BACKGROUND:Hypertension remains a major global health burden, often undetected until complications occur. In Indonesia, evidence integrating multiyear surveillance data with machine learning (ML) to predict population-level risk remains limited. The objective of the study was to examine temporal trends in hypertension risk and develop predictive models at the population level.MATERIALS AND METHODS:This observational study utilized community health surveillance data on 196,951 adults (2019-2021). Blood pressure was classified using World Health Organization/Joint National Committee 7 criteria, with prehypertension and hypertension combined as abnormal (y = 1). Predictors included sociodemographic characteristics, anthropometric measurements, various health behaviors, and comorbidities. Missing values were imputed using K-Nearest Neighbors. Logistic Regression, Random Forest, Gradient Boosting, eXtreme Gradient Boosting (XGBoost), and Support Vector Machine models were developed using an 80:20 split, 10-fold cross-validation, and hyperparameter tuning. Model interpretability was assessed using SHapley Additive exPlanations (SHAP).RESULTS:Abnormal blood pressure prevalence increased from 74.4% (2019) to 79.7% (2020) and 80.2% (2021). XGBoost demonstrated superior performance, achieving 78.3% accuracy and an area under the curve of 0.736, outperforming other models. SHAP analysis identified age, waist circumference, body mass index, and male sex as the strongest predictors of the risk of hypertension.CONCLUSION:Hypertension risk in Indonesia rose from 2019 to 2021. Interpretable ML models, particularly XGBoost, show potential for population-level risk stratification and early detection in community and primary healthcare settings.
BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major global health burden, with many patients failing to achieve optimal glycemic targets. Family and peer support are recognized as important determinants of effective diabetes self-management. However, there is little evidence of the combined impact. Therefore, this study aimed to evaluate the effectiveness of a structured family and peer support intervention, delivered alongside standard diabetes care, to improve glycemic control. MATERIALS AND METHODS: A randomized controlled trial was conducted on 120 patients with T2DM, allocated into two equal intervention and control groups. The intervention consisted of eight weekly group-based educational sessions followed by four structured weekly telephone follow-ups, during which emphasis was placed on family and peer support in diabetes education, self-management, and problem-solving strategies. The primary outcome was glycemic control measured with Glycated hemoglobin (HbA1c), while the secondary outcomes included self-management, knowledge, and diabetes-related quality of life (DQoL). Data were analyzed using SPSS. Chi-square test and independent t-test were used to compare baseline data between groups. Mann Whitney U test or t-test, as appropriate, assessed the changes from baseline to 12 weeks. RESULTS: A total of 110 subjects completed 12 week follow-up. Majority (75%) were females, and were aged 46-65 years (>70.0%). At the 3-month follow-up, the intervention group demonstrated significantly greater reductions in HbA1c compared to the control (6.7% ± 0.8% vs. 7.2% ± 0.8%, P = 0.002). Significant improvements were also observed in self-management scores (56.1 ± 2.7 vs. 46.1 ± 3.4, P < 0.001), DQoL (46.3 ± 7.9 vs. 37.1 ± 8.4, P < 0.001), and knowledge of diabetes (4.31 ± 0.61 vs. 3.91 ± 0.72, P < 0.001). CONCLUSION: Family and peer support intervention significantly improved glycemic control, self-management behaviors, diabetes knowledge, and the quality of life of patients with T2DM. Therefore, healthcare providers should consider making family members and peers an essential part of the diabetes management routine.
