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Arafa A, Negida A, Elsheikh M, Emadeldin M, Hegazi H, Senosy S. Defensive medicine practices as a result of malpractice claims and workplace physical violence: a cross-sectional study from Egypt. Sci Rep 2023; 13:22371. [PMID: 38102200 PMCID: PMC10724153 DOI: 10.1038/s41598-023-47720-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023] Open
Abstract
Defensive medicine refers to practices motivated mainly by legal rather than medical purposes. Increased healthcare costs, overutilization of medical services, and potential harm to patients from unnecessary procedures are among its drawbacks. We performed this study to assess the prevalence of defensive medicine practices in Egypt and their associations with experiencing malpractice claims and workplace physical violence. We investigated 1797 physicians (68.1% male), with an average age of 36.8 ± 9.1 years, practicing in Egypt between January 14th and February 23rd, 2023. SPSS was used for statistical analysis. The majority reported engaging in defensive medicine practices. Specifically, 89.6% acknowledged avoiding high-risk procedures, 87.8% refrained from treating high-risk patients, 86.8% admitted to making unnecessary referrals, 84.9% acknowledged ordering unnecessary tests, 61.4% reported performing unnecessary procedures, and 56.4% disclosed prescribing unnecessary medications. Obstetricians and surgeons exhibited the highest rates of defensive medicine. Using linear regression analysis adjusted for age and sex, malpractice claims and workplace physical violence were associated with defensive medicine score (zero-100): βs (95% CIs) = 5.05 (3.10, 6.99) and 5.60 (3.50, 7.71), respectively, (p values < 0.001). In conclusion, defensive medicine is deeply ingrained in the clinical routines of Egyptian physicians. Establishing a comprehensive national medical liability framework is required.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Ahmed Negida
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Elsheikh
- Department of Health Informatics, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
- Department of Emergency Medicine and Traumatology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Emadeldin
- Department of Urology, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Hesham Hegazi
- Wirral University Teaching Hospital NHS Foundation Trust, Wirral, UK
| | - Shaimaa Senosy
- Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Zimba O, Gasparyan AY. Designing, Conducting, and Reporting Survey Studies: A Primer for Researchers. J Korean Med Sci 2023; 38:e403. [PMID: 38084027 PMCID: PMC10713437 DOI: 10.3346/jkms.2023.38.e403] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 11/14/2023] [Indexed: 12/18/2023] Open
Abstract
Survey studies have become instrumental in contributing to the evidence accumulation in rapidly developing medical disciplines such as medical education, public health, and nursing. The global medical community has seen an upsurge of surveys covering the experience and perceptions of health specialists, patients, and public representatives in the peri-pandemic coronavirus disease 2019 period. Currently, surveys can play a central role in increasing research activities in non-mainstream science countries where limited research funding and other barriers hinder science growth. Planning surveys starts with overviewing related reviews and other publications which may help to design questionnaires with comprehensive coverage of all related points. The validity and reliability of questionnaires rely on input from experts and potential responders who may suggest pertinent revisions to prepare forms with attractive designs, easily understandable questions, and correctly ordered points that appeal to target respondents. Currently available numerous online platforms such as Google Forms and Survey Monkey enable moderating online surveys and collecting responses from a large number of responders. Online surveys benefit from disseminating questionnaires via social media and other online platforms which facilitate the survey internationalization and participation of large groups of responders. Survey reporting can be arranged in line with related recommendations and reporting standards all of which have their strengths and limitations. The current article overviews available recommendations and presents pointers on designing, conducting, and reporting surveys.
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Affiliation(s)
- Olena Zimba
- Department of Clinical Rheumatology and Immunology, University Hospital in Krakow, Krakow, Poland
- National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
- Department of Internal Medicine N2, Danylo Halytsky Lviv National Medical University, Lviv, Ukraine.
| | - Armen Yuri Gasparyan
- Departments of Rheumatology and Research and Development, Dudley Group NHS Foundation Trust (Teaching Trust of the University of Birmingham, UK), Russells Hall Hospital, Dudley, UK
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Asokan N. Community Dermatology: Current Status and the Way Forward. Indian Dermatol Online J 2023; 14:762-768. [PMID: 38099039 PMCID: PMC10718120 DOI: 10.4103/idoj.idoj_497_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/02/2022] [Accepted: 12/13/2022] [Indexed: 12/17/2023] Open
Abstract
Community health interventions in dermatology have the potential to deliver healthcare to large populations. Such interventions can bridge the gap between increasing demands from vast populations and limited availability and asymmetric geographical distribution of specialist doctors. This narrative review aims to delineate various areas in which community dermatology initiatives are useful, the different approaches used, and the factors which could determine their effectiveness. We did a PubMed search using the search terms, "Community Health Services"[Mesh]) AND "Dermatology"[Mesh]. A further literature search was performed by cross-referencing these articles. In addition to its primary purpose of increasing access, community involvement can augment medical education, foster research, and help to develop more patient-centered clinical guidelines, understand disease trends and influences of the environment on various diseases, and formulate population-centered health policy. Task shifting, development of culture-sensitive and gender-sensitive community healthcare teams, disease-specific patient support groups, and use of advances in technology such as telemedicine are some of the important methods used in community dermatology. Task shifting may be performed at different levels - general practitioners, pharmacists, nurses, and community health workers. Community interventions harness volunteerism among health professionals as well as various stakeholders in the community. Partnering with non-governmental organizations, involving members of the community, and being a part of a long-term public health program help to sustain community interventions. The interventions should adapt to the ethical and cultural norms of the community. Continuity of care, fidelity, and evidence support are crucial for the success of community interventions in dermatology.
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Affiliation(s)
- Neelakandhan Asokan
- Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India
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Makhmudova U, Wolf M, Willfeld K, Beier L, Weingärtner O. [Primary and secondary prevention in hypercholesterolemia: differences relevant to patient care in the PROCYON trial]. Dtsch Med Wochenschr 2023; 148:e101-e110. [PMID: 37604168 PMCID: PMC10946085 DOI: 10.1055/a-2117-6504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
BACKGROUND Cardiovascular disease accounts for one third of deaths in Germany. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are considered a major risk factor. Lowering LDL-C levels is therefore an integral part of the prevention of cardiovascular events. METHODS The aim of this work is to identify potential differences between primary prevention (PP) and secondary prevention (SP) by means of a post-hoc comparison of cross-sectional data from the PROCYON survey. Medical history, concomitant diseases, adherence, and disease awareness in relation to hypercholesterolemia were queried. RESULTS 5,494 patients had participated in the survey (PP: 3,798; SP: 1,696). Comparison of the results showed a numerically higher proportion of women (PP 70.7% vs. SP 42.5%) as well as more frequent comorbidities such as hypertension (PP 45.6% vs. SP 61.0%), obesity (PP 20.9% vs. SP 27.4%), and type 2 diabetes mellitus (PP 14.1% vs. SP 23.8%). In primary prevention, hypercholesterolemia was most often diagnosed during screening (PP 74.6%), and in secondary prevention, the diagnosis was most often made during cardiovascular-related hospitalization (SP 58.0%). A cardiologist was consulted by 16.3% (PP) and 54.0% (SP) of patients, respectively. At least semiannual LDL-C checks (PP 46.8% vs. SP 77.9%) and drug intervention (PP 43.0% vs. SP 87.0%) were more frequent in the secondary prevention group. In addition, differences in the implementation of lifestyle changes, improvement of LDL-C levels, adjustment of therapy as well as adherence, treatment satisfaction and patient knowledge were observed. CONCLUSION The comparison of primary and secondary prevention from the PROCYON survey shows overall better utilization of treatment options and higher intensity of care in the secondary prevention group. However, there is still great potential for improvement in both groups to ensure efficient prevention of cardiovascular events.
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Affiliation(s)
| | - Michaela Wolf
- Cholesterin & Co e. V.: Patientenorganisation für Patienten mit Familiärer Hypercholesterinämie oder anderen schweren genetischen Fettstoffwechselstörungen (CholCo e. V.), Frankfurt/M
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Sáenz-Ravello G, Matamala L, Cisternas P, Gamonal J, Hernández P, Santos NCD, Deng K, Baeza M. Association between the Mediterranean Diet Index and self-reported Gingival Health Status Indicators in a population of Chilean adults: a cross-sectional study. J Appl Oral Sci 2023; 31:e20230100. [PMID: 37403879 DOI: 10.1590/1678-7757-2023-0100] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/30/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Despite the recognized impact of diet on non-communicable diseases, the association between the Mediterranean diet and periodontal diseases is still uncertain. This study aimed to determine the association between adherence to the Mediterranean Diet Index (MDI) and self-reported gingival health status in Chilean adults, exploring the feasibility of using validated web-based survey questionnaires. METHODOLOGY Cross-sectional data were collected from a representative sample of a population of Chilean adults (18-60 years old) using a low-cost and time-saving methodology. By the PsyToolkit platform, anonymous survey data were downloaded and analyzed in bivariate (crude) and backward stepwise selection multivariate logistic regression models adjusted for sociodemographic determinants, smoking, and dental attendance using STATA 17. Odds ratios (OR) [95% confidence intervals] were estimated. RESULTS In total, 351 complete statistical data were mostly obtained from female university students who had never smoked and reported having visited a dentist in the previous year. Multivariate regression models showed an association between MDI and very good/good gingival health status (OR 1.18 [95% CI 1.04-1.34], p=0.013), absence of bleeding on toothbrushing (OR 1.12 [95% CI 1.01-1.25], p=0.035), and absence of clinical signs of gingival inflammation (OR 1.24 [95% CI 1.10-1.40], p<0.001), after controlling for age, sex, educational level, smoking, and dental attendance. CONCLUSIONS We associated adherence to the Mediterranean diet with better self-reported gingival health status in a population of Chilean adults in an entirely web-based research environment. Longitudinal studies with random sampling are required to establish the effect of diet on gingival and periodontal health. Nevertheless, this evidence could contribute to the design of low-cost surveillance programs to reduce the burden of periodontal disease and related "common risk factors".
