Primary Care Centers Research Articles

EHealth Literacy and Health-Related Internet Use Among Swedish Primary Health Care Visitors: Cross-Sectional Questionnaire Study.

Digitalization has profoundly transformed health care delivery, especially within primary health care, as a crucial avenue for providing accessible, cost-effective care. While eHealth services are frequently highlighted for improving health care availability and promoting equality, it is essential to recognize that digitalization can inadvertently exclude individuals who lack the prerequisites to use eHealth services, that is, those with low eHealth literacy. Previous research has identified lower eHealth literacy among older individuals, those with lower educational levels, and those who use the internet less frequently. However, in a Swedish context, only a few studies have investigated eHealth literacy. This study investigated eHealth literacy and its association with health-related internet use and sociodemographic characteristics among primary health care visitors. This cross-sectional study used a quantitative, descriptive approach. Swedish-speaking patients visiting a primary health care center participated by answering the multidimensional eHealth Literacy Questionnaire (eHLQ) and questions regarding sociodemographic characteristics and internet usage. The study compared mean scores using the Mann-Whitney U test and the Kruskal-Wallis test. A logistic regression analysis also explored the associations between eHealth literacy and significant independent variables identified in the univariate analyses. As a group, the 172 participants rated highest in understanding and engagement with their health (median eHLQ score 3, IQR 2.8-3.4), as well as in feeling secure about the confidentiality of eHealth services (median eHLQ score 3, IQR 2-3), while they rated lower in motivation to use eHealth (median eHLQ score 2.6, IQR 2-3), the suitability of eHealth services to their personal needs (median eHLQ score 2.75, IQR 2-3), and their perceived ability to understand and use health-related internet information (median eHLQ score 2.6, IQR 2-3). The logistic regression analysis identified that lower eHealth literacy was associated with older age, particularly in domains related to finding, understanding, and using health-related internet information (odds ratio [OR] 1.02, 95% CI 1-1.05; P=.03); digital technology use (OR 1.05, 95% CI 1.02-1.08; P<.001); and accessing well-functioning eHealth services (OR 1.02, 95% CI 1-1.05; P=.03). Additionally, in the logistic regression analysis, perceiving health-related internet information as not useful was linked to lower literacy in all eHLQ domains except one. Our findings regarding the primary challenges within our sample underscore the importance of developing and tailoring eHealth services to accommodate users' individual needs better, enhancing motivation for eHealth use, and continuing efforts to improve overall health literacy. These measures, which both eHealth developers and health care professionals should consider, are crucial for addressing the digital divide and expanding access to eHealth services for as many people as possible.

NARRATIVE REVIEW: DRUG AVAILABILITY IN HEALTHCARE SERVICES IN INDONESIA

This narrative review delves into the availability of drugs within Indonesia’s healthcare services, analyzing 11 articles to uncover prevalent issues such as drug shortages, inadequate planning, and various factors influencing drug availability. This review underscores the critical need to ensure sufficient drug availability to enhance patient safety across healthcare settings. By examining journal articles, this review sheds light on the multifaceted aspects of drug availability, including planning management and the methods employed to evaluate their ability. The findings provide valuable insights into improving strategies for drug availability in hospitals and primary health care centers in Indonesia. This study found that out of the 11 articles reviewed, six reported insufficient drug availability, highlighting significant challenges in ensuring consistent access to necessary medications across different healthcare settings, including both primary healthcare centers and hospitals. Furthermore, the study identified geographical disparities in drug availability, with studies conducted outside Java Island reporting more severe drug shortages than those within Java Island. In summary, this study highlights the complex interplay between factors affecting drug availability in Indonesia, including geographical location, supply chain management, and procurement practices. This underscores the need for targeted interventions to address these challenges and improve drug availability across the healthcare system. Keywords: drug availability in Indonesia, patient safety, drug procurement in Indonesia, drug shortage.

