RESUMO
Job satisfaction is the affective orientation that an employee has towards his work. Greater physician satisfaction is associated with greater patient adherence and satisfaction. Nurses' job satisfaction, have great impact on the organizational success. Knowing parts of job dissatisfaction among physicians and nurses is important in forming strategies for retaining them in primary health care (PHC) centers. Therefore, this study aimed at assessing the level of job satisfaction among PHC physicians and nurses in Al- Madina Al- Munawwara. Also, to explore the relationship of their personal and job characteristics with job satisfaction. A descriptive cross- sectional epidemiological approach was adopted. A self completion questionnaire was distributed to physicians and nurses at PHC centers. A multi-dimensional job scale adopted by Traynor and Wade (1993) was modified and used. The studied sample included 445 health care providers, 23.6% were physicians and 76.4% were nurses. Job dissatisfaction was highly encountered where 67.1% of the nurses & 52.4% of physicians were dissatisfied. Professional opportunities, patient care and financial reward were the most frequently encountered domains with which physicians were dissatisfied. The dissatisfying domains for majority of nurses were professional opportunities, workload and appreciation reward. Exploring the relation between demographic and job characteristics with job satisfaction revealed that older, male, non-Saudi, specialists physicians had insignificantly higher mean score of job satisfaction than their counterparts. While older, female, non-Saudi, senior nurses had significantly higher mean score than their counterparts. It is highly recommended to reduce workload for nurses and provision of better opportunities promotional for PHC physicians and nurses.
RESUMO
Pre-eclampsia and eclampsia remain one of the major obstetrical problems in less developed countries. Proper antenatal care (ANC) with regular measurement of blood pressure remains the mainstay of screening for hypertension in pregnancy. The aim of the current study was to identify frequency and characteristics of women with toxemia of pregnancy, assess both the quantitative and qualitative adequacy of antenatal care among cases with toxemia of pregnancy and to evaluate the effect of antenatal care on maternal and perinatal outcome. A cross-sectional case series study design was utilized .The study population was all cases, with confirmed diagnosis of toxemia of pregnancy who were admitted to El-Shatby University hospital during the period from January to May 2005. A structured interviewing schedule was used to collect data on characteristics of cases, maternal and fetal outcome. Site, adequacy and quality of received antenatal care were assessed. Out of total cases (336), 14.29% were diagnosed as mild pre-eclampsia, 83.31% were found to have severe pre-eclampsia while 2.40% were suffering from eclampsia. The severity of the condition was significantly associated with older maternal age, multiple pregnancy, primigravity, nulliparity, low socioeconomic conditions, husband's smoking and excessive caffeine consumption. Three-quarters of eclampsia cases (75.0%) didn't receive antenatal care and 60.0% of severe pre-eclamptics received inadequate antenatal care. The mean percent score of quality care domains of antenatal care content for mild pre-eclamptics was 75.62 +/- 13.80%. This was significantly higher than that for those of severe (59.96 +/- 27.95%) or for eclampsia cases (48.75 +/- 20.04%) where X(2) of Kruskal-Wallis=8.316 (P<0.001). Adverse maternal and fetal outcome occurred in 79.4% of women and 72.3% of babies for those who received poor quality ANC. In conclusion, the complications of pre-eclampsia and eclampsia could be prevented by wide spread use of adequate antenatal care, education and training of primary medical care personnel, prompt diagnosis of high risk patients and timely referral to higher level health care.
RESUMO
Pregnancy is a period at which a woman's health is placed at risk. However, health care professionals providing antenatal care (ANC) can reduce that risk by monitoring women' health regularly arid offering both preventive and curative services. Worldwide, an estimated 515,000 women die of pregnancy-related causes, a rate of over 1,400 maternal deaths each year. The overwhelming majority of these deaths and complications occur in developing countries. Effective ANC, appropriate emergency treatment of complications and competent referral level encompass the most effective answers to reduction of maternal deaths. Data related to rural/urban difference concerning knowledge, attitudes and practices of women towards ANC in Alexandria are lacking. The present study is aimed at comparing knowledge, attitudes and practices towards ANC between rural and urban women in Alexandria and also, to identify certain related factors. A cross-sectional, community- based house-to-house survey was conducted in Alexandria using cluster-sampling technique (30 clusters from urban areas and30 clusters from rural areas). Each cluster consisted of 5 women who had given birth within the last 2 years preceding the survey. Urban women had a higher mean total score for their knowledge on ANC than their counterparts of rural women, with a statistical significant difference (11.23 +/- 2.91 and 6.59 +/- 4.14, respectively and Z = 9.73, P < 0.001). Also, Urban women had a significantly higher mean total score for their attitudes towards ANC compared to the rural women (10.66 +/- 2.33 versus 8.55 +/- 2.39, P < 0.001). Concerning maternal practices, the current study revealed rural/urban disparities as significantly higher proportions of urban women had proper practices during antenatal period in their last pregnancy as regards utilization, earlier initiation and frequent visits of antenatal care. On the other hand, nearly half of urban women (45.3%) had not been vaccinated during their last pregnancy compared to only 24.7% of rural ones, (P < 0.001).
