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   2017| May-August  | Volume 24 | Issue 2  
    Online since April 25, 2017

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Parents' perceptions about child abuse and their impact on physical and emotional child abuse: A study from primary health care centers in Riyadh, Saudi Arabia
Mohammed N Al Dosari, Mazen Ferwana, Imad Abdulmajeed, Khaled K Aldossari, Jamaan M Al-Zahrani
May-August 2017, 24(2):79-85
DOI:10.4103/2230-8229.205110  PMID:28566970
OBJECTIVE: To determine perceptions of parents about child abuse, and their impact on physical and emotional child abuse. MATERIALS AND METHODS: Two hundred parents attending three primary health care centers (PHCCs) in Riyadh serving National Guard employes and their families, were requested to participate in this survey. Data was collected by self administered questionnaire. Five main risk factors areas/domains were explored; three were parent related (personal factors, history of parents' childhood abuse, and parental attitude toward punishment), and two were family/community effects and factors specific to the child. SPSS was used for data entry and analysis. Descriptive analysis included computation of mean, median, mode, frequencies, and percentages; Chi-square test and t-test were used to test for statistical significance, and regression analysis performed to explore relationships between child abuse and various risk factors. RESULTS: Thirty-four percent of the parents reported a childhood history of physical abuse. Almost 18% of the parents used physical punishment. The risk factors associated significantly with child abuse were parents' history of physical abuse, young parent, witness to domestic violence, and poor self-control. Child-related factors included a child who is difficult to control or has attention deficit hyperactivity disorder (ADHD). Parents who did not own a house were more likely to use physical punishment. Abusive beliefs of parent as risk factors were: physical punishment as an effective educational tool for a noisy child; parents' assent to physical punishment for children; it is difficult to differentiate between physical punishment and child abuse; parents have the right to discipline their child as they deem necessary; and there is no need for a system for the prevention of child abuse. CONCLUSION: The causes of child abuse and neglect are complex. Though detecting child abuse may be difficult in primary care practice, many risk factors can be identified early. Parents' attitudes can be measured, and prevention initiatives, such as screening and counseling for parents of children at risk, can be developed and incorporated into primary care practice.
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Prevalence and spectrum of functional disability of urban elderly subjects: A community-based study from Central India
Priya Keshari, Hari Shankar
May-August 2017, 24(2):86-90
DOI:10.4103/jfcm.JFCM_80_16  PMID:28566971
INTRODUCTION: One of the major determinants of the quality of life of elderly subjects is their functional status, which refers to their ability to perform normal daily activities. This study was carried out to determine the prevalence of functional disability in terms of restriction in the activities of daily livings (ADLs) in elderly subjects. MATERIALS AND METHODS: This community-based cross-sectional study was conducted in an urban area of Varanasi, India, with 616 elderly subjects (60 years and above) selected for the study by an appropriate sampling procedure. A predesigned and pretested questionnaire was used to elicit the desired information after taking consent from the study subjects. Statistical Package for Social Sciences (SPSS 21st version) was used for analysis; Chi-square test and z-test were used to test for statistical significance. RESULTS: Prevalence of functional disability in elderly subjects was 53.6% (95% confidence interval: 49.67–57.5%). Restriction of any ADL with maximum severity was observed in 13.5% of the subjects. Independence in ADLs was maximum (100%) for bowel continence and lowest for climbing stairs (47.4%). On the basis of Barthel Index score, 25.2% and 4.4% of the subjects had moderate and severe dependency, respectively. In comparison to mobility restriction, the proportion of subjects whose ADLs were not affected was significantly (P < 0.01) more in the self-care domain. CONCLUSION: Nearly half of the elderly subjects were functionally disabled on the basis of ADL performance. The number of persons of this age group in the domain of restricted mobility is quite high. It is necessary and also possible to design and implement programs that will involve all persons concerned with their care to improve the functional status of the geriatric population.
  2,608 346 -
To what extent are Arab pilgrims to Makkah aware of the middle east respiratory syndrome coronavirus and the precautions against it?
