Burnout Syndrome Among Primary Care Physicians in Oman

Objectives: Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among primary care physicians (PCPs) in Oman and explore risk factors for its development. Methods: We conducted a cross-sectional, analytical study among a random cluster sample of 190 PCP working in Muscat, Oman. Indices of burnout (emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)) were noted using the Maslach Burnout Inventory-Human Services Survey (MBIHSS). We also used a questionnaire to obtain sociodemographic and job characteristics data. We used a binary logistic regression model and both unadjusted and adjusted odds ratios for statistical analysis. Results: The prevalence of burnout in all three dimensions was 6.3%. High levels of MBI-HSS subscales were reported on EE, DP and PA with 17.8%, 38.2%, and 21.5%, respectively. Logistic regression analysis revealed that working over 40 hours per week was the most important risk factor for burnout among PCPs. Conclusions: A total of 6.3% of PCPs working in urban areas in Oman suffered burnout. Long working hours was strongly associated with high occupational burnout. Solutions to eliminate or decrease the rate of burnout involve institutional changes, primarily respecting weekly working hours, and in more severe cases psychotherapy help is very important

Implementing Lean Management Techniques at a Radiation Oncology Department

Objectives: Lean management (LM) principles were first developed by a Japanese manufacturing company to maximise value and minimise waste in the automotive industry. However, these principles can also be applied in the healthcare sector. This study aimed to illustrate the process of implementing LM principles in a radiation oncology department to streamline workflow and identify and reduce waste. Methods: This study took place in the Department of Radiation Oncology, Royal Hospital, Muscat, Oman, in December 2016. A value stream map (VSM) was created for the chain of processes followed in the department. A waste analysis was conducted to determine which processes did not add value for the patient or healthcare provider. Results: Based on the VSM analysis, only six out of 13 steps were found to be of value. Necessary and unnecessary non-value-adding activities were identified. Sources of waste included parking and registration. In addition, variabilities in workload were noted. Conclusion: Overall, LM principles improve workflow, reduce waste and enhance patient and staff satisfaction. In the current study, the application of LM principles helped to improve value in a radiation oncology department.Keywords: Health Services Administration; Healthcare Quality Assurance; Total Quality Management; Organization and Administration; Efficiency; Oman

Prevalence and Correlates of Depressive Symptoms among Medical Students: a Crosssectional Single-centre Study

Background: Depressive symptoms are common among medical students. The aim of the present study was to determine the prevalence and risk factors of depressive symptoms among medical students in Sultan Qaboos University in Oman. Method: A cross-sectional study was conducted among a random sample selected from 1041 medical students at Sultan Qaboos University, Oman. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to determine risk factors for depressive symptoms. Results: Of 197 medical students selected, 189 (61 men and 128 women) responded. The PHQ-9 results showed that the prevalence of depressive symptoms was 41.3%. In multivariate analysis, female students were more likely than male students to develop depression (adjusted odds ratio = 2.866, p = 0.004). Medical students with a family history of depression were more likely to develop depression than those without a family history of depression (adjusted odds ratio = 4.150, p = 0.014). Conclusion: Depressive symptoms are common among medical students in Sultan Qaboos University. Risk factors for depressive symptoms are female sex and family history of depression

Effectiveness of Stimulating Neural Branching Strategies in Developing Creative and Critical Thinking among Eighth Grade Students in Sultanate of Oman

This research aims to examine the effect of teaching by using strategies that stimulate neural branching in creative and critical thinking of study groups. The sample of this study consisted of two experimental groups and a control group. In terms of the treatment, one experimental group was taught using strategies that stimulate the neural branching in human brain mentally. The other experimental group was taught using the same strategies supported by technology. The control group was taught using the traditional instruction. The sample included (95) male student and (102) female students from two schools of the governorate of Muscat. To answer the research questions, Torrance test of creative thinking (TTCT) and Watson & Glaser critical thinking test (WGCTT) were used. The results show that the experimental groups significantly outperformed the control group with respect to the creative thinking test. However there were no statistically significant differences between the study's groups in the critical thinking test. This study recommends investment of mental capacities of the learners to encourage creative thinking and train teachers on using methods that stimulate neural branching

The Psychological Impact of Referral for Mammography Screening for Breast Cancer Among Women in Muscat Governorate: A cross-sectional study

Objectives: Breast cancer constitutes the majority of diagnosed cancers in Oman’s females, accounting for 19.2%, which prompted the introduction of a breast cancer screening programme into the Omani healthcare system. There are rising international concerns about the effectiveness of mammography as a screening tool and its psychological impact. The current study aimed to determine the social, emotional and physical dysfunction caused by the waiting time from the day of scheduling the appointment until the day of screening and explore associated risk factors. Methods: This cross-sectional study was conducted between March and December 2017 at Khoula Hospital, Muscat, Oman, using a two-part self-administered questionnaire. Part one of the questionnaire collected clinical and demographic data. Part two consisted of the Psychological Consequences Questionnaire (PCQ) and focused on psychological consequences, measuring the effect of mammographic screening on emotional, physical and social functions. Results: A total of 300 women aged ≥40 years old participated in this study (response rate: 100%). Results revealed that there was a minimal negative psychological impact from screening using mammograms. All PCQ domains were significantly impacted for participants who reported a family history of cancer (P = 0.007). The social score was significantly higher among women between 40–50 years old (P = 0.008). Scores of emotional and social functions were significantly affected by participants’ employment status; employed women were more affected than those who were not (P = 0.043 and 0.012, respectively). However, women’s levels of literacy did not affect any of the domains. Conclusion: The psychosocial impact of the waiting period between scheduling and undergoing mammography screening was minimal in the current sample. Future research should evaluate the psychosocial impact on patients at different recall times.Keywords: Breast Cancer; Mammography; Psychological Factors; Depression; Anxiety; Oman

