Knowledge and factors affecting breast self-examination among Kuwaiti women

To determine the frequency of practicing breast self-examination [BSE] among Kuwaiti females and factors that may influence it Questionnaire based cross-sectional survey Multi-Ministries Compound, Kuwait Data was collected from 966 educated Kuwaiti female volunteers through a self-administered questionnaire. Data regarding the practice of BSE and factors influencing it Among the study sample 357 [37.0%] were practicing BSE. Their mean age was 31.6 +/- 8.8 years. The main reasons for not practicing BSE were fear of cancer discovery [13.5%], forgetfulness and failure to realize its importance [15.3%]. Moreover, 28.9% did not know the method of examination and 27.8% wished to learn. Only 21.6% reported that they did BSE practice on monthly basis. Women aged 20-29 years, married with middle income were insignificantly less likely to practice BSE than other categories. Students were more likely to practice BSE than working ladies [OR = 0.3, 95% CI 0.1-0.7]. There was a lower possibility of practicing BSE among women receiving their knowledge from TV / radio, newspapers / magazines and friends / relatives than those receiving from doctors. Moreover, the possibility of not practicing BSE decreased if the main source of knowledge were friends/relatives, nurse, media/newspapers respectively compared to those with no source of information. The frequency of BSE is low. It appears that a health education and training program will improve the rate of correct BSE performance

Assessment of target organ damage in hypertension through a clinical audit in Kuwait family practice

To review our progress for delivering effective health care against standard targets. A great amount of work has already been done to change doctor's a w a reness to adhere to the new guidelines for the diagnosis and management of hypertension according to the Kuwait protocol. In this study we were looking at the doctor's awareness of the importance of checking and recording target organ damage and associated clinical conditions to improve the diagnosis and management of hypertension. Design: Review of medical records in general practices to identify hypertensive patients, followed up by assessment of the pre- and post-educational management of interventions. Setting: One family practice centre from Hadiya and another one from Yarmouk, in Kuwait. Subjects: Two hundred hypertensive patients managed by ten family practitioners were included in the study. Main Outcome Measured: I m p roved level of management and care in terms of: 1] better level of recording of history of associated clinical conditions with hypertension including cerebrovascular disease, cardiovascular disease, renovascular disease, peripheral vascular disease and retinopathy; 2] better level of recording of target org a n damage including left ventricular hypertrophy by chest Xray or ECG or echo, urine protein, serum creatinine, fundoscopy and evidence of peripheral atherosclerotic plaque by ultrasound or X-ray and, 3] better follow-up care by the availability of hypertension flow chart. Improvement [either by reaching the standard target or by showing significant increase] was noted in both clinics in the recording of cerebral, cardiac, renal and retinal diseases as well as recording of left ventricular hypertrophy, serum creatinine, fundoscopy and availability of hypertension flow chart. Urine protein recording was improved in the Yarmouk clinic but not in the Hadiya and vice versa for recording of peripheral vascular diseases. No improvement was noted with regard to recording of evidence of peripheral atherosclerotic plaque in either of the two clinics. Clinical behaviour of family practitioners can be changed by peer review in terms of a better registration system of simple investigations [such as ECG, urine for protein, etc]. Ordering special investigation for specific target organ involvement [such as Doppler study] needs further assessment to see whether it is practical