Health coaching for hypertension control in primary care patients with uncontrolled hypertension in Egypt.

BACKGROUND: Health coaching effectively improves hypertension self-care activities and the control of blood pressure (BP) in hypertensive patients. Studies on the effects of health coaching on patients in primary care with uncontrolled hypertension in developing countries are limited. In this study, the effectiveness of health coaching on hypertension self-care and BP control was assessed in patients who have uncontrolled hypertension compared to standard care in Egypt. MATERIALS AND METHODS: Our quasi-experimental study included control and intervention groups. The intervention group included 70 participants who received health coaching sessions (face-to-face and by telephone) besides the standard care, whereas the control group included 71 participants who only received the standard care. The study was conducted between July 2020 and November 2021. The participants were recruited from three primary healthcare settings in the Port Said Governorate. Personal and medical history, BP measurements, and hypertension self-care activity level effects (H-SCALE) were obtained. Paired-t-test was used to assess the changes in BP measurement, and H-SCALE score before and after receiving the health coaching. McNemar's test was used to assess changes in controlled BP and optimal hypertension self-care activities between control and health coached groups. Multiple logistic regression analysis assessed the predictors of better BP control. RESULTS: Health coaching resulted in more controlled BP (51.4%, P < 0.001) compared to the delivery of only usual care (11.3%, P = 0.008). The intervention showed a significant promotion in hypertension self-care activities, including medication usage (P < 0.001), low-salt diet (P < 0.001), and weight management (P < 0.001). The H-SCALE score mean change was the only predictor for BP control (odds ratio 1.057, P = 0.048) in the intervention group after 6 months. CONCLUSION: Intervention including traditional health coaching and phone calls is a beneficial modality for the promotion of hypertension self-care and improvement of BP control in primary care patients with uncontrolled hypertension.

Illness perception, medication adherence and glycemic control among primary health-care patients with type 2 diabetes mellitus at Port Said City, Egypt.

Aims: Despite the availability of a wide selection of antidiabetic treatments, many patients with type 2 diabetes mellitus (T2DM) still do not have controlled glucose levels. This study aimed to assess illness perception, medication adherence, and glycemic control among primary care attendees with T2DM. Methods: A cross-sectional study was conducted between July 2019 and November 2020. A random sample of 265 Egyptian T2DM patients were enrolled from primary health-care settings in Port Said, Egypt. Data on socio-demographic characteristics, lifestyle habits, and diabetic medical history were collected using a semi-structured questionnaire. The Brief Illness Perception Questionnaire (B-IPQ) was used to assess diabetes perception, whereas the 8-item Morisky Medication Adherence Scale (MMAS-8) was used to investigate medication adherence. Results: There was a significant difference in B-IPQ scores between different groups of the patients in terms of diabetic medications, complications, and glycemic control (p < 0.05). There was a significant difference in MMAS-8 score found between different groups of the patients in terms of disease duration, family history of T2DM, and glycemic control (p < 0.05). Further, there was a significant difference in HbA1c score found between different groups of patients in terms of disease duration, medications, complications, and family history of T2DM (p < 0.05). Higher BMI, a positive family history of T2DM, patients who take insulin, high illness perception, and poor medication adherence were the factors associated with higher HbA1c level. Conclusion: Higher HbA1c levels were linked to a higher BMI, a positive family history of T2DM, insulin users, high illness perception, and poor medication adherence.

Association of anxiety-depressive disorders with irritable bowel syndrome among patients attending a rural family practice center: a comparative cross-sectional study.

BACKGROUND: Comorbidity of irritable bowel syndrome (IBS) and psychiatric disorders is common, and the prevalence of at least one psychiatric disorder has been reported as high as 80% among patients with IBS. AIMS: To explore the association of anxiety-depressive disorders with IBS and its different subtypes, and to evaluate the associations of lifestyle habits, dietary habits and sleeping quality with IBS. METHODS: A comparative cross-sectional study was conducted at the AL-Mahsama Family Practice Center, Ismailia, Egypt. It was carried out between October 2019 and October 2020. Participants were categorised into 175 patients with IBS, diagnosed using the Rome IV criteria, and 175 patients without IBS. A semistructured questionnaire was used to collect data on sociodemographic characteristics, lifestyle habits, dietary habits and sleep quality from both groups. The Hamilton Anxiety Rating Scale was used to assess anxiety symptoms, whereas the Beck Depression Inventory Second Edition was used to assess depression symptoms. RESULTS: There was a high statistically significant difference between both groups with regard to age, education, occupation and socioeconomic status (SES), being a smoker, being physically inactive, having sleep disturbance and having irregular meals; being either obese or overweight was more reported in the IBS group. There was a high statistically significant difference in the rate of anxiety and depression between patients with and without IBS. Mild, moderate and severe anxiety were reported in 37.1%, 42.9% and 20.0% of patients with IBS while most (80.0%) of the patients without IBS reported mild anxiety. Regarding depression, mild, moderate and severe depression were reported in 60.0%, 14.3% and 25.7% of the patients with IBS while most (82.9%) of the non-IBS participants reported mild depression. CONCLUSIONS: The study shows a significant association between anxiety-depressive disorders and IBS, but no significant associations between anxiety-depressive disorders and IBS subtypes.

