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Background: Pregnant women can get infected with COVID-19 with serious sequelae to them and their fetus. Concerns about COVID-19 vaccination safety to mothers and babies, and doubts about its effectiveness, have hindered vaccine acceptance throughout the COVID-19 crisis. The objective of the current investigation was to estimate COVID-19 acceptance rates among pregnant women in Abha city, Aseer region, Saudi Arabia, and determine its clinical and demographic correlates. Method: Descriptive questionnaire-based cross-sectional survey of a sample of pregnant women attending regular antenatal care services in Abha. We used backward stepwise multiple logistic regression analysis to evaluate the predictability of vaccine acceptance in terms of baseline clinical and demographic factors. Results: The survey included 572 pregnant women. The prevalence of acceptance of COVID-19 vaccine was high (93.7%; 95%CI: 91.7–95.7%). University graduates and women with a later gestational age were more likely to accept vaccination (OR = 6.120, p = 0.009), (t = 2.163, p = 0.036), respectively. Confidence in vaccine safety was associated with better acceptance (OR = 3.431, p = 0.001). Conclusions: The acceptance rate for vaccination among pregnant women in Abha, Saudi Arabia, is higher compared to international rate. However, our results indicate that confidence in vaccine safety was associated with better acceptance. Hence, vaccine safety was the overarching predictor for harboring positive attitudes towards it. Public health policies should capitalize on such positive attitudes and aim for total coverage of pregnant women with COVID-19 vaccination including booster dosages. [ABSTRACT FROM AUTHOR]

Background: Chronic skin diseases have been recognised as having a detrimental effect on patients' social functions. Objectives: To assess the perceived social support in patients with chronic skin disease and its associated factors. Methods: A cross-sectional study was conducted between January and April 2019 on patients with skin diseases taking treatment at Asir Central Hospital, Abha, Saudi Arabia. Patients of both sexes aged above 18 years undergoing treatment for a skin disease in ACH for more than 3 months (chronic skin disease) were recruited by simple random sampling, and a total of 249 patients returned completed questionnaires. A self-administered questionnaire was used to collect relevant information about the background and disease characteristics of the patients and the Multidimensional Scale of Perceived Social Support (MSPSS). The software package IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY, USA: IBM Corp., was used for data entry and analysis. Descriptive statistics were used for patient characteristics, and perceived social support was analysed according to specific scoring criteria. The Kruskal–Wallis test and Mann–Whitney U test were used to find out the association of background and disease variables with the perceived social support. Correlation analysis was used to find the relationship of social support with the age of the patient. All associations were considered significant at p < 0.05. Result: The mean age of the study group was 36.52 ± 14.22 years. The majority of the patients were females (71.1%). Atopic dermatitis was the most common skin disease reported, with 22.1% of all patients suffering from it. Mean scores of perceived social support score were low globally (24.97 ± 12.31), as well as in the three dimensions of significant other (7.75 ± 4.14), friends (7.90 ± 4.59), and family support (9.40 ± 5.48). A significant difference in social support was perceived by patients with a disease duration of 3 months to 1 year and those with papulo-squamous skin disease as compared to acne. The presence of skin disease in a second-degree relative indicated a higher level of social support perception and had a significant positive correlation (r = 0.194, p = 0.002) with the age of the patient. Conclusion: Saudi patients with chronic skin disease have low social support. Some important insights into the functioning of social support were suggested by the study finding, which pointed to the significant effect of disease duration, type of disease, and presence of disease in second-degree relatives on the perception of social support in patients with a variety of chronic skin diseases. Qualitative exploratory and prospective research could help in understanding this aspect of psychosocial health in a better way and help to provide solutions. [ABSTRACT FROM AUTHOR]

