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Siraj RA, Alrajeh A, Aldabayan YS, Aldhahir AM, Alqahtani JS, Alghamdi SM, Alqarni AA, Banakher BO, Algarni SS, Alhotye M, Khormi SK, Alghamdi HS, Alotaibi FF, Alahmari MA. Attitudes, confidence, barriers and current practice of managing depression in patients with COPD in Saudi Arabia: a national cross-sectional survey. BMJ Open 2023; 13:e069670. [PMID: 37156583 PMCID: PMC10173993 DOI: 10.1136/bmjopen-2022-069670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 04/27/2023] [Indexed: 05/10/2023] Open
Abstract
OBJECTIVE To investigate physicians' perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD). DESIGN A cross-sectional online survey was employed between March and September 2022. SETTINGS Saudi Arabia. PARTICIPANTS 1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists. PRIMARY OUTCOME MEASURES Physicians' perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD. RESULTS A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients' feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%). CONCLUSION The prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.
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Affiliation(s)
- Rayan A Siraj
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia
| | - Ahmed Alrajeh
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia
| | - Yousef S Aldabayan
- Department of Respiratory Care, College of Applied Medical Sciences, King Faisal University, Al-Ahasa, Saudi Arabia
| | | | - Jaber S Alqahtani
- Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Saeed M Alghamdi
- Department of Clinical Technology, Respiratory Care Program, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bashaer O Banakher
- Department of Respiratory Therapy, Maternity and Children's Specialized Hospital, Jeddah, Saudi Arabia
| | - Saleh S Algarni
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Munyra Alhotye
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Shahad K Khormi
- Department of Respiratory Therapy, King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia
| | - Hussam S Alghamdi
- Family Medicine, King Fahd Military Medical Complex, Dhahran, Saudi Arabia
| | - Faisal F Alotaibi
- Public Security, Medical Service, Ministry of Interior, Dhahran, Saudi Arabia
| | - Mushabbab A Alahmari
- Department of Respiratory Therapy, College of Applied Medical Sciences, University of Bisha, Bisha, Saudi Arabia
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Aldhahir AM, Alqahtani JS, AlDraiwiesh IA, Alghamdi SM, Alsulayyim AS, Alqarni AA, Alhotye M, Alwafi H, Siraj R, Alrajeh A, Aldabayan YS, Alzahrani EM, Hakamy A. Healthcare providers' attitudes, beliefs and barriers to pulmonary rehabilitation for patients with chronic obstructive pulmonary disease in Saudi Arabia: a cross-sectional study. BMJ Open 2022; 12:e063900. [PMID: 36302583 PMCID: PMC9621177 DOI: 10.1136/bmjopen-2022-063900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To assess the attitude of healthcare providers (HCPs) towards the delivering of pulmonary rehabilitation (PR) to patients with chronic obstructive pulmonary disease (COPD) and identify factors and barriers that might influence referral. DESIGN A cross-sectional online survey consisting of nine multiple-choice questions. SETTINGS Saudi Arabia. PARTICIPANTS 980 HCPs including nurses, respiratory therapists (RT) and physiotherapists. PRIMARY OUTCOME MEASURES HCPs attitudes towards and expectations of the delivery of PR to COPD patients and the identification of factors and barriers that might influence referral in Saudi Arabia. RESULTS Overall, 980 HCPs, 53.1% of whom were men, completed the survey. Nurses accounted for 40.1% of the total sample size, and RTs and physiotherapists accounted for 32.1% and 16.5%, respectively. The majority of HCPs strongly agreed that PR would improve exercise capacity 589 (60.1%), health-related quality of life 571 (58.3%), and disease self-management in patients with COPD 589 (60.1%). Moreover, the in-hospital supervised PR programme was the preferred method of delivering PR, according to 374 (38.16%) HCPs. Around 85% of HCPs perceived information about COPD, followed by smoking cessation 787 (80.3%) as essential components of PR besides the exercise component. The most common patient-related factor that strongly influenced referral decisions was 'mobility affected by breathlessness' (64%), while the 'availability of PR centres' (61%), the 'lack of trained HCPs' (52%) and the 'lack of authority to refer patients' (44%) were the most common barriers to referral. CONCLUSION PR is perceived as an effective management strategy for patients with COPD. A supervised hospital-based programme is the preferred method of delivering PR, with information about COPD and smoking cessation considered essential components of PR besides the exercise component. A lack of PR centres, well-trained staff and the authority to refer patients were major barriers to referring patients with COPD. Further research is needed to confirm HCP perceptions of patient-related barriers.
