Primary Health Care Centers Research Articles

Efficiency of night shifts in Primary Healthcare Centers, Aseer Region, Saudi Arabia: Data envelopment analysis

BACKGROUND: Efficient allocation of healthcare resources is essential for meeting the increasing demand for healthcare services. This study aimed at exploring the performance of both one- and two-shift Primary Healthcare Centers (PHCCs) and examining the efficiency of healthcare centers to discover how efficiency is affected by the levels of resource allocation and staffing. MATERIALS AND METHODS: The study was conducted at 31 PHCCs assigned to cover extended hours, from 4:00 PM to 8:00 AM during May-October 2023. Study employed a quantitative approach and the data envelopment analysis technique to assess the efficiency of PHCCs, specifically focusing on night shift performance. Data were collected through interviews and surveys with primary healthcare staff including 99 doctors, 119 nurses, and 139 support staff using structured questionnaire. The DEA technique was utilized to measure the relative efficiency of the PHCCs by comparing the inputs and outputs. RESULTS: Out of 31 PHCCs, 45.2% run two shifts. Over the reported period, a total of 126,619 patient visits were recorded; 81.7% came to the two-shift PHCCs and 18.3% to the one-shift PHCCs. On average, each two-shift PHCC received approximately 161 visits/ shift, and the one-shift received 123 visits. Upper respiratory tract infections accounted for 30% of morbidities and chronic diseases for more than 20%. The performance of the two-shifts PHCCs revealed varying levels of efficiency with a score of 1.00 for the most efficient PHCC and 0.31 for the least efficient PHCC. CONCLUSION: This study underscores the importance of data-driven decision-making for healthcare administrators. Ongoing assessments and benchmarking are essential for continuously improving the quality of healthcare service and optimizing utilization of resources. Future research in this field can further explore the factors that contribute to healthcare efficiency and provide deeper insights into healthcare resource management and optimization of service delivery.

Exploring the lack of continuity of care in older cancer patients under China's 'integrated health system' reform.

Continuity of care is essential to older patients' health outcomes, especially for those with complex needs. It is a key function of primary healthcare. Despite China's policy efforts to promote continuity of care and an integrated healthcare system, primary healthcare centres (PHCs) are generally very underused. To explore the experience and perception of continuity of care in older cancer patients, and to examine how PHCs play a role in the continuity of care within the healthcare system in China. A qualitative study using semi-structured interviews was conducted in two tertiary hospitals in Nantong city, Jiangsu province, China. A combination of deductive and inductive analysis was conducted thematically. Interviews with 29 patients highlighted three key themes: no guidance for patients in connecting with different levels of doctors, unmet patients' needs under specialist-led follow-up care, and poor coordination and communication across healthcare levels. This study clearly illustrated patients' lack of personal awareness and experience of care continuity, a key issue despite China's drive for an integrated healthcare system. The need for continuity of care at each stage of cancer care is largely unmeasured in the current healthcare system for older patients. PHCs offer benefits which include convenience, less burdened doctors with more time, and lower out-of-pocket payment compared to tertiary hospitals, especially for patients with long-term healthcare needs. However, addressing barriers such as the absence of integrated medical records and unclear roles of PHCs are needed to improve the crucial role of PHCs in continuity of care.

