Exploring the effectiveness of crisis counseling and psychoeducation in relation to improving mental well-being, quality of life and treatment compliance of breast cancer patients in Qatar

Reem Jawad Al-Sulaiman,1 Abdulbari Bener,2,3 Lisa Doodson,4 Salha Bujassoum Al Bader,1 Suhaila Ghuloum,5 Alain Lemaux,1 Hekmat Bugrein,1 Reena Alassam,1 Aisha Karim1 1Department of Medical Oncology, National Center of Cancer Care and Research, Doha, Qatar; 2Istanbul Medipol University, International School of Medicine, Istanbul, Turkey; 3Department of Biostatistics and Medical Informatics, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey; 4Department of Psychotherapy and Counseling Studies, Regent’s University London, London, UK; 5Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar Background: An insufficient number of studies have been carried out in the Middle East to evaluate the role of structured psychotherapeutic interventions in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance. This study has been designed to address this limitation by exploring the benefit of two structured psychotherapeutic interventions, crisis counseling and psychoeducation, in enhancing breast cancer patients’ psychological well-being, quality of life and treatment compliance in Qatar. Methods: A total of 201 women with early-stage breast cancer from the state of Qatar were recruited and randomized into either the control group or one of the treatment groups (crisis counseling or psychoeducation). Each of the two treatment interventions consisted of a total of six 60- to 90-minute sessions, which were provided over a period of 12 weeks. The short- and long-term benefits of the crisis counseling and psychoeducation interventions were evaluated in terms of improving patients’ psychological well-being, quality of life and treatment compliance by asking all the patients to complete the Depression, Anxiety and Stress Scale, 21 item version (DASS-21) and European Organization for Research and Treatment of Cancer Quality of Life scale (QLQ-C30) instruments at different points in time and by monitoring their compliance to chemotherapy and radiotherapy treatment. Results: This study revealed that both of the study interventions, crisis counseling and psychoeducation, were effective in improving women’s psychological well-being and quality of life over time in comparison to the control group, but had no significant impact on patients’ compliance with treatment. In addition, the study showed that psychoeducation conferred a greater advantage than did the crisis counseling model, especially in improving women’s psychological well-being over time. Conclusion: This study is considered the first of its kind in Qatar to provide evidence on the benefit of crisis counseling and psychoeducation interventions in improving the psychological well-being and quality of life of women with early-stage breast cancer in Qatar. In addition, this study has provided innovative research that can be used as evidence to propose changes to the psychotherapy services for breast cancer patients in Qatar. This research study aims to provide a first step toward further research in the future, which will hopefully lead to a better health care system for cancer patients in Qatar. Keywords: breast cancer, DASS-21, QLQ-C30, crisis counseling, psychoeducation, NCCCR, Qatar, psycho-oncology, psychotherapy, cancer, psychological wellbein

Breast Cancer Screening Amongst Arabic Women Living in the State of Qatar: Preliminary Results of the Cross-Sectional Community Based Survey

Background: Breast cancer is the most common cancer among women in Qatar, incidence rate is rising and it is often diagnosed at advanced stages. Early detection of breast cancer through regular screening activities has been found to decrease morbidity and mortality rates. Although research on breast cancer screening in the Middle East is scarce, low levels of knowledge and poor participation rates have been found to act as barriers towards breast cancer screening activities such as breast self-examination, clinical breast examination and mammography. Various other barriers have been described in the literature. Identification of these potential barriers and facilitators is urgently needed in order to develop culturally appropriate interventions aiming to improve awareness and breast cancer screening participation rates. Objectives: A three-phase research program for which the goals are to (1) Understand breast health issues in Qatar; (2) Identify and implement strategies that assist Arabic women’s participation in breast cancer screening activities (3) Evaluate, facilitate and sustain these strategies. Methods: In Phase 1 two studies are conducted. Study 1: this quantitative study examines data from a convenience sample of 1063 Arabic women in Qatar on a cross sectional community based survey. Face to face interviews are used to investigate knowledge, attitudes, practices, barriers and facilitators regarding breast cancer screening activities. Study 2: Using an ethnographic qualitative methodology, this study will capture the complexity and diversity of reasons of health behaviour choices on a purposive sample of 50 women, 50 men and 30 health care providers. Results: Preliminary results from study 1 will be presented. These will include: participation rates of breast cancer screening activities of Arabic women in Qatar such as breast self-examination, clinical breast examination and mammography; levels of knowledge of breast cancer and its screening; identified barriers and facilitators to breast cancer screening as experienced by these women. Conclusion: Combined results will enable development of culturally appropriate intervention strategies to raise awareness and participation rate in breast cancer screening among Arabic women living in Qatar and the Gulf regio