Relationship between Type 2 Diabetes Mellitus and Red Cell Distribution Width

Background and objectives: Type 2 diabetes mellitus is a prevalent health problem in the Kurdistan region/Iraq. Numerous biochemical parameters are important for screening and monitoring of diabetes mellitus, Red Cell Distribution Width is one of them. Methods: A cross-sectional study was conducted in Erbil Teaching Hospital, Rizgary Teaching Hospital, and Layla Qassim primary health care center in Erbil city-Kurdistan region/Iraq from 1st of August, 2022 to 31st of July, 2023 on one hundred and twenty type 2 diabetic patients. Many biochemical and hematological parameters were evaluated and compared with Red Cell Distribution Width in this study. Results: The mean Red Cell Distribution Width of diabetic patients was (16.64%); 61.7% of them had a high Red Cell Distribution Width. A weak positive correlation was observed between Red Cell Distribution Width -CV and each female gender, Body Mass Index, White Blood Cell count, and triglyceride (p?0.05). A potent positive and significant correlation was noticed between Red Cell Distribution Width -CV and fasting blood sugar (r=0.76, p&lt;0.001) as well as HbA1c level (r=0.92, p&lt;0.001). A moderate positive significant correlation was observed between Red Cell Distribution Width -CV and cholesterol, low-density lipoprotein cholesterol as well as serum creatinine levels (p?0.05). A weak negative correlation between Red Cell Distribution Width -CV and HDL (p&lt;0.001). Conclusion: The red blood cell distribution width might be a helpful marker in monitoring and assessing the severity of type 2 diabetes mellitus and could also help in predicting cardiovascular and renal complications.

Self-care practices among hypertensive patients at the primary health care centers in Unaizah city, Saudi Arabia

BackgroundThis study assessed the self-care practices among hypertensive patients at the primary health centers in Unaizah city, Saudi Arabia.MethodsThis cross-sectional study was conducted in 2023, at all primary healthcare centers in Unaizah city. A total of 372 hypertensive patients, aged 18 and older, who had been on follow-up care for at least 6 months were randomly selected using a cluster sampling method. Data regarding socio-demographics, health history, and hypertensive self-care practices (H-SCALE) were collected using a validated questionnaire.ResultsThe mean age of the participants was 41.4 ± 9.6 years. Of them, 34.1% were males and 65.9% were females. Only 14.0% were smokers, 55.9% had hypertension for less than 1 year, and 53.8% did not monitor their blood pressure. None of them was addicted to any substance or using alcohol. The most commonly associated chronic disease among the participants was hyperlipidemia (61.3%), followed by diabetes mellitus. The participants were most likely reported engaging in weight management-related self-care activities, followed by healthy diet activities, and medication adherence. The H-SCALE scores increased as the frequency of engagement in self-care activities increased. There were significant differences in H-SCALE scores based on age, gender, education level, and employment status.ConclusionEngaging in self-care activities is associated with better self-care behavior. Age, gender, education level, and employment status are significant predictors of hypertension self-care behaviors. Healthcare providers should educate hypertensive patients on blood pressure monitoring and integrated management of hypertension and other chronic diseases.

Knowledge, attitude and practice regarding antibiotics misuse among attendants of primary health care centers / descriptive cross-section study in Basra center

Abstract Background: Antibiotics are the communal drugs used in developing countries. The irrational use of antibiotics (Abs) is a huge problem on the national health care system which lead to development of antimicrobial resistance (AMR). Objectives: To assess the knowledge, attitude and practice regarding misuse of antibiotics by attendants of primary health care centers (PHCCs) in Basra center and studying the factors contributing to this problem. Method: A descriptive cross-sectional study conducted in 20 out of 40 PHCCs in 1st, 2nd and 3rd sectors of PHC in Basra city center /Iraq between 1st of February and the 31st of July 2023.The target population was attendants of PHCCs, then the collected data was analyzed by using Statistical Package for the Social Sciences program version 26. Results: Data of the study showed a relatively good knowledge score 77.71% regarding the proper use of Abs and AMR for the participants. 90% of the participants knew about side effects of Abs. 76.29% of the participants in the study showed good attitude about the problem of AMR and risk factors leading to it, however 2.29% of the participants had good practice which was a very low percentage and these results caused by many factors related to the persons themselves, sociodemographic features, doctors-patients and pharmacists-patients relationships, the results of current study showed that 25.7% of participants using self-prescription strategy in using of Abs. Conclusions: - Final results of statistical analysis of data collected in this study showed a relatively good knowledge about the uses of Abs and good attitude regarding misuse of Abs and risk of AMR, but despite of that there was a higher percent of bad behaviors and unproper usage of these medications. Age and educational level had strongest effects on the degree of knowledge, believes and behaviors. Despite of high percent of information sources was from educational programs in health care institutes, but some of them need to increase works on the methods of health education strategies. Keywords: knowledge, attitude, practice, antibiotics, misuse, primary health care (PHC), Basra city, Iraq

