Assessing Functional Status in Geriatric Patients Attending Primary Healthcare Centers in Qassim Region, Saudi Arabia.

Background There is an increase in the geriatric population globally. Also, in Saudi Arabia, the elderly population is expected to become a significant proportion of the total population in future decades. To provide comprehensive care to the geriatric population, an assessment of their functional capacity is crucial. Objectives This study aims to assess functional capacity and identify factors associated with functional impairment among geriatric patients at primary healthcare centers (PHCCs) in Qassim Region, Saudi Arabia. Methods A cross-sectional study was conducted among 310 geriatric patients, including 155 males and 155 females, attending PHCCs. An interviewer-administered survey was conducted from June through October 2023. The interviews were conducted by trained physicians. To assess functional capacity, the Katz index of independence in activities of daily living (Katz ADL), the Lawton-Brody instrumental activities of daily living (Lawton-Brody IADL) scale, and Wudu (ablution) performance were used as assessment tools. The data was collected via a Google Form (Google LLC, California, USA) through an interviewer-administered questionnaire. The data was analyzed using SPSS Statistics version 21 (IBM Corp. Released 2012. IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.). Results The mean age of the study participants was 71.9 (±7.02) years. A vast majority (91.9%) had chronic diseases. Among basic ADL, the respondents had a high level of independence in feeding (99.4%) and transferring (95.5%), while there was a low level of independence in bathing (13.2%). The analysis of the Lawton-Brody IADL showed independence in medication management (75.8%) and telephone use (72.9%); however, 54.8% of the study participants were unable to perform laundry-related activities independently. Around three-fourths (76.8%) of the study participants were able to perform Wudu independently. IADL independence was statistically significantly associated (p<0.001) with age, gender, education, and chronic diseases. The Katz ADL and Lawton-Brody IADL were correlated (r=0.607, p<0.0001), and Wudu performance was positively correlated with both indices (r=0.636, r=0.60, p<0.0001). Conclusions Assessing elderly functional capacity and addressing the risk factors of functional impairment is crucial to improving the quality of life in this segment of the population. Future research is needed to validate the use of Wudu performance as an assessment tool for functional capacity in the elderly population.

Awareness of Gestational Diabetes Mellitus Maternal and Neonatal Outcomes Among Women Attending Primary Healthcare Centers in Qassim, Saudi Arabia.

Background Gestational diabetes mellitus (GDM), diagnosed during pregnancy, can harm both mothers and neonates. GDM awareness among women varies among various countries. Understanding the level of awareness is vital for designing effective health interventions. Objectives This study aimed to evaluate GDM awareness among married females at primary healthcare centers (PHCCs) in Qassim, Saudi Arabia, focusing on knowledge regarding adverse maternal and fetal outcomes of GDM. Methods An observational cross-sectional study was conducted among married females at PHCCs in Qassim, from June 2023 to October 2023. A two-stage cluster sampling method was used. Four PHCCs were selected in the first stage, and study participants were selected from these centers in the second stage. A self-administered questionnaire was used. Statistical Product and Service Solutions (SPSS, version 23; IBM SPSS Statistics for Windows, Armonk, NY) was used for statistical analysis. Results Of the 270 participants, the majority (72.2%) demonstrated 'poor' knowledge about GDM adverse outcomes for both mothers and neonates, 17.8% demonstrated a 'fair' level, and only 10% displayed a 'good' knowledge. Participants' educational level, personal history of diabetes, and age were associated with knowledge levels. Awareness of specific outcomes related to GDM, both maternal and neonatal, varied among participants. Information on GDM was mainly obtained from mass media and personal networks, while healthcare providers were reported as the least common source. Conclusion Based on the results of our study, we conclude that educational interventions, especially involving healthcare providers, are essential to improve awareness about GDM adverse outcomes. Strategies involving educational sessions by healthcare providers and health education materials at PHCCs can improve awareness leading to effective management of GDM and improved maternal and neonatal outcomes.

Knowledge, attitudes, and practice about hepatitis B infection among primary health care nurses in Buraidah, Qassim Region, Saudi Arabia.