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Affiliation(s)
- Gustavo Sáenz-Ravello
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Loreto Matamala
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | | | - Jorge Gamonal
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Patricia Hernández
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
| | - Nidia Castro Dos Santos
- Universidade Guarulhos, Divisão de Pesquisa Odontológica, Guarulhos, SP, Brasil
- The Forsyth Institute, Cambridge, MA, United States
| | - Ke Deng
- The University of Hong Kong, Faculty of Dentistry, Division of Periodontology and Implant Dentistry, Hong Kong SAR, China
| | - Mauricio Baeza
- Universidad de Chile, Facultad de Odontología, Centro de Epidemiologia y Vigilancia de las Enfermedades Orales (CEVEO), Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Departmento de Odontología Conservadora, Santiago, Chile
- Universidad de Chile, Facultad de Odontología, Santiago, Chile
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Sheerah HA, Almuzaini Y, Khan A. Public Health Challenges in Saudi Arabia during the COVID-19 Pandemic: A Literature Review. Healthcare (Basel) 2023; 11:1757. [PMID: 37372875 DOI: 10.3390/healthcare11121757] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023] Open
Abstract
Similar to most countries, Saudi Arabia faced several challenges during the novel coronavirus disease 2019 (COVID-19) pandemic, some of which were related to the religious position of the country. The main challenges included deficits in knowledge, attitudes, and practices toward COVID-19, the negative psychological impacts of the pandemic on the general population and healthcare workers, vaccine hesitancy, the management of religious mass gatherings (e.g., Hajj and Umrah), and the imposition of travel regulations. In this article, we discuss these challenges based on evidence from studies involving Saudi Arabian populations. We outline the measures through which the Saudi authorities managed to minimize the negative impacts of these challenges in the context of international health regulations and recommendations.
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Affiliation(s)
- Haytham A Sheerah
- International Collaborations, Ministry of Health, Riyadh 11176, Saudi Arabia
| | - Yasir Almuzaini
- Public Health Authority, Riyadh 13351, Saudi Arabia
- Department of Public Health, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam 31445, Saudi Arabia
| | - Anas Khan
- Global Center for Mass Gatherings Medicine, Ministry of Health, Riyadh 11176, Saudi Arabia
- Department of Emergency Medicine, College of Medicine, King Saud University, Riyadh 12372, Saudi Arabia
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Christ M, Schuh K, Bayas A. Large-scale cross-sectional online survey on patient-neurologist communication, burden of disease assessment and disease monitoring in people with multiple sclerosis. Front Neurol 2023; 13:1093352. [PMID: 36686532 PMCID: PMC9848394 DOI: 10.3389/fneur.2022.1093352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background Management of multiple sclerosis (MS) requires a high level of communication between health care professionals (HCPs) and people with MS (pwMS) including profound investigation and discussion of symptoms to identify therapeutic needs. For treatment decisions, monitoring of disease activity is important, in this respect self-monitoring devices and apps, as well as magnetic resonance imaging are important tools. Methods MS Perspectives is a cross-sectional online survey conducted in Germany which was designed to collect data, among others, on the communication between pwMS and HCPs regarding treatment goals, symptom assessment, usage of devices and apps to self-monitor health functions, as well as to identify patients' attitude toward the role of magnetic resonance imaging (MRI). Between December 2021 and February 2022, 4,555 pwMS completed the survey. Results In total, 63.7% of participants reported that treatment goals have been discussed with their HCPs. Symptoms worsening in the past 12 months independent of relapses was more often reported by pwMS than inquired by HCPs, according to patients' report. Devices or apps for health monitoring were used by less than half of participants. Frequency of MRI controls was much lower in participants with longer compared to shorter disease duration (47.5 vs. 86.3%). The proportion of patients with annual or semiannual scans was highest among pwMS receiving infusion therapy (93.5%), followed by oral medication (82.5%) and injectables (73.4%), and lowest for pwMS without immunotherapy (58.2%). Conclusion MS Perspectives identified a rather low patient involvement regarding treatment goals and symptom assessment in clinical practice. Regarding this and our findings for health self-monitoring and MRI usage, strategies for improving patient-HCP communication and disease monitoring may be considered.
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Affiliation(s)
- Monika Christ
- Department of Neurology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | | | - Antonios Bayas
- Department of Neurology, Faculty of Medicine, University of Augsburg, Augsburg, Germany,*Correspondence: Antonios Bayas ✉
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Makhmudova U, Wolf M, Willfeld K, Beier L, Weingärtner O. Different Perspectives of Patients and Physicians on LDL-C Target Achievement in the Treatment of Hypercholesterolemia: Results on Secondary Prevention from the German PROCYON Survey. Adv Ther 2023; 40:460-473. [PMID: 36355313 PMCID: PMC9898401 DOI: 10.1007/s12325-022-02357-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 10/12/2022] [Indexed: 11/12/2022]
Abstract
AIMS Low-density lipoprotein cholesterol (LDL-C) reduction in hypercholesterolemia patients at very high cardiovascular (CV) risk is essential in preventing future CV events. The objective was to assess the perception on hypercholesterolemia management in secondary prevention in Germany. METHODS PROCYON was a two-part online survey, including a patient questionnaire as well as a physician questionnaire. RESULTS A total of 109 general practitioners, internists, and cardiologists participated. The current ESC/EAS recommendation for high-risk patients is followed by 19.3% of the physicians. The majority (80.7%) reported an LDL-C target failure rate of at least 30%. More than two thirds (71.6%) have stated treating less than half of their patients with the maximum approved statin dose. The survey included 1696 secondary prevention patients. The majority (86.7%) consult their general practitioner for hypercholesterolemia; 54.0% consult a cardiologist (multiple answers allowed). Most patients (87.0%) were receiving lipid-lowering medication. Among these, 800 (54.2%) reported improved LDL-C levels since diagnosis, 569 (38.6%) reported no improvement, and 106 (7.2%) had no information. Of the treated patients with (N' = 800) and without (N' = 569) improvement, 34.3% vs. 37.3% were on their initial drug and dose, 24.8% vs. 23.7% received multiple drug therapy, 48.9% vs. 48.9% reported a dose change, and 16.1% vs. 14.2% had discontinued at least one drug (multiple answers). Disease knowledge was rated as good or very good by 29.8% of patients. CONCLUSION PROCYON demonstrated insufficient ESC/EAS guideline implementation regarding target levels and therapeutic escalation strategies. Furthermore, a lack of specialist involvement and patient education was identified.
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Affiliation(s)
- Umidakhon Makhmudova
- grid.275559.90000 0000 8517 6224Klinik Für Innere Medizin I, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Michaela Wolf
- Cholesterin & Co E. V.: Patientenorganisation Für Patienten Mit Familiärer Hypercholesterinämie Oder Anderen Schweren Genetischen Fettstoffwechselstörungen (CholCo), Frankfurt/M., Germany
| | - Kathy Willfeld
- grid.467675.10000 0004 0629 4302Novartis Pharma GmbH, Nuremberg, Germany
| | - Lea Beier
- grid.467675.10000 0004 0629 4302Novartis Pharma GmbH, Nuremberg, Germany
| | - Oliver Weingärtner
- Klinik Für Innere Medizin I, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Germany.
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mHealth App Barriers, Usability, and Personalization: A Cross-Sectional Study from Egypt and Saudi Arabia. J Pers Med 2022; 12:jpm12122038. [PMID: 36556257 PMCID: PMC9786142 DOI: 10.3390/jpm12122038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Mobile health (mHealth) has emerged as a substantial segment of eHealth. Herein, we conducted a cross-sectional study to investigate mHealth app barriers, usability, and personalization in Egypt and Saudi Arabia. We used a Google survey to recruit participants from both countries between the 15th of September and the 15th of October 2022. Among 299 participants (247 from Egypt and 52 from Saudi Arabia), aged ≥ 18 years, 27.4% reported mHealth app use. In the age-, sex-, and country-adjusted regression models, age > 25 years: OR (95% CI) = 1.98 (1.11, 3.54), residing in Saudi Arabia: OR (95% CI) = 4.33 (2.22, 8.48), and physical activity: OR (95% CI) = 2.53 (1.44, 4.44) were associated with mHealth app use. The main mHealth app purposes were lifestyle promotion (35.4%), diet and nutrition (30.5%), and administrative services (13.4%). On a scale from 20 to 100, mHealth app usability scores were 46.3% (20−40), 7.3% (41−60), 31.7% (61−80), and 14.7% (81−100). According to 93.9% of users, mHealth app features were modifiable to meet personal health goals, while 37% stated that mHealth apps helped them set new personal health goals. In conclusion, age, residing in Saudi Arabia (compared to Egypt), and physical activity were positively associated with mHealth app use. mHealth app feature personalization and helping users set new personal health goals were largely reported, suggesting that mHealth has the potential to help put personalized healthcare into practice.
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Bayas A, Schuh K, Christ M. Self-assessment of people with relapsing-remitting and progressive multiple sclerosis towards burden of disease, progression, and treatment utilization-Results of a large-scale cross-sectional online survey (MS Perspectives). Mult Scler Relat Disord 2022; 68:104166. [PMID: 36115289 DOI: 10.1016/j.msard.2022.104166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 08/13/2022] [Accepted: 09/06/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Assessment of the disease course by people with multiple sclerosis (pwMS) themselves is important for a better understanding of the complex disease, patient counseling and treatment decisions. This may also facilitate identifying the often-unnoticed transition from relapsing-remitting (RRMS) to secondary progressive multiple sclerosis (SPMS). OBJECTIVE MS Perspectives was designed to collect data on patients' self-assessment of multiple sclerosis (MS) symptoms, relapse-independent progression, and impact on everyday life. METHODS MS Perspectives is a cross-sectional online survey conducted among adult pwMS in Germany. The questionnaire included 36 items on sociodemographic and clinical characteristics as well as pharmacological and non-pharmacological treatment. RESULTS In total, 4555 pwMS completed the survey between December 2021 and February 2022, 69.2% had RRMS, 15.1% had SPMS. Relapse-independent worsening of symptoms was reported by 88.9% of RRMS patients with marked to severe and by 61.8% with no or mild to moderate disability. Problems with walking were most frequently (32.1%) mentioned as most bothersome by RRMS patients with marked to severe disability, fatigue, and cognitive impairment by RRMS patients with no or mild to moderate disability. CONCLUSION MS Perspectives gives an important insight in the self-assessed disease course and impact on daily life in a large-scale cohort of pwMS.