BACKGROUND: Indonesia has the fourth-largest older adult population with minimal physical activity levels globally. Physical inactivity reduces physical fitness and increases the risk of sarcopenia, osteoporosis, and social isolation, whereas group exercise promotes physical activity and develops social relationships among older adults. This study assessed whether participation in group exercise sessions is associated with the quality of life of community-dwelling older adults. MATERIALS AND METHODS: This cross-sectional study was carried out among older adults participating in community-based group exercise programs in Indonesia from January to December 2024. One hundred twenty-one persons were selected using convenience sampling technique. Physical activity was assessed through interviews. Physical fitness was evaluated using the modified 30-s sit-to-stand test and the 4-m gait speed (4MGS), whereas EuroQol 5-Dimension (EQ-5D) questionnaire was used to measure quality of life. RESULTS: Majority (80%) were aged 60-74 years, were females (72%); 60% were categorized as having moderate physical activity levels with a mean metabolic equivalent value of 4.08 ± 0.67. A mild correlation was observed between physical activity level and mobility (r = 0.181, P = 0.047), while a significant moderate correlation was found with physical fitness (r = 0.202, P = 0.026). Quality of life was generally good (mean EQ-5D index 0.89 ± 0.15). Older adults with higher physical fitness levels demonstrated significantly better scores (0.92 ± 0.11). CONCLUSION: Participation in group exercise sessions was associated with better quality of life in older adults and was linked to higher physical activity levels, improved physical fitness, mobility, and peer socialization.
Medical malpractice insurance (MMI) is a critical determinant of healthcare quality, health partitioners’ behavior, and health system sustainability in many countries. Despite decades of global efforts to reform MMI, evidence of the structure, awareness, implementation, and the impact of its framework remains fragmented. The aim of this review was to synthesize the global literature to map current evidence on the MMI legal framework, its economic viability, barriers to its implementation, and the implications for healthcare delivery and patient safety. A narrative review, informed by a systematic search, was conducted according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) 2020 guidelines. Fourteen studies published between 2004 and 2022 were identified from multiple countries, including the United States, Spain, Switzerland, Georgia, Nigeria, and Turkey. Eligible studies included published reviews, empirical studies, and modeling studies related to MMI and its framework. Data were extracted on study characteristics, legal contexts, economic viability assessment, implementation challenges, and patient safety implications. The included studies address a broad range of malpractice-related issues. The evidence revealed substantial variability in how countries regulate and implement MMI, with notable gaps in practitioner knowledge, legal coherence, and affordability. A lack of awareness of health practitioners, regulatory fragmentation, and economically regressive insurance models continue to shape health practitioners’ behavior that could indirectly affect safety and access. The literature lacks robust empirical evaluations that quantify how specific liability reforms translate into improved patient-level outcomes. Future research can prioritize comparative analysis to evaluate policy reforms to create balanced protection for both health practitioners and patients.
BACKGROUND: Depressive disorders (DD) are highly prevalent in patients with diabetic neuropathy (DN), yet a little is known about how commonly used neuropathic agents, duloxetine and gabapentin, differentially influence psychiatric outcomes in this population. MATERIALS AND METHODS: We conducted a retrospective cohort analysis using the TriNetX electronic health record network containing patient data from more than 69 healthcare organizations, version v5.0, between January 2000 and December 2025. After propensity score matching, patients treated for diabetic neuropathy were grouped into balanced cohorts of 18,674 gabapentin-treated patients and 16,223 duloxetine-treated patients. The primary outcome was new-onset DD within 5 years following initiation of treatment. Risk estimates and survival analyses compared cohorts. RESULTS: Patients treated with duloxetine had a significantly higher 5-year risk of developing DD than those treated with gabapentin (16.3% vs. 14.8%; risk ratio 1.099, 95% confidence interval [CI]: 1.046-1.154). Kaplan-Meier analysis demonstrated a lower survival probability free from DD in the duloxetine group (83.7% vs. 85.2%), with a hazard ratio of 1.318 (95% CI 1.250-1.391, P < 0.001). CONCLUSION: In this propensity score-matched real-world cohort, duloxetine was associated with a significantly higher, albeit small absolute risk of incident DD compared with gabapentin. These findings suggest a correlational association with the use of duloxetine and psychiatric risk in this specific patient population. This highlights possible consideration of psychiatric outcomes when treatments are selected for DN and also supports the need for future prospective studies to confirm causality and further evaluate the psychiatric effects of therapies for neuropathic pain.
