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Article
Perception of Specialist and Junior Doctors toward the Concept of Family Medicine
ادراك الاطباء تجاه مفهوم طب الاسرة

Authors: Riyadh K Lafta د. رياض لفته --- Noora Abd Al-Hussein Dawood د. نورا عبد الحسين
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2011 Volume: 24 Issue: 2 Pages: 88-93
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Family medicine has been particularly proactive in conceptualizing new, improved ways of health care delivery, despite its early promise; family medicine has struggled to realize its full potential as an exciting conceptual model for the practice of medicine in primary care settings.Objective: To explore the attitude of specialists and junior doctors working in teaching hospitals and Family medicine centers/ Al-Karkh health directorate towards the concept of Family medicine.Methods: This cross sectional study was carried out at three Family Centers (Al-Tobchii, Al-Mansour and Al-Salam) and two teaching hospitals (Al-Kadhmya and Al- Yarmouk ), over the period from May 2009 to July 2010. The study population included all specialists in the major clinical departments and junior doctors working in the teaching hospitals, in addition to the physicians working in the mentioned Family Centers. Data was obtained by using an already prepared self administered questionnaire.Results: A sample of 170 specialists and junior doctors participated in the study, 75% of them expressed positive attitude to the concept of family medicine. The most frequent services and skill perceived by the respondents to be effective in the development of the branch were Conference attendance (94%) and training in managing minor operations (93%). Surprisingly; 94% of the responded clinicians agreed that family health system limits the unnecessary referral from primary to secondary health care levels. The majority of the responded specialists (94%) expressed a positive attitude to the necessity of establishing updated national guidelines and regarded it as the main barrier towards the development of the branch. Most of the junior doctors (64%) do not have a will to adopt Family Medicine specialty as a medical career. Conclusion: Academic settings contributed substantially to the low appeal of being a primary care physician at a time when the primary care sector is widely recognized as the cornerstone of any health care system and when health authorities are struggling to initiate extensive primary care reforms, in addition the national guidelines perceived to be of great importance in organizing the interface between the primary and secondary levels. Keywords: Perception, Specialists, Juniors, Family Medicine

الخلفية : يعتبر طب الاسرة فرعا حيويا في ادراك الطرق الجديدة والمتطورة في الرعاية لصحية بالرغم من حداثته. لقد جاهد طب الاسرة لتحقيق اهدافه كنموذج ادراكي مثير للاهتمام لممارسة الطب في مجال الرعاية الصحية .الهدف : استكشاف مواقف الاطباء الاختصاص والجدد الذين يعملون في المستشفيات التعليمية ومراكز طب الاسرة في دائرة صحة الكرخ تجاه مفهوم طب الاسرة .طرائق العمل : اجريت هذه الدراسة المقطعية في ثلاث مراكز لطب الاسرة ( الطوبجيي، المنصور، السلام ) ومستشفيان تعليميان ( الكاظمية واليرموك ) خلال الفترة ( ايار 2009 –تموز 2010)، تضمنت عينة الدراسة جميع الاطباء الاختصاص في الاقسام السريرية الكبرى والاطباء الجدد العاملين في المستشفيات التعليمية اضافة الى الأطباء الممارسين العاملين في مراكز طب الأسرة المذكورة. تم جمع المعلومات عن طريق استفتاء مهيأ يملأ ذاتيا . النتائج : شارك في الدراسة 170 طبيب اختصاص وغير اختصاص 75% منهم أعطوا موقفا ايجابيا تجاه مفهوم طب الاسرة . أكثر الخدمات والمهارات التي حددت من قبل المشاركين لتكون مؤثرة في هذا الفرع كانت : حضور الموتمرات (94%) التدريب في تدبير العمليات الصغرى (93%)، ومن الجدير بالذكر ان 94؟% من الاطباء السريرين وافقوا ان نظام طب الاسرة يقلل من الاحالات غير الضرورية من مراكز الرعاية الصحية الاولية الى المستشفيات . معظم الاختصاصيين المستجيبين (94%) ابدوا موقفا ايجابيا تجاه ضرورة الشروع في تحديث الدلائل الوطنية واعتبارها كحاجز رئيس بأتجاه نمو هذا الفرع . معظم الاطباء الجدد (64% ) ليس لديهم رغبة في تبني اختصاص طب الاسرة كمهنة طبية مستقبلية .