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Affiliation(s)
- A Bayas
- Department of Neurology, Faculty of Medicine, University of Augsburg, Augsburg, Germany.
| | - K Schuh
- Novartis Pharma GmbH, Nuremberg, Germany
| | - M Christ
- Department of Neurology, Faculty of Medicine, University of Augsburg, Augsburg, Germany
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Peck GM, Roberson FA, Feldman SR. Reasons for Visits to the Dermatologist Stratified by Race. South Med J 2022; 115:780-783. [DOI: 10.14423/smj.0000000000001448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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12
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Page SD, Lee C, Aryal S, Freedland K, Stromberg A, Vellone E, Westland H, Wiebe DJ, Jaarsma T, Riegel B. Development and testing of an instrument to measure contextual factors influencing self-care decisions among adults with chronic illness. Health Qual Life Outcomes 2022; 20:83. [PMID: 35606792 PMCID: PMC9125861 DOI: 10.1186/s12955-022-01990-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
Background Decisions about how to manage bothersome symptoms of chronic illness are complex and influenced by factors related to the patient, their illness, and their environment. Naturalistic decision-making describes decision-making when conditions are dynamically evolving, and the decision maker may be uncertain because the situation is ambiguous and missing information. Contextual factors, including time stress, the perception of high stakes, and input from others may facilitate or complicate decisions about the self-care of symptoms. There is no valid instrument to measure these contextual factors. The purpose of this study was to develop and test a self-report instrument measuring the contextual factors that influence self-care decisions about symptoms. Methods Items were drafted from the literature and refined with patient input. Content validity of the instrument was evaluated using a Delphi survey of expert clinicians and researchers, and cognitive interviews with adults with chronic illness. Psychometric testing included exploratory factor analysis to test dimensionality, item response theory-based approaches for item recalibration, confirmatory factor analysis to generate factor determinacy scores, and evaluation of construct validity. Results Ten contextual factors influencing decision-making were identified and multiple items per factor were generated. Items were refined based on cognitive interviews with five adults with chronic illness. After a two round Delphi survey of expert clinicians (n = 12) all items had a content validity index of > 0.78. Five additional adults with chronic illness endorsed the relevance, comprehensiveness, and comprehensibility of the inventory during cognitive interviews. Initial psychometric testing (n = 431) revealed a 6-factor multidimensional structure that was further refined for precision, and high multidimensional reliability (0.864). In construct validity testing, there were modest associations with some scales of the Melbourne Decision Making Questionnaire and the Self-Care of Chronic Illness Inventory.
Conclusion The Self-Care Decisions Inventory is a 27-item self-report instrument that measures the extent to which contextual factors influence decisions about symptoms of chronic illness. The six scales (external, urgency, uncertainty, cognitive/affective, waiting/cue competition, and concealment) reflect naturalistic decision making, have excellent content validity, and demonstrate high multidimensional reliability. Additional testing of the instrument is needed to evaluate clinical utility. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-022-01990-2.
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Affiliation(s)
| | - Christopher Lee
- Boston College William F. Connell School of Nursing, Chestnut Hill, MA, US.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Subhash Aryal
- University of Pennsylvania School of Nursing, Philadelphia, PA, US
| | | | - Anna Stromberg
- Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden
| | | | | | - Douglas J Wiebe
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, US
| | - Tiny Jaarsma
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.,Department of Health, Medicine and Caring Sciences, Linkoping University, Linkoping, Sweden.,University Medical Center Utrecht, Utrecht, the Netherlands
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, PA, US.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Luciani M, De Maria M, Page SD, Barbaranelli C, Ausili D, Riegel B. Measuring self-care in the general adult population: development and psychometric testing of the Self-Care Inventory. BMC Public Health 2022; 22:598. [PMID: 35346104 PMCID: PMC8960109 DOI: 10.1186/s12889-022-12913-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 02/28/2022] [Indexed: 11/16/2022] Open
Abstract
Background Self-care is important at all stages of life and health status to promote well-being, prevent disease, and improve health outcomes. Currently, there is a need to better conceptualize self-care in the general adult population and provide an instrument to measure self-care in this group. Therefore, the aim of this study was to develop and evaluate the Self-Care Inventory (SCI), a theory-based instrument to measure self-care in the general adult population. Methods Based on the Middle Range Theory of Self-Care, the 20-item SCI was developed with three scales: Self-Care Maintenance (8 items), Self-Care Monitoring (6 items), and Self-Care Management (6 items). A cross sectional study with a US-based sample (n = 294) was conducted to test the SCI. Internal validity was assessed with Confirmatory Factor Analysis. Internal consistency reliability was assessed with Cronbach alpha for unidimensional scales or composite reliability and the global reliability index for multidimensional scales. Construct validity was investigated with Pearson correlation to test the relationship between general self-efficacy, positivity, stress, and self-care scores. Results The Self-Care Maintenance and Management scales were multidimensional and the Self-Care Monitoring scale was unidimensional. The global reliability index for multidimensional scales was 0.85 (self-care maintenance) and 0.88 (self-care management). Cronbach alpha coefficient of the self-care monitoring scale was 0.88. Test-retest reliability was 0.81 (self-care maintenance), 0.91 (self-care monitoring), and 0.76 (self-care management). The General Self-Efficacy Scale was positively related to all three self-care scale scores: self-care maintenance r = 0.46, p < 0. 001, self-care monitoring r = 0.31, p < 0. 001, and self-care management r = 0.32, p < 0. 001. The positivity score was positively related to self-care maintenance (r = 0.42, p < 0. 001), self-care monitoring (r = 0.29, p < 0. 001), and self-care management (r = 0.34, p < 0. 001) scores. The perceived stress was positively related to the self-care management (r = 0.20, p < 0. 001) score. Conclusions The SCI is a theoretically based instrument designed to measure self-care in the general adult population. Preliminary evidence of validity and reliability supports its use in the general adult population.
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Why Do Patients in the United States Seek Care from Dermatologists? Dermatol Ther (Heidelb) 2022; 12:1065-1072. [PMID: 35286613 PMCID: PMC9021350 DOI: 10.1007/s13555-022-00706-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction While the diagnoses made at visits to the dermatologist are well characterized, the reasons patients visit the dermatologists are not well described. Understanding why patients present to dermatologists could be helpful in identifying patients’ unmet needs and developing outreach programs to improve patients’ access to care. The purpose of this study is to characterize the reasons why US patients sought medical attention from dermatologists. Methods We evaluated the National Ambulatory Medical Care Survey (NAMCS) between 2007 and 2018, the most recent years available, to characterize the most common reasons patients visit the dermatologist. Results Sixty-four thousand records were identified in the NAMCS estimating 1.55 billion visits to the dermatologist in the US during the study period. The most common reasons for visits were skin examination (7.8%), skin lesion (7.5%), and discoloration/abnormal pigmentation (7.3%). For patients ≤ 18 years, the most common reasons for visits were acne (28%), warts (7.7%), and skin rash (6.4%). For patients 19–65 years and ≥ 66 years, skin examinations (7.7%) and skin lesions (10%) were the most common reasons for visits to dermatologists, respectively. Conclusion By identifying the most common reasons for visits to the dermatologist, we can improve our understanding of a patient’s needs and appropriate health outreach resources to improve patients’ access to care. Skin conditions affect 1.9 billion people globally. While we understand the most common diagnoses made at a dermatology visit, the reasons why patients visit the dermatologist have not been evaluated. We utilized an annual survey conducted by the Centers for Disease Control and Prevention (CDC), the National Ambulatory Medical Care Survey (NAMCS), to identify the most common reasons patients visited the dermatologist between the years 2007 and 2018, the most recent years of the survey available. The most common reasons for visits were skin examination, skin lesion, and discoloration/abnormal pigmentation. For patients ≤ 18 years, the most common reasons for visits were acne, warts, and skin rash. For patients 19–65 years and ≥ 66 years, skin examinations and skin lesions were the most common reasons for visits to dermatologists, respectively. By identifying the most common reasons for visit to the dermatologist, we can better understand a patient’s needs and improve a patient’s ability to access care for skin conditions.
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Özses M, Ozbal Batuk M, Yilmaz Isikhan S, Cicek Cinar B. Validity and Reliability of Turkish Version of the Auditory Behavior in Everyday Life Questionnaire. Am J Audiol 2022; 31:155-165. [PMID: 35114797 DOI: 10.1044/2021_aja-21-00094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE This study aimed to investigate the validity and reliability of the Turkish version of the Auditory Behavior in Everyday Life (ABEL) questionnaire. METHOD The ABEL questionnaire was translated into Turkish using the "back-translation" method. The study included 130 parents of children with cochlear implantation, and 126 parents of children with typical hearing were included as a control group. In the study group, there were 62 unilateral and 68 bilateral cochlear implant (CI) users. The age at implantation ranged from 1 to 10 years, as they have substantial auditory skills. The participants' parents completed the ABEL individually, and 73 parents (28, study group; 45, control group) completed the ABEL again for test-retest reliability. Construct validity was tested using confirmatory factor analysis (CFA), and internal consistency was tested using Cronbach's alpha. Spearman's correlation test was used to assess the external validity of the total and all subscales of the ABEL and the Meaningful Auditory Integration Scale (MAIS). Test-retest reliability was measured using the intraclass correlation coefficient. RESULTS The Cronbach's α values for subscales ranged from .67 to .89, and the value was .93 (excellent) for the overall scale. External validity analyses showed moderate to strong correlations between the total and subscale scores of the ABEL and the MAIS, indicating high external validity. According to the CFA findings, the construct validity of the Turkish version of the ABEL was satisfactory. For the three-factor structure, the goodness-of-fit indices revealed a good fit, and only the normed fit index revealed an acceptable fit. CONCLUSION The Turkish version of the ABEL is a reliable and valid assessment tool for children with CIs.
