Search

Background: A vaccine ensures children that they are immune to or resistant to an infectious disease. Objectives: The study aimed to assess mothers’ knowledge. In addition, identify the reasons for noncompliance with vaccination of their children, and the relationship between the mothers’ knowledge with their educational level. Materials and Methods: A descriptive study was designed for a sample of 250 mothers attending primary health care centers between September 15, 2022, and December 20, 2022, for their children’s immunizations. The tool of the study contains questions about the sample’s sociodemographic characteristics. As well as 7 questions about the mother’s knowledge and 12 questions about reasons for children’s inadequate immunizations. Descriptive and inferential statistics were performed. Results: The results revealed that regarding mothers’ knowledge about immunization, the study revealed that most mothers do not have sufficient knowledge about vaccinations for their children. Most of them believe that vaccines can be harmful to the child (81.2%). The study found a linkage between mothers’ knowledge of vaccinations with their educational level. Conclusion: This study concludes that insufficient knowledge of mothers about vaccination and the reasons for fear of side effects and the unavailability of the vaccine entails effective dissemination of information, campaigning, and family involvement.

Copyright of Medical Journal of Babylon is the property of Wolters Kluwer India Pvt Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Primary healthcare centers provide a wide range of healthcare services, with nurses playing pivotal roles in maintaining the quality of care. To enhance nurse performance, it is essential to gain insights into their experiences regarding the implementation of nursing services in these institutions. Objective: This study aimed to explore the issues and challenges related to nursing services in primary health care centers through the perspectives of Indonesian nurses. Methods: Qualitative research using a phenomenological approach was conducted. Twelve nurses from primary health care centers were purposively selected as study participants. Data were collected through face-to-face, semi-structured interviews between January 2022 and March 2022. Thematic analysis was employed for data analysis. Results: The analysis yielded five main themes: 1) Working with additional roles and duties, 2) Uncertainty regarding nurses’ roles and functions, 3) Nurses' concerns about the nursing profession, 4) Barriers to implementing nursing services, and 5) Nurses' expectations concerning nursing services. Conclusion: Nurses in primary health care centers face challenges in fully carrying out nursing services. Numerous issues and obstacles exist in the provision of nursing services at primary healthcare facilities. Therefore, it is essential to strengthen the authority and autonomy of nurses working in primary health care settings.

Background: Primary healthcare centers provide a wide range of healthcare services, with nurses playing pivotal roles in maintaining the quality of care. To enhance nurse performance, it is essential to gain insights into their experiences regarding the implementation of nursing services in these institutions. Objective: This study aimed to explore the issues and challenges related to nursing services in primary health care centers through the perspectives of Indonesian nurses. Methods: Qualitative research using a phenomenological approach was conducted. Twelve nurses from primary health care centers were purposively selected as study participants. Data were collected through face-to-face, semi-structured interviews between January 2022 and March 2022. Thematic analysis was employed for data analysis. Results: The analysis yielded five main themes: 1) Working with additional roles and duties, 2) Uncertainty regarding nurses' roles and functions, 3) Nurses' concerns about the nursing profession, 4) Barriers to implementing nursing services, and 5) Nurses' expectations concerning nursing services. Conclusion: Nurses in primary health care centers face challenges in fully carrying out nursing services. Numerous issues and obstacles exist in the provision of nursing services at primary healthcare facilities. Therefore, it is essential to strengthen the authority and autonomy of nurses working in primary health care settings. [ABSTRACT FROM AUTHOR]