Article
Factors associated with fatigue in patients attending a family medicine health center in Erbil city
العوامل المرتبطة بالإرهاق لدى مرضى مركز صحة طب الأسرة في مدينة أربيل

Author: Jwan Muhammad Sabir
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2013 Volume: 17 Issue: 1 Pages: 337-343
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Fatigue, is a common presenting symptom in primary care which negatively impacts work performance, family life, and social relationships. The aim of this study is to determine the causes of fatigue and to explore the relationship between fatigue and physical, mental, social and demographic factors among patients with special reference to gender. Methods: A cross sectional study was carried out at the Brayati Family Medicine Center in Erbil city from 1st of July to the 31st of October 2011. We studied 320 patients of both genders attending the center for various reason complaining from fatigue. Formal consent was obtained. Demographic data in addition to two questionnaires were completed, Lowa fatigue scale and Hospital Anxiety and Depression Scale. Results: 86 males (26.88%) and 234 females (73.12%). The age of the subjects varied from 16-74 years .The mean age was 29.2 years, 39.69% were in the age range 30-44 years. 58.12% were illiterate or read and write only; 65.63% were married and 57.19% reported their economic level as medium. 38.44% were fatigued according to lowa fatigue scale. Higher level was detected among older age group, singles, and low economic and minimum educational status (51.16%, 45.31%, 41.80%, 41.18 and 42.57% respectively). Depression was significantly associated with fatigue, 70% of patients who were depressed complained from fatigue. Findings indicated that, in addition to increasing anxiety among the study sample, higher levels of fatigue were detected in 61.36% of them. Conclusion: Fatigue as a symptom is very common both in community and health care settings but remains medically unexplained. The most important confounders in our studied population were depression and anxiety.


Article
THE PERCEPTION OF GRADUATES OF DUHOK COLLEGE OF MEDICINE ABOUT FAMILY MEDICINE
نظرة خريجي كلية الطب/ دهوك نحو طب الأسرة

Authors: DELDAR MORAD ABDULAH دلدار مراد عبدالله --- RAJAB H. SANAAN, MBChB رجب سنعان --- SAEID KHEZER AHMED سعيد خزر احمد
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2017 Volume: 11 Issue: 1 Pages: 79-92
Publisher: University of Dohuk جامعة دهوك

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Background: There is the shortage in the number of family doctors in this region and across the world. The perception of medicine graduates toward family medicine as a career may provide information on the future supply of family doctors in Kurdistan region of Iraq. The perception and specialty preferences of graduates of Duhok College of Medicine toward family medicine were examined in the current study.Subject and Methods: A cross-sectional study involving 131 medical graduates aged 24-29 years old of last three years from University of Duhok, College of Medicine working in Duhok governorate hospitals and its primary health centers was applied. Data were collected by the use of an anonymous self-administered questionnaire in English. Descriptive and analytic statistical methods were performed to find out the various aspects of the medical graduates’ preferences toward family medicine.Results: The number of participants was 131 medical graduates included 59.5% males and 40.5% females. The study revealed that the mean age of the sample population was 26.31±1.36 years. The preferred medical specialties were radiology (40.5%), pediatrics (40.5%), internal medicine (33.6%), and general surgery (32.8%) by both genders. The lowest interest was shown toward the family medicine (10.0%) compared with other medical specialties. Working time (72.5%), prestige (66.9%), and patient interaction (65.6%) have been the most important aspects of their specialty selection in both genders. The majority of them stated that family medicine is poorly valued by our society (79.4%), family doctors have limited career possibilities (43.5%). The family medicine was poorly valued in our society because it does not able to increase the private job opportunities (p=0.003), is not very attractive (p=0.015), have limited career possibilities (p=0.006). Moreover, the graduates did not show their interest towards family medicine because it does not provide the salary as high as other medical fields in our society (p=0.018).Conclusions: The medical graduates have currently a positive perception of family medicine as an essential clinical specialty in the region; however, they showed low interest in its selection as a future career. Numerous essential steps recommended to be done to reach the sufficient number of family doctor that would fulfill the need of our community.