Background: Nurses are at increased risk of acquiring HB infection due to occupational exposure. To control this infection, basic knowledge and a positive attitude toward HB prevention are required. This study was conducted to assess knowledge, attitude, and practice of HB infection preventative measures among primary healthcare nurses in Buraidah, Saudi Arabia. Materials and Methods: A descriptive cross-sectional survey was conducted from February to March 2018. A self-administered questionnaire was distributed to all nurses working in primary healthcare centers. Data were analyzed with descriptive and inferential statistics. Results: Of the 335 eligible participants, 262 (78%) responded to the survey. Overall, 41.2% of participants had a moderate level of knowledge about HB; however, there was no significant difference in knowledge between males and females. The majority (94.7%) had positive attitudes toward HB. Male nurses displayed significantly more positive attitudes than female nurses (P = 0.0075). Most of the respondents practiced good compliance with universal precautions. The majority (85.5%) were vaccinated, of whom 72.3% were completely vaccinated. About 14.1% of nurses were exposed to high-risk HB conditions; of these, 40.5% immediately reported their injuries. Conclusions: The majority of participants had moderate knowledge and a positive attitude but still need more information about HB prevention. Improving knowledge, attitudes, and good practices regarding hepatitis B prevention will contribute to increased awareness among nurses, leading to improvement in healthcare services.

Three years versus four years Saudi Board Family Medicine program: Graduates' academic performance, perceptions, burnout, and satisfaction with professional life.

Background: The specialty of family medicine, established in Saudi Arabia in the 1980s, has rapidly progressed in healthcare settings and is increasingly utilized by the population as well as recent MBBS graduates. Universally, there is ambiguity in the duration, curriculum, and assessment methods used in family medicine specialization programs. Methodology: A cross-sectional study was conducted among 183 fresh graduates from a 3-year and 4-year residency program. Data were collected using electronic forms, which were subsequently transferred to Microsoft Excel. Following appropriate coding, the data were transferred to SPSS for analysis. The dataset was then cleaned, and statistical tests, such as Chi-square and independent t-tests, were used to draw inferences. Results: Males (50.3%) and females (49.7%) had almost equal distribution in the study. Overall, 67.6% of respondents had passed the final exam; the pass percentage was 69.3% for the 3-year residency program and 66.4% for the 4-year program. The overall mean score for perceived achievement of SaudiMED-FM 2020 competencies was 23.06 ± 5.52 out of a total score of 30. On comparing the 3-year versus 4-year residency program, there was no statistically significant difference between perceived competency scores and professional satisfaction scores. Among the study participants, 19 (10.4%) had 'serious burnout', and 22 (12%) had 'extremely serious burnout'. Professional satisfaction was significantly associated with burnout (P = 0.006). Conclusions: Based on the study results, there was no significant difference regarding academic performance, perceived competencies, and professional satisfaction among the graduates of the 3-year versus 4-year residency program. Approximately more than half of the graduates had suffered from burnout which was reported more by the females and those with financial issues. The majority of the respondents suggested improvements in clinical rotation and assessment methods.

Infant care practices among mothers attending well-baby clinics at primary health care centers in Unaizah city.

Background: Infant care, crucial for the well-being of infants, is an inherent human practice. Although there are important implications of infant care practices on infant health, there is a dearth of comprehensive studies covering all important aspects of infant care in an individual study. Objectives: To determine practices regarding infant feeding, infant sleep, use of pacifiers, and immunization, and to explore the association of these practices with mother's demographic data. Methods: A cross-sectional study was conducted using a self-administrated questionnaire distributed among mothers attending well-baby clinics in Primary Health Care Centers (PHCCs), Unaizah city, Qassim region, Saudi Arabia. By using the two-stage cluster sampling method, 50 women participated from each of the four selected PHCCs, leading to a total of 200 participants. The survey was conducted from December 2020 to February 2021. Data were analyzed using SPSS software. Results: A total of 124 (62%) respondents were between the ages of 26 and 35 years, 64% had a bachelor's degree, and 69.5% were housewives. Breastfeeding was practiced by 88% of women, 48% began infant weaning at 6 months of age, and 49% put their infant to sleep on their back. Up-to-date vaccination was reported for 188 (94%) infants. Infant pacifier use was reported by 58% of the respondents, and 82.5% of the participants had been offered formula milk for the newborn at the hospital. Vaginal delivery, absence of complications during pregnancy or labor, presence of a housemaid, and family income of more than 10,000 Saudi Riyals were significantly associated with better infant care practices. Conclusion: The study participants have good practices for certain infant care aspects such as immunization; however, improvement is needed for other practices, including weaning at the proper age, infant sleep position, and the use of pacifiers. Administrative measures are required to monitor the use of formula milk at hospitals and to enhance health education for mothers.

