Biomedical informatics &Medical statistics

Violence against women is a worldwide problem with extensive repercussions. Primary care physicians frequently are the first in the community to encounter the battered woman. They must be equipped with the necessary knowledge, training and experience. We developed a questionnaire to obtain information from the physicians and nurses on various aspects of domestic violence (DV) Objectives: The aim of this study was to test the reliability and validity of this questionnaire to evaluate knowledge and attitude of primary care providers towards DV. Methods: This study was carried out in 5 primary health care centers on 10 physicians and 10 nurses who were asked to complete a self-administered close-ended questionnaire that included 4 main aspects relevant to DV, namely Knowledge, attitude,

Background: Domestic violence (DV) against women has increased during the past few years and became an important public health problem. Personal values and beliefs of primary health care workers can affect both diagnostic and management procedures adopted to deal with battered women. Objectives: The current study was formulated to compare attitude of physicians and nurses towards DV against women. were asked to answer a self-administered questionnaire. Out of them, 1553 completed the questionnaire with an overall response rate of 61.7%. Results: Physicians tended to have a higher positive overall attitude score towards violence against women than nurses (60.75 + 13.16% compared with 58.3 + 13.82%, P <0.001), with a mean percent score of 75.73 + 21.80% compared with 69.7 + 21.3% for good reasons to hit women domain. No significant differences were revealed between the two groups for either the relationship between partners domain (42.36 + 15.37% compared with 42.9 + 15.99%, P = 0.679) or the management domain (58.39 + 17.11% compared with 58.7 + 20.59%, P = 0.104). Conclusion: Relatively low positive attitude scores were recorded by primary care physicians and nurses Yet, physicians tended to have higher scores than nurses. There is a great need to improve attitude of health care workers, especially nurses, about DV against women through properly planned training programs.

Background: Peak expiratory flow meter (PEFM) may reduce diagnostic delay and improve decision-making in asthma by providing an objective assessment of their flow. Knowledge of nurses and physicians in primary health care can play an essential role to enhance the response of patients about the measurements of peak expiratory flow (PEF). Objective: The aim of the study was to reveal the extent and pattern of knowledge and perception of physicians and nurses about PEFM. Methods: Out of the total primary health care centers in Kuwait; only 50% were randomly selected. A total of 895 physicians and nurses were interviewed out of 1324 individuals currently working in the selected centers for this study with an overall response rate of 74.4%. The questionnaire contained a knowledge section consisted of seven domains with a total of 41 questions. Results: The results of this study showed that physicians had a relatively higher total knowledge score percent than nurses (66.2 ± 10.5% compared with 64.7 ± 7.3%, P = 0.004). Physicians tended to have higher knowledge score for steps of use, defining normal values, and concepts of measurements domains of knowledge, while nurses had significantly higher score values for benefits of use, indicators of use, general concepts, and instructions for learning patients' knowledge domains of PEFM. Conclusion: Due to different patterns of knowledge and practice of nurses and physicians, training programs should be specifically tailored for each group to bridge the gap of knowledge and improve deficient practices.

Background: Peak expiratory flow meter (PEFM) is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. Objective: The aim of the study is to reveal the extent of knowledge and perception of nurses about PEFM and factors affecting their knowledge. Methods: Out of the total primary health care centers in Kuwait, 50% were randomly selected. Out of 699 nurses currently working in the selected centers, 516 nurses were interviewed for this study with an overall response rate of 73.8%. Results: The results of this study showed that nurses had a relatively low total knowledge score percent of 64.7 ± 7.3%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (39.0 ± 24.1%). The highest percent knowledge score was that of benefits of use and content instructions for teaching patients (78.3 ± 19.5% and 78.1 ± 12.0%, respectively). Sociodemographic factors did not affect the total knowledge score. Receiving training, availability of PRFM in the health center and being responsible about taking the measurements for patients proved to significantly affect the level of knowledge of nurses.

