Knowledge of Risk Factors, Symptoms and Barriers to Seeking Medical Help for Cervical Cancer among Omani Women Attending Sultan Qaboos University Hospital

Objectives: This study aimed to assess knowledge and attitudes among Omani woman regarding cervical cancer risk factors and symptoms as well as barriers to them seeking medical help. Methods: This cross-sectional study was conducted between December 2017 and March 2018 at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A validated Arabic-language version of the Cervical Cancer Awareness Measure questionnaire was used to collect data from 550 Omani women visiting SQUH during the study period. Results: A total of 490 women participated (response rate: 89.1%) in this study. Overall, the women demonstrated low levels of knowledge of cervical cancer risk factors and symptoms (28.5% and 45.0%, respectively). The most frequently recognised risk factor was having many children (36.1%), while the most recognised symptom was unexplained vaginal bleeding (69.8%). Women reported that being too scared was the greatest barrier to seeking medical help (68.0%). Various factors were significantly associated with greater knowledge of cervical cancer signs and symptoms including education level (odds ratio [OR] = 2.85; 95% confidence interval [CI]: 1.0–8.22; P <0.05), income (OR = 4.34; 95% CI: 1.70–11.12; P <0.05), parity (OR = 3.59; 95% CI: 1.38–9.36; P <0.05) and a family history of cancer (OR = 1.71; CI: 1.0–2.90; P <0.05). Conclusion: Overall, Omani women demonstrated poor knowledge with regards to cervical cancer; in addition, they identified several emotional barriers to seeking medical help. Healthcare practitioners should reassure female patients to encourage care-seeking behaviour. A national screening programme is also recommended to increase awareness and early diagnosis of cervical cancer in Oman.Keywords: Cervical Cancer; Knowledge; Awareness; Risk Factors; Health Care Seeking Behavior; Women; Oman

The differential mediating roles of resilience in the relationship between meaningful living and stress among college students during the COVID-19 pandemic

The current literature, mostly Euro-American based, indicates that the presence of meaning in life (MIL) improves resilience and lowers stress. However, the differential mediating roles of resilience in the relationship between the search for and presence of MIL, and stress have not been explored. This study aimed to investigate the differential mediating roles of resilience in the relationship between the presence of and search for MIL, and stress among Omani college students amid the COVID-19 pandemic. This cross-sectional study consisted of the Brief Resilience Scale, Perceived Stress Scale 4, and Meaning in Life Questionnaire, as well as socio-demographic questions. A path analysis model was used to examine the hypothesis. A total of 970 Omani college students responded to the questionnaire. Findings indicate that searching for MIL was significantly associated with a high level of stress directly (β = 0.023; p < 0.001) and indirectly, through a negative effect on resilience (β =  0.006; p < 0.001). Conversely, the presence of MIL was significantly associated with a decreased level of stress directly (β = − 0.045; p < 0.001) and indirectly via a positive effect on resilience (β = − 0.151; p < 0.001). In keeping with the proposed hypothesis, this study contributes to the current knowledge, by extrapolating the effect of searching for MIL on resilience and stress, and culturally re-contextualizing MIL research. University counseling centers could adopt meaning-based strategies to mitigate stress by promoting meaningful living and resilience

Factors predicting medication adherence among Omani patients with chronic diseases through a multicenter cross-sectional study

Abstract Management of chronic diseases is complex and requires a long-term commitment to therapeutic medications. However, medication adherence is suboptimal. There is limited understanding of factors predicting medication adherence in chronic diseases in Oman. This study aimed to examine predictors of medication adherence (i.e. patient clinical and demographic data, patient-physician relationship, health literacy, social support) among Omani patients with chronic diseases. This study used a cross-sectional correlation design. Data were collected from 800 participants using convenience sampling between December 2019 and April 2020. Arabic versions of the Brief Health Literacy Screening tool, Multidimensional Scale of Perceived Social Support, Patient-Doctor Relationship Questionnaire, and Adherence in Chronic Disease Scale were used to measure study variables. Descriptive statistics, independent t tests, one-way ANOVA, Pearson correlations, and multivariate linear regression were used for analysis. The study found that factors such as the patient-physician relationship, social support, disease duration, employment status, and medication frequency significantly predicted medication adherence. Medication adherence was higher among those who were unemployed, had a better patient-physician relationship, and greater social support. However, medication adherence was lower with longer disease duration and higher daily medication frequency. Additionally, medication adherence was positively associated with perceived social support and the patient-physician relationship, but not with health literacy. In conclusion, the study reveals that patient characteristics, social support, and patient-physician relationships are key factors in predicting medication adherence in patients with chronic diseases in the Middle East. It emphasizes the importance of improving these aspects, considering factors like employment status, disease duration, and medication frequency, and enhancing healthcare provider-patient relationships and social support systems to boost adherence