DRUG UTILIZATION PATTERN IN AN INTENSIVE CARE UNIT AT A TERTIARY CARE TEACHING HOSPITAL IN OMAN

Objectives: To evaluate the drug prescribing trends in the ICU department and correlate them with the disease patterns and patients' outcomes.Methods: The case records of patients admitted to the ICU at Sultan Qaboos University Hospital (SQUH), a teaching hospital in Oman, during a 5-month period between June 1st to October 31st 2013 were analyzed. The variables collected included demographic and clinical characteristics as well as duration of hospitalization, indications and utilization of different drugs.Results: A total of 138 patients were evaluated with an average of age ‎46±19‎ years. The average length of stay at ICU‎ was ‎4.5±3.5 days. The‎ average number of drugs per prescription was ‎8.0±4.6‎. The most common route used was the parenteral route (66%) followed by the enteral route (25%). Anti-infective drugs were the most commonly prescribed class of drugs (25%) followed by gastrointestinal drugs (20%). Antibiotics accounted for 12% of the total drugs prescribed. Trauma was the most common indication for the admission to the ICU (22%).Conclusion: Drugs prescription patterns in the ICU appeared to be similar to those reported in previous studies. However, prescription protocols need to be addressed to guide appropriate use of drugs in the ICU setting.Â

FACTORS INFLUENCING THE PREFERENCE OF PRIVATE HOSPITALS TO PUBLIC HOSPITALS IN OMAN

Purpose: The objectives of the study are to analyze the factors which influence patients to go to private hospitals against public hospitals of Oman and to analyze the expectations of patients from the integrated public hospitals in Oman.Design/methodology/approach: The study was carried out with a well-defined questionnaire through which 251 survey samples were collected on a random sampling basis.Findings: The results of the study reveal that there is an association between the selection of hospital and services and the cost of the services offered in the hospital and it is found that the cost of services incurred makes an impact in the selection of hospital for medical treatment. The study also revealed that in private hospitals patients could easily approach anyone including the reception staff and all are helpful, and the private hospitals are equipped with modern equipment, and doctors treat patients in a friendly manner.Research limitations/Implications: The majority of the population taken for the study are aged above 20 years, and the samples were collected from selected regions of Oman, and wide range collection of samples from all the regions will help to improve the solution.Social implications: The study suggests that sufficient medicines should be provided in all the public health centers and periodic inspection should be conducted at regular intervals to improve the standards of the public health Centers and Government Hospitals concerning cleanliness, treatments and the front line services.Originality/Value: No study has examined the causes for the hospital selection delay in the construction projects of Oman, and it is a first-hand study of its kind and the results will be useful to the stakeholders

Go Lean, Get Leaner: The application of lean management in Omani healthcare

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Predictors of Burden of Care Among Caregivers of Drug-Naive Children and Adolescents With ADHD: A Cross-Sectional Correlative Study From Muscat, Oman.

The study assessed the prevalence of burden of care among caregivers of children with ADHD in Oman. A related aim is to explore the predictors of the burden of care, subtypes of ADHD, and socio-demographic factors. Arabic version of the Zarit Burden Interview (ZBI) was administered to 117 caregivers of drug-naive children with ADHD. Sociodemographic background and clinical data were gathered from medical records and from the attending caregivers themselves. The ADHD symptoms were grouped under three categories : hyperactive, inattentive, or mixed. the prevalence of the burden of care was estimated to be 34%. Income levels and the child's ADHD diagnosis being of "mixed" type have significant impact on the burden of care. the results of this study indicate that the prevalence of the burden of care among the caregivers of ADHD children in Oman is comparable with that in the other regions of the world

Health professionals’ perceptions about physical activity promotion in diabetes care within primary health care settings in Oman

Background: As part of formative work to inform an interventional design to increase physical activity (PA) in patients with type 2 diabetes in Oman, this qualitative study aimed to determine health professionals’ perception of barriers and opportunities, personnel responsibilities and plausible PA promotional approaches. Methods: Four focus group discussions were carried out with groups of health care professionals (family physicians, dieticians and health educators, managers and general practitioners). All discussions were audio recorded and transcribed. Responses were analysed using a thematic analysis. Results: Barriers to PA reported by participants (n = 29) were identified at three levels: health care system (e.g. deficient PA guidelines); individual (e.g. obstructive social norms) and community (e.g. lack of facilities). Participants felt that a multilevel approach is needed to address perceived barriers and to widen current opportunities. In the presence of various diabetes primary care providers, the potential for dieticians to include individualised PA consultations as part of their role was highlighted. Participants felt that consultations should be augmented by approaches within the community (volunteer support and/or appropriate facilities). However, despite lack of experience with technology supported approaches and motivational tools, the telephone application “WhatsApp” and use of pedometers were considered potentially suitable. The need for training in behaviour change techniques and clearly communicated intervention guidelines was emphasised. Conclusions: A multi-component approach including PA consultations, possibly led by trained dieticians, technological routes for providing support along with community mapping for resources appear to offer promising approaches for further PA intervention studies within diabetes primary health care