Quality of life of Bahraini women with breast cancer

Breast cancer is the most prevalent cancer in women worldwide as well as in Bahrain. This thesis investigates the quality o f life o f Bahraini women with breast cancer using both a quantitative and a qualitative approach. I also investigated the effect of psychological intervention in women with non metastatic breast cancer in a systematic review and meta-analysis. Twenty three trials were included and four meta-analyses were generated. The intervention proved to be effective in reducing anxiety, mood disturbance and depression (in group sessions). The improvement in survival is less promising and warrant more research before a solid conclusion can be made. The results should be interpreted cautiously considering the remarkable heterogeneity and shortcomings of included trials. I have presented data from a randomly recruited sample of 239 Bahraini women with breast cancer in a cross-sectional study. Results showed that women had a comparable quality o f life to western women with a mean score for global health o f 63.9 (95% Cl 61.2-66.6). The presence o f metastases, having had a mastectomy as opposed to lumpectomy and the shorter time elapsed since diagnosis had a major effect across all the domains of quality of life o f breast cancer survivors. I used a qualitative method to gain deeper understanding o f the quality o f life of Bahraini women with breast cancer. I undertook 12 semi-structured interviews to explore the beliefs, perceptions and attitudes of Bahraini women who have survived breast cancer towards their quality of life. Theme analysis revealed both similarities and differences between Bahraini Arab women and women in previous studies in their beliefs and perceptions towards breast cancer. This qualitative method has captured elements related to quality o f life of breast cancer survivors, particularly those with a more cultural and religious basis. This is important to healthcare professionals in ensuring an individualised approach to women with breast cancer. This report explored another dimension o f quality of life of women with breast cancer in this region and set the platform for further comparative and longitudinal studies. Furthermore, the tentative effectiveness o f psychological interventions on psychological outcomes and survival in non-metastatic breast cancer warrants vigilant approaches and possibly targeting the population that need it the most. In this thesis I have managed to describe the quality o f life of breast cancer survivors in an Arab culture from both a quantitative and qualitative approach. The Cochrane review highlights the inadequacy o f knowledge concerning the most appropriate methods o f supporting breast cancer survivors. The results of this thesis raise issues for delivery of healthcare to this vulnerable population, for the role of women in this society and for future research into more effective support mechanisms

Quality of life of Bahraini women with breast cancer: a cross sectional study.

BACKGROUND: Breast cancer can impact survivors in many aspects of their life. Scarce information is currently available on the quality of life of cancer survivors in Bahrain. The objective of this study is to describe the quality of life of Bahraini women with breast cancer and its association with their sociodemographic and clinical data. METHODS: This is a cross sectional study in which the European Organization for Research and Treatment of Cancer Quality of Life Cancer Specific version translated into Arabic was administered to a random sample of 337 Bahraini women with breast cancer. Relevant descriptive statistics were computed for all items. The equality of means across the categories of each categorical independent variable was tested using parametric tests (ANOVA and independent t-test) or non-parametric tests (Kruskal Wallis and Mann Whitney tests) of association where appropriate. RESULTS: Of the total sample, 239 consented to participation. The mean and median age of participants were 50.2 (SD ± 11.1) and 48.0 respectively. Participants had a mean score for global health of 63.9 (95% CI 61.21-66.66). Among functional scales, social functioning scored the highest (Mean 77.5 [95% CI 73.65-81.38]) whereas emotional functioning scored the lowest (63.4 [95% CI 59.12-67.71]). The most distressing symptom on the symptom scales was fatigability (Mean 35.2 [95% CI 31.38-39.18]). Using the disease specific tool it was found that sexual functioning scored the lowest (Mean 25.9 [95% CI 70.23-77.90]). On the symptom scale, upset due to hair loss scored the highest (Mean 46.3 [95% CI 37.82-54.84]). Significant mean differences were noted for many functional and symptom scales. CONCLUSION: Bahraini breast cancer survivors reported favorable overall global quality of life. Factors associated with a major reduction in all domains of quality of life included the presence of metastases, having had a mastectomy as opposed to a lumpectomy and a shorter time elapsed since diagnosis. Poorest functioning was noted in the emotional and sexual domains. The most bothersome symptoms were fatigability, upset due to hair loss and arm symptoms. This study identifies the categories of women at risk of poorer quality of life after breast cancer and the issues that most need to be addressed in this Middle East society

Reliability and validity of the Arabic version of the EORTC QLQ-C30 and QLQ-BR23 questionnaires

