Background: The use of acute health care resources for asthma is considerable. Disease severity i... more Background: The use of acute health care resources for asthma is considerable. Disease severity is an established risk factor, but ethnicity and health care factors are less well studied. Objective: To investigate the independent associations of ethnicity and health care factors with acute resource use for asthma. Methods: Longitudinal data from a national adult asthma management program providing universal access to care were analyzed. Outcome measures were unscheduled physician visits with urgent nebulization, emergency department (ED) visits, and hospitalizations. Results: In multivariate analyses, markers of disease severity were found to be significantly associated with all acute resource use. After controlling for disease severity, ethnicity was associated with increased risk of all acute resource use; Indian (vs Chinese) ethnicity was associated with increased risk of unscheduled physician visits (hazard ratio [
International Journal of Adolescent Medicine and Health
Objectives Psychoactive substance experimentation among Tunisian adolescents remains one of the m... more Objectives Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. Methods We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019–2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer’ factors. Results Tobacco was the most commonly experimented substance with a prevalence rate ...
Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and espec... more Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and especially in intensive care units (ICUs) where they are more likely to occur. Monitoring of AEs can provide insight into the status and advances of patient safety. This study aimed at examining the AEs reported during 20 months after the implementation of AE reporting system. Methods We conducted a retrospective analysis of a voluntary ICU AE reporting system. Incidents were reported by staff from 10 ICUs in the Sahloul University Hospital (Tunisia) between February 2020 and September 2021. Results A total of 265 reports were received, of which, 61.9% were deemed preventable. The most reported event was healthcare-associated infections (30.2%, n=80), followed by pressure ulcers (18.5%, n=49). At the time of reporting, 25 patients (9.4%) had died as a result of an AE and in 51.3% of cases, the event had resulted in an increased length of stay. Provider-related factors contributed to 64.2% of ...
Childhood asthma still imposes an enormous burden on children and their families. To the best of ... more Childhood asthma still imposes an enormous burden on children and their families. To the best of our knowledge, no study reviewed the literature on the effect of family asthma education on major asthma outcomes. This study aimed to explore the effect of family education programs on major asthma outcomes in children. Quasi-experimental studies and randomized controlled trials were conducted among children with asthma aged 6–18 years and their parents were included. Pub Med, Science Direct, and Trip databases were used to extract data published in English from 2010 to 2021. Twenty-two studies were reported in this review. It was demonstrated that family empowerment interventions were effective in improving the quality of life of children and their parents, asthma symptom control, and pulmonary function. Family education that was specific to medication improved medication adherence, inhalation technique, and asthma control. Family asthma education enhanced asthma management and family ...
Background Routine assessments of patient safety culture within hospitals have been widely recomm... more Background Routine assessments of patient safety culture within hospitals have been widely recommended to improve patient safety. Experts suggested that mixed-methods studies can help gain a deeper understanding of the concept. However, studies combining quantitative and qualitative approaches exploring patient safety culture are still lacking. This study aimed to explore patient safety culture as perceived by operating room professionals of two university hospitals in Sousse, Tunisia. Methods Based on a mixed-methods approach, a cross-sectional survey followed by semi-structured interviews were conducted over a period of two months (December 2019 to January 2020). This study took place in all the operating rooms of two public university hospitals in the district of Sousse, Tunisia. To collect data for this survey, the French version of the Hospital Survey On Patient Safety Culture was used. For interviews, 13 participants were selected purposively using a critical case sampling app...
Journal for Specialists in Pediatric Nursing, 2021
PurposeIn pediatric asthma, family empowerment education has been beneficial for the quality of l... more PurposeIn pediatric asthma, family empowerment education has been beneficial for the quality of life, pulmonary function, and family functioning. Few studies addressed the impact of a family empowerment program on asthma symptom control, acute healthcare use (AHCU), and medication use in children with asthma. This study aimed to assess the effect of a family empowerment intervention on asthma symptom control, AHCU, inhaler technique, and controller adherence in children with asthma.Design and MethodsA single‐center study using a randomized controlled design was conducted in a university hospital in the center of Tunisia from May 2018 to September 2019. Eighty‐two families were randomly assigned to the intervention group (n = 41) of 8 weeks of group training sessions, or to the control group (n = 41) of usual care education. Thirty‐seven families in the intervention group and 39 families in the control group received allocated intervention at baseline. Thirty‐four families in each gr...
