SO005BARRIERS TO PERITONEAL DIALYSIS IN SASKATCHEWAN CANADA: RESULTS FROM A PROVINCE WIDE SURVEY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bhanu Prasad ◽  
Lucas Diebel ◽  
Maryam Jafari ◽  
Sachin Shah
Keyword(s):  
Peritoneal Dialysis ◽  
Treatment Option ◽  
Formal Education ◽  
Informed Choice ◽  
Patient Specific ◽  
Educational Strategies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Active Involvement

Abstract Background and Aims Peritoneal dialysis (PD) offers similar clinical outcomes to hemodialysis (HD) at a fraction of the cost. PD remains underutilized as remote HD patients in the province of Saskatchewan often relocate or travel hundreds of kilometers weekly in order to receive dialysis related care. Many barriers to patient uptake of PD have been described, but the scale of their impact on our patient population have not been quantified. To improve uptake of peritoneal dialysis in Saskatchewan, we need to address the most prominent barriers to patient access to PD to ensure that they truly have a choice in determining the modality with which they choose to dialyze. The purpose of this study was to determine the barriers to receiving PD in Saskatchewan Method We conducted a cross sectional survey of in-center HD patients across the province of Saskatchewan, Canada. A total of 740 in-center HD patients at two academic sites and 7 satellite units were approached by study coordinators. 421 patients (n=268 in the main units and n=153 in the satellite units) agreed to participate in the study. A questionnaire using a five-point Likert scale was created to identify barriers to PD with questions addressing PD awareness and knowledge, accessibility, and risks, fears, beliefs surrounding PD. Responses were anonymous and tabulated using a data collection tool. Survey data were summarized using descriptive statistics. Results 45.9% of participants had more than 12 years of formal education. 11% lived on farm, 19% on reserve, and 71% in town/city. The median (interquartile range=IQR) distance of home to in-center dialysis units was 10 (5-70) kilometers. Only 82% of patients were aware of PD as a treatment option. 35% of patients felt they had no understanding of the benefits or risks of PD. Despite only 13% of patients being told they were unsuitable for PD by their nephrologist, approximately half (47%) had ever considered it as a treatment option. Prominent barriers to PD that we identified were: excellent care in the HD unit (62%), proximity to dialysis unit (41%), unwilling to dialyze daily (36%), and unwilling to learn a new technique (34%). Beliefs held by patients that figured prominently in their decision to choose HD over PD included not wanting to take their disease home (32%), fear of being a burden on family (32%), lack of space (28%), risk of infection, issues with self-image while on PD, and PD being an inferior modality to HD (all approximately 24%). Conclusion Several barriers to PD were identified with a few consistent themes being identified, including deficiencies in knowledge, patient specific beliefs, poor patient education, and perceived benefits of in-center care (satisfaction with current care). The most frequently reported knowledge barrier was a lack of understanding of benefits and risks of PD. These findings suggest that not enough patients are receiving formal education, or active involvement in deciding which modality they would be most suitable for them when initiating dialysis. To improve uptake of PD in Saskatchewan, we will have to generate both increased awareness of PD as a treatment modality, alongside improved educational strategies to enable patients to make an informed choice about how they receive renal replacement therapy. While the study does not reflect the views of all patients, the information gained will be valuable in designing an educational program to improve adoption of PD within our province.

scholarly journals MO028BARRIERS TO HOME HEMODIALYSIS IN SASKATCHWAN CANADA: RESULTS FROM A PROVINCIAL SURVEY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Bhanu Prasad ◽  
Maryam Jafari ◽  
Lucas Diebel ◽  
Sachin Shah
Keyword(s):  
Formal Education ◽  
System Level ◽  
Patient Specific ◽  
Cross Sectional Survey ◽  
Home Hemodialysis ◽  
Cross Sectional ◽  
Active Involvement ◽  
Potential Benefits ◽  
The Cost ◽  
At Home

