Background: Continuous safety culture assessment, especially in high-risk areas as the intensive care unit (ICU) is one of the requirements for patient safety. This study aimed to assess patient safety attitude in the intensive care units of four public hospitals in Egypt, compare it with benchmarking data, and identify opportunities for improvement.
Methods: A cross-sectional design was used. The Safety Attitudes Questionnaire (SAQ) was distributed in March 2024 to a total of 543 physicians and nurses involved in direct patient care in eight ICU of four public hospitals. A response rate of 85% was achieved (65.12% for physicians and 89.28% for nurses). Safety culture score (ranges from 0 to 100) and percent-positive scores (percentage of respondents with a mean score of > 75 where 100 is best) were calculated according to the tool scoring key. The scores were also compared with the benchmarking scores.
Results: The overall mean scale score was 63.7 ± 13.4 and the percentage of positive responses was 58.1%. Job satisfaction was the dimension with the highest total mean and percentage of positive responses (70.0 and 65.1%, respectively). On the other hand, stress recognition was the dimension with the lowest mean score and percentage of positive responses (59.4 ± 23.8 and 53.6%, respectively). Physicians attained a significantly higher total mean scale score for the teamwork climate, job satisfaction, perceptions of management and work conditions dimensions compared to nurses (73.8 ± 10.4, 81.7 ± 14.6, 72.5 ± 19.4, 70.6 ± 18.1 for physicians compared to 61.0 ± 15.4, 68.4 ± 23.0, 60.8 ± 22.4, 61.8 ± 22.3 for nurses, respectively) (p < 0.05) while "stress recognition'' was significantly higher among nurses (mean scale score for nurses was 60.4 ± 23.6, p < 0.05 compared to 52.0 ± 24.0, p < 0.05 for physicians). The dimensions "teamwork climate'', "safety climate'' and "stress recognition'' attained lower scores in the current study compared to the benchmark data.
Conclusion: The dimensions "teamwork climate'', "safety climate'', and "stress recognition'' attained relatively low scores which calls for interventions such as team trainings, limitation of work hours and senior executive safety rounds. Physicians had significantly higher scores than nurses in four out of six domains which needs further research to identify the reasons and plan the appropriate improvement strategies. Future studies should track changes over time.
Background: Nurses are vulnerable to burnout due to the high risk and pressure associated with their job performance. The coronavirus disease of 2019 (COVID-19) pandemic imposed an additional demand and stress on the healthcare workforce worldwide. This study aimed to assess the magnitude of burnout syndrome among nurses working in COVID-19 isolation hospitals and its associated factors.
Methods: A cross-sectional study was conducted among 385 nurses working in two COVID-19 isolation hospitals between April and August 2022 in Alexandria, Egypt. A predesigned self-administered questionnaire including questions about sociodemographic and work-related factors and an Arabic-translated version of Maslach Burnout Inventory Human Services Survey "MBI-HSS" was used.
Results: Of the total sample, 82.3% had high levels of emotional exhaustion (EE) with a mean score of 35.43 ± 9.52 (The range of the subscale score for EE = 0-54), 60.8% had a high level of depersonalization (DP) with a mean of 13.63 ± 5.81 (The range for DP = 0-30), 34.5% had a low level of personal accomplishment (PA) with a mean score of 33.70 ± 7.43 (The range for PA = 0-48 (reversed). Nurses having no children, nurses with higher educational level, and those who reported inadequacy of the number of physicians had significantly higher odds (3.98, 2.37, and 3.25, respectively) of having a high level of emotional exhaustion. Nurses having no children, and those who reported inadequacy of the number of physicians in their units had significantly higher odds (2.4 and 2.2) of having a high level of depersonalization.
Conclusion: Nurses working in COVID-19 isolation hospitals had high levels of burnout syndrome. Predictors of EE or DP included having no children, higher levels of education, and reporting an inadequate number of physicians. Stress coping training and psychological and social support services are recommended to overcome the relevant stresses and burnout provoking factors.
Background: Obesity is becoming increasingly prevalent throughout the world, impairing both life expectancy and quality of life. Despite existing knowledge and awareness about obesity, significant gaps remain in understanding its associated factors and the effectiveness of interventions. This study estimates the prevalence of obesity, identifies its associated factors, and assesses participants' awareness, attitudes, and practices concerning obesity.
