Frontiers in Endocrinology
Volume 8, Issue OCT, 2017

Attitudes of palestinian health-care professionals in Gaza to clinical practice guideline for diagnosis and treatment of diabetes mellitus (Article) (Open Access)

Radwan M.* , Akbari Sari A. , Rashidian A. , Takian A. , Abou-Dagga S. , Elsous A.
  • a Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran, International Cooperation Directorate, Palestinian Ministry of Health, Gaza City, Palestine
  • b Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
  • c Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran
  • d Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran, Health Equity Research Center (HERC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
  • e Department of Research Affairs and Graduates Studies, Islamic University of Gaza, Gaza City, Palestine
  • f Department of Health Management and Economics, School of Public Health, International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran

Abstract

Background: Despite the huge numbers of the internationally produced and implemented Clinical Practice Guidelines (CPGs), the compliance with them is still low in health care. This study aimed at assessing the attitudes of Palestinian health-care professionals toward the most perceived factors influencing the adherence to the CPG for Diabetes Mellitus in the Primary Health-care centers of the Ministry of Health (PHC-MoH) and the Primary Health-care centers of the United Nations Relief and Works Agency for Palestine Refugees (PHC-UNRWA) using a validated questionnaire. Methods: A cross-sectional design was employed with a census sample of all Palestinian family doctors and nurses (n = 323). The Cabana theoretical framework was used to develop a study questionnaire. A cross cultural adaptation framework was followed to develop the Arabic version questionnaire. The psychometric properties of Arabic version were finally assessed. Results: The Arabic version questionnaire showed a good construct validity and internal consistency reliability. The overall adherence level to the diabetic guideline was disappointingly suboptimal 51.5% (47.3% in the PHC-MoH and 55.5% in the PHC-UNRWA) P = 0.000. The most frequently perceived barriers in the PHC-MoH were lack of incentives, lack of resources, and lack of guideline trustworthiness, whereas the lack of time and the lack of guideline trustworthiness were the most prominent barriers in the PHC-UNRWA. In spite of the lack of trustworthiness of the diabetic guideline, most respondents in both settings had a positive attitude toward guidelines in general, but this attitude was not a predictor of guideline adherence. Conclusion: The good validity and reliability of our questionnaire can provide support for the accuracy of our findings. Multifaceted implementation strategies targeting the main barriers elicited from this study are required for addressing the lack of incentives, organizational resources, lack of confidence in the guideline, and time constraints. © 2017 Radwan, Akbari Sari, Rashidian, Takian, Abou-Dagga and Elsous.

Author Keywords

Barriers psychometric properties adherence Diabetes mellitus Clinical practice guideline

Index Keywords

Likert scale health care personnel motivation human middle aged protocol compliance diabetes mellitus microalbuminuria knowledge health personnel attitude prescription cross-sectional study male female personnel management questionnaire psychometry Article dipeptidyl carboxypeptidase inhibitor adult health care quality skill patient preference practice guideline primary health care
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85032739833&doi=10.3389%2ffendo.2017.00288&partnerID=40&md5=65892e71c937748383a102071c4911e2
DOI: 10.3389/fendo.2017.00288
ISSN: 16642392
Original Language: English