Abstract Background and Aims Home hemodialysis (HHD) offers similar, and perhaps even superior clinical outcomes to in-center hemodialysis (HD) at a fraction of the cost. HHD remains underutilized as remote HD patients in the province of Saskatchewan often relocate or travel hundreds of kilometers weekly in order to receive dialysis related care. Many barriers to accessing and utilizing HHD have been described, but the degree to which these factors impact our province’s residents has not been quantified. In quantifying these barriers we can better design better protocols to address the unique barriers leading to low utilization of HHD in our province. The purpose of this study was to determine the barriers to receiving HHD in the province of Saskatchewan. Method We conducted a cross sectional survey of in-center HD patients across the province of Saskatchewan, Canada. A total of 740 in-center HD patients (two academic sites, 7 satellite units) were approached by study coordinators. 421 patients (n=268 in the main units and n=153 in the satellite units) agreed to participate in the study. A five-point Likert scale survey was created to identify barriers to HHD with questions addressing HHD awareness and knowledge, accessibility, home constraints, impact on family members, and risks, fears, beliefs surrounding HHD. Responses were anonymous and tabulated using a data collection tool. Survey data were summarized using descriptive statistics. Results 41.7 % of participants had more than 12 years of formal education. 12% lived on reserve, 18% on farm, and 70% in town/city. The median (interquartile range=IQR) distance of home to in-center dialysis units was 12 (5-80) kilometers. Only 76% of patients were aware of HHD. 46% of patients felt they had no understanding of the benefits or risks of HHD. Despite only 8% of patients being told they were unsuitable for HHD by their nephrologist, only 28% had ever considered it as a treatment option. Other prominent barriers to HHD were: satisfaction with in-center HD (76%), medical supervision during HD (76%), opportunity to socialize with in-center HD patients (73%), increase in utility payments (54%), and fear of having a major health event at home (51%). Other home constraints (space, inability to make modifications to the home) also figured prominently (35%). Conclusion In this study, we identified patient specific barriers to HHD in a prevalent cohort of HD patients. Several barriers were identified with a few consistent themes being identified, including deficiencies in knowledge and awareness, home constraints, and perceived benefits of in-center care (satisfaction with current care, socializing with patients and staff, and fear of a catastrophic event at home). The most frequently reported knowledge barrier was a lack of understanding of the benefits and risks of HHD. These findings suggest that not enough patients are receiving formal education, or active involvement in deciding which modality they would be most suitable for them when initiating dialysis. In center dialysis is considered the ‘default’ option for many patients, resulting in limited education on HHD. Changing the culture surrounding in-center dialysis as the ‘default’ method of dialysis requires broader physician, allied health professional, and system level recognition of the potential benefits HHD could offer patients. Differences in remuneration for HHD and in-center HD also pose an obstacle to ensuring patients are making truly informed choices when it comes to in-center HD versus HHD. While the study does not reflect views of all the patients, this information will be valuable in designing an educational program to improve adoption of HHD within our province.

Malaria Prevention and Mothers: Sudan

2021 ◽  
Author(s):  
Yousif Elmosaad ◽  
Ahmed Al Rajeh ◽  
Asif khan ◽  
Elfatih Malik ◽  
Ilias Mahmud
Keyword(s):  
Formal Education ◽  
Effective Means ◽  
Malaria Prevention ◽  
Good Knowledge ◽  
Bed Nets ◽  
Cluster Sampling ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Positive Attitudes

This study assessed the knowledge, attitudes, and practices (KAP) in malaria prevention using insecticide-treated bed nets (ITNs) among mothers of children under five years of age in White Nile State, Sudan. Multistage cluster sampling was used to select 761 mothers for this cross-sectional survey. There were gaps in the KAP in malaria prevention. Only 46.3% of the mothers stated personal protective measures (PPMs) as the best malaria prevention strategy; 54.9% considered ITNs as an effective means; and only 18.7% reported sleeping under an ITN every day. Older mothers were less likely to have good knowledge (OR=0.96), attitudes (OR=0.98) and practices (OR=0.98). Having a Government employee as the head of the household was positively associated with knowledge (OR=2.16) and attitudes (OR=1.96). The mother having a formal education was also positively associated with good knowledge (OR=1.55) and positive attitudes (OR=1.69). Mothers with a monthly household income of <491 Sudanese Pound were more likely to have good knowledge (OR=1.43). Mothers who had good knowledge (OR=4.99) and positive attitudes towards PPMs (OR=2.60) in malaria prevention were found to be more likely to practice preventive measures. Therefore, we recommend focusing on raising mothers’ awareness of the different preventive activities to protect them and their family from malaria.

