The role of patients' families in treatment decision-making among adult cancer patients in the Sultanate of Oman.

There are limited numbers of studies available in Middle Eastern Arabic countries regarding participation of family members in cancer treatment decision-making (TDM). The aim of this study was to evaluate the role of family members' in TDM among adult Omani cancer patients. A cross-sectional study was conducted in two main teaching hospitals. All adult Omani patients who were diagnosed with cancer and their nominated family members were invited to participate. A tool developed by Cancer Care Outcomes Research and Surveillance Consortium was used to identify the level of family involvement in TDM. A weighted kappa (k) was significant (p < .001) and showed almost full agreement between the patients' experiences and their preferences ( k = .98) and between family members' experiences and their preferences ( k = .96) of family involvement in TDM. Binary logistic regression showed significant family-controlled TDM if the patient communicated less with oncologists (OR = 9.89; 95% CI: 3.79-25.81); financial dependence of the patient on their families (OR = 6.21; 95% CI: 2.19-17.10 ); and advanced stages of cancer at the time of diagnosis (OR = 3.10; 95% CI: 1.37-7.03). Oncologists in Oman should be aware of the strong family involvement in TDM to allow a successful cancer treatment.

Prevalence of aging population in the Middle East and its implications on cancer incidence and care.

The Middle Eastern population is aging rapidly, and as aging is the main risk factor for cancer, the incidence and prevalence of that disease are increasing among all the populations in the region. These developments represent huge challenges to national and community-based health services. At the current state of affairs, most Middle Eastern countries require the cooperation of international agencies in order to cope with such new challenges to their health systems. The focus and emphasis in facing these changing circumstances lie in the education and training of professionals, mainly physicians and nurses, at the primary, secondary and tertiary levels of health services. It is imperative that these training initiatives include clinical practice, with priority given to the creation of multidisciplinary teams both at the cancer centers and for home-based services.