Methods: An analytical cross-sectional study was conducted among 368 adults visiting primary care facilities in Makkah, Saudi Arabia. A structured, pre-validated questionnaire adapted from previous research was used to collect demographic information and assess respondents' awareness, attitude, and practices regarding obesity.
Results: The mean age of the participants was 41.8 ± 2.2 years, and 57.6% were females. Most respondents (97.8%) did not smoke, 32.1% had a family history of obesity, 86.1% consumed an unhealthy diet, and 76.6% did not engage in physical exercise. Approximately 37% of participants were overweight or obese. The study found that 85.9% of participants had a good awareness of obesity, 51.4% demonstrated a favorable attitude, and 33.4% exhibited adequate practices regarding obesity. A considerable proportion of participants (56.3%) recognized obesity based on self-perception. Approximately 38% of participants consumed high-calorie meals when stressed, 24.7% did not get sufficient sleep, and 64.4% did not drink enough water. Most of the participants (91.6%) perceived obesity as a disease, and 60.3% were satisfied with their body shapes. The logistic regression analysis demonstrated that the strongest predictors of obesity were poor awareness of obesity (OR = 10.6, p < 0.001), followed by irregular exercise (OR = 6.3, p < 0.05), and being female (OR = 4.8, p < 0.001). Adequate water intake was found to decrease the likelihood of obesity (OR = 0.1, p < 0.001).
Conclusion: Obesity is prevalent among adults in Makkah. Despite a favorable attitude and a good awareness of most aspects relating to obesity, inappropriate practices are common. Additional action and decisions are required to put awareness and attitude into practice.
Background: The COVID-19 pandemic posed a significant threat to public health, particularly mental well-being. Due to the rapid spread of the virus and quarantine restrictions, social media usage increased dramatically. Excessive and unregulated social media use may negatively impact mental health, contributing to heightened feelings of helplessness and anxiety. This study aimed to examine the relationship between the frequency and duration of social media use and symptoms of depression and anxiety among employees at Ain Shams University during the COVID-19 pandemic.
Methods: A cross-sectional analytical study was conducted over 6 months, from September 1, 2021, to March 31, 2022, among 405 employees at Ain Shams University. A stratified random sampling method was employed in two stages. First, the university's faculties were categorized into four disciplines: humanities and social sciences, natural sciences, mathematics, statistics, computer science and engineering, and medical and health sciences. Second, two faculties were randomly selected from each discipline to ensure representative sampling. Data were collected using a structured questionnaire, which included the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9) scales to assess anxiety and depression levels.
Results: A total of 405 participants were enrolled, comprising 203 males and 202 females, with a mean age of 42.15 ± 10.72 years (range: 20.00-59.00). The majority (77%) held a university degree, and 68.9% were married. A history of COVID-19 infection was reported by 38.3% of participants, and 78.8% used social media to stay updated about the pandemic. Approximately, half of the participants accessed social media three to four times per day, spending an average of 2 to 3 h daily. According to the PHQ-9 scale, 40.7% of employees who accessed social media six or more times per day experienced severe depression symptoms. Similarly, based on the GAD-7 scale, 41.6% of employees who accessed social media six or more times daily reported severe anxiety symptoms.
Conclusion: The findings suggest a concerning association between frequent COVID-19-related social media exposure and symptoms of depression and anxiety. These results highlight the potential mental health risks associated with excessive social media use, emphasizing the need for mental health awareness programs and strategies to combat misinformation during crises.
Background: Mental health awareness has the potential to contribute to the prompt identification and effective management of mental disorders. The negative perception connected to mental conditions presents a significant challenge for individuals seeking mental health services and the professionals providing them. This study aims to compare mental health literacy-encompassing knowledge, attitudes, and behaviors-between adults and adolescents attending Ain Shams University Hospitals' outpatient clinics and identify the socio-demographic factors that could predict these components.
Methods: The present survey was carried out during the years 2022-2023 on 369 individuals, who were 11 years or older. An Arabic questionnaire, validated and tested for reliability, was employed to evaluate knowledge, attitudes, and behaviors related to mental disorders. The tools consisted of three validated scales: the Mental Health Knowledge Schedule (MAKS), the Community Attitudes towards Mental Illness (CAMI), and the Reported and Intended Behavior Scale (RIBS).
