Physicians' therapeutic practice and compliance of diabetic patients attending rural primary health care units in Alexandria.

OBJECTIVES: The objectives of the study were to investigate physician's therapeutic practice and the compliance of diabetic patients attending rural primary health units in Alexandria. MATERIAL AND METHODS: A cross-sectional study was conducted and a multistage stratified random sample method was used for the selection of 600 diabetic patients. Data were collected by means of an interviewing questionnaire, an observation checklist, review of prescriptions and laboratory investigations. A scoring system was made for a diabetic patient's knowledge and skills, patient's compliance, doctor-patient relationship, and glycemic control. RESULTS: About 57% always took their medication as prescribed by doctor and on time, only 2.2% always complied with dietary regimen while no one reported regular compliance with exercise regimen. Complications of the regimen was the commonest cause (63.3%) of noncompliance. A highly statistically significant difference was found between compliance with all regimens and patient's knowledge of diabetes. The scores for doctor-patient relationship were all unsatisfactory. Results of glycosylated hemoglobin (HbA1c) revealed that metabolic control of four-fifth of the patients was satisfactory, 12% had fair and 8% had poor metabolic control. CONCLUSIONS: Patient's compliance with most of the diabetes regimen was low. Doctor-patient relationship and patient's compliance should be improved by conducting educational and training programs.

Impact of a health education program for secondary school Saudi girls about menstruation at Riyadh city.

An experimental study was conducted to assess the impact and suitability of menstrual education program (MEP) for 1st and 2nd graders at a girls' secondary school in Riyadh city. The MEP was conducted on 5 classes, through one session and one assessment. The results revealed that the mean scores of knowledge, attitude and practice of the intervention classes (1st and 2nd graders) were significantly higher than that of the control classes. Stepwise linear regression models show that the age of menarche and grade were the predictors of students' knowledge among the control group and explained 7.8% of the variation of the knowledge score. Knowledge was a predictor of students' attitude of both groups (control and intervention) (beta = 0.359, 0.300 respectively). Knowledge was also a predictor of students' menstrual practice among control group (beta = -2.12). Attitude was a predictor of students' menstrual practice for both groups (beta = 0.360, 0.252 respectively). The study recommended the replication of the same program among elementary, preparatory, and other secondary schools for improvement of students' menstrual knowledge, attitudes and practice.

Impact evaluation of nutrition education intervention for an elementary school in riyadh city.

A nutritional education intervention (NEI) was conducted to assess its impact and suitability for the 5th and 6th graders at a governmental girls' elementary school in Riyadh city. The study design was a randomized posttest only control group. The results revealed that the mean knowledge score of the first posttest for intervention classes was higher than that of their controls (F=91.147, p<0.001). This score increased markedly among all classes at the post-posttest. The mean self-efficacy (SE) score of the control class of 5th graders and intervention class of 6th graders at posttest were much lower than that of their comparable classes and both classes showed significant increase of SE in the post-posttest (paired t=2.819 and 4.561, p<0.01 and p<0.001 respectively). The mean practice score of the posttest was lower among intervention class of the 5th graders than their control, but both means were much higher than that of both classes of the 6th graders (F=6.856, p<0.001). Only control class of the 6th graders showed increased mean practice score at the post-posttest. Stepwise linear regression models reveal that exposure to NEI session was a major predictor of students knowledge at posttest (R(2)=.345). Knowledge score was a predictor of students' dietary SE and practices scores at posttest (R(2)=.041 & .136). Self efficacy was a predictor of students' dietary practices at posttest and post-posttest (R(2)=.107 & .162) as well as lower body mass index (R(2)=.048). The study recommends the replication of such a program among diverse population of school students to have more improvement in students' dietary knowledge, SE and practices.

An intervention study for prevention of HCV infection in some hemodialysis units in alexandria.