Prevalence and associated risk factors of insomnia among adults attending primary health care settings in the Kingdom of Bahrain

ABSTRACT Background: Insomnia patients often visit their primary care physician, but their sleep disorders go undiagnosed and many sufferers do not receive adequate care. This study aims to detect insomnia among adults in Bahrain and its associated risk factors in order to provide a better quality of sleep for these individuals. Methods: A cross-sectional study was conducted in a primary health care center with 400 adult participants in Bahrain. The study participants completed a self-administered questionnaire containing two parts: a structured part for sociodemographic and lifestyle factors, and the AIS. Results: Among the participants, 59% had insomnia. The highest prevalence was among students (80%) (P &lt; 0.001). Regarding risk factors, insomnia was more prevalent in females (64.5%) (P = 0.017), unmarried (66.9%) (P = 0.037), and those who practiced physical activity less than 30 minutes per day (53.9%) (P = 0.032). Conclusion: Insomnia is a prevalent problem among primary healthcare attendees that needs special attention. It is mostly associated, according to this study, with young age &lt; 30 years, female sex, being a student, and physical inactivity.

KNOWLEDGE AND SKILLS IN MANAGEMENT OF COMMON PAEDIATRIC EMERGENCIES AMONG HEALTH WORKERS IN PRIMARY HEALTH CARE CENTRES IN ZARIA

Every day, Nigeria witnesses the loss of approximately 2,300 children under the age of five, primarily due to preventable and treatable conditions such as pneumonia, malaria, and diarrhoea. These high mortality rates are disproportionately higher in rural areas compared to urban regions, where primary health care (PHC) centres often represent the only accessible medical services. Given that PHC centres serve as the first point of contact with the healthcare system for most Nigerians, it is imperative to assess the capabilities of health workers in these facilities, particularly in the management of paediatric emergencies. This study aimed to evaluate the knowledge and skills of health workers in PHC centres in Zaria concerning the management of common paediatric emergencies. A cross-sectional descriptive study was conducted among 139 health workers in PHC centres, randomly selected through a multi-stage sampling technique from both Sabon Gari and Zaria Local Government Areas. Data collection was performed using a pre-tested, semi-structured, self-administered questionnaire. The collected data were analysed using SPSS version 21, with the chi-square test applied to assess associations, and results presented in tables and charts. The findings revealed a generally low level of knowledge and skills in managing common paediatric emergencies among the health workers surveyed. Specifically, 66 (48.5%) of the respondents exhibited very poor knowledge of the causes of common paediatric emergencies, 32 (23.5%) had poor knowledge, 34 (25.0%) demonstrated good knowledge, and only 4 (2.9%) had excellent knowledge. In terms of treatment knowledge, 46.7% of respondents had very poor knowledge, 34.1% had poor knowledge, 16.3% had good knowledge, and only 3.0% had excellent knowledge. Diagnostic skills were similarly deficient, with 41 (37.3%) of respondents displaying very poor skills, 39 (35.5%) poor skills, 26 (23.6%) good skills, and only 4 (3.6%) exhibiting excellent skills. Additionally, 24.8% of respondents had very poor skills in the treatment of paediatric emergencies, 42.3% had poor skills, and 32.8% had good skills, with none achieving excellent skills. A statistically significant relationship was observed between academic qualification and knowledge of causes (p=0.004) and treatment (p=0.000), as well as between academic qualification and diagnostic skills (p=0.006). The pervasive low level of knowledge and skills among PHC health workers is alarming, particularly given Nigeria's already dire childhood mortality statistics. These findings underscore the urgent need for a strategic partnership between the Department of Paediatrics at Ahmadu Bello University Teaching Hospital and the Department of Primary Health Care in Zaria and Sabon Gari Local Governments. Such collaborations could facilitate quarterly training sessions and workshops aimed at enhancing the management of paediatric emergencies in these critical frontline health centers.

Impact of WHO's Surgical Safety Checklist-Based Program on Cleft-lip and Palate Repair Outcomes in LMICs-The CLEAN CLEFT Program.