Intensity of nursing work in a primary healthcare center: an observational study

ObjectivesIn the sphere of occupational intensity, nursing stands recognized for its inherently demanding nature, marked by a rapid succession of tasks. Our primary aim was to assess the level of job intensity within nursing by analyzing the frequency and duration of activities performed by nurses, instances of task overlap, and the distribution of break times within a primary healthcare center. MethodsThis study was conducted using a descriptive working method. Nursing activities were recorded with the observation of six nurses, each monitored for 37.5 hours. We used the Maribor System for measuring Quantity in Nursing Care in Primary Health Care Settings to measure the nursing care activities about direct patient care, indirect patient care, and other unproductive aspects through direct non-participant observations. ResultsAbout 41.5% (n = 1,640) of all nursing activities involving direct contact with patients, about 38.2% (n = 1,508) was indirect patient care, where a large amount worked with paper files (n = 666, 16.9%). In addition, about 15.0% were other nursing activities (mostly computer work), and just 5.3% (n = 210) of tasks were unproductive. The observational findings indicate a pronounced level of work intensity experienced by nurses in primary health clinics. Significantly, nurses were predominantly engaged in direct patient care tasks, often managing multiple activities simultaneously. Their transitions between tasks occurred approximately every three minutes, frequently without adequate intervals for breaks. ConclusionsThis study highlights the need to shift nurses’ focus from a task-centric approach to one centered on patient care. The prevailing emphasis on tasks may contribute to enduring fatigue and professional dissatisfaction. Consequently, there is an urgent need to redefine the scope of a nurse’s role and implement a comprehensive computer information system as an integral part of this redefined approach.

Prevalence, characteristics, and risk factors for urinary incontinence among women attending Primary Healthcare Centers in Bahrain, 2023

BACKGROUND: Urinary incontinence (UI) is a common health concern of women that often goes untreated owing to a lack of awareness and social stigma. It is associated with a lower quality of life and negative bio-psycho-social consequences. Therefore, it is crucial to diagnose UI and manage it in its early stages. This study aimed to assess the prevalence, characteristics, and risk factors in females attending Primary Healthcare Centers (PHCCs) in Bahrain. MATERIALS AND METHODS: A cross-sectional study was conducted in 8 PHCCs in Bahrain in April 2023. Females aged 18 and above were included. A multistage sampling technique was adopted. A self-administered questionnaire consisting of sociodemographic characteristics, risk factors and the International Consultation on Incontinence Questionnaire Short Form was used. Univariate and logistic regression analyses were performed. RESULTS: A total of 875 adult females were enrolled in the study with an average age of 37.5 (standard deviation = 12.3) years. Of the cohort, 24.8% patients had UI with stress incontinence as the most common type (71%), followed by urgency UI (21.2%). However, only 21.7% women had sought medical attention. Being a widow (Odds ratio [OR] = 2.49, P=0.007), retired (OR = 1.98, P=0.016), having had multiple pregnancies (95% CI: 0.82, 0.98; P = 0.016), having urogenital infection (OR = 2.50, P=0.001), having undergone surgery other than C-section (OR = 1.60, P=0.017), and constipation (OR = 1.62, P=0.038) were associated with increased risk for UI. CONCLUSION: This study revealed a relatively high prevalence of UI in females attending PHCCs. Since most patients with incontinence did not seek medical care, primary care physicians should address UI in patients using a well-structured screening tool and provide relevant health education.

Examining the multifaceted factors of night eating syndrome among adults in Saudi Arabia: A nursing perspective

BackgroundNight Eating Syndrome (NES) is a prevalent eating disorder that significantly impacts individuals' quality of life and well-being. However, most NES research has focused on adolescent populations, leaving a significant gap in our understanding of its prevalence and predictors among adults, particularly in the MENA region. This study, therefore, presents a novel contribution by filling this gap and determining the prevalence of NES and its predictors among adults in Abha, Saudi Arabia. DesignA descriptive correctional design was conducted on 714 adults randomly recruited from primary healthcare centers (PHCCs). MethodsA self-administered questionnaire, which comprised a demographic and lifestyle data sheet and the Arabic version of the NES questionnaire, was used for data collection. Results13.3 % of the participants reported having full syndrome of NES, with 16.1 % of males and 22.5 % of females reporting high NES awareness. Meanwhile, 14.4 % of the participants were non-emotional eaters. This finding is significant as it sheds light on the high prevalence of NES among Saudi adults. Significant differences were observed between NES and higher education, sleeping patterns, smoking habits, dietary type, and exercise routines, with an OR of 1.422, 40.78, 6.14, 66.70, and 4.47, respectively, and a p-value of <0.001. ConclusionNES was a common eating disorder among Saudi adults. Higher education, inadequate sleep, smoking, unhealthy diet, and lack of exercise were the most significant predictors of NES. These findings underline the importance of addressing these factors in preventing and managing NES. Social media campaigns, awareness campaigns, and cognitive behavioral and mindfulness therapies could effectively address NES. However, further research is necessary to identify underlying causes and assess their association with comorbidities, providing a clear direction for future studies.

