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Wejdan M Al-Johani,1 Nouf A AlShamlan,1 Manar F AlGhamdi,2 Assim M AlAbdulkader,1 Waleed M Aljohani,3 Rehab F AlGhamdi,2 Munir Alrefae,4 Muna Alshehabi,5 Reem S AlOmar,1 Moataza M Abdel Wahab1 1Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 34224, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Supply Chain Department, Security Forces Hospital, Dammam, Saudi Arabia; 4Department of Internal medicine, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 5Palliative Medicine Department, King Fahad Specialist Hospital, Dammam, Saudi ArabiaCorrespondence: Wejdan M Al-Johani, Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, 34224, Saudi Arabia, Tel +966599721175, Email wmaljohani@iau.edu.saPurpose: A cancer diagnosis is an overwhelming process for both patients and doctors. Many studies have addressed doctors’ opinions and knowledge regarding breaking bad news (BBN). However, scarce knowledge exists regarding patients’ perspectives for communicating bad news. Therefore, the current study aims to assess cancer patient preferences and satisfaction about BBN.Patients and Methods: This is a mixed methods study consisting of two phases; an in-depth interview and cross-sectional quantitative analysis. Thematic analysis was used for the qualitative data to explore patients’ satisfaction and preferences about BBN. For quantitative analyses, the overall satisfaction was calculated as satisfaction percent. Bivariate analyses were performed, and statistical significance was set as p < 0.05. Quality function deployment was used to effectively define patient requirements of highest priority.Results: Thematic analysis revealed two main themes. Theme 1; patients’ requirements for BBN and theme 2; patients’ reaction at the time of diagnosis with their categories. For the quantitative part, a total of 222 patients responded to the survey, females made up 70% of the sample. Satisfaction score percent ranged from 25.5 to 100%, with a mean of 82.7± 11.9%. The most preferred items were mainly concerned with the doctor being honest and encouraging, good listener and interacting giving simple smooth explanations without using medical terms, and empathetic (average score 4.8/5). Also, providing the diagnosis in a calm and private environment (4.7/5). Analysis also found that the requirements for improvement included providing a written summary after receiving the diagnosis and patient perception assessed by the doctor before telling the diagnosis.Conclusion: Communicating bad news effectively is crucial in the management of cancer patients. The process of BBN should be patient-centered, focusing on patients’ needs. Thus, the current study has demonstrated the patients’ preferences and the requirements, which should be incorporated into BBN protocols.Keywords: breaking bad news, cancer, patients’ preferences, patients’ satisfaction

Nouf A AlShamlan, Malak A Al Shammari, Reem S AlOmar, Danya Gari, Assim M AlAbdulKader, Sameerah Motabgani, Abdulaziz Farea, Magdy A Darwish Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Nouf A AlShamlanDepartment of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaTel +966504901406Email nashamlan@iau.edu.saBackground: Understanding the distribution of blood groups and blood donation willingness in a population is crucial in managing blood banks and transfusion services. Moreover, awareness of one’s own blood group is essential especially in emergencies that mandate blood donation. This study aimed to determine the distribution of ABO and Rhesus (Rh) blood groups among health students, the students’ knowledge about their blood group, and their willingness to donate blood.Methods: This cross-sectional study included all newly accepted health students in a large university in the Eastern Province of Saudi Arabia (N=1145) during August 2020. The data included a self-administered questionnaire and the serology results of ABO and Rh factors. Chi-squared and Fisher’s exact tests were performed followed by a multivariable binary logistic regression analysis which identified the predictors of willingness of blood donation.Results: Blood group O was the most frequent type among students (51.1%), followed by group A (24.5%) and B (20.4%). The majority (93.3%) of students had Rh-positive factor. When we compared students’ answers with their sample results, most students (75.5%) correctly reported their ABO and Rh blood groups. Male students and those with a previous history of blood donation correctly reported their blood group more than others. Of the total sample, 47.3% were willing to donate blood within the next year. Positive predictors of the willingness of student to donate blood included being male, and those with a history of blood donation. Interestingly, students with a family member in the healthcare field were significantly less likely to donate blood.Conclusion: Blood group O and Rh positive were the most frequent blood groups. Most students had a good knowledge about their blood groups, and about half of students were willing to donate blood. Efforts to encourage the young population to participate in blood donation are crucial.Keywords: ABO blood group, Rh factor, blood donation, Saudi, students

To assess the seroprevalence of Hepatitis B (HBV), Hepatitis C (HCV), and Human Immunodeficiency Virus (HIV) among newly admitted health track students in a large university in the Eastern Province of Saudi Arabia, and determine the students' immunity against HBV, and bloodborne viral infection risk factors or practices among them.Information about the 1145 students, vaccination history, and exposure to bloodborne viral infections risk factors/practices were collected using a structured questionnaire during August 2020. The results of serological data were obtained from students' electronic files.All students tested negative for HBV, HCV, and HIV infections. The seroprevalence of positivity against HBV was 25.8%, and the frequencies of students with protective levels of anti-HBV were inversely related to their age. The majority (70.8%) of students had 1 or 2 identifiable risk factors for bloodborne diseases, and the most frequent risk factor was history of dental intervention. Female students were more than four-times likely to be in the high-risk group for bloodborne infections than males (OR = 4.4; 95% CI: 3.3-5.9). Being from the Central Province of Saudi Arabia (OR = 1.9; 95% CI: 1.2-3.1) and having a mother's educational level of master or doctorate (OR = 3.0; 95% CI: 1.3-6.7) were found to be independent predictors of being in the high-risk group. On the other hand, having a family member in the healthcare field was found as a predictor of being in the low-risk group for bloodborne diseases (OR = 0.7; 95% CI: 0.5-0.9).About three-fourth of students in this study were susceptible to HBV. Our findings stress the need to develop policies to raise awareness regarding bloodborne infectious diseases, in addition to expanding access to HBV vaccination for healthcare staff, especially in older ages.

