Journal of family & community medicine最新文献

{"title":"A review of the global feasibility of medical malpractice insurance: Legal frameworks, economic viability, implementation challenges, and impact on patient safety.","authors":"Afnan Aljaffary","doi":"10.4103/jfcm.jfcm_376_25","DOIUrl":"10.4103/jfcm.jfcm_376_25","url":null,"abstract":"<p><p>Medical malpractice insurance (MMI) is a critical determinant of healthcare quality, health partitioners' behavior, and health system sustainability in many countries. Despite decades of global efforts to reform MMI, evidence of the structure, awareness, implementation, and the impact of its framework remains fragmented. The aim of this review was to synthesize the global literature to map current evidence on the MMI legal framework, its economic viability, barriers to its implementation, and the implications for healthcare delivery and patient safety. A narrative review, informed by a systematic search, was conducted according to PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) 2020 guidelines. Fourteen studies published between 2004 and 2022 were identified from multiple countries, including the United States, Spain, Switzerland, Georgia, Nigeria, and Turkey. Eligible studies included published reviews, empirical studies, and modeling studies related to MMI and its framework. Data were extracted on study characteristics, legal contexts, economic viability assessment, implementation challenges, and patient safety implications. The included studies address a broad range of malpractice-related issues. The evidence revealed substantial variability in how countries regulate and implement MMI, with notable gaps in practitioner knowledge, legal coherence, and affordability. A lack of awareness of health practitioners, regulatory fragmentation, and economically regressive insurance models continue to shape health practitioners' behavior that could indirectly affect safety and access. The literature lacks robust empirical evaluations that quantify how specific liability reforms translate into improved patient-level outcomes. Future research can prioritize comparative analysis to evaluate policy reforms to create balanced protection for both health practitioners and patients.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 2","pages":"71-83"},"PeriodicalIF":0.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13225751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148152779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author's reply.","authors":"Noha M A Elsaid, Hend A H Ismail, Almaza A Salim, Doaa Kamal, Heba S Mohammed, Fawaz E Edris, Asmaa A Ibrahim, Abeer E Ameen","doi":"10.4103/jfcm.jfcm_328_25","DOIUrl":"10.4103/jfcm.jfcm_328_25","url":null,"abstract":"","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"55-56"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying NDUFA12 mutation in a Saudi family: An unusual presentation of mitochondrial Complex I deficiency mimicking as idiopathic intracranial hypertension in a patient with papilledema and visual loss.","authors":"Foziah J Alshamrani, Modhi S Alajmi, Nora I Almuslim, Muneerah M Alsubaie, Ghadeer M Fardan, Majed M Alabdali","doi":"10.4103/jfcm.jfcm_322_25","DOIUrl":"10.4103/jfcm.jfcm_322_25","url":null,"abstract":"<p><p>Mitochondrial diseases are considered one of the most common groups of neurogenetic diseases. Complex I (CI) deficiency is the most encountered single enzyme deficiency of the mitochondrial diseases. The mutation of the NDUFA is linked to Leigh syndrome and CI defects. This article reports on a patient with mutation in NDUFA12 that was initially perceived as idiopathic intracranial hypertension, calling attention to the importance of considering NDUFA12 mutations in optic atrophy and dystonia diagnoses, particularly in young patients with new onset headache and progressive bilateral visual impairment. In addition, it emphasizes the need to explore other nonneurological features in diagnosing mitochondrial disease in those who do not fit into a defined syndrome. Further research on NDUFA12 variants is essential for a better understanding of their wide phenotypic spectrum.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"47-52"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors' reply.","authors":"Noor H AlYousef, Fatimah M Alhakeem, Kawthar A AlNasser, Zainab H AlSinan, Zainab K Alessa, Fatemah M AlDawood, Marwa M Shafey, Wejdan M Al-Johani","doi":"10.4103/jfcm.jfcm_337_25","DOIUrl":"10.4103/jfcm.jfcm_337_25","url":null,"abstract":"","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"59-60"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Educational intervention and its effect on medical students' knowledge and readiness for cervical cancer screening and human papillomavirus vaccination.","authors":"Suman Ray, Akash