Knowledge and competence of primary healthcare physicians in the management of diabetes-related chronic kidney disease

BACKGROUND: Diabetes mellitus (DM) is a primary cause of chronic kidney disease (CKD), a significant and growing global health issue. Primary healthcare physicians (PHPs) are crucial in detecting, managing, and preventing CKD, but many lack the necessary knowledge and skills to effectively diagnose and manage the disease. This study assessed the knowledge and competence of PHPs in managing diabetes-related CKD. MATERIALS AND METHODS: This cross-sectional study was conducted among all Primary Healthcare Physicians (PHPs) working at Primary Healthcare Center (PHC) in King Abdulaziz Medical City of the National Guard, Jeddah, Saudi Arabia. An online questionnaire was sent to all PHPs and data were collected from January 2024 to February 2024. Data analysis performed utilizing RStudio (version 4.3.1). Categorical variables were expressed as frequencies and percentages, whereas mean and standard deviations were computed for continuous variables. Kruskal–Wallis rank sum test was used to determine differences in confidence scores across various demographic and occupational characteristics. A multivariable linear regression analysis was performed to identify factors related to confidence. RESULTS: Of 141 PHPs, 122 filled online questionnaire yielding a response rate of 86.5%. responded. The majority (90.2%) were 18–45 years of age, 68.0% were qualified as family physicians, 38.0% belonged to the specialized poly clinic, and 54.9% had less than 5 years of experience. PHPs showed a varied levels of confidence and knowledge. While 76.2% were confident about the stages of kidney disease and 65.6% acknowledged the importance of the urine albumin-creatinine ratio (uACR) test, 58.1% were uncertain of interpreting uACR results and CKD diagnostic criteria. More than 60.0% were uncertain of the treatment steps postdiagnosis and prediction of CKD prognosis. Age, qualification, specialization in family medicine, and clinic affiliation were significantly related to confidence levels. CONCLUSION: The study underscores notable gaps in PHPs' knowledge and confidence concerning CKD screening, diagnosis, and management. Continuous education and targeted interventions are essential for the improvement of PHPs' competence and patient outcomes in the management of CKD.

Design of a Health Education Program to Manage Chronic Neck Pain: Protocol for a Development Study.

Chronic neck pain (CNP) needs attention to its physical, cognitive, and social dimensions. We aimed to design a health education program (HEP) with a biopsychosocial approach for patients with CNP. A literature search on CNP, health education, and biopsychosocial models was carried out. Seven physiotherapists with expertise in HEPs and chronic pain participated in three teams that evaluated the literature and prepared a synthesis document in relation to the three target topics. Experts compiled the information obtained and prepared a proposal for an HEP with a biopsychosocial approach aimed at patients with CNP. This proposal was tested in the physiotherapy units of primary care health centers belonging to the East Assistance Directorate of Madrid, and suggestions were included in the final program. The HEP for CNP with a biopsychosocial approach consists of 5 educational sessions lasting between 90 and 120 minutes, carried out every other day. Cognitive, emotional, and physical dimensions were addressed in all sessions, with particular attention to the psychosocial factors associated with people who have CNP. The proposed HEP with a biopsychosocial approach emphasizes emotional management, especially stress, without neglecting the importance of physical and recreational exercises for the individual's return to social activities. The objective of this program was to achieve a clinically relevant reduction in perceived pain intensity and functional disability as well as an improvement in quality of life in the short and medium term. ClinicalTrials.gov NCT02703506; https://clinicaltrials.gov/study/NCT02703506. DERR1-10.2196/56632.

