Communicating uncertainty in pathology reports: a descriptive study from a specialized cancer center.

Pathologists use certain terminologies to communicate uncertainty in pathology reports. The message conveyed in pathology reports may be interpreted differently by clinicians leading to possible miscommunication. We aimed to compare the interpretation and impact of uncertainty phrases between pathologists and clinicians. A survey with examples of uncertain diagnoses containing ("suspicious for", "indefinite for", "favor", "cannot exclude", "suggestive of", "compatible with", "cannot rule out", "highly suspicious for" and "consistent with") was sent to pathologists and clinicians. For each diagnosis, participants assigned a level of certainty from 1 to 10 and were asked whether they would recommend treatment based on such phraseology. Thirty-six responses (from 7 pathologists, 10 surgeons, 8 pediatric oncologists, 8 medical oncologists, 2 radiation oncologists and 1 diagnostic radiologist) were received. Pathologists had a narrower range of uncertainty compared to clinicians. Wide variation between both groups was seen for all phrases except "compatible with" and "highly suspicious for". 'Indefinite for' showed the lowest mean of certainty (4.67 for pathologists; 4.00 for clinicians) whereas 'consistent with' had the highest (8.83 for pathologists and 9.38 for clinicians). There was a significant difference in the degree of certainty between both groups for "compatible with" (7.83 for pathologists and 9.06 for clinicians, p = .009). For treatment decisions, pathologists and clinicians agreed on initiating treatment when "consistent with" and "compatible with" were used and gave variable responses for the other terms. They proposed opposing treatment recommendations for "favor". Pathologists and clinicians varied in interpretation of uncertainty phrases which may impact treatment.

Identifying modifiable factors associated with COVID-19 vaccine hesitancy and acceptance among cancer patients in Jordan.

Introduction: Vaccines stand amongst the most effective medical interventions for the management of infectious diseases, and are pivotal tools for public health. The acceptance of vaccines is heavily influenced by perceptions of efficacy, safety and other modifiable factors. Purpose: This cross-sectional study sought to identify and examine the modifiable factors that can help address COVID-19 vaccine hesitancy and acceptance among cancer patients. Methods: The study was conducted between February and April 2021 using an online survey questionnaire comprising of four domains. The survey was administered to cancer patients in Jordan. Results: Among the 1,029 cancer patients who completed the online questionnaire (response rate= 73%), 58% (n=597) expressed willingness (intent) to take the vaccine. Notably, 72.5% (n=433) of those intending to take the vaccine were currently undergoing treatment. Knowledge and awareness played a significant role, with 54.3% considering them essential for vaccine acceptance. Fear of infection significantly influenced vaccine acceptance (p<0.001), with 66.8% expressing concern about potential infections. Peer encouragement was also a crucial factor, as 82.4% regarded it as an important driver for influencing vaccine acceptance (p<0.001). Conclusion: Peer encouragement, awareness, and fear emerged as the primary modifiable factors associated with greater vaccine acceptance by patients with active malignancies. Study results suggest that providing personalized and tailored information about vaccinations, focusing on safety and potential interactions with cancer and its treatment, are potentially excellent strategies for improving vaccine acceptance among cancer patients.

Assessing pharmacists and other healthcare providers' knowledge of hand sanitization during COVID-19 pandemic in Jordan: A comparative study.

BACKGROUND: Health care providers including pharmacists are often on the first line when dealing with COVID -19; they can be under threat of contracting and spreading the disease. We aimed to assess and compare their knowledge of hand sanitization during COVID-19 pandemic to improve quality of care. METHODS: A cross-sectional study was conducted in Jordan, on healthcare providers in different settings from 27 October till 3 December 2020, using a pre-validated electronic questionnaire. Participants (n = 523) were healthcare providers practicing in different settings. Descriptive and association statistical analyses were produced on the data using SPSS 26. Chi square was used for the categorical variables, and One way ANOVA was used on the continuous and categorical variables. RESULTS: A significant difference was recorded in total knowledge mean according to gender (59.78 vs 61.79 p = 0.030) in favor of men, and between pharmacists and other healthcare providers in favor of the latter (59.22 vs 61.45, p = 0.02). No significant difference was generally noticed between those who attended hand hygiene training and those who did not. CONCLUSION: Healthcare providers' knowledge of hand hygiene was generally good among participants, regardless of training and it was possibly increased because of fear of COVID-19 infection. Physicians were the most knowledgeable in regard of hand hygiene while pharmacists were the least among healthcare providers. Thus, structured, more frequent, and tailored training on hand sanitization in addition to new educational strategies are recommended for healthcare providers, in particular, pharmacists for better quality of care especially in pandemics.