"Clean Cleft" (CC) is an adaptation of the Lifebox Clean Cut program, designed to reduce surgical site infections (SSIs) in cleft lip and palate repairs. It focuses on 6 key processes: hand and site decontamination, surgical linen integrity, instrument sterility, timely antibiotic use, gauze counting, and WHO Surgical Safety Checklist compliance. The study explores CC's effectiveness in reducing infections, other complications, and enhancing early recovery. CC was piloted in 2 Ethiopian hospitals and 1 in Côte d'Ivoire, the primary public cleft care centers in each country. Baseline data were collected through direct observation in the operating room, with patients monitored postoperatively for infections and complications through daily ward visits and follow-up calls or clinic visits at 30 days. Post-intervention data were collected for 5 months. Data was captured in DHIS2 software and analyzed using SPSS version 26. The program enrolled 275 patients, with 156 during baseline and 119 post-implementation. Complications significantly dropped from 21.7% to 8.7% (P = .008), a 60% decrease. SSI rates fell from 18.1% to 8.0% (P = .03), while palatal fistulas decreased from 13.0% to 6.1% (P = .1) and wound dehiscence from 18.0% to 8.0% (P = .03). Adherence to perioperative standards improved, except for hand and skin preparation while pain management remained effective throughout the program. CC improved perioperative practices, significantly reducing infections, palatal fistulas, and wound dehiscence, supporting the broader program expansion to any subspecialty.

Negotiating care in organizational borderlands: a grounded theory of inter-organizational collaboration in coordination of care

BackgroundAlthough coordination of care and integrated care models aim to enhance patient satisfaction and perceived care quality, evidence regarding their practical implementation remains scarce. Understanding the nuances of collaboration across care providers to achieve effective coordination of care is imperative for seamless care integration. The aim of this study was to construct a grounded theory of how inter-organizational collaboration is performed to support coordination of care for patients with complex care needs.MethodsA qualitative design with a constructivist grounded theory approach was applied. In total, 86 participants with diverse backgrounds were recruited across multiple care settings, including hospitals, ambulance services, primary care centers, municipal home healthcare and home care services. The grounded theory was developed iteratively, based on a combination of observations and interviews, and using constant comparative analysis.ResultsCoordination of care, a complex process that occurs across interconnected healthcare organizations, is manifested as “Negotiating care in organizational borderlands.” Care coordination evolves through a spectrum of inter-organizational collaboration, ranging from “Dividing care by disease-specific expertise” to “Establishing paths for collaboration” and ultimately “Co-constructing a comprehensive whole.” These categories highlight the challenges of coordinating care across both professional and organizational boundaries. In the multifaceted healthcare landscape, effective care coordination occurs when healthcare professionals actively bridge the divides, leveraging their collective expertise. Importantly, organizational boundaries may serve a purpose and should not be dissolved to facilitate effective care coordination.ConclusionsThe key to effective care coordination lies in robust inter-organizational collaboration. Even when patients receive integrated care, healthcare professionals may have fragmented roles. This research emphasizes the importance of clearly defined lines of accountability, reinforcing mutual responsibility and facilitating bridging of professional and organizational boundaries. Healthcare professionals and policymakers can use these insights to effectively utilize inter-organizational collaboration in supporting care coordination for patients with complex care needs.

A consolidated framework for implementation research (CFIR) guided exploration of key informant perspectives on establishing a pharmacist-led anticoagulation service in primary care: a qualitative study.

Globally, pharmacist-led anticoagulation services have improved patient outcomes in secondary and tertiary care settings. However, there is a paucity of literature about establishing such services within primary care settings. This study explored key informants' perceptions regarding the systemic and procedural factors influencing development and implementation of a pharmacist-led anticoagulation service in a primary care setting. A descriptive qualitative study was conducted at Qatar's largest primary healthcare institution, the Primary Health Care Corporation (PHCC). Selected key informants, including healthcare center managers, pharmacy leads, physician leads and primary care physicians with cardiology privileges, were purposively recruited. Semi-structured interviews were guided by the Consolidated Framework for Implementation Research (CFIR) and analyzed using framework analysis. Elven key informants were interviewed. The participants expressed confidence in the feasibility and effectiveness of implementing anticoagulation service in primary care to address patients' needs. Key factors (mapped to CFIR domains) included ensuring pharmacist competency (Characteristics of Individuals), establishing effective internal and external communication (Inner and Outer Setting), and addressing staffing shortages (Inner Setting). Participants also emphasized on developing standardized operational protocols and training programs (Process), as well as integrating services with secondary care (Outer Setting). Despite challenges such as staffing, participants believed the service would effectively address patient needs if adequately supported. The implementation of pharmacist-led anticoagulation services in primary care settings was identified as both feasible and essential for improving patient outcomes. The insights from this study can inform future initiatives aimed at enhancing anticoagulation management in primary care settings.