Prevalence of Anxiety among Qassim university female medical students during Covid-19 Pandemic in Saudi Arabia.

Background and Objectives: Anxiety disorders are common but under-recognized psychiatric disorders. The objectives of the study were to determine the prevalence of anxiety and factors associated with anxiety during the Covid 19 pandemic among female medical students at Qassim University, Saudi Arabia. Methods: An online cross-sectional survey, using a self-administered questionnaire, was conducted from August to December 2021. The questionnaire using Google Forms, submitted to the WhatsApp groups of female medical students, gathered personal data and information related to the Covid19 pandemic effects. Beck Anxiety Inventory (BAI) was used for measuring the severity of anxiety. Results: Out of 278 invited students, 179 responded (response rate: 64.4%). Mean age of the respondents was 22.45 (±1.57) years, 89.9% were living with their parents, and 46.9% perceived their academic performance as 'Good'. A total of 34 (19%) suffered from COVID-19, and 50.3% (n=90) of students reported family members affected by COVID-19, and 24.4% of the affected family members were hospitalized. The prevalence of anxiety among study participants was 26.8% (n=48); 31 (17.3%) participants had moderate and 17 (9.5%) had severe anxiety. The overall median anxiety score was 11 (IQR=21). In the younger age group (18-22 years), those who perceived their academic performance as 'poor or fair, and those living alone or with relatives and friends had higher anxiety scores, and the differences were statistically significant at p=0.042, p=0.018, and p=0.01, respectively. Conclusion: Anxiety among female medical students during the COVID-19 pandemic was high. Mental health services including counseling and mental health education in universities are recommended.

Prevalence and Associated Risk Factors of Irritable Bowel Syndrome Among Female Secondary School students in Ar Rass City, Qassim Region.

Background: Irritable bowel syndrome (IBS) is a common chronic gastrointestinal condition associated with many modifiable and non-modifiable risk factors. Objectives: To determine the prevalence of IBS and the associated risk factors among female secondary school students in Ar Rass city, Qassim region, Saudi Arabia. Methods: A cross-sectional study was conducted from June to August 2021 among female students attending government secondary schools at Ar Rass city, Qassim region. Two schools were selected by simple random sampling. A self-administered questionnaire using Google Form, submitted to the WhatsApp groups of the students, gathered personal data, and behavioral, lifestyle and health background characteristics of the participants. The questionnaire included Rome IV criteria for IBS diagnosis. Results: Out of 612 invited students, 429 responded (response rate: 70.1%). Twenty-eight incomplete questionnaires were excluded leading to 401 participants in the final analysis. The mean (± SD) age of study participants was 17.3 (±2.05) years. The overall prevalence of IBS was 21.4% (n=86); 11.7% (n=47) were already diagnosed; however, 9.7% (n=39) were newly detected in our survey. The factors associated with IBS included frequent consumption of soft drinks (p=0.016), low vegetable consumption (p=0.003), poor mental health (p<0.0001), family history of IBS (p<0.0001) and history of chronic disease (p<0.0001). Conclusion: IBS is prevalent among female secondary school students in Ar Rass city. Unhealthy diet and poor mental health are associated with IBS. Creating awareness regarding IBS and about importance of healthy lifestyle is recommended. School staff need to be trained to promote the physical and mental health of the students.