الخلفية والهدف: نظرا لنقص عدد أطباء الأسرة في هذه المنطقة وفي جميع أنحاء العالم.نظرة الطبيب المتخرج نحو طب الأسرة على النحو الوظيفي، قد توفر معلومات عن العرض المستقبلي لأطباء الأسرة في إقليم كردستان العراق. وقد تم دراسة نظرة والتفضيلات التخصصية لخريجي كلية الطب في دهوك تجاه طب الأسرة في الدراسة الحالية.طرق البحث: تم تطبيق دراسة مستعرضة تشمل 131 من خريجي كلية الطب جامعة دهوك الذين تتراوح أعمارهم بين 24-29 سنة خلال السنوات الثلاث الماضية الذين يعملون في مستشفيات محافظة دهوك ومراكز الرعاية الصحية الأولية, تم جمع البيانات عن طريق استخدام استبيان يتم ملاها ذاتيا باللغة الإنجليزية. تم استخدام الأساليب الإحصائية الوصفية والتحليلية لمعرفة الجوانب المختلفة لرغبات خريجي الطب تجاه طب الأسرة.النتائج: بلغ عدد المشاركين (131) متخرج من كلية الطب منهم 59.5٪ من الذكور و 40.5٪ من الإناث. وكشفت الدراسة أن متوسط عمر أفراد العينة هو 26.31 ± 1.36 سنة. وكانت التخصصات الطبية الأكثر تفضيلا الأشعة (40.5٪)، طب الأطفال (40.5٪)، الطب الباطني (33.6٪)، والجراحة العامة (32.8٪) من كلا الجنسين. وقد أظهرت اهتماما أقل نحو طب الأسرة (10.0٪) مقارنة مع التخصصات الطبية الأخرى. وقت العمل (72.5٪)، تاثير (66.9٪)، وتفاعل المريض (65.6٪) كانت أهم جوانب اختيارهم التخصص في كلا الجنسين. وغالبيتهم ذكروا أن طب الأسرة لا يقدره مجتمعنا بشكل كاف (79.4٪)، و ذلك لأن أطباء الأسرة لديهم امكانيات مهنية محدودة (43.5٪). وطبيب الأسرة في مجتمعنا لا يستطيع زيادة فرص العمل الخاصة (p = 0.003)، ليس مرغوبا بشكل كافي (p = 0.015)، لديه إمكانيات مهنية محدودة (p = 0.006). وعلاوة على ذلك، لم يظهر الخريجون اهتمامهم بطب الأسرة لأنه لا يوفر رواتب عالية مثل المجالات الطبية الأخرى في مجتمعنا (p = 0.018).الاستنتاجات: إن خريجي كلية الطب لديهم حاليا تصور إيجابي نحو طب الأسرة باعتباره التخصص السريري الأساسي في المنطقة؛ ومع ذلك، فإنهم أظهروا رغبة قليلة في اختيارها كمهنة المستقبل. خطوات أساسية عديدة أوصى أن يتم الوصول إلى عدد كاف من أطباء العائلة التي من شأنها تلبية الحاجة في مجتمعنا.

Keywords

Family Medicine --- Perception --- Iraq --- Duhok.


Article
Assessment of Family Medicine Residents’ Perception about their Specialty and Residency Program in Iraq

Authors: Mais Ahmed Abd Ali --- Ali Abdulridha Abutiheen --- Hasan Alwan Ba’aie
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2019 Volume: 12 Issue: 1 Pages: 4132-4142
Publisher: Kerbala University جامعة كربلاء

