Physicians' job satisfaction and its correlates in a tertiary medical care center, Riyadh, Saudi Arabia

Objectives: to measure the degree of job satisfaction among physicians working in a Tertiary Care Hospital and to identify background and work environment characteristics that affect overall and differential job satisfaction

Subjects and Methods: this is a cross-sectional study of 340 physicians selected from a Tertiary Care Center using a stratified random sample with proportional allocation using a self-administered questionnaire with the 5-point Likert scale. From the 340 physicians requested to participate in the study, 217 [63.8%] completed the questionnaire. Descriptive statistics were used appropriately, including mean +/- standard deviation for the quantitative variables, while frequency and percentages were used for the qualitative variables. ANOVA, t-test, and Chi-square were used as necessary to determine if there are any significant relationships between satisfaction scores and the predictor variables

Results: a total of 217 physicians [males 75.6% females 24.4%] completed the questionnaire. Of this total, 52.5% were non-Saudis. The overall perceived satisfaction as measured by one question was 3.42 points out of 5 [68.4%] significantly lower than the overall satisfaction which took in consideration all variables 3.67 points [73.4%]. Mean satisfaction scores were significantly negatively related to the number of children [P < 0.001] the physicians had, but positively correlated to stipend, duration of vacation leave, sick leave policy, health coverage for the employee and family, overall benefits package, involvement in academic work, and involvement in research work [P < 0.001]

Conclusion: the working environment and policies of an organization play important roles in the satisfaction of its physicians. Boosting physician satisfaction is important for both the success of a Tertiary Care Center and for the high quality services offered to patients

demographic and clinical characteristics of leprosy in Saudi Arabia

Leprosy is a chronic disease caused by Mycobacterium leprae. Although the occurrence of leprosy has declined in Saudi Arabia, it has not yet been eradicated. To our knowledge, this descriptive retrospective study is the first to assess the clinical presentation of leprosy at the time of diagnosis in Saudi Arabia. All study subjects were leprosy patients admitted to Ibn Sina hospital, the only referral hospital for leprosy in Saudi Arabia, between January 2000 and May 2012. A total of 164 subjects, the majority of whom [65%] were between 21 and 50 years of age, were included, and the male-to-female ratio was 2.8:1. Of these 164 patients, 63% were Saudis, and 77% of all admitted patients were from the western region. Lepromatous leprosy was observed most frequently [33%], and 31% of cases had a positive history of close contact with leprosy. At the time of diagnosis, 84% of all subjects presented with skin manifestation. The prevalence of neurological deficit at the time of diagnosis was 87%. Erythema nodosum leprosum [E.N.L.] developed in only 10% of all subjects. Further studies are needed to determine the clinical characteristics pertaining to each type of leprosy in the region, and training courses in caring for and diagnosing patients with leprosy should be organized for health workers

Smoking pattern among female college students in Dammam, Saudi Arabia

Smoking is the most important avoidable cause of premature morbidity and mortality in the world. The estimated annual death rate of 4.9 million people in 1999 is expected to rise to 10 million by the 2020s and 2030s, 7 million of which will occur in developing countries. The aim of the present study was to estimate the prevalence of smoking and assess its pattern among non-medical female college students in Dammam, Saudi Arabia. A cross-sectional study was conducted of 1020 female students selected from the literature and science colleges by multi-stage stratified random sampling technique with proportional allocation. Data were collected using a self-administered modified WHO Global Youth Tobacco Survey questionnaire. Results revealed that occurrence of smoking among female college students was 8.6%. It was significantly higher among literature college students [12.1%] than among Science College students [3.4%]. The mean age at which smoking started was 16 +/- 2.4 years, with a minimum of 11 years. More than half of the students who smoked were cigarette smokers, while 43.2% were shisha smokers. There was a strong relationship between parents who smoked and daughters who smoked. The main motive for smoking was curiosity [44.3%], followed by relief of tension [26.1%]. It may be concluded that smoking is increasing among female college students in Saudi Arabia. Accordingly, it is recommended that a preventive comprehensive health education program on smoking be initiated for females in middle schools, that stricter tobacco control measures be adopted by the government, and that anti-smoking clinics be established in colleges

Comparison of physical activity patterns among diabetic and non diabetic adults in Saudi Arabia