Prevalence of Postpartum Depression among Women in Childbearing Age Attending Primary Health Care Centres, Qassim Region.

Background and Objectives: Postpartum Depression (PPD) is a significant threat to mothering and has negative impact on both mothers and children. There is limited information about PPD prevalence and associated factors in Saudi Arabia particularly in Qassim region. This study aimed to determine the prevalence of PPD and factors associated with PPD among women of childbearing age in Buraidah, Qassim region, Saudi Arabia. Methods: This was a cross sectional study including 204 mothers aged 18-45 years in postpartum period attending primary health care centres in Buraidah during April to August 2021. A self-administered questionnaire was used to gather data regarding socio-demographic characteristics, newborn related factors, marital and family relationship factors, and social support factors of the participants. Edinburgh Postnatal Depression Scale (EPDS) was used to determine PPD among the participants. Results: Out of 229 invited women, 204 willingly participated (response rate: 89.1%). More than half of the participants (58.3%) belonged to 18-30 years age group; 62.3% participants had university or above education; 82.4% were housewives; and household income level was considered 'moderate' by 65.7% of the participants. According to EPDS, the prevalence of PPD was 13.7% while 17.6% had 'possible Post-Partum Depression', and 12.3% had 'fairly high possibility of Depression'. PPD was significantly associated with friend support (p=0.03) husband support (p=0.01) and absence of conflict with the husband (p=0.02). Conclusion: More than a quarter of women were likely to have PPD needing monitoring, diagnostic assessment and possible treatment by primary health care physicians or specialists. Comprehensive post-natal care including screening for PPD in primary health care centers is recommended.

The Prevalence of Child Restraint System Use and Pattern of Child Transportation in Buraidah City.

BACKGROUND: The motor vehicle crash (MVC) is a major cause of injuries and deaths among children worldwide. The child restraint system (CRS) is designed to protect children from injury and death if passengers are involved in MVC. OBJECTIVES: To determine the prevalence of CRS use for children aged 5 years and below and to explore the pattern of child transportation inside cars in Buraidah, Saudi Arabia. METHODS: A cross-sectional study was conducted using a self-administered questionnaire distributed among parents attending primary healthcare centers. Simple random sampling was used to select 330 participants. The survey was conducted from January to March 2020. RESULTS: A total of 135 (40.9%) respondents had CRS available in their cars, and only 51 (15.5%) participants reported using it 'always'. Child discomfort, difficulty in handling CRS, and being unaware of CRS importance were the commonly reported reasons of not using CRS. The most common practiced mode of transportation, in case of not using CRS, was seating the child in the front seat on an adult lap. Twenty-eight (8.2%) respondents experienced a MVC while driving with a child; half (53.6%) of these were not using CRS at the time of the accident. Less than half (47.1%) of the participants were aware of the CRS law in Saudi Arabia. CONCLUSION: The prevalence of using CRS is low. Creating awareness among parents and strict implementation of the CRS law can lead to increase in the use of CRS which will lead to prevention of traffic-related injuries and deaths among children.

Mobile phone use while driving: Prevalence, task management strategies, risk perception and attitude among Qassim University students.

BACKGROUND: Globally, motor vehicle accidents (MVAs) cause around 1.35 million deaths annually. Distracted driving, a risk factor for MVA, includes diversion of attention from driving because of use of mobile phone. OBJECTIVES: The aim of this study was to determine prevalence of mobile phone use and to explore task management strategies, risk perception and attitude towards mobile phone use while driving among Qassim University students. METHODS: An online cross-sectional survey among 212 randomly selected medical (n = 83) and engineering students (n = 129) of Qassim University, Saudi Arabia, through semi-structured, self-administered questionnaire, designed using Google forms. The survey was conducted from February to March 2020. RESULTS: The overall prevalence of mobile phone use while driving was 93.4% (medical students: 96.4%; engineering students: 91.5%). Around 49.5% participants 'often' or 'always' used mobile phone while driving. Among task management strategies, 169 (79.7%) participants were 'likely' or 'very likely' to lower their driving speed while 90 (42.5%) were 'likely' or 'very likely' to increase control over the steering while using mobile phone during driving. Regarding risk perception, 173 (81.6%) participants thought that they were 'unlikely' or 'very unlikely' to have MVA on looking at phone continuously for more than 2 s, and 185 (87.3%) participants thought that they were 'unlikely' or 'very unlikely' to have MVA by texting or browsing while driving. Thirty-six (17%) participants reported MVA because of distraction by mobile phone use while driving. CONCLUSION: High prevalence of mobile phone use during driving and low perceived risk of experiencing MVA because of mobile phone use was found among Qassim University students. Creating awareness on risks of mobile phone use while driving is recommended.