Yusransyah,1,2 Eli Halimah,1,3 Auliya A Suwantika1,3 1Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, West Java, Indonesia; 2STIKes Salsabila Serang, Pharmacy Study Program, Banten, Indonesia; 3Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, West Java, IndonesiaCorrespondence: Eli HalimahPharmacy Faculty, Padjadjaran University, Jl. Raya Bandung Sumedang KM 21, Jatinangor, West Java, IndonesiaTel +11 8122138616Email eli.halimah@unpad.ac.idIntroduction: The prevalence of hypertension in Indonesia is increasing, not least in some peripheral areas, including in Pandeglang District, Banten Province. The government of Indonesia, through the Social Health Insurance Administration Body (BPJS Kesehatan) has launched a chronic disease management program (Prolanis) to achieve more optimal results in treating patients with chronic diseases, including hypertension.Objective: This study aimed to measure the quality of life of Prolanis hypertension patients at the primary healthcare centers (PHCs) using EuroQol-5 Dimensions-5 Levels (EQ-5D-5L) instrument and taking pharmacists’ counseling intervention into account. This study was conducted in 96 Prolanis patients, consisting of 48 patients from 8 PHCs who did not receive pharmacists’ counseling intervention (control group) and 48 other patients from 8 different PHCs who received 4 times intervention (intervention group). This study was conducted in a period of 3 months (June–August 2019) in 16 sub-districts of Pandeglang District.Methods: An experimental study design was applied by considering a purposive sampling method. Patients’ quality of life were measured by using EQ-5D-5L instrument and its Indonesian value set. For data analysis, we applied the Kruskal–Wallis, Mann–Whitney, Wilcoxon, and Binomial tests to investigate the differences of patients’ quality of life in both groups of control and intervention.Results and Conclusions: The results showed that the average utility value of the intervention group experienced an improvement at each meeting (m1 = 51.25%; m2 = 66.25%; m3 = 84.17%; and m4 = 91.67%), while the control group experienced a lower and more fluctuative improvement than the intervention group (m1 = 65.42%; m2 = 70.42%; m3 = 80.42%; and m4 = 76.67%). The same results also occurred in the average value of visual analogue scale (VAS). There was a better improvement in the intervention group than in the control group.Clinical Trial Registration Number: 62/UN6.KEP/EC/2019.Keywords: quality of life, Prolanis, hypertension, primary healthcare center, BPJS Kesehatan, EQ-5D-5L

Objective: Proper use of inhaler devices is essential in the management of chronic obstructive pulmonary disease (COPD) and asthma. The aim of this study was to evaluate the inhalation device usage skills of COPD and asthma patients who admitted to the primary health care centers and try to figure out suggestions for good inhalation technique. Methods: Patients aged 18 to 80 years, who applied to primary health care center with the diagnosis of COPD and asthma and using inhaler devices were included in the study. Demographic data of the patients were recorded. Patients were asked to demonstrate the use of their prescribed inhaler devices. Inhaler technique was assessed by the inhaler device usage scoring system. Skill scores for each inhaler devices were calculated. The relation between inhaler device, inhaler device skill scores and demographic parameters were evaluated. Results: In total, 120 patients (62 male, 58 female) were included in the study. The mean age of the study population was 59±11.5. Fifty-one point seven percent of the patients had COPD and 48.3% had asthma. Of those 56.7% of the patients were using metered dose inhaler (MDI), 20% were using turbohaler, 20% were using discus and 40.8% were using dry powder inhalers (aeroliz er,handihaler,capsair,neohaler). Average skill scores for inhaler devices were 4.4±2.77, 5.6±2.05, 5.9±2.71 and 8±1.64 for MDI, turbuhaler, discus and dry powder inhalers (DPI) respectively. There was a positive correlation between ODI skill score and education level (r=0.400, p=0.019). In patients with COPD, use of DPI was more frequent and the average score was higher than in patients with asthma. (p=0.003, p=0.002 respectively). Conclusion: The inhaler device most used and has the lowest skill score was MDI. DPI was the devices with the highest rate of use with proper technique. Primary health care centers may play a more effective role regarding inhaler device use with proper technique in the management of COPD and asthma. Evaluating of the patients' ability to use inhaler devices and retraining if necessary, will have positive impacts on the long-term outcomes of COPD and asthma. [ABSTRACT FROM AUTHOR]