BACKGROUND: Thyroid dysfunction during pregnancy can have significant implications for both maternal and fetal health. The physiological changes of pregnancy, including increased thyroxine-binding globulin and human chorionic gonadotropin-mediated thyroid-stimulating hormone (TSH) suppression, alter thyroid hormone concentrations and highlight the need for population-specific reference ranges. This study aimed to characterize trimester-specific thyroid function patterns and hypothyroidism in Saudi pregnant women. MATERIALS AND METHODS: This cross-sectional study was conducted among Saudi women who delivered singleton live births during January1 and December31, 2023 at a tertiary care hospital in Riyadh, Saudi Arabia. A random sample of 329 women meeting the inclusion criteria was selected from a total of 2259 women who delivered during the study period. Data regarding patient demographic characteristics, thyroid disease history, TSH levels, thyroid peroxidase antibody (TPO-Ab) status, and the use of levothyroxine was abstracted from hospital’s electronic health record system using a structured data collection sheet. Data were analyzed using SPSS; Categorical variables were summarized as frequencies and percentages, whereas mean and standard deviation was calculated for continuous variables. Categorical variables were summarized as frequencies and percentages. Thyroid function parameters were compared across clinical groups using ANOVA or Kruskal-Wallis test, as appropriate. RESULTS: Thyroid dysfunction was identified in 27.4% of the 329 Saudi pregnant women; 21.6% of these were subclinical, and 5.8% were overt hypothyroidism. Median TSH concentrations were 2.03, 2.46, and 2.26 mIU/L across the first, second, and third trimesters, respectively. The mean TSH levels differed significantly across thyroid function groups in all trimesters (P<0.01). TPO-Ab positivity was uncommon (5.2%), and levothyroxine was used by 31.0%. CONCLUSION: A notable proportion of Saudi pregnant women exhibited thyroid dysfunction, underscoring the importance of locally derived trimester-specific TSH data. These findings provide useful baseline information that could guide future multicenter or prospective studies and support the refinement of thyroid screening practices in Saudi Arabia.
INTRODUCTION: Child marriage and adolescent pregnancy are significant public health concerns in Indonesia associated with increased obstetric and perinatal risks. Adequate antenatal care (ANC) is essential to mitigate these risks. The objective of this study was to identify the predictors of adequate ANC utilization by underage mothers in Indonesia, with specific focus on rural-urban disparities. MATERIALS AND METHODS: This cross-sectional study utilized the secondary data from the 2023 Indonesian Health Survey. The sample comprised 2927 underage mothers (<20 years) consisting of 1873 rural and 1054 urban residents, who had at least one pregnancy. Adequate ANC was defined in accordance with the Indonesian Ministry of Health guidelines as at least six visits throughout the stages of pregnancy. Data were analyzed using SPSS; descriptive statistics were used to describe the study variables. Chi-square test assessed the associations between ANC utilization and various independent variables. Logistic regression analysis determined the factors associated with adequate ANC, adjusting for potential confounders; separate models were developed for urban and rural subsamples. RESULTS: Only 33.0% of underage mothers received adequate ANC and only 6.5% received all 10 essential ANC components. Higher educational attainment, health insurance ownership, and better economic status were significantly associated with likelihood of adequate ANC, particularly in rural areas. Urban residence was marginally associated with higher ANC adequacy (odds ratio = 1.19). Underage mothers with separated marital status were less likely to have adequate ANC utilization, particularly in the urban settings. Knowledge of the danger signs in pregnancy was not significantly associated with ANC adequacy. CONCLUSION: Adequate and comprehensive utilization of ANC by underage mothers in Indonesia remains low, with persistent urban-rural inequalities. There should be targeted, adolescent-friendly interventions that focus on education, insurance coverage, and socioeconomic support, especially for rural and disadvantaged adolescents.
