Self-Perceived Competence of Primary Healthcare Physicians in Managing Medical Emergencies in Health Centers; Kingdom of Bahrain: A Cross-Sectional Study

Abstract

Background: Primary care physicians (PCPs) are the first point of contact for individuals when seeking healthcare and the cornerstone for providing a wide variety of preventive and curative services. Family physicians and general practitioners in primary care often encounter medical emergencies and their role in dealing with emergencies is essential to improve the patient’s outcome. Data about self-perceived competence of primary care physicians in dealing with emergencies in primary care in the Kingdom of Bahrain are lacking. This study aims at assessing the self-perceived competence of primary healthcare physicians in dealing with emergencies in primary care settings. Methods: A descriptive questionnaire-based cross-sectional study of primary healthcare family physicians and general practitioners in the Kingdom of Bahrain was conducted in January to February 2022. A total of 375 family physicians and general practitioners working in health centers were identified from Ministry of health database and 7 element anonymous self-administered electronic questionnaires were sent to their email to evaluate their level of competence in managing emergencies. Results: out of 375 PCPs; 184 (45.5%) participated and returned answered questionnaires. Most of the PCPs were females 117 (83.6%) with median age of 35 years. Regarding the level of competency in managing emergencies the majority either agreed feeling competent (37.5%) or were not sure if they feel competent in managing emergencies in primary care(37.5%).The study did not find any statistical significance or correlation between the reported competency among primary care physicians(PCPs) and age (P=0.486), years of practice(P=0.462), specialty(P=0.053), or the attended course; basic life support (BLS)(p=0.334),advanced cardiovascular life support (ACLS) (P=0.156), advanced trauma life support (ATLS)(P=0.691), pediatric advanced life support (PALS) (P=0.920).Study revealed that highest number of participants reported not feeling comfortable in dealing with major and multiple traumas in adults (n= 67, 47.86%) and pediatrics (n= 63, 45%) . The lowest level of competence in performing emergency skills was found in transcutaneous pacing, cardioversion, and nasogastric tube (NGT) insertion at which PCPs reported that they wouldn’t know how to start transcutaneous pacing (n= 67, 47.9%), while (n= 51, 36.4%) would perform cardioversion and nasogastric tube insertion (n= 43, 30.7%) only if no-one else was available. Most PCPs (n= 137, 97.9%) think that they need training in emergencies and the preferred method is practical training in health center by qualified staff (n= 122, 87.1%). Conclusion: Based on study findings, more efforts should be directed towards practical training of healthcare physicians in dealing with emergencies and the barriers should be explored. More practical training sessions should be devoted to pediatric emergencies, transcutaneous pacing, and cardioversion.