Studying family function in two Arabic countries-Egypt and United Arab Emirates

The family is an important determinant in health and illness. If the family is functiong properly, this may be reflected in a good health of family members. On the other hand family may be source of stress and illness to its members if it is dysfunctional. Considering such background, assessment of family function is of a great relevance for family physician while he/she is caring the patient and family. This study was conducted to provide a database regarding family function and factors that might affect in two Arabic countries [Egypt and United Arab Emirates]. This study has taken place in two Arabic countries [Egypt and United Arab Emirates]. The purpose of selecting these countries was as a research project based on the interest of two organizations where the researcher was working. It is a cross-sectional study. The subjects for this study were 1018 cusotmers attending in two Family Practice Centers [El Mahsma Family Practice Center [EFPC] which is affiliated to Faculty of Medicine-Suez Canal University [FOM-SCU]-Ismailia-Egypt] and Ras Al Khaimah Family Practice Center [RAK-FPC] belonging to RAK Medical District-UAE. The studied population were selected randomlly among the customers attending FPCs who aged >/= 14 years old. A pilot study was carried out to test the measurement tool. The measurement tool was the Family Function Questionnaire [APGAR] developed by Smilkstein. This tool was tested and validated in other studies. Statistical Package for Social Science [SPSS] was used for data entry and statistical analysis. Chi square and Fisher exact tests were used to test the significance. Also, multivariant logistic regression analysis was used to test association of family dysfunction with the studied variables. p value <0.05 was considered significant. The study showed that, the average score of the studied population was 6.96 +/- 2.3 [total score=10]. A higher score was reported among customers attending EFPC [7.2] comparable with [6.6] in RAK-FPC. About 38.8% of the customers have got family dysfunction [either moderate or severe]. Family dysfunction was reported more among customers attending RAK-FPC [45.8%] comparable with those in EFPC [35.4%]. After adjustment using stepwise logestic regression analysis, the following variables were linked to family dysfunction among the studied population: Being older in the age [>/= 45 years]; completed secondary/university education; having inadequate monthly income and existence of health problems among the family members. The present study concluded that, family dysfunction is a considerable problem among customers attending family practice centers. It was significantly associated with some socio-demographic variables such as age, education, income and existence of reported health problems among family-members. The family Apgar questionnaire is a simple and useful instrument to screen out family dysfunction. Family physician is keeping a good doctor-patient relationship with practice population. Therefore, he/she is in a unique position to include such screening activity in daily practice aiming at providing comprehensive and high quality care

Quality of consultation in Fanara family practice center- Ismailia governorate

The outcomes of consultations include patient satisfaction, recall of the physician's explanations and changes in the patients' concern about their symptoms. Intermediate outcomes refer to the patient's compliance with the physician's instructions. Finally, the long-term outcome of greatest importance is the change in the patient's health status. The aim of this study was to study the quality of consultation regarding its duration and out comes in terms of enablement [satisfaction] and compliance. All patients aged? 18 years attended Fanara PHC centers affiliated to Suez Canal University and Ministry of Health and Population were selected randomly according to the sample size equation [375 patients]. They exposed to a pre-consultation questionnaire including questions about some sociodemographic variables and the type of patient problem [acute or chronic], the cause of visit, his ability to choose his consulting physician and previous physician n patient relationship. Doctors, completed another questionnaire including the duration of the consultation and whether the consultation was new or follow up session. After the consultation, the patient completed the patient enablement instrument, all information were recorded on a single form. The patient's pre-consultation information were hidden from the doctor on completion, and outcome questions were hidden from the patient before the consultation. After one week or in next, session the patient compliance determined by using bill counting method. The main duration of consultation in this study was [6.69] minutes. About 68% of physician consultations were of duration

Pattern of referral and hospital feedback in family practice centers Ismailia-Egypt

Referral rate varies widely, even among family physicians within the same practice. No body can deny the increasing cost of the health care. Health care costs are tried to be cut by family physicians/general practitioners. This could be achieved partly by treating patients on an ambulatory care basis rather than hospitalizing them through appropriate shared consultation with other specialties in addition to rational use of available resources through use of the referral system appropriately. The present study aimed at identifying the rate of referral and hospital feedback at family practice centers affiliated to faculty of medicine-Suez Canal University [FOM-SCU] an that belonging to Ministry of Health and Population [MOHP]. Also, the quality of referral letters was assessed. This study was conducted in four family practice centers in EL Mahsama and Abou Khalifa villages in Ismailia Governorate, two centers belonging to the Faculty of Medicine of Suez Canal University, while the other two centers belonging to Ministry of Health and Population. Over a period of 6 months, the medical records in these centers were examined to identify the total number of patients attending these health facilities through reviewing the daily sheet of the clinics. Over the period of study a duplicate forms of the referral letter with hospital feedback were dept in the family practice centers in the referral register. Data obtained from medical records were evaluated to identify rate of referral and hospital feedback. The quality of referral letter was evaluated for the presence or absence of predetermined items for both identification and clinical data that recommended by WHO. Results showed that, the rate of referral from these family practice centers is low compared to other studies [2.27%] also, there was statistically significant difference in referral rate between family practice centers of FOM-SCU and MOHP [X2 =4.02, p<0.05]. it was found that, although the referral rate among qualified physicians [2%] was lower than noon-qualified physicians [2.3%], there was no significant difference [X=0.94, p=0.3324]. referral for further investigations and unavailable treatment modalities came at the top of reasons for referral with rate of 34.29% and 26.81% respectively. Referral for shared consultation represented only 15.38%. surgery, laboratory and obstetric and gynecology departments come at the top of the list [20.44%, 16.7% and 14.72% respectively. The study revealed the absence of adequate, efficient hospital feedback and the connection between the family physicians in family practice centers and specialists in hospitals is nearly lost [very low rate of hospital feedback [0.8%]]. It was found that 47.4% of referral letters were poor [score <13 items]. Understanding and awareness among primary health care physicians [PHCs] and specialists regarding the organization of the referral system is needed to deliver a better health are to the patients. This study highlighted some of the inadequacies that may hinder the effectiveness of the referral system in the family practice centers as the absence of feedback report by the hospital to which these patients are referred. Such problems will affect the continuity of care of patients negatively and may result in lack of patient satisfaction. In addition, lack of facilities in family practice centers make the highest referral rate by the physicians is for doing laboratory investigation to reach the final diagnosis