Today mothers or the clients who attending to hospitals or Primary Health Care Centers prefer high-quality care services so they interact everybody from the reception, admission staff, doctors, nurses, ward staff, ambulance, personnel, so clients are satisfied with health services if the physicians and nurses worked properly and with good quality. If the performance is good and perfect mothers or clients are highly satisfied. The objectives of the study are to identify the client’s satisfaction with family planning. A descriptive, cross-sectional design. Anon-probability convenient methods were used. The sample was included one hundred women who attended to Primary Health Care Centers in Erbil City. The study conducted in main primary Health Care Centers in Erbil from September 2015 to September 2016. The data collection was collected by the interview technique with clients and women depending on the questionnaire. The questionnaire was used for data collection, including three parts; part one socio-demographic characteristics for sample study and; part two included questions related to client's satisfaction regarding practices about family planning methods and; part three questions related to their satisfaction regarding knowledge of family planning methods, so depending on scoring system for data collection as (1 for Yes, and 2 for No). The study revealed that three levels of client’s satisfaction (good 23%, fair 44%, 33% bad) regarding family planning and there was no significant association between most of the variables and their satisfaction except their level of education and age so there was highly significant association between age, education level and their satisfaction with family planning knowledge and practices. Majority of the sample study were from urban, and most of them were illiterate. The study revealed that there were three levels of satisfaction about family planning, and there was no significant association between most of the variables and client’s satisfaction regarding family planning except age and their educational level so there was the highly significant association between these two variables and client’s satisfaction. .

Introduction: The economic burden of diabetes could result in public health problems. To formulate an effective response, it is important to understand the cost of illness of the disease. This study aimed to determine the cost of illness in type 2 diabetes mellitus patients in Surabaya, Indonesia. Methods: The study was conducted in 15 Primary Healthcare Centers in Surabaya on January-March 2019. This was a cross sectional study using purposive sampling method. The study was based on a societal perspective. The cost measurement method used a list of interview questions to determine the cost of illness. Results: Fifteen Primary Health Care Centers in Surabaya were chosen. A number of 218 patients who received either insulin (in monotherapy or combination) or oral antidiabetic drug (in monotherapy or combination) were interviewed. Results showed that the average total annual costs of type 2 diabetes mellitus patients was IDR 1,712,133.30 ± 2,498,851.17 per patient per year; direct medical costs was IDR 1,274,307.43 ± 2,395,862.84 per patient per year; direct non-medical costs was IDR 145,812.62 ± 299,984.61 per patient per year; and indirect cost was IDR 292,013.24 ± 483,597.68 per patient per year. The highest cost was direct medical cost which was drug cost accounted for IDR 969,730.10 ± 2,343,852.46 per patient per year. Conclusion: This study provides important data regarding cost of illness in type 2 diabetes mellitus patients and can be used as a guide for further research and policy. [ABSTRACT FROM AUTHOR]

Copyright of Multi-Knowledge Electronic Comprehensive Journal For Education & Science Publications (MECSJ) is the property of Multi-Knowledge Electronic Comprehensive Journal For Education & Science Publications (MECSJ) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To determine the relationship between severity of anemia and nutritional factors determinant at Primary Health Care Centers. Methods: A descriptive study has been carried out at AL.Russafa Health Directorate (Bab AL Muadham, and AL Mustanseria) ideal training health care center. AL-Karkh Health Directorate (AL-Salam) ideal training health care center. Non-probability sample consists of (76) anemic pregnant women. questionnaire has been designed and constructed to be used as a means of data collection. Data collection is performed through interview techniques, and the use of the study instrument after permission were obtained from the pregnant women for the period 2nd January to 17th March 2020. Results: The results of nutritional factors indicates that (consumption of dairy products, vegetables, eggs, and fruits) are highly consumed per day (77.6%, 100%, 46.1%, and 92.1%) as indicated by high mean scores. While (consumption of poultry meat, dates and nuts) are moderately consumed per weeks (55.3%, and 56.6%). The remaining nutritional items are lower consuming that is (red meat products, fish, liver, and nutritional plants). Sever anemia found in (6.6%), moderate severity of anemia in (61.8%), and mild anemia in (31.6%). high significant relationships found among severity of anemia with consumption of red meat, consumption of poultry meat, and fish consumption (p-value= 0.004, 0.001, and 0.005); the finding also show significant relationship between severity of anemia and eating nutritional plants (p-value=0.007). Conclusions: the study results concluded high significant relationships between severity of anemia with consumption of red meat, consumption of poultry meat, and fish consumption and eating nutritional plants. Recommendation: Teach women in pregnancy age to dietary habits as a part of an overall approach to health promotion, Increasing level of awareness in women and their families about the risk of anemia on pregnancy. [ABSTRACT FROM AUTHOR]