Nagar","doi":"10.4103/jfcm.jfcm_290_25","DOIUrl":"10.4103/jfcm.jfcm_290_25","url":null,"abstract":"","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"53-54"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to mental healthcare seeking among individuals attending primary healthcare centers in Riyadh, Saudi Arabia.","authors":"Khalid A Al Nasser, Esra A Alhwsawi, Alaa O Abusarir, Magran S Almutairi, Karam M Basham","doi":"10.4103/jfcm.jfcm_315_25","DOIUrl":"10.4103/jfcm.jfcm_315_25","url":null,"abstract":"<p><strong>Background: </strong>Mental health conditions remain a major global public health concern. Despite national efforts to integrate mental health services into primary healthcare (PH) in Saudi Arabia, its utilization remains limited. Understanding stigma-related and nonstigma-related barriers is essential to improving access and informing service development.</p><p><strong>Materials and methods: </strong>A cross-sectional survey was conducted between April and August 2025 among Saudi adults attending PH centers (PHCs) in Riyadh. Participants were recruited through convenience sampling; data was collected using a validated self-administered questionnaire in Arabic. Barriers to Access to Care Evaluation (BACE-III) scale was used to measure stigma and nonstigma barriers. Initial analysis included descriptive statistics; t-tests and ANOVA were used to compare the mean stigma and nonstigma domain scores, and multiple linear regression was performed to determine predictors of perceived barriers. Reliability of the BACE-III in this sample was high (Cronbach's α = 0.956).</p><p><strong>Results: </strong>A total of 416 participants were surveyed. Younger age, lower educational level, and student status were associated with significantly higher stigma and nonstigma barrier scores (<i>P</i> < 0.001). Awareness of the availability of mental health services in PHCs was strongly associated with lower perceived barriers (<i>P</i> < 0.001). No significant differences based on gender, health insurance status, or prior experience with mental health services were observed. Regression analyses showed that age and awareness independently predicted perceived barriers.</p><p><strong>Conclusion: </strong>Stigma-related and nonstigma-related barriers continue to impede utilization of mental health services in PH settings. Increasing public awareness, affirming the assurance of confidentiality, and implementing community-level antistigma initiatives may improve equitable access and support the goals of the Saudi Vision 2030 health transformation.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"12-19"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors that contribute to non-urgent utilization of emergency services in the Eastern Province of Saudi Arabia.","authors":"Sarah A Alahmadi, Dunya N Alfaraj, Fatimah A Altayeb, Renad M Alamri, Fay T Abuaisha, Shahad A Alshamlan, Batool A Alshawakir, Mohannad A Alghamdi","doi":"10.4103/jfcm.jfcm_232_25","DOIUrl":"10.4103/jfcm.jfcm_232_25","url":null,"abstract":"<p><strong>Background: </strong>The utilization of the Emergency Department (ED) for non-urgent care poses a major problem to the healthcare system. The objective of the study was to assess non-urgent visits to ED and determine the factors influencing non-urgent visits to the ED.</p><p><strong>Materials and methods: </strong>A cross-sectional study was conducted at a secondary level hospital in the Eastern Province of Saudi Arabia from October 2024 to February 2025. Study included 412 Canadian Triage and Acuity Scale (CTAS) IV and V patients. Data was collected by interviewing the patients or their relative using a validated structured questionnaire. Data was analyzed using SPSS version 29; categorical data was presented as frequencies and percentages. Chi-square test or Fisher's exact test, as appropriate, was used to determine association between non-urgent ED visit and various factors. Multiple logistic regression analysis was performed to identify predictors of non-urgent ED visits.</p><p><strong>Results: </strong>Majority of the patients were Saudis (85.0%), more than half (55.8%) were female, and more than one-third (38.1%) were aged 20-34 years. Common presenting complaints included abdominal pain (20.9%), cold/flu symptoms (10.4%), and back/leg pain (8.7%); Most patients (46.8%) reported symptoms lasting <1 week. At univariate analysis, non-urgent ED visits were significantly associated with age (P = 0.049) and region of residence (P = 0.018). Logistic regression showed weak association between non-urgent ED visit and marital status, employment, type of accommodation, and presence of a chronic disease but these were not statistically significant (P > 0.05). Accessibility (43.4%) and perceived urgency (41.0%) were key drivers for the preference of the ED to primary care.