Attitudes Towards Cancer Patients: A cross-sectional study of Omani patients and attendees at a university teaching hospital

Objectives: Many cancer patients experience social difficulties and feelings of isolation. This study aimed to evaluate patients’ and attendees’ attitudes towards cancer patients. Methods: A cross-sectional study was conducted of patients and attendees attending Sultan Qaboos University Hospital (SQUH), Muscat, Oman, from December 2018 to March 2019. Results: A total of 1,190 people participated (response rate: 91.5%). The majority (90.7%) did not express reluctance to help cancer patients. Most agreed that cancer patients were productive (76.2%) and are respected by the public (75.0%). However, many participants (63.1%) felt that cancer patients might face difficulties getting married. Multivariate analysis showed that participants who had a family history of cancer or had previously been a caregiver for cancer patients were more likely to believe that cancer patients could be productive (odds ratio [OR] = 1.92, 95% confidence interval [CI]: 1.31–2.82; P &lt;0.05). Less-educated participants were more likely to believe that cancer patients feared not being productive (OR = 1.49, 95% CI: 1.01–2.19; P &lt;0.05). Male and single participants were more likely to perceive that cancer patients faced difficulties getting married (OR = 1.56, 95% CI: 1.20–2.02 and OR = 1.68, 95% CI: 1.22–2.32, respectively; P &lt;0.05 each). Conclusion: Patients and attendees attending SQUH in Oman appeared to have positive and supportive attitudes towards cancer patients, although some felt that cancer patients might encounter social obstacles. Healthcare professionals should consider reassuring cancer patients of such positive sentiments. Governmental and non-governmental organisations should act to promote a supportive environment for cancer patients in Oman. Keywords: Cancer; Attitudes; Patients; Surveys and Questionnaires; Oman

Assessing Barriers to Insulin Therapy among Omani Diabetic Patients Attending Three Main Diabetes Clinics in Muscat, Oman

Objectives: This study aimed to identify the main barriers which prevent patients with diabetes mellitus from accepting insulin therapy. Methods: This cross-sectional study was conducted from May to December, 2019. Convenience sampling was used to recruit participants from three Diabetes Clinics in Muscat. Eligible participants were interviewed in person based on a pre-prepared questionnaire. The questionnaire, which was administered in Arabic, includes demographic data, and 19 specific items on barriers to insulin therapy. Results: A total of 201 participants (response rate 93 %) were enrolled in the study. The commonest barriers were as follows: concern of frequent blood glucose checking (36.3%), long- term injections (33.8%), side-effects of insulin (29.9%), and weight gain (29.4%). Needle phobia was considered as a barrier by only 9% of the participants. Overall, 125 (62.2%) of the participants were willing to initiate insulin therapy despite of the presence of these barriers and only 20 (10%) of the participants were influenced by these barriers to the degree that they would reject insulin therapy. Conclusion: The majority of our participants had no identifiable reasons which would stop them from accepting insulin therapy. Effective strategies should be developed to address each of the main barriers to improve acceptance and adherence to insulin therapy. Keywords: Diabetes; Insulin; Barrier; Needle phobia; Hypoglycemia; Weight gain

The Unmet Supportive Care Needs of Omani Women Diagnosed with Breast Cancer

Objectives: This study aimed to assess the unmet supportive care needs of Omani women with breast cancer (BC). Methods: This cross-sectional study was conducted from November 2020 to February 2021 among 250 adult Omani women diagnosed with BC at a university teaching hospital in Muscat, Oman. An Arabic version of the 34-item Supportive Care Needs Survey-Short Form tool was used to determine perceived unmet supportive care needs across five domains. Results: A total of 181 women participated in the study (response rate: 72.4%). The domain with the highest mean score per item was health system and information (mean score: 3.33), with the greatest unmet need in this domain being informed about things that the patient could do to help themselves get well (40.9%). The domain with the second highest mean score per item was patient care and support (mean score: 3.04), with the greatest unmet need being for clinicians to be more sincere with the patient (36.5%). Higher total mean scores were reported by women who had visited the hospital four times or more over the past two months (P = 0.045), those with stage 3 or 4 cancer (P = 0.047) and those who had recently undergone radiotherapy or chemotherapy (P = 0.014). Conclusion: Most unmet supportive care needs fell under the health system and information domain. Healthcare providers in Oman should explore patient concerns and provide sufficient information at various stages of the care process in order to decrease the anxiety associated with living with cancer. Keywords: Breast Neoplasms; Needs Assessment; Supportive Care; Women; Oman

Clinical profile of Omani keratoconus patients: An experience from a tertiary referral centre in Muscat