Backgrounds: Violence against women is an important public health problem that draws attention of a wide spectrum of clinicians. However, multiple barriers undermine the efforts of primary health care workers to screen battered women. Objectives: Reveal barriers that might impede screening of women for domestic violence and compare the list of barriers of physicians and nurses. Methods: An observational cross-sectional study was carried out in primary health care centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A selfadministered questionnaire was used for data collection. Results: Barriers related to the battered woman herself topped the list of ranks for both physicians (92.9 ± 19.7%) and nurses (85.9 ± 17.6%), P = 0.02, followed by women culture in general (89.5 ± 17.2% for physician and 83.8 + 20.8% for nurses, P = 0.38), then health administration

Background: Violence against women is an important public-health problem that draws attention of a wide spectrum of clinicians. However, multiple barriers undermine the efforts of primary health care workers to properly manage and deal with battered women. Objectives: The aim of the present study was to reveal barriers that might impede administering comprehensive health care to battered women and compare these barriers between nurses and physicians and identify factors affecting such barriers. Methods: A total of 1553 medical staff from 78 primary health care units agreed to share in this study, of these 565 were physicians and 988 were nurses. Results: Barriers related to the battered woman topped the list of ranks for both physicians (93.1 ± 17.4%) and nurses (82.rank list of physicians while for the list of nurses, social barriers (75.1 ± 30.1%), institutional barriers (74.3 ± 31.7%) followed with barriers related to health staff (70.0 ± 30.0%) at the bottom of the list. Only duration spent at work and degree of education of nurses were significantly affecting the total barrier score, while these factors had no significant association among physicians. Conclusion: Real barriers exist that might interfere with administering proper comprehensive health care at the primary health care units by both physicians and nurses. This necessitates design of specific programs to improve both the knowledge and skills of the medical staff to deal with violence among women. Also, available resources and infrastructure must be strengthened to face this problem and enable primary health care staff to care for battered women.

Background: Violence against women is a major public health problem. Primary health care workers are involved in both detection and management of violence. Screening of women for violence is an important tool for early detection and prevention of violence through a valid and accepted screening tool. Objectives: The purpose of this study was to identify the main elements and characteristics of a violence screening tool that can be used in primary health care centers. Methods: An observational cross-sectional study was carried out in primary health care centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A selfadministrative questionnaire was used for data collection. Results: Physicians favored an indirect question about violence (79.7%), while a question about feeling safe (83.6%) was suggested by nurses. The most frequently suggested method was searching for signs of violence. The majority of both nurses (82.4%) and physicians (82.0%) suggested physicians to carry out the screening process for domestic violence against women. The primary health care level was suggested to be in charge of screening for violence by 88.7% of nurses and 82.0% of * Corresponding author. Present address

Background: Violence against women is an important public health problem that draws attention of a wide spectrum of clinicians. Attitude and knowledge of the primary health care (PHC) staff can affect their ability and willingness to screen for and manage domestic violence (DV) against women. Objectives: Reveal the impact of knowledge and attitude of workers to screen for DV against women. Methods: An observational cross-sectional study was carried out in PHC centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A self-administrative questionnaire was used for data collection. It included four main aspects relevant to knowledge and one attitude domain regarding DV. A 5-point, Likert-scale was used to assess participant's answers for each item.

Introduction: Domestic violence (DV) against women has been identified as a serious public health problem. Primary care nurses usually play an important role in managing battered women. They must be equipped with the necessary knowledge, training and experience. Objective: The aim of this work was to study the knowledge and perception of primary care nurses about DV. Methods: This study was carried out in all primary health care centers in Kuwait. All nurses who were currently working in these centers during the study period were asked to complete a selfadministered close-ended questionnaire that included personal and working conditions information. It included also knowledge about prevalence of DV, and four main aspects relevant to DV, namely deprivation, psychological, physical and sexual domains. A 5-point, Likert-scale was used to assess participant's answers for each item. For each participant, the scores were summed and categorized into high and low considering the median as the cutoff level. Results: Out of 1617 nurses currently working in primary care, 988 returned the filled questionnaire with a response rate of 61.1%. The study revealed that nurses' knowledge about the prevalence of DV were poor. A large group of nurses had negative perception to DV particularly regarding deprivation aspect. Nearly all nurses agreed about statements of physical and sexual domains. Psychological items scores came in between deprivation in one side and physical and sexual aspects in the other side. After adjustment for confounding, only female gender remained as a significant factor associated with high knowledge and perception scores. About a third of the participating nurses received their knowledge and instructions about DV from scientific formal sources as medical schools, training courses and conferences. The majority of them indicated that they were willing to receive training or guidelines instructions in the different topics for management of DV in the future. Conclusion: Overall, primary care nurses had poor knowledge regarding DV. Although female nurses are somewhat more knowledgeable about DV, many more educational activities are needed.

