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

Comparison between Efficacy of Human Milk Fortification Using Human Milk Fortifier versus Preterm Formula: A Retrospective Single-institutional Experience

Objectives: This study sought to evaluate the relative efficacy of expressed breast milk (EBM) fortified using human milk fortifier (HMF) compared to commercial preterm formula (PF) on preterm and very low birth weight (VLBW) infants in a major tertiary healthcare center in Oman. Methods: This retrospective cohort study included two cohorts of preterm (< 32 weeks gestation) or VLBW infants (birth weight < 1500 g) treated in the neonatal intensive care unit (NICU). Cohort one included infants who were given PF-fortified EBM between January and December 2016, and cohort two were given newly-introduced HMF-fortified EBM between November 2018 and December 2019. Analysis was performed to compare the cohorts with respect to baseline characteristics, primary outcomes, and secondary outcomes. Results: A total of 103 neonates were included (cohort 1: n = 55, cohort 2: n = 48). There were no significant differences in the growth of the weekly length, the growth of the head circumference, or discharge growth parameters. Compared to PF, HMF was associated with significantly better weight gain velocity (g/kg/day) during the first week (p =0.009) and second week (p =0.050) after starting fortification, lower need for other adjunctive forms of fortification (p =0.035), and lower rates of necrotizing enterocolitis in premature infants or VLBW (p =0.018). Conclusions: This is likely to be the first study to analyze the relative efficacy of HMF and PF in the Middle East. The results of this study will be helpful in guiding standards of nutritional care in NICUs in Oman

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

Assessment of patient safety culture in primary health care in Muscat, Oman: a questionnaire -based survey

Abstract Background Patient safety is a universal issue which affects countries at all stages of health system development. Patient safety research in primary care reveals that globally millions of people suffer disabilities, injuries, or death due to unsafe medical practices. This study aims to explore the understanding of frontline primary health care professionals regarding patient safety culture in health care facilities in Oman. Methods A questionnaire–based survey was conducted using a validated Hospital Survey of Patient Safety Culture tool. Invitations were sent to all 198 health professionals from each occupational category from each primary care center in Muscat, Oman. Results The total number of respondents was 186 participants out of 198 (response rate: 94%). Overall, the staff had a strong sense of teamwork within the units (85%), they reported organization learning for continuous improvement (84%) and teamwork across the units (82%). However, the four dimensions which received the lowest scores were related to communication problems between the staff (23%), non-punitive response to errors (27%), frequency of event reporting (40%), and errors occurring when transferring patients to higher levels of health care during handoffs and transitions (46%). Conclusions Overall, the participants rated patient safety in the primary health care setting as excellent or very good and the perception of patient safety was moderately positive. The core areas of strength were teamwork within the units with positivity and organization learning and continuous improvement. The weaknesses were non-punitive response to errors, inadequate staffing and hand offs and transition. The results of this study will provide policy makers and health care professionals with a detailed understanding of the current patient safety culture in primary care in Muscat, Oman. The results will be used by the Ministry of Health to inform policy and strategies to strengthen patient safety within primary health care in Oman

Preoperative predictors of poor laryngoscope views in pediatric population undergoing cardiac catheterization

Background: The primary objective of this study was to identify pre-anesthetic airway assessment parameters that would predict Cormack and Lehane grade III and IV laryngoscopy views in pediatric patients undergoing cardiac catheterization procedures. The secondary end points were to identify factors that would contribute to difficult laryngoscope views in this subset of patients. Settings and Design: Prospective observational study performed at a single tertiary cardiac care center. Materials and Methods: 199 children below 5 years of age undergoing elective cardiac catheterization were included. Pre-anesthetic airway assessment was done by modified Mallampati grading, lower lip to chin distance [LCD], tragus to mouth angle [TMA], thyromental distance [TMD], neck circumference [NC], and the ratio of height to thyromental distance [RHTMD]. Demographic data including American Society of Anesthesiologists physical status [ASA PS] were recorded for each child. Receiver Operating Characteristic curves were plotted and Areas Under the Curve were measured to identify the best cut off values for each of the airway evaluation method that would predict poor laryngoscopy views as well as assess their accuracy in doing so. Results: LCD, TMD and low body mass index were found to have good sensitivity, specificity and accuracy in predicting Grade III and IV laryngoscope views. ASA PS grade III and above patients had a significantly higher incidence of poor laryngoscope visualization. Conclusions: LCD, TMA, TMD, NC, RHTMD and BMI could all be used combinedly as screening tools during pre-anesthetic airway evaluation for predicting difficult laryngoscope views in children. Among these, LCD, TMD along with low body mass index might have better accuracy

Influence of Eysenckian Personality Traits in Choice of Specialization by Young Omani Doctors

Objectives:The role of personality in occupational specialty choices has been explored in many parts of the world. To our knowledge, there is a dearth of such studies in the Arab/Islamic population and Oman is no exception. This study aimed to explore the relationship between personality traits and specialty choice among residents of Oman Medical Specialty Board (OMSB). Methods: A cross-sectional study was carried out among Omani resident physicians working under OMSB. The Eysenck Personality Questionnaire–Revised was employed to quantify personality subtypes (e.g., psychoticism, extraversion, and neuroticism). Specialties were categorized as surgical, medical, and diagnostics as per standard of North American medical specialties. A total of 255 residents in 17 medical specialties participated in the study (m = 40.4%; f = 59.6%) of 300 eligible subjects giving a response rate of 85.0%. Results: Respondents who had chosen surgical specialties scored significantly higher on the psychoticism subscale than those who had opted for medical and diagnostic specialties. As for individual specialties, orthopedic respondents had statistically significant higher mean scores on psychoticism and neuroticism compared to radiologists and psychiatrists who scored the lowest in the two personality traits, respectively. Conclusions: This study found statistically significant associations between personality traits and choices of specialty by young Omani doctors. We recommend more detailed studies that examine further psychological and cultural variables that are likely to affect the choices of specializations by young Omani professionals in both medical and non-medical fields

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