Efficacy of the Otago-Exercise-Programme to reduce falls in community-dwelling adults aged 65-80 when delivered as group or individual training: Non-inferiority-clinical-trial

BackgroundThe Otago Exercise Programme is an effective intervention for falls prevention. However, there is limited evidence in relation to studies that compare efficacy for falls prevention when delivered Otago Exercise Programme in a group or individual format in a primary care context.ObjectiveTo compare the Otago Exercise Programme delivered as a group vs. individual format for community dwelling older adults, over a one year period. The hypothesis was that neither format would be inferior to the other.MethodsDesign:A four-year multicentre, randomized, non-inferiority clinical trial, with two arms— Otago Exercise Programme group training and individual Otago exercise training. Setting(s): 21 primary healthcare centers. Participants: A sample size of 728 participants was established. Participants were aged between 65 and 80 years; living in the community; able to walk independently; and agreed to take part in the study and provided signed informed consent. Intervention: The Otago Exercise Programme was delivered mainly by nurses in primary care, with five face to face sessions, and a reinforcement 6 months later. Participants were encouraged to exercise at home between face to face sessions. Data collection: at baseline and after 6 and 12 months from October 2017 to 2020. Primary outcome: people who reported at least one fall. Secondary outcomes: number of falls, cause of falls, consequences and assistance, adherence and satisfaction. Group allocation was blinded to the researchers involved in analysis. Reporting: Consolidated Standards of Reporting Trials recommendations for the Statement for Randomized Trials of Nonpharmacologic Treatments.ResultsEight hundred twenty-seven participants were randomized (226 were allocated in group training and 272 in individual training). The analysis of the proportion of people who reported at least one fall and number of falls showed no differences between individual and group training. Assessment of the equivalence between the interventions at 12 months showed that the confidence interval for the difference of people who reported at least one fall was found to be within the equivalence limit of 10% considered. However, in those participants with a previous history of falls, group format showed potentially greater benefit. The participants in individual training presented higher scores on the Exercise Adherence Rating Scale test. No differences were found in satisfaction between the groups.ConclusionsThe group Otago Exercise Programme is equivalent to individually delivered Otago Exercise Programme in terms of prevention of falls over a 12-month follow up. Adherence was higher in individual training. Implications: Healthcare professionals could offer either Otago Exercise Programme format dependent on patient preference and be confident that that standardized intervention provides patient benefit.Trial RegistrationClinicalTrials.gov (NCT03320668). Data registration 31/10/2017.

Comparative Analysis and Spatial Distribution of the Primary Health Care Centers and Health Manpower Across Saudi Arabia Using Shapiro-Wilk Test.

Due to the growing demand for better health services by the population pressure, Saudi Arabia is facing challenges in providing the required coverage in primary health care over all regions. The study aims to do a comparative analysis of the spatial distribution of the primary healthcare centers and health manpower across Saudi Arabia. This study deals with the analysis of the spatial distribution of the PHCCs and health manpower in Saudi Arabia regions during the period 2017-2021 by applying the Shapiro-Wilk test. This study relied on a dataset issued by the Ministry of Health (MoH). The variance of the spatial distribution of the dataset was also analyzed using the T-student and Binomial tests. This study found that PHCCs of 2020; the dentists of 2021; and Allied Health Personnel of 2017, 2020, and 2021 were normally distributed. However, the distribution of the population and all datasets of the other health indicators is a non-normal distribution. In addition, the correlation between the number of PHCCs and regions based on population is significant in all the regions. Moreover, The number of dentists showed a significant correlation with the population in most regions, except Riyadh, Makkah, and Jazan. However, the number of physicians, allied health personnel, nurses, and family medicine practitioners generally did not correlate significantly with the population, with exceptions for nurses in Tabuk and family medicine in the Northern Borders. Finally, the spatial distribution of the population shows the concentration in three major regions which are Riyadh, Makkah, and Eastern Province. Despite the expansion in the number of PHCCs and health workers and spread in all regions of Saudi Arabia, their spatial distribution still requires the establishment of more of them to provide the basic health services necessary to cover the actual needs of the population.

Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) Online: a mixed methods evaluation exploring the feasibility of implementing a virtual culturally tailored diabetes self-management programme for African and Caribbean communities

ObjectivesTo assess the feasibility and acceptability of delivering Healthy Eating and Active Lifestyles for Diabetes (HEAL-D) Online.InterventionHEAL-D Online—a 7-week culturally tailored type 2 diabetes educational programme delivered using online platform.SettingProgramme...