Knowledge and practice of self-hygiene during menstruation among female adolescent students in Buraidah city.

BACKGROUND: Menstruation is a physiological phenomenon that begins in females in adolescent age. Poor menstrual hygiene can result in significant reproductive disorders. However, improving the knowledge about menstruation even before menarche can improve menstrual hygiene. OBJECTIVE: The aim of this study was to determine the knowledge and practice of adolescent girls towards menstrual hygiene, in Buraidah city. MATERIALS AND METHODS: A cross-sectional study was conducted among 258 intermediate school girls in Buraidah city. A semi-structured, self-administered questionnaire was used to collect information on demographics, menstrual history, knowledge about menstruation, hygiene practices, and school absence during menstruation. The survey was conducted from December 2019 to Februry 2020. RESULTS: Before menarche, 49.6% of the girls knew about menstruation. The mothers were the most common (94%) source of information about menstruation. Regarding menstruation, 68.2% had bleeding for four to six days, and 42.2% had an interval of 21 to 35 days between periods. Approximately 61.7% participants had 'acceptable' level of knowledge, 2.0% had a 'good' knowledge and 36.3% had 'poor' knowledge regarding menstruation. Most (60.5%) students were categorized as having unsatisfactory self-hygiene practice. During the last three months, 35.8% of the girls were absent for one day due to menstruation. 47.7% of the students omit some foods and drinks from their diet during menstruation; soft drinks were the most omitted. Mother's occupation (P = 0.022), family monthly income (P = 0.007), and prior knowledge on menstruation (P = 0.006) were significantly associated with knowledge regarding menstruation. CONCLUSION: Knowledge and practice toward menstrual hygiene is unsatisfactory. Creating awareness on self-hygiene during menstruation is recommended.

Prevalence of home related injuries among children under 5 years old and practice of mothers toward first aid in Buraidah, Qassim.

BACKGROUND: Unintentional injuries are reported to be the most common mechanism of childhood injuries; large proportion of these occur in or around home. Quick response and appropriate first aid is vital in saving life and preventing negative outcomes. OBJECTIVES: The aim of this study was to determine prevalence of home injuries among children five years old and younger and to explore their mothers' knowledge, attitude and practice toward first aid. METHODS: A cross-sectional study was conducted among 250 mothers attending well baby clinics at primary health care centers (PHCC) in Buraidah city. The survey was conducted from February to June 2020. Simple random sampling was used to select PHCCs and systematic random sampling was used for participant selection. A self-administered, semi-structured questionnaire was used to collect data. RESULTS: A history of home-related injury to the youngest child was reported by 114 (46.3%) mothers. The common home injuries were falls (50%), cut wounds (15.2%) and burns (10.7%). Among less than one-year age, injuries were more prevalent among males (41.4%) as compared to females (27.6%). Majority (58.2%) of mothers had fair knowledge about first aid. Internet websites (53.6%) followed by social media (47.6%) were the main sources of their knowledge. Mothers showed appropriate practice in dealing with suspected fracture (85.9%) and foreign body ingestion (80%) while burn (55.5%) and choking (43.2%) had the lowest appropriate practice. CONCLUSION: Home injuries are common among children. However, mothers' knowledge and practice of first aid is inadequate. To reduce the injuries' related morbidity and mortality, increasing awareness and organizing first aid training courses are recommended.

Preventive Practices of Ophthalmologists During COVID-19 Pandemic.