Quantifying the magnitude and risk factors of Diabetes Mellitus in the community is essential for all intervention strategies. The objective of this study is to assess physical activity as a risk factor of diabetes mellitus by comparing physical activity patterns of diabetics and non diabetics. A community-based cross-sectional study using STEPwise approach among adults using a multistage, stratified, cluster random sample. Data was collected using a questionnaire which included patterns and durations of physical activity, sociodemographics, and history of diabetes, biochemical and anthropometric measurements. Of the total 4657 subjects, 712[15.3%] were diabetic [369[16%] for males and 343[14.6%] for females]. Of all subjects only 12.1, 20.2 and 46.1% were physically active in recreational, work and transport respectively. Diabetes was significantly negatively associated with total level of physical activity .All lower levels of physical activity in leisure, transport and work were significantly associated with increased risk of diabetes .Physical activity at work and walking or cycling for 10 minutes continuously were significant predictors of diabetes. Diabetes mellitus among adults in associated with lower levels of all patterns of physical activity. Specifically tailored and culturally sensitive physical activity interventions, is necessary for preventing, controlling diabetes. Females, elderly and retired persons need special attention

Pilgrims satisfaction with ambulatory health services in Makkah, 2008

The main objective of this study was to assess the level and correlates of patients' satisfaction with ambulatory health services provided for pilgrims during Hajj period in 2008. This was a facility-based, cross-sectional study conducted in the Makkah region during the Hajj season in December 2008. A two-stage technique was used to select 500 patients from those who attended the ambulatory health services. One hundred subjects were selected by systematic random sampling [every fifth] from each of the five hospitals included in the study and asked to fill in a pilot-tested self-administered questionnaire. A total of 487 questionnaires were analyzed. Descriptive statistics and t-test, Mann Whitney test and ANOVA, or Kruskal-Wallis test was used as appropriate after checking for normality. Level of significance level was set to be <0.05 throughout the study. From 478 subjects analyzed, 390 [81.6%] were man, 345 [72.2%] were married, 28.9% had either intermediate or high secondary school education, and 2.4% were skilled laborers. The total satisfaction score for health facilities was 20.45 +/- 4.03 of 25. The satisfaction scores were 20.15 +/- 4.7 of 25 for patient satisfaction with physicians and 21.35 +/- 4.5 for patient satisfaction with paramedical personnel. The overall satisfaction score was 61.5 +/- 4.5 of 75 points. There were significant relations between total satisfaction of health facilities with education level and with occupation [P = 0.012, 0.001, respectively]. The total satisfaction of patients with physicians was significant only with education level. The overall satisfaction score had a significant relation with occupation [P = 0.03], but a borderline relation with the education level [P = 0.056]. Satisfaction with ambulatory Hajj health services is acceptable. Some physicians and waiting area services need special attention to improve satisfaction levels with ambulatory health in the subsequent Hajj seasons

Health-related quality of life in type 2 diabetic patients

Health-related quality of life [HRQOL] is an important health outcome, representing one of the most important goals of all health interventions. The objectives of this study were to determine HRQOL and the factors affecting it in type 2 diabetic patients. This cross-sectional study was conducted in five primary health care [PHC] centers in the Al-Khobar area. From a random sample of 225 type 2 diabetic patients, 216 patients were included in the study along with 216 age-, sex- and nationality-matched controls. Nine patients refused to participate. Type 2 diabetic patients and controls were interviewed with the translated Arabic SF-12 questionnaire. The mean ages were 50.0 +/- 10.0 years for cases and of 49.3 +/- 10.3 years for controls [P=.526]. Type 2 diabetic patients had lower socioeconomic status and educational level than controls. Obesity was significantly higher in diabetics than controls. HRQOL in type 2 diabetic patients was significantly lower than controls. The mean physical component score was 41.3 +/- 8.9 for cases vs. 47.5 +/- 9.5 for controls [P<.001], and the mean menttal component score 47.8 +/- 9.1 in cases vs. 51.5 +/- 9.4 in controls [P<.001]. HRQOL was significantly lower in females than males [P<.001]. HRQOL was impaired in uncontrolled patients [fasting plasma glucose [FPG]>130 mg/dL] in comparison with controlled patients [FPG?130 mg/dL] [P<.05]. HRQOL was lower in type 2 diabetic patients than controls and was affected by many factors. Females had lower HRQOL than males, possibly because of a higher incidence of obesity. Uncontrolled diabetic patients had a lower HRQOL than controlled diabetics. Improving HRQOL in diabbetic patients is important

Images in clinical medicine congenital neural malformations related to their embryological background

Congenital neural malformations are complex anomalies, which stem from an abnormality in the embryological development of the nervous system. The development of the nervous system begins by the formation of the neural tube and its subsequent closure. The failure of closure results in neural tube defects [NTD]. Defect in the formation of prosencephalon or rhornbencephalon will result in holoprosencephaly or Dandy walker complex respectively. The formation of neuroblasts and their migration to cerebral cortex may be altered by many neuronal migration disorders, Lissencephaly, schizencephaly, and heterotopic gray matter are the most prominent. The objective of the study is relating congenital neural malformations to their corresponding embryological background, and so helping in better understanding the time and the way of the occurrence of such anomalies

