RESUMEN

A questionnaire survey was made of primary health care physicians in Asir region, Saudi Arabia in 1999 to explore their awareness of and attitude towards evidence-based medicine. The 272 respondents welcomed the principles of evidence-based medicine. Awareness and use of extracting journals, review publications and databases was low. Pharmaceutical company sponsored journals were the most commonly read. Bibliographic databases could only be accessed by 13% of respondents and the Internet by only 6%. There was only partial understanding of technical terms used in evidence-based medicine. Absence of a local library and increased patient workload were seen by most respondents as the main obstacles to practising evidence-based medicine.

Asunto(s)

Actitud del Personal de Salud , Medicina Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Médicos de Familia/psicología , Adulto , Análisis de Varianza , Concienciación , Distribución de Chi-Cuadrado , Competencia Clínica , Estudios Transversales , Toma de Decisiones , Difusión de Innovaciones , Evaluación Educacional , Medicina Basada en la Evidencia/educación , Medicina Basada en la Evidencia/organización & administración , Femenino , Humanos , Bibliotecas Médicas , Masculino , Evaluación de Necesidades , Publicaciones Periódicas como Asunto , Médicos de Familia/educación , Médicos de Familia/organización & administración , Pautas de la Práctica en Medicina/organización & administración , Población Rural/estadística & datos numéricos , Arabia Saudita , Encuestas y Cuestionarios , Carga de Trabajo/psicología , Carga de Trabajo/estadística & datos numéricos

RESUMEN

A questionnaire survey was made of primary health care physicians in ِAsir region, Saudi Arabia in 1999 to explore their awareness of and attitude towards evidence - based medicine. The 272 respondents welcomed the principles of evidence- based medicine. Awareness and use of extracting journals, review publications and databases was low. Pharmaceutical company sponsored journals were the most commonly read. Bibliographic databases could only be accessed by 13% of respondents and the Internet by only 6%. There was only partial understanding of technical terms used in medicine. Absence of a local library and increased patient workload were seen by most respondents evidence-based as the main obstacles to practising evidence - based medicine

Asunto(s)

Actitud , Encuestas y Cuestionarios , Concienciación , Médicos de Familia , Medicina Basada en la Evidencia

RESUMEN

This was a cross-sectional national survey of the elderly population of Saudi Arabia conducted between January 1994 and December 1995. The participants' physical, mental, social, and environmental health status were assessed in a personal interview during which a structured data form was completed by a trained research team. Data on 6,139 elderly participants have been analyzed: 64.2 percent were males mean age: 69.2 +/- 7.8 years which was higher than females 68.0 +/- 7.6 years (P < 0.0001). The widowhood (46.7%) status was also higher than the widowerhood (4.1%) and 9.3 percent of the participants were never married. The proportion of female illiterates (95.8%) was higher than the males (71.4%). The proportion of participants with definite psychopathology was 33.8 percent and this increased with age and higher among females than males. Overall, 18.8 percent were dependent on others for ADL. Other clinical findings included visual impairment (46.1%) and difficulty in hearing (19.9%). However, a sizeable majority (72.2%) enjoyed good health. Only 3.7 percent lived alone. The proportion of the elderly taking part in any recreational exercise was 14.7 percent and only 4.3 percent had any experience of physical therapy. There were no special hospital wards for the elderly patients, and they were treated by general internists. There is a need for a national cost-effective program for the care of the elderly. The present widespread primary health care centers can be upgraded to coordinate the proposed services.

Asunto(s)

Anciano/psicología , Planificación en Salud , Servicios de Salud para Ancianos , Estado de Salud , Salud Mental , Actividades Cotidianas , Anciano de 80 o más Años , Actitud Frente a la Salud , Estudios Transversales , Femenino , Humanos , Actividades Recreativas , Masculino , Trastornos Mentales/epidemiología , Morbilidad , Arabia Saudita/epidemiología , Factores Socioeconómicos

RESUMEN

The objective of the study was to assess the suitability of the structure of Primary Health Care Centers to cater to the needs of patients with asthma. Standards for optimal care were defined by the authors. The worst deficiencies identified were in the availability peak flow meters, inhaler devices and antiinflammatory drugs. Assessment of the optimal structure for asthma care was found to demonstrate variance with national standards. More effort is recommended in central development of guidelines. This assessment can be used to measure future changes in asthma care.

