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issn:2229-340
1.  Attitude of primary care physicians toward patient safety in Aseer region, Saudi Arabia 
Objective:
The objective of this study was to assess the attitude of physicians at primary health-care centers (PHCC) in Aseer region toward patient safety.
Materials and Methods:
This study was conducted among working primary health-care physicians in Aseer region, Saudi Arabia, in August 2011. A self-administered questionnaire consisting of three parts was used; the first part was on the socio-demographic, academic and about the work profile of the participants. The attitude consisting of 26 questions was assessed on a Likert scale of 7 points using attitude to patients safety questionnaire-III items and the last part concerned training on “patient safety”, definition and factors that contribute to medical errors. Data of the questionnaire were entered and analyzed by Statistical Package for the Social Sciences (SPSS) version 15.
Results:
The total number of participants was 228 doctors who represent about 65% of the physicians at PHCC, one-third of whom had attended a course on patient safety and only 52% of whom defined medical error correctly. The best score was given for the reduction of medical errors (6.2 points), followed by role of training and learning on patient safety (6 and 5.9 points), but undergraduate training on patient safety was given the least score. Confidence to report medical errors scored 4.6 points as did reporting the errors of other people and 5.6 points for being open with the supervisor about an error made. Participants agreed that “even the most experienced and competent doctors make errors” (5.9 points), on the other hand, they disagreed that most medical errors resulted from nurses’ carelessness (3.9 points) or doctors’ carelessness (4 points).
Conclusion:
This study showed that PHCC physicians in Aseer region had a positive attitude toward patient safety. Most of them need training on patient safety. Undergraduate education on patient safety which was considered a priority for making future doctors’ work effective was inadequate.
doi:10.4103/2230-8229.121976
PMCID: PMC3957167  PMID: 24672271
Aseer region; attitude; patient safety; primary health-care centers
2.  Experience of the health promotion clinics in Aseer region, Saudi Arabia 
Context:
Health promotion is the most important element of primary health care. Therefore, it is essential for the health team to apply such activity.
Objective:
To describe a newly established health promotion clinic at primary health care centers, in Abha city, KSA.
Materials and Methods:
The study was conducted during the year 2009. The files of 429 individuals were reviewed after one year from attending the health promotion clinics in Abha city, KSA. Master sheet was designed based on the relevant items of the file. The health promotion services used in the study were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Program for the Social Sciences (SPSS). P-values less than 0.05 were selected for statistical significance.
Results:
After one year, the percentage of the individuals who intake imbalanced diet and did not perform any type of physical activity was more than 90% while 8% are currently smokers and 14% had depression. Clinical examination and investigation revealed that more than one quarter of our subjects were overweight. Obesity was 42% in males versus 51% in females (P<0.04). Pre-hypertension and hypertension were detected among 44 and 12% respectively. About one fifth of our subjects had pre-diabetes 21% and 3% were confirmed to have diabetes mellitus. Diet and physical activity counseling was given to all participants while referral to concerned clinics was done for individuals who suffer from high blood sugar, abnormal lipid profile, obesity and depression.
Conclusion:
This study demonstrated that health promotion clinics provided by trained professional health care team can be used as a new approach for early detection and management of the common health problems in primary health care centers.
doi:10.4103/2230-8229.90012
PMCID: PMC3237201  PMID: 22175040
Health promotion; primary health care center; services
3.  Quality of hypertension care in the family practice center, Aseer Region, Saudi Arabia 
Introduction:
Hypertension (HTN) is a common health problem in Saudi Arabia. Good control depends on the quality of care, which should be supervised and monitored regularly through clinical audit.
Aims:
The objective of this study was to assess the quality of HTN care at Al-Manhal Family Practice, Aseer Region, Saudi Arabia.
Settings and Design:
This study was conductedin 2009 at Al-Manhal Family Practice, Aseer Region, Saudi Arabia.
Materials and Methods:
Medical records of all hypertensive patients were extracted and reviewed using master sheets. Assessment of processes and outcomes of HTN care were based on the standards of quality assurance manual issuedby the Ministry of Health.
Statistical Analysis Used:
Data were entered and analyzed by SPPS, version 15. Relevant statistical tests were used accordingly and the P-value was considered significant when it was less than 0.05.
Results:
A total of 295 medical records were reviewed and assessed. Most patients were Saudi, married, and about 50% were educated. Two-hundred and thirty-one records were assessed for processes and outcomes of HTN care. Weight measurement and physical examination were carried out for 99% and 97% of the patients, respectively. For 53% of the patients, blood was checked for glucose and kidney function and a lipid profile was done. More than two-thirds of the patients were overweight and obese while 46% had diabetes. Less than one half of the patients had good control of HTN.