BACKGROUND: The use of nutritional supplements (NSs) has increased worldwide and is usually driven by improved health, athletic performance, and esthetics. However, motivations, practices, and health impacts differ across populations. The aim of this research was to assess knowledge, attitudes, and practices of NSs, especially those with public health implications, such as folic acid and iodine. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted among Saudi adults in the Eastern Province. Using convenient sampling, online questionnaire solicited data on demographics, health status, knowledge, attitudes, and practices regarding NSs. Initial data analysis included descriptive statistics; knowledge scores between groups were compared using Mann-Whitney U test or Kruskal-Wallis test. RESULTS : A total of 483 Saudi adults completed the questionnaire; 55.3% were male and 43.9% were aged 18 to <36 years. Knowledge about iodine and Vitamin B12 was highest but was moderate for folic acid and Vitamin C. Knowledge of folic acid/iodine and Vitamin C varied significantly by age, sex, education, employment, and smoking status (P < 0.05). Most respondents (69.8%) had a favorable attitude toward supplements. About half of the participants reported using nutritional supplements, but only 20.4% used supplements regularly, mainly Vitamin D and multivitamins. Most commonly reported barriers included costs and the fear of side effects. CONCLUSION: Respondents had good knowledge and positive attitudes toward NSs, but usage was low. Knowledge gaps included folic acid fortification and awareness of Vitamin C deficiency. This highlights the need for targeted educational campaigns.
BACKGROUND:The potentially inappropriate medications (PIMs) are a list of drugs that should be avoided or used with caution in geriatric patients. Therefore, the aim of this study was to explore the prevalence of PIMs use and potential risk factors in geriatric patients with diabetes mellitus (DM) and hypertension (HTN). MATERIALS AND METHODS:This cross-sectional study was conducted between June 1, 2023, and October 31, 2024. Data were obtained from the outpatient clinics of elderly people aged 65 years and older. The 2023 updated Beers Criteria, developed by the American Geriatrics Society, was used to determine the use of PIMs among persons aged ≥65 years. The prevalence of PIMs was based on ≥1 PIM prescription divided by the total number of patients. Data analyzed using SPSS; Chi-square test, independent samples t-test, and logistic regression analysis were performed. RESULTS:The entire sample included 198 patients with DM and HTN; 58.6% of the study participants showed PIM use. The most frequently prescribed classes of PIMs that should be avoided were gastrointestinal agents (n = 136). The multivariable logistic regression showed a considerably higher risk of PIMs in females (adjusted odds ratio [AOR] = 2.59, 95% confidence interval [CI]: 1.20-5.60), people with genitourinary diseases (AOR = 3.88, 95% CI: 1.53-9.87), and polypharmacy (AOR = 1.09, 95% CI: 1.05-1.13). The most frequently used PIM that should be avoided was proton-pump inhibitors (97.8%). In contrast, the PIM that should be used with caution was dapagliflozin (99.0%). CONCLUSIONS:The prevalence of PIMs was high in geriatric patients with DM and HTN. In addition, the predictors that could significantly affect the PIMs were female gender, comorbid genitourinary disease, and polypharmacy. Thus, the results of this study could help healthcare providers improve safe prescribing for geriatric patients diagnosed with DM and HTN.
BACKGROUND: Health-seeking behavior is crucial to healthcare delivery by driving the individual’s healthcare utilization patterns and subsequent health outcomes. Examination of health-seeking behavior reveals gaps and inequalities in access to healthcare and detects the barriers to healthcare utilization. Our aim in this article was to assess the effect of coronavirus disease 2019 (COVID-19) on the public’s healthcare-seeking behavior in Saudi Arabia and any changes in the use of the healthcare services, factors that drove this change, and the resulting health-related consequences for individuals. MATERIALS AND METHODS: This Nation-wide cross-sectional study was conducted among general population in Saudi Arabia between November 2021 and May 2022. Data were collected through an online, self-administered questionnaire; 4254 participants were recruited from all five main administrative regions in Saudi Arabia through the key social media platforms. Categorical variables were presented as frequencies and percentages, while mean and standard deviation were calculated for age. Chi-square test was used to determine association between region of residence in Saudi Arabia and change in seeking healthcare services and the change in disease symptoms during the pandemic. RESULTS: About half (53%) of participants reported a change in their use of healthcare services, with the fear of COVID-19 infection being the major change-driving-factor (21.4%). Medical appointments were rescheduled for 50.1% of participants, 8.5% experienced a delay in receiving a diagnosis of their medical condition, 8.6% reported worsening of their disease symptoms as a consequence of the delay, and 13.5% reported restricted access to medications. To enhance healthcare provision during any possible future pandemics or public health emergencies, 19.7% of respondents wanted less waiting time to access healthcare services with strict adherence to precautionary (19.7%) and infection control measures (17.6%). CONCLUSION: Our data showed that because of the pandemic, over half of respondents changed their healthcare-seeking behavior with fear of COVID-19 infection being a major driver of this change.
