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

Emirati women’s knowledge about the menopause and menopausal hormone therapy

The aim of this study was to investigate the knowledge of Emirati women aged 30–64 about menopause, menopausal hormone therapy (MHT), and their associated health risks, and additionally, to determine the relationships between Emirati women’s knowledge about menopause and their sociodemographic and reproductive characteristics. A community-based cross-sectional study was conducted of 497 Emirati women visiting five primary healthcare centers in Dubai. Data were collected using a questionnaire composed of sociodemographic and reproductive characteristics, menopause knowledge scale (MKS), and menopause symptoms knowledge and MHT practice. The mean menopause symptoms knowledge percentage was 41%, with a standard deviation of 21%. There were significant differences in the mean knowledge percentage among categories of education level (p < 0.001) and employment (p = 0.003). No significant differences in the knowledge percentages were found among categories of menopausal status. “Pregnancy cannot occur after menopause” was the statement with the highest knowledge percentage (83.3%), while the lowest knowledge percentages were “risk of cardiovascular diseases increases with menopause” (23.1%), “MHT increases risk of breast cancer” (22.1%), and “MHT decreases risk of colon cancer” (13.9%). The knowledge of Emirati women about menopause, MHT, and related heart diseases was very low; therefore, an education campaign about menopause and MHT risks is needed to improve their knowledge for better coping with the symptoms

Burnout syndrome in medical students in the Kingdom of Bahrain

OBJECTIVES: To assess stress and burnout, and identify common stressors, among medical students in the Kingdom of Bahrain. STUDY DESIGN: A cross-sectional study with students being evaluated from March to September 2017 at two medical colleges in the Kingdom of Bahrain. METHODOLOGY: Survey conducted on a total sample of 533 clerkship-training students with a total of 347 respondents. The instruments used were Cohen’s Perceived Stress Scale; the Maslach Burnout Inventory; and a common stressors questionnaire. RESULTS: 65% (347/533) of the students from the two medical colleges responded to the questionnaire. It was found that the mean (SD) of Cohen stress score in this study was 21.76 (5.60), with a stress and burnout prevalence of 47% and 43.43% respectively. A high percentage of respondent students (68%) also exhibited high emotional exhaustion scores > 14. More than half of the respondents (53.3%) exhibited high cynicism score > 6. Statistically significant differences were observed across gender categories with Cohen mean score, emotional exhaustion and cynicism. Multiple linear regressions revealed gender to be the only statistically significant predictor of the Cohen score (p. value 0.042). CONCLUSION: Clerkship medical students displayed high levels of both stress and burnout prevalence. Medical educators must be aware of the early signs, causes and consequences of student stress. They should also be able to encourage students to improve their mental and physical health, promote mental well-being and teach stress management.</p

Barriers to nurse-patient communication in primary healthcare centers in Bahrain: Patient perspective

Objectives: Effective and efficient communication is a core element in healthcare systems, especially between healthcare providers and patients. This study aimed to identify communication barriers between nurses and patients in primary healthcare centers in Bahrain. Methods: This is a cross-sectional study conducted across primary healthcare centers in Bahrain. Four hundred and two patients were recruited using convenience sampling. A self-administered questionnaire comprising 29 items on communication barriers was used. Results: A total of 402 patients consented to participate. The majority of participants reported the following statements had large effects on communication: "shortage in the number of nurses compared to the large number of patients" (254/401, 63.3%), "lack of desire of nurse to communicate with patients" (246/402, 61.2%), and "negative attitude of the nurse toward the patient" (238/401, 59.4%). Further, "difference in language between nurses and patients," "lack of self-confidence by nurses," and "nurses overwhelmed by work" were ranked as top three statements with a significant influence on communication between nurses and patients. Conclusions: Communication between healthcare providers and patients is pivotal for an optimal healthcare service. Based on the findings of this study and the literature, we recommend formal training of health care workers in improving communication skills and including this not only in medical curriculum but also in the form of continuing medical education (CMEs).</p

Practice and attitudes of physicians regarding disclosure of information to patients with serious illness

BACKGROUND: Health Information disclosure is the cornerstone in respecting the patients’ autonomy and beneficence, particularly in the context of serious illness. Some Middle Eastern cultures prioritise beneficence over patient autonomy. This may be used as a justification when patient’s family takes over the decision-making process. Although guidelines and protocols regarding information disclosure are fast evolving, there are no sufficient data regarding the application of these guidelines in the clinical context. The objective of this study is to explore the truth disclosure practices of physicians in Bahrain. METHOD: In this cross sectional study, a random sample of 234 physicians was obtained from the database of Salmaniya Medical Complex (the largest public hospital in Bahrain). We used self-administered 21-item questionnaire to assess the practices and attitudes of physicians regarding disclosure of information to patients with serious illnesses. RESULTS: A total of 200 physicians completed the questionnaire with a response rate of 69.6%. The question about the usual policy of disclosure revealed that 62.5% (125) of the doctors would always disclose the diagnosis to the patients, 26% (52) would often disclose the diagnosis and only 1% would never disclose the real diagnosis to a competent adult. Only 15% of the physicians would never make exceptions to their policy of “telling the patient” while all remaining physicians (85%) made exceptions to their policy either often, occasionally or rarely. The most common reason for not disclosing the diagnosis was family request (39.5%). About 64.5% of the physicians were not aware of any existing protocol or policy for diagnosis disclosure to patients. There was no statistically significant association between doctors’ policy of disclosure and other demographic variables. CONCLUSION: Most physicians opt to disclose the truth; however, the majority would make exceptions at some point particularly upon family request. Regional truth disclosure policies should take into consideration the interplay and balance between patient autonomy and the role played by the family in the decision-making process.</p

Efficacy of anti-microbial catheters in preventing catheter associated urinary tract infections in hospitalized patients: A review on recent updates.