Materials and methods: A cross-sectional study was carried out. A total of 337 subjects were recruited from the Oncology Centre in Bahrain and 239 consented to participation. The European Organization for Research and Treatment-QOL questionnaire and breast cancer-specific module (EORTC QLQ-C30 and QLQ-BR23) were used to measure the HRQOL among women with breast cancer. All statistical tests were performed using SPSS Version 20. The reliability of the EORTC QLQ-C30 and QLQ-BR23 questionnaires was examined using Cronbach's alpha test. The construct validity of both questionnaires was tested using the exploratory factor analysis.Results: Exploratory factor analysis results of EORTC QLQ-C30 showed that Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy was 0.878 and Bartlett's Test of Sphericity is Conclusion: The EORTC QLQ-C30 and QLQ-BR23 questionnaires are feasible and promising instruments to measure the levels of HRQOL among Arabic-speaking women with breast cancer in future studies with some suggested modifications in some of the domains or items</p

Knowledge of health professional students on waterpipe tobacco smoking: curricula implications.

Tobacco prevention research traditionally focuses upon cigarette smoking, but there is also a need to implement and evaluate the usefulness of waterpipe tobacco smoking (WTS) interventions since it is considered less harmful than cigarettes. This study aimed to assess the impact of an educational intervention on WTS knowledge of health professional students in three academic health institutions in Bahrain. Conclusions: Our educational intervention with health professional students improved their knowledge about the health effects of WTS. Medical and nursing institutions may consider using various methods such as informative videos and expert lectures to include in their teaching curricula as part of WTS prevention strategies

Knowledge of health professional students on waterpipe tobacco smoking: curricula implications

Abstract Background Tobacco prevention research traditionally focuses upon cigarette smoking, but there is also a need to implement and evaluate the usefulness of waterpipe tobacco smoking (WTS) interventions since it is considered less harmful than cigarettes. This study aimed to assess the impact of an educational intervention on WTS knowledge of health professional students in three academic health institutions in Bahrain. Methods A quasi-experimental design was used to include medical students from the Arabian Gulf University, medical and nursing students from the Royal College of Surgeons in Ireland-Bahrain and nursing students from the University of Bahrain. Two hundred fifty students participated in the three phases of the study during October 2015–June 2016 from an original sample of 335. The participants answered knowledge questions on WTS before and after an intervention, which included a lecture by an expert and a video on the awareness about the health hazards of WTS. Results The mean age of starting cigarette and WTS was 16.8 ± 2.8 and 17.5 ± 1.7 years, respectively. The prevalence of ever smoking any type of tobacco among students was 22.4% (medical 25.8% and nursing 37.5%) and that of WTS, 17.7% (medical 20.0%, nursing 13.6%). The prevalence of current cigarette smoking was 9.6% among medical and nursing students combined with 10.3 and 8.5% for medical and nursing students, respectively. WTS was prevalent at a proportion of 6.8% among medical and nursing students combined with 6.5% in medical and 14.8% in nursing students. The university curriculum as the main source of knowledge on WTS increased from 14.2 to 33.3% after the intervention (p < 0.005). Knowledge about the hazards of WTS increased in 16 of the 20 statements. The difference in overall knowledge score was significant (p < 0.05) for nursing (77. 5 ± 1.5 vs 85.8 ± 2.2) compared to medical students (85.3 ± 1.0 vs 87.3 ± 0.9) after the intervention. Conclusions Our educational intervention with health professional students improved their knowledge about the health effects of WTS. Medical and nursing institutions may consider using various methods such as informative videos and expert lectures to include in their teaching curricula as part of WTS prevention strategies

Transient anosmia and dysgeusia in COVID-19 disease: a cross sectional study

Objective: This study aims to explore the prevalence of anosmia and dysgeusia and their impact on COVID-19 patients. Methods: This is a cross-sectional study. Patients diagnosed with COVID-19 between 1st October 2020 and 30th June 2021 were randomly selected from a national COVID-19 registry. COVID-19 cases were diagnosed using molecular testing method which measured the viral E gene. The Anosmia Reporting Tool, and a brief version of the questionnaire on olfactory disorders were used to measure the outcomes via telephone interviews. Data were analysed using SPSS 27 statistics software. Results: A total of 405 COVID-19 adults were included in this study, 220 (54.3%) were males and 185 (45.8%) were females. The mean±SD age of participants was 38.2 ± 11.3 years. Alterations in the sense of smell and taste were reported by 206 (50.9%), and 195 (48.1%) of the patients, respectively. Sex and nationality of participants were significantly associated with anosmia and dysgeusia (p Conclusion: Anosmia and dysgeusia are prevalent symptoms of COVID-19 disease, especially among females. Although transient, anosmia and dysgeusia had considerable impact on patient's life. Neuropsychological implications of COVID-19 in acute infection phase and prognosis of anosmia and dysgeusia in COVID-19 are areas for further exploration.</p