95% CI (1.02–1.20)], and a heavy pre-pregnancy smoking pattern [OR = 13.9, 95% CI (1.40, 137.4)]. Conclusion: Policies and programs to eliminate or reduce smoking during pregnancy should be targeted toward young and less educated females and involving the spouse. Obstetricians should promote smoking cessation during pregnancy using evidence-based methods.

Validation of the Arabic version of the Cohen perceived stress scale (PSS-10) among pregnant and postpartum women

BackgroundThis study was conducted to evaluate the validity of the Arabic translation of the Cohen Perceived Stress Scale (PSS-10) in pregnant and postpartum women.MethodsA sample of 268 women participated. These included 113 women in their third trimester of pregnancy, 97 in the postpartum period and 58 healthy female university students. GHQ-12 and EPDS were also administered to the participants. Internal consistency reliability, assessed using Cronbachs α, was 0.74.ResultsPSS-10 significantly correlated with both EPDS and GHQ12 (ρ = 0.58 and ρ = 0.48 respectively), and significantly increased with higher scores on stressful life events. PSS-10 scores were higher among university students who also recorded higher stressful life events scores.ConclusionThe Arabic translated version of the PSS-10 showed reasonably adequate psychometric properties.

Religiosity and depression in older people: Evidence from underprivileged refugee and non-refugee communities in Lebanon

Religiosity is an important aspect of the life of older people, particularly in the Arab region where religiosity is an important part of daily social and political life. Studies have documented the relationship between religiosity and depression among older people, but none in the region. A total of 740 persons aged 60 + were interviewed in three poor urban areas of Lebanon, one of which was a Palestinian refugee camp. The questionnaire included five items on religiosity covering organizational and intrinsic religiosity. Depression was assessed using the 15-item Geriatric Depression Score (GDS-15). Depression was prevalent in 24% of the older persons interviewed with the highest proportion being from the Palestinian refugee camp (31%). Results suggest that only organizational religiosity was related to depression and this pattern was only significant among the refugee population. Religious practice is discussed as an indicator of social solidarity rather than an aspect of religiosity. Minority groups may rely on religious stratagems to cope with their distress more than other groups.

Predictors of psychological distress in Lebanese hostages of war

A cross-sectional study addressed the experience of Lebanese hostages of war in Lebanon. It specifically assessed the prevalence of general distress and its relationship to captivity-related factors and selected psychosocial variables. Trained field researchers using standard measurements interviewed 118 Lebanese hostages released from Khiam prison, an Israeli detention center in Lebanon. Questionnaires administered included the GHQ-12 and the Harvard Trauma Questionnaire. Individuals were detained for 3.4 years on average, and 86% were tortured. Psychological distress was present in 42.1% of the sample compared to 27.8% among the control group. In the multivariate analysis, the significant predictors for distress were: years of education and increase in religiosity after release. In conclusion, even after 2 years of release, more than one-third of the Lebanese hostages released from Khiam prison were found to have psychological distress. Caregivers need to pay special attention to the mental health of hostages of war. The paper discusses the meaning and implications of the factors predicting resilience and vulnerability in this particular population.

Maternal smoking: determinants and associated morbidity in two areas in Lebanon.

ObjectivesThis study assessed the factors related to smoking during pregnancy in two areas in Lebanon, and the association of smoking to selected maternal and newborn health related factors.MethodsThis was a secondary analysis of data on 538 women who delivered in nine hospitals in two areas in Lebanon. Women were interviewed about their smoking practices, and on demographic and psychosocial variables. 396 women were followed up and re-interviewed about their smoking status, and the mother’s and baby’s health after delivery. Smoking during pregnancy included both cigarettes and narghile smoking.ResultsAbout 25.7% of women were smoking some kind of tobacco during pregnancy. Older women, Muslim women, women with poor education, those who had financial difficulty, nervousness, lower support, and delay in seeking prenatal care were more likely to smoke during pregnancy. Women who smoked during pregnancy were more likely to have a low birth weight baby and to stop breastfeeding.ConclusionsIt is important to address smoking among women in general, and not only during pregnancy. We discuss the role of public and private sectors in smoking cessation and interventions.

