Knowledge of health professional students on waterpipe tobacco smoking: curricula implications.

BACKGROUND: Tobacco prevention research traditionally focuses upon cigarette smoking, but there is also a need to implement and evaluate the usefulness of waterpipe tobacco smoking (WTS) interventions since it is considered less harmful than cigarettes. This study aimed to assess the impact of an educational intervention on WTS knowledge of health professional students in three academic health institutions in Bahrain. METHODS: A quasi-experimental design was used to include medical students from the Arabian Gulf University, medical and nursing students from the Royal College of Surgeons in Ireland-Bahrain and nursing students from the University of Bahrain. Two hundred fifty students participated in the three phases of the study during October 2015-June 2016 from an original sample of 335. The participants answered knowledge questions on WTS before and after an intervention, which included a lecture by an expert and a video on the awareness about the health hazards of WTS. RESULTS: The mean age of starting cigarette and WTS was 16.8 ± 2.8 and 17.5 ± 1.7 years, respectively. The prevalence of ever smoking any type of tobacco among students was 22.4% (medical 25.8% and nursing 37.5%) and that of WTS, 17.7% (medical 20.0%, nursing 13.6%). The prevalence of current cigarette smoking was 9.6% among medical and nursing students combined with 10.3 and 8.5% for medical and nursing students, respectively. WTS was prevalent at a proportion of 6.8% among medical and nursing students combined with 6.5% in medical and 14.8% in nursing students. The university curriculum as the main source of knowledge on WTS increased from 14.2 to 33.3% after the intervention (p < 0.005). Knowledge about the hazards of WTS increased in 16 of the 20 statements. The difference in overall knowledge score was significant (p < 0.05) for nursing (77. 5 ± 1.5 vs 85.8 ± 2.2) compared to medical students (85.3 ± 1.0 vs 87.3 ± 0.9) after the intervention. CONCLUSIONS: Our educational intervention with health professional students improved their knowledge about the health effects of WTS. Medical and nursing institutions may consider using various methods such as informative videos and expert lectures to include in their teaching curricula as part of WTS prevention strategies.

Quality of life of Bahraini women with breast cancer: a cross sectional study.

BACKGROUND: Breast cancer can impact survivors in many aspects of their life. Scarce information is currently available on the quality of life of cancer survivors in Bahrain. The objective of this study is to describe the quality of life of Bahraini women with breast cancer and its association with their sociodemographic and clinical data. METHODS: This is a cross sectional study in which the European Organization for Research and Treatment of Cancer Quality of Life Cancer Specific version translated into Arabic was administered to a random sample of 337 Bahraini women with breast cancer. Relevant descriptive statistics were computed for all items. The equality of means across the categories of each categorical independent variable was tested using parametric tests (ANOVA and independent t-test) or non-parametric tests (Kruskal Wallis and Mann Whitney tests) of association where appropriate. RESULTS: Of the total sample, 239 consented to participation. The mean and median age of participants were 50.2 (SD ± 11.1) and 48.0 respectively. Participants had a mean score for global health of 63.9 (95% CI 61.21-66.66). Among functional scales, social functioning scored the highest (Mean 77.5 [95% CI 73.65-81.38]) whereas emotional functioning scored the lowest (63.4 [95% CI 59.12-67.71]). The most distressing symptom on the symptom scales was fatigability (Mean 35.2 [95% CI 31.38-39.18]). Using the disease specific tool it was found that sexual functioning scored the lowest (Mean 25.9 [95% CI 70.23-77.90]). On the symptom scale, upset due to hair loss scored the highest (Mean 46.3 [95% CI 37.82-54.84]). Significant mean differences were noted for many functional and symptom scales. CONCLUSION: Bahraini breast cancer survivors reported favorable overall global quality of life. Factors associated with a major reduction in all domains of quality of life included the presence of metastases, having had a mastectomy as opposed to a lumpectomy and a shorter time elapsed since diagnosis. Poorest functioning was noted in the emotional and sexual domains. The most bothersome symptoms were fatigability, upset due to hair loss and arm symptoms. This study identifies the categories of women at risk of poorer quality of life after breast cancer and the issues that most need to be addressed in this Middle East society.

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).

Attitudes of Bahraini women towards the menopause: implications for health care policy.

OBJECTIVES: To assess the attitudes of Bahraini women aged 30-64 years towards the menopause and to examine the relationship between attitudes of Bahraini women towards menopause and their sociodemographic data and reproductive characteristics. MATERIALS AND METHODS: A cross-sectional study of 260 Bahraini women attending primary health care centers was conducted. A multistage stratified and clustered random sampling technique was used. The women were interviewed using a questionnaire composed of Attitude Towards Menopause scale and sociodemographics. RESULTS: The mean+/-S.D. of women's age and age at menopause were 45.04+/-9.43 and 48.67+/-2.92 years, respectively. Respondents' median age and median age at menopause were 45.5 and 48.0 years, respectively. Almost half of the women (48.5%) had completed high school or diploma, and 41.5% were currently employed outside home. Over half of the women (53.5%) were premenopausal, 19.6% perimenopausal and 26.9% were postmenopausal. The Mean Average Attitude Score (MAAS)+/-S.D. was 2.4+/-0.26 where the minimum score is 1 indicating very negative attitudes and the maximum is 4 indicating very positive attitudes. Statistically significant differences in means were noted among categories of educational level, menopausal status, and marital status. Moreover, MAAS was positively correlated with age of respondents. Premenopausal women had more negative attitudes towards menopause than peri- or postmenopausal women. CONCLUSIONS: Bahraini women display a considerable range of attitudes towards the menopause, with their general attitudes ranging from neutral to positive. Postmenopausal women had more positive attitudes towards menopause than premenopausal women. Implications for health care policy were explored in this study.