Search

Breast cancer (BC) is a major health concern in Lebanon, with an increasing incidence rate due to advancements in treatment modalities. Evaluating the impact of the BC and its treatment on a woman's Health-Related Quality of Life (HRQoL), and comparing these patterns before and after breast conserving surgery is important to identify areas where interventions may be needed to improve the overall well-being of women with BC. This study aimed to evaluate the HRQoL pre and post-operative breast conserving surgery and just prior to initiation of adjuvant therapy in newly diagnosed patients with BC in Lebanon, specifically focusing on changes in body image. A prospective cohort study was conducted on 120 patients in two health care facilities in Lebanon, collecting sociodemographic and clinical data, and using the EORTC QLQ-C30 and QLQ-BR23 questionnaires to evaluate HRQoL. The outcomes were measured at baseline and then one-day post-operative breast surgery. Results revealed a statistically and clinically significant decrease in body image (mean difference of 8.1 points (95% 4.3;11.1)), physical functioning (mean difference of 6.1 points (95% 3.3;8.5)), and emotional functioning (mean difference of -8.4 points (95%-12.4; -4.9) after surgery. Positive change of physical functioning score was observed among married women. Positive change of emotional functioning score was observed among patients with poor body image score and high future perspective score. Our findings provide valuable insights for clinicians and researchers on the impact of breast conserving surgery on HRQoL in Lebanese women.

The potential effects of breast cancer (BC) on health-related quality of life (HRQoL) should be considered in clinical and policy decision-making, as the economic burden of BC management is currently assessed. In the last decades, time-to-HRQoL score deterioration (TTD) has been proposed as an approach to the analysis of longitudinal HRQoL in oncology. The main objectives of the current study were to investigate the evolution of the utility values in BC patients after diagnosis and during follow-ups and to evaluate the TTD in utility values among women in all stages of BC.Health-state utility values (HSUV) were assessed using the EuroQol 5-Dimension 3-Level at diagnosis, at the end of the first hospitalization and 3 and 6 months after the first hospitalization. For a given baseline score, HSUV was considered to have deteriorated if this score decreased by ≥ 0.08 points of the EQ-5D utility index score and ≥ 7 points of the EQ visual analogue scale. TTD curves were calculated using the Kaplan-Meier estimation method.Overall 381 patients were enrolled between February 2006 and February 2008. The highest proportions of respondents at the baseline and all follow-ups reporting some and extreme problems were in pain discomfort and anxiety/depression dimensions; more than 80% of patients experienced a deterioration in EQ-5D utility index score and EQ VAS score with a median TTD of 3.15 months and 6.24 Months, respectively.BC patients undergoing therapy need psychological support to cope with their discomfort, pain, depression, anxiety, and fear during the process of diagnosis and treatment to improve their QoL.

Background The use of music interventions as a non-pharmacological therapy to improve cognitive and behavioral symptoms in Alzheimer’s disease (AD) patients has gained popularity in recent years, but the evidence for their effectiveness remains inconsistent. Objectives To summarize the evidence of the effect of music therapy (alone or in combination with pharmacological therapies) on cognitive functions in AD patients compared to those without the intervention. Methods A systematic literature search was performed in PubMed, Cochrane library, and HINARI for papers published from 1 January 2012 to 25 June 2022. All randomized controlled trials that compared music therapy with standard care or other non-musical intervention and evaluation of cognitive functions are included. Cognitive outcomes included: global cognition, memory, language, speed of information processing, verbal fluency, and attention. Quality assessment and narrative synthesis of the studies were performed. Results A total of 8 studies out of 144 met the inclusion criteria (689 participants, mean age range 60.47–87.1). Of the total studies, 4 were conducted in Europe (2 in France, 2 in Spain), 3 in Asia (2 in China, 1 in Japan), and 1 in the USA. Quality assessment of the retrieved studies revealed that 6 out of 8 studies were of high quality. The results showed that compared to different control groups, there is an improvement in cognitive functions after music therapy application. A greater effect was shown when patients are involved in the music making when using active music intervention (AMI). Conclusion The results of this review highlight the potential benefits of music therapy as a complementary treatment option for individuals with AD and the importance of continued investigation in this field. More research is needed to fully understand the effects of music therapy, to determine the optimal intervention strategy, and to assess the long-term effects of music therapy on cognitive functions.