Mitochondrial diseases are considered one of the most common groups of neurogenetic diseases. Complex I (CI) deficiency is the most encountered single enzyme deficiency of the mitochondrial diseases. The mutation of the NDUFA is linked to Leigh syndrome and CI defects. This article reports on a patient with mutation in NDUFA12 that was initially perceived as idiopathic intracranial hypertension, calling attention to the importance of considering NDUFA12 mutations in optic atrophy and dystonia diagnoses, particularly in young patients with new onset headache and progressive bilateral visual impairment. In addition, it emphasizes the need to explore other nonneurological features in diagnosing mitochondrial disease in those who do not fit into a defined syndrome. Further research on NDUFA12 variants is essential for a better understanding of their wide phenotypic spectrum.
BACKGROUND: Mental health conditions remain a major global public health concern. Despite national efforts to integrate mental health services into primary healthcare (PH) in Saudi Arabia, its utilization remains limited. Understanding stigma-related and nonstigma-related barriers is essential to improving access and informing service development. MATERIALS AND METHODS: A cross-sectional survey was conducted between April and August 2025 among Saudi adults attending PH centers (PHCs) in Riyadh. Participants were recruited through convenience sampling; data was collected using a validated self-administered questionnaire in Arabic. Barriers to Access to Care Evaluation (BACE-III) scale was used to measure stigma and nonstigma barriers. Initial analysis included descriptive statistics; t-tests and ANOVA were used to compare the mean stigma and nonstigma domain scores, and multiple linear regression was performed to determine predictors of perceived barriers. Reliability of the BACE-III in this sample was high (Cronbach’s α = 0.956). RESULTS: A total of 416 participants were surveyed. Younger age, lower educational level, and student status were associated with significantly higher stigma and nonstigma barrier scores (P < 0.001). Awareness of the availability of mental health services in PHCs was strongly associated with lower perceived barriers (P < 0.001). No significant differences based on gender, health insurance status, or prior experience with mental health services were observed. Regression analyses showed that age and awareness independently predicted perceived barriers. CONCLUSION: Stigma-related and nonstigma-related barriers continue to impede utilization of mental health services in PH settings. Increasing public awareness, affirming the assurance of confidentiality, and implementing community-level antistigma initiatives may improve equitable access and support the goals of the Saudi Vision 2030 health transformation.
This case from Saudi Arabia describes a 27-year-old woman at 39 weeks and 6 days of gestation in spontaneous labor, who had had two prior cesarean deliveries and no previous vaginal births, but declined cesarean delivery despite worsening fetal heart tracings and labor dystocia. Repeated counseling was provided, and an ethics consultation was done as the intrapartum refusal persisted. After approximately 12 hours of labor and no cervical changes, she consented to cesarean delivery. The neonate was born with metabolic acidosis related to three tight nuchal cords. This case illustrates the ethical conflict between maternal autonomy and fetal beneficence in the context of the trial of labor after two cesarean deliveries. It emphasizes the importance of clear communication, early antenatal counseling, and the application of culturally relevant ethical framework, including Islamic bioethics, to support balanced and safe decision-making.