Background A large proportion of maternal deaths are related to the health care system, including... more Background A large proportion of maternal deaths are related to the health care system, including the failure of the referral system between maternity wards. The objectives of this study were to determine the frequency and the indications of obstetric referrals in a Tunisian regional care maternity and to assess the conformity of referral mechanisms with the National Perinatality Programme guidelines. Methods A descriptive study was carried out at the regional maternity facility of the regional Hospital of Kasserine in 2018, among parturients referred during a period of three months. Data collection was carried out prospectively from medical records, transfer documents, interviews with parturients and with the nursing staff of the reference maternity hospital. The ICD-10 was used to code recorded indications and diagnoses for referrals. Results A total of 234 parturients were included. Referrals represented 15.1% of the obstetric activity in this facility. There were 26 reasons for ...
Background Adolescence is one of the main growth periods of life during which dietary needs are s... more Background Adolescence is one of the main growth periods of life during which dietary needs are specific and where diet quality is important for healthy development. Nonetheless, unhealthy eating behaviours are common among adolescents including over consumption of unhealthy fast food, sugar and fat and skipping meals. Exposure to unhealthy eating can lead to chronic conditions such as obesity and diabetes. In this context, we conducted this study to describe the quality of the diet of middle school students in the Region of Kairouan in Tunisia. Methods This is a cross-sectional study conducted in 2017 among middle school students in the Region of Kairouan. Data collection was carried out using a self-administered questionnaire. Results In this study, 494 students were included. In terms of food type, fast food meals (sandwiches) were the most preferred type of food (52.6%). Daily consumption of vegetables and fruit was reported by 48.8% of students. Among the participants, 46.8% re...
Introduction Smoking cessation is the most important step to limit the complications of chronic o... more Introduction Smoking cessation is the most important step to limit the complications of chronic obstructive pulmonary disease (COPD). Outcomes from studies that assessed the association between health-related quality of life (HRQL) and smoking cessation have been controversial. This study aimed to assess the relationship between HRQL and smoking cessation in patients with COPD in Tunisia. Methods A cross-sectional study was carried out in the two main primary care centers in the center of Tunisia over a period of three months (April-June 2016). Clinic and socio-demographic data were collected from patients' records. HRQL was assessed by the Medical Outcomes Study Short-form 36 (SF-36). This instrument is composed of two dimensions: physical and mental components. The questionnaire outcomes were described as means and standard deviation. T-test was performed to assess the statistical difference between the dependent and categorical variables. Results A total of 249 COPD patients ...
Background The Operating Room (OR) is a complex, stressful and potentially dangerous environment.... more Background The Operating Room (OR) is a complex, stressful and potentially dangerous environment. In fact, the professionals practicing in these units suffer from a continuous exposure to multiple stressors that can, eventually, lead to a state of Burnout. The aim of this study was to estimate the prevalence of burnout in the OR and to determine the possible associated factors with this syndrome. Methods This is a cross-sectional study that was carried out among surgeons and paramedical staff in twelve ORs in the teaching hospitals in Sousse, Tunisia, using an auto-administred questionnaire. It was spread over a 4-month period; from January 1st to April 30th 2018. Data was entered and analyzed using SPSS 20.0. Also, all confidentiality and anonymity measures were respected. Results A total of 225 OR professionals participated with a response rate of 76.8%. The medical profession was represented by 46 surgeons and the female gender, overall, was predominant and accounted for 60.9% of...
Background Participation in a humanitarian mission can be considered as a heroic work especially ... more Background Participation in a humanitarian mission can be considered as a heroic work especially for health professionals. In 2011, a refugee camp was set up in southern Tunisia. The objective of this study was to describe and better understand the experience of Tunisian nurses in the Choucha refugee campbased on the Meleis transition theory. Methods We conducted a qualitative, phenomenological study among 14 nurses using an interview guide. Data analysis was carried out according to the method of Giorgi, from which 5 core themes and 28 sub-themes had emerged. Results This studydescribed the experience of nurses as a passage between 4 different phases: before, during, after the passage to the refugee camp and the memory.Five core themes emerged from our research:1) Trigger events: 3 sub-themes were evoked for the reason of participation: motivation, commitment and expectations; 2) Professional and interpersonal relationships marked the integration of the interviewees despite some mi...
Background The intensive care units are a high-risk environments for the occurrence of adverse ev... more Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals part...