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background: Family Medicine (FM) specialists are the frontline of medical services. Where they require a wide range of knowledge, practice and experience. A periodic evaluation of family medicine residency training and the exploration of residents’ perception toward their specialty and training are important.Objective: To assess factors affecting clinical training of family medicine residents in training centers and evaluates their satisfaction about their training program.Subjects and methods: A cross sectional study. Several training centers in Iraq were covered for the period of February 1 to July 31, 2018. A special self-administered questionnaire based on 5 points Likert scale prepared for this purpose and been tested by a pilot study. The response rate for the questionnaire was 75.6%.Results: The accomplished sample was 187; female represents 93% of them. Nearly 55% indicate that they if time is back they will choose FM again and similar percentage indicate that they will recommend FM to others. Nearly 75% of participants have positive feeling towards their future as family physicians. While 63.6% were dissatisfied with their residency training program. Lack of commitment of teaching hospitals to training curriculum, and poor understanding and acceptance to them and FM specialty from physicians of other clinical branches was the main weak areas highlighted by them. Conclusion: Family medicine residents still in favorite of their specialty, but they have many critiques concerning their residency training curricula and the application clinical training in the hospitals. These points are vital and need to be considered by their supervisors and higher committees concerned.


Article
Evidence- based medicine among family physicians in Mosul city: knowledge and attitudes
الطب المبني على الدليل بين أطباء الأسرة في مدينة الموصل: المعارف والمواقف

Author: Anmar B. Al-Dewachi انمار برهان الديوجي
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 1 Pages: 38-44
Publisher: Mosul University جامعة الموصل

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ABSTRACTObjectives: The aim of this study is to assess knowledge and attitudes of family physicians in Mosul city toward evidence-based medicine and to describe the major barriers to practicing evidence based medicine.Method: A cross sectional questionnaire based survey has been adopted for this study. For the period between the 1st of June and 31st of August 2012; a self-administered questionnaire had been distributed to all 71 family physicians registered in Nineveh Health Directorate and practicing in primary health centers in Mosul city. The main outcome measures were: participants’ attitudes toward evidence –based medicine (EBM), their knowledge about the important technical terms used in EBM and their perception of barriers to EBM practice.Results: Sixty one family physicians participated in this study, 24 (39.3%) were males and 37 (60.7%) were females. The response rate was 85.9%. The mean age of the participants was 36.15 years. Most of the respondents had positive attitudes toward EBM: 54.1% showed welcoming attitudes towards EBM; 44.3% showed strongly welcoming attitudes towards EBM; 65.6% believed that most of their clinical practice was evidence based; 90% agreed with the concept of practicing EBM improves patients care. The participants showed deficient knowledge regarding the technical terms commonly used in EBM. Patients overload and lack of personal time were the major perceived barriers to practicing EBM (78.7% and 65.6%) respectively.Conclusion: Although this research revealed high support among family physicians in Mosul for the practice of EBM, they showed a deficiency in knowledge about EBM. Keywords: EBM, family physicians, family medicine, knowledge, attitudes.

الخلاصةأهداف الدراسة: تقييم معارف ومواقف أطباء الأسرة في مدينة الموصل من الطب المبني على الدليل، وكذلك لوصف المعوقات الرئيسة لممارسة الطب المبني على الدليل. طرق العمل: هذه دراسة مقطعية بإستخدام إستبيان خلال الفترة الممتدة من الأول من حزيران إلى الحادي والثلاثين من آب 2012. تم توزيع إستبيان على جميع أطباء الأسرة المسجلين في دائرة صحة نينوى والعاملين في مراكز الرعاية الصحية الأولية في مدينة الموصل، والبالغ عددهم 71 طبيب أسرة. وإعتمدت مقاييس الحصيلة على النحو التالي: مواقف المشاركين من الطب المبني على الدليل, معارف المشاركين فيما يخص المصطلحات الفنية المستخدمة في الطب المبني على الدليل والعوائق التي تحول دون ممارستهم للطب المبني على الدليل.النتائج: شارك في الدراسة 61 طبيب أسرة, 24 (39,3%) من الذكور و37 (60,7%) من الإناث. وكان معدل الاستجابة 85,9%. وكان معدل أعمار المشاركين 36,15 سنة. أظهرت الدراسة أن معظم المشاركين لديهم مواقف إيجابية من الطب المبني على الدليل، وكانت على النحو التالي: أظهر 54,1% موقفا مرحبا من الطب المبني على الدليل، كما أظهر 44,3% موقفا مرحبا بشدة من الطب المبني على الدليل وأن 65,6% من المشاركين يعتقدون أن معظم ممارساتهم السريرية مبنية على الطب المبني على الدليل وأن 90% من المشاركين متفقون مع المفهوم القائل أن الطب المبني على الدليل يحسن مستوى الرعاية الصحية المقدمة للمرضى. وأظهرت الدراسة كذلك قلة معرفة المشاركين بالمصطلحات الفنية المستخدمة في الطب المبني على الدليل. كما أظهرت أيضا أن العدد الكبير للمرضى إضافة إلى نقص أوقات الفراغ الشخصي كانت من أهم العوائق في وجه ممارسة الطب المبني على الدليل (78,7% و 65,6%) على التوالي. الاستنتاج: على الرغم من أن هذا البحث أظهر تأييدا عاليا من قبل أطباء الأسرة في مدينة الموصل لممارسة الطب المبني على الدليل إللا أنه أظهر نقصا في معارف هؤلاء الأطباء بتفاصيل الطب المبني على الدليل.