Asunto(s)

Asma/terapia , Centros Comunitarios de Salud/organización & administración , Evaluación de Necesidades , Atención Primaria de Salud/organización & administración , Femenino , Investigación sobre Servicios de Salud , Humanos , Masculino , Admisión y Programación de Personal/normas , Guías de Práctica Clínica como Asunto , Evaluación de Programas y Proyectos de Salud , Arabia Saudita , Encuestas y Cuestionarios

RESUMEN

In order to evaluate the effect of training primary health care (PHC) physicians to recognize mental disorders, an intervention randomized controlled trial was conducted. Three categories of PHC physicians were selected: the index group (n = 12 doctors), control group 1 (n = 12) and control group 2 (n = 4). For 1 week randomly selected patients from all trial centres were asked to complete the General Health Questionnaire (GHQ-28), and the three groups of doctors were asked to identify the presence of and rate the severity of any mental disorder in these patients. The same process was repeated for all three groups after a 6-month training course which was provided for the index group only. The doctors' ability to detect mental disorders was measured by calculating Spearman's correlation coefficient between their severity rating and the GHQ scores of their patients. Training produced a noticeable improvement in the diagnostic accuracy of the index group, whereas there was minimal improvement in control group 1 and deterioration in control group 2. Recommendations to improve the ability of PHC physicians to detect mental disorders are discussed.

Asunto(s)

Trastornos Mentales/diagnóstico , Médicos de Familia/educación , Enseñanza/métodos , Adulto , Competencia Clínica , Femenino , Humanos , Masculino , Trastornos Mentales/clasificación , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica/estadística & datos numéricos , Psiquiatría/educación , Arabia Saudita , Índice de Severidad de la Enfermedad

RESUMEN

This is a retrospective study of the medical records of asthamtics using a predesigned form. The purpose of the study is to define the number of patients registered as asthamatics at a random selection of primary health care centers (PHCCs) in Riyadh and to describe sociodemographic, clinical and management characteristics of this population of asthmatics with a view to recommending changes which might improve the care for asthma patients. Patients from 60 primary health care centers were studied. There were 2081 asthamatic patients found in the studied PHCCs (out of 255,145 surveyed), giving a rate of 0.8%. Out of all the patients, 32.8% were children 16 years of age or below and 24.7% were above 5 years of age. The male to female ratio was 1.2:1. The presenting symptoms were cough in 82.3% and shortness of breath 64.8%. Atopic disorders such as eczema and allergic rhinitis were recorded in 27.7%. PHCCs diagnosed 61.9% depending on history and clinical examination. Out of all patients, 10.6% did not utilize a PHCC, 29.5% were referred to a specialist and 8.7% needed admission to the hospital one or more times. Oral salbutamol was used in more than 45.7% of the patients. The number of registered bronchial asthma patients at the PHCCs was very low. Even when registered, asthmatic patients are getting suboptimal care. The present study provides a basis for intervention and a baseline from which to measure the benefits of intervention. It also provides the strongest possible support for the Ministry of Health, who recently initiated a National Asthma Program.

RESUMEN

OBJECTIVE: To determine the prevalence and determinants of cigarette smoking among intermediate (junior secondary) schoolboys in Riyadh, Saudi Arabia. PARTICIPANTS: A sample of 1382 students (ages 12-19 years) in 45 classes randomly selected from 15 schools, using a two-stage stratified cluster sampling scheme. DESIGN: Students in the selected classes were requested to complete an anonymous questionnaire, under the supervision of trained interviewers. Univariate and multivariate statistical analyses of potential risk factors were performed. SETTING: Intermediate schools in Riyadh, Saudi Arabia. MAIN OUTCOME MEASURES: Association between current smoking and socio-demographic variables, history of smoking, age of smoking initiation, smoking behaviour among family members, knowledge of the harmful effects of smoking, and whether smoking is allowed in the presence of relatives and acquaintances. RESULTS: The prevalence of current smokers was 13.2% overall, ranging from 3.2% in those 12-13 years old to 31.1% in those aged 18-19. Some of the variables (nationality, father's education, and smoking allowed in the presence of parents or teachers) found to be associated with current smoking in a univariate analysis were no longer significantly associated with smoking in the multivariate analysis. By multivariate analysis, knowledge of the harmful effects of smoking, age, smoking allowed in the presence of friends or brothers, and previous smoking were statistically significant determinants of current smoking. CONCLUSIONS: Current health education activities against smoking should be continued and extended to the young population to further reduce the prevalence of smoking and its health consequences. Religious antipathy toward smoking should be emphasised in any local anti-smoking campaigns.