Objective: The aim of the study was to reveal extent of burnout problem among primary care physicians and the socio-demographic factors affecting its occurrence. Methods: The target population included all physicians working in these two health regions in Kuwait. Two hundred physicians working in the primary health care units in the selected regions agreed to participate in the study. A specifically designed questionnaire for this research was derived from Maslach Burnout Inventory (BMI). It included four domains, namely emotional exhaustion, depersonalization, personal accomplishment, and involvement. In addition, socio-demographic and work characteristics of physicians were studied and their association with burnout domains was illustrated. Results: More than half the sample was females (56%), in the age group 30-49 (56.5%) and of non-Kuwait nationality (51%). Emotional exhaustion and depersonalization had lower percentage scores than the positive ones namely, personal accomplishment, and involvement. Physicians had a mean percent score of 37.1 + 29.0% on the emotional exhaustion domain, 21.0 + 22.9% on the depersonalization domain, 63.2 + 26.3% on the personal accomplishment domain, and 46.2 + 29.9% on the involvement domain. The four domains of MBI were associated only with some of the studied socio-demographic and job characteristics of the studied physicians. Nationality, place of work, job and income had a significant association with emotional exhaustion, depersonalization, and personal accomplishment domains. Conclusion: Burnout syndrome is relatively common among Kuwaiti physicians working at the primary care level. The syndrome is more common among non-Kuwaiti physicians, general practitioners, and those with lower income. There is a need for training the physicians about how to cope with stress at work.

Background: Screening for violence against women provides an important opportunity for early detection and proper management of affected women. Primary health care workers can play an important role to implement screening measures for women. Multiple factors such as knowledge, attitude as well as barriers and enabling factors available for medical staff can affect these programs. Objectives: The aim of this study was to reveal the extent of screening for domestic violence among physicians and nurses in the primary health care unit, identify knowledge, attitude, and barriers toward violence screening, and reveal factors affecting screening. Subjects and methods: To achieve these objectives, an observational cross-sectional study was carried out in PHC centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A self-administrative questionnaire was used for data collection. Results: Less than two-thirds (62.5%) of the primary health care workers were aware about the topic while only about one-third (34.7%) regularly screened for violence among women. Of those regularly

Background: Work stress is an important problem that affects physicians. Multiple sources can contribute to this problem. High rates of stress among physicians can be manifested in various expressions including cognitive, behavioral, and somatic expressions. Work performance and quality of medical care administered to the patients can be undermined by over stressed physicians. Objective: The aim of the study was to reveal sources and expressions of stress among hospital physicians and their relationship with socio-demographic and job factors. Subjects and methods: Two hundred and forty-seven physicians working in a general hospital in Kuwait were the candidates of this study. Quick Stress Questionnaire (QSQ) was used. It consisted mainly of two parts, the first dealt with the sources of stress while the second entailed cognitive, behavioral, and somatic expressions of stress. In addition, sociopage title demographic and work characteristics of physicians were studied and their association with stress domains was illustrated. Results: The most commonly encountered sources of work stress were work concerns (55.9%),

Introduction: Domestic violence against women is an important public health problem. The medical practitioner's personal value system and beliefs about domestic violence can play an important role to deal with problem and provide support to battered women. Objective: The current study was formulated to reveal attitude of physicians towards domestic violence against women and factors affecting this attitude. Methods: To achieve such aims, a sample of 565 physicians were interviewed out of 899 physicians selected for this study with an overall response rate of 62.8%. The target population for this study was all physicians in the primary health care centers in Kuwait. Results: The results of the current study revealed that physicians tended to have a relatively low positive overall attitude score towards violence against women (60.75 + 13.16%), with a mean percent score of 42.36 + 15.37% for relationship between partners domain, 75.73 + 21.80% for good reasons to hit wives domain, and 58.39 + 17.11% for management of domestic violence domain. Female physicians tended to have a higher positive attitude score than males (62.9 + 13.36% compared with 58.3 + 12.52%, P < 0.001) as well as for each attitude domain. Years spent at the current job negatively correlated with the total attitude score of physicians towards domestic violence against women. Conclusion: There is a great need to improve attitude of physicians about domestic violence, especially against women through properly planned training programs so that a better medical care and support of battered women can be achieved.

