ObjectiveTo check if mobile health (m-Health) short message service (SMS) can improve the knowledge and practice of the American Diabetic Association preventive care guidelines (ADA guidelines) recommendations among physicians.MethodologyQuasi-experimental pre–post study design with a control group.ParticipantsThe participants of the study were 62 medical officers/medical postgraduate trainees from two hospitals in Lahore, Pakistan. Pretested questionnaire was used to collect baseline information about physicians’ knowledge and adherence according to the ADA guidelines. All the respondents attended 1-day workshop about the guidelines. The intervention group received regular reminders by SMS about the ADA guidelines for the next 5 months. Postintervention knowledge and practice scores of 13 variables were checked again using the same questionnaire. Statistical analysis included χ2 and McNemar’s tests for categorical variables and t-test for continuous variables. Pearson’s correlation analysis was done to check correlation between knowledge and practice scores in the intervention group. P values of <0.05 were considered statistically significant.ResultsThe total number of participating physicians was 62. Fifty-three (85.5%) respondents completed the study. Composite scores within the intervention group showed statistically significant improvement in knowledge (p<0.001) and practice (p<0.001) postintervention. The overall composite scores preintervention and postintervention also showed statistically significant difference of improvement in knowledge (p=0.002) and practice (p=0.001) between non-intervention and intervention groups. Adherence to individual 13 ADA preventive care guidelines level was noted to be suboptimal at baseline. Statistically significant improvement in the intervention group was seen in the following individual variables: review of symptoms of hypoglycaemia and hyperglycaemia, eye examination, neurological examination, lipid examination, referral to ophthalmologist, and counselling about non-smoking.Conclusionm-Health technology can be a useful educational tool to help with improving knowledge and practice of diabetic guidelines. Future multicentre trials will help to scale this intervention for wider use in resource-limited countries.
Background The unprecedented public health crisis of the COVID-19 pandemic has caused heightened levels of stress and fear among health care workers.With the advent of COVID-19 in Pakistan,frontline workers of POEs have been under physical and psychological pressure including a high risk of infection, abnormal levels of workload, prolonged working hours, lack of personal protective equipment for safety from contagion, isolation, exhaustion, and lack of contact with family.The study aims to assess the impact of Covid-19 on the mental health of frontline healthcare workers. Methods A descriptive study was conducted among HCWs across points of entry from 1st October 2020 to 31st December 2020.Data was collected using a structured questionnaire.Depression, anxiety, and stress scale (DASS-21)was used for the assessment of depression, stress, anxiety. Descriptive analysis of socio-demographic and professional factors was done. Multivariable logistic regression analysis (MLRA) was performed using SPSS version 23.0. Results A total of 628 participants (586 males and 42 females) completed questionnaire.The mean age of the participants was 42.6 ± 45.9 years. The majority of the respondents were married (94.3%). The frequency of depression, anxiety, and stress in the HCWs was 12.1%, 42.3%, and 22.1 %, respectively. Multivariable logistic regression analysis found that the depression in HCWs was significantly associated with the profession and age (P < 0.001). The anxiety in HCWs was associated with their age and gender (P < 0.005). The stress in HCWs was significantly associated with their age (P < 0.05). Conclusions The HCWs at the Points of entry across Pakistan showed mild to moderate symptoms of DAS. The COVID-19 pandemic has caused a heavy psychological impact among the frontline healthcare professionals. Timely psychological counseling and early psychological intervention need to be implemented for HCWs to alleviate their anxiety and stress and improve their general mental health. Key messages • The COVID-19 pandemic has caused a heavy psychological impact. • Timely psychological counseling and early psychological intervention.
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