Psychiatry Residents' Attitudes towards Spirituality in Psychiatric Practice in Saudi Arabia.

OBJECTIVES: This study examined residents' attitudes and practices regarding the relevance of spirituality in psychiatry within Saudi residency training programs; their experiences and comfort levels in addressing patients' spiritual concerns; and their interest and past learning experiences in this area of training and practice. METHODS: This cross-sectional study targeted trainees and recent graduates of residency programs across Saudi Arabia. The study materials consisted of an electronic questionnaire that was adapted with permission. RESULTS: The total number of respondents was 71 out of 180 potential participants (39.44%). Most residents (64.8%) felt that it was appropriate to inquire about the spiritual aspects of patients' lives and that it was essential to address spiritual problems or needs that patients may have within the clinical setting (71.8%). Many participants (40.80%) described themselves as being both religious and spiritual. Most respondents (94.4%) did not receive any training on spirituality and psychiatry, and 80.3% said they would like to learn more about the subject. CONCLUSIONS: Our findings indicate that residents have an overall high level of personal spirituality and that they feel it is relevant in clinical practice. However, they have not had much training in this area and are interested in learning more. Educational initiatives would be beneficial for improving the effectiveness of residents and patient care in this untapped area of spirituality in psychiatry.

Incidence, risk factors, clinical presentation, and outcomes of hemorrhagic transformation in patients with ischemic stroke admitted to a tertiary hospital in Kingdom of Saudi Arabia.

OBJECTIVE: To describe the incidence rate, clinical presentation, relevant risk factors, and outcome of hemorrhagic transformation (HT) among ischemic stroke patients. METHODS: This retrospective study analyzed HT in patients with ischemic stroke admitted to King Abdullah Medical City from August 2011 to April 2019. Data were analyzed using SPSS. Patients characteristics, procedures, treatments, and outcomes were reported. RESULTS: There were 504 ischemic stroke patients. The HT was detected in 38 patients (8%). The median age was 66.5 (54.3 -77.5) years, and 24 (63%) were males. HT was classified as hemorrhagic infarction (HI) in 22 patients (58%) while 16 patients (42%) were parenchymal hematoma (PH). The most common risk factors noted were: hypertension (74%), diabetes mellitus (DM) (66%), hyperlipidemia (63%) and ischemic heart disease (IHD) (61%). Nine patients (23.6%) developed HT after receiving thrombolytic therapy. Only one patient (3%) died of HT patients. CONCLUSION: HT accounted for (8%) of all ischemic stroke patients. Old age, DM, hypertension, and hyperlipidemia are frequently encountered with stroke patients who developed HT. Follow up CT brain could be of value and could identify HT early to get better outcomes.

Attitudes of cancer patients and their families toward disclosure of cancer diagnosis in Saudi Arabia: a Middle Eastern population example.

OBJECTIVES: Particularly in the Middle East, few studies have explored the attitude of cancer patients and their families toward cancer diagnosis disclosure (CDD). This study was conducted to investigate the preference and attitude of a sample of cancer patients and their families in Saudi Arabia toward CDD. METHODS: We constructed a questionnaire based on previous studies. The questionnaire assessed preference and attitude toward CDD. Participants were recruited from the King Abdullah Medical City, which has one of the largest cancer centers in Saudi Arabia. RESULTS: Three hundred and four cancer patients and 277 of their family members participated in the study. The patient group preferred CDD more than the family group (82.6% vs 75.3%, P<0.05). This preference is especially more evident toward disclosure of detailed cancer information (status, prognosis, and treatment) (83.6% vs 59.9%, P<0.001). In a binary logistic regression, factors associated with preference toward CDD included having information about cancer (odds ratio [OR] 1.8; 95% confidence interval [CI], 1.15-2.84) and being employed (OR, 1.77; 95% CI, 1-2.82) while being from the patient group was the only factor associated with preference toward detailed cancer information (OR, 3.25; 95% CI, 2.11-5.05). In terms of patient reaction after CDD, "fear" was the attitude expected by the family group more than the patient group (56.3% vs 70.4%, P<0.001) while "acceptance" was the attitude anticipated by the patient group more than the family group (38% vs 15.2%, P<0.001). CONCLUSION: Patients preferred CDD and disclosure of related information, while their families were more inclined toward scarce disclosure. Family members seem to experience negative attitudes more than the patients themselves.

Incidence and impact of stroke during Hajj. Results of 2015 Hajj stroke registry.

OBJECTIVE: To investigate the incidence of stroke among pilgrims and describe factors associated with presentation and management during Hajj. Physical stress, age and vascular risk factors render pilgrims at a high risk of stroke. METHODS: This is a prospective registry of all acute stroke patients admitted to 6 hospitals during the 2015 Hajj season from 9 September to 4 November. Participating hospitals were King Abdullah Medical City (KAMC), Al-Noor, King Abdulaziz hospital, King Faisal hospital, Hira, and Mena general hospitals; all in Makkah city. Stroke diagnosis was confirmed by imaging. Clinical, demographic and outcome variables were collected. RESULTS: The incidence of stroke during 2015 Hajj season is 8.9/100,000; 186 cases. The peak incidence was noted on the day after Arafat. Saudis represented 17.2% while 36% were females. Hemorrhagic stroke occurred in 35 patients (18.8%). The mean age was 60.8+/-12.9 years while the most common risk factors were hypertension (57.0%) and diabetes (40.9%). Only 5 patients received intravenous tissue plasminogen activator. The median length of hospital stay was 4 days. Twenty-one patients (11.3%) died during hospitalization. The only factor that approached significance in predicting mortality was hemorrhagic stroke (odds ratio of 1.62; 95% CI: 0.97 to 2.70; p=0.063). CONCLUSION: Stroke is a major health burden during Hajj. Educational programs for pilgrims and healthcare workers together with protocol-driven care are expected to positively impact stroke care.