Background Patients use medicinal plants as the first-line treatment for many chronic and acute m... more Background Patients use medicinal plants as the first-line treatment for many chronic and acute medical conditions. The lack of access to conventional health care, historical, cultural and economic considerations contributes to the important use of these plants. The purpose was to identify medicinal plants used by primary Health Care Centers' visitors in the region of Sousse (Tunisia) and to assess its associated factors. Methods A cross-sectional descriptive study was conducted among Primary health care centers' visitors of the region of Sousse (Tunisia) in 2018. We randomly selected 18 primary health centers and 50 participants were chosen from each center. Data were collected using a pre-tested questionnaire, filled through a direct interview with participants which explores: socio-demographic variables and medicinal plants' use (name of plants, symptoms, methods of preparation, routes of administration, plant source, tolerance and side effects). Results 900 persons w...
Introduction Stress and its deleterious effects are currently a major topic in public health. Hea... more Introduction Stress and its deleterious effects are currently a major topic in public health. Health care studies can be very stressful as they pose a challenge for students around the world. The aim of this study was to assess stress perception among healthcare students and to identify its associated factors. Methods A descriptive cross-sectional study was carried out over a five-month period (January-May 2017) among healthcare students at the Higher School of Health Sciences, University of Sousse (Tunisia), during the 2016/2017 academic year. The socio-demographic and health status data have been collected using a pre-established data collection sheet. Stress perception was assessed by the French version of the Perceived Stress Scale with 10 items (PSS-10). Factors associated with stress were examined using ANOVA and T-student tests. Results A total of 237 students participated in the study with a response rate of 64.40%. The average age was 20.57±1.05 with a female predominance o...
Introduction In 1993, the World Health Organization declared that tuberculosis is a public health... more Introduction In 1993, the World Health Organization declared that tuberculosis is a public health emergency of global concern. All efforts were made in accordance with the Millennium Development Goals (MDGs) to reduce the burden of Tuberculosis. The MDG framework built into national priorities and development strategies has, in fact, strengthened epidemiological surveillance and the use of reliable data to make decisions based on objective data. These data are essential for planning, managing the activities of the National Tuberculosis program, monitoring and ongoing evaluation of its performance. In this context, we conducted this study to trace the trend of Tuberculosis incidence rate recorded in the Sousse Region between 1992 and 2016. Methods This is a longitudinal study of the registered data of tuberculosis cases in Sousse between 1992 and 2016. For the trend analysis the software JOINPOINT version 4.5.0.1 was used. This software offers the closest possible regression model of...
S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieu... more S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieur à l'effet volume positif (moins d'unités ont été consommées mais la composition du panier de consommation s'est déformée au profit des biomédicaments les plus chers). La décomposition des effets sur le sous-échantillon des biomédicaments immunosuppresseurs (dont la part est grandissante) conduit aux mêmes résultats. Discussion/conclusion Bien que leurs prix soient élevés, la croissance de la dépense en biomédicaments au sein de la liste en sus ne s'explique pas donc par une hausse de leurs prix mais par une orientation croissante de la prescription vers les biomédicaments les plus chers. Mots clés Molécules onéreuses ; Innovations thérapeutiques ; Indices de prix Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieu... more S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieur à l'effet volume positif (moins d'unités ont été consommées mais la composition du panier de consommation s'est déformée au profit des biomédicaments les plus chers). La décomposition des effets sur le sous-échantillon des biomédicaments immunosuppresseurs (dont la part est grandissante) conduit aux mêmes résultats. Discussion/conclusion Bien que leurs prix soient élevés, la croissance de la dépense en biomédicaments au sein de la liste en sus ne s'explique pas donc par une hausse de leurs prix mais par une orientation croissante de la prescription vers les biomédicaments les plus chers. Mots clés Molécules onéreuses ; Innovations thérapeutiques ; Indices de prix Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Introduction Selon l’Organisation mondiale de la sante (OMS), l’analyse des cas de morbidite mate... more Introduction Selon l’Organisation mondiale de la sante (OMS), l’analyse des cas de morbidite maternelle grave (MMG) ou « Near miss » constitue une pratique de reference pour la surveillance de la qualite des soins en sante maternelle. C’est ainsi, qu’en 2009, l’OMS a elabore des criteres standardises pour leur diagnostic. Notre objectif etait de decrire les cas de « Near Miss » hospitalises a la maternite de l’hopital Universitaire Farhat Hached de Sousse (Tunisie). Methodes Une