Maternal near-miss (MNM) is recognized as a new concept and has emerged as an adjunct to investigation of maternal deaths as the two represent similar pathways. A conceptual model that had helped us to explain the underlying preventable causes of MNM by examining three phases of delay on maternal healthcare utilization was developed by Thaddeus and Maine. By identifying and reducing the three delays, we will have the greatest impact in reducing MNM and hence maternal deaths. Aim The aim of this study was to describe the extent, main types, and contributed factors for three delays in care associated with MNM among women admitted in Women’s Health Hospital, Assiut University, Egypt. Methods A prospective case–control study was conducted over a period of 1 year from 1 May 2014 to 30 April 2015 at Women’s Health Hospital, Assiut University; 342 MNM women and 684 age-matched control women were included in the study. The criteria we used for the identification of MNM were generally based on the presence of different levels of organ dysfunction, which have been identified as recommended by WHO. Data were collected through two approaches: record review and direct interview before discharge. Delays experienced by the study population were collected according to the three-delay model of Thaddeus and Maine. Results A high proportion of the MNM group had experienced delay irrespective of the type, with statically significant differences from their controls. Nearly 50% of near-miss cases were more likely to have experienced two or more types of delays compared with 7.7% of controls. Financial problems, fear of being maltreated in hospitals, lack of awareness about signs of obstetric complications, lack of participation in decision making, lack of antenatal care, negative attitude of healthcare worker, and lack of blood availability were associated with delays among MNM cases compared with controls. Having experienced third delay within the intermediate facilities (referral status) was the highest significant predictor that contributed to MNM by delay types. Conclusion and recommendations Third delay experienced by the women within the intermediate facilities (referral status) was the most prevalent delay among studied women. Reformation of healthcare system on multiple levels and improvement of the socioeconomic status of women are necessary in Upper Egypt to overcome causes of delay among MNM cases.

Maternal near-miss (MNM) is recognized as a new concept and has emerged as an adjunct to investigation of maternal deaths as the two represent similar pathways. A conceptual model that had helped us to explain the underlying preventable causes of MNM by examining three phases of delay on maternal healthcare utilization was developed by Thaddeus and Maine. By identifying and reducing the three delays, we will have the greatest impact in reducing MNM and hence maternal deaths. Aim The aim of this study was to describe the extent, main types, and contributed factors for three delays in care associated with MNM among women admitted in Women’s Health Hospital, Assiut University, Egypt. Methods A prospective case–control study was conducted over a period of 1 year from 1 May 2014 to 30 April 2015 at Women’s Health Hospital, Assiut University; 342 MNM women and 684 age-matched control women were included in the study. The criteria we used for the identification of MNM were generally based on the presence of different levels of organ dysfunction, which have been identified as recommended by WHO. Data were collected through two approaches: record review and direct interview before discharge. Delays experienced by the study population were collected according to the three-delay model of Thaddeus and Maine. Results A high proportion of the MNM group had experienced delay irrespective of the type, with statically significant differences from their controls. Nearly 50% of near-miss cases were more likely to have experienced two or more types of delays compared with 7.7% of controls. Financial problems, fear of being maltreated in hospitals, lack of awareness about signs of obstetric complications, lack of participation in decision making, lack of antenatal care, negative attitude of healthcare worker, and lack of blood availability were associated with delays among MNM cases compared with controls. Having experienced third delay within the intermediate facilities (referral status) was the highest significant predictor that contributed to MNM by delay types. Conclusion and recommendations Third delay experienced by the women within the intermediate facilities (referral status) was the most prevalent delay among studied women. Reformation of healthcare system on multiple levels and improvement of the socioeconomic status of women are necessary in Upper Egypt to overcome causes of delay among MNM cases.