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Affiliation(s)
- Abdulelah M Aldhahir
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ibrahim A AlDraiwiesh
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Saeed M Alghamdi
- Clinical Technology Department, Respiratory Care Program, College of Applied Medical Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdullah S Alsulayyim
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Abdullah A Alqarni
- Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Munyra Alhotye
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Hassan Alwafi
- Faculty of Medicine, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Rayan Siraj
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia
| | - Ahmed Alrajeh
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia
| | - Yousef S Aldabayan
- Department of Respiratory Therapy, College of Applied Medical Sciences, King Faisal University, Al-Hasa, Saudi Arabia
| | - Eidan M Alzahrani
- Department of Physiotherapy, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Ali Hakamy
- Respiratory Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
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Alqahtani JS, Mendes RG, Aldhahir A, Rowley D, AlAhmari MD, Ntoumenopoulos G, Alghamdi SM, Sreedharan JK, Aldabayan YS, Oyelade T, Alrajeh A, Olivieri C, AlQuaimi M, Sullivan J, Almeshari MA, Esquinas A. Global Current Practices of Ventilatory Support Management in COVID-19 Patients: An International Survey. J Multidiscip Healthc 2020; 13:1635-1648. [PMID: 33239884 PMCID: PMC7680685 DOI: 10.2147/jmdh.s279031] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 10/19/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND As the global outbreak of COVID-19 continues to ravage the world, it is important to understand how frontline clinicians manage ventilatory support and the various limiting factors. METHODS An online survey composed of 32 questions was developed and validated by an international expert panel. RESULTS Overall, 502 respondents from 40 countries across six continents completed the survey. The mean number (±SD) of ICU beds was 64 ± 84. The most popular initial diagnostic tools used for treatment initiation were arterial blood gas (48%) and clinical presentation (37.5%), while the national COVID-19 guidelines were the most used (61.2%). High flow nasal cannula (HFNC) (53.8%), non-invasive ventilation (NIV) (47%), and invasive mechanical ventilation (IMV) (92%) were mostly used for mild, moderate, and severe COVID-19 cases, respectively. However, only 38.8%, 56.6% and 82.9% of the respondents had standard protocols for HFNC, NIV, and IMV, respectively. The most frequently used modes of IMV and NIV were volume control (VC) (36.1%) and continuous positive airway pressure/pressure support (CPAP/PS) (40.6%). About 54% of the respondents did not adhere to the recommended, regular ventilator check interval. The majority of the respondents (85.7%) used proning with IMV, with 48.4% using it for 12-16 hours, and 46.2% had tried awake proning in combination with HFNC or NIV. Increased staff workload (45.02%), lack of trained staff (44.22%) and shortage of personal protective equipment (PPE) (42.63%) were the main barriers to COVID-19 management. CONCLUSION Our results show that general clinical practices involving ventilatory support were highly heterogeneous, with limited use of standard protocols and most frontline clinicians depending on isolated and varied management guidelines. We found increased staff workload, lack of trained staff and shortage of PPE to be the main limiting factors affecting global COVID-19 ventilatory support management.
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Affiliation(s)
- Jaber S Alqahtani
- UCL Respiratory, University College London, London, UK
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Renata G Mendes
- Department of Physical Therapy, Cardiopulmonary Physiotherapy Laboratory, Federal University of São Carlos, São Paulo, Brazil
| | - Abdulelah Aldhahir
- UCL Respiratory, University College London, London, UK
- Respiratory Care Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Daniel Rowley
- Pulmonary Diagnostics & Respiratory Therapy Services, University of Virginia Medical Center, Charlottesville, VA, USA
| | - Mohammed D AlAhmari
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
- Dammam Health Network, Dammam, Saudi Arabia
| | - George Ntoumenopoulos
- Consultant Physiotherapist, Physiotherapy Department St Vincent’s Hospital Sydney, Sydney, NSW, Australia
| | - Saeed M Alghamdi
- National Heart and Lung Institute, Imperial College London, London, UK
- Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Jithin K Sreedharan
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | | | - Tope Oyelade
- UCL Institute for Liver and Digestive Health, London, UK
| | - Ahmed Alrajeh
- Respiratory Care, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Carlo Olivieri
- Emergency Department, Ospedale Sant’Andrea, Vercelli13100, Italy
| | - Maher AlQuaimi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Jerome Sullivan
- President, International Council for Respiratory Care, Professor Emeritus & Respiratory Care Program Director, The University of Toledo, Toledo, OH, USA
| | - Mohammed A Almeshari
- Rehabilitation Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Antonio Esquinas
- Director International NIV School, Intensive Care Unit, Hospital Morales Meseguer, Murcia, Spain
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