Prevalence and Antibiotic Susceptibility Profile of Uropathogenic ESBL-producing Klebsiella pneumoniae in Keffi Metropolis, Nigeria

Urinary tract infection (UTI) remains the most common bacterial infection in humans despite the widespread availability of antibiotics. Exteded spectrum beta-lactamase production is an important mechanism of antibiotic resistance in the Enterobacteriaceae. Antibiotic resistance is a rising dilemma of significant implications on global public health. Few data exist for the prevalence and trends of Klebsiella pneumoniae antibiotic resistance in Keffi metropolis Nigeria. This study was done to determine the prevalence of ESBL-producing K. pneumoniae as well as its antibiotic susceptibility pattern regarding some predisposing factors. Aim: This study was carried out to determine the prevalence and antibiotic susceptibility pattern of uropathogenic K. pneumoniae in Keffi metropolis, Nigeria. Methodology: The current study was a carried out in Keffi, Nasarawa state, Nigeria from July to October 2024. It was a cross-sectional study comprising of 160 early morning urine samples randomly collected from consenting participants in the six selected hospitals. Isolation and identification of K. pneumoniae was done using standard microbiological methods. The antibiotic susceptibility profile of isolates was carried out using the Kirby-Bauer disc diffusion method and interpretation was done following the Clinical and Laboratory Standards Institute protocol. Results obtained in this study were analysed using Smith’s Statistical Package (version 2.8, California, USA) and P value of ≤ 0.05 was considered statistically significant. Results: The result of this study revealed an overall prevalence of 20/160 (12.5%). The highest prevalence of the isolate was seen in females 14(8.75) compared to males 6 (3.75%), while the highest prevance regarding age was recorded among the 15-34 age group 12 (7.5%) while the least was recorded among those greater than 65 years 0 (0%). Furthermore, the highest number of isolate was recorded at FMCK 7 (4.4%) followed jointly by GHK and PHC TK 4 (2.5%) with PHC, KP and PHC AJ 1 (0.63%) beign the least respectively. There was a high level of resistance to ceftazidime 20 (100%), followed jointly by ceftriaxone, cefurexime and treptomycin 19 (95%) and augmentin 18 (90%) but low to amoxicillin 6 (30%) and ofloxacin 6 (30%) respectively. Most of the isolates tested were multidrug resistant and all were extended spectrum beta lactamase (ESBL) producing. Conclusion: The relatively high detection rate of multidrug resistant uropathogenic K. pneumoniae in this study calls for concern. More concerning is the isolation from primary health care centers (PHCs) signifying the importance of universal health coverage and the place of PHCs in antimicrobial stewardship (AMS) programs as one of the strategies to control the spread of antimocrobial resistance.

Assessing Associations of Nurse-Managed Hypertension Care on Pharmacotherapy, Lifestyle Counseling, and Prevalence of Comorbid Cardiometabolic Diseases in All Patients With Hypertension That Are Treated in Primary Care in Stockholm, Sweden.

The aim was to study if nurse-managed hypertension care was associated with differences in pharmacotherapy, lifestyle counseling, and prevalence of comorbid cardiometabolic diseases among patients receiving care at primary health care centers. To assess the extent of nurses' involvement in the hypertension care, a questionnaire was distributed to all primary health care centers in Region Stockholm. Age-adjusted logistic regression models were used to analyze the results, odds ratios with 99% confidence intervals. Data was acquired from VAL, the administrative databases of Region Stockholm in Sweden, encompassing all individuals 30 years or older with a registered hypertension diagnosis who attended to the primary health care center they were registered at. Our analysis comprised 119267 patients diagnosed with hypertension registered in one of the 224 included primary health care centers. Of the 81 primary health care centers that responded to the questionnaire, 54 reported having nurse-managed hypertension care. Nurse-managed hypertension care was not significantly associated with differences in pharmacotherapy or patients' comorbidity, except for diabetes. Primary health care centers with nurse-managed hypertension care had a 10% greater adherence to national guidelines for lifestyle counseling (33.5%) compared to those without nurse-managed hypertension care (22.5%). Regardless of the organizational form of hypertension care management, more men received lifestyle counseling according to guidelines compared to women. In-house routines for hypertension care, with designated nurses, and booking systems were associated with more lifestyle counseling, which has been associated with signs of better hypertension care.