scholarly journals Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet’s Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 18 (2) ◽  
pp. 673
Author(s):  
Hashim A. Mahdi ◽  
Hamza M. Assaggaf ◽  
Mohammad Alfelali ◽  
Omar B. Ahmed ◽  
Radi Alsafi ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Graduate Education ◽  
Formal Education ◽  
Demographic Data ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet’s Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants’ demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18–65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors’ mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

scholarly journals Influence on attitudes and lifestyle due to lockdown amidst COVID-19 pandemic: a perception-based analysis among Bangladeshi residents

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Md. Saiful Islam ◽  
Md. Asad Ullah ◽  
Ummay Soumayia Islam ◽  
Sahadat Hossain ◽  
Yusha Araf ◽  
...  
Keyword(s):  
Associated Factors ◽  
Formal Education ◽  
Rural Residence ◽  
Regression Analyses ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Associated ◽  
Positive Attitudes ◽  
The Mean ◽  
Structured Questionnaire

Abstract Background Countrywide lockdown or stay-at-home order has been implemented to slow down the transmission of emergent coronavirus. However, the influence on attitudes and lifestyle due to lockdown amidst the coronavirus disease 2019 (COVID-19) pandemic has been poorly understood. The present study aimed to investigate the influence on attitudes and lifestyle due to lockdown amidst the COVID-19 pandemic among Bangladeshi residents. Methods A cross-sectional survey carried out involving 1635 community dwellers across eight divisions in Bangladesh conducted from April 15, 2020 to May 10, 2020. A structured questionnaire incorporating socio-demographic, attitudes towards lockdown and adverse lifestyle amidst lockdown measures was employed to collect data using the Google Forms. Multiple regression analyses were executed to determine the associated factors of positive attitudes towards lockdown and adverse lifestyle. Results The mean scores of attitudes towards lockdown were 67.9 (SD = 8.4) out of 85 with an overall correct rate (positive attitudes) of 79.9%; whereas the mean scores of adverse lifestyle amidst lockdown were 16.1 (SD = 4.8) out of 34 with an overall rate of 47.4%. The factors associated with more positive attitudes towards lockdown included being female, divorced, higher educated, and students. Conversely, being male, having no formal education, and rural residence were associated factors of adverse lifestyle amidst the COVID-19 pandemic. Conclusions The findings reflect how the COVID-19 lockdown has preciously impacted the attitudes, and lifestyle of Bangladeshi citizens, which will contribute to promoting appropriate measures during a subsequent zonal or complete lockdown.

scholarly journals The Use and Potential Interactions of Herbal Medicines among Diabetic Patients in Saudi Arabia: A Cross-sectional Study

2021 ◽  
pp. 226-234
Author(s):  
Saleh Alghamdi
Keyword(s):  
Saudi Arabia ◽  
Traditional Medicine ◽  
Formal Education ◽  
Descriptive Analysis ◽  
Herbal Medicines ◽  
Black Tea ◽  
Diabetic Patients ◽  
Cross Sectional Survey ◽  
Research Committee ◽  
Cross Sectional

Objectives: The use of herbal medicines as non-conventional treatment is popular, especially in developing countries where people suffering from chronic diseases as diabetes mellitus are more likely to use herbal medicines along with conventional medicines. However, their simultaneous use may concur serious drug interactions and may therefore result in a serious outcome. The present study was designed to identify the most commonly used herbal medicines and conventional anti-diabetic medications among Saudi population. Methods: A cross-sectional survey was developed and piloted.Data were retrieved and manually entered in Excel 2016. Frequencies and percentages were utilized to perform descriptive analysis. The study was approved by the Scientific and Research Committee of the main hospital taking part in the study. Results: A total of 347 responses were recorded (69.4% response rate). 54% of participants were male, 53% were between the age of 41 and 64 years, and 35.5% had no formal education. Black tea, Peppermint, ginger, green tea, olive oil, and black seed were among the frequently mentioned herbal medicines. Black tea was used by the majority of patients (80%) while peppermint and ginger were used by more than half of patients, i.e., (56.5%) and (52.7%) respectively. Least common herb used by patients was Artemisia species (2.8%). A majority of patients (53.4%) used traditional medicine at least once daily, and 83% used traditional medicine without their physician's prescription. Conclusion: Concomitant use of herbal and conventional anti-diabetic medication was a common practice among patients in Saudi Arabia, therefore, pharmacists-led educational programs should target both prescribers and general public about the possible interactions/risks of herbal medicines.