Background The Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) evaluates perceived cognitive functioning and their impact on quality of life. This study was designed to evaluate the factors associated with cognitive functioning in a sample of women with breast cancer (BC) in Lebanon. We also sought to explore the psychometric properties of the FACT-Cog Arabic version. Methods A cross-sectional study was carried out between March and August 2020 among women with BC. Socio-demographic and clinical characteristics were collected. In addition, patients were asked to complete the FACT-Cog Arabic version as well as the European Organization for Research and Treatment of Cancer Quality of Life Core Questionnaire 30, the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder (GAD-7). The internal consistency of the FACT-Cog tool was evaluated using Cronbach’s alpha. Content, convergent, and known group validity of the FACT-Cog Arabic version were also evaluated. All statistical analyses were performed using SPSS version 23.0. Results A sample of 134 women with BC was collected. Internal consistencies of the FACT-cog total scale and its subscales were high (Cronbach’s α between 0.83 and 0.95). The convergent validity of the FACT-Cog Arabic version was supported by the positive correlation with the EORTC-cognitive functioning subscale. Moreover, negative correlations were found between FACT-Cog scale and fatigue, pain, anxiety, as well as depression. Known-group validity was supported by the statistically significant mean differences of the FACT-Cog total scale between patients in early (I &II) and late (III & IV) BC stages. Unmarried BC patients as well as those having higher depressive symptoms and a lower quality of life were found to be at higher risk of cognitive impairment. Conclusion The FACT-Cog Lebanese Arabic version is a valid and reliable tool for assessing perceived cognitive functioning in BC women. Higher level of depression and impaired quality of life were associated with a decline in cognitive functioning.

Background Community pharmacists (CPs) are one of the frontline healthcare workers (HCWs) working diligently to provide much-needed services during the COVID-19 pandemic. Burnout was one of the detrimental outcomes of the pandemic on the mental health of Lebanese CPs. To assess the extent of this syndrome among Lebanese CPs, a psychometrically reliable and valid tool is needed. Objectives This study aimed to validate the Arabic version of the Copenhagen Burnout Inventory (CBI-A) for use in the assessment of burnout among CPs. Methods A web-based cross-sectional study was conducted among Lebanese CPs over February 2021. Data were collected using an anonymous Arabic self-administered questionnaire that includes information on socio-demographic characteristics, work-related variables, in addition to the measurements: the CBI which includes personal, work-related, and patient-related dimensions of burnout, and the hospital anxiety and depression scale. Data were analyzed using SPSS and Amos software. Exploratory factor analysis and confirmatory factor analysis were performed to explore the factorial structure and to measure model fit. Cronbach’s alpha was used to assess internal consistency. The criterion validity of the CBI was assessed. Multivariable linear regression analyses were used to explore the association between different aspects of burnout and mental health outcomes such as depression and anxiety. Results The CBI-A showed high internal consistency with Cronbach’s alphas varied from 0.774 to 0.902 and a low floor and ceiling effect (1–9%). As for the CBI-A construct validity, the exploratory factor analysis showed three factors with good factor loadings and explained 72.17% of the variance. The confirmatory analysis supported the three-factorial structure of the CBI that presented a good overall fit based on the goodness-of-fit indices. Ad hoc modifications to the model were introduced based on the modification indices to achieve a satisfactory fit by allowing one covariate error between one pair of items within the personal burnout domain. All of the 19 items were kept in the construct since they showed a good factorial weight. The CBI-A is associated with burnout-related factors in expected directions, including extensive working hours, sleeping hours, and job satisfaction, indicating, therefore, the criterion validity of the tool. CBI subscales were also found positively associated with mental health outcomes such as depression and anxiety demonstrating, in turn, a predictive validity. Conclusion This study provides evidence for the validity and reliability of the Arabic version of CBI as an adequate tool for assessing burnout among CPs. Such an instrument could be useful for assessing such syndrome among other healthcare workers.

Background Health-care workers (HCWs) are at a higher occupational risk of contracting and transmitting influenza. Annual vaccination is an essential tool to prevent seasonal influenza infection. However, HCWs vaccine hesitancy remains a leading global health threat. This study aims to evaluate the flu vaccination coverage rates among Lebanese HCWs and to assess their knowledge, attitudes, practices, perceived barriers, and benefits toward the flu vaccine during the COVID-19 pandemic. In addition, we sought to identify the factors associated with flu vaccine uptake. Methods A cross-sectional study using an online survey was conducted in Lebanon among HCWs between 14 and 28 October 2020. Multivariable logistic regression was carried out to identify the factors associated with influenza vaccine uptake. Results A total of 560 HCWs participated in the survey of whom 72.9% were females, and 53.9% were aged between 30-49 years. Regarding Flu vaccination uptake, the rate has risen from 32.1% in 2019-2020 to 80.2% in 2020-2021 flu season. The majority of HCWs had a good knowledge level and a positive attitude toward flu vaccination. Regarding their practices, less than 50% of HCW were currently promoting the importance of getting the flu vaccine. The majority (83.3%) ranked the availability of a sufficient quantity of vaccines as the most significant barrier to flu vaccination. The main perceived flu vaccination benefits were enhancing patient safety, minimizing the viral reservoir in the population, decreasing hospital admission, and avoiding influenza and COVID-19 co-infection. The odds of influenza vaccine uptake was lower in unmarried compared to married HCWs (OR = 0.527, CI (0.284-0.978). However, HCWs having received the influenza vaccine in the previous season (OR = 6.812, CI (3.045-15.239)), those with good knowledge level (OR = 3.305, CI (1.155-9.457)), low perceived barriers (OR = 4.130, CI (1.827-9.334)) and high perceived level of the benefits (OR = 6.264, CI (2.919-13.442)) of the flu vaccination were found more prone to get the flu vaccine. Conclusion Flu vaccination uptake has increased among HCWs during the 2020-2021 flu season compared with the previous one. Continuing education as well as ensuring free, equitable, and convenient access to vaccination are still required to increase the annual flu vaccination uptake among HCWs.

