Assessment of the field course in King Faisal University Department of family and community medicine

The Field Exercise in Family and Community Medicine in King Faisal University is a 2 unit course taken in duration of two weeks. It aims to provide an opportunity to Medical Students to apply their knowledge and skills as well as develop professional attitudes for the effective delivery of primary health care, and to understand the fundamental concepts of applied medical research as related to the health needs in Saudi Arabia. The present study is an assessment of the course which has been offered for 10 years in the University. This is a descriptive cross sectional research which made use of the evaluations done by all students at the end of the field course in order to measure its efficacy and rate it by their gains in skills and knowledge of the Family and Community Medicine and Physician using a specially-made questionnaire. The assessment was done on March 2006. The students rated the overall totality of the attainment of skills of the components of the field course a mean rating of 2.71 + .5273 which can be interpreted as very good. The skill regarding health education was rated the highest [3.10] and doing video was rated the lowest [2.34]. The students rated the objectives as important as shown in the overall mean rating of 3.0651+ .66237. They rated the field course objective [to conduct health education campaign [as having the highest rating of 3.21, and to describe the organizational and operational aspects of health care delivery system [2.90].] The overall mean rating of the students regarding their knowledge of the importance and functions of Family Medicine before they took the field course was 3.6036 +/- .82674. Their knowledge about the Family Medicine's functions and importance was significantly improved after taking the field course at p =.011. On their knowledge of the Family Physician's role and functions in health care, the medical students were knowledgeable both before [mean rating = 4.0379 +/- .97849] and after [mean rating = 4.1931 +/- .90235] taking the field course. They showed improvement after the course. But the improvement was not significant [p =0.551]. The non-quantitative data from the comments of graduates in the ten-year duration affirmed the results of the quantitative data. They find the objectives of and methods used in the field course very relevant and functional to their practice in Family and Community Medicine. The objectives of the field course are relevant, utilizable, and fit to train future family and community doctors the components of the practice of Family and Community Medicine. The methods and strategies of the field course were sound and appropriate for the objectives set. Students indicated that they learned Family and Community Medicine component skills. Students significantly improved their knowledge of the functions and roles of Family and Community Medicine after taking the course. Students improved their knowledge of the functions and roles of Family and Community Physicians after taking the course, but the change was insignificant

profile of long-term care patients in Al-Khobar and Dammam, Saudi Arabia

To find out the profile of patients who stay more than 20 days in hospital in Al-Khobar and Al-Dammam. A cross sectional descriptive study was designed using a questionnaire completed by health care providers [physicians, nurses, physiotherapists, and social workers] of a random sample of 159 patients out of 318 patients identified as having stayed in the hospital for more than 20 days. The mean length of stay of the patients were 358.6 +/- 776 days in government hospitals, and 1014.4 +/- 1018.3 days in private hospitals. Patients were seen as stable by their doctors, 66.7% in government hospitals and 93.9% in private hospitals [statistically significant different at p<0.001. Physicians agreed that about two thirds of the patients could have been managed at home. 57.2% of the patients had no active problems. Diseases of the nervous system and sense organs accounted for 67.9% of the diagnoses, followed by endocrine, nutritional, and metabolic diseases [37.1%], diseases of the circulatory system [32.7%], and neoplasms [1.9%]. Diabetes mellitus was the commonest illness making up 53.2% and 57.1% of the long-term patients in private and government hospitals respectively. The active problems of 25% and 23.5% of the patients was tracheostomy care and ventilation respectively. Long-term patients tended to stay longer in private hospitals than in government hospitals, had diseases related to the nervous and endocrine systems and nutritional metabolism, were in stable condition with no active problems, and could thus, be managed at home

Primary health care physicians' attitudes toward and assessment of continuing medical education in Al-Madina Al Munawara Province, Saudi, Arabia