Objectives: The burden of postpartum depression (PPD) is significant because it remains unrecognized, and it not only affects the mother adversely but also has a negative consequence on the family life and the development of the infant. The aim of the study was to measure the prevalence of PPD and identify the risk factors of PPD among mothers attending the well-baby clinic of six Primary Health Care centers in Abha city, Southwest Saudi Arabia. Materials and Methods: A total of 228 Saudi women having a child aged between two weeks to one year were recruited in the study by using a consecutive sampling technique. The Arabic version of the Edinburgh Postnatal Depression Scale (EPDS) was used as a screening tool to measure the prevalence of PPD. The mothers were also inquired about their socio-demographic characteristics and risk factors. Results: The prevalence rate of postpartum depression was 43.4%. Family conflict, and lack of support by spouse and family during pregnancy were found to be the strongest predictors of developing PPD. Women who had reported family conflict were at six times higher risk for developing PPD compared to those who did not have a family conflict (aOR = 6.5, 95% CI = 2.3–18.4). Women who reported a lack of spousal support during pregnancy encountered 2.3 fold increased risk for PPD (aOR = 2.3, 95% CI = 1.0–4.8) and women who had not received family support during pregnancy period were more than three times (aOR = 3.5, 95 % CI 1.6–7.7) likely to experience PPD. Conclusion: The risk of PPD among Saudi postnatal women was high. PPD screening should be an integral part of postnatal care. Awareness of women, spouses and families about potential risk factors can be a preventive strategy. The early identification of high-risk women during the antenatal and post-natal period could help to prevent this condition. [ABSTRACT FROM AUTHOR]

Aim of the Study. To construct then examine the internal consistency, reliability and validity of the Arabic consultation and relational empathy (CARE) measurement tool. Design and Methodology. The CARE measurement tool was translated into Arabic version and examined on 1245 patients of a primary health care center in the eastern province of Saudi Arabia. Results. The majority of the item's responses showed high level of satisfaction. The coronach alpha of our study that examines the Arabic version of the CARE measurement tool 10 items was 0.96 showing an excellent internal consistency. The Kaiser-Meyer-Olkin measure was 0.96 indicating the adequacy of the data for factor analysis and the Bartlett test of sphericity shows (x2(45) = 8743.126, p < 0.001) indicating the adequacy of the correlation matrix for analysis. Conclusion. The Arabic version of CARE Measure seems to be consistent and reliable in the primary health care setting. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the knowledge, attitudes and practices of medical ethics among resident doctors under Saudi commission for health specialties. METHODOLOGY: A cross sectional descriptive study was conducted in June to December, 2016 on a sample of 261 resident doctors, who were available on a predetermined date of interview. A self-administered questionnaire was used to collect data, which was analysed using SPSS 20. Frequencies and percentages were used for descriptive analysis. RESULTS: More than one third (35.6%) of the respondents have poor knowledge and only 20% had good knowledge of medical ethics. Regarding source of ethics knowledge, 27% residents reported experience and 15 % reported training during residency. More respondents had positive attitude in aspects of purpose of ethics, abandoning confidentiality, reporting examination findings as normal without doing the examination. Most of the respondents exhibited a positive attitude by disagreeing that doctors should accept commission by referring patients for investigations or taking incentives from drug companies. Only 25.6% respondents reported never having encountered unethical practices by team members while a good number reported having faced it sometimes and few (16.9%) reported frequent such encounters. CONCLUSION: The findings suggest that there are gaps in knowledge attitude and practice of medical ethics among the residents, underlining the importance of strengthening medical ethics education in Saudi Arabia. [ABSTRACT FROM AUTHOR]