Catheter-associated urinary tract infections (CAUTIs) are the common hospital-associated infections (HAIs), which can be prevented by practicing necessary precautions and by using antimicrobial urinary catheters (UCs). The efficacy of antimicrobial UCs against standard catheters for averting CAUTIs is poorly studied. The objective of the review is to analyze the efficacy of various types of antimicrobial UCs used in hospitalized patients in preventing CAUTIs. The major antimicrobial UCs are silver and antibiotic catheters, in contrast, few antimicrobial catheters include antimicrobial peptides, bactericidal enzymes, bacteriophages, and many are under clinical evaluation. The review concludes that even though many antimicrobial methods are available to prevent CAUTIs, the incidence rate is still high. Antibiotic resistance, leaching of catheter materials which may cause side effects and additional costs are the major challenges for the UCs. Further research is warranted and should focus on cost-effective and ideal antimicrobial UCs, in which the microorganisms cannot form biofilms or develop resistance.</div

Career choices among medical students and factors influencing their choices

Background: Physicians’ specialty choices have a direct impact on medical workforce. As medical students progress through medical school, it is observed that their interests in specialties change due to one reason or another. The aim of this study is to firstly identify factors that influence medical students’ career choices using a cross sectional study. Secondly, to analyze which factors are the most influential with the aim of informing the work force and curriculum developers and thus enhance the employability of graduates. Methods: A computer generated random sample of 131 medical students was taken from the preclinical second-year medical students at the Royal College of Surgeons in Ireland-Medical University of Bahrain. Questionnaires were distributed face to face and later retrieved for data collection and analysis. Results: Eighty-four (70%) students responded to the survey. Thirty-two (38.1%) of the respondents were male and fifty-two (61.9%) were female. The top three preferred specialty choices were Surgery 22 (26.5%) followed by Internal medicine 12 (14.5%) and Paediatrics 11 (13.3%). The most popular factor in specialty choice was interesting field and the least popular factor was geographical location of the hospital or health instituation. Conclusion: The top three career choices were selected because those students felt they were interesting fields. The least important factors were geographical location of the hospitals or health instituations, media influence and financial reasons respectively.</p

Epidemiological profile of cervical cancer in Bahrain (2005 to 2015)

Background The objective of this study is to analyze the trend of cervical cancer in Bahrain over a 10 year period (2005 to 2015) with the aim of gaining insight into changes in the presentation of cervical cancer. Methods This is a cross sectional study in which we analyzed all cervical cancer cases that are registered in Bahrain cancer registry between the period of 2005 and 2015 for their epidemiological and clinical profile. Results A total of 165 cases were included and analyzed. The mean (SD) and median age of women at diagnosis during this 10-year period are 49.41 (12.57) and 49 years respectively. Almost 60% of the cases are for Bahraini and 40% for non-Bahraini women. Squamous cell carcinoma (43.6%) is the most common type of cancer followed by adenocarcinoma (17%). Surgery was the treatment of choice in 42.4%. Only 33.3% have received radiotherapy, and 32.7% have received chemotherapy. Forty-two patients out of 165 (25.5%) died because of the cancer itself. Conclusion The study findings revealed important implications to the formulation of new healthcare strategies and policies, particularly in regards to cervical cancer screening and introducing the HPV vaccine into the immunization schedule.</div

Knowledge towards human papilloma virus (HPV) infection and attitude towards its vaccine in the Kingdom of Bahrain: cross-sectional study.

Objectives: To determine the level of awareness of human papilloma virus (HPV) infection and to assess attitudes towards receiving the vaccine among men and women in Bahrain.Design: A cross-sectional study. An interview-based questionnaire was used to measure HPV knowledge and attitude towards HPV vaccine.Setting: Ten randomly selected primary health centres (PHCs) in the Kingdom of Bahrain.Participants: 408 PHC attendees, including 268 women and 140 men aged 18-65 years. Only residents from Bahrain and English or Arabic speakers were invited to participate.Primary and secondary outcome measures: Extent of awareness of HPV infection, acceptance of HPV vaccine and describing the results in association to gender, educational level and other demographics.Results: A response rate of 91.4% was achieved, with a majority being female responders as opposed to male responders (65.7% vs 34.3%, respectively). Only 13.5% of the participants had heard of HPV, with female gender and employment in the health sector (pConclusion: Despite the limited knowledge about HPV infection among the study's participants, there is a favourable attitude towards the HPV vaccine. These data can support the initiation of a nationwide HPV immunisation programme.</p

Psychological impact of COVID-19, isolation, and quarantine: a cross-sectional study

Purpose: The COVID-19 pandemic has resulted in mandatory isolation and quarantine. The objective of this study was to describe and compare the psychological impacts of COVID-19 isolation and quarantine.Methods: This was a cross-sectional retrospective study. Participants were Bahrainis aged >18 years who had undergone either isolation or quarantine. Eligible participants were identified from the COVID-19 contacts (quarantine) and cases (isolation) database of Bahrain. Validated questionnaires for self-reported depression (Center for Epidemiological Studies - depression [CES-D]), posttraumatic stress (Impact of Event Scale - revised [IES-R]), and perceived stigma (Stigma Scale [SS]) were administered.Results: Mean CES-D, IES-R, and SS scores were 16.76±5.65, 13.50±14.67, and 25.29±7.99, respectively. In sum, 40% (205 of 502) of participants showed clinically significant depression, and Conclusion: Isolated and quarantined individuals reported depression, perceived stigma, and to a lesser extent distress. Psychological interventions identifying and targeting people with different-severity psychological burdens are in urgent need.</p