Quality of life and family function of parents of children with attention deficit hyperactivity disorder.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is a common paediatric neurodevelopmental disorder, with serious impacts on individuals, families and communities. It is associated with cognitive, behavioural, emotional, social and developmental disturbances and impaired academic achievement. AIMS: To describe quality of life (QOL) of parents of ADHD children and family function. To determine the relationship between QOL, family function and sociodemographic characteristics. METHODS: This was a cross-sectional study of 125 parents of children with any type of ADHD who were selected by systematic random sampling. The study was conducted between May and December 2015 in the Outpatient Family Medicine Clinic at Suez Canal University Hospital. The World Health Organization Quality of Life-Brief (WHOQOL-BREF) and Adaptability, Participation, Growth, Affection, Resolution (APGAR) questionnaires were used for data collection. RESULTS: Median physical, psychological and social domain scores were 12, and mean environmental domain score was 11.9. The median scores of perception of health and QOL of the parents were 3.0. Most of the families (79.2%) were dysfunctional. Statistically significant relationships were found between all domains and education; physical scores of QOL and gender, employment and income; psychological scores of QOL and residence; environmental scores of QOL and age, income and marital status. Dysfunctional families were likely to be affected by age, gender, physical and psychological domain scores of QOL of parents. CONCLUSIONS: Parents of children with ADHD had average QOL. Most parents had dysfunctional families. Future family intervention studies are recommended.

Statistical methods and errors in family medicine articles between 2010 and 2014-Suez Canal University, Egypt: A cross-sectional study.

BACKGROUND: With limited statistical knowledge of most physicians it is not uncommon to find statistical errors in research articles. OBJECTIVES: To determine the statistical methods and to assess the statistical errors in family medicine (FM) research articles that were published between 2010 and 2014. METHODS: This was a cross-sectional study. All 66 FM research articles that were published over 5 years by FM authors with affiliation to Suez Canal University were screened by the researcher between May and August 2015. Types and frequencies of statistical methods were reviewed in all 66 FM articles. All 60 articles with identified inferential statistics were examined for statistical errors and deficiencies. A comprehensive 58-item checklist based on statistical guidelines was used to evaluate the statistical quality of FM articles. RESULTS: Inferential methods were recorded in 62/66 (93.9%) of FM articles. Advanced analyses were used in 29/66 (43.9%). Contingency tables 38/66 (57.6%), regression (logistic, linear) 26/66 (39.4%), and t-test 17/66 (25.8%) were the most commonly used inferential tests. Within 60 FM articles with identified inferential statistics, no prior sample size 19/60 (31.7%), application of wrong statistical tests 17/60 (28.3%), incomplete documentation of statistics 59/60 (98.3%), reporting P value without test statistics 32/60 (53.3%), no reporting confidence interval with effect size measures 12/60 (20.0%), use of mean (standard deviation) to describe ordinal/nonnormal data 8/60 (13.3%), and errors related to interpretation were mainly for conclusions without support by the study data 5/60 (8.3%). CONCLUSION: Inferential statistics were used in the majority of FM articles. Data analysis and reporting statistics are areas for improvement in FM research articles.

Master's and doctoral theses in family medicine and their publication output, Suez Canal University, Egypt.

BACKGROUND: The completion of a thesis is a significant requirement for both a Master's and a doctorate degree in general practice/family medicine (GP/FM). A postgraduate thesis is a well-planned, time-intensive activity carried out over several years. The quality of the theses can be judged by the proportion of published papers. OBJECTIVE: This study aimed to describe Master's and doctoral theses in family medicine and their publications between 1982 and 2014. MATERIALS AND METHODS: GP/FM degree theses were reviewed at the Faculty of Medicine and central Suez Canal libraries. Several characteristics were extracted from each thesis relating to the main researcher, supervisors, themes, and study methods according to predefined criteria. Publications from the theses were described. RESULTS: Over 33 years, 208 theses were completed by 173 GP/FM researchers. The majority of the theses were for Master's degrees (84.1%). Regarding the study design, most of the degree theses were cross-sectional studies (76.9%). The adult population was targeted in 33.7% of research theses. Nonprobability sampling was used in 51%. Rural communities were the setting of research in 43.8%, and primary health center (PHC)-based studies in 59.1%. The "Patient" category exceeded the other categories (28.4%). Publication from theses started in the second decade of research production. Of the degree theses, 21.6% original articles were published. Only 13.3% of articles from theses were published in PubMed-indexed journals. The researcher was first author in 62.2% of published articles. CONCLUSION: The production of GP/FM theses and their publications are going to increase. Continuous assessment and planning for GP/FM studies are recommended.