INTRODUCTION: It is well acknowledged that health workers experience higher level of stress and stress related health problems than other occupational groups. Thus, measuring physician stress and understanding its related factors is a topic of importance with public health implications. OBJECTIVES: To measure the level of stress and to identify the socio-demographic and practice factors associated with stress among physicians in Aseer region. STUDY DESIGN: Cross sectional study. STUDY SETTING: Physicians in government health service, Aseer region, Saudi Arabia. METHODOLOGY: A self administered questionnaire based on Perceived Stress Scale (PSS) was used in the study. Study included 375 participants across three levels (resident, specialist, consultant) and six broad specialties (Surgical, Medical, Obstetrics/Gynaecology, Paediatrics, Dermatology, Emergency & ICU); selected following a two stage sampling procedure. RESULTS: A total of 303 physicians returned completely filled questionnaires. A high mean stress score was reported (18.07±5.1). Though highest mean stress scores were found for dermatologists (21.00), no significant differences in stress was found based upon nationality, smoking status, presence of any chronic illness and specialty. Significantly more stress was found in females (df =301, t=3.68, p<0.001); and singles as compared to married physicians (df=301, t=4.52, p<0.001). ANOVA across multiple groups revealed significant difference in stress scores between younger age groups with F (2,300) =9.402; p<0.001, η²=0.05; mean=(19.10±4.91) and other age groups, and also between residents, F(2,300)=9.76; p<0.001; η²=0.06, mean=19.34±4.81 as compared to specialists (17.04±5.30) and consultants (16.56±5.11). CONCLUSION: Physicians in Aseer region experience high level of stress. Gender, age, marital status and position are significantly related to stress. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of this study was to explore gender differences in the prevalence of silent and clinical apparent cardiovascular risk factors among adolescents in Aseer Region, southwestern Saudi Arabia. Materials and methods: A cross-sectional study on a stratified sample of 1869 adolescents was carried out. They were interviewed and examined for weight and height, systolic and diastolic blood pressure using standardized techniques. Results: The study revealed high prevalence of some potential behavioral and biological cardiovascular diseases (CVD) risk factors among adolescent males and females in the study area. Behavioral risk factors included inadequate low consumption of fruits and vegetables, physical inactivity, and smoking. Physical inactivity was significantly more prevalent among females than males (42.9% and 25.7%, respectively). Smoking was significantly more among females than males (11.8% and 1.3%, respectively). Biological risk factors found were family history of CVD, obesity and high blood pressure. Obesity was significantly prevalent among females (29.4%) compared to males (20.6%). Males had significantly more high blood pressure than females. In logistic regression analysis, being male (aOR=2.992, 95% CI=1.933–4.742) and obesity (aOR=2.995, 95% CI=2.342–3.991) were found to be significant risk factors in developing high blood pressure among adolescents in the region. Conclusions: Presence of cardiovascular risk factors among adolescents is a public health problem in the region. There is a need for a national program in the country to prevent and control cardiovascular risk factors among adolescents. [Copyright &y& Elsevier]

Dravet syndrome (DS) is an epileptic encephalopathy that presents with protracted seizures in infancy, associated with fever, and frequently categorized as febrile seizure at first presentation. In the second year, myoclonia, atypical absence and complex partial seizures develop. The correct diagnosis of DS and appropriate follow-up are delayed until after appearance of signs of developmental regression in the second year of life. Timely detection and diagnosis of DS followed by management with suitable anticonvulsants and treatment plan may reduce the seizure burden and improve long-term developmental outcome. We present a case of 2 years old female with recurrent attacks of generalized tonic colonic convulsion after 1st febrile convulsion diagnosed as Dravet syndrome. The diagnosis was based on history and gene study (SCN1A). [ABSTRACT FROM AUTHOR]

Objective: To measure the unmet need and demand for family planning among Saudi women; to delineate the major reasons for not using contraceptives and identify the associated factors. Methodology: This cross sectional study was conducted in six primary health care centres in Abha city among 402 women of reproductive age ranged between 15 to 49 years, having atleast one child. Face to face interview was conducted by using a validated questionnaire. Results: The prevalence of unmet need was 32.6%. The proportion of spacers and limiters among this group was 65.7% and 34.4% respectively. The proportion of spacers among unmet need was significantly high among the younger age group and proportion of limiters were high in the older age group (p = 0.001). The major reasons for not using contraceptives was inaccessibility of family planning methods (68.0%), lack of knowledge (59.5%), religious belief (49.6%), fear of side effects of contraceptives they had suffered in the past, and opposition by husband 42.7%. Unmet need was significantly high amongst the women with lower and older age group. Low level of education is significantly associated with unmet need for contraceptive (p = 0.043). Conclusion: Around one third of the women in the present study have an unmet need for family planning and demand for Contraception for this population has been found to be high. All these findings point out the need of action in this regards. [ABSTRACT FROM AUTHOR]