Objective: To identify the effect of the Instruction program on the Practices of pregnant women who suffering anemia. A quasi-experimental design was carried out with the application of pre- post test for the study and the control group. Purposive sample, consists of (60) pregnant women diagnosed with anemia attending four health care centers in Baquba city. The highest percentage of pregnant women (30%) (33.3%), respectively, at age group (25-29) years for study and control, with regard to the educational level (30%) (36.7) respectively intermediate and primary school graduate. (96.7%) (100%) in both groups were housewives. The two groups (36.7%) were within (low socioeconomic status), (43.7%) (56.7%) having (1-2) pregnancies, in which (46.7%) of women are reveal a level of (8.1-9) g/dl that is less than normal pre instructional program and the level is increased to normal level post instructional program (10.1-11) g/dl in (53.3%), and to (> 11) g/dl in (30%) of pregnant women. The results also present that the pregnant women in study group showing fair level of Practices about anemia in pre-instructional program and their level increased to (100%) in post-instructional program. While the level of control group did not changed. [ABSTRACT FROM AUTHOR]

Diabetes in combination with abdominal obesity and hypertension is the leading cause of cardiovascular diseases (CVD) and death. Type 2 diabetes (T2DM) increases CVD risk in two- to fourfold. The prevalence of CVD is constantly rising in India and is higher in urban areas. In addition, more than 50% of diabetic patients are still undiagnosed in the general population. The Madras Diabetes Research Foundation-Indian Diabetes Risk Score (MDRF-IDRS) is a cost-effective and very simple tool, which can be used at a primary health care center routinely. It is observed that people with increasing age, sedentary lifestyle, greater abdominal obesity, and family history of diabetes are at a high risk for diabetes and its complications. MDRF-IDRS is helpful for mass screening of diabetes and its complications in North Indian population to prevent the incidence of diabetes and with lifestyle interventions, knowledge, and awareness, it helps to reduce and revert the complications of diabetes. It is suggested that regular practice of MDRF-IDRS-based screening at primary health care center may also reduce the burden at the critical care center in North India. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The objective of the study was to assess the availability of human and nonhuman resources for emergency medical services (EMSs) at the primary health care (PHC) level. MATERIALS AND METHODS: A cross-sectional study with mixed research methods (quantitative and qualitative) was carried out in governmental PHC centers in Dammam, Eastern Province of Saudi Arabia, between September 2014 and January 2015. Using systematic random sampling technique, 13 out of 26 PHC centers were included in the study. The study consisted of two main parts: The first involved the completion of an observational checklist to assess the availability and adequacy of human and nonhuman resources (workforce, emergency infrastructure, equipment, drugs and supporting facilities). The second part involved face-to-face interviews with key informants of nurses from the emergency room (ER) in the sampled centers. RESULTS: Analysis of the checklist showed that the total number of physicians “actually” present ranged from 2 to 8 per center and nurses actually present were 4–11 whereas the officially assigned number was 3–12 physicians and 8–17 nurses per center. Only 2 out of 13 (15.4%) centers had a place reserved for EMS in each male and female section. Only 4 (30.8%) PHC centers had a male ER located on the ground floor, near the entrance, and with a separate ramp. None of the centers had the emergency drugs such as metergotamine, calcium chloride, and naloxone. Regarding ER equipment, none of the studied centers had cervical collars, mouth gags, or a tracheostomy sets. Only one (7.6%) center had a functioning fully equipped ambulance. Five (38.46%) centers were equipped with electrocardiogram and X-ray machines. In the interviews, the informants confirmed the deficiencies identified in the checklist. CONCLUSION: Resources for EMS at Dammam PHC centers were deficient in infrastructure and supporting facilities.

