Prevalence and Risk Factors of Burnout Among Female Oncologists From the Middle East and North Africa.

Background: Burnout (BO) is a recognized challenge among the oncology workforce. It affects both genders with a higher frequency among women. This study examined the factors contributing to the development of burnout among female oncologists from the Middle East and North Africa (MENA). Methods: An online cross-sectional survey was distributed to oncology professionals from different countries in the MENA region. The validated Maslach Burnout Inventory (MBI) of emotional exhaustion (EE), Depersonalization (DE), and Personal Achievement (PA) plus questions about demography/work-related factors and attitudes toward oncology were included. Data were analyzed to measure BO prevalence and related factors. Results: Between 10 February and 15 March 2020, 545 responses were submitted by female oncologists. The responses pre-dated the COVID-19 pandemic emergence in the region. BO prevalence was 71% among female professionals. Women aged <44 years represented 85% of the cohort. Sixty-two percent were married, 52% with children and one-third practiced a hobby. Two-thirds worked in medical oncology, worked for <10 years and 35% worked in academia. The majority (73%) spent >25% on administrative work daily. Nearly half of the respondents (49%) expressed a recurring thought of quitting oncology and 70% had no burnout support or education. Inability to deliver optimal care was reported as distressing for career development in 82%. Factors significantly influencing the BO risk were identified. Marital status, having children, academia and years in practice did not impact the risk of BO among female oncologists from MENA. Conclusion: Female oncologists from the Middle East and North Africa (MENA) were found to have a high prevalence of BO. In this cohort, the majority of women oncology workers were young and in their early to mid-career stages. Burnout was linked to being younger, practicing in North African nations, having a heavy administrative load, and having persistent thoughts of quitting. Practicing a hobby and engaging in oncology communication, on the other hand, reduced the chance of BO. Burnout support and education, specifically for oncology women, is required.

Predictors of poor precautionary practices towards COVID-19 among cancer patients.

Objective: Our study goal was to evaluate the behavioral response and practices of cancer patients to the coronavirus disease 2019 (COVID-19) pandemic in the Middle East and north Africa. Methods: A cross-sectional study was conducted using a validated anonymous 45-question survey administered via SurveyMonkey® to cancer patients in 13 centers in Algeria, Egypt, Jordan, Kuwait, Morocco and Saudi Arabia. Results: During the study period (from 21 April to 30 May 2020), 3642 patients participated in the study. The majority of patients (84.81%) were worried about contracting the infection. The reported strict adherence to precautions included avoiding the following actions: hand-shaking (77.40%), hugging and kissing (82.89%), social gathering (90.09%), meeting friends (84.68%) and visiting markets (75.65%). In a multivariate analysis, patients with poor precautionary practices were about twice as likely to cancel their medical appointment or a treatment session. Conclusion: Improving cancer patients' knowledge of and adherence to precautionary measures is needed not just to reduce the risk of acquiring infection but also to minimize the interruption of their medical care.

Lay abstract COVID-19 poses a higher risk for patients with cancer than other patients; therefore, it is prudent that they adhere to precautionary measures to protect themselves from the infection. We conducted a study to evaluate the behaviors and practices of these patients in response to the COVID-19 pandemic in the Middle, East and North Africa. We developed a survey of 45 questions that was distributed in 13 centers in Algeria, Egypt, Jordan, Kuwait, Morocco and Saudi Arabia between 21 April and 30 May 2020. About 85% of the 3642 patients who participated in the study were worried about contracting the infection. A substantial percentage of them (10­30%) were not adhering to various precautions and social distancing rules. On the other hand, 16% of them canceled medical appointments and 12% canceled treatment sessions. Our study showed the need for better adherence of patients with cancer to the infection precautions and most importantly, the need to have a better compliance with their treatment plans, such as keeping their scheduled appointments, to avoid harms from treatment delays.

Implementation of breast cancer continuum of care in low- and middle-income countries during the COVID-19 pandemic.

Breast cancer is the most common malignancy among women worldwide. The current COVID-19 pandemic represents an unprecedented challenge leading to care disruption, which is more severe in low- and middle-income countries (LMIC) due to existing economic obstacles. This review presents the global perspective and preparedness plans for breast cancer continuum of care amid the COVID-19 outbreak and discusses challenges faced by LMIC in implementing these strategies. Prioritization and triage of breast cancer patients in a multidisciplinary team setting are of paramount importance. Deescalation of systemic and radiation therapy can be utilized safely in selected clinical scenarios. The presence of a framework and resource-adapted recommendations exploiting available evidence-based data with judicious personalized use of current resources is essential for breast cancer care in LMIC during the COVID-19 pandemic.