PURPOSE: To explore ophthalmologists' preventive practices, and their perceived seriousness and perceived risk of transmission of coronavirus disease 2019 (COVID-19). METHODS: In a cross-sectional study, a semi-structured questionnaire was distributed online among ophthalmologists. Questions about COVID-19 infection, perceived seriousness, perceived risk of transmission, and recommended COVID-19 preventive practices were asked. Based on the adoption of a preventive measure and its frequency, a maximum preventive score of 25 was computed. RESULTS: Among 126 respondents, the mean±SD age was 45.3±10.9 years, and 57.9% worked in a tertiary care hospital. Regarding preventive practices, 96.8% of ophthalmologists wore face masks, 89.6% avoided talking during the slit lamp examination, and 72.2% wore gloves during the ophthalmic examination. Availability of plastic barriers and regular disinfection of slit lamps were reported by 78.6% and 43.7% of ophthalmologists, respectively. The mean preventive score increased with increasing age (p=0.001), and was higher for males (18.96±4.60) compared to females (17.81±4.96). The mean score for perceived severity was higher (p<0.0001) among ophthalmologists with more than 10 years of experience (8.76±1.58) than those with experience of 10 years or less (7.49±1.86). Out of 29 ophthalmologists who had been tested for COVID-19, 11 were found to be positive, giving an overall incidence of COVID-19 infection of 8.7%. CONCLUSION: The ophthalmologists were generally compliant with recommended preventive measures. Some preventive measures, such as the wearing of gloves and regular disinfection of slit lamps, need improvement. We recommend creating awareness of and monitoring for COVID-19 infection control measures in healthcare settings.

Satisfaction Of Trainees With Family Medicine Training Program: A Cross Sectional Study From Qassim, Saudi Arabia.

BACKGROUND: Focus on quality of postgraduate training has increased. One of the quality indicators is satisfaction of trainees with the residency programs. We aimed to assess the level of satisfaction of Saudi Board family medicine trainees with training program in Qassim. METHODS: Anonymized online survey, using a structured questionnaire, was conducted among the current family medicine residents (n=60) in Qassim in 2019. Descriptive analyses were carried out to calculate frequencies of the responses. Satisfaction level was compared between basic (R1, R2) and advance (R3, R4) levels using Chi-square test. RESULTS: About 67% (40) were basic level trainees. A higher proportion (>80%) of trainees was satisfied with the program director. Satisfaction with trainers ranged 45% to 85% for different items. About 79% of the trainees were satisfied with the training program organization. In the domain of training processes higher proportion (73-83%) was satisfied with supervision and feedback while a lower proportion (63- 68%) was satisfied with evaluations. Proportion of satisfied trainees in the domain of hospital rotations was lowest (43%) for academic activities in the hospitals. About family medicine rotations, a higher proportion (75%) was satisfied with academic activities. Higher proportion of trainees (78-86%) was satisfied with research facilitation and supervision. Mean score for overall satisfaction was 7.63 out of 10. CONCLUSIONS: The results of this study would help focus on certain domains to improve the quality of program. We recommend family medicine programs to regularly carry out such surveys for continuous quality improvement.

Primary health care physicians' prescribing patterns for children under five in Qassim, Saudi Arabia.

BACKGROUND: Irrational prescription of drugs in children is reported to be widespread. There are scarce studies on the pediatric prescribing pattern especially at primary health care (PHC) level. AIM: To determine the physicians' prescribing patterns for children under five years, to explore completeness of prescriptions' recorded information, and to analyze the core indicators of drug prescribing at primary health care centers (PHCC) in Qassim. METHODS: This cross-sectional study was conducted on 25 randomly selected PHCCs. All prescriptions, for the first week of first six months of the year 1437 Hijrah (October 2015 to April 2016), were reviewed. Among 25 012 prescriptions, 4125 (16.5%) were for children under five years. We randomly selected 1212 prescriptions for the study. World Health Organization (WHO) specified drug use indicators, and index of rational drug prescribing (IRDP) with a maximum value of 5, were calculated. The physicians and pharmacists of sampled PHCCs were also surveyed to explore prescribing issues. FINDINGS: The completeness of recorded date, patient age, and gender was more than 90%. The diagnosis was legibly written in 842 (69.5%), while the patient weight was recorded in 307 (25.3%) prescriptions. The least commonly recorded instruction was the drug strength (26.8%), while the dose and frequency of use were stated for 91.3% and 90.8% of the drugs, respectively. The average number of drugs per prescription was 2.35 ± 0.89; 72.97% drugs were prescribed by generic name; in 65.98% patient encounters, antibiotics were prescribed. The overall IRDP was 3.56. Most of the physicians and pharmacists reported availability of the drug list and Saudi PHC formulary in their PHCCs. CONCLUSION: PHC physicians' drug prescribing was not at the optimal level of rational use, especially regarding prescription of antibiotics. Creating awareness about rational drug use and hazards of overuse of antibiotics is needed.