Article
Satisfaction of Attendants to a Family Medicine Training Center and a Primary Health Care Center in Baghdad

Authors: Faris H. Al-Lami --- Meha Al-Jumaily
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 1 Pages: 41-45
Publisher: Baghdad University جامعة بغداد

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Background: In Iraq, Primary Health Care (PHC) services are provided trough a network of about 1900 PHC Centers (PHCC). Recently, attempts were made to enhance the practice of primary health care to encompass the family health model. Expressed attendants' satisfaction and opinion about provided care at any health care setting is an important predictor of utilization and continuity of obtaining care from the same source. The objective: is to describe and compare satisfaction of attendants of a Family Medicine Training Center (FMTC) and a PHCC in Baghdad.
Subjects and Methods: a comparative cross sectional study conducted on a random sample of 300 attendants from each center. Attendants’ satisfaction towards the center’s building; doctor's approach, provided medical services and attendants’ continuity manner were studied.
Results: About 53% of FMTC attendants and 40% of PHCC attendants stated a very good building's location. Around 7.3% of PHCC attendants, and 3.7% of FMTC attendants considered hygienic standard as "poor", (P=0.05). Doctor reception was considered as “poor” in 2.7% of FMTC attendants compared to 0% for the PHCC, (P=0.000). Around 16% of FMTC attendants considered the time spent by the doctor as "inadequate" compared to 4.7% of PHCC attendants, (P=0.000). Around 48% of PHCC attendants were given appointment for follow up, compared to 19% of FMC attendants (P=0.000). About 58% reported availability of investigations and drugs in FMTC compared to 40.3% for PHCC attendants, (P=0.000). Conclusion: FMTC attendants are more satisfied to building's related variables and availability of medical services but less satisfied by doctor's approach with less intention to continue attending the center.


Article
EDITORIAL SPECIALIZATION IN FAMILY MEDICINE; A NECESSITY OR A FASHION

Author: SAMIM A. AL-DABBAGH صميم الدباغي
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2007 Volume: 1 Issue: 1 Pages: 1-3
Publisher: University of Dohuk جامعة دهوك

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Article
Impact of Family Physicians' Practices upon the Quality of Family Medicine Health Care Services at Model Primary Health Care Centers in Baghdad City
اثر ممارسات أطباء العائلة على جودة خدمات الرعاية الصحية لطب الاسرة في مراكز الرعاية الصحية النموذجية في مدينة بغداد