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Affiliation(s)
- Merve Özses
- Department of Audiology, Hacettepe University, Ankara, Turkey
| | | | - Selen Yilmaz Isikhan
- Vocational School of Social Sciences, Hacettepe University, Ankara, Turkey
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Merchant H, Khan F, Dewalwar V, Roy P, Das S, Desousa A. The silent toll of second COVID-19 wave: A dass-21 questionnaire survey among health-care workers at a Tertiary-Care Public Hospital, Mumbai. ANNALS OF INDIAN PSYCHIATRY 2022. [DOI: 10.4103/aip.aip_61_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Patient and Physician Reported Perception on Hypercholesterolemia Management in Primary Prevention in Germany: Results from a Nationwide Online Survey. Adv Ther 2022; 39:4315-4329. [PMID: 35907154 PMCID: PMC9402504 DOI: 10.1007/s12325-022-02266-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 07/07/2022] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Effective hypercholesterolemia management is essential in primary prevention of cardiovascular events. The objective of PROCYON was to assess the perception on hypercholesterolemia management in primary prevention and to identify reasons for insufficient target attainment in clinical practice in Germany. METHODS PROCYON was a two-part online survey including a patient questionnaire on treatment status and disease knowledge and a physician questionnaire on guideline awareness and patient management. A conjoint analysis on the relative importance of cardiovascular risk factors was incorporated. RESULTS Of 3798 primary prevention patients included, 1632 (43.0%) received lipid-lowering medication. Of these, 790 (48.4%) reported improved low-density lipoprotein cholesterol (LDL-C) levels, 670 (41.1%) reported no improvement, and 172 (10.5%) had no information. Of the treated patients with (N' = 790) and without (N' = 670) improvement, 52.4% vs. 47.9% were on their initial drug and dose, 8.9% vs. 9.0% received multiple drug therapy, 34.7% vs. 38.8% reported a dose change, and 16.0% vs. 19.4% had discontinued at least one drug (multiple answers). In total, 109 physicians participated. In the conjoint analysis, LDL-C level was attributed the highest relative importance (32.0%), followed by diabetes (24.5%) and systolic blood pressure (15.8%). Lipid-lowering therapy is initiated at an LDL-C level > 150 mg/dl by 63 physicians (57.8%). One third (n = 35; 32.1%) stated that ≥ 60% of their primary prevention patients do not receive lipid-lowering medication. CONCLUSION PROCYON suggests a need for consequent LDL-C target-based treatment implementation.
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Puto G, Jurzec M, Leja-Szpak A, Bonior J, Muszalik M, Gniadek A. Stress and Coping Strategies of Nurses Working with Patients Infected with and Not Infected with SARS-CoV-2 Virus. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:ijerph19010195. [PMID: 35010454 PMCID: PMC8750468 DOI: 10.3390/ijerph19010195] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/04/2021] [Accepted: 12/22/2021] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Working during the COVID-19 pandemic is a particular challenge for nurses because, while performing their daily routines, they are exposed to physical and social consequences of the SARS-CoV-2 virus, which is accompanied by intensified stress. The aim of this study was to assess the intensity of stress and coping strategies applied by nurses working with both infected and non-infected patients with SARS-CoV-2 virus during the COVID-19 pandemic. MATERIALS AND METHODS The study was conducted between January and March 2021. Due to the epidemiological situation, the questionnaire was posted on Facebook in nurses' groups and sent out via the "Messenger" and "WhatsApp" applications. Stress intensity was assessed by means of the Perceived Stress Scale (PSS-10), whereas coping strategies were assessed using the Mini-COPE stress coping inventory. RESULTS Among 151 surveyed nurses, more than half (52.3%) worked with infected patients and the remaining ones (47.7%) worked with non-infected patients. The level of stress perceived by nurses working with infected patients was higher than among nurses working with patients without SARS-CoV-2 infection (22.22 ± 5.94 vs. 20.21 ± 5.68, p = 0.03). The nurses working with infected patients were most likely to choose coping strategies focused on the problem (2.00 ± 0.62) and emotions (2.01 ± 0.69), whereas those working with non-infected patients usually chose strategies focused only on the problem (2.11 ± 0.58). CONCLUSIONS During the COVID-19 pandemic, nurses working with SARS-CoV-2 patients experienced more intense stress than those working with non-infected patients. Nurses working with SARS-CoV-2 patients tended to cope with stress using strategies focused on the problem and on emotions, while those working with non-infected patients were more likely to choose strategies focused only on the problem.
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Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland; (M.J.); (A.G.)
- Correspondence:
| | - Maria Jurzec
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland; (M.J.); (A.G.)
| | - Anna Leja-Szpak
- Department of Medical Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (A.L.-S.); (J.B.)
| | - Joanna Bonior
- Department of Medical Physiology, Faculty of Health Sciences, Jagiellonian University Medical College, 31-126 Krakow, Poland; (A.L.-S.); (J.B.)
| | - Marta Muszalik
- Department of Geriatrics, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland;
| | - Agnieszka Gniadek
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, 31-501 Krakow, Poland; (M.J.); (A.G.)
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Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID-19. Int J Clin Pract 2021; 75:e15000. [PMID: 34714575 PMCID: PMC8646275 DOI: 10.1111/ijcp.15000] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 09/20/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022] Open
Abstract
AIMS The enormous spread of the novel Corona virus disease (COVID-19) represents a challenge to dermatological practice. Accumulating evidence has suggested a possible role of teledermatology in facing this challenge. In this article, we aimed to give a general overview of teledermatology in terms of models of practice, modes of delivery, advantages, limitations, ethical considerations and legislative challenges as well as discussing, using examples from literature, how dermatological practice can benefit from teledermatology during the time of the COVID-19 pandemic. DISCUSSION AND CONCLUSION Teledermatology could be an accessible, accurate and cost-effective substitute for conventional face-to-face dermatological consultations during the COVID-19 pandemic. However, teledermatology practice needs updated legislation and guidelines. More efforts should be done to encourage dermatologists, especially in underserved communities, to provide teledermatology services. Ethical issues and data security related to teledermatology have to be considered.
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Affiliation(s)
- Ahmed Elsayed Ibrahim
- Department of NeuropsychiatryFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Mayar Magdy
- Barnet HospitalThe Royal Free London NHS Foundation TrustLondonUK
| | - Eslam M. Khalaf
- Department of Critical MedicineFaculty of MedicineAlexandria UniversityAlexandriaEgypt
| | - Alshimaa Mostafa
- Department of DermatologyGraduate School of MedicineKyoto UniversityKyotoJapan
- Department of DermatologyFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
| | - Ahmed Arafa
- Department of Public HealthGraduate School of MedicineOsaka UniversitySuitaJapan
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
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Mohammed Z, Arafa A, Atlam E, El‐Qerafi N, El‐Shazly M, Al‐Hazazi O, Ewis A. Psychological problems among the university students in Saudi Arabia during the COVID-19 pandemic. Int J Clin Pract 2021; 75:e14853. [PMID: 34516702 PMCID: PMC8646281 DOI: 10.1111/ijcp.14853] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/15/2021] [Accepted: 09/10/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency that represents a challenge to psychological health. This study aimed to assess the psychological conditions among university students in Saudi Arabia during the COVID-19 pandemic. METHODS During the period between the 4th and 18th of June 2020, the students of Umm AlQura University in Saudi Arabia were invited to complete an online survey. The survey assessed their sociodemographic characteristics, educational disciplines, and manifestations of psychological health problems including depression, anxiety, and stress as determined by the Arabic version of the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS The study included 936 university students (56.4% women and 43.6% men). Of them, 41.1% had depressive symptoms (31.7% mild to moderate and 9.4% severe to very severe), 26.9% had anxiety symptoms (15.8% mild to moderate and 11.1% severe to very severe), and 22.4% had stress symptoms (15.2% mild to moderate and 7.2% severe to very severe). Students who reported having a friend or relative infected with or died of COVID-19, watching or reading news about the pandemic ≥2 hours/day, and not getting emotional support from family, university, and society were more likely to show psychological problems. CONCLUSION Symptoms of depression, anxiety, and stress were common among Saudi university students during the COVID-19 pandemic. Psychological counselling and support should be provided to university students in Saudi Arabia.