Patient hand hygiene experiences in a primary care centre in Ireland during COVID-19

The implementation of proper hand hygiene (HH) has been shown to reduce the risk of developing healthcare-associated infections. There is an increased awareness of the importance of HH since the onset of COVID-19. This study used an interpretive descriptive qualitative design to explore patients’ experiences of healthc workers’ (HCWs’) HH practices in a primary care centre in Ireland during COVID-19. The data were collected from 12 participants using in-depth, semi-structured interviews and analysed using reflexive thematic analysis. Two themes were constructed, each with two subthemes. Theme 1, ‘Focus and Awareness’, had the subthemes ‘Hand Hygiene and Patient’s Awareness’ and ‘Positive Effects of COVID-19’. Theme 2, ‘Breaking Barriers’, had the subthemes ‘Fear of Repercussions’ and ‘Responsibility and Empowerment’. Patients believed they should have a role when it comes to ensuring correct HH is performed during their episode of care. Barriers to this included the perceived reaction of HCWs to the feedback and a lack of knowledge of the five moments of hand hygiene.

The effect of interhospital transfer on pediatric burn injury mortality in a resource-limited setting.

The World Health Organization's burn mortality estimate is 180,000 annually. Ninety-five percent of all mortality caused by fire-related burns worldwide occurs in low- and middle-income countries (LMICs). Prior studies have shown that transfer status (direct transfer from an injury scene to a trauma center vs. indirect transfer from another health facility) affects patient outcomes. We evaluated the effect of interhospital transfer on burn mortality. We analyzed a burn database of pediatric patients admitted to the Kamuzu Central Hospital (KCH) burn unit in Lilongwe, Malawi. We performed a bivariate analysis based on their transfer status and mortality and a logistic regression analysis to determine the effect of transfer status on mortality after burn injury. A total of 2301 patients were analyzed, with 1095 (47.6%) being in the transfer cohort from referring hospitals. The median age was 3years (IQR 1-4). The transfer cohort had more patients presenting to the hospital more than 48h after injury. Upon multivariate logistic regression, controlling for pertinent variables, including time to presentation, burn-injured patients in the transfer cohort had increased odds of mortality (OR 2.26, 95% CI 1.22-4.19, and p=0.01) compared to patients who were not transferred. The predictive probabilities of burn mortality by TBSA showed significant differences in mortality based on transfer status at TBSA between 20% and 80%. Ensuring district hospitals and other primary health care centers in resource-limited settings are sufficiently equipped to provide initial burn resuscitation and care may decrease mortality rates associated with transferred patients.

Knowledge, attitude, and practice regarding dengue vaccine: a baseline study of community members and health providers in Indonesia.

Despite recent behavioral interventions aimed at reducing the burden of dengue, persistent unfavorable related behaviors in the Indonesian community suggest that vaccination could be effective. However, before this is implemented nationally, public perception and acceptance of the vaccine should be assessed in addition to health providers' points of view. This study aimed to assess the knowledge, attitudes, and practices (KAP) of community members and health providers in Indonesia. A cross-sectional survey was conducted in six districts of three Indonesian provinces. Respondents included both community members and health providers living within the territory of the selected primary health care centers. Pretested questionnaires were used to gather information on the sociodemographic characteristics and KAPs regarding dengue vaccines. An independent t-test was performed to compare the mean KAP scores between community members and health providers, while a logistic regression analysis was used to identify the predictors in each domain. Only 18.5% of health providers possessed high knowledge of the dengue vaccine versus only 12.5% of community members. Approximately one-third of the health providers versus one-fourth of community members displayed a high to moderate score for attitudes about dengue vaccines. Dengue vaccination practices demonstrated a more favorable score for both health providers and community members at 59.1% and 41.1%, respectively. No individual sociodemographic characteristics were associated with KAPs; rather, only education was correlated with better dengue vaccination practices. We also found that good knowledge of dengue was the only factor associated with all domains. Our findings highlight the urgent need to deliver educational interventions to health providers and community members in Indonesia to improve their awareness of dengue vaccines.