The effect of lifestyle modification on severity of constipation and quality of life of elders in nursing homes at Ismailia city, Egypt.

BACKGROUND: Constipation has a significant impact on the quality of life (QOL). Lifestyle modification is widely accepted and recommended by experts as first-line therapy. AIM: This study aimed at using education on lifestyle modification to improve the QOL of the elderly in nursing homes suffering from functional constipation (FC). MATERIALS AND METHODS: This study was conducted in nursing homes in Ismailia city, Egypt. It involved 23 elderly patients suffering from FC, who were randomly selected according to the sample equation. They fulfilled the inclusion criteria of being ≥60 years age and according to Rome II criteria. Participants completed personal characteristics and lifestyle questionnaire, the Patient Assessment of Constipation Symptom questionnaire (PAC-SYM) to assess the severity of symptoms, and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL) to assess pre- and post-intervention. The intervention was conducted in three sessions, of 30 min each, 2 weeks apart using group discussions to educate the sample about dietary pattern, fluid intake, regular physical activity, and the use of laxatives. STATISTICAL ANALYSIS: Data were analyzed using a statistical package for social sciences (SPSS version 20). RESULTS: The lifestyle modification education on constipation significantly reduced the severity of symptoms as measured by PAC-SYM, including its total score and subscores (P < 0.001). It also improved the QOL of elderly suffering from constipation as measured by PAC-QOL and reduced total scores of dissatisfaction (P = 0.001) with the exception of the psychosocial subscale. It also significantly increased the satisfaction subscale of PAC-SYM (P < 0.001). CONCLUSION: Education on lifestyle modification leads to an improvement in the severity of the symptoms of constipation and the QOL of the elderly in nursing homes.

Research publications in medical journals (1992-2013) by family medicine authors - suez canal university-egypt.

BACKGROUND: Research in family medicine (FM) provides an important contribution to its discipline. Family medicine research can contribute to many areas of primary care, ranging from the early diagnosis to equitable health care. Publication productivity is important in academic settings as a marker for career advancement. OBJECTIVE: To describe the publications by family medicine researcher authors between 1992 and 2013. MATERIALS AND METHODS: All full text, original articles published by family medicine researcher; author with affiliation to the Suez Canal University were collected using the internet and hand search. The journals that published for family medicine researcher authors were identified. Author characteristics were described. The trend of publications was described. All articles were analyzed for their characteristics, including the themes and study designs according to predefined criteria. RESULTS: Along 22 years, 149 research articles were published by 48 family medicine authors in 39 medical journals. The largest category in publications was related to Family physician/Health service (FP-HS, n = 52 articles), followed by 'Patient' category (n = 42). All the studies were quantitative; the largest group was represented by cross-sectional studies (76.5%). CONCLUSIONS: The publication productivity by family medicine researchers are going to be increased. FP-HS and patient topics were mostly addressed in publications. Cross-sectional studies exceeded any other designs. There is need to put more emphasis on intervention studies. Continuous assessment and improvement of FM research production and publication is recommended.

Global Cardiovascular Risk Assessment by Family Physicians in Suez Canal University-Family Medicine Centers-Egypt.

BACKGROUND: The close sustained contact of family physician with their patients and local community makes preventive care an integral part of their routine work. Most cardiovascular diseases (CVD) can be prevented by addressing their risk factors. There are several guidelines that recommend different CV risk assessment tools to support CV prevention strategies. AIM: This study aimed to assess awareness and attitude of global CV risk assessment and use of their tools by family physicians; aiming to improve CV prevention service. METHODS: The current study is a cross-sectional descriptive analytic. Sixty-five family physicians were asked to respond to, validated anonymous questionnaire to collect data about characteristics of family physicians, their awareness, attitude, current use, barriers, and recommendations of global CV risk assessment. Statistical Package for Social Sciences (SPSS) version 18 was used for data entry and analysis. RESULTS: Awareness of guidelines of global CV risk assessment was relatively higher regarding the American guidelines (30.8%) than that recommended by World Health Organization (WHO) for Egypt (20.2%). 50.8% of participants had favorable attitude. There was statistical significant relationship between attitude scores and physician characteristics; age (P = 0.003), qualification (P = 0.001) and number of patients seen per week (P = 0.009). Routine use of global CV risk assessment tools was reported only (23%) by family physicians. CONCLUSION: Relative higher attitude scores than use of global CV risk assessment tools in practice. The most frequent barriers were related to lack of resources and shortage in training/skills and the raised suggestions were towards training.