In 2018, a new training program for primary care physicians was launched in Japan. As physicians responsible for the training of new primary care physicians, we have faced many problems, particularly in rural areas. The influence of this new program on primary care physicians in rural areas of Japan has not been sufficiently investigated. The aim of this research was to improve training for primary care physicians in Japan by examining training programs in Sweden, where the population challenges are similar to those seen in Japan. In this paper, we will express our opinions and describe the differences in the primary care fostering systems and clinical research training for generalist in Japan and Sweden. [ABSTRACT FROM AUTHOR]

Background: Carpal tunnel syndrome (CTS) is one of the commonest conditions encountered in primary care centers as mentioned earlier. CTS of mild to moderate severity can often be effectively treated in a primary care environment. However, many patients being referred immediately to hospital for consideration of surgical decompression. Objective: In this study, we aim to evaluate the available primary care options and their efficacy in dealing with CTS. Methods: PubMed database was used for articles selection, and the following keys used in the mesh (("Carpal tunnel syndrome"[Mesh]) AND ("Carpal tunnel syndrome/Management"[Mesh] OR "Carpal tunnel syndrome/Diagnosis"[Mesh] OR "Carpal tunnel syndrome/ Primary Health Care Center)). 5 studies were enrolled according to our inclusion, and exclusion criteria. Results: Patients successfully treated with wrist splinting alone reported a higher level of satisfaction with their treatment compared to patients who failed wrist splint treatment or had surgical decompressionMechanical traction is associated with fewer surgical interventions compared to care as usual in CTS patients. Reductions in patient-reported symptoms at 6 months' follow-up was similar in both groups.Steroid injection combined with splinting resulted in modestly greater reduction of symptoms, functional recovery, and improvement of nerve function at 12-week follow-up compared to steroid injection alone. Conclusion: CTS is commonly encountered in primary care. So, a trial of conservative treatment can be done before referral for surgical decompression. Conservative treatment of CTS had shown a clear reduction in hand surgery waitlists, thus reduction in expenditures and costs. Wrist splinting is recommended as first line treatment for patients with symptoms of CTS. Other methods of nonsurgical treatment include steroid injection, osteopathic manipulative therapy, mechanical wrist traction and combining wrist splinting with steroid injection or with NSAIDs use. Referral for surgical decompression may be a more appropriate option when the level of numbness and other symptoms are getting worse, or when conservative management has failed and is likely to lead to dissatisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis is a communicable disease caused by Mycobacterium tuberculosis. Based on the tuberculosis control strategy with a Directly Observed Treatment Shortcourse, the patient is given free medication with the fixed-dose combination antituberculosis drug at the primary health care center for six months. This study aims to determine the relationship of family support to medication adherence in tuberculosis patients. Methods: This cross-sectional study employed a non-random sampling technique in the form of accidental sampling. The family support questionnaire instrument from Nurwulan 2017 was used to measure family support and adherence to refill. Medication scale questionnaire from Kripalani et al., 2009 with modification from Aulia 2021 was also used to measure adherence. This study involves 56 patients with tuberculosis at the Perak Timur Primary Health Care Center, Surabaya City who met all the inclusion criteria from March 2023 until May 2023. Results: The results of the correlation analysis using the Charles Spearman test obtained was p=0.000 and r=-0.453 for overall family support, which means that there was a significant relationship between family support both as a whole and family support in tuberculosis patients. Conclusion: Health workers are expected to be able to provide information not only to patients with tuberculosis, but also to the patient's family to provide support and monitor patients in using antituberculosis drugs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The objective of the study was to assess the availability of human and nonhuman resources for emergency medical services (EMSs) at the primary health care (PHC) level. MATERIALS AND METHODS: A cross-sectional study with mixed research methods (quantitative and qualitative) was carried out in governmental PHC centers in Dammam, Eastern Province of Saudi Arabia, between September 2014 and January 2015. Using systematic random sampling technique, 13 out of 26 PHC centers were included in the study. The study consisted of two main parts: The first involved the completion of an observational checklist to assess the availability and adequacy of human and nonhuman resources (workforce, emergency infrastructure, equipment, drugs and supporting facilities). The second part involved face-to-face interviews with key informants of nurses from the emergency room (ER) in the sampled centers. RESULTS: Analysis of the checklist showed that the total number of physicians "actually" present ranged from 2 to 8 per center and nurses actually present were 4-11 whereas the officially assigned number was 3-12 physicians and 8-17 nurses per center. Only 2 out of 13 (15.4%) centers had a place reserved for EMS in each male and female section. Only 4 (30.8%) PHC centers had a male ER located on the ground floor, near the entrance, and with a separate ramp. None of the centers had the emergency drugs such as metergotamine, calcium chloride, and naloxone. Regarding ER equipment, none of the studied centers had cervical collars, mouth gags, or a tracheostomy sets. Only one (7.6%) center had a functioning fully equipped ambulance. Five (38.46%) centers were equipped with electrocardiogram and X-ray machines. In the interviews, the informants confirmed the deficiencies identified in the checklist. CONCLUSION: Resources for EMS at Dammam PHC centers were deficient in infrastructure and supporting facilities. [ABSTRACT FROM AUTHOR]