Meshaal S Alotaibi, Abdulaziz M Alsubaie, Khaled A Almohaimede, Turki A Alotaibi, Omar A Alharbi, Abdulrahman F Aljadoa, Abdulaziz H Alhamad, Mazin Barry
May-August 2017, 24(2):91-96
DOI:10.4103/2230-8229.205119  PMID:28566972
BACKGROUND: Approximately, 80% of the many cases of the Middle East respiratory syndrome coronavirus (MERS-CoV) confirmed worldwide were diagnosed in the Kingdom of Saudi Arabia (KSA). The risk of the disease spreading internationally is especially worrying given the role of KSA as the home of the most important Islamic pilgrimage sites. This means the need to assess Arab pilgrims' awareness of MERS-CoV is of paramount importance. MATERIALS AND METHODS: A cross-sectional study was carried out during Ramadan 2015 in the Holy Mosque in Makkah, Saudi Arabia. Self-administered questionnaires were distributed to 417 Arab participants at King Fahad Extension, King Abdullah Prayer Extension and, King Abdullah Piazza Extension after Taraweeh and Fajr prayers. RESULTS: The mean MERS-CoV knowledge score was 52.56. Majority of the respondents (91.3%) were familiar with MERS-CoV. Saudis had significantly higher knowledge of MERS-CoV than non-Saudis (56.92 ± 18.55 vs. 44.91 ± 25.46, p = 0.001). Females had significantly more knowledge about consanguineous MERS-CoV than males (55.82 ± 19.35 vs. 49.93 ± 23.66, p = 0.006). The average knowledge was significantly higher in respondents who had received health advice on MERS-CoV (56.08 ± 20.86 vs. 50.65 ± 22.51, p = 0.024). With respect to stepwise linear regression, knowledge of MERS-CoV tended to increase by 14.23 (B = 14.23%, p = 0.001) in participants who were familiar with MERS-CoV, and by 8.50 (B = 8.50, p = 0.001) in those who perceived MERS-CoV as a very serious disease. CONCLUSION: There is a great need for educational programs to increase awareness about MERS-CoV.
  2,538 287 -
Doctors' knowledge of patients' rights at King Fahd Hospital of the University
Sarah A Al-Muammar, Danya M. K Gari
May-August 2017, 24(2):106-110
DOI:10.4103/jfcm.JFCM_97_16  PMID:28566975
OBJECTIVES: To assess the level of physicians' knowledge about the contents of patients' bill of rights (PBR) and its implementation. MATERIALS AND METHODS: This cross-sectional study was carried out at a university hospital in the Eastern Province of Saudi Arabia. All physicians working in the hospital received a self-administered questionnaire to measure their level of knowledge of PBR. Scoring was done to determine the knowledge of the details. The study was approved by the Institutional Review Board of the University Hospital and permission sought from the administration. Data analysis performed with SPSS; descriptive analyses included frequency and percentages for categorical variables, and mean and standard deviations for continuous variables. Bivariate analyses were carried out to determine association between sociodemographic variables and the level of knowledge (adequate/inadequate). Logistic regression analysis were performed to calculate adjusted odds ratio at 0.05 significance level. RESULTS: Most (52.7%) of the physicians were females, were aged between 25 and 30 years (58.5%), and Saudi (80.2%). The majority of the physicians belonged to the residency program (44.9%) and had work experience of 1–5 years (45.4%). About 44% physicians had adequate knowledge about PBR and 55.56% had inadequate knowledge. Regarding physician's response to each item of PBR, the majority (98.1%) gave correct answer to Item 2: “Patients should know the identity and professional status of the healthcare providers responsible for their treatment” (98.1%). Item 25: “Doctors are entitled to withhold any procedures related to a patient's condition if the patient refuses their choice of treatment” was the item with the least correct response (15.5%). CONCLUSION: Reinforcement and strict implementation of PBR are necessary. The institution should provide training and motivate physicians, especially younger doctors regarding PBR to ensure good health for all and safeguard the integrity of both the physician and the hospital.
  2,415 349 -
Perspective of Saudi women in the Makkah region on breast cancer awareness
Tahani H Nageeti, Arwa A. N Abdelhameed, Raid A Jastania, Rania M Felemban
May-August 2017, 24(2):97-101
DOI:10.4103/2230-8229.205116  PMID:28566973
OBJECTIVE: To assess the perspective of Saudi women in the Makkah region on breast cancer awareness and early detection. MATERIALS AND METHODS: A mixed method study was conducted among 25-65 years old healthy Saudi females from Makkah region during the awareness campaign in October 2014. The participants were recruited by personal invitations at the women's places of work and social gatherings. The initial invitations were issued by either the research coordinator or the investigator. All women were asked to complete a short questionnaire on basic knowledge on breast cancer. This was followed by focus group discussions. All interviews were carried out by female breast cancer consultant oncologists. All discussion transcripts were summarized and categorized into main themes; data presented as frequencies and percentages. RESULTS: Forty Saudi females, aged 25-65 years, were included in the study. Nearly 38% of them had never attended any awareness campaign on breast cancer. Only 10% of the participants correctly answered all five basic questions on the risk and early detection of breast cancer; 63% of the women had never been taught breast self-examination. Participants' perception was discussed in five focus groups. Four themes were identified during the discussions: knowledge about breast cancer and screening; resources of breast cancer awareness; social support for access to awareness program; and beliefs on breast cancer and early detection. CONCLUSION: We recommend that strategies on breast cancer awareness in our population should focus on early detection by improving the knowledge and skills of women. These strategies should include programs widely accessible through primary health-care centers and other health-care institutions. In addition, we recommend that physicians and family members should be involved in these programs.