Assessment of Women's Knowledge about the Risks of Medication Use During Pregnancy in Al - Najaf Provence

Objective: The current study aims to assess women's knowledge about the Risks of Medication Use during Pregnancy and determine the relationship between Women's Knowledge about the Risks of Medication Use during Pregnancy and demographic characteristics. Methodology: A descriptive design /cross sectional study was conducted using analytical utilities to accomplish the stated objectives. In the time frame of 1st November 2023 to 19th July 2024. A non-probability sampling (Purposive sample) approach was used, based on the following criteria: pregnant women in any stage of the pregnancy, including the first, second, and third trimesters (primi gravida and multigravida). A sample of 250 pregnant women was chosen from those admitted to Al-Zahraa Maternity Teaching Hospital/ Al-Furat Teaching Hospital/ AL-Hakim Teaching hospital / primary Health care centers (Maternal, child, and infant care units). Results: the results show the level of knowledge differs significantly (P&lt;0.05) according to level of education in which women who have institute and above exhibited the highest level of knowledge (MS=2.05). On the other hand, women whose husbands work in free jobs showed the highest level of knowledge (MS=1.97) while those whose husbands are retired exhibited the lowest level of knowledge (MS=1.50). Regarding gestational age, pregnant women within the (18-22) weeks exhibited the highest knowledge (MS=2.03). Conclusion: The study found that Women knew very little about the possible effects of some medications on fetal development, on the other hand the participants had little awareness of the safety of anticonvulsants and medications for the common cold and flu. Women had moderate levels of knowledge regarding the safety of using paracetamol (acetaminophen) for pain and fever during pregnancy.

Access to Maternal and Child Health Care Services in Primary Health Care Centers in Nigeria: Perspectives from Primary Health Care Nurses

Access to Maternal and Child Health Care Services in Primary Health Care Centers in Nigeria: Perspectives from Primary Health Care Nurses

Primary Healthcare Services and Health-Related Quality of Life of Older Persons with Non-Communicable Diseases: A Narrative Literature Review

In response to the rising burden of non-communicable disease (NDC), the World Health Organization (WHO) developed tools to enable early detection and management of NCDs in Primary Healthcare centers (PHC). Globally, the prevalence of NCDs remains alarmingly high with 41 million deaths annually. Of these, 17 million people die before the age of 70, and 86% of these premature deaths occur in low-and middle-income countries. This narrative review aimed to assess the effect of PHC services on health-related quality of life (HRQoL) of older persons with NCDs, to critically analyze the potential of the existing literature in informing improvements in PHC services. We searched various databases (PubMed, Springer, Scopus, and ScienceDirect) for relevant literature. Peer-reviewed articles on the influence of PHC services on HRQoL among older persons with NCDs written and published in English between January 2013 and May 2024 were considered. The review indicates that effective PHC services are linked to good HRQoL. However, PHC services are sub-optimal and poor in low- and middle-income countries, hence more health interventions are essential to improve PHC services to enhance HRQoL of older persons.

A cross-sectional study on knowledge, attitude, and practice among type 2 diabetes mellitus patients attending a primary health care center in the rural region of Tamil Nadu

A cross-sectional study on knowledge, attitude, and practice among type 2 diabetes mellitus patients attending a primary health care center in the rural region of Tamil Nadu

Perception towards electronic health records & uptake of digital health IDs among the urban residents in northern India: A mixed methods study.