To identify the primary health care [PHC] physicians attitudes toward and assessment of continuing medical education [CME] physicians in Al Munawara Province. This is a cross-sectional descriptive study with analytic component of 115 physicians in Al Munawara Province conducted in 2000. Of the participants, 83 or 72.2% of them were urban based and 32 or 37.8% were rural based. A self-administered questionnaire was designed for this study. Around 75% of PHC physicians received a basic CME training course during practice. The physicians who attended CME activities agreed that the CME activities were a stimulus for them to keep up-to-date [95.0%], improved practice [95.0%], gave more confidence and competence [78.3%], and offered opportunities [78.3%]. Primary health care physicians who evaluated the medical education centers' [MEC] contribution and continuing medical education programs [CME] with high marks got higher assessment scores than those who evaluated with low marks [P= 0.0074 and P = 0.021, respectively]. Primary health care physicians who had higher degrees and more experience in medical practice got higher attitudes scores than those who had fewer degrees and less experience [P= 0.0130 and P= 0.0096, respectively]. Continuing medical education was significantly affected by the physicians' experience in medical practice [P= 0.0173], number of PHC physicians in the working area [P= 0.0330], attachment to hospitals [P= 0.0382], and activities outside PHC centers [P= 0.0204]. The physicians' positive assessment of CME activities was significantly associated with a higher grade of evaluation of both the contribution of the MEC and CME. In addition, positive attitudes toward CME were significantly and positively associated with age, postgraduate qualifications, more experience in medical practice, and a higher grade of evaluation of both MEC contribution and CME achievement

barriers of breast cancer screening programs among PHHC female physicians

While breast cancer is a serious health problem to countries as well, breast cancer screening remains underutilized because of many barriers such as costs, pain due to mammogram procedures, lack of knowledge about the benefits of early screening, and many other barriers such as cultural or social factors. But fighting breast cancer means educating women on the importance of early breast screening and detection for prevention as well as for management. In order to educate the general population on the benefits of breast cancer, the present study was done to identify and describe barriers to early detection of breast cancer. This is a survey of 75 female PHC physicians who responded out of the total 79 available female physicians in 43 Primary Health Centers in Al Khobar, Al Dammam, and Al Qatif, Saudi Arabia in 2004 regarding the barriers in implementing of breast cancer screening programs using a specially designed questionnaire which divided into two parts [demographic data, and items regarding barriers in implementing breast cancer screening programs]. Most of the female physicians were Saudi [65%] with mean age of 35.93 +/- 7.23 in years from PHHCs in Al Khobar, Al Dammam, and Al Qatif. The average mean duration of work as physician is 8.82 years and the average duration of work a PHC physician is 8.2 years. 95% of physicians in the study did not undergo post graduate training as compared to literature. The 2 physicians [5%] in the study did not have graduate degrees in family and community medicine but had master's degree in pediatrics [3], obstetrics [1], and gynecology [1]. The physicians reported the different barriers which have prevented them from practicing screening programs in PHHCs with the main barrier given as: there was no national screening program [56 physicians], time pressure [55 physicians], physician's lack of training [48 physicians], lack of good communication between physician and patients [46 physicians], there were not enough facilities in the PHHCs [42 physicians], lack of women cooperation and trust [33 physicians], walk-in clinic [4 physicians], and social and cultural reasons [4 physicians]. Costs and unavailability of mammography are the main barriers in other countries including the United States of America. Such is not the case in Saudi Arabia since mammography is usually given free to Saudi citizens or is part of the patient's insurance coverage. It was found out that physicians who thought that BC screening is important tended to advice patients to undergo BC screening. Physicians with low scores in BC epidemiology in Saudi Arabia claimed Saudi women are not at risk of BC [p = 0.04]. The main barrier of the BC screening program which may be instituted by PHCs female physicians was unavailability of a national screening program. Other barriers include time pressure, lack of training on the part of the physician, lack of good communication, there were not enough facilities in the PHHCs, lack of women cooperation and trust, walk-in clinic, and social and cultural reasons. Development and institutionalization of breast cancer screening program, massive educational program on breast cancer using multi-media tools and strategies, training and intervention program for PHC physicians on breast cancer including screening and early detection, and inclusion of breast cancer education on the medical curriculum are some of the recommendations arising from the study's results

effects of breast cancer early detection training program on the knowledge, attitudes, and practice of female PHHC physicians [Eastern Province; 2004]