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Affiliation(s)
- Zeinab Mohammed
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
| | - Ahmed Arafa
- Department of Public HealthFaculty of MedicineBeni‐Suef UniversityBeni‐SuefEgypt
- Department of Public HealthGraduate School of MedicineOsaka UniversityOsakaJapan
| | - El‐Sayed Atlam
- Department of computer scienceFaculty of ScienceTanta UniversityEgypt
- Department of computer scienceCollege of Computer Science and EngineeringTaibah UniversityYanbuSaudi Arabia
| | - Nader El‐Qerafi
- Department of Occupational and Environmental HealthAl‐Madinah Health Affairs DirectorateAl‐Madinah Al‐MunawwarahSaudi Arabia
| | - Momen El‐Shazly
- Department of MedicineTaibah College of MedicineTaibah UniversityAl‐Madinah Al‐MunawwarahSaudi Arabia
- Department of Occupational MedicineFaculty of MedicineSohag UniversitySohagEgypt
| | - Omar Al‐Hazazi
- Department of ChemistryFaculty of ScienceUmm AlQura UniversityMeccaSaudi Arabia
| | - Ashraf Ewis
- Department of Public Health and Occupational MedicineFaculty of MedicineMinia UniversityEl‐MiniaEgypt
- Department of Public HealthFaculty of Health Sciences – AlQunfudahUmm AlQura UniversityMeccaSaudi Arabia
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21
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Al-Hazmi AM, Sheerah HA, Arafa A. Perspectives on Telemedicine during the Era of COVID-19; What Can Saudi Arabia Do? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10617. [PMID: 34682363 PMCID: PMC8535869 DOI: 10.3390/ijerph182010617] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 12/12/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has represented a challenge to medical practice in Saudi Arabia and worldwide. In contrary to the increasing numbers of COVID-19 patients, there was a limitation in the capacity of medical practices and access to healthcare. A growing body of evidence from healthcare settings in Saudi Arabia and worldwide has suggested a possible role for telemedicine in responding to this evolving need. Telemedicine can be used for triage, direct care, follow-up, and consultation. It could be delivered through synchronous, asynchronous, and mixed approaches. While telemedicine has several advantages, such as accessibility and cost-effectiveness, its diagnostic reliability should be further investigated. The Saudi Vision (2030) has drawn up a roadmap to invest in digital healthcare during the coming decade; however, some barriers related to using telemedicine in Saudi healthcare settings, including cultural issues and technical difficulties, should be openly discussed. In addition, before putting telemedicine in practice on a wide scale in Saudi Arabia, more efforts should be carried out to issue updated legislation and regulations, discuss and respond to ethical concerns, and ensure data security.
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Affiliation(s)
- Ali Mohsen Al-Hazmi
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Department of Family & Community Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Haytham A. Sheerah
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita 564-8565, Japan
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
| | - Ahmed Arafa
- Health Promotion and Health Education Research Chair, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia; (A.M.A.-H.); (A.A.)
- Public Health, Department of Social Medicine, Graduate School of Medicine, Osaka University, Osaka 565-0871, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt
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Al-Mansour K. Stress and turnover intention among healthcare workers in Saudi Arabia during the time of COVID-19: Can social support play a role? PLoS One 2021; 16:e0258101. [PMID: 34618851 PMCID: PMC8496805 DOI: 10.1371/journal.pone.0258101] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022] Open
Abstract
The turnover intention of healthcare workers is a threat to the competence of health services, especially during COVID-19 time. This study aimed to investigate the association between stress and turnover intention among healthcare workers in Saudi Arabia and whether social support could affect this association. In this cross-sectional study, healthcare workers in primary healthcare centers in Saudi Arabia responded to an online questionnaire assessing their sociodemographic and occupational history, stress levels using the Perceived Stress Scale-10 (PSS-10), social support using the Multidimensional Scale of Perceived Social Support (MSPSS), and turnover intention within the next few months. Path analysis was conducted to assess the mediating effect of social support on the association between stress and turnover intention. A total of 1101 healthcare workers (242 physicians, 340 nurses, 310 paramedics, and 209 administrative workers) participated in this study. The path between stress and support had a significant standardized regression weight (-.34, p < .05). The path between support and turnover had a significant standardized regression weight (.08, p < .05). The standardized total effect of stress on turnover without the impact of support was significant (-.39, p < .05). The direct effect of stress on turnover with the presence of support was significant (-.36, p < .05). The indirect effect of stress on turnover with the presence of support was significant (-.03, p < .05). Thus, there is evidence to show that support mediates the relationship between stress and support. Stress is associated with turnover intention among healthcare workers in Saudi Arabia. Social support had a mitigating effect on the relationship between stress and turnover intention.
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Affiliation(s)
- Khalid Al-Mansour
- Department of Social Studies, College of Arts, King Saud University, Riyadh, Saudi Arabia
- General Administration for Primary Health Centers, Ministry of Health, Riyadh, Saudi Arabia
- * E-mail: ,
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Alyahya SA, Al-Mansour KA, Alkohaiz MA, Almalki MA. Association between role conflict and ambiguity and stress among nurses in primary health care centers in Saudi Arabia during the coronavirus disease 2019 pandemic: A cross-sectional study. Medicine (Baltimore) 2021; 100:e27294. [PMID: 34664892 PMCID: PMC8447988 DOI: 10.1097/md.0000000000027294] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022] Open
Abstract
This study aimed to assess the association between role conflict and ambiguity among nurses in primary healthcare centers (PHCs) in Saudi Arabia and their stress levels during the coronavirus disease 2019 (COVID-19) pandemic.In this online cross-sectional study, sociodemographic and occupational characteristics, role conflict, and ambiguity of 432 nurses were assessed using the Bowling Scale for Role Conflict and Ambiguity and stress was assessed using the 10-item Perceived Stress Scale from September 27 to October 17, 2020. Logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for above-median stress levels of nurses with average and high (2nd and 3rd tertiles) role conflict and ambiguity compared with nurses with low role conflict and ambiguity (1st tertile).The mean (standard deviation) age of the nurses was 36.5 ± 6.6 years, and 25.9% of them were males. After adjusting for PHC type and working hours, nurses with average and high role conflict had significantly higher stress rates than those with low role conflict, with ORs (95% CIs) of 2.69 (1.62-4.46) and 6.31 (3.78-10.53), respectively. Similarly, nurses with average- and high-role ambiguity had significantly higher stress than those with low role ambiguity, with ORs (95% CIs) of 2.15 (1.30-3.55) and 7.68 (4.54-13.01), respectively. Increasing stress rates were detected across increasing categories of role conflict and ambiguity (P values for trend <.001).We found that role conflict and ambiguity were associated with stress among nurses in PHCs in Saudi Arabia during the COVID-19 pandemic.
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Affiliation(s)
| | - Khalid A. Al-Mansour
- General Administration for Primary Health Centers, Ministry of Health
- Department of Social Studies, College of Arts, King Saud University, Riyadh
| | | | - Mansour A. Almalki
- Department of Sociology and Social Work, Facility of Arts and Humanities, King Abdulaziz University, Jeddah, Saudi Arabia
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Factors Affecting COVID-19 Vaccination among the General Population in Saudi Arabia. Healthcare (Basel) 2021; 9:healthcare9091218. [PMID: 34574992 PMCID: PMC8469638 DOI: 10.3390/healthcare9091218] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/08/2021] [Accepted: 09/13/2021] [Indexed: 11/17/2022] Open
Abstract
Vaccine refusal or hesitancy is one of the significant issues that can have an adverse impact on people’s health and their countries’ economy. Additionally, vaccine acceptance or refusal could have a decisive role in controlling the COVID-19 pandemic. This study aims to investigate the factors affecting COVID-19 vaccine refusal and hesitancy among the general population in Saudi Arabia. The method is a cross-sectional survey using an online questionnaire, and data were collected from 1935 participants between 18 February 2021 and 1 April 2021. Out of 1935 participants aged ≥18 years and residing in Saudi Arabia, 46.9% reported their intention to receive the COVID-19 vaccine, 22.4% had received the vaccine, 9.5% did not intend to receive the vaccine, and 21.2% had not made their decision. In the multinomial logistic regression models, vaccine refusal was associated with age (OR: 0.961), nationality (OR: 0.182), monthly income of more than SAR 18,000 (OR: 2.325), chronic diseases (OR: 0.521), knowledge about the vaccine (OR: 0.937), and concerns about the vaccine (OR: 1.5). The hesitancy was associated with age (OR: 0.977), nationality (OR: 0.231), monthly income between SAR 6000 to 12,000 (OR: 0.607), chronic diseases (OR: 0.640), knowledge about the vaccine (OR: 0.907), and concerns about the vaccine (OR: 1.3). The main concerns about the vaccine were “COVID-19 vaccines are not tested enough on people”, “drug companies are interested in COVID-19 vaccine sales only”, and “COVID-19 vaccines have serious adverse effects”. Awareness programs and vaccination campaigns should consider people’s concerns and correct their misinformation.
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Huet F, Taieb C, Corgibet F, Brenaut E, Richard MA, Misery L. Pruritus, Pain, and Depression Associated with the Most Common Skin Diseases: Data from the French Study "Objectifs Peau". Dermatology 2021; 238:448-453. [PMID: 34515100 DOI: 10.1159/000518220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/26/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The prevalence and impact of pruritus, pain, and other sensory symptoms in skin diseases are poorly known. OBJECTIVE To assess the frequency of these symptoms with dermatoses and their association with depression using data from the "Objectifs Peau" survey. METHODS A representative sample of 20,012 French individuals was created using the usual quota method. RESULTS When patients suffered from both pruritus and skin pain, they had a higher relative risk of psychological suffering (2.9) than those who suffered only from pruritus (1.4) or skin pain (1.2). Pruritus was reported in 48.55% of patients with acne, 43.24% with mycoses, 44.35% with warts, and 36.51% with rosacea. For skin pain, the results were 11.22%, 27.59%, and 16.13% for atopic dermatitis, acne, and warts, respectively. Other unpleasant sensations, such as tingling or burning, were also frequently reported. CONCLUSION Pruritus, pain, or other sensory symptoms were found to be common not only in classic pruritic skin diseases but also in acne, rosacea, or warts. The association of pruritus and pain dramatically increased psychological suffering. These symptoms must be systematically searched for in patients, especially since new therapeutic possibilities are emerging for the symptomatic treatment of pruritus.