Background & objectives Ayushman Bharat Digital Mission (ABDM) envisages a unique digital health ID for all citizens of India, to create electronic health records (EHR) of individuals. The present study assessed the uptake of Digital Health IDs by the patient and general population, their attitude toward EHR, and explored the barriers to digital ID and utilizing electronic health records services. Methods A concurrent explanatory mixed methods study was undertaken in Chandigarh, India, with an analytical cross-sectional design as a quantitative part and a qualitative descriptive study. The study participants were 419 individuals aged ≥18 yr who attended the urban primary healthcare centre (n=399) and the community-based screening camps (n=20) between July 2021 and January 2022. Latent Class Analysis (LCA) was undertaken to identify hidden sub-population characteristics. In-depth interviews were done to identify the barriers to health ID uptake. Results The digital health ID uptake rate was 78 per cent (n=327). Among the study participants, those who were aware of EHR, those who wanted a national EHR system, those who were confident with the government on EHR security, and those who were willing to make national EHR accessible for research showed significantly higher digital health ID uptake than their counterparts. The themes identified under barriers of uptake from the qualitative interviews were lack of awareness, technology-related (including digital literacy) and utility-related. Interpretation & conclusions Increasing EHR awareness, digital health literacy, and enacting data protection laws may improve the acceptance of the digital health ecosystem in India.

Parental knowledge and attitudes toward food allergies: a cross-sectional study on determinants and educational needs

BackgroundFood allergy (FA) may often lead to fatal consequences if it is treated promptly. Parents of children with FA should have adequate knowledge to improve health outcomes and reduce the associated burden. This study aimed to examine the knowledge and attitudes regarding FA among parents of children with FA.MethodsThis was a cross-sectional study conducted among parents attending a primary healthcare center using convenience sampling. The minimum sample size of 280 was calculated using an equation based on the local prevalence of FA among children, and was increased to account for missing data. The data were collected using a four-section questionnaire that collected data about the parents and their children and included questions about knowledge and attitudes regarding FA. The knowledge score was calculated by summing the number of correct answers, with a maximum of 15 points. The Mann–Whitney and Kruskal–Wallis tests were used to examine the associations between the knowledge score and other variables. Spearman’s correlation was employed to test the correlations between the knowledge score and other variables.ResultsA total of 381 parents completed the questionnaires, of whom 71.9% were mothers and 28.1% were fathers. The prevalence of food allergies was 14.22%. Almost one-third had children who had one or more types of FA (32.8%). Most of those patients had received a professional diagnosis of FA (75.3%). The median knowledge score was 7.0 (IQR = 6–8), with variable proportions of correct answers across and within topics. A higher knowledge score was significantly associated with parenting a child with FA (p = 0.006), comorbid asthma or eczema (p = 0.012), the preference to acquire information from professional health agencies (p < 0.001), and higher educational (p = 0.002) and income (p = 0.001) levels. Moreover, the number of discussions held with a healthcare professional regarding FA was significantly correlated with the knowledge score (r = 0.210, p = 0.019). Online resources were the most commonly reported source of information (65.4%). Parents believed that having a child with FA can cause stress in the family (76.1%) and impact siblings’ daily lives (66.7%), while only a minority viewed FA as stigmatizing. Additionally, the majority encouraged governmental spending on FA research (92.9%).ConclusionsParenting a child with FA, comorbid asthma or eczema, number of discussions held with healthcare professionals, and education and income levels were significantly associated with a higher knowledge score. Educational interventions targeting parents should blend emotional regulation, medical information, and management skills to increase knowledge about FA and alleviate associated stress.

Assessment of knowledge regarding prediabetes among a sample of family physicians in (Baghdad city).

To assess the level of knowledge among family physicians regarding prediabetes. The cross-sectional study was conducted from March 1 to June 30, 2020, at primary healthcare centers in Al-Karkh and Al-Rusafa health directorates of Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad. The sample comprised family physicians of either gender. Data was collected using an pre-designed, structured questionnaire that was disseminated online. Data was collected using SPSS 25. Of the 145 questionnaires distributed, 113(78%) were returned duly filled; 99(87.6%) females and 14(12.4%) males. The overall mean age was 34.21±5.8 years (range: 26-49 years), The knowledge level was good in 60(53.1%) cases, and 59(52.2%) suggested screening programmes as a preventive measure. Good level of knowledge was significantly associated with having diabetes or family member with diabetes 44(51.7%), attending training courses 37(44.1%) and professional experience >10 years 15(25%). More than half the respondents had a good level of knowledge about prediabetes. There is a need to improve the knowledge of physicians further about prediabetes.