FREQUENCY OF INFECTIOUS AND NON-INFECTIOUS DISEASES DURING THE WAR IN UKRAINE BASED ON SOME PRIMARY MEDICAL CARE UNITS' DATA IN THE CHERNIVTSI REGION

Aim – to investigate the impact of the war in Ukraine and COVID-19 on the frequency of infectious (COVID-19, tuberculosis) and non-infectious diseases (hypertension (AH), diabetes mellitus (DM), obesity, thyroid pathology, chronic kidney disease (CKD)) according to data from primary health care units in Chernivtsi region..Material and methods. The statistical reports of Communal Non-commercial Enterprises (CNEs) "Kitsman Center of Primary Medical Care" of the Kitsman District Council and "City Polyclinic No. 1" of the Chernivtsi City Council for the years 2019-2023 with the number of observed population subject to medical care - 36,508 and 58,500, respectively, were analyzed.Results. During the COVID-19 pandemic (2021-2022), a surge in the incidence of tuberculosis was observed in separate communities, with an almost 7% increase per 100,000 residents in the Chernivtsi region as a whole (in 2022-2023), caused, in our opinion, by the war and an increased population migration. During the period of the COVID-19 pandemic and with the beginning of the full-scale invasion of the russian federation on the territory of Ukraine, a strict trend in the incidence of DM increase (mainly non-insulin-dependent) was established. The frequency of obesity in women increased as well by 17.5%, while in men, on the contrary, it decreased – by 17.42%. The frequency of diffuse goiter in the structure of thyroid diseases decreased by 3%, with a slight elevation in autoimmune thyroiditis.Conclusion. An obvious dependence of changes in the incidence of CKD and hypertension in linkage with the COVID-19 pandemic and the war in Ukraine was not established in the analyzed communities.

“A bit of a cough, tired, not very resilient – is that already Long-COVID?” perceptions and experiences of GPs with Long-COVID in year three of the pandemic. a qualitative interview study in Austria

BackgroundLong-COVID is a new multisectoral healthcare challenge. This study aims at understanding experiences, knowledge, attitudes and (information) needs that GPs had and have in relation to Long-COVID and how these evolved since the beginning of the COVID-19 pandemic.MethodsThe study used an exploratory qualitative research design using semistructured interviews. A total of 30 semistructured interviews with GPs in different primary care settings (single practices, group practices, primary care centres) were conducted between February and July 2022. The data were analysed using qualitative thematic content analysis with the software Atlas.ti.ResultsThis is the first study that empirically investigated Long-COVID management by GPs in Austria during the third year of the pandemic. All GPs indicated having experience with Long-COVID. In cities, GPs tended to have slightly better networks with specialists. The GPs who already worked in teams tended to find the management of Long-COVID easier. The symptoms that the physicians described as Long-COVID symptoms corresponded to those described in the international literature, but it is unclear whether syndromes and symptomes such as Post-Exertional-Malaise, autonomic dysfunction such as postural tachycardia syndrome or Mast-Cell-Overactivation-Syndrom, and cognitive dysfunctions were also recognized and correctly classified since they were never mentioned. Most GPs reacted quickly by granting the needed sick leaves and by seeing and discussing with the patients often.The treatment of the patients is described as an enormous challenge and frustrating for patient and GP if the treatment does not yield to significantly improved health also due to the high costs for the patient.ConclusionLong-COVID will continue to preoccupy our health care systems for a long time to come, as new variants of COVID-19 will continue to produce new patients without adequate prevention strategies. Therefore, it is not a question of if but when good support for GPs and adequate care pathways for people with Long-COVID will be implemented. Specific contact points that are familiar with therapy-refractory postacute infection syndromes like the postacute COVID condition as a subgroup of Long-COVID are urgently needed.