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Affiliation(s)
- Flavien Huet
- Société Française de Dermatologie (SFD), Paris, France.,Service de Dermatologie, CHRU de Brest, Brest, France.,Univ Brest, LIEN, Brest, France
| | - Charles Taieb
- Société Française de Dermatologie (SFD), Paris, France
| | - Florence Corgibet
- Société Française de Dermatologie (SFD), Paris, France.,Fédération Française de Formation Continue et d'Evaluation en Dermatologie-Vénéréologie (FFFCED), Paris, France
| | - Emilie Brenaut
- Société Française de Dermatologie (SFD), Paris, France.,Service de Dermatologie, CHRU de Brest, Brest, France.,Univ Brest, LIEN, Brest, France.,Collège des Enseignants en Dermatologie de France (CEDEF), Paris, France
| | - Marie-Aleth Richard
- Société Française de Dermatologie (SFD), Paris, France.,Collège des Enseignants en Dermatologie de France (CEDEF), Paris, France.,Service de Dermatologie, CHU Timone, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Laurent Misery
- Société Française de Dermatologie (SFD), Paris, France.,Service de Dermatologie, CHRU de Brest, Brest, France.,Univ Brest, LIEN, Brest, France.,Collège des Enseignants en Dermatologie de France (CEDEF), Paris, France
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Trotz einer großen Auswahl wirksame Medikamente: Psoriatiker scheinen immer noch untertherapiert zu sein. J Dtsch Dermatol Ges 2021; 19:1003-1012. [PMID: 34288484 DOI: 10.1111/ddg.14387_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/26/2022]
Abstract
HINTERGRUND UND ZIELE Durch die Entwicklung neuer anti-psoriatischer Medikamente und verbesserte Strukturen zu deren flächendeckender Einführung hat sich die medizinische Versorgung von Psoriasis-Patienten deutlich verbessert. In dieser Studie haben wir die tatsächliche Inanspruchnahme des Gesundheitswesens untersucht und Gründe für die Unzufriedenheit der Betroffenen ermittelt. PATIENTEN UND METHODIK Diese nicht-interventionelle Querschnittsstudie wurde als anonyme Online-Befragung von 12/2018 bis 01/2019 in Deutschland durchgeführt. Teilnehmer mit einer selbstberichteten, von einem Arzt gestellten Psoriasis-Diagnose und Symptomen beantworteten Fragen zu ihrer Erkrankung, deren Einfluss auf das tägliche Leben und ihrer medizinischen Versorgung. ERGEBNISSE 649 Teilnehmer mit einem mittleren Alter von 42,5 ± 13,7 Jahren und ausgewogener Geschlechterverteilung (männlich: 50,2 %) wurden ausgewertet. 54,1 % waren zum Zeitpunkt der Studie in ärztlicher Behandlung, 45,9 % nicht. Von den Teilnehmern mit medizinischer Versorgung waren 59,3 % nur mäßig oder weniger zufrieden mit ihrer Behandlung. Gründe für die Unzufriedenheit mit der Medikation waren unter anderem mangelnde Wirksamkeit und Nebenwirkungen. Von den nicht in ärztlicher Behandlung befindlichen Teilnehmern wurde "Zeitmangel des Arztes" als Hauptgrund für die Nichtinanspruchnahme ärztlicher Hilfe angegeben. SCHLUSSFOLGERUNGEN Trotz der Verfügbarkeit effizienter Therapieoptionen in Deutschland sind viele Betroffene mit Psoriasis unzufrieden. Diese unterbehandelte Gruppe wurde als neue Zielgruppe identifiziert.
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Affiliation(s)
- Anna Caroline Pilz
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Alexander Zink
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
| | - Maximilian C Schielein
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | - Katharina Hell
- Klinik für Dermatologie und Allergologie, Medizinische Fakultät, Technische Universität München
- Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität, München
| | | | | | | | | | - Nicola Wagner
- Hautklinik, Universitätsklinikum der Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen
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Work-Related Stressors among the Healthcare Professionals in the Fever Clinic Centers for Individuals with Symptoms of COVID-19. Healthcare (Basel) 2021; 9:healthcare9050548. [PMID: 34066666 PMCID: PMC8151647 DOI: 10.3390/healthcare9050548] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/23/2021] [Accepted: 04/29/2021] [Indexed: 12/24/2022] Open
Abstract
Work-related stress can affect the quality of healthcare during the COVID-19 pandemic. This study aimed to assess the relationship between selected work-related stressors and stress levels among healthcare professionals providing preventive and curative services to people with COVID-19 symptoms in the Fever Clinics in Saudi Arabia. A systematic random sampling using an online questionnaire approach was used to select healthcare professionals in the Fever Clinics in Saudi Arabia during September 2020. Participants were asked to fill out a questionnaire including data on their sociodemographic and occupational characteristics, role conflict and ambiguity, social support, and stress. The results showed that role conflict and ambiguity were significant risk factors for stress, and social support was negatively associated with stress levels. Additionally, younger and non-Saudi healthcare professionals exhibited higher stress levels than their older and Saudi counterparts. In conclusion, role conflict, ambiguity, and social support can predict the risk of stress among healthcare professionals in the Fever Clinics in Saudi Arabia.
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Pilz AC, Zink A, Schielein MC, Hell K, Romer K, Hillmann E, Bäumer D, Reinhardt M, Wagner N. Despite large choice of effective therapies: Individuals with psoriasis still seem undertreated. J Dtsch Dermatol Ges 2021; 19:1003-1011. [PMID: 33955676 DOI: 10.1111/ddg.14387] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Due to the development of new anti-psoriatic drugs in combination with improved structures for implementation throughout Germany, the medical care of psoriasis patients has markedly improved. In this study we investigated the real-life utilization of the health care system and identified reasons for dissatisfaction in affected individuals. PATIENTS AND METHODS This non-interventional cross-sectional study was conducted as an anonymous online survey from 12/2018 to 01/2019 in Germany. Participants with a self-reported physician-confirmed diagnosis of psoriasis and symptoms answered questions about their disease, its influence on daily life and their medical care. RESULTS 649 participants with a mean age of 42.5 ± 13.7 years and equal gender distribution (male: 50.2 %) were evaluated. 54.1 % received medical treatment at the time of the study, 45.9 % did not. Among the participants with medical care, 59.3 % were only moderately or less satisfied with their treatment. Reasons for dissatisfaction with the medication included lack of efficacy and side effects. Participants without medical treatment specified a physician's lack of time as a main reason for not seeking medical help. CONCLUSIONS Despite the availability of efficient therapeutic options in Germany, many individuals with psoriasis are not satisfied. This under-treated group was identified as a new target population.
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Affiliation(s)
- Anna Caroline Pilz
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilian-University, Munich, Germany
| | | | | | | | | | - Nicola Wagner
- Department of Dermatology, University Hospital, Friedrich-Alexander-University of Erlangen-Nuremberg (FAU), Erlangen, Germany
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Wagner N, Zink A, Hell K, Reinhardt M, Romer K, Hillmann E, Baeumer D, Schielein MC. Patients with Chronic Urticaria Remain Largely Undertreated: Results from the DERMLINE Online Survey. Dermatol Ther (Heidelb) 2021; 11:1027-1039. [PMID: 33945120 PMCID: PMC8163939 DOI: 10.1007/s13555-021-00537-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 04/16/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction Chronic urticaria (CU) is an unpredictable disease, with high disease burden and a significant negative impact on quality of life, especially in patients of working age. Many patients are undertreated, and there is poor awareness of strategies to manage patients with CU in the real-world setting. The current study aimed to gain a better understanding of CU from the patients’ perspective, including the body areas most affected by wheals and angioedema, the disease burden and current use of the healthcare system. Methods A nationwide online survey was performed in Germany involving individuals who reported a diagnosis of CU and experienced symptoms within 3 months prior to inclusion. Results This self-report survey included 1037 participants (89.2% female), with a mean ± standard deviation (SD) age of 33.4 ± 11.0 years and a mean ± SD disease duration of 10.0 ± 9.4 years. On average, participants suffered from urticaria symptoms for 3.0 ± 4.3 years before diagnosis. In 73% of participants, symptoms worsened due to external factors, with the majority specifying stress in their personal life or work-related stress as eliciting factors. Within the previous 3 months, 87.4 and 44.1% of participants experienced wheals and angioedema, respectively, at multiple body areas, and most (79.6%) participants had uncontrolled symptoms as measured with the Urticaria Control Test. Despite the high burden of disease, 60.3% of participants stated that they were not currently receiving treatment. The most commonly used therapies to treat CU were oral (72.8%) and non-prescription (43.3%) and prescription (47.3%) topical drugs, with 18.0% of the participants receiving injectable/infused drugs. Conclusion The majority of the participants responding to the survey reported that CU is not sufficiently controlled, thereby severely influencing a highly productive time in their life. The body areas most affected by wheals and angioedema are specified, based on data provided by a large group of affected participants. A greater awareness of disease burden and available treatment options is needed. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-021-00537-5.
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Affiliation(s)
- Nicola Wagner
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
| | - Katharina Hell
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Institute for Medical Information Processing, Biometry and Epidemiology (IBE), Ludwig Maximilian University (LMU), Munich, Germany
| | | | | | | | | | - Maximilian C Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Oladele DA, Idigbe IE, Musa AZ, Gbaja-Biamila T, Bamidele T, Ohihoin AG, Salako A, Odubela T, Aina O, Ohihoin E, David A, Ezechi O, Odunukwe N, Salako BL. Self-reported use of and access to personal protective equipment among healthcare workers during the COVID-19 outbreak in Nigeria. Heliyon 2021; 7:e07100. [PMID: 34031646 PMCID: PMC8133390 DOI: 10.1016/j.heliyon.2021.e07100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/02/2021] [Accepted: 05/14/2021] [Indexed: 01/02/2023] Open
Abstract
The SARS-CoV-2 virus is highly infectious resulting in increased infection and death among the front-line Healthcare Workers (HCW) because of limited access to personal protective equipment (PPE). This study assesses the availability and self-reported use of PPE amongst HCW during the COVID-19 pandemic in Nigeria. A mixed-method study was conducted through a cross-sectional survey and in-depth interviews amongst HCW. Quantitative data analysis was done using SPSS version 26 and thematic analysis was done for the in-depth interview. A total of 258 HCW completed the survey while 15 HCW took part in the in-depth interview. The mean age was 40 (±8.6) years, 67.4% were female and 83.3% were married. 49% were Doctors, 21.1% were Nurses, 28.7% were other allied HCW and 62.2% had at least 10 years of practice experience. Only 22.1% of HCWs had regular access to PPE and only 20.6% had access to N-95 facemask compare to other PPEs. Male HCWs and those working at secondary or tertiary facilities had access to N-95 facemask (p-value 0.025 and 0.010 respectively). The facilitator of PPE use is leadership quality of hospital head and donation of PPE to the facilities while the barriers to PPE use include a limited supply of PPE, as well as facility's infrastructural and operational challenges. The study reported limited access to essential PPE with varying perspectives on its use. Therefore, access, knowledge, and appropriate use of PPE need urgent attention with improved implementation of infection control policy at the facility level.