BACKGROUND: The utilization of the Emergency Department (ED) for non-urgent care poses a major problem to the healthcare system. The objective of the study was to assess non-urgent visits to ED and determine the factors influencing non-urgent visits to the ED. MATERIALS AND METHODS: A cross-sectional study was conducted at a secondary level hospital in the Eastern Province of Saudi Arabia from October 2024 to February 2025. Study included 412 Canadian Triage and Acuity Scale (CTAS) IV and V patients. Data was collected by interviewing the patients or their relative using a validated structured questionnaire. Data was analyzed using SPSS version 29; categorical data was presented as frequencies and percentages. Chi-square test or Fisher’s exact test, as appropriate, was used to determine association between non-urgent ED visit and various factors. Multiple logistic regression analysis was performed to identify predictors of non-urgent ED visits. RESULTS: Majority of the patients were Saudis (85.0%), more than half (55.8%) were female, and more than one-third (38.1%) were aged 20-34 years. Common presenting complaints included abdominal pain (20.9%), cold/flu symptoms (10.4%), and back/leg pain (8.7%); Most patients (46.8%) reported symptoms lasting <1 week. At univariate analysis, non-urgent ED visits were significantly associated with age (P = 0.049) and region of residence (P = 0.018). Logistic regression showed weak association between non-urgent ED visit and marital status, employment, type of accommodation, and presence of a chronic disease but these were not statistically significant (P > 0.05). Accessibility (43.4%) and perceived urgency (41.0%) were key drivers for the preference of the ED to primary care. CONCLUSION: The study highlights key factors that influence non-urgent visits, with accessibility and perceived urgency being the primary drivers. Findings highlight the need to improve primary healthcare access and triage awareness to reduce unnecessary ED visits.
BACKGROUND:Hypertension is a major public health challenge, particularly in Saudi Arabia, where control rates remain suboptimal. Aim of this study was to describe the epidemiological characteristics and clinical presentation of hypertensive patients visiting the urgent care clinic at a primary healthcare center in Dammam, Saudi Arabia. MATERIALS AND METHODS:This cross-sectional study included all patients with documented diagnoses of hypertension who attended the urgent care clinic of a single primary healthcare center in Dammam, Saudi Arabia, between July 1, 2023, and April 30, 2025. Data were obtained from the TrakCare® electronic health record system and included demographics, clinical characteristics, and visit details. Data analyzed using Stata version 15; initial analysis included descriptive statistics. Chi-square or Fisher's exact test, as appropriate, assessed the association between hypertension type and other categorical variables. To compare qualitative data between groups, independent sample t-test or Mann-Whitney U test was used. RESULTS:Of 542 visits, 95.9% were on account of primary hypertension. Patients with secondary hypertension were younger (46.5 ± 14.6 years vs. 52.9 ± 13.4 years; P = 0.03) and were more likely to be male (P = 0.04). Hypertensive crises accounted for 19.7% of all visits, with most cases being due to primary hypertension (82.2%); however, the proportion of crises was substantially higher in patients with secondary hypertension (86.4% vs. 16.9%). Medication refills were the most common reason for visit (69.7%). Captopril 25 mg was most frequently administered (19.2%) medication. Secondary hypertension was associated with higher triage acuity (P < 0.001). CONCLUSION:Primary hypertension predominates in urgent care, but secondary hypertension presents with higher acuity. High medication refill visits highlight gaps in the continuity of chronic care. Enhanced patient education and care coordination are recommended.
BACKGROUND: Urinary incontinence (UI) is a prevalent yet underreported condition that adversely affects the quality of life of older adults. This study aimed to assess the frequency and risk factors of UI and its impact on the quality of life of adults aged 50 years and older attending outpatient clinics of a tertiary care teaching hospital in the Eastern Province, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted from December 15, 2024, to March 10, 2025. Four hundred persons aged 50 years or older attending outpatient clinics, selected by convenient sampling, filled a structured validated questionnaire in Arabic. International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form assessed UI, and the Incontinence Impact Questionnaire Short Form (IIQ-7 SF) determined the impact of UI on the quality of life. Data were analyzed using SPSS and included descriptive statistics, Chi-square test, and logistic regression analysis. RESULTS: The majority of participants were Saudis (86.3%), aged 50-64 (75.6%), and females (59.3%); 32.5% participants reported UI. Of the females, a family history of UI (odds ratio [OR] = 2.48 [1.27-4.85], P = 0.008) and uterine prolapse (OR = 6.80 [2.57-18.18), P < 0.001) were the most significant risk factors for UI. Benign prostatic hyperplasia was a significant risk factor for UI (OR = 4.50 [1.88-10.82], P = 0.001) in males. Mean score for interference of urinary leakage with daily life, on a scale of 0-10, was 5.03 +/- 3.69. UI showed a mild to moderate impact on participants' quality of life. However, 20.8% reported a "great" impact on traveling by car or bus for more than 30 minutes from home. CONCLUSION: UI is common in adults 50 years or older (32.5%) and has a substantial impact on their quality of life, affecting physical, emotional, and social well-being. Despite its effects, underreporting remains common because of the stigma and the lack of awareness.
