Assessment Knowledge, Attitude, and Practice Toward Tuberculosis Among Syrian People: An online cross-sectional study

Background: TB was reported to have the highest mortality rate among other infectious diseases in 2018 worldwide. Syria and other low-income countries have a higher incidence rate of TB in comparison to high-income countries. Stigma toward TB is extremely high in low-income countries like Syria, and these stigma delays patients from seeking healthcare facilities. Our purpose in this study is to assess the Syrian's knowledge, attitudes, and practices toward TB and understand their Practice related to this disease.    Methods: An online cross-sectional questionnaire was distributed between15 September 7 October 2022, among Syrians to assess their knowledge, attitudes, and practices toward TB. This questionnaire was adapted from a published study, and the inclusion criteria were all male and female Syrian citizens aged 18 or above. The survey was divided into four questions: the first section assessed sociodemographics, and the other sections were about knowledge, attitude, and practices, respectively. Using IBM SPSS V. 28.0, the data were submitted to descriptive and multivariate logistic regression analyses.   Results: About (38.6%) of the 1407 participants in this research were male. The research participants' knowledge scores indicated that 78.1% have excellent knowledge. However, 54.1% of interviewees agreed that shaking someone's hand may transmit tuberculosis. Regarding attitude, more than two-thirds (85.7%) of the participants in the survey had an optimistic outlook. Accordingly, most participants (81.3%) had effective TB preventive and control practices. Participants aged 61 to 70 had more TB knowledge than other age groups (P value<0.05; mean=6.63, SD=1.13). Participants with chronic illness had a more positive attitude toward tuberculosis than those without (P value<0.05) (mean=2.17, SD=0.63). Participants with a university degree demonstrated more TB practice than those with lower levels of education (mean=6.17, SD=0.85). Participants with a university degree were expected to have 4.38 times more TB knowledge than those without formal education (P 0.05). Participants with a university degree were projected to practice tuberculosis 10.63 times more often than those without education (P 0.001).   Conclusion: Our results indicate that there is poor knowledge regarding the route of transmission of TB; therefore, more efforts should be made to raise awareness about TB transmission, as understanding these facts is a crucial aspect in mitigating the incidence of TB. Consequently, individuals reported poor practices toward TB; for that reason, educating individuals about good practices toward TB should take priority in Syria as war has destroyed the understructure of the healthcare system

Syrian Health Providers' Knowledge of Palliative Care: An Online Cross‑Sectional Study in Syria

Background: Palliative care is a method to alleviate pain and enhance the quality of life for patients suffering from the consequences of a life-threatening illness. The knowledge of palliative care among healthcare professionals is poor; therefore, training programs are needed to offer patients appropriate treatment and improve their health. In Syria, as palliative care programs are rarely applied, we aim to evaluate the knowledge regarding palliative care among healthcare workers.   Methods: This is an online cross-sectional study conducted between July 24 and August 28, 2022 to measure palliative care knowledge and its applications among Syrian healthcare workers. The questionnaire for the study was designed in light of a previous study, and the inclusion criteria were Syrian healthcare workers, including physicians and nurses, as well as medical and nursing students. The four sections of the questionnaire included sociodemographic information in the first part, while the second, third, and fourth parts assessed experience, knowledge, and attitude toward palliative care among healthcare workers, respectively. Data were analyzed in IBM SPSS V. 28.0 using descriptive and multivariate logistic regression analysis.   Results: Among 602 participants, 66.2% of participants were females. Most respondents were medical students (72.9%), while residents and nurses or nursing students represented 18.8% and 8.3%, respectively. The majority of participants (84%) answered the question about pain treatment goals correctly, while a small percentage (5.3%) answered the question about whether or not long-term opioid use is addictive correctly. No significant difference in the overall knowledge score was shown among geographical areas, genders, and different specialties. Regarding the knowledge questions related to palliative care, only 14 participants were considered knowledgeable. The three most responses that received agreement regarding the attitudes towards palliative care were “Pain relievers should be given as needed to terminally ill patients” (89.7%), “Spiritual care must include counseling for the terminally ill patient” (84.3%), “Patients have the right to determine their own degree of psychosocial intervention” (81%).  A significant difference existed between urban and rural residents in terms of the attitude score. When comparing first-year students to those in their fifth year, students in their fifth year were 8.06 times more likely to have a positive attitude.       Conclusions: Our results demonstrated that healthcare professionals have inadequate knowledge about palliative care. There is an urgent need to introduce palliative care to the health system in Syria in order to improve the quality of life of these patients in their terminal stages of illness and to provide care for patients who need it