Perception of the importance of continuing professional development among pharmacists in a middle east country: A cross-sectional study.

BACKGROUND: The role of pharmacists has recently expanded, necessitating enhanced competencies. This requires pharmacists' participation in continuing education initiatives. This study aims to explore attitudes, motivations, opportunities, and challenges of pharmacists in a country in the middle east, towards continuous professional development. METHODS: A cross-sectional observational close-ended questions study was conducted in Jordan between September and October 2021, and enrolled 309 pharmacists, the tool was developed by the research team and experts in the field to evaluate the continuous professional development perception among pharmacists. The research was approved by the Ethics and Research Committee in an area hospital and a University. RESULTS: The majority of participants had confidence that continuous professional development prepares pharmacists for practical development, believed that it enhances the status of the profession with other health care professionals as well as with the public, and felt confident that it meets their needs (> 98%). Most of the participants agreed that job restrictions (91%) and lack of time (83%) were the major barriers to participation in continuous professional development. The motivation was positively correlated with attitudes (R = 0.551, P < .001). However, barriers were not significantly correlated with either attitudes or motivations. CONCLUSION: Our findings emphasize the positive attitude of pharmacists towards continuous professional development. Identified barriers to continuous professional development participation included job constraints and lack of time. The study highlights the need for policies and procedures that address these issues before the implementation of mandatory continuous professional development programs for pharmacists.

Amenorrhea, fertility preservation, and counseling among young women treated with anthracyclines and taxanes for early-stage breast cancer, a retrospective study.

Chemotherapy may cause ovarian toxicity and infertility. Cancer patients are usually overwhelmed, and focus exclusively on cancer diagnosis and may not pay attention to fertility-related issues. In this paper we look at the rate of amenorrhea and fertility counseling among such young patients.Premenopausal women with early-stage breast cancer treated with adjuvant or neoadjuvant chemotherapy were recruited. Amenorrhea was defined as absence of menstruation for ≥12 months after the completion of chemotherapy.A total of 94 patients met the eligibility criteria and were included in this analysis. Median age at diagnosis was 35.7 (range, 22-44) years. Seventy-nine (85.9%) respondents were counseled about amenorrhea and 37 (40.2%) were considering having children. Long-term amenorrhea was reported by 51 (54.3%) patients. The addition of taxanes to anthracyclines, in 2 different regimens, increased the risk of amenorrhea to 69.2% and 66.7% compared to 38.9% with anthracycline-alone, P < .0001. Longer duration of chemotherapy (≥24 weeks) might also be associated with higher rate of amenorrhea (67.7%) compared to 43.4% in those who had shorter duration (<24 weeks), P = .031.The addition of taxanes to anthracycline-based chemotherapy increased the risk of amenorrhea. However, shorter duration of chemotherapy, even with taxanes, may lower such risk. Our study highlights the importance of fertility counseling to improve fertility preservation rates. Given the importance of taxanes, shorter regimens are associated with lower amenorrhea rates and should be preferred over longer ones.

Psychometric properties of the Arabic version of EORTC QLQ-C15-PAL among cancer patients in Jordan.

PURPOSE: Health related quality of life (HRQOL) is an important outcome in cancer care and needs assessment by a valid questionnaire. HRQOL questionnaires need to be validated after translations to other languages and cultural settings. The purpose of this study is to evaluate the psychometric properties of the Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life 15 items Questionnaire for Palliative Care (EORTC QLQ-C15-PAL). METHODS: This is a cross-sectional study of a convenient sample of inpatients with cancer. RESULTS: One hundred seventy-five patients completed the EORTC QLQ-C15-PAL questionnaire. Cronbach's alpha coefficient met the 0.7 alpha criterion. Confirmatory factor analysis met the goodness of fit criteria; goodness-of-fit index (GFI), comparative fit index (CFI), normed fit index (NFI) and non-normed fit index (NNFI) >0.90 and root mean square error of approximation (RMSEA) <0.06. All item-scale correlation coefficients exceeded the set value of 0.40, indicating satisfactory convergent validity. In terms of discriminant validity, all items in the questionnaire showed a higher item-scale correlation than item-other scale correlation, except for items 1 and 2 (physical function scale) that showed a higher correlation with fatigue. Construct validity was tested by item inter scale correlation coefficient. All constructs had correlation coefficient <0.70. External validity was tested by comparison of scores of patients who had metastasis and who did not have metastasis. Significant differences (P value <0.05) were found in all scales except for nausea. Age groups were compared and showed significant differences for physical function, fatigue, and global score of HRQOL. CONCLUSION: The Arabic version of the EORTC QLQ-C15-PAL is valid and reliable.