Introduction: Work-related stress (WRS) is an insidious and persistent part of everyday life related to the response of people to work environment. Nursing is a strenuous job and WRS is prevalent among nurses. The aim of this study was to estimate the prevalence of WRS among nurses working in primary and secondary health care levels in Dammam, Eastern Saudi Arabia. Materials and Methods: A cross-sectional epidemiological study was conducted in 17 primary health care centers (PHCCs) representing the primary level of health care and  Medical Tower Complex (MTC) representing the secondary health care level in Dammam city. The total number of nurses included in the study was 637 nurses (144 in PHCCs) and (493 MTC). Data were collected using a self-administered questionnaire, which was developed based on the pertinent literature. It included two main parts: Sociodemographic and job characteristics of nurses and 31 WRS questions. Results: The overall prevalence of WRS among all studied nurses was 45.5%; 43.1% and 46.2% in primary and secondary levels, respectively. In the primary level, there was a statistical significant association between WRS and being married (85.5%), and having living three children and more (53.2%). Moreover, younger age group 20-<30 years (79.4%), Saudi nationality (86.8%), being married (74.6%), having nonbachelor degree (83.3%), work shifts (89.5%), and working in surgical department (46.5%) were the significant associating factors with the occurrence of WRS among nurses in secondary levels. Young age was the only predicting factor for WRS in primary care level. While being female, Saudi, married, with work shifts, and working in surgical department were found to predict WRS in the secondary level. Recommendations: Appropriate strategy in health care organization to investigate stress in health care settings is recommended. Moreover, interventional programs to identify, and relieve sources and effects of stress should be developed.

Background: Breaking bad news is one of the most stressful and difficult things a physician has to do. Good communication skills are required in order to ensure that bad news is delivered in a humane but effective way. Objectives: This study was designed to explore the preferences and attitude of the Saudi population toward receiving bad news. Second, it was to identify the associations between preferences, attitudes, and sociodemographic characteristics. Materials and Methods: This was a cross-sectional study conducted during the month of April 2009 in Riyadh. Data were collected from 1013 adult Saudis. Stratified random sampling technique was used through a self-administered questionnaire. Results: In this study, 474 (46.8%) were males and 539 (53.2%) were females. Almost two-third of the participants preferred to be the first to receive the bad news. A majority of the participants 695 (68.6%) preferred to be told the bad news at a private place, whereas, 441 (43.5%) preferred to be told by the head of the medical team. Moreover, almost half of the participants would like the one who breaks the bad news to remain with them to give them some more information about the disease. Significant associations were observed between participants' perception and attitude with age, marital status, gender, and education (P < 0.001), respectively. Conclusion: Factors such as marital status, age, and gender, and education play significant roles in how bad news is received. Understanding what is important in the process of breaking bad news may help in determining how best to perform this challenging task.

Objective: To identify the determinants of misconceptions about diabetes in patients registered with a diabetes clinic at a tertiary care hospital in Eastern Saudi Arabia. Materials and Methods: This cross-sectional survey was carried out at a diabetes clinic of a tertiary care hospital in Eastern Saudi Arabia, from January to December 2012. A total of 200 diabetic patients were interviewed using a questionnaire comprising 36 popular misconceptions. The total misconception score was calculated and categorized into low (0-12), moderate (13-24) and high (25-36) scores. The association of misconception score with various potential determinants was calculated using Chi-square test. Step-wise logistic regression was applied to the variables showing significant association with the misconception score in order to identify the determinants of misconceptions. Results: The mean age was 39.62 ± 16.7 and 112 (56%) subjects were females. Type 1 diabetics were 78 (39%), while 122 (61%) had Type 2 diabetes. Insulin was being used by 105 (52.5%), 124 (62%) were self-monitoring blood glucose and 112 (56%) were using diet control. Formal education on diabetes awareness had been received by 167 (83.5%) before the interview. The mean misconception score was 10.29 ± 4.92 with 115 (57.5%) subjects had low misconception scores (<12/36). On the Chi-square test, female gender, rural area of residence, little or no education, <5 or >15 years since diagnosis, no self-monitoring, no dietary control and no diabetes education were all significantly (P < 0.05) associated with higher misconception scores. Step-wise logistic regression suggested that diabetes education, gender, education and time since diagnosis were significant (P < 0.05) predictors of misconception scores. Conclusions: The strongest determinants of misconceptions about diabetes in our study population were female gender, rural area of residence, illiteracy or little education, <5 or >15 years since diagnosis, no self-monitoring, no diet control and no education about diabetes.