Background: The increasing occupational challenges inflicted on community pharmacists (CPs) in the wake of COVID-19 lays this valuable human resource at increased risk of burnout.Objectives: This study aimed to assess the prevalence of burnout among Lebanese CPs in the era of COVID-19 and to identify its associated factors.Methods: A web-based cross-sectional study was conducted among Lebanese CPs between the 1st of February and the end of March 2021 using a snowball sampling technique. Data was collected using an anonymous Arabic self-administered questionnaire that includes information on socio-demographic characteristics, exposure and work-related variables, and two scales: the Copenhagen burnout inventory (CBI) which includes personal, work-related, and patient-related dimensions of burnout, and the COVID-19 threat perception scale. To evaluate the prevalence of burnout, CBI scale cut-off score of 50 was used. Bivariate and multivariable logistic regression analyses were used to identify the factors associated with burnout among CPs.Results: Burnout was detected among 81.9% of surveyed CPs, where 61% had a moderate burnout and 20.9% had a high level of burnout. Client burnout (CB) ranked first among other burnout aspects (89.7%) followed by personal burnout (77.8%) and work-related burnout (76.8%). Younger age, female gender, being staff pharmacist, working in pharmacy operating around the clock and working more than 40 hours per week were associated with higher level of burnout. Similarly, suffering from comorbidity, having a dependent child or living a family member with comorbidities, experiencing sleep disturbance and high perception of COVID-19 threat were also associated with higher burnout. However, being married, having large professional experience, having high socioeconomic situation, accepting the risk of dealing with COVID-19 cases and having previous history of COVID-19 were negatively associated to burnout.Conclusion: Burnout hits 81.9% of the Lebanese CPs. This alarming prevalence called health authorities to take prompt and warranted measures based on the factors associated with this syndrome unearthed in this study, to prevent burnout and mitigate among CPs in order to support resiliency in the profession.

Background Utilizing community pharmacists (CPs) as immunizers has being adopted in various countries as approach to boost influenza vaccination coverage. Our study aims to explore the Lebanese CPs’ willingness to administer influenza vaccine, and to identify factors associated with this willingness. Methods This is a web-based, cross-sectional study, conducted over 2 months, from the 1st of November to the end of December 2020. Self-reported data were collected electronically from Lebanese CPs through an anonymous, questionnaire using google form. The collected data were analyzed using the statistical software SPSS (Statistical Package for Social Sciences). Bivariate and multivariable analyses were performed to examine factors associated with the willingness of CPs to administer influenza vaccine. Results A total of 412 CPs participated in this survey of which 76.9% are willing to administer influenza vaccines. More than 90% of them had a good overall knowledge score and 88.8% of CPs showed a positive overall attitude score, particularly towards involvement of CPs in influenza vaccine provision. Their willingness to administer vaccine was positively associated with the younger age (aOR = 3.12 with 95% CI (1.597–4.040)), higher education level (aOR = 2.02 with 95% CI (1.093–3.741)), previous experience in immunization (aOR = 2.72 with 95% CI (1.320–5.627)) and urbanicity of pharmacy (aOR = 1.542 with 95% CI (1.219–4.627)). Extensive working hours (aOR = 2.34 with 95% CI (1.131–4.845)), working in pharmacies that are operating round-the-clock, showing positive attitude towards immunization (aOR = 3.01 with 95% CI (1.872–6.422)) and towards provision of influenza vaccines (aOR = 13.72 with 95% CI (13.721–38.507)) were also positively associated to this willingness. Conversely, patient privacy (aOR = 0.55 with 95% CI (0.079–0.983)), time and cost for professional development (aOR = 0.55 with 95% CI (0.172–0.918)), limited patient’s trust (aOR = 0.39 with 95% CI (0.203–0.784)), financial remuneration (aOR = 0.18 with 95% CI (0.088–0.377)), and requirement of formal certification in vaccine administration (aOR = 0.07 with 95% CI (0.020–0.279)) were negatively associated to this willingness. Conclusion Addressing the unearthed concerns related to utilizing CPs as influenza immunizers through a concerted effort is a key to success in any future implementation of vaccination services in pharmacies.