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Zemni I, Zemni K, Gara A, Maatouk A, Ben Fredj M, Abroug H, Kacem M, Benasrallah C, Dhouib W, Bouanene I, Belguith Sriha A. Associated factors with adherence to preventive behaviors related to COVID-19 among medical students in the university of Monastir, Tunisia. PLoS One 2023; 18:e0280921. [PMID: 36917588 PMCID: PMC10013900 DOI: 10.1371/journal.pone.0280921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/27/2022] [Indexed: 03/15/2023] Open
Abstract
INTRODUCTION Medical students should act as a model for the community in terms of compliance with preventive practices toward COVID-19. The aim of this study was to assess adherence to preventive behaviors related to COVID-19 among medical students and to identify its associated factors. POPULATION AND METHODS We conducted a cross-sectional survey in October 2020 in the faculty of medicine of Monastir. We included a representative sample of medical students during registration days for the 2020-2021 academic year. The data were collected through a self-administered anonymous questionnaire. Eleven items related to preventive practices against COVID-19 were assessed (respiratory hygiene practices (Six Item), hand hygiene practices (Three Items) and social distancing (two items)). Items were evaluated using a Likert scale of five points (from 0: (Never) to 4: (Always)). The score obtained from the sum of these items allowed to classify students into two categories: "Good compliance" if the score was ≥ 80% and "Poor compliance" if the score was less than 80%. Scores were compared according to the study population characteristics. Multivariate analysis was used to identify associated factors with good practices. The threshold of statistical significance was set at p < 0.05. RESULTS We included 678 medical students. The average age was 21.76 (SD = 1.89 years) with a sex ratio of 0.40. The protection measures most respected by the participants were related to the respiratory hygiene: correct coverage of the nose and mouth with the mask (80%), wearing masks regardless of the presence of symptoms (73.3%) and coverage of the mouth during coughing or sneezing (76.6%). Adherence to hand hygiene measures ranged from 51.4% to 66.3%. The least respected measures were related to social distancing: distancing of at least one meter from others (31.2%) and avoiding crowded places (42.5%). An overall score ≥ 80% was obtained among 61.5% of students. Referring to multivariate analysis, variables that positively affected the overall score of preventive measures related to COVID-19 were the female sex and living alone, with Beta coefficients of 3.82 and 1.37 respectively. The perceived level of stress, E-cigarette and Chicha consumption negatively affected the score with Beta coefficients of (-0.13), (-5.11) and (-2.33) respectively. CONCLUSION The level of adherence to good practice among medical students was overall moderate. Awareness programs would be needed in this population, especially for men and those who smoke and vape.
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Affiliation(s)
- Imen Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
- * E-mail:
| | - Kaouthar Zemni
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Family Medicine, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Amal Gara
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Amani Maatouk
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Manel Ben Fredj
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Hela Abroug
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Meriem Kacem
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Cyrine Benasrallah
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Wafa Dhouib
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
| | - Ines Bouanene
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Asma Belguith Sriha
- Department of Epidemiology and Preventive Medicine, Fattouma Bourguiba University Hospital, University of Monastir, Monastir, Tunisia
- Department of Epidemiology, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
- Technology and Medical Imaging Research Laboratory—LTIM—LR12ES06, University of Monastir, Monastir, Tunisia
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Abroug H, El Hraiech A, Ben Fredj M, Kacem M, Zemni I, Benasrallah C, Wafa Dhouib W, Rania Bannour R, Mehrez O, Sriha A. Smoking abstinence 1 year after acute coronary syndrome in Tunisian adults. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.1149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
In Tunisia, coronary heart disease(CHD) is the first cause of mortality, accounting one third (33.23%) of total deaths in 2017. Although smoking cessation is the most effective CHD prevention strategy, quitting smoking is difficult and two thirds of patients return to smoking within 1 year of their acute coronary syndrome (ACS). The present study aimed to evaluate the smoking cessation rate and to assess predictors of smoking abstinence in patients with ACS, one year after hospital discharge.
Methods
A prospective cohort study was conducted in the Cardiology Department and Smoking Cessation Service at University Hospital of Monastir, Tunisia from January 2015 to December 2017. During their hospitalization, all patients in the sample received individual therapeutic education including a motivational interview. The follow-up were carried out by clinic visits every two weeks. Logistic regression analysis was used to evaluate the independent predictors of smoking abstinence. The statistical analysis was conducted with SPSS software, version 21.0. A p value of < 0.05 was considered statistically significant.
Results
A total of 288 smoking patients were included in our study. All participants were male and the mean age was 55 ± 11 years. More than half (55.4%) of patients had a high level of nicotine dependence. Successful smoking cessation rate was 35.7 % [95% confidence interval (CI): 29.4-42.5%]. Independent predictors of smoking abstinence were: therapeutic adherence (odds ratio(OR): 13.8, p < 0.001), the level of nicotinic dependence (OR: 0.26, p = 0.02), the length of stay in the ICU (OR: 8.31, p = 0.001) and diabetic status (OR: 4.54, p = 0.01).
Conclusions
This study for smoking cessation highlights the importance to generalize our protocol for all Tunisian patient with cardiovascular risk.
Key messages
Smoking cessation is the most effective coronary heart disease prevention strategy. More efforts are required to improve smoking cessation in patients with cardiovascular risk.
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Affiliation(s)
- H Abroug
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - A El Hraiech
- Departement of Cardiologie, University of Monastir, Monastir, Tunisia
| | - M Ben Fredj
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - M Kacem
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - I Zemni
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - C Benasrallah
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - W Wafa Dhouib
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - R Rania Bannour
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
| | - O Mehrez
- Departement of Family Medicine, University of Monastir, Monastir, Tunisia
| | - A Sriha
- Department of Preventive Medicine and Epidemiology, University of Monastir, Monastir, Tunisia
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