Assessment Syrian Population Knowledge, Attitudes and Perceptions Towards Stroke: A Cross-Sectional Study from Syria

Background: Based on the stroke mortality rate, Syria was ranked 98th worldwide in 2020. Approximately 80% of strokes are avoidable by managing well-known modifiable risk factors, such as diabetes, hypertension, and cardiovascular disease. Due to the high prevalence of several modifiable risk factors for stroke in Syria, it is necessary to increase Syrians' understanding of strokes and encourage people to engage in healthy practices to eradicate these risk factors. This research aimed to evaluate the knowledge, attitudes, and health-related perceptions of adult Syrians about stroke.   Methods: This cross-sectional research was conducted between 2 September and 10 October 2022 among Syrians using an online survey to measure their knowledge, attitudes, and practices regarding stroke. This questionnaire was derived from a previously published article, and the inclusion criteria for this research were all Syrian residents aged 18 or older. The questionnaire utilized for this study consisted of three major sections: socio-demographic data, knowledge of stroke, and attitudes and perceptions about stroke.   RESULTS: 53.3 % of the 1,143 research participants were female. Most respondents (94.3%) recognized the brain as the organ impacted by stroke. Hypertension was the stroke's most identifiable cause and risk factor (72.8% and 73.6%, respectively). 72.8 % of participants recognized hypertension and atherosclerosis as causes of stroke. 94.3 % of survey participants accurately identified the oranges impacted by the stroke; however, only 50.1% properly identified the warning symptoms. 61.4 % of participants utilize the Internet as a source of stroke-related information. 22.3% of individuals aged 21 to 30 had identified at least one stroke warning sign. 12.58% of individuals with a high socioeconomic position have shown a solid understanding of stroke risk factors. Females were projected to be 1.55 times more knowledgeable about stroke warning signs than men (P value<0.05). It was expected that participants who believed that stroke is avoidable would be 2.2 times more knowledgeable about stroke warning signals than those who disagreed (P value<0.05). Participants who identified more than four causes of stroke were expected to have 14.77 times more knowledge of stroke risk factors than those who did not (P value<0.05).   Conclusion: Our research shows that although knowledge of stroke risk factors and symptoms is moderate to good, there is still a lack of perceptions toward this disease. Hopefully, this will encourage hospitals and other medical groups to continue their awareness-raising campaigns about the dangers of this illness. Stroke prevention and community response may be greatly enhanced by raising public consciousness of the condition and fostering individual agency in coping with it

Assessment of the competence in electrocardiographic interpretation among Arabic resident doctors at the emergency medicine and internal medicine departments: A multi-center online cross-sectional study

BackgroundThis study aims to assess the electrocardiographic interpretation abilities of resident doctors at internal medicine and emergency medicine departments in eight Arabic countries.MethodsAn online cross-sectional study was conducted between October 7, 2022 and October 21, 2022 in eight Arabic countries. The questionnaire consisted of two main sections: the first section included sociodemographic information, while the second section contained 12 clinical case questions of the most severe cardiac abnormalities with their electrocardiography (ECG) recordings.ResultsOut of 2,509 responses, 630 were eligible for the data analysis. More than half of the participants were males (52.4%). Internal medicine residents were (n = 530, 84.1%), whereas emergency medicine residents were (n = 100, 15.9%). Almost participants were in their first or second years of residency (79.8%). Only 36.2% of the inquired resident doctors had attended an ECG course. Most participants, 85.6%, recognized the ECG wave order correctly, and 50.5% of the participants scored above 7.5/10 on the ECG interpretation scale. The proportions of participants who were properly diagnosed with atrial fibrillation, third-degree heart block, and atrial tachycardia were 71.1, 76.7, and 56.6%, respectively. No statistically significant difference was defined between the internal and emergency medicine residents regarding their knowledge of ECG interpretation (p value = 0.42). However, there was a significant correlation between ECG interpretation and medical residency year (p value < 0.001); the fourth-year resident doctors had the highest scores (mean = 9.24, SD = 1.6). As well, participants in the third and second years of postgraduate medical residency have a probability of adequate knowledge of ECG interpretation more than participants in the first year of residency (OR = 2.1, p value = 0.001) and (OR = 1.88, p value = 0.002), respectively.ConclusionAccording to our research findings, resident doctors in departments of internal medicine and emergency medicine in Arabic nations have adequate ECG interpretation abilities; nevertheless, additional development is required to avoid misconceptions about critical cardiac conditions

Assessing social accountability perspectives among Syrian medical students: a cross-sectional study