Menopausal symptoms and quality of life

This study was to assess the association between menopausal symptoms and the women's quality of life [QOL]. An exploratory descriptive study was conducted at Faculty of Nursing, university of Alexandria. Subjects of the study included all employees of the previously mentioned setting aged between 40 to 55 years old. Assessment sheet, Menopause Rating Scale and Quality of Life scale are the tools for data collection. Findings revealed that those who had no psychological symptoms reported better quality of life [X=94.50 +/- 1 1.475] than those who had severe psychological symptoms [X=62.64 +/- 12.549]. The same results were observed with the somatic symptoms and urogenital symptoms, as the mean score of quality of life of those who had no somatic [X88.00 +/- 11.314] or urogenital symptoms [X=83.14 +/- 12.104] was higher than who had severe somatic [X=7531 +/- 11.026] or sever urogenital symptoms [X=68.50 +/- 12.021]. In relation to the total score of menopause rating scale and the total score of quality of life, it was found that better quality of life was reported among those who had no symptoms [X=88.00 +/- 1 1.314] or mild symptoms [X=88.04 +/- 11.314]. The results also revealed that there were statistically significant differences between the total score of quality of life and the number of living children [P<0.028], medical history of the woman [P<0.041], housing condition [P<0.001], and income [P<0.001]. It can be concluded that severity of menopausal symptoms has a negative association with overall quality of life. Increased number of children, presence of health problems, not suitable housing condition, and not enough income were negatively associated with QOL. Most of the quality of life domains are adversely affected by the presence of menopausal changes. Further researches are required to assess the intervention for pen-and postmenopausal women in context of their needs and expectation

Prevalence and pattern of skin disorders among female school children in Eastern Saudi Arabia

To determine the prevalence and pattern of skin disorders among female schoolchildren in primary and intermediate schools in Al-Khobar city, Eastern Saudi Arabia. This is a cross-sectional study conducted in Al-Khobar city, Kingdom of Saudi Arabia during the period from January-March 2003. It involved 2239 female schoolchildren randomly selected from 30 regular public and private primary and preparatory schools. We used a multi-stage stratified random sampling technique with proportional allocation. We collected data using a pre-designed structured questionnaire and clinical examination. The prevalence of skin diseases among female schoolchildren in Al-Khobar city was 98.6%. The most common skin disease and conditions group was the pigmentary disorders [91.6%], followed by a group of dermatitis/eczema and related conditions [26.7%], and disorders of skin appendages [25.3%]. The common skin diseases and conditions in this study were melanocytic nevi [MN] [68%], post-inflammatory pigmentation [56.6%], scars [26.8%], acne [22.5%], dandruff [18.1%], pediculosis capitis [5.2%] and eczema [3.1%]. Postinflammatory hyper/hypo pigmentation was more common among primary schoolchildren, whereas MN, dandruff, keratosis pilaris, acne and folliculitis were significantly more common among preparatory schoolchildren. The prevalence of skin disorders among female schoolchildren in Al-Khobar city was very high. Therefore, we recommended the introduction of a preventive health education program for schoolchildren at different levels and their families and teachers on skin diseases

Physicians' knowledge about evidence-based medicine in eastern Saudi Arabia

To explore the knowledge about Evidence-Based Medicine [EBM] among physicians, and to compare the results between hospitals and primary health care centers [PHCCs] physicians. This is a cross-sectional study conducted in May 2002 on all physicians in PHCCs and general hospitals in the Dammam area, Eastern Saudi Arabia. A random sample size of 409 physicians was chosen. The tool of data collection was a self-administered questionnaire. Score was used to assess physicians' knowledge. Out of the respondents, 39.6% had heard about the concept of EBM. Of these, 12% scored more than the cut-of point on the knowledge about EBM. Hospital physicians, scored significantly higher in knowledge than the PHC physicians. There was a low level of awareness of the meaning of critical appraisal and EBM web sites. Even, most of those who were aware did not use them. Physicians rated their knowledge about epidemiological terms higher than their actual knowledge. Results revealed a low level of knowledge in the concept of EBM among physicians, in spite of their awareness of its importance. Hospital physicians were more knowledgeable in EBM than PHC physicians were

Treatment-related misconceptions among diabetic patients in western Saudi Arabia

To describe the types and pattern of treatment-related misconceptions among Primary Health Care Centers [PHCCs] registered diabetic patients in Makkah, Kingdom of Saudi Arabia. A sample of 1039 PHCCs registered diabetic patients were interviewed using a structured questionnaire, concerning diabetic treatment-related misconceptions. This cross-sectional study was carried out in Makkah city, Kingdom of Saudi Arabia from May 2000 to September 2000. A scoring system was used to document the frequency of misconceptions. The relationship of misconceptions to socio-demographic and diabetes-related variables were assessed using chi-squared tests. Four hundred and five [39%] patients had a high treatment misconception score. The score was significantly higher among females than males [P< 0.00001], and also among patients older than 35 years [P< 0.05]. There were no statistically significant differences between Saudis and non-Saudis, or in association with different education levels. Also, the score was significantly higher among patients with a shorter disease duration [P<0.04], and among patients who did not enjoy continuity of care [P<0.00001]. Patients' misconceptions were mostly related to reasons for stopping medications. Moreover, patients thought that cure from diabetes was expected following a short course of treatment [16.5%] and that one could eat what he or she liked as long as medications were taken [23%]. The results of this study showed the rate of treatment-related misconceptions to be high. It stresses the need for constant motivation and one on one level education at frequent intervals to encourage better knowledge regarding the disease and subsequent compliance to treatment