OBJECTIVE: To determine the demographics and associated clinical features of Omani keratoconus patients presenting to the Ministry of Defence Hospital (MODH) in Muscat. METHODS: This is a retrospective, descriptive study whereby the electronic medical records of all Omani keratoconus patients presenting to the MODH between January 2011 and December 2015 were reviewed. Demographic details, corrected distance visual acuity, refraction, corneal topography, pachymetry, and treatment received were all documented. RESULTS: There were 458 new keratoconus patients (257 males, 201 females) comprising a total of 893 eyes with a mean age of 20 years ± 5.6 (standard deviation) (range 6–46 years). On their first visit, 35% of eyes had spectacle-corrected distance visual acuity <0.5 logarithm of the minimum angle of resolution (LogMAR), 38% had central corneal thickness <450 um, and 25% had a mean keratometry more than 53 Diopter (D). According to the Amsler-Krumeich classification, 37%, 30%, 18%, and 16% of eyes classified into stages I, II, III, and IV, respectively. The severity of keratoconus did not correlate with the age of patients (rs = −0.13, P < 0.05). Over the 5-year period of the study, 502 eyes were fitted with rigid gas permeable lenses with 91% achieving the vision of 0.1 LogMAR or better, 22% of eyes underwent collagen cross linking, 3% underwent intracorneal ring segments implantation, and 4% underwent corneal grafting. CONCLUSION: A significant proportion of Omani keratoconus patients seen in the MODH showed advanced disease on their first visit. There was no correlation between severity and age suggesting that keratoconus can progress quickly in our pediatric group. Population-based studies are an important next step. Meanwhile, early detection and timely interventions to limit the burden of the disease are crucial

Differential executive functioning in the topology of Spirit possession or dissociative disorders: an explorative cultural study

Background In Oman, anecdotal and impressionistic observation have helped parse and categorize various manifestations of spirit possession into two broad and distinct categories: intermittent dissociative phenomenon and transitory dissociative phenomenon. The primary aim of the present study was to compare the performance of participants on neuropsychological tests among different grades of possession. Other correlates were also sought. Methods Assessment criteria for the two groups included measures examining executive functioning: controlled oral word association test Verbal Fluency, Wisconsin Card Sorting Test (Perseverative error and the number of categories achieved), Trail Making Test and the Tower of London Test (number of correctly solved problems). Sociodemographic variables and the history of trauma were also sought. Result Among 84 participants, one third of them presented the intermittent possession type and two thirds, the transitory possession type. Their mean age was 34.17 ± 11.82 and 56% of them were female. Nearly 35% of them endorsed a history of a traumatic experience. Both the multivariate models showed statistical significance (F (5, 78) = 5.57, p  Conclusions This study suggests that typology of spirit possession found in Oman tends to differ on indices of executive function. Those with ‘diagnosis’ of intermittent possession showed impairment in many indices of executive functioning. Despite its wide prevalence, spirit possession has not been examined in terms of its neuropsychological functioning. We believe that this study will be instrumental in laying the groundwork for a more robust methodology.Other Information Published in: BMC Psychiatry License: http://creativecommons.org/licenses/by/4.0/See article on publisher's website: http://dx.doi.org/10.1186/s12888-019-2358-2</p

Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman

Objectives: Haemolytic disease of the fetus and newborn (HDFN) causes hydrops fetalis. The successful treatment of HDFN has been reported with intrauterine blood transfusion (IUT). This study aimed to describe the initial experience with IUT procedures in Oman. Methods: This retrospective observational study took place at the Royal Hospital and Sultan Qaboos University Hospital Blood Bank, Muscat, Oman, and included all women who underwent IUT procedures in Oman between March 2012 and March 2016. Gestational and neonatal outcomes were assessed, including complications, morbidity, neurodevelopmental sequelae and mortality. Results: A total of 28 IUT procedures for 13 fetuses carried by 11 women were performed. Gestational age at the time of referral ranged from 13–30 weeks, while the median gestational age at first IUT procedure was 26 weeks (range: 19–30 weeks). Indications for the procedure included HDFN caused by anti-D (n = 6), a combination of anti-D and anti-C (n = 4), anti-K (n = 1) and anti-Jsb (n = 1) antibodies and nonimmune hydrops fetalis due to a congenital parvovirus infection (n = 1). Median fetal haemoglobin levels at the beginning and end of the procedure were 4.6 g/dL and 12.8 g/dL, respectively. Most procedures were transplacental intravascular transfusions through the placental umbilical cord root (71.4%), followed by transamniotic intravascular transfusions (14.3%). The overall survival rate was 61.5%, with five deaths; of these, four were intrauterine and one was an early neonatal death due to non-resolved hydrops and severe cardiac dysfunction. Conclusion: As a relatively novel obstetric procedure in Oman, IUT seems to result in a favourable outcome for hydropic fetuses