Knowledge and practice of breast self-examination among breast cancer patients in Damascus, Syria.

BACKGROUND: Breast cancer (BC) represents an important cause of cancer death, its incidence rate has been rising gradually in the Arab world, and in Syria, BC is the most common cancer and the leading cause of cancer death; its prognosis gets better as we detect it early in its first stages. So, it is very important to implement one or more early detection methods such as Breast Self-Examination (BSE), Clinical Breast Examination (CBE), and mammography. BSE represents an effective method to find out changes in breast structure when they happen. This study investigates the knowledge of BSE and its practice in BC patients. METHODS: A quantitative cross-sectional study in Al-Bairouni hospital in Damascus-Syria was carried out using face-to-face interviews based on a structured questionnaire, which consisted of 4 sections. The data were subjected to statistical analysis using various analytical tests, including the independent t-test, one-way analysis of variance (ANOVA), and Chi-square test. RESULTS: Five hundred patients were interviewed. Only 27.4% of patients had a good knowledge of BSE, 17.4% had average knowledge, and 55.2% had low knowledge of BSE. The factors that have an impact on the knowledge of BSE were: family breast cancer history (first and second-degree relatives), education, and the region of living (between governorates). The effect of knowledge of BSE on its practice was positive. However, only 24.8% of patients have been practicing BSE; the reasons for not practicing BSE were: no one has told the patient about it (64.8% of cases), and the patient does not have any symptoms relating to the breast (21.4%).Breast cancer was identified through breast self-examination (BSE) in 15.6% of cases. CONCLUSION: There is a low degree of knowledge and little practice of BSE among Syrian breast cancer patients. Family breast cancer history, governate, occupation, and level of education had a statistically significant effect on knowledge scores of BSE, unlike age and social status. So, some steps should be taken to increase awareness about BSE among Syrian females.

Syrian medical students' acceptance of peer physical examination and its associating factors: a cross-sectional study.

BACKGROUND: This study aimed to evaluate the acceptance of Peer Physical Examination (PPE) in middle Eastern society with its associate factors, and PPE acceptance during Covid-19 pandemic. The acceptance of PPE is considered high in multiple studies carried out in the west, but there were nearly no studies investigating the acceptance of PPE in the middle east or low-income countries. METHODS: A questionnaire was shared through social media with students with focus on clinical-year students. A total number of 657 medical students were collected with a 74.5% response rate. The questionnaire gathered demographic information and recorded previous experience of PPE. A 5-point-likert scale was used to assess acceptance of PPE, factors affecting it, and the influence of COVID-19 pandemic. It also considered body's areas students would accept to be examined. Associations between participants' demographic and other details were tested using independent-samples T Test and other tests, and a p-value of < 0.05 was considered significant. RESULTS: Eighty percent of medical students accepted PPE, while 3% did not, and 17% were neutral. Males had statistically significantly higher acceptance rates of PPE (M = 3.94 out of 5). Also, females had lower acceptance of being examined by other gender than males but did not mind examining other gender. Furthermore, the groin area (thigh) was the most rejected area for examination (20% only accept it), followed by the breast (23%). There was no statistically significant difference between different Universities groups or between different academic performance groups, finally there was statistically significant effect of religion and society on acceptance of PPE and religion has affected females more than males (p- value = 0.002). 70.8% of students supported PPE during the COVID-19 pandemic, while 6.8% did not, and 22.4% were neutral. There was not a significant difference in acceptance and supporting of PPE during the COVID-19 pandemic between males and females. CONCLUSIONS: With an 80% acceptance rate, PPE represents an effective alternative to the absent life models in Syrian universities. The application of PPE is less likely to go without difficulties, but authors suggest the presence of a supervisor and single-gender groups with friends paired together if possible.

Depression, anxiety and related factors among Syrian breast cancer patients: a cross-sectional study.

INTRODUCTION: Breast cancer represents a traumatic experience with a psychological burden. The prevalence of psychological distress (which include depression and anxiety) among breast cancer patients is estimated to be 15 to 54%, but studies have shown that applying some psychological treatments has contributed to decreasing depression and anxiety. So, it is crucial to diagnose and treat patients with the appropriate means. After reviewing the literature, no studies discussed depression and anxiety among Syrian breast cancer patients. METHODS: A cross-sectional study in Al-Bairouni hospital in Damascus, Syria carried out using face-to-face interviews based on a structured questionnaire. All breast cancer patients were included, except who refused to participate, and responses with missing data were excluded. The questionnaire consisted of 2 sections: the first included Socio-demographic characteristics, and the other evaluated patients' depression using PHQ-2 and GAD-2 scales. Data were gathered using the Kobo toolbox app and then entered into an Excel sheet. RESULTS: Five hundred patients were interviewed. 35.6% of the patients had a GAD-2 score greater than or equal to 3.00, while 35% had a PHQ-2 score greater than or equal to 3.00. There is a significant negative relationship between the age of the patient and the GAD-2 score and PHQ-2 score, which means the older the patient is, the lower the GAD-2 and PHQ-2 scores are. A multivariable regression model showed that younger (age ≤ 45 years) and being widowed were associated with being positive for further evaluation for generalized anxiety disorder. Similarly, patients younger than 45 are significantly associated with the need for further evaluation for major depressive disorder (MDD). Social status had a stronger association with the need for further assessment for MDD, with divorced women showing the strongest association, followed by widowed and married women compared to single women. CONCLUSION: This study showed high anxiety and depression among breast cancer patients. The patient's age and social status were significant factors in determining the need for further psychological assessment. In General, Younger patients showed higher levels of depression and anxiety, the size of the tumor did not show significant association with psychological distress.