This study was conducted aiming to compare between strict adherence to the universal precautions and anti HCV seropositive patients isolation as a preventive measure. To fulfill this aim, 80 anti HCV seronegative patients and 44 staff members working in three hemodialysis units were included in the study. A predesigned questionnaire was filled for all patients that included history of hepatitis risk factors, which are related, or not to dialysis process. Another questionnaire was filled for all medical and paramedical staff in the studied units, which included their knowledge, attitude and practice (KAP) as regard HCV. Pretest was done, followed by health education program (HEP). A posttest was performed after one month and every 6 months for 18 months. An observational sheet was filled by one of the researchers to describe the hemodialysis units environment and to record the practice of the staff in the studied units. Blood samples were collected from the study subjects at baseline, every 3 months for patients and every 6 months for the staff. Sera were separated and tested for anti HCV seropositivity using enzyme linked immunosorbent assay [ELISA] test third generation. Marked increase in staff's knowledge was evident one month after HEP and decreased gradually throughout the follow up period. The attitude was slightly elevated and remained nearly unchanged throughout the follow up. Only in unit A the mean preventive score was markedly increased 6 months after HEP and remained high throughout the follow up period. The incidence rate of anti HCV seroconversion decreased in unit A from (10% to 0%), where universal precautions was applied, and in unit C from (24.4% to 10%), where isolation of anti seropositive patients was done in the first and third 6 months of the follow up period respectively. It increased in unit B, where no measure was taken, from 10.5% to 16.7%.

Health education program for mothers of children suffering from iron deficiency anemia in United Arab Emirates.

The present study was designed to assess knowledge, beliefs and practices of mothers regarding factors leading to iron deficiency anemia among children, to develop a health education (HE) program according to the needs of the target group, to determine the effect of the program in terms of changes in mothers' knowledge, practices and beliefs using Health Belief Model (HBM), and to determine the hemoglobin and hematocrite levels of the children of the target group before and after the program. The sample size was 200 anemic children aged 6-24 months and their mothers, 100 of them were randomly assigned to face to face intervention program (experimental group) (I), the other 100 were the control group (II). Only 16% of mothers of group I and 18% of mothers of group II got satisfactory level of knowledge. After the conduction of HE program, the mothers' knowledge was significantly increased among group I, while almost there was no change of the knowledge's level among group II. Only 7% of mothers of group I and 27% of those of group II had high perceived severity. Only 8% of mothers of group I and 14% of those of group II had low perceived barriers. After the program, 58% of mothers in group I got low perceived barriers. Only 28% of mothers of group I and 21% of those of group II had good dietary practice. After the program, 74% of mothers in group I showed good dietary practice. There were highly significant increases in the levels of hemoglobin and hematocrite of children of group I after the program, while the increases were not significant in group II.

Impact of a simple health education program about antenatal care on knowledge, attitudes, subjective norms and intention of pregnant women.

The aim of this study was to identify pregnant women practices and to assess the impact of simple health education program on knowledge attitudes, subjective norms and intentions to antenatal care of pregnant women The randomized post-test only control group design was used among 200 pregnant women attending Maternal and Child Health (MCH) centers. One hundred women represented the intervention group who received a simple health eduction program and another 100 women constituted the control group. The study demonstated that nearly the intervention and control group women were equal in sociodemographic characteristics as there was no statistically significant difference in any item studied. It was found that 92% of the intervention group women had high outcome belief that attending Ante-Natal Care (ANC) leads to early detection of dangerous signs of pregnancy compared to 77% of the control group. Also 88% of the intervention group women perceived the importance of early detection of dangerous signs compared to 75% of the control group. Also 95% of the intervention group women had high normative belief that their physician believe that they must go for check up during pregnancy compared to 87% of the control group. The study also clarified that 85% of the intervention group had high motivation to comply with their physicians compared to 73% of the control group. Only 43% of the control group had regular medical check up. The mean scores of indirect attitude, subjective norms, indirect subjective norms, intention and practice were highest for the intervention and control groups among those having more than 12 years of education. The mean score of indirect attitudes increased with increasing level of knowledge among both the intervention and control groups. The mean score of practice was highest among those having positive indirect attitudes among both the intervention and control group. The mean score of practice was highest among those having high indirect subjective norm either in the intervention or the control group.