Maternal near-miss (MNM) is recognized as a new concept and has emerged as an adjunct to investigation of maternal deaths as the two represent similar pathways. A conceptual model that had helped us to explain the underlying preventable causes of MNM by examining three phases of delay on maternal healthcare utilization was developed by Thaddeus and Maine. By identifying and reducing the three delays, we will have the greatest impact in reducing MNM and hence maternal deaths. Aim The aim of this study was to describe the extent, main types, and contributed factors for three delays in care associated with MNM among women admitted in Women’s Health Hospital, Assiut University, Egypt. Methods A prospective case–control study was conducted over a period of 1 year from 1 May 2014 to 30 April 2015 at Women’s Health Hospital, Assiut University; 342 MNM women and 684 age-matched control women were included in the study. The criteria we used for the identification of MNM were generally based on the presence of different levels of organ dysfunction, which have been identified as recommended by WHO. Data were collected through two approaches: record review and direct interview before discharge. Delays experienced by the study population were collected according to the three-delay model of Thaddeus and Maine. Results A high proportion of the MNM group had experienced delay irrespective of the type, with statically significant differences from their controls. Nearly 50% of near-miss cases were more likely to have experienced two or more types of delays compared with 7.7% of controls. Financial problems, fear of being maltreated in hospitals, lack of awareness about signs of obstetric complications, lack of participation in decision making, lack of antenatal care, negative attitude of healthcare worker, and lack of blood availability were associated with delays among MNM cases compared with controls. Having experienced third delay within the intermediate facilities (referral status) was the highest significant predictor that contributed to MNM by delay types. Conclusion and recommendations Third delay experienced by the women within the intermediate facilities (referral status) was the most prevalent delay among studied women. Reformation of healthcare system on multiple levels and improvement of the socioeconomic status of women are necessary in Upper Egypt to overcome causes of delay among MNM cases.

Maternal near-miss (MNM) is recognized as a new concept and has emerged as an adjunct to investigation of maternal deaths as the two represent similar pathways. A conceptual model that had helped us to explain the underlying preventable causes of MNM by examining three phases of delay on maternal healthcare utilization was developed by Thaddeus and Maine. By identifying and reducing the three delays, we will have the greatest impact in reducing MNM and hence maternal deaths. Aim The aim of this study was to describe the extent, main types, and contributed factors for three delays in care associated with MNM among women admitted in Women’s Health Hospital, Assiut University, Egypt. Methods A prospective case–control study was conducted over a period of 1 year from 1 May 2014 to 30 April 2015 at Women’s Health Hospital, Assiut University; 342 MNM women and 684 age-matched control women were included in the study. The criteria we used for the identification of MNM were generally based on the presence of different levels of organ dysfunction, which have been identified as recommended by WHO. Data were collected through two approaches: record review and direct interview before discharge. Delays experienced by the study population were collected according to the three-delay model of Thaddeus and Maine. Results A high proportion of the MNM group had experienced delay irrespective of the type, with statically significant differences from their controls. Nearly 50% of near-miss cases were more likely to have experienced two or more types of delays compared with 7.7% of controls. Financial problems, fear of being maltreated in hospitals, lack of awareness about signs of obstetric complications, lack of participation in decision making, lack of antenatal care, negative attitude of healthcare worker, and lack of blood availability were associated with delays among MNM cases compared with controls. Having experienced third delay within the intermediate facilities (referral status) was the highest significant predictor that contributed to MNM by delay types. Conclusion and recommendations Third delay experienced by the women within the intermediate facilities (referral status) was the most prevalent delay among studied women. Reformation of healthcare system on multiple levels and improvement of the socioeconomic status of women are necessary in Upper Egypt to overcome causes of delay among MNM cases.