etude descriptive retrospective a ete menee aupres des femmes hospitalisees pendant l’annee 2010 a la maternite de l’Hopital Farhat Hached. Une grille de collecte de donnees, basee sur les criteres de classification des « Near Miss » de l’OMS, a ete concue. Cette classification adopte l’approche basee sur les dysfonctions d’organes. Resultats Cinquante-huit cas de « Near Miss » ont ete enregistres, soit 5,8 pour 1000 naissances vivantes. L’âge moyen de ces parturientes etait de 32,4 ans [22–43 ans]. La dysfonction cardio-vasculaire etait le trouble le plus frequent (53,4 %), suivi du trouble de la coagulation (36,2 %), de la dysfonction renale (10,3 %), de la dysfonction respiratoire (8,6 %), des troubles neurologiques (5,2 %) et de la dysfonction hepatique (1,7 %). Par ailleurs, les hemorragies obstetricales representaient la cause le plus frequente de MMG (74,1 %) suivies des troubles hypertensifs (20,7 %). Discussion La MMG constitue un probleme de sante publique dans les pays en developpement. Son analyse permet de fournir des informations complementaires aux indicateurs de mortalite maternelle afin de garantir des soins obstetricaux de qualite.
Background: The use of acute health care resources for asthma is considerable. Disease severity i... more Background: The use of acute health care resources for asthma is considerable. Disease severity is an established risk factor, but ethnicity and health care factors are less well studied. Objective: To investigate the independent associations of ethnicity and health care factors with acute resource use for asthma. Methods: Longitudinal data from a national adult asthma management program providing universal access to care were analyzed. Outcome measures were unscheduled physician visits with urgent nebulization, emergency department (ED) visits, and hospitalizations. Results: In multivariate analyses, markers of disease severity were found to be significantly associated with all acute resource use. After controlling for disease severity, ethnicity was associated with increased risk of all acute resource use; Indian (vs Chinese) ethnicity was associated with increased risk of unscheduled physician visits (hazard ratio [
International Journal of Adolescent Medicine and Health
Objectives Psychoactive substance experimentation among Tunisian adolescents remains one of the m... more Objectives Psychoactive substance experimentation among Tunisian adolescents remains one of the most threatening public health concerns. In spite of this, little is known about the prevalence and predictors of these behaviors in the Tunisian context. This study aims to assess the prevalence of tobacco, alcohol and illicit drug experimentation and its predictive factors among adolescents in the delegation of Nfidha, Sousse governorate, Tunisia. Methods We conducted a cross sectional study in middle and high schools in the delegation of Nfidha, Sousse governorate, Tunisia, during the first trimester of the 2019–2020 school year using an anonymous questionnaire self-administered to a randomly drawn representative sample of 1,352 pupils. Data collected included socio-demographic characteristics, substance experimentation among school-adolescents, academic performance as well as family and peer’ factors. Results Tobacco was the most commonly experimented substance with a prevalence rate ...
Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and espec... more Introduction Adverse events (AEs) that occur in hospitals remain a challenge worldwide, and especially in intensive care units (ICUs) where they are more likely to occur. Monitoring of AEs can provide insight into the status and advances of patient safety. This study aimed at examining the AEs reported during 20 months after the implementation of AE reporting system. Methods We conducted a retrospective analysis of a voluntary ICU AE reporting system. Incidents were reported by staff from 10 ICUs in the Sahloul University Hospital (Tunisia) between February 2020 and September 2021. Results A total of 265 reports were received, of which, 61.9% were deemed preventable. The most reported event was healthcare-associated infections (30.2%, n=80), followed by pressure ulcers (18.5%, n=49). At the time of reporting, 25 patients (9.4%) had died as a result of an AE and in 51.3% of cases, the event had resulted in an increased length of stay. Provider-related factors contributed to 64.2% of ...
Childhood asthma still imposes an enormous burden on children and their families. To the best of ... more Childhood asthma still imposes an enormous burden on children and their families. To the best of our knowledge, no study reviewed the literature on the effect of family asthma education on major asthma outcomes. This study aimed to explore the effect of family education programs on major asthma outcomes in children. Quasi-experimental studies and randomized controlled trials were conducted among children with asthma aged 6–18 years and their parents were included. Pub Med, Science Direct, and Trip databases were used to extract data published in English from 2010 to 2021. Twenty-two studies were reported in this review. It was demonstrated that family empowerment interventions were effective in improving the quality of life of children and their parents, asthma symptom control, and pulmonary function. Family education that was specific to medication improved medication adherence, inhalation technique, and asthma control. Family asthma education enhanced asthma management and family ...