It has been shown by many studies that early detection and management of breast cancer had decreased mortality and morbidity from the disease. Several studies showed that physicians' ordering of screening depended on: levels of confidence and comfort, and knowledge of breast screening guidelines, 11 their colleague's mammography practices, the adequacy of insurance coverage, and how often they had spent an unreasonable time explaining mammography results, 12 and beliefs of physicians.1 The present study studied the effects of breast cancer early detection training program on the knowledge, attitudes, and practice of female PHHC physicians. This is a non-r and omized experimental design with 45 PHCCs' female physicians in Al Khobar, and Al Qatif cities [experimental group] during the period: Oct 2003- Feb 2004 participating. A workshop on knowledge of BC concepts and skills was developed and implemented on the participants. A 3-part structured questionnaire [demographic data, general knowledge, and early detection] based on fundamental knowledge of breast cancer and early detection was used as pre-post test instrument. The knowledge measurement is composed of 65 close-ended items with two choices [agree/disagree]. A 30-item likert type of 5 choices questions were used to assess the attitudes of physicians. The Mamma Care program models were used to assess the ability of the physicians in detecting lumps and evaluating the nature of breast tissues. Another part of the assessment tool was the practice part totaling to 16 points, which assessed the lumps using two breast models with 5 lumps. The cut-off points of Knowledge and Practice are: Poor < 60%, Good 6 1-80%, Excellent > 80%. The cut-off points of attitudes were determined after taking the mean of all the respondents. 65% of the respondents were Saudis, 95% hold bachelor's degree and 5% held master's degree. The mean age was 35.91 years. The mean duration of PHHC practice was 6.065 years, and mean duration of practice is 8.35 years. The findings of the study show that the program improved the PHC physicians' KAP significantly. Before intervention was given, the physicians had good knowledge about breast cancer and early detection [67%], but scored low regarding practice of BC [36%], and just 37% had a positive attitude. The pre and post-test mean scores of female physicians on the study group show a marked significant increase on the indicators of KAP after intervention; for knowledge from 67% to 96% [p < 0.001], attitude from 68% to 78% [p < 0.001], and for examination skills from 33% to 77% [p < 0.001]. Before intervention was given, the physicians had good knowledge about breast cancer and early detection but scored low regarding practice of BC early detection and had a negative attitude of it too, and after the educational program, there were significant positive changes in physicians KAP

Health Knowledge among students of a Saudi girls college

To assess the knowledge and misconceptions regarding health among students of Science and Arts in the Dammam Girls College. A structured questionnaire was used to assess students' knowledge. The Girls' College in Dammam, Kingdom of Saudi Arabia. Data was collected from a sample of 632 students who were enrolled in the Faculties of Arts and Sciences. Students from the Faculties of Sciences and Arts constituted 68.8% and 30.4% of the sample respectively. The overall mean knowledge score was 24.04 +/- 4.8. Only 9.8% of students had a score of 30 or more out of a total of 40. The mean knowledge score was significantly higher among students from the Faculty of Sciences than those from the Faculty of Arts. Conclusions: Introducing the topic of health education in schools and colleges is mandatory to improve the deficiency of knowledge regarding health in the curricula of schools and colleges

Utilization of health services by the primary health care centres-registered elderly people in Burraidah city, Saudi Arabia

To assess the pattern of and factors associated with geriatrics' utilisation of health services. Design: A cross-sectional, study involving a random sample of 266 elderly subjects registered in the primary health care centres in Burraidah city, Saudi Arabia. Setting: The primary health care centres in Qassim Region, Saudi Arabia. Data was collected from PHC centres-registered elderly subjects at their homes. Information including utilisation of primary health centres, hospital admissions and duration of hospital stay were recorded. The response rate was 96.7%. Twenty% of the sample had not used any health services facility during the previous year. Two-thirds of subjects made visits to the primary health care centres, majority of them having made 6 visits or less. Significant factors positively associated with those visits were female, advancing age, and having a family. Three-quarters of the sample did not have hospital admissions. Significant factors positively associated with admissions were diabetes mellitus, hypertension, paralysis, advanced age, and living with a family. Conclusions: Geriatric health services utilisation by the study sample is affected by family ties and the high prevalence of chronic diseases. Subjects living alone or crippled by immobility may not be able to utilise available health services properly. Community based geriatrics services can help this vulnerable group