Breaking bad news issues: a survey among physicians

The aim of this study was to explore the physicians perspectives and practices in relation to breaking bad news [BBN] to patients. A quantitative survey was performed in the Qassim Region from January to July 2011. A cross-sectional study was conducted using a questionnaire administered to all practicing physicians working in both hospitals and Primary Healthcare centers in the Qassim Region Anonymity was maintained throughout. The target groups received a self-administered questionnaire with a covering letter introducing the study and explaining their rights. A total of 458 physicians participated in the study Physicians with higher qualifications had lower total scores of the mean in BBN skills. The majority [70%] preferred to discuss information with close relatives rather than the patients. In case of serious diseases, only 32% said that they would inform the patients family without the patient's consent. More than 90% of our study sample did not avoid telling their patients the bad news; however, physicians working in Primary Healthcare centers were less reserved. Although most of the participating physicians were keen to help their patients, they lacked the essential knowledge and skills for breaking bad news. Thus, they are in need of specific training in this regard

Impact of health education on lifestyles in central Saudi Arabia

To assess the impact of health education on diet, smoking, and physical activity among patients visiting the primary health care centers [PHCCs] in Al-Qassim province, Kingdom of Saudi Arabia [KSA]. We conducted an uncontrolled experimental study from January to October 2009 to evaluate the impact of health education on smoking, diet, and physical activity among attendees of PHCCs in Al-Qassim province, KSA. We trained the PHCC staff in health education skills and introduced health education seminars organized by the medical students. Baseline [n= 1.254] and follow-up [n=l.011] sample surveys were conducted to measure the prevalence of risk factors in target population before and after intervention. We used logistic regression analysis to control for the effects of possible confounding variables. After the intervention, consumption of kabsa, bakery items, and dates decreased, and that of fish and fresh vegetables increased [p<0.001]. Compared to the baseline, male respondents in the follow-up survey were less likely to smoke and more likely to do regular exercise. These improvements persisted after controlling for gender, age, marital status, education, and presence, or family history of hypertension and/or diabetes. We conclude that enhancing the quality and scope of health education to patients visiting the PHCCs would improve the awareness and practice of healthy behaviors

Lifestyle related risk factors of type 2 diabetes mellitus in Saudi Arabia

To assess the impact of diet and physical activity on the risk of type 2 diabetes mellitus [T2DM] in the Kingdom of Saudi Arabia [KSA] after adjusting for family history of diabetes. We conducted a case-control study in Al Qassim, KSA to test the hypothesis that dietary practices and physical activity modify the risk of type 2 diabetes regardless of family history. Male and female Saudi citizens 30-70 years of age were eligible to participate. The sample included 283 cases [T2DM patients] and 215 non-diabetic controls randomly selected from patients visiting the primary health care centers from September to November 2009. We collected information on demographic variables, family history, dietary habits, and physical activity. Using logistic regression, we estimated adjusted odds ratios [AOR] for dietary habits and physical activity after controlling for the effects of gender, age, education, and family history of diabetes. There is strong association between diabetes and maternal history of diabetes, education, lack of exercise, and dietary habits. The AOR for regular eating of Kabsa was 5.5 [95% confidence limits [CL]: 2.3-13.5]; for vegetables an AOR of 0.4 [95% CL: 0.2-0.7]; for dates an AOR of 1.8 [95% CL: 1.0-3.3] ;and the AOR for sedentary lifestyle was 2.5 [95% CL: 1.2-5.0]. Healthy diet and active lifestyle may significantly decrease the risk of T2DM in spite of having a family history of diabetes. Effective health education programs promoting healthy diet and regular exercise are needed to reduce the burden of diabetes in Saudi Arabia