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Affiliation(s)
- David Ayoola Oladele
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Ifeoma Eugenia Idigbe
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Adesola Zaidat Musa
- Monitoring and Evaluation Unit, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Titilola Gbaja-Biamila
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Tajudeen Bamidele
- Department of Molecular Biology, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Aigbe Gregory Ohihoin
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Abideen Salako
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Tosin Odubela
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Oluwagbemiga Aina
- Department of Biochemistry and Nutrition, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Esther Ohihoin
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Agatha David
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Oliver Ezechi
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Nkiruka Odunukwe
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Babatunde Lawal Salako
- Clinical Sciences Department, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
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Walss M, Anzengruber F, Arafa A, Djamei V, Navarini AA. Implementing Medical Chatbots: An Application on Hidradenitis Suppurativa. Dermatology 2021; 237:712-718. [PMID: 33744903 PMCID: PMC8491464 DOI: 10.1159/000511706] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The use of digital health resources is growing quickly as they are easily accessible and permit self-evaluation. Yet, research on consumer health informatics platforms is insufficient. Chatbots, interactive conversational platforms based on artificial intelligence, can facilitate access to specific information. Hidradenitis suppurativa (HS) is burdensome and has a high threshold for consultation. OBJECTIVES We aimed to identify the most important principles for the assembly of medical chatbots through the analysis of usage data. METHODS The HS Chatbot 1 is a question-and-answer platform in the style of a chatbot. Usage data were collected over the course of a year. 254 responses were statistically analysed. RESULTS 239 users were alleged patients. 82.9% were looking for a tentative diagnosis. The users were on average 32.49 (±11.33) years old and predominantly female (70.2%). The average number of clicks per visit on the website was 14.69 (±8.83). CONCLUSIONS A medical chatbot has to be customised to the specific subject whilst general principles have to be considered. High-quality information has to be available in just a few clicks. People concerned about HS are looking for a diagnosis online and often have not seen a doctor previously. Guidance towards appropriate care should be provided.
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Affiliation(s)
- Manuel Walss
- Department of Medicine, University of Zurich, Zurich, Switzerland
| | | | - Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
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Pilz AC, Tizek L, Rüth M, Seiringer P, Biedermann T, Zink A. Interest in Sexually Transmitted Infections: Analysis of Web Search Data Terms in Eleven Large German Cities from 2015 to 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052771. [PMID: 33803324 PMCID: PMC7975972 DOI: 10.3390/ijerph18052771] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 01/17/2023]
Abstract
Incidence of sexually transmitted infections (STIs) such as chlamydia, gonorrhea, and syphilis has increased in recent years in the US and in European countries. In order to implement effective educational programs, the interests of target populations have to be identified. Since the internet is an important source of information-gathering on health issues, this study investigates web search data in large German cities related to STIs. Google Ads Keyword Planner was used to identify STI-related terms and their search volume in eleven German cities from June 2015 to May 2019. The data obtained were analyzed descriptively with regard to total search volumes, search volumes of specific thematic areas, and search volumes per 100,000 inhabitants. Overall, 741 terms with a total search volume of 5,142,560 queries were identified, with more than 70% of all search queries including a specific disease and “chlamydia” being the overall most often searched term (n = 1,196,160). Time courses of search behavior displayed a continuous interest in STIs with synchronal and national rather than regional peaks. Volumes of search queries lacked periodic patterns. Based on the findings of this study, a more open public discussion about STIs with linkage to increased media coverage and clarification of responsibilities among all STI-treating disciplines concerning management of STIs seem advisable.
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Al-Mansour K, Alfuzan A, Alsarheed D, Alenezi M, Abogazalah F. Work-Related Challenges among Primary Health Centers Workers during COVID-19 in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1898. [PMID: 33669440 PMCID: PMC7920431 DOI: 10.3390/ijerph18041898] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 12/14/2022]
Abstract
This study aimed to identify certain occupational risk factors for stress among healthcare workers (HCWs) during the COVID-19 pandemic. Using a multistage random sampling approach, an online questionnaire was applied to collect data on role conflict and ambiguity, self-esteem and social support from 1378 HCWs working in primary health centers (regular and fever clinics; clinics specialized in managing patients with COVID-19 symptoms) across Saudi Arabia. The results showed that stress correlated positively with role conflict and ambiguity and negatively with social support. HCWs in fever clinics exhibited significantly more stress and role conflict and ambiguity than those who were working in regular primary healthcare centers. In conclusion, role conflict and ambiguity and social support were determinants for stress among HCWs, especially those working in fever clinics.
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Affiliation(s)
- Khalid Al-Mansour
- Department of Social Studies, College of Arts, King Saud University, Riyadh 11451, Saudi Arabia;
- General Administration for Primary Health Centers, Ministry of Health, Riyadh 12628, Saudi Arabia; (D.A.); (M.A.); (F.A.)
| | - Abdullatif Alfuzan
- Department of Social Studies, College of Arts, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Danya Alsarheed
- General Administration for Primary Health Centers, Ministry of Health, Riyadh 12628, Saudi Arabia; (D.A.); (M.A.); (F.A.)
| | - Munwer Alenezi
- General Administration for Primary Health Centers, Ministry of Health, Riyadh 12628, Saudi Arabia; (D.A.); (M.A.); (F.A.)
| | - Fouad Abogazalah
- General Administration for Primary Health Centers, Ministry of Health, Riyadh 12628, Saudi Arabia; (D.A.); (M.A.); (F.A.)
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Schielein MC, Tizek L, Baeumer D, Hillmann E, Romer K, Wagner N, Zink A. People-centered care for psoriasis and urticaria: Are we overlooking Internet addiction while only considering patients and physician settings? J Dermatol 2021; 48:825-834. [PMID: 33406282 DOI: 10.1111/1346-8138.15740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/29/2020] [Accepted: 12/06/2020] [Indexed: 11/27/2022]
Abstract
Psoriasis and chronic urticaria (CU) are chronic skin diseases with a high impact on individuals' life and mental health. Some studies indicate a high prevalence of Internet addiction and many affected individuals seem not to utilize healthcare, but rather search for health-related information online. The aims of the study were to assess Internet addiction as a potential comorbidity in both diseases as well as identify differences in healthcare utilization between individuals with psoriasis and CU. This cross-sectional study is based on self-reported data from individuals with psoriasis and CU living throughout Germany using the framework of an online survey from 12/2018 to 01/2019. Advertisements on Google and Facebook were used to address Internet users who searched online for information on psoriasis or CU. The study questionnaire comprised questions on demographics, current contact with physicians, and disease history as well as validated screening tools for well-being and Internet addiction. Overall, 1686 participants (74.0% female, 38.5% psoriasis) with a mean age of 36.9 ± 12.9 years were analyzed. Participants with CU were more likely female (89.2% vs 49.8%, P < 0.001) and not in medical care compared to participants with psoriasis (60.3% vs 45.9%, P < 0.001). Sixteen percent of the participants overall were screened positive for Internet addiction. Furthermore, not utilizing medical care showed a significant association with being screened positive for Internet addiction in participants with CU (adjusted odds ratio [aOR] = 1.49, 95% confidence interval [CI] 1.10-2.02), but not in those with psoriasis. The study revealed a high proportion of affected individuals not being in medical care and a high prevalence of Internet addiction, with individuals with CU not utilizing medical resources having a higher chance of being screened positive for Internet addiction. This underlines the approach of people-centered care and highlights its importance for further research.
