Effect of physical activity on controlling blood pressure among hypertensive patients from Mishref area of Kuwait

A variety of lifestyle modifications including weight loss in the overweight and physical activity have been shown in clinical trials to lower blood pressure in hypertensive patients. To demonstrate the effect of physical activity on controlling blood pressure among hypertensive patients from Mishref area of Kuwait. A sample of 240 Kuwaiti patients diagnosed with hypertension for more than one year were randomly selected from those hypertensive patients visited the primary care center for their regular follow up. Patients were labeled as uncontrolled hypertensive if their systolic blood pressure [SBP] was ?140 mmHg and /or diastolic blood pressure [DBP] was ?90 mmHg. Patients with uncontrolled hypertension [n = 106] were compared with 134 patients with controlled hypertension. A structured questionnaire with questions on socio-demographic characteristics, dieting and physical activity was administered. The prevalence of uncontrolled hypertension among our sample was 44.4%. More than half of patients who reported not practicing physical activity had uncontrolled hypertension compared to a quarter of those who were practicing it. The multiple logistic regression analysis showed that age, body mass index [BMI], diet, and physical activity were the independent significant risk factors on controlling hypertension among our study population. Our findings should alert health care providers to find innovative means of physical activity recommendation to improve blood pressure control among hypertensive patients. On a large scale, the ministry of health in Kuwait can reinforce the concept of physical activity in order to regulate blood pressure through a national campaign

Understanding trainees' perception concerning the educational process in general practice, does it help?

Trainees' skills and the teaching process can be improved by consideration of candidates' views. To find out the trainees' perception and views about the features and teaching methods of the Family Practice Training Program [FPSTP] in Kuwait to upgrade its standard. The study design is cross sectional descriptive one. Data were collected from fifty seven trainees and twenty seven newly graduated doctors from FPSTP in Kuwait. The questionnaire included, in addition to personal characteristic, two sections. The first one was used to explore their views about different teaching methods. The second one included questions related to specific aspects of the program. The response rate was 93.3%. Most of the trainees received tutorials [76.2%] and case discussions [72.6%]. About half of them [54.8%] had joint consultations. More than half of them [63.1%] think that joint consultation sessions are useful. Video consultation analysis was viewed beneficial by about half of them [57.1%]. The majority of the participants think that communicative skills improved by case discussion [91.7%] and observed consultation [89.3%], and they find it easy to discuss clinical problems with trainers [82.1%]. Most of the graduated doctors [74.4%] think that Clinical Audit is useful for the training program, while less than half of the trainees [49.1%] believe in this, with a significant difference. [P = 0.03] between the two groups of participants. Feedback from trainees is essential in order to measure their level of satisfaction with teaching methods and for improvement of the educational process for family practitioners

Job satisfaction among physicians in Al-Sabah hospital, Kuwait

The prevalence of dissatisfaction among doctors has been given considerable importance in recent years as it affects the quality of health care. The aim of the present study was to determine the level of job satisfaction among doctors working at AL-Sabah Hospital in Kuwait, identify aspects of dissatisfaction and factors that could be associated with. All sixty physicians currently working in the department of internal medicine were asked to participate. A self-administered close-ended questionnaire was used to obtain personal data and information from the physicians on various aspects of job satisfaction. It included 20 items divided into 5 aspects that are relevant to a number of job facets. A 5-point, Likert-scale was used. Analysis was carried out using Chi-square and Fisher Exact tests. The response rate was 83.3%. Overall, 50% of participating physicians were generally satisfied with their job. Higher scores of satisfaction were reported among male, married, with longer experience, with higher qualification. Proportions of satisfaction with each item were presented. No significant difference could be detected according to personal factors and working conditions regarding these items except for nationality. Higher proportions of satisfied non Kuwaiti physicians were recorded regarding the freedom to use their own judgment [62.2% versus 14.4%, P = 0.004] and to do their own method to do the job [59.5% versus 23.1%, P = 0.02], whereas only 18.9% of non-Kuwaiti physicians were satisfied with their payment as compared with 69.2% in Kuwaiti physicians [P= 0.002] It is urgent and necessary to improve physician working conditions and their working pattern to maintain job satisfaction. Physicians themselves, hospital administrators and the government should take the initiative to improve the working conditions in Kuwait hospitals. Larger multi-centric research about this issue is needed