Validation of the Arabic version of the short Geriatric Depression Scale (GDS-15)

BACKGROUND This study aimed to examine the validity and reliability of an Arabic version of the 15-item Geriatric Depression Scale (GDS-15). METHODS 121 community-dwelling older adults and primary care patients aged 60 and above participated in this study. Older adults with dementia, those with thyroid dysfunction, and hearing or speech impairments were excluded. Test-retest reliability was examined by re-administering the translated GDS-15 to a subset of 38 participants at least seven days after the initial interview. RESULTS The Arabic GDS-15 had good psychometric properties, but the best properties were reported for the 7/8 cutoff. Cronbachs alpha as a measure of internal consistency reliability was high (0.88) and kappa ranged from 0.57 to 0.75. The performance of the GDS-15 was equally good for both community-dwelling older adults and those in primary care settings, and for both forms of the GDS (examiner administered vs. self-administered). CONCLUSION The Arabic GDS is a useful measure to assess depression among community-dwelling older adults and primary care patients who do not have dementia. Because of the use of formal Arabic, GDS-15 can be widely used with all Arabic-speaking people.

High burden of rheumatic diseases in Lebanon: a COPCORD study

Aim:  To estimate the prevalence of rheumatic diseases in Lebanon and to explore their distribution by geographic location, age, and gender.

Gender Differences in Physical Disability Among Older Adults in Underprivileged Communities in Lebanon

Objective: To examine the role of health conditions, socioeconomic, and socioenvironmental factors in explaining gender differences in physical disability among older adults. Method: We compared 412 women and 328 men residing in underprivileged communities in Lebanon on their activities of daily living (ADL), instrumental activities of daily living (IADL), and physical tasks (PT). Binary logistic regression analyses adjusting for possible explanatory covariates were conducted sequentially. Results: Women showed higher prevalence rates of ADL, IADL, and PT compared to men. Gender disparities in ADL disability were explained by chronic-disease risk factors and health conditions (OR = 1.46; 95% CI = 0.94-2.25). The odds of disability in IADL and PT remained significantly higher for women compared to men after accounting for all available covariates. Discussion: These results suggest underlying differences in functional status between women and men, yet, may have been influenced by the sensitivity of the measures to the social context and gendered environment surrounding daily activities.

Validation of the Arabic version of the 5‐item WHO well being index in elderly population

Bonsignore M, 2001, EUR ARCH PSYCHIAT S2, V251, pII27; Chaaya M, 2008, INT PSYCHOGERIATR, V20, P571, DOI 10.1017-S1041610208006741; Chaaya M, 2007, AGING MENT HEALTH, V11, P37, DOI 10.1080-13607860600735812; Heun R, 1999, ACTA PSYCHIAT SCAND, V99, P171, DOI 10.1111-j.1600-0447.1999.tb00973.x; Karam EG, 2006, LANCET, V367, P1000, DOI 10.1016-S0140-6736(06)68427-4

Ethnic differences in weight loss behavior among secondary school students in Beirut: the role of weight perception

SummaryObjectives: Assessing the prevalence of weight loss attempts in Beirut, Lebanon, a country characterized by a diversity of ethnic and religious groups and examining the interplay between ethnicity, body mass index (BMI) and weight perception and their relationship to weight loss behavior. Methods: A school-based survey of risk behaviors conducted among secondary students (grade 10–12) in 1997. Subjects consisted of 827 boys and girls, aged 15 to 23 years, the majority of whom were Moslems (65.4%). Multiple logistic regression was used to estimate the association between ethnicity and weight perception with the likelihood of trying to lose weight controlling for BMI and a number of potential covariates. Results: The prevalence of weight loss attempts was 19.1% and 42.6% in boys and girls respectively. Christians were more likely to perceive themselves as overweight and to attempt weight loss than Moslems across all BMI levels, however this trend was significant in the underweight category. While controlling for BMI did not change appreciably the results observed, after controlling for weight perception, ethnic differences in weight-loss behavior disappeared. Conclusion: Findings of the study suggest that whereas actual weight may constitute only partially the driving force for differentials by ethnicity, the perception of body weight acts as a mediating factor in the relationship between ethnicity and weight loss behavior. Understanding the disparities in weight management behavior across various adolescent groups is key to develop culturally appropriate educational and intervention programs for the youths.