Background: Violence against women is an important public health problem that draws attention of a wide spectrum of clinicians. Attitude and knowledge of the primary health care (PHC) staff can affect their ability and willingness to screen for and manage domestic violence (DV) against women. Objectives: Reveal the impact of knowledge and attitude of workers to screen for DV against women. Methods: An observational cross-sectional study was carried out in PHC centers located in two randomly selected health regions in Kuwait. The study involved all available physicians (210) and nurses (464) in the selected centers. The overall response rate was 54.3%. A self-administrative questionnaire was used for data collection. It included four main aspects relevant to knowledge and one attitude domain regarding DV. A 5-point, Likert-scale was used to assess participant's answers for each item.

Introduction: Domestic violence (DV) has a deteriorating influence on society by affecting victims, their children, families, and friends, as well as social and financial relationships. Primary care providers, including physicians and nurses, frequently are the first in the community to encounter the battered women. Objective: The aim of this work was to compare the knowledge and perception of primary care physicians and nurses about DV. Methods: This study was carried out in all primary health care centers in Kuwait. All physicians and nurses who were currently working in these centers during the study period were asked to complete a self-administered close-ended questionnaire that included personal and working conditions information. It included also knowledge about prevalence of DV, and four main aspects relevant to DV, namely deprivation, psychological, physical and sexual domains. A 5-point, Likert-scale was used to assess participant's answers for each item. Results: The response rate was 62.8% for physicians and 61.1% for nurses. The study revealed that the overall knowledge score was higher in physicians than nurses. Also, the scores for the individual domains were significantly higher for physicians than nurses except for psychological one. Conclusion: Overall, primary care physicians and nurses had poor knowledge and many had negative perception regarding DV. Although physicians are somewhat more knowledgeable about DV, many more educational activities are needed.

Objective: The aim of the study was to reveal extent of burnout problem among primary care physicians and the socio-demographic factors affecting its occurrence. Methods: The target population included all physicians working in these two health regions in Kuwait. Two hundred physicians working in the primary health care units in the selected regions agreed to participate in the study. A specifically designed questionnaire for this research was derived from Maslach Burnout Inventory (BMI). It included four domains, namely emotional exhaustion, depersonalization, personal accomplishment, and involvement. In addition, socio-demographic and work characteristics of physicians were studied and their association with burnout domains was illustrated. Results: More than half the sample was females (56%), in the age group 30-49 (56.5%) and of non-Kuwait nationality (51%). Emotional exhaustion and depersonalization had lower percentage scores than the positive ones namely, personal accomplishment, and involvement. Physicians had a mean percent score of 37.1 + 29.0% on the emotional exhaustion domain, 21.0 + 22.9% on the depersonalization domain, 63.2 + 26.3% on the personal accomplishment domain, and 46.2 + 29.9% on the involvement domain. The four domains of MBI were associated only with some of the studied socio-demographic and job characteristics of the studied physicians. Nationality, place of work, job and income had a significant association with emotional exhaustion, depersonalization, and personal accomplishment domains. Conclusion: Burnout syndrome is relatively common among Kuwaiti physicians working at the primary care level. The syndrome is more common among non-Kuwaiti physicians, general practitioners, and those with lower income. There is a need for training the physicians about how to cope with stress at work.

Background: Job burnout is an important syndrome that can deplete the emotional health aspects of physicians. Its impacts are reflected both on the physicians and their patients through undermining the performance of physicians and degrading the quality of the administered medical care leading to dissatisfaction of the patients about the medical service.

Background: Peak expiratory flow meter (PEFM) is an easy to use, relatively cheap device that can be used for guiding management of bronchial asthma by the patients at home according to a preset plan by health care workers. Objective: The aim of the study is to reveal the extent of knowledge and perception of nurses about PEFM and factors affecting their knowledge. Methods: Out of the total primary health care centers in Kuwait, 50% were randomly selected. Out of 699 nurses currently working in the selected centers, 516 nurses were interviewed for this study with an overall response rate of 73.8%. Results: The results of this study showed that nurses had a relatively low total knowledge score percent of 64.7 ± 7.3%. The lowest individual mean percent score was that of procedures and steps of measuring peak expiratory flow rate (39.0 ± 24.1%). The highest percent knowledge score was that of benefits of use and content instructions for teaching patients (78.3 ± 19.5% and 78.1 ± 12.0%, respectively). Sociodemographic factors did not affect the total knowledge score. Receiving training, availability of PRFM in the health center and being responsible about taking the measurements for patients proved to significantly affect the level of knowledge of nurses.