Conclusions:
By most standards, quality of HTN care in Al-Manhal Family Practice was unsatisfactory. Most of the patients had comorbidities and poor HTN control. Essential facilities should be provided to the practice to optimize HTN care and to improve the degree of control.
doi:10.4103/2230-8229.83366
PMCID: PMC3159226  PMID: 21897909
Aseer Region; family practice; hypertension; quality
4.  BARRIERS AGAINST APPLICATION OF EVIDENCE-BASED MEDICINE IN GENERAL HOSPITALS IN ASEER REGION, KINGDOM OF SAUDI ARABIA 
Objective:
To explore the attitudes of doctors in the general hospitals and their application of evidence-based medicine (EBM) and to identify the barriers that hinder its use.
Subjects and Methods:
This study included 346 doctors in the general hospitals of Aseer. A questionnaire was designed to assess their awareness as well as the barriers that hinder their practice of EBM. A visual analogue scale was used to assess their attitude.
Results:
The attitudes of doctors toward aspects of EBM were generally positive. However, their use of EBM sources and application were generally poor. The main reasons for retrieving evidence were to keep them up-to-date (72.8%) and to help make clinical decisions (70.2%). The least mentioned reason for evidence retrieval was research (41.9%). Review of textbooks was the main method of evidence retrieval (71.1%), while a database search was the method least used (22.8%). The main barriers to the practice of EBM practice were “lack of facilities” followed by “lack of time”, while the barrier least mentioned was the “lack of interest”.
Conclusions:
Although doctors have positive attitudes toward EBM, their knowledge and application of EBM need much improvement. The main barriers to their application of EBM are the lack of facilities and the lack of time.
Recommendations:
The necessary infrastructure for the application of EBM should be made available for all medical staff. There is a need for special courses and hands-on workshops in general hospitals to address the necessary knowledge and skills of EBM are essential.
PMCID: PMC3377014  PMID: 23012182
Evidence based medicine; Barriers; Aseer
5.  FOOT CARE AMONG MALE DIABETICS IN FAMILY PRACTICE CENTER, ABHA, SAUDI ARABIA 
Objective:
This study aims to assess the behaviors of diabetic males towards their foot care at Al-Manhal Center of Family Practice, Aseer Region, KSA.
Methodology:
A cross-sectional study was conducted for male diabetics in the Aseer region, KSA, during the first quarter of the year 2004. A questionnaire and physical examination of the foot were used to assess their behaviors towards foot care.
Results:
All the male diabetic patients (107) who attended during the study period were assessed. Mean age was 58 years, mean duration of DM was 10 years. Good diabetic control was 24%, 37% did not know the negative effect of DM on the feet,9-22% had different symptoms of diabetic foot, 53% checked their feet regularly, 31% had fungal infection while an absence of pulse was detected in 7%.
Conclusion:
This study revealed that many diabetics had negative behaviors towards foot care. There is a need for intensive health education and regular assessment in order to detect, prevent and manage diabetic foot as early as possible.
PMCID: PMC3377122  PMID: 23012175
Diabetes; Foot Care; Behaviors; Family Practice; Aseer Region
6.  ATTITUDE AND PRACTICE TOWARDS ROAD TRAFFIC REGULATIONS AMONG STUDENTS OF HEALTH SCIENCES COLLEGE IN ASEER REGION 
Objective:
The objectives of this study were to assess the knowledge, attitudes and practices of male students at the Health Science College in Abha, towards road traffic regulations.
Material and Methods:
This study was carried out during the second semester of the academic year 2002G among the students studying at the Health Science College for Boys in Abha, Aseer Region, Saudi Arabia. A questionnaire of 28 different questions was distributed to all available students and responded to under the direct supervision of the heads of the six departments of the college. The questionnaire consisted of three main parts; the first was about the socio-demographic and scientific data of the students; the second on the knowledge of road traffic regulations and the third dealt with attitudes and practice of driving and the use of seat belts.
Results:
Two hundred thirty eight out of 297 students (80%) responded to the questionnaire in this study. The mean age of the participants was 21 years, 47% lived in cities, 70% and 72% had cars and driving licenses respectively. More than half of the students had been involved in road traffic accidents (RTAs), 22% of these had been injured in these RTAs and 13% admitted to hospital for an average of nine days. High speed was the main cause of their RTAs. The mean speed at which the students drove their cars within and outside the city boundaries were 81 KM/h and 127 KM/h respectively.