Asunto(s)

Fumar/epidemiología , Adolescente , Adulto , Factores de Edad , Edad de Inicio , Niño , Cultura , Humanos , Incidencia , Masculino , Arabia Saudita

RESUMEN

The objective of this study was to identify important risk factors for spontaneous abortion (SA) among Saudi women. It was a case-control study conducted at King Khalid University Hospital, Riyadh, Saudi Arabia. The cases were 226 consecutive women hospitalized for SA between October 1992 and January 1993. The controls were 226 consecutive women who had normal delivery in the same hospital during the same period. Bivariate analysis using chi-square tests and estimates of relative risks indicated a positive association of age at menarche with risk of SA (P < 0.01). Also, there was a significant higher risk of SA when a women was married to a blood related husband than if married to a non relative (RR = 2.1). The number of previous abortions was also positively related to the risk of SA in the current pregnancy (P < 0.01). Compared to primigravidas, the risk of SA was 3.2 times greater than if the outcome of the most recent pregnancy was also an SA. Other factors that had significant bivariate association with SA were a family history of SA, abdominal trauma, and infection during pregnancy. When multiple logistic regression was used to adjust for the effects of confounding variables, all the factors that showed significant bivariate association with SA (except outcome of the last pregnancy) remained significant. Early menarche may be protective, but further study is needed to confirm this. Greater attention should be given to pregnant women who had personal or family history of SA and those who had trauma and/or infection during pregnancy. Premarital counselling concerning consanguineous marriages is recommended.

Asunto(s)

Aborto Espontáneo/etiología , Adulto , Estudios de Casos y Controles , Distribución de Chi-Cuadrado , Femenino , Hospitalización , Humanos , Modelos Logísticos , Embarazo , Riesgo , Factores de Riesgo , Arabia Saudita , Factores Socioeconómicos , Encuestas y Cuestionarios

RESUMEN

A preliminary case-control study was conducted on Saudi women to detect possible risk factors for spontaneous abortion (SA). Two hundred and twenty six consecutive women hospitalised for SA and 226 women admitted for normal delivery and used as controls, were studied. Women with SA were significantly older at menarche (Relative Risk (RR) = 3.2), more frequently married to blood-related husbands (RR = 2.1) and husbands older than 50 years (RR = 2.4). Number of previous abortions related linearly to the risk of aborting spontaneously in the next pregnancy. Compared to primigravidas, the RR was 3.2 if the outcome of the most recent pregnancy was SA, and 0.8 if it was a livebirth. A family history of SA was more common among cases (RR = 4.6). Spontaneous abortion was also associated with daily consumption of more than 150 mg of caffeine, abdominal trauma, infection and fever during pregnancy. No significant association, however, emerged with maternal age, social class, education, exposure to video display terminals, parity, use of contraception, diabetes or obesity. The application of these data in clinical practice and future research needs are discussed.

Asunto(s)

Aborto Espontáneo/etiología , Aborto Espontáneo/epidemiología , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Oportunidad Relativa , Embarazo , Historia Reproductiva , Factores de Riesgo , Arabia Saudita/epidemiología

RESUMEN

The ability of primary care physicians (PCPs) to diagnose neurologic disorders was assessed from the records of 166 patients referred to the neurology outpatient clinic in one year. At the time of referral, 74.7% were correctly diagnosed. Primary care physicians were competent in the diagnosis of cerebrovascular accidents, epilepsy, space-occupying lesions, dementia, extrapyramidal and cerebellar disorders. More specific diagnosis was difficult at the primary care level in cases of headache, spinal cord and peripheral nerve disorders. The implications of these results and possible reasons for them are discussed. Solutions to improve on this situation are recommended with emphasis on both undergraduate and postgraduate training in neurological bedside skills. The complementary roles of the primary care physician and the neurologist are stressed.