The psychological impact of COVID-19 pandemic on Iraqi health workers.

To explore the psychological impact of coronavirus disease-2019 on frontline healthcare workers in Iraq. The cross-sectional study was conducted from November 2020 to September 2021 after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad, Iraq, and comprised doctors and nurses from 4 teaching hospitals and 8 primary healthcare centres in Baghdad. Psychological sequels, like anxiety, depression, fear and insomnia, were assessed along with exposure to coronavirus disease-2019. The study questionnaire was based on the Patient Health Questionnaire Anxiety and Depression Scale. Data was analysed using SPSS 26. Of the 400 participants, 288(72%) were doctors and 112(28%) were nurses. Overall, 215(53.7%) subjects had had a coronavirus disease-2019 infection, 192(48%) reported having anxiety, 148(37%) fear, 100(25%) depressive symptoms, and 51(12.8%) complained of insomnia. Doctors were more likely to have anxiety than nurses (p<0.05), but the difference in terms of depression was not significant (p>0.05). The mental health of the frontline healthcare workers was found to have been affected by the coronavirus disease-2019 pandemic, with anxiety and fear being the main symptoms.

Factors affecting symptom duration and recovery among home-treated COVID- 19 patients in Baghdad-Iraq: a cross-sectional study.

To determine the prevalence of Long COVID among home-treated coronavirus disease-2019 cases, and the factors that may influence the duration of symptoms. The cross-sectional study was conducted from February to July 2021 at 20 primary healthcare centres in 10 health districts of Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad. Those included were adults of both genders who previously had coronavirus disease-2019 infection as diagnosed through on polymerase chain reaction test, and received supportive treatment during isolation at home. Data was collected through direct interview using a questionnaire which consisted of demographic characteristics, comorbidities, smoking history and symptoms of coronavirus disease-2019 along with their duration. Measurement of weight and height was also done for each subject. Data was analysed using SPSS 27. Of the 400 participants, 248(62%) were males and 152(38%) were females. The overall mean age was 40.8±12.8 years (range: 18-71 years). Of the total, 121(30.25%) subjects had persistent symptoms for >4 weeks. The mean duration of illness was 4.2±3.6 weeks (range: 1-16 weeks). The symptoms that lasted for >4 weeks were fatigue 94(23.5%), loss of smell or taste 59(14.75%), and cough 8(2%). Age, smoking status, comorbidities and the total number of initial symptoms showed a significant association with the duration of illness (p<0.05). A substantial number of mild to moderate coronavirus disease-2019 cases suffered from persistent symptoms. The duration of illness could have been influenced by age, comorbidities, smoking status and total number of initial symptoms.

Nurses' health promotion practices in rural primary health care in Nigeria. A qualitative study.

Nurses play a vital role in providing high-quality primary healthcare and health promotion services. The state of research highlights their often complex operational realities and shows the need for an evidence-based understanding of nurses' perspectives on health promotion practices, especially in low-resource settings. This study focuses on how community health nurses in rural primary healthcare centers in Nigeria perceive their health promotion role and the opportunities and challenges of, and potential entry points for strengthening, their practice. A sample of 10 nurses from eight rural primary healthcare centers in eight local government areas of Anambra state, Nigeria, was purposively selected. Data were collected via semistructured telephone and written interviews and analyzed by qualitative content analysis using a deductive-inductive approach. Nurses emphasized their commitment to supporting patients and communities to develop skills and take control of their own lives. Nurses described their role as facilitators of behavioral and environmental change, individual and community empowerment facilitators as well as social activists. Factors that enhance the health promotion practice of nurses include adequate skills, sufficient human and material resources and community support and participation. Inhibiting factors included insufficient funding, poor working conditions, staff shortages, high workload, lack of training opportunities and low participation of community members. Overcoming challenges and facilitating health promotion activities in rural communities require bolstering nurses by providing further training opportunities for enhancing their health promotion competencies and creating supportive environments. Future research should focus on how to strengthen nurses' health promotion efforts through interprofessional and intersectoral collaboration.