Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross‐sectional study

Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross‐sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio‐demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory‐HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological and professional well‐being of their HCP. The aforementioned suggestions are necessary to strengthen and sustain PHC HCP and support the provision of universal health coverage to the Lebanese population.     

Domestic violence: the Lebanese experience

OBJECTIVES: To estimate the prevalence of domestic violence among women presenting to primary health care facilities in Lebanon; to identify presenting symptoms and responses to varied forms of violence; and to examine variables associated with domestic violence. STUDY DESIGN/METHODS: A cross-sectional survey of all women presenting to four primary health care centres in different geographic areas of Lebanon from September 2002 to October 2002. A questionnaire was administered in interview format. The following information was collected from participants: demographic characteristics, perceived health status, prior exposure and responses to domestic violence, and characteristics of the perpetrators. RESULTS: Of the 1418 participants, 494 (35%) reported experiencing domestic violence and 307 (22%) had family members who had been exposed to domestic violence. Among the women exposed to violence, verbal abuse or insult was most common (88%) followed by physical violence (66%); 57% reported their experiences to family, friends or authorities, whereas the remainder kept silent. Women who were exposed to domestic violence had higher frequencies of reported physical symptoms than those who were not exposed. Generally, the perpetrators were spouses who had demographic backgrounds comparable to their wives. Multiple regression analyses showed that women's education levels, work status, health status, and familial violence predicted domestic violence. CONCLUSIONS: Women readily talk about their abuse when asked. The rate of domestic violence is high among Lebanese women and is a significant health issue. Additional research is needed to better understand the extent of the problem and to develop more effective reporting methods.     

National trends in open surgical,endovascular, and branched-fenestrated endovascular aortic aneurysm repair in Medicare patients

Background

Open repair effectively prevents rupture for patients with abdominal aortic aneurysm (AAA) and is commonly studied as a metric reflecting hospital and surgeon expertise in cardiovascular care. However, given recent advances in endovascular aneurysm repair (EVAR), such as branched-fenestrated EVAR, it is unknown how commonly open surgical repair is still used in everyday practice.

Improvements in economic,social, and food security outcomes of Palestinian refugee women and diet diversity of Palestinian schoolchildren in Lebanon: the Healthy Kitchens,Healthy Children intervention

Background

Palestinian refugees living in Lebanon continue to face social and economic exclusion that hinders their ability to improve their living conditions and livelihoods. This study aimed to investigate the effect of a two-pronged intervention that employed women through social enterprises to deliver a subsidised healthy daily school meal to elementary schoolchildren in Palestinian camps.

Mutational spectrum of cystic fibrosis in the Lebanese population

BackgroundCystic fibrosis (CF) is the most common autosomal recessive disease in Caucasians; it is however, considered to be rare in the Arab populations. Reports of the cystic fibrosis transmembrane regulator (CFTR) mutations from Arabs, especially from the Lebanese population, are limited.MethodsTwenty-two unrelated Lebanese families, with at least one child with CF, were studied. DNA extracts from blood samples of patients and parents were screened for CFTR gene mutations.ResultsEleven different mutations were identified. Of the 44 alleles studied, the most common mutations were: F508del (34%), N1303K (27%), W1282X (7%), and S4X (7%). Five mutations – not previously reported in the Lebanese population – were identified; these are: S549N, G542X, 2043delG, 4016insG, and R117H-7T.ConclusionsThe most common CFTR mutations in addition to five mutations not previously described in the Lebanese population were identified. Identification of CFTR mutations in the Lebanese population is important for molecular investigations and genetic counseling.     

The impact of damage to buildings on displacement during the 2014 Israel–Gaza war: a propensity score matching study

Background

The July 2014 war in Gaza caused more devastation in the area than at any time since the Israeli occupation began in 1967. The 50-day war resulted in more than 2200 Palestinian deaths, over 11?000 injuries, and large-scale destruction of infrastructure and displacement of over a quarter of the Palestinian population in Gaza. In this study, we examined the causal effect of damage to buildings within a neighbourhood on displacement behaviour in Gaza. Identifying demographic and socioeconomic predictors of displacement, given ongoing exposure to chronic violence and precarious living conditions in Gaza, will allow for action to be taken to avert the consequences of modifiable risk factors of displacement in this population.

Effects of a Single Dose of Ivermectin on Viral and Clinical Outcomes in Asymptomatic SARS-CoV-2 Infected Subjects: A Pilot Clinical Trial in Lebanon

Objective: This study was designed to determine the efficacy of ivermectin, an FDA-approved drug, in producing clinical benefits and decreasing the viral load of SARS-CoV-2 among asymptomatic subjects that tested positive for this virus in Lebanon. Methods: A randomized controlled trial was conducted in 100 asymptomatic Lebanese subjects that have tested positive for SARS-CoV2. Fifty patients received standard preventive treatment, mainly supplements, and the experimental group received a single dose (according to body weight) of ivermectin, in addition to the same supplements the control group received. Results: There was no significant difference (p = 0.06) between Ct-values of the two groups before the regimen was started (day zero), indicating that subjects in both groups had similar viral loads. At 72 h after the regimen started, the increase in Ct-values was dramatically higher in the ivermectin than in the control group. In the ivermectin group, Ct increased from 15.13 ± 2.07 (day zero) to 30.14 ± 6.22 (day three; mean ± SD), compared to the control group, where the Ct values increased only from 14.20 ± 2.48 (day zero) to 18.96 ± 3.26 (day three; mean ± SD). Moreover, more subjects in the control group developed clinical symptoms. Three individuals (6%) required hospitalization, compared to the ivermectin group (0%). Conclusion: Ivermectin appears to be efficacious in providing clinical benefits in a randomized treatment of asymptomatic SARS-CoV-2-positive subjects, effectively resulting in fewer symptoms, lower viral load and reduced hospital admissions. However, larger-scale trials are warranted for this conclusion to be further cemented.