Maternal near-miss (MNM) is recognized as a new concept and has emerged as an adjunct to investigation of maternal deaths as the two represent similar pathways. A conceptual model that had helped us to explain the underlying preventable causes of MNM by examining three phases of delay on maternal healthcare utilization was developed by Thaddeus and Maine. By identifying and reducing the three delays, we will have the greatest impact in reducing MNM and hence maternal deaths. Aim The aim of this study was to describe the extent, main types, and contributed factors for three delays in care associated with MNM among women admitted in Women’s Health Hospital, Assiut University, Egypt. Methods A prospective case–control study was conducted over a period of 1 year from 1 May 2014 to 30 April 2015 at Women’s Health Hospital, Assiut University; 342 MNM women and 684 age-matched control women were included in the study. The criteria we used for the identification of MNM were generally based on the presence of different levels of organ dysfunction, which have been identified as recommended by WHO. Data were collected through two approaches: record review and direct interview before discharge. Delays experienced by the study population were collected according to the three-delay model of Thaddeus and Maine. Results A high proportion of the MNM group had experienced delay irrespective of the type, with statically significant differences from their controls. Nearly 50% of near-miss cases were more likely to have experienced two or more types of delays compared with 7.7% of controls. Financial problems, fear of being maltreated in hospitals, lack of awareness about signs of obstetric complications, lack of participation in decision making, lack of antenatal care, negative attitude of healthcare worker, and lack of blood availability were associated with delays among MNM cases compared with controls. Having experienced third delay within the intermediate facilities (referral status) was the highest significant predictor that contributed to MNM by delay types. Conclusion and recommendations Third delay experienced by the women within the intermediate facilities (referral status) was the most prevalent delay among studied women. Reformation of healthcare system on multiple levels and improvement of the socioeconomic status of women are necessary in Upper Egypt to overcome causes of delay among MNM cases.

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p 0.0001 and 101.93 ± 22.16 and p 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p 0.0001 and 101.93 ± 22.16 and p 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p 0.0001 and 101.93 ± 22.16 and p 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p 0.0001 and 101.93 ± 22.16 and p 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.

Background: Stoke is a long-term condition. Estimation of stroke outcomes is lacking. Stroke is known as the most common cause of disability among adults. The measurement of Health-Related Quality of Life (HRQOL) is important to understand the actual status of the patients. Aim: The aim of this study was to assess HRQOL among stroke patients and analyze clinical and functional factors that influence it. Material and method: A cross-sectional study was applied to 65 strokes outpatients, 33 from Assiut University hospital, Assiut, Egypt and 32 from, King Abdulaziz University, Jeddah, Saudi Arabia. A questionnaire was used to complete related data and assessment of HRQOL was done by the use of Barthel index, SF36, and SSQOL by personal interview. Result: No significant differences were detected between two studied groups in all characteristics. For all study sample, our patients had low mean scores in all SF36 domains, the lowest was for RE with 3.46 ± 9.1 and GH was the best mean (51.7 ± 12.99). As regards SSQOL, patients had low mean scores on the lowest subscale in productivity (6.72 ± 3.21), whereas the language was the least affected (15.86 ± 6.26). There was a significant difference between the means of PCS and SSQOL in post-stroke duration which was significantly higher in >24 months (37.21 ± 8.59 and p = 0.007and 141.57 ± 36.12 and p = 0.052 respectively) than in the shorter durations. The independent patients had significantly higher PCS and SSQOL mean scores than who need assistance and immobile ones (26.79 ± 5.09 and p 0.0001 and 101.93 ± 22.16 and p 0.0001 respectively). Age and mobility were significantly negative correlated with PCS, SSQOL, and Barthel scores while there was a significant positive correlation between ULVC and LLVC testing grades and PCS, MCS, SSQOL and Barthel index scores. In the linear regression model, duration, mobility and voluntary control of lower limbs were predictors for PCS of SF-36 (p = 0.045, 0.000 and 0.036 respectively). There were no significant predictors on MCS. On the other hand Mobility and voluntary control of lower limbs were significant predictors for SSQOL (p = 0.001 and 0.051 respectively). Conclusion: Stroke patient had poor QOL. A need for post-stroke care programs for improving the physical, mental and social quality of life for those patients is mandatory.