Background: Widespread recognition of the impact of healthcare adverse events has triggered incident reporting system implementation to promote patient safety. The aim was to assess the effectiveness, usability, enablers, and barriers of the Electronic Occurrence Variance Reporting System (eOVR) in addition to end user satisfaction., Methods: This study comprised a cross-sectional survey two years after implementation of the eOVR. Secondary data analysis evaluated the volume of incident reporting before and after implementing the eOVR., Outcome Measures: Primary outcome measures: satisfaction and system usability, system security, workplace safety culture, training, and reporting trends. An overall satisfaction was collected., Secondary Outcome: rate of reported OVRs per 1000 admissions. Furthermore, barriers and enablers to the reporting process were explored., Results: Study findings indicate that the eOVR has been successful in terms of high satisfaction according to respondents. Most of the respondents found the system easy to access, maintained patient confidentiality and reporting anonymity. Around half the respondents indicated having a non-punitive culture of reporting in their hospital. Physicians had significantly lower scores in all primary outcomes Incident reporting increased by 33.6% (p < 0.0001) after implementing the eOVR., Conclusion: Successful incident reporting systems should be easy and simple to use, accessible and include features that guarantee anonymity and confidentiality. End-users should be trained prior to launching such a system. The implementation of such systems needs to be combined with promoting a just culture in the organization, timely feedback, more involvement and focus on physicians and junior staff which will improve user satisfaction and reporting rates., (© 2021 John Wiley & Sons, Ltd.)

Background: Continuing medical education (CME) is an everlasting process throughout the physician's working life. It helps to deliver better services for the patients., Objectives: To explore CME among resident physicians in Abha City; their current practices, their opinions, and barriers faced., Methods: A cross-sectional study was conducted among resident physicians at the Ministry of Health hospitals in Abha City using a validated self-administered questionnaire. It included personal characteristics, current CME practices, satisfaction with CME, and barriers to attendance., Results: The present study included 300 residents from 15 training specialties. Their reported CME activities during the previous year were lectures and seminars (79.7%) followed by conferences (43.7%), case presentations (39.7%), workshops (34.0%), group discussion (29/7%), and journal clubs (27.3%). Astonishingly enough, very few (8%) attended online electronic CME activities. There were significant differences in CME satisfaction scores by different training specialties. Regarding residents' perceptions of the effectiveness of different CME activities (conferences/symposia, workshops/courses, and interdepartmental activities) the results showed that workshops and courses were significantly the most effective method compared to the other two methods in retention of knowledge, improving attitudes, improving clinical skills, improving managerial skills, and in improving practice behaviors. Barriers reported were being busy, lack of interest, high cost, and lack of suitable providers., Conclusion: Based on the findings of this study, it is recommended that online learning be promoted as a CME format for trainees. There should be support of residents and clinicians through the provision of protected time for their CME activities outside their daily clinical commitments.