  2,397 265 -
Mild respiratory symptoms in asthmatic patients might not be due to bronchoconstriction
Tarig H Merghani
May-August 2017, 24(2):102-105
DOI:10.4103/jfcm.JFCM_111_16  PMID:28566974
BACKGROUND: Although respiratory symptoms in asthmatic patients are likely to be caused by bronchoconstriction, this should be confirmed by spirometry. In this study, our aim was to determine the percentage of asthmatic patients who present with mild respiratory symptoms but fail to show any evidence of bronchoconstriction in spirometry. MATERIALS AND METHODS: A total of 428 known asthmatic patients (57.5% females) participated in the study. Inclusion criteria were age ≥16 years, known asthmatics for at least 1 year, presenting with mild respiratory symptoms including cough, wheezes, shortness of breath, and chest tightness. Patients presenting with moderate or severe asthma exacerbations were excluded from the study. Spirometry measurements were performed according to the guidelines of the American Thoracic Society. SPSS was used for data analysis. The percentage of patients who did not show any evidence of airway obstruction was calculated. For spirometry variables, mean and standard deviation were calculated. For the categorical variables, Chi-square test was performed to determine statistical significance at alpha=0.05. RESULTS: Typical obstructive pattern was found in 38 (or 9%) of all participants. Evidence of obstruction within small or middle airways was found in all those who showed an obstructive pattern and more than 90% of those who showed restrictive or mixed patterns. About 11% of the participants showed a normal spirometric pattern with no evidence of small airway obstruction. Statistical analysis showed an insignificant relation between patterns of spirometry and gender or body mass index of the participants. CONCLUSION: About 11% of asthmatic patients with mild respiratory symptoms who attended the respiratory clinic have no evidence of bronchoconstriction. Spirometry is an essential step for evaluation of every asthmatic patient who presents with respiratory symptoms.
  2,411 211 -
Eagle's syndrome with facial palsy
Mohammed Al-Hashim, Nasser Al-Jazan, Abdulrahman Abdulqader, Mohammed Al-Ghamdi
May-August 2017, 24(2):128-130
DOI:10.4103/jfcm.JFCM_134_16  PMID:28566979
Eagle's syndrome (ES) is a rare disease in which the styloid process is elongated and compressing adjacent structures. We describe a rare presentation of ES in which the patient presented with facial palsy. Facial palsy as a presentation of ES is very rare. A review of the English literature revealed only one previously reported case. Our case is a 39-year-old male who presented with left facial palsy. He also reported a 9-year history of the classical symptoms of ES. A computed tomography scan with three-dimensional reconstruction confirmed the diagnoses. He was started on conservative management but without significant improvement. Surgical intervention was offered, but the patient refused. It is important for otolaryngologists, dentists, and other specialists who deal with head and neck problems to be able to recognize ES despite its rarity. Although the patient responded to a treatment similar to that of Bell's palsy because of the clinical features and imaging, ES was most likely the cause of his facial palsy.
