RESUMEN
BACKGROUND: Unhealthy lifestyle behaviors are the main reason for the worldwide epidemic of chronic diseases. Changes in lifestyle, such as physical activity, healthy diet, and non-smoking, require preventive strategies at the national and individual levels. Clinical counseling is one of these strategies which helps patients to be motivated and enhance their self-management. The present study aimed to improve clinical counseling practice at the National Guard Primary Health Care Center, Jeddah, Saudi Arabia. Objective:To assess the quality of counseling from the patient's perspective in the primary care center of the National Guard (specialized polyclinic center) using a modified counseling quality instrument (CQI). Subjects and methods: In a cross-sectional study and through a convenient sampling technique from the patients visiting the National Guard Primary Health Care Center (specialized polyclinic center), 358 patients completed a self-administered questionnaire regarding their experiences of clinical counseling. The Kruskal-Wallis test was used to record the statistically significant differences between the ordinal variable of participants' quality scores and their demographic characteristics. RESULTS: The mean age of participants was 35± 8 years, ranging between 22 to 69 years. Most of the participating patients were women (63%). Slightly more than half the patients obtained clinical counseling during their appointments, and physicians at the clinic gave 57% of these clinical counseling sessions. The patients were generally satisfied with the counseling. They rated the counseling sessions as good in terms of content, the process of counseling, the way of interaction, and the degree of goal-oriented discussion. In addition to receiving counseling from physicians, older participants and those with postgraduate education were found to significantly positively affect patient perceptions of counseling quality. CONCLUSION: This study found that half of the participants did not get clinical counseling during their visits, indicating no standardization in clinical counseling services for all patients. Although patients were generally satisfied with the counseling session provided to them, time constraint was the highest dissatisfaction item among two-thirds of the patients in the present study.
RESUMEN
Pediatric cancers are relatively rare diseases when considering all types of cancer. Platinum-based chemotherapeutic agents are potent agents against a variety of pediatric malignancies. An important adverse effect of platinum-based agents is the occurrence of hearing loss. This hearing loss can pose a challenge to detect especially if the child is in his early of life. It will also significantly affect the child development of social, pedagogical, and personal dimensions. It is integral to identify incidence of platinum-based ototoxicity and risk factors that increase the likelihood of developing hearing loss in cancer children. We performed a retrospective chart review of 123 pediatric patients who had completed cisplatin and carboplatin therapy for a variety of malignancies. Patients were diagnosed at Princess Nourah Oncology Centre between January 2011 and December 2016, were less than 14 years old at diagnosis. Audiograms were scored using the International Society of Pediatric Oncology (SIOP) Boston Scale (0-4), a validated grading system for cisplatin-related hearing loss. Ototoxicity was reported in 16 patients out of 123 with a rate of 13%. The incidence of ototoxicity was highest in CNS tumors such as medulloblastoma (37.5%) and optic glioma (25%). Males were at greater risk for developing hearing loss than females. Cumulative cisplatin dose and addition radiation therapy were also identified as risk factors for development of ototoxicity (P = 0.008). Nature and location of cancer, gender, cumulative dose, and addition of radiation therapy are important clinical biomarkers of cisplatin ototoxicity.