scholarly journals Teacher Qualifications and Academic Performance of Pupils in Public Primary Schools in Hargeisa District

2021 ◽  
Author(s):  
Gulled M. Yasin
Keyword(s):  
Academic Achievement ◽  
Academic Performance ◽  
Primary Schools ◽  
Formal Education ◽  
Teaching Experience ◽  
Teacher Qualifications ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Average Value ◽  
Teacher Qualification

This study investigated effect of teacher qualifications on the academic performance of pupils in primary schools in Hargeisa districts. Teacher qualifications were operationalized as Formal education, certification and teaching experience. The study emerged from the deteriorating academic achievement of pupils in Somaliland National Primary Examinations. The deteriorating academic performance was well demonstrated from increase number of failures in Somaliland National Exams. The study employed cross sectional survey research design, on a sample of 160 teachers, the study found out that, Fo = 15.838 &gt; F (2,157) = 3.06; p = .000. The eta-square returned an average value of η 2 = 16.8%. Therefore, teacher qualification accounts for 16.8% of the variance in academic performance of pupils in pubic primary schools in Hargeisa. The rest 83.2% are due to factors not investigated here, and errors in measurements. The study findings indicate that teacher qualifications affect to the academic performance of pupils in public primary schools in Hargeisa District.

scholarly journals Dietary intakes and body mass indices of non-pregnant, non-lactating (NPNL) women from the Coastal and Guinea savannah zones of Ghana

2012 ◽  
Vol 12 (49) ◽  
pp. 5843-5861
Author(s):  
GY Kobati ◽  
◽  
A Lartey ◽  
GS Marquis ◽  
EK Colecraft ◽  
...  
Keyword(s):  
Body Mass ◽  
Coastal Zone ◽  
Formal Education ◽  
Maternal Nutrition ◽  
Dietary Intakes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dietary Recall ◽  
Working Day ◽  
Savannah Zone

Adequate maternal nutrition prior to pregnancy is important for maternal health and favourable pregnancy outcomes. However, information on the dietary intakes of NonPregnant, Non-Lactating (NPNL) women in Ghana is lacking. A cross-sectional survey was undertaken to compare the dietary intakes of NPNL women of children aged 2 to 5 years who are either living in the Coastal (n=79) or Guinea Savannah (n=89) zones. Data were collected using various methods namely interviewer administered socio-demographic questionnaire, 24hr dietary recall records, with data collected on one working and one non-working day within a week, and a 1-week food frequency questionnaire. Body mass index was derived from height and weight measurements. Women in the Coastal Savannah zone had significantly (p=0.05) more formal education (3.9 ± 2.5 years) and earned a higher (p<0.001) weekly income (Gh¢ 6.8 ± 2.7) than women in the Guinea Savannah zone with educational level and incomes of 2.2±1.6 years and Gh¢ 3.9±2.4 respectively. More women in the Coastal zone had significantly (p<0.05) fewer births and were heads of their households. Cereal-based foods were consumed daily by all women during the two-day observation period. Fish was the predominant animal source food in the diet in both zones. Significantly (p<0.05) more women in the Guinea Savannah zone did not meet their Estimated Average Requirements (EAR) for protein (81%), vitamin A (94.4%), and vitamin C (72%) compared to women in the Coastal zone (44%, 22%, and 31% respectively).The diets of both groups of women were low in calcium. Generally, women in the Coastal zone had a significantly (p<0.001) higher BMI (24.2 ± 4.6 kg/m2) than their counterparts in the Guinea Savannah zone (21.3± 2.4 kg/m2).The overall quality of dietary intakes and nutritional status of women in the Guinea Savannah zone was poorer than that of Coastal women. Dietary deficiencies are also present in NPNL women in Ghana. Efforts are needed to improve diet quality and to increase access to resources especially for women in the Guinea Savannah zone of Ghana.