Background Routine assessments of patient safety culture within hospitals have been widely recomm... more Background Routine assessments of patient safety culture within hospitals have been widely recommended to improve patient safety. Experts suggested that mixed-methods studies can help gain a deeper understanding of the concept. However, studies combining quantitative and qualitative approaches exploring patient safety culture are still lacking. This study aimed to explore patient safety culture as perceived by operating room professionals of two university hospitals in Sousse, Tunisia. Methods Based on a mixed-methods approach, a cross-sectional survey followed by semi-structured interviews were conducted over a period of two months (December 2019 to January 2020). This study took place in all the operating rooms of two public university hospitals in the district of Sousse, Tunisia. To collect data for this survey, the French version of the Hospital Survey On Patient Safety Culture was used. For interviews, 13 participants were selected purposively using a critical case sampling app...
Journal for Specialists in Pediatric Nursing, 2021
PurposeIn pediatric asthma, family empowerment education has been beneficial for the quality of l... more PurposeIn pediatric asthma, family empowerment education has been beneficial for the quality of life, pulmonary function, and family functioning. Few studies addressed the impact of a family empowerment program on asthma symptom control, acute healthcare use (AHCU), and medication use in children with asthma. This study aimed to assess the effect of a family empowerment intervention on asthma symptom control, AHCU, inhaler technique, and controller adherence in children with asthma.Design and MethodsA single‐center study using a randomized controlled design was conducted in a university hospital in the center of Tunisia from May 2018 to September 2019. Eighty‐two families were randomly assigned to the intervention group (n = 41) of 8 weeks of group training sessions, or to the control group (n = 41) of usual care education. Thirty‐seven families in the intervention group and 39 families in the control group received allocated intervention at baseline. Thirty‐four families in each gr...
Background A large proportion of maternal deaths are related to the health care system, including... more Background A large proportion of maternal deaths are related to the health care system, including the failure of the referral system between maternity wards. The objectives of this study were to determine the frequency and the indications of obstetric referrals in a Tunisian regional care maternity and to assess the conformity of referral mechanisms with the National Perinatality Programme guidelines. Methods A descriptive study was carried out at the regional maternity facility of the regional Hospital of Kasserine in 2018, among parturients referred during a period of three months. Data collection was carried out prospectively from medical records, transfer documents, interviews with parturients and with the nursing staff of the reference maternity hospital. The ICD-10 was used to code recorded indications and diagnoses for referrals. Results A total of 234 parturients were included. Referrals represented 15.1% of the obstetric activity in this facility. There were 26 reasons for ...
Background Adolescence is one of the main growth periods of life during which dietary needs are s... more Background Adolescence is one of the main growth periods of life during which dietary needs are specific and where diet quality is important for healthy development. Nonetheless, unhealthy eating behaviours are common among adolescents including over consumption of unhealthy fast food, sugar and fat and skipping meals. Exposure to unhealthy eating can lead to chronic conditions such as obesity and diabetes. In this context, we conducted this study to describe the quality of the diet of middle school students in the Region of Kairouan in Tunisia. Methods This is a cross-sectional study conducted in 2017 among middle school students in the Region of Kairouan. Data collection was carried out using a self-administered questionnaire. Results In this study, 494 students were included. In terms of food type, fast food meals (sandwiches) were the most preferred type of food (52.6%). Daily consumption of vegetables and fruit was reported by 48.8% of students. Among the participants, 46.8% re...
Introduction Smoking cessation is the most important step to limit the complications of chronic o... more Introduction Smoking cessation is the most important step to limit the complications of chronic obstructive pulmonary disease (COPD). Outcomes from studies that assessed the association between health-related quality of life (HRQL) and smoking cessation have been controversial. This study aimed to assess the relationship between HRQL and smoking cessation in patients with COPD in Tunisia. Methods A cross-sectional study was carried out in the two main primary care centers in the center of Tunisia over a period of three months (April-June 2016). Clinic and socio-demographic data were collected from patients' records. HRQL was assessed by the Medical Outcomes Study Short-form 36 (SF-36). This instrument is composed of two dimensions: physical and mental components. The questionnaire outcomes were described as means and standard deviation. T-test was performed to assess the statistical difference between the dependent and categorical variables. Results A total of 249 COPD patients ...