Primary health care research in Saudi Arabia: A quantitative analysis.

OBJECTIVES: The objective of this study was to analyze the published primary health care (PHC) research conducted in Saudi Arabia quantitatively and to determine the distribution of these research publications according to the topic, time, geographical location, and institution. METHODS: In this descriptive study, we conducted literature search in PubMed and Google Scholar. The Medical Subject Headings terms: "Primary Health" AND "Saudi" and "Primary Care" AND "Saudi" were used for searching relevant journal articles. Relevant information about the journal articles, published till December 2011, was recorded on a coding instrument. RESULTS: From 1983 to 2011, a total of 655 PHC research articles were found. The publication output showed an increase with time. Original research articles (85.6%) were the main type of publications, and the most common study design was cross-sectional (93.4%). "Chronic diseases" and "health services research" were the main topics addressed. Riyadh province had the highest proportion (46.3%) of publications, and the universities (56.2%), followed by the Saudi Ministry of Health (24.9%), were the main institutions publishing the research. CONCLUSION: Despite a well-established PHC setup in Saudi Arabia, the research outputs are low. Most of the published articles are cross-sectional studies and are conducted by the universities. Enhancing the PHC research by creating a supportive environment will lead to an increased evidence base for PHC and its effective translation into service delivery.

Attitudes to statistics in primary health care physicians, Qassim province.

UNLABELLED: Aim To investigate primary health care (PHC) physicians' attitudes to statistics, their self-reported knowledge level, and their perceived training needs in statistics. BACKGROUND: In spite of realization of the importance of statistics, inadequacies in physicians' knowledge and skills have been found, underscoring the need for in-service training. Understanding physicians' attitudes to statistics is vital in planning statistics training. METHODS: The study was based on theory of planned behavior. A cross-sectional survey of all PHC physicians was conducted in Qassim province, from August to October 2014. Attitudes to statistics were determined by a self-administered questionnaire. The attitudes were assessed on four subscales including general perceptions; perceptions of knowledge and training; perceptions of statistics and evidence-based medicine; and perceptions of future learning. Findings Of 416 eligible participants, 338 (81.25%) responded to the survey. On a scale of 1-10, the majority (73.6%) of the participants self-assessed their level of statistics knowledge as five or below. The attitude scores could have a minimum of 20 and a maximum of 100, with higher scores showing a positive attitude. The participants showed a positive attitude with the mean score of 71.14 (±7.73). Out of the four subscales, 'perceptions of statistics and evidence-based medicine' subscale scored the highest, followed by 'perceptions of future learning'. CONCLUSION: PHC physicians have a positive attitude to statistics. However, they realize their gaps in knowledge in statistics, and are keen to fill these gaps. Statistics training, resulting in improved statistics knowledge is expected to lead to clinical care utilizing evidence-based medicine, and thus improvement to health care services.

Suitability assessment of health education brochures in Qassim province, Kingdom of Saudi Arabia.