</p><p><strong>Conclusion: </strong>The study highlights key factors that influence non-urgent visits, with accessibility and perceived urgency being the primary drivers. Findings highlight the need to improve primary healthcare access and triage awareness to reduce unnecessary ED visits.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"28-36"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital dependency and the erosion of attention: A growing public health challenge for low- and middle-income countries.","authors":"Shatavisa Mukherjee","doi":"10.4103/jfcm.jfcm_311_25","DOIUrl":"10.4103/jfcm.jfcm_311_25","url":null,"abstract":"","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"57-58"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged intrapartum refusal of cesarean delivery and eventual consent: A case report on the ethical boundaries of maternal autonomy in obstetrics.","authors":"Eman S Alsulmi","doi":"10.4103/jfcm.jfcm_288_25","DOIUrl":"10.4103/jfcm.jfcm_288_25","url":null,"abstract":"<p><p>This case from Saudi Arabia describes a 27-year-old woman at 39 weeks and 6 days of gestation in spontaneous labor, who had had two prior cesarean deliveries and no previous vaginal births, but declined cesarean delivery despite worsening fetal heart tracings and labor dystocia. Repeated counseling was provided, and an ethics consultation was done as the intrapartum refusal persisted. After approximately 12 hours of labor and no cervical changes, she consented to cesarean delivery. The neonate was born with metabolic acidosis related to three tight nuchal cords. This case illustrates the ethical conflict between maternal autonomy and fetal beneficence in the context of the trial of labor after two cesarean deliveries. It emphasizes the importance of clear communication, early antenatal counseling, and the application of culturally relevant ethical framework, including Islamic bioethics, to support balanced and safe decision-making.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"44-46"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An account of the healthcare-seeking behavior of the public in response to a healthcare emergency (coronavirus disease 2019): The Saudi community experience.","authors":"Dalia Yahia M El Kheir, Mohammed A Al-Ibrahim, Mohammed I Alhaddad, Hussam J Alsafwani, Mohammed N Alkhater, Mohammed H Alameer, Mohammed H Almousa","doi":"10.4103/jfcm.jfcm_149_25","DOIUrl":"10.4103/jfcm.jfcm_149_25","url":null,"abstract":"<p><strong>Background: </strong>Health-seeking behavior is crucial to healthcare delivery by driving the individual's healthcare utilization patterns and subsequent health outcomes. Examination of health-seeking behavior reveals gaps and inequalities in access to healthcare and detects the barriers to healthcare utilization. Our aim in this article was to assess the effect of coronavirus disease 2019 (COVID-19) on the public's healthcare-seeking behavior in Saudi Arabia and any changes in the use of the healthcare services, factors that drove this change, and the resulting health-related consequences for individuals.</p><p><strong>Materials and methods: </strong>This Nation-wide cross-sectional study was conducted among general population in Saudi Arabia between November 2021 and May 2022. Data were collected through an online, self-administered questionnaire; 4254 participants were recruited from all five main administrative regions in Saudi Arabia through the key social media platforms. Categorical variables were presented as frequencies and percentages, while mean and standard deviation were calculated for age. Chi-square test was used to determine association between region of residence in Saudi Arabia and change in seeking healthcare services and the change in disease symptoms during the pandemic.</p><p><strong>Results: </strong>About half (53%) of participants reported a change in their use of healthcare services, with the fear of COVID-19 infection being the major change-driving-factor (21.4%). Medical appointments were rescheduled for 50.1% of participants, 8.5% experienced a delay in receiving a diagnosis of their medical condition, 8.6% reported worsening of their disease symptoms as a consequence of the delay, and 13.5% reported restricted access to medications. To enhance healthcare provision during any possible future pandemics or public health emergencies, 19.7% of respondents wanted less waiting time to access healthcare services with strict adherence to precautionary (19.7%) and infection control measures (17.6%).</p><p><strong>Conclusion: </strong>Our data showed that because of the pandemic, over half of respondents changed their healthcare-seeking behavior with fear of COVID-19 infection being a major driver of this change.</p>","PeriodicalId":101441,"journal":{"name":"Journal of family & community medicine","volume":"33 1","pages":"20-27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900413/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146204655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}