The degree of knowledge of road traffic regulation was moderate to high in more than 75% of the students, while more than 90% of them believed in the importance of the use of seat belts. More than 75% of the participants mentioned that they had problems with the use of seat belts, the most common of which were forgetfulness and anxiety.
Conclusion:
This study revealed that many students had been involved in RTAs as a result of driving at high speed. Most of the students had good attitudes towards the use of seat belts. The rate of compliance to the use of seat belts increased with the legislation on its use. Continuing health education and the monitoring of compliance to road traffic regulations is necessary if the incidence of RTAs is to be reduced.
PMCID: PMC3410057  PMID: 23012129
Attitudes; Practice; Road Traffic Regulations; Students
7.  PRESCRIBING PATTERNS FOR ACUTE RESPIRATORY INFECTIONS IN PRIMARY HEALTH CARE, ASEER REGION, SAUDI ARABIA 
Objective:
The objective of this study was to identify the patterns of prescribing for Acute respiratory infections in patients attending primary health care centers in the Aseer region, southwestern Saudi Arabia.
Materials & Methods:
This study was conducted at primary health care centers in the Aseer region during November 2003. A master sheet designed by the investigator was distributed to all the working physicians in the primary health care center in the Aseer region. The master sheet included the age, sex, complaints, signs, clinical diagnosis and the type of medications prescribed. Physicians were asked to include all patients attending on 17th November 2003, and send the master sheet to the Technical Supervision Unit at Primary Care Department, General Directorate of Health Affairs. Data of the master sheet was entered and analyzed by using SPSS.
Results:
The total number of patients attending with acute respiratory infections(ARIs) was 3000 which represented 25% of the patients attending primary health care centers that day. Children formed 60% of the total number of cases. Regarding symptoms and signs, it was found that 70% had a cough, 59% had a runny nose, and 43% had a sore throat . The common cold was the most common diagnosis (42%). Antipyretics, antihistamines, antibiotics and antitussives were prescribed for 78%, 48%, 45% and 25% respectively. Statistical analysis using logistic regression revealed that the higher the temperature, the more severe the throat congestion and the presence of exudates on pharynx, the higher the likelihood to prescribe antibiotics.
Conclusion:
In this study, it was found that the prescription of all drugs for ARIs was still high in spite of the fact that these conditions are self-limiting. To rationalize prescribing for ARI, implementation of the national protocol for diagnosis and treatment of ARIs is mandatory. Further studies to explore the physician's knowledge, attitudes and behavior concerning prescribing for ARI is strongly recommended.
PMCID: PMC3410106  PMID: 23012089
Prescribing; Acute Respiratory Infections; Primary health care centers
8.  HEALTH EDUCATION RESOURCES AVAILABILITY FOR DIABETES AND HYPERTENSION AT PRIMARY CARE SETTINGS, ASEER REGION, SAUDI ARABIA 
Objective:
The aim of this study was to evaluate the availability of health materials and means on diabetes and hypertension at PHCCs in Aseer region, Saudi Arabia.
Materials and methods:
This study was carried out in PHCCs in Aseer region. A questionnaire was distributed to all PHCCs in the region. The questionnaire elicited information on the total population served, the number of diabetic and hypertensive patients, and the availability of health materials for diabetes and hypertension. Data were entered and analyzed by using SPSS.
Results:
A total of 242 PHCCs out of 245 responded to this questionnaire. There were 20 health educators (8%).Availability of health education materials ranged between 10 to 50%. Health education programs for Diabetes and hypertension were available in more than 90% of PHCCs.
Conclusion:
This study revealed that most of PHCCs in Aseer region lacked essential health education materials and means for diabetes and hypertension and, therefore were in urgent need of these materials from the Health Education Department, private health sectors and drug companies.
PMCID: PMC3410125  PMID: 23012079
Health education; availability; Diabetes; Hypertension; Aseer Region
9.  TOURIST SATISFACTION WITH PRIMARY HEALTH CARE SERVICES IN ASEER REGION 
Objective:
The objective of this study was to assess the satisfaction of tourists who utilized health care services of five selected primary health care centers in Abha, Aseer region of Saudi Arabia in the summer of the year 2000.
Methods:
This study was conducted during July of 2000 in five primary health care centers (PHCCs) in Aseer region, Saudi Arabia. Self-administered questionnaire designed by the investigators was distributed to all tourists who fulfilled the following criteria: aged above 15 years, can read and write and has intent on participating voluntarily. The questionnaire concerned satisfaction with different health care services delivered by the PHCCs and suggestions for the improvement of the services. Data was entered and analyzed using SPSS.