BACKGROUND:Childhood asthma significantly strains caregivers emotionally, physically, and financially, affecting their quality of life and child health outcomes. Nurse-led education can improve caregiver knowledge, confidence, and coping abilities. A study to assess the effectiveness of nurse-led education in reducing the burden and improving quality of life of pediatric asthma caregivers. MATERIALS AND METHODS:A quasi-experimental pre- and posttest control group design was conducted in selected tertiary care hospitals in Chengalpattu, Tamil Nadu. Forty primary caregivers were randomly allocated to a study group or a control group (n = 40 each). Caregiver's burden and quality of life were assessed using the Zarit Burden Interview and Pediatric Asthma Caregivers' Quality of Life Questionnaire, respectively. The study group received a structured nurse-led educational session on asthma care; the control group received routine care. Outcomes were reassessed after one week. Paired and independent t-tests compared pre- and post-intervention scores. Pearson correlation assessed the relationship between caregiver's burden and the quality of life. RESULTS:The study group showed a significant reduction in the burden (25.50-19.15; P = 0.001) and an improvement in the Quality of life (44.10-53.00; P < 0.001). The control group showed no significant changes. A negative correlation was observed (r = -0.617; P = 0.004). CONCLUSION:Nurse-led education significantly reduces caregiver's burden and enhances the quality of life, especially in resource-limited settings.
BACKGROUND: Noncommunicable diseases (NCDs) are prevalent worldwide and contribute to public health challenges. Health education, driven by World Health Organization’s (WHO’s) Package of Essential Non-Communicable Diseases (PEN), is a mainstay in managing these NCDs in primary healthcare settings in Palestine. This study evaluated the effect of the WHO’s PEN’s health education protocol on NCD patients’ bio-physical outcomes in the West Bank, Palestine. MATERIALS AND METHODS: Patients with NCDs receiving within PEN protocol at 49 primary healthcare clinics in the Ramallah district of the West Bank were identified and were selected into study consecutively at the time of their visit to the clinic. Patients’ perspectives towards management of their NCDs were retrieved from the WHO STEPwise approach to NCD risk factor surveillance (STEPS). Bio-physical measurements were taken at the time of the visit to clinic and compared to previous records. Data analysis performed using SPSS; mean and standard deviations computed for continuous variables, while categorical variables were presented as frequencies and percentages. Paired sample t-test used to test for statistical significance for changes between initial and last bio-physical or bio-chemical measurements. RESULTS: A total of 377 patients were included in the study. Self-evaluation showed positive feedback towards assessing, monitoring, and managing all assessed NCDs. Majority of participants reported rarely or never receiving health education on quitting smoking (85.6%), nutrition (95.5%), physical exercise (91.5%), and medication-related issues (84.9%). Biophysical parameters showed reductions in weight by 1.5 kg/m2, waist circumference by 2.2 cm, and systolic and diastolic BP by 6.5 and 4 mmHg, respectively. Biochemical value reductions were observed for Hemoglobin A1c by 0.6%, total cholesterol by 25mg/dl, triglyceride by 11.5mg/dl, and low-density lipoprotein by 25mg/dl over a year. CONCLUSION: Despite its significant bio-physical outcomes, the PEN health education protocol needs systematic planning and evaluation to attain the best outcomes.
