RESUMEN

The COVID-19 pandemic has caused a lot of stress for healthcare personnel. They are subjected to arduous and stressful working hours and may contract infection. The objectives of this study were to (i) assess the level of occupational stress and the prevalence of burnout among healthcare workers (HCWs) in the Kingdom of Saudi Arabia during the COVID-19 pandemic and (ii) to identify some sociodemographic characteristics and work-related factors that may influence the level of stress and burnout among such HCWs. An online survey was distributed on social media websites and groups of HCWs in KSA. The survey depended on the stress domain of Depression, Anxiety, and Stress Scale-21 (DASS-21) and the work-related burnout domain of Copenhagen Burnout Inventory (CBI). Data were collected using a Google form and then analyzed. Among 478 respondents, 37.7% of studied HCWs reported mild to extremely severe stress, and 47.9% of them reported work-related burnout. Occupational stress and burnout were more prevalent among front-line HCWs (43.9% and 55%) than among second-line HCWs (31.2% and 40.8%). The mean scores of occupational stress and burnout were significantly much higher among frontline physicians and nurses particularly those who are females, of younger age (≤40 years), with few years of work experience (≤15 years), being married, having chronic disease, and those previously infected by COVID-19. HCWs reported a high prevalence of occupational stress and burnout during the COVID-19 pandemic. Establishing policies and guidelines, enhancing working conditions, and providing continuous psychological support and assurance to HCWs are recommended to improve their resilience and increase their coping capacities toward pandemics.

Asunto(s)

Agotamiento Profesional , COVID-19 , Personal de Salud , Estrés Laboral , Humanos , COVID-19/epidemiología , COVID-19/psicología , Arabia Saudita/epidemiología , Femenino , Masculino , Personal de Salud/psicología , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Adulto , Estrés Laboral/epidemiología , Estrés Laboral/psicología , Persona de Mediana Edad , Prevalencia , SARS-CoV-2 , Encuestas y Cuestionarios , Pandemias , Estudios Transversales

RESUMEN

OBJECTIVES: Our study aims to assess the effectiveness of implementing a case manager-led Multidisciplinary Team approach in the primary healthcare setting on improving glycemic control and reducing cardiovascular risks for T2DM patients over a 6-month period. METHODS: This retrospective record-based follow-up study was carried out on 3060 uncontrolled T2DM patients in primary healthcare centers in Riyadh First Health Cluster over a period of 6 months. The patient records are investigated and analyzed, including demographic characteristics and measurements of Hemoglobin A1c (HbA1c), Low-Density Lipoprotein Cholesterol (LDL-C), total cholesterol, and BP levels at enrollment and after 6 months of Multi-Disciplinary Team follow-up. The changes in the study variables and their correlations to each other are tested using Statistical Package for the Social Sciences software. RESULTS: At enrollment, our patients were characterized by poor glycemic control (HbAIC > 8%). Most of them have high body weight with a mean BMI of (31.2 ± 1.7), and nearly two-thirds are either hypertensive or have dyslipidemia (43.4% and 47.3% respectively). After 6 months of MDT follow-up, there is a significant improvement in glycemic control among 1971 patients (64.4%), with a reduction in the mean level of different outcomes relative to baseline HbA1c (-15%, P < .001), total cholesterol (-9.0%, P < .001), LDL-C (-11.0%, P < .001), systolic BP (-7.7%, P < .001), and diastolic BP (-10.5%, P < .001). The improved glycemic control showed a significant positive correlation with the number of MDT visits but negatively correlated with BMI and the number of comorbidities. In addition, the improvements in secondary outcomes were positively and significantly correlated with such improvements in glycemic control. CONCLUSION: Case-manager-led MDT approach significantly improves glycemic control and significantly improves control over dyslipidemia and hypertension, reducing cardiovascular risks, and unfavorable events among such diabetic patients. We highly recommend developing more MDTs, training case managers, and rigorously evaluating the MDT approach.

Asunto(s)

Gestores de Casos , Diabetes Mellitus Tipo 2 , Dislipidemias , Hipertensión , Humanos , LDL-Colesterol , Estudios de Seguimiento , Hemoglobina Glucada , Control Glucémico , Estudios Retrospectivos , Dislipidemias/epidemiología , Atención Primaria de Salud , Diabetes Mellitus Tipo 2/terapia

RESUMEN

Purpose: The objectives of the study are to assess the outcome and cost-effectiveness of specialized reference clinics (SRCs) in primary health care centers (PHCCs) of Riyadh First Health Cluster (RFHC), then to estimate the patient satisfaction among clients utilizing such SRCs. Patients and Methods: This facility-based study was conducted in Riyadh city, Saudi Arabia among six PHCCs in RFHC that contain SRCs. Records of all patients utilizing SRCs and their referral information were studied along two years. An in-depth interview was conducted with health care providers in SRCs. Cost analysis was calculated by the financial support group within RFHC. Also, a randomly selected 400 subjects utilizing SRCs were asked to fill patient satisfaction questionnaire. Results: Over two years, a total number of 55,084 patients utilized SRCs among different specialties. Most of these patients (86.7%) had full medical service within PHC-SRCs with no need for referral to hospitals. SRCs are significantly effective in decreasing the burden on hospitals in most specialties (p < 0.001). This effectiveness is significantly increased during the 2nd year of service. The time spent until appointment is significantly reduced from an average of six weeks in hospitals to an average of one week in SRCs. SRCs are very cost-effective as they reduced referrals to hospitals by 86.7% among 55,084 patients who utilized SRCs over two years, saving total costs of about 14.08 million Saudi Riyals (3.75 million US dollars). Most of the specialties are cost-effective except for urology and general surgery clinics, which are not cost-effective. Patient satisfaction is high regarding all service domains. The overall patient satisfaction score increased from 71.4% in the 1st year up to 73.2% in the second year. Conclusion: PHC-SRCs are cost-effective health services and their creation is reasonable and beneficial in terms of reducing costs of health care delivery, reducing the burden on hospitals, and improving patient satisfaction.