Physicians Perspective Towards Impaired Awareness of Hypoglycaemia in Patients With Diabetes: A Forgotten Area

Aim This study aims to assess knowledge, and practices of primary care physician in Saudi Arabia about IAH. Method: A cross-sectional study conducted using a newly designed self-administered questionnaire among 292 primary care physicians at three tertiary hospitals and primary care clinics in Riyadh, Saudi Arabia between December 2018 and June 2019. Results Of the participants, 59.9% of them had acceptable knowledge of IAH while only 40.1% had poor knowledge. Around half (46.2%) of physicians rated their familiarity with IAH as average or above average, and these had higher mean knowledge scores than participants who reported below average familiarity (mean 5.32 versus 4.39) (P = 0.000). Higher mean knowledge scores were found among physicians who have managed IAH patients than those who have not managed IAH patients (5.58 versus 5.01) (P = 0.019). The differences between physicians’ mean knowledge scores and their ages, levels of training, and years in practice were statistically significant. Conclusion: A considerable gap was established in the knowledge, awareness, and practice of IAH among physicians in Saudi Arabia. An effort is needed to implement extensive educational activities about impaired hypoglycemia awareness to be directed to primary care physicians and further research in this area is warranted

COVID-19 Delta Variant: Perceptions, Worries, and Vaccine-Booster Acceptability among Healthcare Workers

Background: As the COVID-19 Delta variant has spread across the globe, healthcare workers’ (HCWs) knowledge, worries, and vaccine booster acceptance should be assessed. Methods: Online questionnaires aimed at HCWs in Saudi Arabia were distributed between 9 and 12 August 2021, aiming to evaluate HCWs’ perceptions and worries about the Delta variant as well as their feelings about receiving a booster-vaccine. Results: A total of 1279 HCWs participated, with 51.1% being physicians and 41.7% nurses. 92.5% were aware of the emergence of the Delta variant. Still, only 28.7% were found to have sufficient knowledge of the variant, and their level of worry about it was higher than their level of worry about the Alpha variant (2.32/5 versus 1.79/5). The main information sources cited by the participants were social media (50.5%), while 30.5% used scientific journals. Overall, 55.3% were willing to receive a vaccine booster, while one third would have preferred to receive a new mRNA vaccine specifically developed for the Delta variant. Factors associated with vaccine booster acceptance were receiving both vaccination doses (p = 0.008), believing that the Pfizer-BioNTech BNT162b2 vaccine is effective against variants (p < 0.001), and agreement that mixing/matching vaccines is effective against variants (p < 0.001). Conclusions: A high percentage of HCWs were aware of the Delta variant, but only a small fraction had decent quality of knowledge about it. The participants exhibited high worry levels and showed a modest acceptance of receiving a vaccine booster dose. These results should encourage public health officials to scale up educational efforts to disseminate reliable information about the different variants and provide recommendations about receiving a vaccine booster. Further research on methods to alleviate HCWs’ worries about emerging variants is warranted

Parental Attitudes and Hesitancy About COVID-19 vs. Routine Childhood Vaccinations: A National Survey

Objectives: To quantify parental acceptance of the COVID-19 vaccine and assess the vaccine hesitancy (VH) for COVID-19 vs. childhood vaccines. Methods: Eight vaccine hesitancy scale (VHS) items, adopted from WHO's Strategic Advisory Group of Immunization (SAGE), were used to assess VH for COVID-19 vaccine vs. routine childhood vaccines. We distributed the online survey to parents with the commence of the national childhood COVID-19 vaccination program in Saudi Arabia. Results: Among 3,167 parents, 47.6% are decided to vaccinate their children against COVID-19. The most common reasons for refusal were inadequate safety information (69%) and worry about side effects (60.6%). Parents have a significantly greater positive attitudes toward children's routine vaccines vs. the COVID-19 vaccine, with higher mean VHS (±SD) = 2.98 ± 0.58 vs. 2.63 ± 0.73, respectively (p-value < 0.001). Parents agreed more that routine childhood vaccines are more essential and effective as compared to the COVID-19 vaccine (Cohen's D: 0.946, and 0.826, consecutively; T-test p-value < 0.00). There is more parental anxiety about serious side effects of the COVID-19 vaccine vs. routine childhood vaccines (Cohen's D = 0.706, p-value < 0.001). Parents who relied on the Ministry of Health information were more predicted (OR = 1.28, p-value = 0.035) to intend to vaccinate as opposed to those who used the WHO website (OR = 0.47, −53%, p-value < 0.001). In a multivariate logistic regression analysis, the factors associated with intention to vaccinate children were parents who received COVID-19 vaccine, older parents, having children aged 12–18, and parents with lower education levels. Conclusions: Significant proportion of parents are hesitant about the COVID-19 vaccine because they are less confident in its effectiveness, safety, and whether it is essential for their children. Relying on the national official healthcare authority's website for the source of information was associated with increased acceptance of childhood COVID-19 vaccination. As parental intention to vaccinate children against COVID-19 is suboptimal, healthcare authorities could boost vaccine uptake by campaigns targeting hesitant parents