BACKGROUND: Health education is the cornerstone of primary health care. Health education materials distributed to the community should, therefore, be suitable and effective. The purpose of this study was to evaluate the health education brochures, designed and disseminated by Ministry of Health institutions in the Qassim province. MATERIALS AND METHODS: The study was a cross-sectional review of health education brochures. We used a structured evaluation form, comprising general information on the brochures and a modified Suitability Assessment of Materials (SAM) score sheet. The SAM consisting of 22 criteria in six groups, includes content, literacy demands, graphics, layout/typography, learning stimulation/motivation, and cultural appropriateness. SAM criteria categorize written material into "superior," "adequate" and "not suitable." Two qualified consultant family physicians evaluated the brochures. Data were analyzed using Epi Info version 3.4 statistical package. RESULTS: We evaluated 110 brochures, the majority of which addressed chronic health conditions such as mental health, diabetes mellitus and hypertension. Seventy-four (67.3%) brochures were evaluated as "adequate," 34 (30.9%) as "not suitable" and 2 (1.8%) as "superior." "Cultural appropriateness" was the highest scoring factor, with 92 (83.6%) brochures falling into either the "superior" or "adequate" category. With regard to "content," 88 (80.0%) brochures fell into either the "superior" or "adequate" category. This was the second highest scoring factor. Graphics was the factor that scored the least. Seventy-five (68.2%) brochures were rated in this factor as "not suitable." CONCLUSIONS: Although two-thirds of our brochures were considered "adequate," the majority needed improvement to their graphics and learning stimulation factors. We recommend that guidelines for designing health education brochures should be formulated to improve the quality of health education brochures.

Priorities for primary health care research in Qassim, central Saudi Arabia.

OBJECTIVE: To determine the major research priorities in the field of Primary Health Care (PHC) in Qassim, Saudi Arabia. METHODS: The study was a cross-sectional survey including academicians, researchers, and PHC program managers in Qassim. A self-administered questionnaire was used as the survey instrument. A scale of 1-5 was given for prioritizing the health issues (5=highest priority; 1=lowest priority). A list of PHC research topics including prevalent health issues addressed by PHC programs was provided to the respondents. Responses were collected from April 2012 to June 2012, and the data was analyzed. RESULTS: A total of 101 eligible participants were invited to participate in the survey; out of these 85 (84.2%) responded. Diabetes mellitus (4.82+/-0.44) was the top priority, followed by hypertension (4.67+/-0.54), and bronchial asthma (4.35+/-0.79). Other priority areas included child health, maternal health, and quality of care. Leishmaniasis and foodborne illness were the lowest priorities. CONCLUSION: This study identified the priority areas that need to be focused on for PHC research in Qassim. The survey lays a foundation upon which we can build future research.

Attitudes of primary health care physician managers toward research: a pre-experimental study.

Research in primary health care (PHC) is underdeveloped and scarce, especially in developing countries. It is important to understand the attitudes and aspirations of PHC physicians for the promotion of research. The aim of this study was to determine the attitudes of PHC physician managers toward research in Qassim province and to identify barriers that impede performing research in the PHC system. The study was based on social cognitive theory framework, and was pre-experimental with a 'one-group pre-test-post-test' design. The study participants were physician managers in PHC administration, Qassim. The participants' attitudes were measured by adapting statements from the Attitude Towards Research scale. The intervention was the 1-day training program 'Introduction to Research in Primary Health Care'. A total of 23 PHC physicians participated in the study. The mean age of the participants was 45.4 (±1.6) years, and the mean years of work experience was 16.2 (±2.2) years. Only one participant had an article published in a peer-reviewed journal. The results of the study showed that PHC physicians had a baseline positive attitude toward research that was further enhanced after participating in an introductory research-training program. During the pre-test, out of the total score of 63, the mean score on attitude toward research was 48.35 (±6.8) while the mean total attitude score in the post-test was 49.7 (±6.6). However, the difference was not statistically significant at P<0.05. The item with the highest score regarded the role of research in the improvement of health care services, while the lowest-scoring item was about support from administration to conduct research. The participants recognised lack of skills, lack of training and inadequate resources as major barriers in conducting research. Our study results suggest that the PHC physicians' positive attitudes toward research can be further improved through in-service training. To promote research in PHC in Qassim, regular research-training programs and incentives for conducting research should be provided to the PHC physicians.