Abstract Background Social accountability (SA) within medical education signifies a commitment to address critical regional, societal, and national issues through educational, research, and service activities. In resource-limited regions, marginalized communities face barriers to accessing quality healthcare, and the concept of SA is often poorly understood by students. This study aims to investigate the perspectives, awareness, and comprehension of Syrian medical students regarding the concepts and principles of SA. Methods This cross-sectional online study was conducted in Syria from June 1st to July 25th, 2023, to assess the perspectives on SA among medical students enrolled in pre-clinical and clinical phases from the 3rd to the 6th year, encompassing both stream I and stream II. The questionnaire included three parts: consent and introduction, socio-demographic data, and a 12-item survey assessing social accountability. Data were analyzed using Statistical Package for the Social Sciences software version 24 (SPSS 24). Results A total of 1312 medical students (62.3% females vs. 37.7% males) participated in our analysis. Less than half of the participants (45.7%) reported that their institution had a limited social mission statement regarding the communities they serve. However, only 39.6% reported that their curriculum partially reflected the needs of the population they serve. A mere 7.5% and 6.8% of respondents indicated that their school had excellent community partners and stakeholders shaping their institution, and they learned significantly about other cultures and social circumstances in the medical context through their curriculum. About 24.1% reported that their institution required them to engage in a substantial amount of community-based learning, and 37.4% believed that their class reflected a good representation of socio-demographic characteristics of the reference population. A significant portion of the participants (44.3%) stated that their school did not encourage them to pursue generalist specialties, and 12.7% felt that their institution did not have a positive impact on the community. Among the included participants, 45.8% had some level of SA status, while 37.7% indicated good SA status. Age, gender, and the phase of study were the only sociodemographic characteristics statistically associated with SA status (p-value  0.05). Conclusion This study underscores the significant influence of clinical experience and gender on Syrian medical students’ perceptions of SA. To enhance these perceptions, medical institutions should tailor support services for different stages of training and target initiatives to engage male students

Attitude of Syrian medical specialty trainees toward providing health care services to patients with mental disorders

Abstract Background The stigma associated with mental diseases in the healthcare system and among healthcare professionals has been identified as a significant barrier to treatment and rehabilitation and to the provision of substandard physical care for persons with mental illnesses. The goal of this study is to assess the attitude of physicians in Syria towards individuals with mental health disorders. Methods An online cross-sectional survey was conducted among phyisicians in Syria to evaluate their attitudes toward patients with mental health disorders and their provided treatment in the time period between August 16 and October 1, 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were all medical specialist trainees from all specialties and residents who had direct contact with people suffering from mental health disorders. The questionnaire was divided into two sections; the first included sociodemographic data on the participants and the second assessed physician’s attitudes toward mental illness patients. With the IBM SPSS V. 28.0 package tool (IBM Corporation, Armonk, NY, USA), descriptive and multivariate logistic regression analyses were used to analyze the data. Results 539 medical residents participated in this research; their average age was 26.11 (+- 1.74) years, and 50.27% were males. City residents had the highest stigma score on the third question (2.66 ± 1.06, P value < 0.05) in the ‘social distance’ domain. The mean stigma scores for these three items in the recovery area were (2.76 ± 1.15, 2.51 ± 0.92, and 3.73 ± 0.83), respectively, for city residents. In the ‘social distance’ domain, the stigma score of two questions (the first and fourth questions) was associated with the resident’s specialty, with dermatology residents having the highest mean score in both questions (mean = 3.6 ± 1.12, 3.43 ± 1.19, respectively). Only the second item in the ‘Detection’ domain was scored higher (mean = 3.850.81) by surgery residents than other residents. The stigma in the ‘Recovery’ domain was greatest among dermatology residents (mean = 3.710.94) than among other residents. There was a statistically significant relationship between residency and the Detection stigma scale (p = 0.03, Adj R2 = 0.008). There was a moderate correlation (Adj R2 = 0.048) between the Recovery scale and three of the six predictors (location, marital status, and the number of years living in the current residence). Two demographic factors (country of residence and marital status) were significantly correlated (p0.05) with the Social Responsibility Scale, and the Adjusted R-Squared Value was 0.006. Conclusion Our findings indicate substantial stigma among resident physicians who treat patients with mental illnesses, which might negatively impact both the efficacy of therapy and the phyisician’s mental health. It is important to educate medical residents on mental health issues so that they can treat their patients appropriately. It is suggested that mental health concerns be included in the curriculum of residency programs for physicians so that they have adequate perspectives and attitudes about treating these patients