A survey of physicians' experience and awareness of institutional provisions designed to foster patient engagement in KSA

الملخص: أهداف البحث: للحصول على تصورات الأطباء عن خبراتهم ووعيهم حول الأحكام المؤسسية التي يمكن أن تعزز مشاركة المريض في المملكة العربية السعودية. طرق البحث: في إبريل٢٠١٧، تم عمل استطلاع عبر الإنترنت عن طريق توزيع استبانة عبر نموذج مستند جوجل للأطباء في المملكة العربية السعودية. يحتوي المستند أسئلة حول خبرة ووعي الأطباء للأحكام المؤسسية من الموارد والدعم. النتائج: استجاب للاستطلاع ٣٢٥ طبيبا. وأوضحت النتائج أن ١٨.٥٪ منهم يرون أن مؤسساتهم تسمح بجدولة المواعيد عن طريق الإنترنت، و٨.٩٪ تسمح بالتواصل بين المرضى والأطباء عبر البريد الإلكتروني، و٢٤٪ تسمح لوصول المرضى للسجلات الصحية ونتائج التحاليل عبر الإنترنت، و٥٥.٧٪ تسمح بتوفير البرامج التعليمية متعددة الوسائط، و٧٤.٨٪ تسمح بصنع القرار-المشترك بين الأطباء والمرضى. كما ذكر ٣٤.٥٪ فقط من المستجيبين أن مؤسساتهم تقوم بتوفير زيارات منزلية للمرضى ذوي الخطورة العالية. يرى ستة من ١٠ مستجيبين أن هذه الأحكام سيكون لها تأثير إيجابي ونتيجة لهم وأيضا لمرضاهم. الاستنتاجات: يعي الأطباء ويقيمون الأحكام التي تعزز مشاركة المريض. ولكن العديد من المؤسسات لا تدعم وتمارس هذه الأحكام التي تعزز مشاركة المريض. الأطباء الذكور ذوي الخبرة الأطول من الممارسة وأولئك الذين يشغلون مناصب إدارية عليا هم أكثر من يقدم الدعم، ويقدر أهمية تعزيز مشاركة المريض في ممارستهم. Abstract: Objectives: To survey physicians' perceptions of their experience and awareness of institutional provisions that can potentially foster patient engagement (PE) in KSA. Methods: In April 2017, an online survey was distributed to clinicians in KSA using Google Forms. The instrument contained questions about the physicians' awareness and experience of their institutions' provision of resources and support. Results: Three hundred and twenty-five clinicians responded to the survey The results showed that 18.5% claimed that their institutions allowed online scheduling of appointments; 8.9% reported the institutions permitted contact between patients and physicians through email; 24.0% reported they provided patients with online access to health records and test results; 55.7% claimed they provided educational multimedia programming; and 74.8% confirmed they encouraged joint decision-making between physicians and patients. Only 34.5% of respondents claimed their institutions provided home visits for high-risk patients. Six of 10 respondents thought that such provisions would have positive outcomes for them and for their patients. Conclusions: Clinicians are aware of and value provisions that foster PE. However, several institutions in KSA do not support or have provisions in place to foster PE. Male clinicians with longer durations of practice and those with higher administrative positions are more likely to value the importance of PE and support and use it in their practice. الكلمات المفتاحية: إشراك, المؤسسية, المريض, الأحكام, الدعم, Keywords: Foster, Institutional provision, Patient engagemen

The interplay between mindfulness, depression, stress and academic performance in medical students: A Saudi perspective.

There is a growing body of research that shows a significant association between mindfulness and mental health. However, studies on Saudi populations are still in their infancy. Mindfulness is a personal tendency to focus on the present time in a non-judgmental manner, including the interior and exterior experience of feelings and events. The first aim of this study is to examine the relationship between mindfulness, stress, depression, and academic performance in a sample of medical students from King Saud University. The second aim is to explore the potential moderation effects of mindfulness on the impact of stress on academic performance and depression in the study population. This cross-sectional study examined 289 medical students who were selected by a stratified random sampling technique and completed validated online questionnaires measuring mindfulness, stress, and depression. The data were analyzed using SAS version 9.2, and R software was used for graphs. Correlation analysis showed that mindfulness is inversely associated with depression and stress, but not with academic performance. Furthermore, multiple logistic regression showed that mindfulness can predict both depression and stress. We also found that two subscales of mindfulness can moderate the relation between stress and depression: non-judging of inner experience and describing. The findings suggest that a higher mindfulness score is associated with lower depression and stress levels and could buffer against depression in a stressful environment. There is a need for further research to investigate the relation of mindfulness with positive psychological outcomes, as well as experimental trials to examine the efficacy of mindfulness training on improving mental wellbeing in our community

Assessment of food labeling knowledge and associated reading barriers among patients with diabetes