Background: In light of the immense attention given to patient safety, this paper details the findings of a baseline assessment of the patient safety culture in a large hospital in Riyadh and compares results with regional and international studies that utilized the Hospital Survey on Patient Safety Culture. This study also aims to explore the association between patient safety culture predictors and outcomes, considering respondent characteristics and facility size., Methods: This cross sectional study adopted a customized version of the HSOPSC and targeted hospital staff fitting sampling criteria (physicians, nurses, clinical and non-clinical staff, pharmacy and laboratory staff, dietary and radiology staff, supervisors, and hospital managers)., Results: 3000 questionnaires were sent and 2572 were returned (response rate of 85.7%). Areas of strength were Organizational Learning and Continuous Improvement and Teamwork within units whereas areas requiring improvement were hospital non-punitive response to error, staffing, and Communication Openness. The comparative analysis noted several areas requiring improvement when results on survey composites were compared with results from Lebanon, and the United States. Regression analysis showed associations between higher patient safety aggregate score and greater age (46 years and above), longer work experience, having a Baccalaureate degree, and being a physician or other health professional., Conclusions: Patient safety practices are crucial toward improving overall performance and quality of services in healthcare organizations. Much can be done in the sampled organizations and in the context of KSA in general to improve areas of weakness and further enhance areas of strength.

Breast cancer is the most common malignancy among women in Saudi Arabia. A cross-sectional study was conducted on 1,092 women attending urban primary health care centers in Abha City southwestern Saudi Arabia about breast cancer knowledge, attitudes, and related practices. Only 22.0% heard about mammography, and 41.5% heard about breast self-examination (BSE). More than half of the women in the study identified changes occurring in case of breast cancer and identified risk factors. Only 8.3% were examined by clinical breast examination (CBE), 6.2% were examined by mammography, and 29.7% performed BSE. The study points to the insufficient knowledge of women and the low practice of BSE, CBE, and mammography. Public awareness should be enhanced by all available means including mass media, schools, social gatherings, and waiting areas in primary health care centers. There is an urgent need for continuing medical education programs for health care workers in the region concerning breast cancer.

The present study targeted health care workers (HCWs) in Governmental Hospitals and Primary Health Care Centers in Abha City, southwestern Saudi Arabia. An anonymous self-report questionnaire was used to assess tobacco use and the reasons for smoking. The present study included 736 HCWs. The overall prevalence of tobacco use amounted to 26.3% (14.8% current and 11.5% former users). In a binary logistic regression analysis, males were found significantly more prone to smoke compared to females (aOR = 3.081, 95% CI: 2.004-4.739). Similarly, parental history of tobacco use was found to be a significant risk factor (aOR = 1.540, 95% CI: 1.040-2.278). Among current users, 89.9% were interested in quitting and 66.1% tried before to quit. The prevalence of smoking among HCWs in the present study, besides being a public health problem, represents a potential barrier in involving this group as a first line for tobacco control. There is a need for a national intervention programme in the country in a tailored manner for HCWs to control tobacco use parallel to the running national program for public. These interventions should begin early in basic medical education and to be applied continually during one's medical career.

Objective: To compare the outcome of breech delivery at term in women before and after the term breech trial (TBT) recommendation., Methods: A retrospective study carried out at Abha Maternity Hospital, Abha, Kingdom of Saudi Arabia comprising 796 women with breech presentation at term who delivered at our hospital between May 1997 and February 2005 divided into 2 groups. Group 1 consisted of 394 patients who were delivered 4 years before the recommendation of the TBT, and group 2 comprised 402 patients delivered 4 years after the recommendation., Results: There were no statistically significant differences between the 2 groups with regards to the mean maternal age and birth weight, p>0.05, however, parity, gestational age at delivery, booking status, and cesarean section (CS) rate reached statistically significant levels, p<0.05. Assisted vaginal delivery was conducted in 106 (26.9%) of patients in group 1 and 69 (17.1%) in group 2, this also was statistically significant. No statistically significant differences were found between the 2 groups regarding the perinatal mortality, low Apgar score, <7 at 5 minutes and complications during delivery, p>0.05., Conclusion: There was a dramatic increase in the rate of CS without a corresponding improvement in the neonatal outcome in the years following the TBT recommendation in our hospital. We suggest that the policy is formulated to reduce the number of unbooked patients with breech presentation at term in our community to reduce the CS rate in these groups of patients.