ABSTRACT
Background@#This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip. @*Methods@#A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach. @*Results@#The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities. @*Conclusion@#The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions.
ABSTRACT
Background@#This study aimed to estimate the prevalence of and determine the factors associated with antihypertensive medication (A-HTNM) non-adherence among hypertension care seekers attending primary health clinics in the Gaza Strip. @*Methods@#A cross-sectional survey was conducted as the recruitment phase of a clustered randomized controlled trial including 538 participants. The participants were randomly selected from 10 primary health care centers by two-stage cluster random sampling. A structured questionnaire was used to collect data through face-to-face interview. The questionnaire was developed based on the World Health Organization determinants for medication non-adherence and the Health Belief Model. The main outcomes of this study were the prevalences of A-HTNM non-adherence and its associated factors. Adherence status was assessed using the eight-item Morisky Self-Report Medication Adherence Scale. Data were analyzed by STATA ver. 14.0 (Stata Corp., College Station, TX, USA) using a standard complex survey, accounting for unresponsiveness and the clustering sampling approach. @*Results@#The overall prevalence of A-HTNM non-adherence was 65.8% (95% confidence interval [CI], 59.2–71.8). Among all studied predictors, only self-efficacy of participants (odds ratio [OR], 3.8; 95% CI, 1.79–2.84) and social support (OR, 2.26; 95% CI, 2.82–5.11) remained significantly associated with A-HTNM non-adherence after adjusting for age, education level, number and frequency of A-HTNM doses per day, and comorbidities. @*Conclusion@#The high prevalence of non-adherence highlights the need for serious intervention to enhance the adherence rate among hypertension patients. The associated factors can be considered when developing appropriate interventions.
ABSTRACT
Objectives: There is a widespread interest in exploring healthcare providers' attitudes and perceptions about patient safety culture. This study was done to determine the reliability and validity of the Arabic version of Safety Attitude Questionnaire [SAQ] in Palestinian hospitals
Methods: This was a methodological study and the SAQ was translated into Arabic using the forward-backward translation technique. Four Ministry of Health hospitals in the Gaza Strip were randomly selected, and proportionate systematic sampling was followed to select the participants. Questionnaires were distributed to 370 physicians and nurses. Face and content validity were tested, and the content validity index was determined using the average approach. Internal consistency was assessed with Cronbach's alpha, split-half reliability, and intercorrelation between the questionnaire scales. Construct validity was assessed through exploratory and confirmatory factor analysis
Results: A total of 339 questionnaires were received, giving a response rate of 91.6%. Questionnaire acceptability was good and relevant to the study purpose. Cronbach's alpha value was 77.7 [74.7-82.2]. Goodness of fit indices from the confirmatory factor analysis showed a satisfactory model fit: comparative fit of indices [CFI = 0.797], root mean square error of approximation [RMSEA = 0.085], and standardized root square residual [SRMR = 0.074]. Factor analysis with varimax rotation revealed that six factors explained 62.3% of the variance
Conclusions: The Arabic version of SAQ [short form 2006] is valid and reliable, and shows a satisfactory model of fit. This instrument shows promise to be a sound tool to assess the safety culture in Palestinian hospitals
ABSTRACT
Brain natriuretic peptide [BNP] has been established as a new and reliable laboratory marker for congestive heart failure [CHF]. BNP is a neurohormone secreted by the cardiac ventricles in response to volume expansion and pressure overload. This study aimed to ascertain whether an association exists between the level of BNP hormone and CHF among hypertensive patients. Retrospective design [case-control study] was used to collect data from 75 patients with CHF and history of hypertension [case group], and 75 patients with history of hypertension only [control group]. CHF subjects consisted of fourteen subjects with acute heart failure, and fifty six subjects with chronic heart failure. CHF group was also classified into four classes; the diagnosis and classification of CHF were done according to the New York Heart Association [NYHA] by two cardiologists. Self report structure interview and Ethylenediamine tetracetic acid [EDTA] blood samples were obtained from both groups. In this study we used Abbott AxSYM in conjunction with a recently available immunoassay kit for BNP hormone MEIA [Microparticles Enzyme Immuno Assay] system. T-test, Kruskal-Wallis and ANOVA-I were used to analyze the data. The results of the study showed a significant relationship between BNP hormone and CHF [P value=0.00]. The obtained data suggest that the measurement of BNP levels may be helpful in the diagnosis and prognosis of CHF and in selecting patients for further evaluation