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Abstract

Objective(s):To evaluate the family physicians' practices and to measure its impact upon the quality of family medicine health care in Baghdad City model primary health care centers.Methodology:Adescriptive study, using the evaluation approach,has evaluated the impact of family physicians' practices upon quality of healthcare in Baghdad's Model Primary Health Care Centers of Family Medicine. It is carried out during 15th of May – 20th of August 2017. The study is conducted at five model primary health care centers of family medicine from two districts; AL-Rusafa and AL-Kurkh.Sample size is calculated to be (76) family physicians.Convenient sample of (124) patients who are attending these primary health care centers to seek family health care services.Adopted structured self-administered questionnaire is used to collect data from the Family physicians. The list of dual-forced items obtained through the Delphi process, which include "Do" or "Don't do". Inpatient care is clarified with (25) statements,urgent care and minor procedures tested in (27) statements andambulatory care includes (16) statements. The quality of health care questionnaire is developed for the purpose of the study. The overall number of items included in the questionnaire is (18) items. Internal consistency "split-half" reliability is obtained through computation of Cronbach's alpha correlation coefficient. Content validity of the questionnaire is determined through panel of (10) experts. Data are collected through the utilization of the questionnaire and the interview technique as means of data collection. Data of both stages is entered to computer using Statistical Package of Social Science, Version (23.00) for windows(10) (SPSS-23) and are handled using descriptive statistical data analysis approach (frequencies, percentages, mean of scores, total scores and Cronbach's alpha correlation coefficient) and inferential statistical data analysis approach(simple linear regression).Results:The study reveals that the majority of the family physicians has performance experienced inadequate of family health care practices. The quality of family medicine health care services in Baghdad's primary health care centers of the patients' perspectives is poor (82.30%).The impact of family physicians' practices upon the quality of family medicine health care services in Baghdad City model primary health care centers presents that family physicians' practices have notmadenoteworthy change on the quality of family medicine health care services.Recommendations: Family physicians can follow the family medicine practices' standards to provide quality of family medicine health care services. The Ministry of Health Department of Primary Health Care can periodically monitor the implementation of family physicians' practices standards for the benefit of better quality of family medicine health care services. The family medicine quality of health care services can be valued on a regular base for the benefits of the patients who are attending the primary health care centers to seek such care.

الأهداف:لغرض تقويم ممارسات أطباء الأسرة وقياس آثرها على جودة رعاية طب الأسرة الصحية في مراكز الرعاية الصحية الأولية النموذجية في مدينة بغداد.المنهجية:دراسة وصفية إعتمدتإسلوب التقويم لتقويمآثر ممارسات أطباء الأسرة على جودة رعاية طب الأسرة الصحية في مراكز الرعاية الصحية الأولية النموذجية في مدينة بغدادتم أجرائها خلال الخامس عشر من أيار (2017) ولغاية العشرون من أب (2017). الدراسة أجريت على خمس من مراكز الرعاية الصحية الأولية النموذجية لطب الأسرة من جانبي الرصافة والكرخ. العينة جمعت لتكون (76) طبيب أسرة. وكانت العينة المتاحة من المرضى (124)الذين يدومون على زيارة هذه المراكز الصحية لطلب خدمات رعاية طب الأسرة الصحية. تم استخدام استمارة إستبيانية منظمة ذاتيا لجمع البيانات من اطباء الأسرة. قائمة العناصر الثنائية تم الحصول عليها من خلال عملية دلفي. التي تحتوي على"أفعل" أو "لا أفعل". يتم توضيح رعاية المريض الداخلي عن طريق (25) فقرة، الرعاية العاجلة والإجراءات البسيطة يتم اختبارها عن طريق (27) فقرة والرعاية الإسعافية تتضمن (16) فقرة.استمارة جودة الرعاية الصحية الاستبيانية تم تطويرها لغرض الدراسة. بلغ عدد البنود الواردة في الاستمارة الاستبيانية (18) فقرة.تم تحديد صدق الإتساق الداخلي من خلال حساب معامل ارتباط الفا كرونباخ. تم تحديدثبات محتوى الاستمارة الاستبيانية من خلال مجموعة من (10) خبراء. جمعت البيانات من خلال إستخدام الإستمارة الإستبيانية والمقابلة المنظمة كوسيلتين لجمع البيانات. ادخلت البيانات الخاصة بالمرحلتين الى الكومبيوتر بواسطة تطبيق الحزمة الإحصائية للعلوم الاجتماعية، الأصدار (23) لنظام الويندوز (10) (SPSS-23) وتم التعامل معها بأستخدام تطبيق الإسلوب الإحصائي الوصفي لتحليل البيانات والذي تضمن (التكرارات، النسبة المئوية، الوسط الحسابي، القيمة الكلية ومعامل ارتباط الفا كرونباخ). ونهج تحليل البيانات الإحصائية الإستنتاجية (الإنحدار الخطي البسيط).النتائج:كشفت الدراسة أن غالبية أطباء الأسرة يعانون من قصور في أداء ممارسات الرعاية الصحية الأسرية.إن جودة خدمات الرعاية الصحية لطب الأسرة في مراكز الرعاية الصحية الأولية في بغداد من وجهة نظر المرضى ضعيفة (82,30%). أن تأثير ممارسات أطباء الأسرة على جودة خدمات رعاية طب الأسرة الصحية في مراكز الرعاية الصحية الأولية النموذجية في مدينة بغداد يبين أن ممارسات أطباء الأسرة لم تحدث تغييراً ملحوظاً على جودة خدمات رعاية طب الأسرة الصحية. التوصيات:يمكن لأطباء الأسرة إتباع معايير ممارسات طب الأسرة لتوفير جودة خدمات الرعاية الصحية لطب الأسرة.ويمكن لوزارة الصحة، قسم الرعاية الصحية الأولية، أن ترصد بصورة دورية تنفيذ معايير ممارسات أطباء الأسرة من أجل تحسين نوعية خدمات الرعاية الصحية لطب الأسرة. ويمكن تقويم خدمات الرعاية الصحية لطب الأسرةعلى أساس منتظم لفائدة المرضى الذين يحضرون إلى مراكز الرعاية الصحية الأولية للحصول على هذه الرعاية.