  2,448 158 -
Health education to diabetic patients before the start of Ramadan: Experience from a teaching hospital in Dammam
Rayyan M Al-Musally, Mais A Al-Sardi, Zainab A Al-Elq, Afnan H Elahi, Rawan K Alduhailan, Muslim A Al-Elq, Fatma A Zainuddin, Noura A Alsafar, Jannat A Altammar, Abdulmohsen H Al-Elq
May-August 2017, 24(2):111-117
DOI:10.4103/jfcm.JFCM_128_16  PMID:28566976
BACKGROUND AND OBJECTIVE: Studies have shown that pre-Ramadan structured educational program for patients with diabetes mellitus (DM) is beneficial. In this study, our aim was to evaluate the degree of adherence of treating physicians to such programs and their influence on the patient's knowledge and behavior. MATERIALS AND METHODS: This cross-sectional study was carried out on adult patients with DM attending a university hospital, who were observed while fasting during Ramadan 1436/2015. Data was collected using a questionnaire-based interview. Baseline characteristics were obtained, and patients were asked whether they had had pre-Ramadan education or not and who the provider was. Patients' knowledge of the components of the recommended structured pre-Ramadan educational program was also tested. Comparison between patients who had the education and those who did not was done using Chi-square test and independent samples Student's t-test; p ≤ 0.05 was considered statistically significant. RESULTS: A total of 298 patients with type 1 or type 2 DM were included in the study; 75.5% of the patients were aged 40 years or older. Only 30% had pre-Ramadan education delivered mainly by diabetic educators or the treating physicians (52% and 44%, respectively). Patients who had the education were younger (mean age: 45.6 ± 17.4 vs. 50.3 ± 14.4, respectively, p = 0.0048), had higher educational qualifications, were more likely to be employed, and self-monitored their blood glucose more frequently (p = 0.0001). There was no difference between the two groups with regard to their knowledge of diet and exercise. CONCLUSION: The adherence to the pre-Ramadan educational program by the treating physician was low. It is necessary to increase the awareness about the importance of these programs among health-care professionals. The programs should target the less educated, the unemployed, and older patients.
  2,365 217 -
Satisfaction with a 2-day communication skills course culturally tailored for medical specialists in Qatar
Carma L Bylund, Khalid Alyafei, Abdelhamid Afana, Sheyma Al-Romaihi, Mohammed Yassin, Maha Elnashar, Banan Al-Arab, Abdullatif Al-Khal
May-August 2017, 24(2):122-127
DOI:10.4103/2230-8229.205118  PMID:28566978
OBJECTIVE: Health-care communication skills training may be particularly needed in the Arabian Gulf countries because of the variety of cultures within the physician and patient populations. This study describes the implementation and results of a communication skills training program for physicians in Qatar that assessed previous training, and effect of previous training on participants' course evaluations. MATERIALS AND METHODS: We conducted a 2-day communication skills training course covering seven culturally adapted modules. Educational strategies included large and small group work with the standardized patient, demonstration videos, and lectures. At the end, participants completed a course evaluation survey. Data analysis performed with SPSS; frequencies and percentages were calculated, and Chi-square test applied to evaluate statistical significance. RESULTS: A total of 410 physicians in Qatar have participated in the course over a period of 2 years. Evaluation ratings of the course were high. Participants rated the module on Breaking Bad News as the most useful, and the small group role-play as the most helpful course component. One-third of participants had previously participated in experiential communication skills training. There was no association between previous experience and evaluation of the course. CONCLUSION: Physicians in Qatar positively evaluated a 2-day communication skills course, though the majority of participants did not have any previous exposure to experiential communication skills training.
  2,399 181 -
Cochlear implants in children: A cross-sectional investigation on the influence of geographic location in Saudi Arabia
Ahmed A Al-Sayed, Abdulrahman AlSanosi
May-August 2017, 24(2):118-121
DOI:10.4103/jfcm.JFCM_142_15  PMID:28566977
INTRODUCTION: The role of the family in detecting a child's hearing difficulty and the age at which an implantation is done have been identified as strong predictors of the outcomes of pediatric cochlear implantation. In the absence of screening programs for hearing loss in Saudi neonates, the family's role is of paramount importance. The aim of this study was to investigate the influence of geographic location on the course of identification, examination, and cochlear implantation in children in Saudi Arabia. MATERIALS AND METHODS: Pediatric patients who had received either unilateral or bilateral cochlear implantation at King Abdulaziz University Hospital in Riyadh, Saudi Arabia, between January 1, 2012, and December 31, 2014, were surveyed. RESULTS: A total of 156 pediatric patients have had a cochlear implant between January 1, 2012, and December 31, 2014. The one-way analysis of variance test to compare the means of the independent sample groups in various geographic zones showed that with a hundred percent access to primary health care, the geographic location of the population had an influence on the detection of hearing loss but not on the cochlear implantation. CONCLUSION: This study found that the geographic location of the population has an influence on the time of detection of hearing loss in children but not on the time of cochlear implantation. Raising parental awareness of the importance of early detection of hearing loss is necessary. Further research is also required to define the role of factors such as the income and the educational level of parents on the early detection of neonatal hearing loss.
  2,044 173 -
Use of International physical activity questionnaire-short form for assessment of physical activity of children
Madhavi Bhargava
May-August 2017, 24(2):131-131
DOI:10.4103/jfcm.JFCM_60_16  PMID:28566980
  1,849 204 -


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Journal of Family and Community Medicine | Published by Wolters Kluwer - Medknow
Online since 05th September, 2010