Estimating parameters in epidemiological and occupational models in the presence of multicollinearily Amonte-Cario stusy

Multiple linear regression [MLR] is a popular used method of estimate parameters in epidemiological and occupational surveys. Multicollinearity happens when the predictive variables are often highly correlated with each other, so that the influence of one cannot be separated from that of another and may yield unstable and not easily interpreted regression estimates. It results in inflated estimates with a high variance and reverse signs, and makes it difficult to determine the importance of any of the predictors due to the high correlation among them. To handle multicollinearity, there are 2 famous approaches, the first technique is dropping one or more of the offending variables from MLR and the second is using an artificial orthogonalization through any form of factor analysis. Both approaches have been proven to be unsatisfactory. This study demonstrated, through simulation, that using ridge regression [RRM] overcomes the problem of multicollinearity and produces more stable and closer estimates to the true values of the coefficients which the analysts are trying to develop

Teaching Biostatistical concepts to health professionals an evaluation of workshops of basic biostatistics with computer application

Health professionals are considered consumers of biostatistical methods throughout their career. Many of health professionals are not familiar enough with biostatistical techniques, and their appropriate uses in their fields. The widespread use of personal computers in the last 2 decades, made it easy for such professionals to apply some statistical tests in their work without knowing the basic assumptions behind each test, and when, where and how to use each test properly in most of the cases. A workshop of basic biostatistics with computer applications has been developed to suite the basic needs of health professionals to be familiar with biostatistical tests and how to use a statistical package to conduct the simple required analysis. Evaluation of the workshops showed that the participants statistical knowledge, and interpretation of statistical results has significantly increased following such workshops, post-tests, compared to pre-tests [P <0.01]. The mathematics, and computer phobia of the participants were faced, and by the end of the workshops, participants gained confidence necessary for carrying out their data analysis. The study recommended conducting such workshops, and that more statistical applications on the computer is proper for health professionals

Maternal knowledge, attitudes and practices as predictors of diarrhoeal disease in Saudi children under 3 years of age

Diarrhoeal disease continues to be a leading cause of morbidity and mortality in many developing countries. This study demonstrates the importance of behavioral risk factors as determinants of diarrhoeal, disease. The study design used is incidence-base, case control design. The cases were obtained from Primary Health Care Centers [PHCC] in Makkah area, Saudi Arabia, during October 1994 to January 1995. The studied sample consisted of 319 cases and 312 controls < 3 years of age. The results showed that mothers of cases were significant inferior knowledge about aetiology and transmission of diarrhoeal disease than did mothers of controls. Poor hygiene was significantly high in households of cases for two items; disposal of faeces in latrine and presence of toilet papers [p < 0.05]. Assuming causal association between the risk factors and diarrhoeal disease, up to 60% of diarrhoeal disease in the study population may be attributable to the Studied behavioral factors

Study of deliberate selff-harm by drug overdose King Abdulaziz University Hospital, Jeddah, Saudi Arabia 1989-1993

To determine the precipitating factors for deliberate self-harm [DSH], the drugs commonly used for DSH, the psychiatric disorders involved and the reasons for admitting such patients to hospital. This study addresses the issue of deliberate self-harm [DSH] by drug overdose of patients admitted to King Abdulaziz University Hospital [KAUH], in Jeddah, Saudi Arabia. Fifty-four patients constituted 0.54% of the admissions at KAUH medical unit over a 5-year period [1989-1993]. The study found that DSH by drug overdose was higher in Saudi patients. By gender, the female to male ratio was 2.6:1 and the majority of patients [85.1%], were between the age of 13 years and 29 years. Mefenamic acid [Ponstan [Registered]] was the most commonly used drug by more than 48% of the patients. Personal problems [66.7%] were considered to be the predominant precipitating factor for DSH by drug overdose, and it was found to be highly significant in female patients. Psychiatric disorders were more significant in male patients. The most common psychiatric disorder diagnosed was depression in 55.6% of the patients. No deaths were reported from attempts of DSH by drug overdose during the period of the study. There is a need for further population-based studies to determine the extent of the problem of DSH by drug overdose. Such findings will provide measures to develop intervention strategies, promote public awareness, and develop improved methods of preventing DSH by overdose