Background The Operating Room (OR) is a complex, stressful and potentially dangerous environment.... more Background The Operating Room (OR) is a complex, stressful and potentially dangerous environment. In fact, the professionals practicing in these units suffer from a continuous exposure to multiple stressors that can, eventually, lead to a state of Burnout. The aim of this study was to estimate the prevalence of burnout in the OR and to determine the possible associated factors with this syndrome. Methods This is a cross-sectional study that was carried out among surgeons and paramedical staff in twelve ORs in the teaching hospitals in Sousse, Tunisia, using an auto-administred questionnaire. It was spread over a 4-month period; from January 1st to April 30th 2018. Data was entered and analyzed using SPSS 20.0. Also, all confidentiality and anonymity measures were respected. Results A total of 225 OR professionals participated with a response rate of 76.8%. The medical profession was represented by 46 surgeons and the female gender, overall, was predominant and accounted for 60.9% of...
Background Participation in a humanitarian mission can be considered as a heroic work especially ... more Background Participation in a humanitarian mission can be considered as a heroic work especially for health professionals. In 2011, a refugee camp was set up in southern Tunisia. The objective of this study was to describe and better understand the experience of Tunisian nurses in the Choucha refugee campbased on the Meleis transition theory. Methods We conducted a qualitative, phenomenological study among 14 nurses using an interview guide. Data analysis was carried out according to the method of Giorgi, from which 5 core themes and 28 sub-themes had emerged. Results This studydescribed the experience of nurses as a passage between 4 different phases: before, during, after the passage to the refugee camp and the memory.Five core themes emerged from our research:1) Trigger events: 3 sub-themes were evoked for the reason of participation: motivation, commitment and expectations; 2) Professional and interpersonal relationships marked the integration of the interviewees despite some mi...
Background The intensive care units are a high-risk environments for the occurrence of adverse ev... more Background The intensive care units are a high-risk environments for the occurrence of adverse events with serious consequences. The development of patient safety culture is a strategic focus to prevent these adverse events and improve patient safety and healthcare quality. This study aimed to assess patient safety culture in Tunisian intensive care units and to determine its associated factors. Methods It is a multicenter, descriptive cross-sectional study, among healthcare professionals of the intensive care units in the Tunisian center. The data collection was spread over a period of 2 months (October-November 2017). The measuring instrument used is the validated French version of the Hospital Survey On Patient Safety Culture questionnaire. Data entry and analysis was carried out by the Statistical Package for Social Sciences (SPSS 20.0) and Epi Info 6.04. Chi-square test was used to explore factors associated with patient safety culture. Results A total of 404 professionals part...
Background Patients use medicinal plants as the first-line treatment for many chronic and acute m... more Background Patients use medicinal plants as the first-line treatment for many chronic and acute medical conditions. The lack of access to conventional health care, historical, cultural and economic considerations contributes to the important use of these plants. The purpose was to identify medicinal plants used by primary Health Care Centers' visitors in the region of Sousse (Tunisia) and to assess its associated factors. Methods A cross-sectional descriptive study was conducted among Primary health care centers' visitors of the region of Sousse (Tunisia) in 2018. We randomly selected 18 primary health centers and 50 participants were chosen from each center. Data were collected using a pre-tested questionnaire, filled through a direct interview with participants which explores: socio-demographic variables and medicinal plants' use (name of plants, symptoms, methods of preparation, routes of administration, plant source, tolerance and side effects). Results 900 persons w...
Introduction Stress and its deleterious effects are currently a major topic in public health. Hea... more Introduction Stress and its deleterious effects are currently a major topic in public health. Health care studies can be very stressful as they pose a challenge for students around the world. The aim of this study was to assess stress perception among healthcare students and to identify its associated factors. Methods A descriptive cross-sectional study was carried out over a five-month period (January-May 2017) among healthcare students at the Higher School of Health Sciences, University of Sousse (Tunisia), during the 2016/2017 academic year. The socio-demographic and health status data have been collected using a pre-established data collection sheet. Stress perception was assessed by the French version of the Perceived Stress Scale with 10 items (PSS-10). Factors associated with stress were examined using ANOVA and T-student tests. Results A total of 237 students participated in the study with a response rate of 64.40%. The average age was 20.57±1.05 with a female predominance o...