Disturbed Appetite Patterns and Nutrient Intake in Peritoneal Dialysis Patients

2003 ◽  
Vol 23 (6) ◽  
pp. 550-556 ◽  
Author(s):  
Mark Wright ◽  
Graham Woodrow ◽  
Siobahn O'Brien ◽  
Neil King ◽  
Louise Dye ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Food Intake ◽  
Nutrient Intake ◽  
Cross Sectional ◽  
Dialysis Unit ◽  
Diurnal Variability ◽  
Patient Reported ◽  
Dietary Records ◽  
The Mean ◽  
The Impact

Objective Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. Design Prospective, cross-sectional comparison of PD patients versus controls. Setting Teaching hospital dialysis unit. Patients 39 PD patients and 42 healthy controls. Intervention Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. Main Outcome Measures Hunger and fullness profiles. Derived hunger and fullness scores. Results Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. Conclusion The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.

scholarly journals Improving access to healthcare for women in Tanzania by addressing socioeconomic determinants and health insurance: a population-based cross-sectional survey

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e023013 ◽  
Author(s):  
Deogratius Bintabara ◽  
Keiko Nakamura ◽  
Kaoruko Seino
Keyword(s):  
Health Insurance ◽  
Low Income ◽  
Formal Education ◽  
Wealth Index ◽  
Population Based ◽  
Reproductive Age ◽  
Low Income Countries ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Low Income Country

ObjectiveThis study was performed to explore the factors associated with accumulation of multiple problems in accessing healthcare among women in Tanzania as an example of a low-income country.DesignPopulation-based cross-sectional survey.SettingNationwide representative data for women of reproductive age obtained from the 2015–2016 Tanzania Demographic and Health Survey were analysed.Primary outcome measuresA composite variable, ‘problems in accessing healthcare’, with five (1-5) categories was created based on the number of problems reported: obtaining permission to go to the doctor, obtaining money to pay for advice or treatment, distance to a health facility and not wanting to go alone. Respondents who reported fewer or more problems placed in lower and higher categories, respectively.ResultsA total of 13 266 women aged 15–49 years, with a median age (IQR) of 27 (20–36) years were interviewed and included in the analysis. About two-thirds (65.53%) of the respondents reported at least one of the four major problems in accessing healthcare. Furthermore, after controlling for other variables included in the final model, women without any type of health insurance, those belonging to the poorest class according to the wealth index, those who had not attended any type of formal education, those who were not employed for cash, each year of increasing age and those who were divorced, separated or widowed were associated with greater problems in accessing healthcare.ConclusionThis study indicated the additive effects of barriers to healthcare in low-income countries such as Tanzania. Based on these results, improving uptake of health insurance and addressing social determinants of health are the first steps towards reducing women’s problems associated with accessing healthcare.

scholarly journals Knowledge, Attitudes, and Practices Regarding Rabies in El Jadida Region, Morocco

2020 ◽  
Vol 7 (1) ◽  
pp. 29
Author(s):  
Khadija Bouaddi ◽  
Abdelali Bitar ◽  
Mohammed Bouslikhane ◽  
Abdesslam Ferssiwi ◽  
Aziz Fitani ◽  
...  
Keyword(s):  
Formal Education ◽  
Public Awareness ◽  
Traditional Healers ◽  
Special Focus ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Study Sites ◽  
El Jadida ◽  
Knowledge Attitudes And Practices

The aim of this study was to evaluate the knowledge, attitudes, and practices regarding rabies in the El Jadida region, Morocco. We conducted a cross-sectional survey using a structured questionnaire among randomly selected residents across 24 study sites. In total, 407 respondents took part in the survey. The majority (367, 92%) were male and had no formal education (270, 66%). Some (118, 29%) believed that rabies does not affect humans. Most respondents (320, 79%) were aware that vaccination could prevent rabies, but nevertheless did not vaccinate their dogs (264, 64.9%) and allowed their dogs to roam freely in search of food. Some (52.8%) would visit traditional healers for treatment in the event of a dog bite incident. Age and educational level were found to be significantly associated with knowledge, attitudes, and practices (p < 0.05). Although respondents demonstrated some level of knowledge about rabies, overall this study reveals critical gaps in their attitudes and practices. These shortcomings may be associated with a low level of education. Therefore, decision-makers need a new approach to control rabies, with a special focus on public awareness and health education, in order to sustain rabies control programs.

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