Results: Adults demonstrated significantly higher knowledge scores (46.33 ± 4.69 vs. 43.16 ± 4.92, p ≤ 0.01) and behavior scores (16.66 ± 3.56 vs. 15.53 ± 3.71, p ≤ 0.01), while adolescents exhibited more favorable attitudes (99.03 ± 17.43 vs. 90.74 ± 11.78, p ≤ 0.01). Higher knowledge was associated with being female, having a university education, living in urban areas, and being employed. Favorable attitudes were linked to adolescents, males, rural residents, and lower educational levels. At the same time, positive behaviors were associated with being female, having a university education, living in urban areas, being employed, and knowing someone with a mental illness. Regression analysis highlighted education and urban residence as consistent predictors across all mental health literacy components, with employment and familiarity with mental illness further enhancing behavior scores.
Conclusion: This study highlights significant differences in mental health literacy between adults and adolescents, with adults exhibiting higher knowledge and behavior scores and adolescents demonstrating more favorable attitudes. Socio-demographic factors, particularly education, urban residence, and employment, emerged as consistent predictors influencing knowledge, attitudes, and behaviors. These findings underscore the need for targeted interventions, such as incorporating mental health education into curricula, launching stigma-reduction campaigns, and improving access to mental health services, particularly in rural areas.
Introduction: Innovative approaches like e-consultation services are critical for improving access to healthcare and promoting equity, particularly in under-resourced settings. Despite their growing prominence, limited tools are available to assess healthcare professionals' acceptance and satisfaction with these services. This study aimed to validate the modified e-consultation TAM questionnaire as a reliable instrument for assessing physicians' perspectives on e-consultation service.
Methods: This study focuses exclusively on physicians receiving (not providing) e-consultation service within the Egyptian Ministry of Health and Population. The tool used for assessing their acceptance of the service consists of three sections: demographic data, items assessing perceived usefulness (PU) and perceived ease of use (PEU) of e-consultation, and questions addressing physicians' satisfaction, challenges, and suggestions to improve e-consultation services. The questionnaire was subjected to thorough validation, including face validity evaluated by an expert panel and construct validity which was assessed through factor analysis.
Results: The modified e-consultation TAM questionnaire demonstrated excellent internal reliability, with Cronbach's alpha coefficient exceeding 0.92 for both PU and PEU. Exploratory factor analysis identified two domains, PU and PEU, explaining 81.17% of the variance, with factor loadings ranging from 0.661 to 0.912. Confirmatory factor analysis (CFA) confirmed the two-factor model, with standardized factor loadings between 0.80 and 0.95, a Comparative Fit Index (CFI) of 0.95, and a Root Mean Square Error of Approximation (RMSEA) of 0.084.
Conclusion: The modified e-consultation TAM questionnaire proves to be a reliable and valid tool for evaluating physicians' acceptance of and satisfaction with e-consultation service. This tool offers potential for future research and practical applications, providing valuable insights to improve the implementation of e-consultation services and inform strategies for advancing healthcare access and equity globally.
Background: Health awareness plays a major role in determining the outcomes of serious medical conditions especially when response time is crucial. STEMI (ST-segment elevation myocardial infarction) patients are prone to serious compilations if they do not receive the appropriate treatment on time. Many factors affect the health awareness of the community, including educational level, previous exposure to similar situations, and exposure to health awareness materials. Those who do not know the symptoms of myocardial infarction will present late to the hospital and are exposed to a higher risk of complications. This study aims to assess the relationship between the health awareness of STEMI patients and the time of presentation to the emergency room (ER).
Methods: A cohort observational study was conducted at the National Heart Institute in Egypt gathering data on 263 STEMI patients presenting for primary percutaneous intervention. All the demographic and clinical necessary data was collected by the researchers in the emergency room, catheterization lab, and during the hospital admission of the patient. This study is a part of our larger cohort study on the relationship between education/health awareness of patients and outcomes of myocardial infarction.
Results: Data from 166 eligible patients were analyzed showing a significant correlation between health awareness and time of presentation to the ER in STEMI patients (p < 0.05). Additionally, there was a significant correlation between educational level and time of presentation to the ER (p < 0.05). The mean time from chest pain to arrival at the ER was 9.5 h. That is far beyond the range recommended internationally. Males, smokers, and younger age patients were significantly more likely to present earlier than their counterparts (p < 0.05).