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Affiliation(s)
- Maximilian Christian Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany.,Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-University Munich, Munich, Germany.,Pettenkofer School of Public Health, Ludwig-Maximilians-University Munich, Munich, Germany
| | | | | | | | - Nicola Wagner
- Department of Dermatology, University Hospital Erlangen-Nürnberg, Erlangen, Germany
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, Munich, Germany
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Arafa A, Mohammed Z, Mahmoud O, Elshazley M, Ewis A. Depressed, anxious, and stressed: What have healthcare workers on the frontlines in Egypt and Saudi Arabia experienced during the COVID-19 pandemic? J Affect Disord 2021; 278:365-371. [PMID: 33007626 PMCID: PMC7831891 DOI: 10.1016/j.jad.2020.09.080] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 08/18/2020] [Accepted: 09/17/2020] [Indexed: 02/09/2023]
Abstract
INTRODUCTION As the Novel Corona Virus Disease (COVID-19) was declared by the world health organization a pandemic in March 2020, thousands of healthcare workers (HCWs) worldwide were on the frontlines fighting against the pandemic. Herein, we selected two Middle East countries; Egypt and Saudi Arabia to investigate the psychological impacts of the COVID-19 pandemic on their HCWs. METHODS In this cross-sectional study, a Google survey was used to access HCWs in many hospitals in Egypt and Saudi Arabia between the 14th and 24th of April 2020. The survey assessed HCWs regarding their sociodemographic and occupational features, sleeping hours, and psychological impacts of the COVID-19 pandemic using the Depression Anxiety Stress Scale-21 (DASS-21). RESULTS This study included 426 HCWs (48.4% physicians, 24.2% nurses, and 27.4% other HCWs). Of them, 69% had depression, 58.9% had anxiety, 55.9% had stress, and 37.3% had inadequate sleeping (<6 h/day). Female sex, age ≤30 years, working in Egypt, attending emergency and night shifts, watching/reading COVID-19 news ≥2 h/day, and not getting emotional support from family, society, and hospital were associated with a high likelihood of depression, anxiety, stress, and inadequate sleeping. LIMITATIONS the cross-sectional design restricted our ability to distinguish between preexisting and emerging psychological symptoms. CONCLUSION HCWs on the frontlines in Egypt and Saudi Arabia experienced depression, anxiety, stress, and inadequate sleeping during the COVID-19 pandemic.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan; Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Zeinab Mohammed
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Omaima Mahmoud
- Department of Psychiatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
| | - Momen Elshazley
- Department of Medicine, Taibah College of Medicine, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia,Department of Occupational Medicine, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Ashraf Ewis
- Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt,Department of Public Health and Occupational Medicine, Faculty of Health Sciences – AlQunfudah, Umm AlQura University, Meccah, Saudi Arabia
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Arafa A, Mohamed A, Saleh L, Senosy S. Psychological Impacts of the COVID-19 Pandemic on the Public in Egypt. Community Ment Health J 2021; 57:64-69. [PMID: 32803445 PMCID: PMC7429137 DOI: 10.1007/s10597-020-00701-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 08/12/2020] [Indexed: 11/26/2022]
Abstract
This study aimed to evaluate the prevalence of depression, anxiety, stress, and inadequate sleeping among the public in Egypt during the novel Corona Virus Disease (COVID-19) pandemic. An online snowball sampling approach was used to collect data from netizens in four Egyptian governorates between 16 and 30 April 2020. A semi-structured questionnaire was designed to assess sociodemographic characteristics, sleeping hours per day, and psychological disturbances (depression, anxiety, and stress) of participants using the Depression Anxiety Stress Scale-21. Out of 1629 participants, 48.1% were aged ≤ 30 years, 42.4% were men, and 20.0% were working in the health sector. The participants reported a high prevalence of depression (67.1%: mild to moderate 44.6% and severe to very severe 22.5%), anxiety (53.5%: mild to moderate 30.6% and severe to very severe 22.9%), stress (48.8%: mild to moderate 33.8% and severe to very severe 15.0%), and inadequate sleeping (< 6 h/day) 23.1%. Female sex, working in sectors other than the health sector, watching/reading COVID-19 news ≥ 2 h/day, and lack of emotional support from family and society were associated with a high prevalence of severe to very severe depression, anxiety, and stress. In conclusion, the psychological impacts of COVID-19 on the public in Egypt were enormous, therefore, providing psychological support and counsel is warranted.
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Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Graduate School of Medicine, Osaka University, Osaka, Japan
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Amel Mohamed
- Department of Community Health, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
| | - Lamiaa Saleh
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Shaimaa Senosy
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
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Irfan M, Shahudin F, Hooper VJ, Akram W, Abdul Ghani RB. The Psychological Impact of Coronavirus on University Students and its Socio-Economic Determinants in Malaysia. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211056217. [PMID: 34802264 PMCID: PMC8606969 DOI: 10.1177/00469580211056217] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The objective of this article is to examine the impact of coronavirus disease 2019 (COVID-19) upon university students’ anxiety level and to find the factors associated with the anxiety level in Malaysia. We collected data from 958 students from 16 different universities using an originally designed questionnaire. The Generalized Anxiety Disorder Scale 7-item (GAD-7) was used to estimate the anxiety. Then we applied the ordered logit model to calculate the odds ratios (OR) and factors associated with the anxiety level. We find that 12.3% of students were normal, whereas 30.5% were experiencing mild anxiety, 31.1% moderate anxiety, and 26.1% severe anxiety. Surprisingly, only 37.2% of students were aware of mental health support that was provided by their universities. However, age above 20 years (OR = 1.30), ethnicity Chinese (OR = 1.72), having any other disease (OR = 2.0), decreased family income (OR = 1.71), more time spent on watching COVID-19-related news (OR = 1.52), and infected relative or friends (OR = 1.62) were risk factors for anxiety among students. We conclude that the government of Malaysia should monitor the mental health of the universities’ students more closely and universities should open online mental health support clinics to avoid the adverse impacts of anxiety.
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Affiliation(s)
- Muhammad Irfan
- School of Economics and Management, Xiamen University Malaysia, Malaysia
| | - Faizah Shahudin
- School of Economics and Management, Xiamen University Malaysia, Malaysia
| | - Vincent J Hooper
- School of Economics and Management, Xiamen University Malaysia, Malaysia
| | - Waqar Akram
- Department of Business Administration, Sukkur Institute of Business Administration, Sukkur, Pakistan
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38
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Self-esteem and perceived social support among Sarahah users. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01088-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Robson JC, Shepherd M, Harper L, Ndosi M, Austin K, Flurey C, Logan S, Dures E. Psychological and self-management support for people with vasculitis or connective tissue diseases: UK health professionals' perspectives. Rheumatol Adv Pract 2020; 4:rkaa016. [PMID: 32968704 PMCID: PMC7494082 DOI: 10.1093/rap/rkaa016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 04/23/2020] [Indexed: 11/14/2022] Open
Abstract
Objectives CTD and systemic vasculitis impact on health-related quality of life. Treatment can be complex, involving multiple medical specialities. The aim of this study was to investigate psychological and self-management support for patients in secondary care. Methods An online survey of health professionals in the UK, including 45 multiple-choice and free-text questions, was analysed descriptively. Free-text survey responses were analysed thematically to identify health professionals' perceptions of best practice and unmet needs. Results The online survey included 120 health professionals (34% specialist nurses, 51% doctors and 12% allied health professionals), predominantly working in rheumatology (52.9%) and nephrology (21.5%) departments. Access to self-management programmes or clinics for people with CTD or vasculitis was available in 23% of rheumatology and 8% of nephrology departments. In response to 'How well is your team providing self-management support to people with CTD or vasculitis?', 38% of respondents reported 'not very well' or 'not well at all'. Direct access to psychological support was available in 76.9% of nephrology and 32.8% of rheumatology departments. More than 80% of respondents would like additional training. Key themes from the qualitative data (free-text survey responses) included the importance of: dedicated psychological support and self-management programmes for people with CTD and vasculitis, a whole-team approach (specialist teams empowering people to manage their own care), staff training (e.g. brief psychological interventions) and signposting to resources, including patient charities. Conclusion People with CTD and vasculitis have complex needs, and improvements in self-management and psychological support are required in UK rheumatology and nephrology departments.
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Affiliation(s)
- Joanna C Robson
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, University of the West of England.,Rheumatology Research, Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol
| | - Michael Shepherd
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, University of the West of England.,Rheumatology Research, Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol
| | - Lorraine Harper
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham.,Nephrology Department, University Hospital Birmingham NHS Foundation Trust, Birmingham
| | - Mwidimi Ndosi
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, University of the West of England.,Rheumatology Research, Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol
| | - Keziah Austin
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, University of the West of England.,Rheumatology Research, Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol
| | - Caroline Flurey
- Department of Health and Social Sciences, Faculty of Health and Applied Science, University of the West of England, Bristol, UK
| | - Sarah Logan
- Nephrology Department, University Hospital Birmingham NHS Foundation Trust, Birmingham
| | - Emma Dures
- Department of Nursing and Midwifery, Faculty of Health and Applied Science, University of the West of England.,Rheumatology Research, Rheumatology Department, University Hospitals Bristol NHS Foundation Trust, Bristol
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Schielein MC, Tizek L, Schuster B, Ziehfreund S, Liebram C, Eyerich K, Zink A. Always Online? Internet Addiction and Social Impairment in Psoriasis across Germany. J Clin Med 2020; 9:E1818. [PMID: 32545234 PMCID: PMC7355796 DOI: 10.3390/jcm9061818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 06/05/2020] [Accepted: 06/07/2020] [Indexed: 01/11/2023] Open
Abstract
With the World Health Organization (WHO) demanding further investigation of the social impairment and psychosocial burden of psoriasis, a first study identified a high prevalence of Internet addiction. The aim of this study was to assess social impairment and estimate the occurrence of Internet addiction along with depression, cigarette smoking, and alcohol dependency in individuals with psoriasis recruited online in a people-centered care approach. A cross-sectional online survey was carried out across Germany between March 2019 and June 2019. The questionnaire contained information on social impairment, smoking habits, as well as validated questionnaires on Internet addiction, depression, and alcohol dependency. Overall, 460 individuals (62.4% female; mean age: 45.9 ± 13.7 years) with psoriasis were included. Of those, 406 (88.3%) stated to be at least rarely socially impaired. The positive screening rate for Internet addiction was 8.5%. Furthermore, 40.0% had positive screenings for depression, 17.1% for alcohol dependency, and 32.6% for daily smoking. Positive screenings for Internet addiction and alcohol dependency were substantially more frequent in individuals with psoriasis than in the German general population. In order to meet the demands of the WHO, Internet addiction could be considered as a potential comorbidity in psoriasis and a focus on people-centered care is advisable for further research.
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Affiliation(s)
- Maximilian Christian Schielein
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Linda Tizek
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Barbara Schuster
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Biometry and Epidemiology (IBE), Department of Medical Informatics, Ludwig-Maximilians-University, 81377 Munich, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Stefanie Ziehfreund
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
| | | | - Kilian Eyerich
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
- Karolinska Institutet, Department of Medicine, Unit of Dermatology and Venerology, Karolinska University Hospital, 171 77 Stockholm, Sweden
| | - Alexander Zink
- Department of Dermatology and Allergy, School of Medicine, Technical University of Munich, 80802 Munich, Germany; (L.T.); (B.S.); (S.Z.); (K.E.)
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Arafa A, Mahmoud O, Abu Salem E. Excessive Internet use and self-esteem among Internet users in Egypt. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2019. [DOI: 10.1080/00207411.2019.1611167] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Ahmed Arafa
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt
| | - Omaima Mahmoud
- Department of Psychiatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
| | - Entisar Abu Salem
- Department of Psychiatric Nursing, Faculty of Nursing, Beni-Suef University, Beni-Suef, Egypt
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