Objectives: Our aim was to determine the prevalence of controlled diabetes on the basis of HbA1c test (Hb ≤ 7) in registered diabetic population in three Primary Health Centers of Ministry of Health Makkah al Mukarrahma. Study Design: Retrospective review of medical records of registered adult Saudi patients with type 2 diabetes. Setting: Three Primary Health Centers of Ministry of Health Makkah al Mukarrahma. Period: 20 June 2015 to 31 December 2015. Methods: The sample size calculated was 354 patients with confidence level of 95% and confidence interval of 5. The cut of values adjusted for all diabetes mellitus patients was, haemogloblin A1c (HBA1c) ≤ 7. Three last readings were recorded and to be declared as controlled diabetic case (valid control), last two readings were required to be within this normal limit. Data was processed on Microsoft Excel and SPSS-23 software. Results: Overall the age range was 21-79 (58) years and a mean of +/- SD of 56.67 +/- 11.97. Male were 206 and female 148 in number. Hb A1c test entries recorded in 292. On the basis of set HbA1c criteria no valid control entry was found in one PHC while in other two, there were 15 (4.23% prevalence) valid control entries. Valid control results were found significant (P < 0.05). Conclusion: Very low Prevalence of controlled diabetes on bases of HbA1c test in Primary Health Centers indicate noncompliance of this test in our study group. Guidelines of the Ministry of Health regarding care of diabetic patients in Primary Health Care should be followed to achieve the recommended outcome. [ABSTRACT FROM AUTHOR]