Conclusions: Both educational level and health awareness of cardiac symptoms are associated with early presentation to the ER in STEMI patients. Developing health awareness activities targeting various population groups regarding cardiac symptoms and how to deal with them and including health education in different educational curricula are recommended.
Background: Despite the proven effectiveness of colorectal cancer (CRC) screening in reducing mortality, adherence rates for fecal occult blood testing (FOBT) and colonoscopy remain low among Turkish adults. This study aimed to assess the stages of adoption of CRC screening behaviors, identify the factors influencing adoption, and examine the perceived benefits and barriers to screening.
Methods: A cross-sectional study was conducted in Istanbul's Anatolian region from May to June 2022, involving 498 adults aged 50-70 years. Multistage cluster sampling was used to select 20 primary healthcare centers. A structured questionnaire was administered to assess sociodemographic characteristics, health perceptions, knowledge of colorectal cancer (CRC) screening, and readiness for screening based on the transtheoretical model. The benefits and barriers to screening were evaluated using the Turkish version of "The Instruments to Measure CRC Screening Benefits and Barriers."
Results: The participants (mean age: 59.10 ± 5.71 years) showed greater recognition of colonoscopy (68.7%) than FOBT (39.8%). Most participants were in the precontemplation stage for FOBT (58.6%) and colonoscopy (63.9%). Perceptions of benefits were associated with education, employment, income, health status, familial CRC history, and screening knowledge (p < 0.05). Perceived barriers were linked to lack of knowledge and provider recommendations (p < 0.05). The participants in the precontemplation stage reported fewer benefits and more barriers compared to those in advanced stages (p < 0.05).
Conclusions: Colonoscopy is more widely recognized than FOBT among the Turkish adult population; however, a significant proportion remains in the precontemplation stage for screening. Perceptions of benefits and barriers are influenced by sociodemographic factors, health status, and CRC knowledge. Interventions addressing these barriers and raising awareness could improve CRC screening uptake and help reduce the disease burden.
Background: Determining the health educational needs of people living with diabetes is essential in developing patient-centered, structured health education programs that aim to improve the outcome of diabetes care.
Objectives: To develop a tool for the identification of the health education needs of individuals living with diabetes in the Jazan Armed Forces Hospital (JAFH) and to standardize the questionnaire through the assessment of its reliability and validity.
Methods: A cross-sectional design was used in the present work, which included 303 participants living with diabetes. The researchers and an expert panel in family medicine and endocrinology created a comprehensive and mutually exhaustive questionnaire covering every potential area of health education needs. It included a 15-item section with questions on a 5-point Likert scale for determining the participants' needs for health education. Cronbach's alpha was used to determine the Likert scale's reliability. Exploratory factor analysis was used to determine the Likert scale's construct validity.
Results: The total number of males was 123 (40.6%) and that of females was 180 (59.4%). Their mean ages were 55.9 ± 12.9, ranging from 18 to 94 years. The reliability of the 15-item Likert scale was 83%, and it increased to 90% when the redundant items (n = 5) were eliminated. The test had an 86% test-retest reliability when repeated. Also, the final 10-item Likert scale has significant face, content, and construct validity. Two components with eigenvalues over 1 (generic knowledge about diabetes, and diabetes and travel) could be extracted out of the 10-item Likert scale.
Conclusion: The final 10-item Likert scale offers a good degree of validity and reliability for determining the health education needs of individuals living with diabetes. The two Likert scale components (general information on diabetes, and diabetes and travel) and their contributing items were identified from the questionnaire, which is standardized and helpful in both practice and research, in order to ascertain patients' needs and develop structured health education programs. The component "General information about diabetes" exhibited significant associations with the following items: diabetes risk factors and prevention; common oral agents for treating hypoglycemia; HbA1c (glycosylated hemoglobin) and normal blood glucose levels; and acute problems related to diabetes, such as hypoglycemia and diabetic ketoacidosis. On the other hand, diabetes and fasting; chronic complications of diabetes; and the significance of the yearly eye screening were the Likert scale items that contributed more to Component 2 (diabetes and travel).
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