Nouf A AlShamlan,1 Reem S AlOmar,1 Omar Y Almukhadhib,2 Saad A Algarni,2 Askar K Alshaibani,2 Sara A Elmaki,3 Malak A Al Shammari,1 Abdulaziz M Sebiany1 1Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Radiology at Family and Community Medicine Center, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Nouf A AlShamlanDepartment of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaTel +966504901406Email nashamlan@iau.edu.saBackground: Breast masses are common among females presenting to primary health care (PHC) facilities. The family physician’s role is crucial in detecting breast disease. Utilization of breast ultrasonography has been increasing recently as a diagnostic tool.Objective: This study aims to determine the characteristics of masses detected on breast ultrasound, their associations with characteristics of females attending the PHC setting and explore the management of these cases by family physicians.Methods: This registered based, cross-sectional study included 321 females who were referred for diagnostic breast ultrasound in the PHC center of the University hospital, Eastern province, Saudi Arabia (2017– 2019). t-test, Chi-squared and Fisher’s Exact tests were performed to assess associations between the presence of breast masses in the ultrasound and patients’ characteristics. Moreover, to compare the breast masses in two groups of patients (< 40 years and ≥ 40 years) regarding their characteristics, ultrasound findings, and further management performed. P < 0.05 was considered statistically significant.Results: Approximately 24% patients had a breast mass and 70.92% of cases were detected among females ≥ 40 years old. The odds of having a breast mass were highest among overweight, females complaining from a breast lump, and who had early menarche. Grand multiparous had lower odds of a breast mass. Females < 40 years old had higher rates of breastfeeding, increasing parity, and obesity than older females. Sonographic examined masses were larger in young females, and posterior enhancement of the mass was more reported in older. BI-RADs of the masses were not associated with the patient’s age.Conclusion: Breast masses were prevalent among females who underwent breast ultrasound. The results support referral for investigation when a female complains of a breast lump. Family physicians have a vital role in encouraging protective behaviors from developing breast masses such as maintaining normal weight and breastfeeding.Keywords: breast, mass, ultrasound, primary care, family physician

Background Anxiety disorders are a significant global health concern with destructive morbidity and mortality. Medical school is a stressful environment worldwide. This study measures the prevalence of anxiety symptoms among clinical-year medical students in Saudi Arabia. As well as to explore its association with students' sociodemographic factors, academic performance, issues experienced by them during the study of medicine, and their perceived readiness for their future specialties. Methods The generalized anxiety disorder (GAD-7) tool along with a sociodemographic questionnaire was distributed to 523 clinical-year medical students (fourth, fifth and sixth years) from the Imam Abdulrahman Bin Faisal University, Saudi Arabia, in this cross-sectional study. Data analysis was performed with SPSS version 23 and it included the Chi-Square or Fisher's exact tests for bivariate analysis, and the multivariable logistic regression to account for confounders. Results The prevalence of anxiety symptoms as measured by the GAD-7 was found to be 31.7%. Of these, 14.3% had severe symptoms. Only 4.4% students went to a healthcare professional and were diagnosed with psychiatric problems. Logistic regression analysis revealed that the odds of anxiety was higher among females and students who had perceived psychological problems. However, students' grade point average (GPA) and perceived readiness for their future specialty were not statistically significant with anxiety symptoms. Conclusion Anxiety was highly prevalent among clinical-year medical students included in this study. This urges periodic mental health screening, proper diagnosis of high-risk individuals in medical schools, and early interventions through confidential access to mental health services.

Background There are few data on assessment methods in the field of family medicine in Arab countries. Imam Abdulrahman Bin Faisal University (IAU) in 2017 established the family medicine clerkship rotation for the fifth-year medical students. The objective of the study is to evaluate the multifaceted assessment of family medicine clerkship and their correlation to each other among fifth-year medical students in IAU. Methods We examined the performance of 455 fifth-year medical students from two batches (2018 and 2019) in the continuous course assessment, Objective Structured Clinical Examinations (OSCE), extended matching questions (EMQ), and multiple-choice questions exams (MCQ). Results The students' total mark range was 55.16 to 95.64. Batch 2018 and females had significantly higher marks (p=0.000). On the other hand, no significant associations were seen between the total marks and the semester in which the clerkship was taken or the order of group in each semester (p= 0.464 and 0.980 respectively). Significant positive correlations were seen between all forms of assessment during the family medicine clerkship (p=0.000). Conclusion This study demonstrates that different assessment methods used to evaluate medical students during the family medicine clerkship were correlated. The performances of the female and the first batch were superior. This finding is the basis for introducing a platform for developing modern learning and the improvement of the assessment standards in family medicine clerkship rotation.