Article
Chronic Pelvic pain of myofascial origin in a 53 year old patient

Authors: Patricia McWalter --- Tarfah Al-Muammar --- Kevin Hafez
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2016 Volume: 29 Issue: 4 Pages: 236-239
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Chronic pelvic pain in women has a multifactorial etiology but pelvic musculoskeletal dysfunction is not routinely evaluated as a cause by gynaecologists. There is no gold standard diagnostic test for pelvic musculoskeletal problems. Our patient presented to a gynaecologist because of chronic pelvic pain. However no gynaecological cause was found for her symptoms. This patient enjoyed sport particularly horse riding. Imaging revealed osteitis pubis and an osteophyte of the sacro-ilium. It has been recognised in athletes that there can be an association between stress injuries to the pubic symphysis and degenerative changes at the sacro-ilium. This case demonstrates the importance of thinking of a myofascial cause for chronic pelvic pain.


Article
Glycemic control among type 2 diabetic patients attending the Family Medicine Health Center and the Diabetic Health Center in Erbil, Iraq: a comparative study
السيطرة على نسبة السكر في الدم بين مرضى السكري من النوع 2 الذين يراجعون مركز طب الأسرة والمركز الصحي لمرضى السكري في أربيل، العراق: دراسة مقارنة

Author: Ali Shakir Dauod
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 3 Pages: 332-341
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Type 2 diabetes mellitus constitutes a universal growing community health problem particularly in developing countries. This study aimed to determine and compare the rate of the glycemic control and other biochemical parameters of type 2 diabetic patients treated in a primary health center and the diabetic center.Methods: A cross-sectional study was carried out on a sample of 300 adult patient’s aged ≥18 years with type 2 diabetes who attended Brayati family medicine center and the diabetic center in Erbil city during the period from the 1st of January 2015 to the 28th of February 2016.Results: The mean hemoglobin A1c among patients of the diabetes center was significantly higher than that among patients of the Brayati center (8.28% and 7.21%, respectively) (P <0.001) and the means of triglycerides, total cholesterol, and LDL were significantly higher among patients of the diabetes center compared with Brayati center (P <0.001). Half of the patients at Brayati center had controlled diabetes compared with only 24.7% of patients at the diabetes center (P <0.001), and 50% of the Brayati center sample had equal or more than three controlled risk factors compared with only one-quarter of the diabetes center sample (P <0.001). Logistic regression analysis showed that being a patient in Brayati center (compared with diabetes center) (P <0.001; OR = 3.1), diabetes duration of less than five years (P <0.001; OR = 3), and controlled lipid profile (P = 0.004; OR = 2.5) were significantly associated with diabetes control.Conclusion: Type 2 diabetes can be effectively managed at primary health care, and good glycemic control can be achieved by a greater effort of the health care providers. Reorganizing primary care practice and shifting toward family medicine practice is necessary.

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