Search

Cancer patient survival has steadily increased following treatment over the last 50 years. However, treatments like radiation or chemotherapy are damaging to human health and result in a wide range of negative side effects. Cranial radiation for example, causes an array of cognitive deficits such as verbal intelligence decline or slower processing speed.1 These types of problems can manifest for years post treatment and cause a range of social, physical and emotional difficulties. Traditional medical survival endpoints ignore these factors. Given this reality, and the increasing number of survivors, it is unsurprising that best practice in oncology has moved towards including the Quality of Life (QoL) monitoring of patients during and post treatment.2 The Qatar Government recognises this and in their Qatar National Cancer Strategy3 advise that ‘the goal of specialised care is achievement of the best quality of life for patients and their families with good symptom management during treatment and at end of life’.Quality of life is defined as an “individuals’ perceptions of their position in life, in the context of the culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns”.4The impact of a cancer diagnosis extends to all those in a patients extended social network. This is especially true for children where cancer procedures produce a great deal of anxiety and distress, as well as pain and physical discomfort. One-third of children who undergo treatment will suffer from moderate or severe side effects.6 and several studies report that the QoL for children under treatment is poor.7,8 Normal psychological functioning can be disrupted and day-to-day living and development perturbed. Reduced motor functioning and autonomy, impaired emotional processing (anxiety, depression) and cognitive problems are common weeks or years after diagnosis. The developmental stages that young people go through make the effects of treatment especially problematic. For example, adolescence is a difficult time and results in a range of psychosocial issues even during normal development (e.g. high suicide rates). Adding a potentially life threating disease to this already complicated developmental stage is potentially of significance. Careful monitoring of the QoL of children, teenagers and young adults (CTYA) therefore, is essential. In doing so it is possible to understand the unique problems young people face with a view to intervention and improved survival.Sixty CTYA constituting 25% of all CTYA oncology patients in Qatar, were given the PedsQL questionnaire (Varni 1998). PedsQL is given to patients and their parents and uses a 5-point Likert scale to ask about physical, emotional, social and school/work functioning. Means and SDs were calculated for each domain as well as psychosocial, physical and overall QoL. In some domains we found one third of patients had poor QoL or were at risk (e.g. 36% were suffering physically). Parents also underestimated their children's emotional well-being. We show how these findings informed the development of a number of interventions and in forming the QoL Clinic at Hamad, the first such dedicated clinic in the Gulf region.

This study aims to investigate the perception of bullying amongst Qataris and Arabic speakers in Qatar by covering several areas (1) to what extent is the term "tanamour" used amongst Arabic speakers to refer to bullying and how far is it promoted; (2) attempts to identify which other words might be used to explain bullying in the country; (3) To what extent are people aware of distinguishing bullying from incidents according to the criteria of imbalance of power, intention, and repetition. Three scenarios were presented orally which contained incidents of bullying or aggression. The first scenario described intentional and repeated direct bullying (a boy continuously having his chocolate stolen at school). The second related a case of intentional and repeated cyberbullying (two boys continuously spread rumours about their classmate). The final scenario was not a case of bullying but rather, a one-off incident where a boy hits their classmate. Participants were asked to describe how they saw these incidents so that the terms used could be recorded (part A). This phase allowed people to describe events in their own words freely without prompting. In the second phase, participants were asked to select from a previously determined list, the most appropriate word they felt described the three scenarios already given and were presented via a laptop. The list contained commonly used terms for bullying behaviours in Arabic. However, if participants felt none of the words adequately described the behaviours, they were encouraged to use their own. Participants were not informed directly that the meetings would be about bullying but rather 'behaviours they may encounter in daily life'. They were also told that there were no 'correct answers' and to just state their opinion as they wished (including saying nothing or ending participation if they wanted). Two researchers were present at every meeting except one where it was appropriate for a female only. All sessions were recorded except one where participants found it inappropriate. Focus groups included 36 participants and took place either in participant's homes or places of work, and took 20-60 minutes long depending on group number and length of discussion. The study took place amongst families, friends and social workers in Qatar where 36% of the sample were Qataris and the rest were from other different Arabic speaking countries such as Egypt, Syria, Yemen, Palestine, Bahrain, Jordan, Somalia and Iraq. Even though this is a preliminary study, the findings indicate that there is some diversity due to the differences in cultures as there is considerable confusion with regards to the terminology used to describe bullying in Arabic. With respect to the aims of the study it has been unequivocally demonstrated that 'tanamor' is not widely used in Qatar and that when it is, it is often misused. There isn't a clear word emerged that has any equivalence to bullying in English. It is clear that there is a tremendous amount of work to be done to qualify both a term and concept behind this damaging behaviour in the Middle-East. Acknowledgements: The authors would like to thank Qatar National Research Fund (QNRF) a member of Qatar Foundation Doha, Qatar, National Priority Research Programs grant (NPRP 5- 1134-3-240) funded to Dr. Muthanna Samara. We also would like to thank the teachers and head teachers in Qatar who were kind enough to provide us with information and advice.