Context: Health promotion is the most important element of primary health care. Therefore, it is essential for the health team to apply such activity. Objective: To describe a newly established health promotion clinic at primary health care centers, in Abha city, KSA. Materials and Methods: The study was conducted during the year 2009. The files of 429 individuals were reviewed after one year from attending the health promotion clinics in Abha city, KSA. Master sheet was designed based on the relevant items of the file. The health promotion services used in the study were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Program for the Social Sciences (SPSS). P-values less than 0.05 were selected for statistical significance. Results: After one year, the percentage of the individuals who intake imbalanced diet and did not perform any type of physical activity was more than 90% while 8% are currently smokers and 14% had depression. Clinical examination and investigation revealed that more than one quarter of our subjects were overweight. Obesity was 42% in males versus 51% in females (P

Quantitative methods used through Geographical Information Systems (GIS) are extremely useful for the treatment of geographic information in Applied Geography studies. A combination of these possibilities is applied in the field of Health Geography to study the spatial distribution of population and health care services. The aim of this paper is to define and analyze the areas of influence of Primary Health Care Centers (PHCC) in the city of Lujan (Province of Buenos Aires) as the basis of health sociospatial system. [ABSTRACT FROM AUTHOR]

Mathematical models allow studying complex systems. In particular, optimal facility location models provide a sound framework to assess the performance of first-level of health care networks. In this work, a methodology founded on need/offer/demand quantification through a facility location-based mathematical model is proposed to assess the performance of existing networks of Primary Health Care Centers (PHCC) and assist in its re-design. The proposed re-design problem investigates the re-allocation of existing resources within the given infrastructure (existing PHCCs) to better satisfy the estimated health needs of the target population. This problem has not been widely addressed in the open literature despite its paramount importance in modern societies with fast demographic dynamics and constrained investment capacities. The model seeks to optimally assign the required type of service and the corresponding capacity to each PHCC (offer). The objective function to be maximized is the number of (needed) patients' visits effectively covered by the network (demand). The following constraints are explicitly considered: i) geographic accessibility from need centers to PHCCs, ii) maximum delivery capacity of each service in each PHCC, and iii) total budget regarding fixed, variable, and relocation costs. The proposed methodology was applied to a medium-size city. Results show that the non-attended necessity can be reduced by introducing capacity modifications in the existing network. Moreover, different solutions are obtained if budgetary restrictions or minimum attention volume constraints are included. This reveals how model-based decision support tools can help health decision-makers assessing primary health care network performance. • Model-based assessment and re-design of first-level health care networks. • Medical consultations need is the driving force of the proposed changes. • Geographic distance and perceived attention quality are explicitly considered. • Satisfied medical consultations demand increases by re-distributing offer capacity within existing centers. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to determine the attitude and behavior of drug usage of participants attending to primary health care center. Materials and methods: This descriptive study was performed among 300 people who admitted at three family health centers located in Mersin city center. Data were collected by using questionnaire. The questionnaire consisted of 30 questions about the demographic characteristics and the attitudes of the applicants' drug use. Descriptive statistics were used for summarizing the data and the chi-square test was used to compare the categorical variables. Results: The mean age of the participants was 36.19±13.27. Of the total participants, 56.3% were female, 37.0% were high school graduated, 9.3% did not have any social insurance. Participants 26% stated that they use medicines without consulting medical doctors, 17.0% of them use medicines with the advice of family/friends/neighbors and 31.3% of them take the drugs without doctor's prescription. The usage of drugs without consulting medical doctor was significantly higher among participants graduated of high school or university, students and unmarried person. The usage of drugs with advice of family/friends/neighbors were significantly higher among participants under the age of 19, students and unmarried person. Totally, 37.0% of the participants had drugs at home without using. Analgesics were the most frequently drugs held at home. Conclusion: Most participants of this study had the behavior of irrational drug use. Health care workers, media and teachers had an important role to ensure the rational drug use of individuals in the community. [ABSTRACT FROM AUTHOR]