Background: The most challenging part of diabetes management for a patient with diabetes is selecting a healthy diet. The purpose of this study is to evaluate participants' knowledge of food labels, to find out the relationship between the type of diabetes mellitus (DM) and knowledge score of food labels, and to explore the barriers that prevent patients from reading food labels. Methodology: This observational study was conducted on patients with type 1 or type 2 diabetes using a validated self-administered questionnaire. The study was conducted at diabetes clinics at King Khalid University Hospital and King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, from November 2019 to February 2020. Data were analyzed using SPSS. Results: A total of 310 participants were enrolled in this study, of which 50.3% had type 1 DM, and more than half of them were female (51.6%). Patients with type 1 DM had higher mean declarative and applied knowledge scores than those with type 2 DM, regardless of whether they were taking pre meals insulin or not. The highest proportion (39.9%) had difficulty in understanding the content of the nutrition labels, and some of them (37.2%) did not receive any educational session about it. Only 9.5% of the participants did not have any difficulties in reading food labels. Conclusion: Patients with both types of diabetes tended to have poor total knowledge about food labels and faced difficulties in reading them. Provided educational sessions by primary health care and specialized physician and DM educator about food labels are recommended to help them to choose food properly

Validation of an Arabic Version of the Adherence to Refills and Medications Scale (ARMS)

Background: Medication non-adherence is a complex multifactorial phenomenon impacting patients with various health conditions worldwide. Therefore, its detection can improve patient outcomes and minimize the risk of adverse consequences. Even though multiple self-reported medication adherence assessment scales are available, very few of them exist in Arabic language. Therefore, the aim of this study was to validate a newly translated Arabic version of the Adherence to Refills and Medications Scale (ARMS) among patients with chronic health conditions. Methods: This is a single-center cross-sectional study that was conducted between October 10th 2018 and March 23rd 2021. ARMS was first translated to Arabic using the forward-backward translation method. The translated scale was then piloted among 21 patients with chronic health conditions (e.g., diabetes, hypertension, etc.…) to examine its reliability and comprehensibility using the test-retest method. Thereafter, the Arabic-translated ARMS was self-administered to adult patients aged ≥18 years with chronic health conditions visiting the primary care clinics of a university-affiliated tertiary care hospital in Riyadh, Saudi Arabia. Construct validity was examined using factor analysis with varimax rotation. Results: Of the 264 patients who were invited to participate, 202 (76.5%) consented and completed the questionnaire. Most of the participants were males (69.9%), married (75.2%), having a college degree or higher (50.9%), retired or unemployed (65.2%), aged ≥ 50 years (65.2%), and are diabetic (95.9%). The 12-item Arabic-translated ARMS mean score was 17.93 ± 4.90, and the scale yielded good internal consistency (Cronbach’s alpha = 0.802) and test-retest reliability (Intraclass correlation coefficient = 0.97). Two factors were extracted explaining 100% of the of the total variance (factor 1 = 52.94% and factor 2 = 47.06%). Conclusions: The 12-item Arabic version of ARMS demonstrated good validity and reliability. Therefore, it should help in the detection of medication non-adherence among Arabic-speaking patient population and minimize the risk of adverse consequences

Assessment of physicians’ awareness and knowledge of familial hypercholesterolemia in Saudi Arabia: Is there a gap?

<div><p>Background</p><p>The scarcity of familial hypercholesterolemia (FH) cases reported in Saudi Arabia might be indicative of a lack of awareness of this common genetic disease among physicians.</p><p>Objective</p><p>To assess physicians’ awareness, practice, and knowledge of FH in Saudi Arabia.</p><p>Methods</p><p>This is a cross-sectional study conducted among physicians at four tertiary hospitals in Riyadh, Saudi Arabia between March 2016 and May 2016 using a self-administered questionnaire.</p><p>Results</p><p>A total of 294 physicians completed the survey (response rate 90.1%). Overall, 92.9% of the participants have poor knowledge of FH while only 7.1% have acceptable knowledge. The majority (68.7%) of physicians rated their familiarity with FH as average or above average, and these had higher mean knowledge scores than participants with self-reported below average familiarity (mean 3.4 versus 2.6) (P < 0.001). Consultant physicians were 4.2 times more likely to be familiar with FH than residents or registrars (OR = 4.2, 95% CI = 1.9–9.1, P < 0.001). Physicians who currently managed FH patients had higher mean knowledge scores compared to those without FH patients in their care (3.5 versus 2.9) (P = 0.006). In addition, there were statistically significant differences between physicians’ mean knowledge scores and their ages, levels of training, and years in practice. Moreover, a substantial deficit was identified in the awareness of various clinical algorithms to diagnose patients with FH, cascade screening, specialist lipid services, and the existence of statin alternatives, such as proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors.</p><p>Conclusion</p><p>A substantial deficit was found in the awareness, knowledge, practice, and detection of FH among physicians in Saudi Arabia. Extensive educational programs are required to raise physician awareness and implement best practices; only then can the impact of these interventions on FH management and patient outcome be assessed.</p></div