Background: Constipation has a significant impact on the quality of life (QOL). Lifestyle modification is widely accepted and recommended by experts as first-line therapy. Aim: This study aimed at using education on lifestyle modification to improve the QOL of the elderly in nursing homes suffering from functional constipation (FC). Materials and Methods: This study was conducted in nursing homes in Ismailia city, Egypt. It involved 23 elderly patients suffering from FC, who were randomly selected according to the sample equation. They fulfilled the inclusion criteria of being ≥60 years age and according to Rome II criteria. Participants completed personal characteristics and lifestyle questionnaire, the Patient Assessment of Constipation Symptom questionnaire (PAC-SYM) to assess the severity of symptoms, and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) to assess pre- and post-intervention. The intervention was conducted in three sessions, of 30 min each, 2 weeks apart using group discussions to educate the sample about dietary pattern, fluid intake, regular physical activity, and the use of laxatives. Statistical analysis: Data were analyzed using a statistical package for social sciences (SPSS version 20). Results: The lifestyle modification education on constipation significantly reduced the severity of symptoms as measured by PAC-SYM, including its total score and subscores (P < 0.001). It also improved the QOL of elderly suffering from constipation as measured by PAC-QOL and reduced total scores of dissatisfaction (P = 0.001) with the exception of the psychosocial subscale. It also significantly increased the satisfaction subscale of PAC-SYM (P < 0.001). Conclusion: Education on lifestyle modification leads to an improvement in the severity of the symptoms of constipation and the QOL of the elderly in nursing homes.

Background: Ultrasound examination is very frequently used for the evaluation of abnormalities in various organs of the body. Our aim was to determine whether the requests by family physicians (FPs) for ultrasound examinations were appropriate. Our secondary objective was to enumerate positive and negative ultrasound reports for various diagnostic indications. Materials and Methods: This cross-sectional study was conducted during the period of month between June and August 2010, at the Family Medicine Department of North West Armed Forces Prince Salman Hospital, Tabuk. We reviewed the ultrasound requests of all patients included in this study and the findings of the procedure. Data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL), version 16.0. Results: The requests and reports of 815 patients for ultrasound were reviewed. Females comprised 58.7% of the referred cases. The mean age of the sample at referral was 30 ± 18.5 for females and 34 ± 20.7 for males. Only 46% of the request forms contained conclusive information and instructions. Abdominal/pelvic ultrasounds were the most frequently requested; Nearly 71.2% of the ultrasound scans were normal. Abdominal/pelvis ultrasound was more likely to be reported as normal than ultrasound scans of other regions ( P = 0.007). Patients aged 41-60 years were more likely to have an abnormal ultrasound (P = 0.02). Conclusion: Our findings suggest that FPs have to be educated about imaging referral protocols in order to achieve better outcomes.

Background: Job satisfaction is a pleasant emotional state associated with the appreciation of one's work and contributes immensely to performance in an organization. The purpose of this study was to assess the comparative job satisfaction among regular and staff on contract in Government Primary Urban Health Centers in Delhi, India. Materials and Methods: The study was conducted in 2013, on a sample of 333 health care providers who were selected using a multistage random sampling technique. The sample included medical officers (MOs), auxiliary nurses and midwives (ANMs), pharmacists and laboratory technicians (LTs)/laboratory assistants (LAs) among regular and staff on contract. Analysis was done using SPSS version 18, and appropriate statistical tests were applied. Results: The job satisfaction for all the regular staff that is, MOs, ANMs, pharmacists, LAs, and LTs were relatively higher (3.3 ± 0.44) than the contract staff (2.7 ± 0.45) with 't'value 10.54 (P < 0.01). The mean score for regular and contract MOs was 3.2 ± 0.46 and 2.7 ± 0.56, respectively, and the same trends were found between regular and ANMs on the contract which was 3.4 ± 0.30 and 2.7 ± 0.38, regular and pharmacists on the contract was 3.3 ± 0.50 and 2.8 ± 0.41, respectively. The differences between groups were significant with a P < 0.01. Conclusion: Overall job satisfaction level was relatively low in both regular and contract staff. The factors contributing to satisfaction level were privileges, interpersonal relations, working-environment, patient relationship, the organization's facilities, career development, and the scarcity of human resources (HRs). Therefore, specific recommendations are suggested to policy makers to take cognizance of the scarcity of HRs and the on-going experimentation with different models under primary health care system.