Results:
A total of 413 tourists fulfilled the selected criteria. The mean age of the participants was 29.2 years; 81.4% were males, 37.3% were highly educated and 32.7% came from western province. PHCCs services were accessible to 87% and the working hours at PHCCs were suitable for 88.6% of the tourists. More than three-quarters of the visitors came for cure. Satisfaction with the different health services on a 5-point scale ranged from 4.63 points for availability of medications to 4.85 points for cooperation of treating doctors. Seventeen suggestions and comments were reported by 26% of the participants. Most of these suggestions and comments were about providing an adequate number of female doctors and medications.
Conclusion:
This study revealed that most of the tourists who utilized the selected PHCCs in Aseer region were satisfied with most of the different PHCCs services. However, many tourists gave valid suggestions and comments which should be considered for the improvement of the quality of care in these PHCCs in the future.
PMCID: PMC3425759  PMID: 23011982
Satisfaction; tourists; PHCCs; Aseer Region
10.  ATTITUDE, PRACTICE AND NEEDS FOR CONTINUING MEDICAL EDUCATION AMONG PRIMARY HEALTH CARE DOCTORS IN ASIR REGION 
Objectives:
Assess the attitude and practice of Primary Health Care (PHC) physicians in Aseer region, their educational needs and recommendations to establish a continuing medical education program (CMEP) to address these needs.
Methods:
This study was carried out during the first half of 1999 in Aseer region, Saudi Arabia. A self-administered questionnaire was distributed to all PHC physicians in Aseer region. The questionnaire explored socio-demographic characteristics, scientific background, the attitude towards CME, the current method for medical updating, the barriers to CME, and the topics requested for a future CMEP.
Results:
There were a total of 383 PHC physicians in Aseer region, 86% of whom responded to this questionnaire. Of these 76.1% were Arabs, 91.2% were married, 26.3% had post-graduate qualifications and 68.6% had had no experience in the PHC field prior to arriving in Saudi Arabia. Most respondents showed a positive attitude toward CME. Nearly two-thirds (64.4%) had adequate time for CME, 86.7% allocated time for CME, and 64.4% were ready to participate as tutors in CMEP. Suggestions were given by 49.6% for establishing a CMEP in the region. The most popular methods practiced for CME were reading medical journals (79.8%) and medical textbooks (53.8%), and attending training courses (39.6%). The medical subjects that were identified as needed were emergency medicine (24.5%), pediatrics (20.8%), internal medicine (20%), and obstetrics/ gynecology (18.7%). However, 75.2% also indicated that computer literacy was a practice requirement, 57.7 and 54.1% thought designing diabetes and hypertension management programs were vital, and 41.7% said learning how to design a PHCC action plan was essential.
Conclusion:
PHC physicians in Aseer region had a positive attitude towards selective CMEP. They needed CMEP but felt its content should be in line with their practice needs.
PMCID: PMC3439742  PMID: 23008649
Attitude assessment; practice needs; CME; primary care physicians; Aseer region
11.  COST OF THE DRUGS DISPENSED FROM PRIMARY HEALTH CARE CENTERS FOR SUMMER VISITORS TO ASEER REGION 
Objectives:
Recognize the patterns and the cost of the drugs dispensed to summer visitors who attended Primary Health Care Centers (PHCCs) in Aseer region.
Methods:
This study was conducted in Aseer region during the summer of 1998. The investigators designed and distributed special forms on which were blanks for names, age, sex, diagnosis and drugs that were prescribed for summer visitors who attended PHCCs in Aseer region. At the end of season, all the forms were collected and analyzed manually by well-trained nurses and assistant pharmacists. The cost of the drugs was calculated according to the price list provided by the Medical Supply Department.
Results:
A total of 96327 forms were evaluated. These represented 25% of the total number of prescriptions issued by PHCC physicians during the summer season. The total cost of the dispensed drugs was estimated as 190533 SR (50808$). About 20% of what was dispensed was for summer visitors who had utilized the PHCC services in Aseer region. Antibiotics and painkillers cost 42% and 21% of the total cost respectively.
Conclusion:
This study showed that the cost of drugs for summer visitors in Aseer region was 20.5% of the total drug cost. This additional cost should be considered in planning the drug budget.
PMCID: PMC3437066  PMID: 23008637
Cost; primary health care centers; summer visitors; Aseer region

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