Frequent attenders at a primary health care center in Kuwait

To determine the frequency of general practice consultations and study personal and health factors associated with frequent attendance. Retrospective descriptive and case control study. Al-Surra Family Practice Health Center [SFPC], Kuwait. Three hundred seventy-two adults categorized as "frequent attenders" [FA] were included as cases. Three hundred sixty-eight adults categorized as "non-frequent attenders" [NFA] represented the controls. Frequency of attendance to polyclinic and associated factors. A total number of 16.068 patients made 77.970 visits to the SFPC during 2003. Out of them, 932 FA made 14,970 visits. The median number of visits per FA patient was 16, whereas it was only four for NFA. Only 45.5% of frequent attenders presented with symptoms while 17.7% attended for repeated medical prescription, and 18.3% showed up for check-up. Logistic regression analysis revealed that Kuwaitis, governmental employees, females in older age groups with chronic illness were more liable to be FAs in general. Among Kuwaitis, governmental job and chronic disease were detected as significant risk factors for being FA. Chronic diseases were the only predictors of FA among non-Kuwaitis. 5.8% of the total number of patients were responsible for 19.2% of the visits to SFPC. Chronic illness correlated strongly with a high rate of attendance. Also socio-demographic factors, especially nationality, gender, age and job type were indicators of frequent attendance in general practice

Awareness and implementation of hypertension guidelines in primary health care in Kuwait

World Health Organization / International Society of Hypertension [WHO/ISH] guideline makes recommendations on primary care management of hypertension. Hypertension control is based on physician awareness and familiarity with these guidelines and their attitudes in clinical practice. This study aimed to evaluate primary health care [PHC] physicians' awareness and attitude towards WHO / ISH guidelines for management of hypertensive patients, and their opinions regarding barriers for implementation of these guidelines. The study is a cross-sectional survey that was conducted from September to October 2008. Self-administered questionnaires were distributed to all physicians currently working in all PHC centers in the five health regions in Kuwait. The questionnaire included data about personal characteristics, level of knowledge and agreement with [WHO / ISH] guidelines as well as implementation of the guidelines and questions related to barriers to improve their hypertensive patient management. Although most physicians [90.7%] were familiar with the new WHO / ISH guidelines. 83.4% of them were in agreement with. Also, it was found that only 26.7% always follow these guidelines, 56.7% sometimes follow them. The median value of the correct answers was 5 from 10 statement with a range from zero to 9. About one fifth of the physicians [20.5%] could not attain 5/10 score, and none chose correctly the 10 correct statements. Results suggest that participants, in their clinical practice, accept higher BP levels than recommnended in clinical practice. Also, they tend to give more attention for hypertensive patients with co-morbidity. The most important barriers for improvement of hypertension control, that physicians stated, were lack of time, non availability of the drugs in the clinic, lake of patient knowledge, poor patient compliance to life style modifications, non adherence of patients to their medications, and follow up by different physicians. The results of this survey indicate that there is an urge tit need to establish nationwide educational and quality monitoring programs to facilitate the implementation of new hypertension guidelines vi PHC clinical practices in Kuwait

Quality of life measurement in patients with Psoriasis in Kuwait

Eighty cases with severe psoriasis and 80 patients with other chronic skin diseases were selected for this study. The subjects were asked to complete a questionnaire that included questions focused on the potential patients' physical activities [ten items], psychological feelings [four items], social relationships [nine items] and sexual activity. All domains were scored in such a way that patients with the worst quality of life had the highest score. The questionnaire was tested for its reliability, internal consistency and construct validity. The study revealed a high degree of repeatability and reliability of the questionnaire. Coefficients of Cronbach's alpha were >0.80 for all domains. The scales of the questionnaire could significantly discriminate between cases with psoriasis and those without. All scores of domains were directly and significantly correlated with each other