Background: Breast cancer (BC) is usually diagnosed in late stages in countries with limited resources. Early detection of BC is likely to improve the outcome of the disease for women in these areas. Objective: The aim of this study was to understand the possible personal, economic, and systems barriers to BC screening in a sample of Egyptian women. Materials and Methods: A cross-sectional study was conducted in family health centers representing the seven districts of Alexandria governorate, Egypt. A total of 612 women were randomly selected from the chosen centers. Results: In this sample of Egyptian women, the most frequently identified potential barriers to BC screening were the following: 81.8% would not seek care until they were ill, 77% were unwilling to have a mammogram until it was recommended by the doctor, 71.4% blamed the, lack of privacy, 69.2% thought that medical checkups were not worthwhile, and 64.6% blamed the cost of services. The study further revealed that women of lower education, women in the lower income category, women who did not do paid work, those who had poor knowledge of the risks of BC, and women with no family history of BC were more likely to perceive different screening barriers compared with their counterparts. Conclusion: Many potential personal, economic, and health system barriers were identified. Addressing these barriers by increasing the awareness of BC and dealing with the misconceptions that the women have can help the policy makers to design more culturally relevant strategies to motivate women to utilize screening services.

Background: The history of resuscitation going back thousands of years has been reported in literature throughout history. This concept has undergone several decisive revolutionary changes particularly in pediatrics. Although the cardio-pulmonary resuscitation (CPR) is relatively new in pediatrics, progress has been remarkable in the last a few decades. As it becomes more popular, especially under the influence of globalizing media, CPR also becomes a life requirement that is not restricted to health professionals. Materials and Methods: This was a cross-sectional community-based survey of 753 individuals of both sexes, visiting the first Pediatric Health Awareness Week held at Dammam University Hospital in April 2013. Data were collected by a personal face-to-face interview during which a short history was taken and a check list of sociodemographic data and questions related to infants' CPR was completed. Statistical analysis was performed by using SPSS. Results: The study was carried out on 753 subjects (602 Saudis, 151 non-Saudis, 483 females, and 270 males). The mean age of participants was 33.3 ± 10.9 years. The postsecondary school level of education was 37.5% among females versus 21.9% among males. Of the participants, 80.8% of the females and 86.5% of males were totally unaware of CPR. The mean number of children among participants was 3.5 ± 2.5 children. There were 150 participants (19.9%) with disabled children; 32% of them (6.4% of all participants) were completely unaware of CPR despite having disabled children. Overall, 15.5% of all female participants had attended some CPR course (s) compared with 6.1% of the males; 18.7% of the females had watched CPR program (s)/video (s) on TV or online compared to 11.1% of the males, and 59.4% of the females were willing and eager to participate in any CPR course compared with 29.3% of the males. The reasons for not wanting to attend CPR courses were as follows: 48.6% indicated that it was because of the unavailability of such courses, 41.4% said because of time constraints, and 10% gave financial reasons. Finally, the study showed that 365 females (84.3%) and 247 males (91.2%) did not know when to perform mouth-to-mouth resuscitation and/or chest compression, and would do it for the wrong reasons. Conclusion: Public awareness and knowledge on CPR was inadequate even among the younger population, and among parents with disabled children. The general public were willing to improve their knowledge and skills of CPR. We recommend that CPR courses/campaigns should be provided to the public and be included in high school curricula.

Introduction: Metabolic syndrome (MS) is a state of deranged metabolic and anthropometric status. It is considered a precursor to various cardiovascular and metabolic diseases. Objectives: (1) To determine the prevalence of MS in adults aged 20 years and above in the rural area of Ambala district, Haryana. (2) To determine the sociodemographic factors associated with MS. Materials and Methods: In a community-based cross-sectional study, a total of 1200 subjects aged 20 years and above were studied, using multi-stage random sampling. Results: The prevalence of MS was estimated by using criterion given by the International Diabetes Federation. MS was found in 110 (9.2%) subjects, being more prevalent in females: 73 (66.36%) when compared to 37 males (33.63%). Sedentary occupation and age were significantly associated with MS. Conclusions: MS is a major health problem in the region and it should be given proper attention in order to prevent and control it.

Objective: The aim of this paper was to determine the validity and reliability of a questionnaire tool for measuring students' attitudes toward components relevant to research training programs in the Kingdom of Saudi Arabia. Materials and Methods: The paper reports the responses of 564 Saudi Arabian students from seven government universities to the questionnaire comprising 16 items on 3 conceptual subscales, which measured students' attitude to research activities in the college; students' opinion of faculty involvement in research; and infrastructural facilities in the college. The results of this study provide the final scale, with all the 16 items of the initial Likert scale, for which strong evidence was obtained. Results: Results indicated that the students' attitude toward the research (SAR) scale had three latent factors, which explained 62% of the variance: The three subscales measured includes: (i) Research activities offered in the college, (ii) students' opinion of faculty involvement in research, and (iii) infrastructural facilities offered in the college for research. The full scale including three subscales had good internal consistency (r_s = 0.72 and α = 0.77 for full scale; and α between 0.71 and 0.79 for three subscales). Conclusion: This study provides evidence of reliability and validity of the SAR scale for the measurement of students' attitudes toward research training programs in Saudi Arabian Universities. The research findings will provide the basis for further research on health science students.