Photo-supported conversations about well-being (BeWellTM) for patients with exhaustion disorders – a controlled clinical intervention study

Introduction Health-promotion approaches to address stress-related exhaustion disorders, reduce personal suffering, improve coping and participation in everyday life are needed in primary care. The aim of this study was to investigate self-reported health and well-being before and after an intervention focusing on well-being with photo-supported conversations (BeWellTM). Material and methods Eighty-one patients (69 women), 20–67 years old, with exhaustion disorders were recruited at Swedish primary health care centres (PHCC) to a controlled clinical study. The intervention group (n = 40) were offered BeWell™ by therapists in addition to care as usual. Controls (n = 41) received only care as usual. The primary outcome, self-rated symptoms of exhaustion (Karolinska exhaustion disorder scale, KEDS), and secondary outcomes, anxiety and depression, sense of coherence, quality of life, occupational balance, and work ability, were assessed by validated questionnaires. Non-parametric statistical analyses were used to compare data collected directly after the treatment period with baseline measures. Results Demographics and self-rated baseline measures of health and well-being were comparable between the groups, apart from sick leave being more common in the intervention group. Participants in the intervention group reduced their level of exhaustion more than the control group (median difference on KEDS −9.0 vs −4.0, p = .035). However, the size of the KEDS reduction was related to baseline KEDS and, not independently associated with group assignment. Both groups improved regarding secondary outcome measures. Conclusion Stress-related symptoms decreased considerably over the treatment period for both groups. The potential benefit of the BeWell™, which was intended to facilitate recovery, needs to be further evaluated.

Patient Satisfaction with Primary Health Care Services in Qatar: A Quality Improvement Study in a Government Staff Clinic

Introduction: Patient satisfaction (PS) is a crucial measure of healthcare quality to ensure effective healthcare systems. Most previous studies focused on PS in primary health care centers, tertiary hospitals, or other settings while only a few addressed PS in staff/employee clinic settings. This study aimed to measure PS and identify factors affecting PS in a government staff clinic in Qatar. Methods: A cross-sectional quantitative research design based on a self-administered validated questionnaire was employed. The study population consisted of employees who visited the “Primary Health Care Corporation” staff clinic for a “physical” consultation between January and November 2023. Phone numbers were extracted from 942 patients’ electronic medical records. SMS texts containing links to the online questionnaire were sent. SMS and telephone reminders were conducted to reach a sufficient sample size. Results: 262 participants yielded a 28% response rate. 92% were satisfied with the overall primary health care services with aspects involving clinic accessibility (86%), physicians’ skills (84%), consultation duration (90%), condition explanation (87%), screening recommendations (80%), and shared decision-making (86%). These variables correlated significantly with the overall PS. Multivariate logistic regression analysis identified two key predictors of PS in the staff clinic: satisfaction with overall GP performance (OR=5.00; 95% CI=1.27–19.78; p=0.022) and satisfaction with overall nursing care (OR=27.88; 95% CI=5.83–133.27; p&lt;0.001). Conclusion: The primary health care services provided in the staff clinic exceeded expectations across structural, clinical, and technical aspects. These results align with the “Qatar National Vision 2030” to foster a mentally and physically resilient population.

Primary care physicians' attitudes, practices, and perceived barriers toward depression screening in older people in the Kingdom of Bahrain.

This study aimed to explore attitudes, practices, and perceived barriers of primary care physicians (PCPs) toward depression screening in older people. This cross-sectional study enrolled PCPs from randomly selected representative primary care centers in Bahrain. A self-administered piloted semi-structured questionnaire was used for data collection. We enrolled 248 PCPs in the study (82.3% females, and the mean age = 40 ± 8.7 years). More than half of the participants (54.4%) had a positive attitude toward depression screening in older people. However, only 10.9% of the participants reported systematically screening for this condition without using specific tools for screening in 45.5%. The most reported barriers toward this service are short consultation time (95%), the presence of multiple co-morbidities in this age group (90%), and the absence of guidelines or appropriate training in around 30%. Positive attitudes were significantly higher among older PCPs (p = 0.039), family physician consultants (p = 0.008), those with more than 10 years of work experience (p = 0.024), and those who participated in related educational activities (p = 0.007). Under-screening practice is associated with perceived short consultation time (p = 0.002), insufficient continuous medical education (CME) activities attendance in older people's mental health (p = 0.048) as well as having a general physician's title (p = 0.049). Only the PCPs' job title, Adjusted Odds Ratio (OR) = 3.513, 95 C.I [1.225-10.074] and attendance of CME activities, OR = 1.278, 95 C.I [1.098 - 3.192] remained significant when controlled for age and experience. More training on older people's mental health and provision of screening and management guidelines are priorities to promote older people's mental health in primary care settings.