Introduction In 1993, the World Health Organization declared that tuberculosis is a public health... more Introduction In 1993, the World Health Organization declared that tuberculosis is a public health emergency of global concern. All efforts were made in accordance with the Millennium Development Goals (MDGs) to reduce the burden of Tuberculosis. The MDG framework built into national priorities and development strategies has, in fact, strengthened epidemiological surveillance and the use of reliable data to make decisions based on objective data. These data are essential for planning, managing the activities of the National Tuberculosis program, monitoring and ongoing evaluation of its performance. In this context, we conducted this study to trace the trend of Tuberculosis incidence rate recorded in the Sousse Region between 1992 and 2016. Methods This is a longitudinal study of the registered data of tuberculosis cases in Sousse between 1992 and 2016. For the trend analysis the software JOINPOINT version 4.5.0.1 was used. This software offers the closest possible regression model of...
S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieu... more S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieur à l'effet volume positif (moins d'unités ont été consommées mais la composition du panier de consommation s'est déformée au profit des biomédicaments les plus chers). La décomposition des effets sur le sous-échantillon des biomédicaments immunosuppresseurs (dont la part est grandissante) conduit aux mêmes résultats. Discussion/conclusion Bien que leurs prix soient élevés, la croissance de la dépense en biomédicaments au sein de la liste en sus ne s'explique pas donc par une hausse de leurs prix mais par une orientation croissante de la prescription vers les biomédicaments les plus chers. Mots clés Molécules onéreuses ; Innovations thérapeutiques ; Indices de prix Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieu... more S31-la dépense en biomédicaments a augmenté : l'effet prix négatif (baisse des prix) est inférieur à l'effet volume positif (moins d'unités ont été consommées mais la composition du panier de consommation s'est déformée au profit des biomédicaments les plus chers). La décomposition des effets sur le sous-échantillon des biomédicaments immunosuppresseurs (dont la part est grandissante) conduit aux mêmes résultats. Discussion/conclusion Bien que leurs prix soient élevés, la croissance de la dépense en biomédicaments au sein de la liste en sus ne s'explique pas donc par une hausse de leurs prix mais par une orientation croissante de la prescription vers les biomédicaments les plus chers. Mots clés Molécules onéreuses ; Innovations thérapeutiques ; Indices de prix Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts.
Introduction Selon l’Organisation mondiale de la sante (OMS), l’analyse des cas de morbidite mate... more Introduction Selon l’Organisation mondiale de la sante (OMS), l’analyse des cas de morbidite maternelle grave (MMG) ou « Near miss » constitue une pratique de reference pour la surveillance de la qualite des soins en sante maternelle. C’est ainsi, qu’en 2009, l’OMS a elabore des criteres standardises pour leur diagnostic. Notre objectif etait de decrire les cas de « Near Miss » hospitalises a la maternite de l’hopital Universitaire Farhat Hached de Sousse (Tunisie). Methodes Une etude descriptive retrospective a ete menee aupres des femmes hospitalisees pendant l’annee 2010 a la maternite de l’Hopital Farhat Hached. Une grille de collecte de donnees, basee sur les criteres de classification des « Near Miss » de l’OMS, a ete concue. Cette classification adopte l’approche basee sur les dysfonctions d’organes. Resultats Cinquante-huit cas de « Near Miss » ont ete enregistres, soit 5,8 pour 1000 naissances vivantes. L’âge moyen de ces parturientes etait de 32,4 ans [22–43 ans]. La dysfonction cardio-vasculaire etait le trouble le plus frequent (53,4 %), suivi du trouble de la coagulation (36,2 %), de la dysfonction renale (10,3 %), de la dysfonction respiratoire (8,6 %), des troubles neurologiques (5,2 %) et de la dysfonction hepatique (1,7 %). Par ailleurs, les hemorragies obstetricales representaient la cause le plus frequente de MMG (74,1 %) suivies des troubles hypertensifs (20,7 %). Discussion La MMG constitue un probleme de sante publique dans les pays en developpement. Son analyse permet de fournir des informations complementaires aux indicateurs de mortalite maternelle afin de garantir des soins obstetricaux de qualite.
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Papers by Manel Mellouli