Context: Health promotion is the most important element of primary health care. Therefore, it is essential for the health team to apply such activity. Objective: To describe a newly established health promotion clinic at primary health care centers, in Abha city, KSA. Materials and Methods: The study was conducted during the year 2009. The files of 429 individuals were reviewed after one year from attending the health promotion clinics in Abha city, KSA. Master sheet was designed based on the relevant items of the file. The health promotion services used in the study were based on the recommendation of the relevant guidelines. Data entry and analysis was carried out using Statistical Program for the Social Sciences (SPSS). P-values less than 0.05 were selected for statistical significance. Results: After one year, the percentage of the individuals who intake imbalanced diet and did not perform any type of physical activity was more than 90% while 8% are currently smokers and 14% had depression. Clinical examination and investigation revealed that more than one quarter of our subjects were overweight. Obesity was 42% in males versus 51% in females (P<0.04). Pre-hypertension and hypertension were detected among 44 and 12% respectively. About one fifth of our subjects had pre-diabetes 21% and 3% were confirmed to have diabetes mellitus. Diet and physical activity counseling was given to all participants while referral to concerned clinics was done for individuals who suffer from high blood sugar, abnormal lipid profile, obesity and depression. Conclusion: This study demonstrated that health promotion clinics provided by trained professional health care team can be used as a new approach for early detection and management of the common health problems in primary health care centers. [ABSTRACT FROM AUTHOR]

AIM: This research was performed to determine the depression and anxiety levels of individuals with chronic disease who presented to the primary health care center in central Erzincan for any reason. METHOD: The population of this descriptive and cross-sectional study consisted of individuals with chronic disease who were on treatment and attended the primary health care center No. 1 in central Erzincan for any reason. No sampling was done and any individuals having the mentioned specifications who volunteered to participate, were able to communicate, and were at or above the age of 18 were included in the study (n=340). Data were collected using a questionnaire that contained identifier characteristics of patients and information relating to the disease prepared by the researchers and the Hospital Anxiety and Depression Scale. RESULTS: Mean anxiety Hospital Anxiety and Depression Scale score of patients was found 10.40±2.58, while their mean depression score was 9.47±2.41. When the scores obtained from subscales of anxiety and depression were assessed as as sub-threshold or supra-threshold, it was found that 51.2% and 81.5% of the patients received supra-threshold scores, respectively. It was observed that age and gender had a statistically significant effect on the mean anxiety score, while age and level of education had such an impact on the mean depression score. Variables such as marital status, profession, place of residence, monthly income, duration of disease, type of disease, medication use, and dietary compliance did not show any statistically significant correlation with the mean scores of anxiety and depression. There was not any statistically significant relationship between the level of education and the mean score of anxiety. Also there was not any statistically significant relationship between the gender and the mean score of depression. CONCLUSION: It may be concluded that a great majority of patients involved in this study are at risk for anxiety and depression. [ABSTRACT FROM AUTHOR]

The current study assessed pregnant women's satisfaction with antenatal care (ANC) services at primary health care centers (PHCs) in Riyadh Cluster One. The study was conducted at 11 PHCs where the ANC initiative has been implemented. A total of 646 pregnant women were enrolled. A questionnaire was completed by participants to measure the level of satisfaction with the provided services, care, and consultation. Subsequently, the data were analyzed to determine the significant differences and conduct regression analysis. The overall satisfaction with initial triage assessment, provided services, consultation, and examination was 93.7%, 87.8%, 71.8%, and 53.9%, respectively. Regarding ANC services, education was the only statistically significant variable that influenced patient satisfaction (p < 0.05). In contrast, satisfaction with the provided care was significantly related to all the variables studied. For consultation, education (p < 0.001) and monthly income (p < 0.05) were the statistically significant role players. In the regression analysis, secondary education was statistically significantly related to the provided services, consultation, and examination. Despite the satisfactory level of ANC at the selected PHCs, higher patient satisfaction could be achieved in the future by improving the consultation and examination practices. Overall satisfaction with the health care workers at PHCs is high. Incorporating implied ameliorations would enhance the quality of services and patient satisfaction. [ABSTRACT FROM AUTHOR]