ABSTRACT
Objectives: COVID-19 pandemic imposed a relevant number of stressful factors potentially impacting either daytime function or sleep quality. This study aimed to assess the sleep quality and anxiety among the general population living in Egypt. Material and Methods: A cross-sectional survey was conducted among 1,000 individuals who have been recruited via a convenience sample. A predesigned questionnaire was distributed online to collect data on sleep quality using the validated Arabic version of the Pittsburgh sleep quality index, anxiety disorders by the generalized anxiety disorder (GAD-7) scale, demographic characteristics, and clinical history. Results: Among the study participants (33.8% males, 46.2% healthcare workers, 25% had chronic diseases, 30.1% were physically active during lockdown, and 70.3% reported work termination due to COVID-19 infection, 68.4% complained of bad sleep and 70.3% showed clinically significant levels of anxiety). In multiple logistic regression analysis, bad sleep quality was significantly associated with moderate anxiety (OR: 1.88; [95% CI: 1.37-2.60]), severe anxiety (OR: 3.15; [95% CI: 2.18-4.55]), being physically active (OR: 0.53; [95% CI: 0.39-0.71]), received higher education as being postgraduate (OR: 0.56; [95% CI: 0.35-0.92]), or living with family (OR: 0.74; [95% CI :0.56-0.98]).The GAD-7 scale added 8% discrimination power for prediction of bad sleep quality compared to the model based on demographic and clinical data [with GAD: AUC=0.70, p<0.001; without GAD: AUC=0.62, p<0.001]. Conclusion: COVID-19 had a significant impact on sleep quality and anxiety among Egyptians. Since both the conditions may overlap and potentiate each other leading to chronic dysfunctional outcomes, an accurate assessment and clinical approach may favor a better prognosis.
ABSTRACT
BACKGROUND: Governance is a system that ensures and promotes accountability and responsibility toward stakeholders. The present study aims to compare the governance structures and practices in for-profit and non-for profit hospitals in Alexandria, Egypt. METHODS: The study is a descriptive cross sectional study in which Chief Executive officers (CEOs) in all hospitals in Alexandria Governorate were interviewed. A predesigned questionnaire was used in the interview that is composed of four section. The first section explored characteristics of study hospitals. The second section assessed the composition and the characteristics of boards. The third section assessed the functions of the board and the fourth section assessed boards' training and evaluation. RESULTS: A centralized board existed in the Health Insurance, Ministry of Health and Population and University hospitals. As for private hospitals, board existed in only 72 hospitals (82.75 %). Almost all boards have CEO duality. Board members were as few as two members in some boards and up to twenty members in others. Some hospital boards did not have an orientation manual or program. CONCLUSION: A proportion of study hospitals does not have a governing board. For the hospitals with governing boards, there were wide variation in governance structures and practices.