Arabic Patients Research Articles

Arabic translation and cross‐cultural adaptation of the Bristol Activities of Daily Living Scale (BADLS)

AbstractIntroductionThe prevalence of dementia is expected to increase exponentially in developing countries over the next few decades.1, 2 Arabic language is widely spoken across the middle east and north Africa, where dementia diagnosis remains challenging.3 Many factors contribute to the underdiagnosis of dementia in Arabic speaking countries including the lack of validated functional assessment tools for patients with cognitive impairment.2, 4 The aim of this study is to translate, cross culturally adapt and validate the widely used Bristol Activity Of Daily Living Scale (BADLS)5 to the Arabic language.MethodsFirst the BADLS was translated to the Arabic language by two independent bilingual experts. The Arabic version was then back translated to English by two independent translators. Then reviewed by expert panel including the original author to keep original meanings, check accuracy and standardization. A pilot study was done for Cognitive Debriefing. Expert panel discussion was done to review cognitive debriefing and finalize. Criterion validity is tested against the validated Arabic version of the Katz Index of Independence in Activities of Daily Living and the Arabic version of the Montreal Cognitive Assessment (MOCA) test.ConclusionTo our knowledge this is the first study to translate the BADLS to the Arabic language. The Arabic BADLS will enable the early and accurate diagnosis of dementia for Arabic speaking patients and caregivers.

Creation and validation of the harmonized Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP)

ABSTRACT Objectives Tocreate and validate a translated Arabic version of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP), a validated patient-reported outcome (PRO) widely used for assessing the quality of life in patients with prostate cancer (PCa). Patients and Methods Using the established protocol as defined by the Professional Society for the Health Economics and Outcomes Research (ISPOR) for translating patient care questionnaires, a harmonised translated Arabic version of EPIC-CP was created. The questionnaire was tested in native Arabic speakers from four different Arabic countries (Saudi Arabia, United Arab Emirates, Jordan, and Kuwait). Cronbach’s alpha and interclass coefficient correlation (ICC) analyses were used to test the internal consistency and test–retest reliability, respectively. In addition, PCa characteristics were collected for participants. Results In total, 168 patients with PCa participated in the study (39 from Saudi Arabia, 23 from United Arab Emirates, 65 from Jordan, and 41 from Kuwait). In all, 52 (31%) participants repeated the questionnaire for test–retest reliability analysis. The median (interquartile range [IQR]) age of patients included in the study was 66 (61–71) years. The median (IQR) PSA level was 9.8 (6–19) ng/mL. Most patients had Grade Group 2 PCa at diagnosis (31%), clinical stage cT1 (42%), managed primarily by urology (79%), and the primary treatment was radical prostatectomy (71%). The total Cronbach’s alpha coefficient was 0.84 demonstrating an acceptable internal consistency. The total ICC was also acceptable at 0.64. Conclusion The Arabic version of the EPIC-CP is a reliable and valid tool for assessing health-related quality of life for Arabic patients with PCa.

Cross cultural adaptation, validity, and reliability of Central Sensitization Inventory in Arabic language

Purpose The Central Sensitization Inventory (CSI) is a tool that aid in identifying symptoms associated with nociplastic pain. The aim of this study is to adapt CSI to Arabic language, and to examine its psychometric properties. Methods Adaptation process followed recommended guidelines. Participants with self-reported chronic pain completed a web-based survey. The internal consistency was calculated. Test–retest reliability was examined by allowing 7–9 day gap between two rounds of measurements. Convergent validity was examined by measuring the correlation with Pain Catastrophizing Scale (PCS), EQ-VAS, and EQ-5D-3L. Discriminant validity was examined by testing four priori hypotheses. Factor analysis with principal components extraction was conducted. Results CSI-Arabic (CSI-Ar) was successfully produced. Its internal consistency and test–retest reliability were excellent (Cronbach's α = 0.88 and ICC2,1=0.94). The standard error of measurement and minimal detectable change 95% were 3.45 and 9.57, respectively. CSI total score correlation with PCS, EQ-5D-3L, and EQ-VAS was moderate. The results lend support to the four hypothesis related to discriminant validity. Factor analysis revealed a four-factor structure of CSI-Ar. Conclusions CSI-Ar showed an internal consistency, test–retest reliability, and validity that are comparable to similar studies. The results support the use of CSI-Ar in assessing chronic pain in Arabic-speaking population. Implications for rehabilitation Central sensitization (CS) mechanisms are thought to contribute to chronic pain. Identifying the presence of CS would personalize management. The Central Sensitization Inventory (CSI) is a valid and reliable tool to aid in identifying symptoms associated with CS. The Arabic version of the CSI is valid and reliable to use in Arabic speaking patients suffering from chronic pain.

Psychometric properties of the Arabic version of the hospital anxiety and depression scale in hemodialysis patients

ABSTRACT The literature lacks a rigorous psychometric evaluation of the Arabic version of Hospital Anxiety and Depression Scale (HADS) in hemodialysis (HD) patients. This study aims to evaluate reliability, determine the underlying factor structure of the Arabic version of HADS and assess its suitability as screening tool for depression and anxiety among Arabic HD patients. A sample of 370 HD patients were recruited from all health districts in Kuwait. Reliability for HADS (all items) and its subscales HADS-A (anxiety) and HADS-D (depression) were estimated using Cronbach’s alpha and item analysis was conducted. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were conducted to extract and test the factor structure for the Arabic version of HADS. Eight models were tested using CFA to determine goodness-of-fit. The Cronbach α for the Arabic HADS (all items), HADS-A and HADS-D were 0.884, 0.852 and 0.764, respectively. Pearson correlation coefficient between HADS-A and HADS-D subscales indicated significant correlation (r = +0.69, PV < 0.001). EFA indicated two factors with eigenvalues >1, which accounted for 48.5% of the total variance. CFA revealed the one-factor model had the poorest fit, the two-factor models with acceptable fit, and three-factor models showed good fit. The Arabic HADS has good reliability and internal consistency, which warrants its use in screening for anxiety and depression among Arabic HD patients. Furthermore, the three-factor structure has shown a better fit which warrants further exploration in HD patients with the advancement in theory of psychological models for anxiety and depression.

Psychometric properties of the Arabic version of the anxiety inventory for respiratory disease in patients with COPD

Purpose The Anxiety Inventory for Respiratory Disease (AIR) is a reliable and valid scale for examining the anxiety in patients with COPD. This study aimed to cross-culturally adapt and translate the original AIR scale into the Arabic language and to examine its reliability and validity in Arab patients with COPD. Material and Methods This was a validation study conducted on 70 Arabic patients with COPD. The AIR-A and the Hospital Anxiety and Depression Scale (HADS) were completed on the first assessment. After two weeks, 55 patients completed the AIR-A scale again. The reliability was assessed by Cronbach’s α and intraclass correlation coefficients (ICC2,1). Exploratory factor analysis (EFA), and the confirmatory factor analysis (CFA) were used to measure the structural validity. The construct validity was also explored. Results The AIR-A questionnaire had a Cronbach’s α of 0.91 and ICC2,1 of 0.86. The EFA revealed that the AIR-A was unidimensional. The CFA showed the single-factor model required minor modifications to reach the best fit. The AIR-A was correlated with the HADS- anxiety (r = 0.89, p < 0.001). Conclusion The Arabic version of AIR scale is reliable, and valid for assessing the anxiety disorder in Arabic speaking patients with COPD worldwide. Implications for Practice The Arabic version of AIR will be useful for examining anxiety in Arabic speaking patients with COPD worldwide. The Arabic version of AIR will help clinicians to monitor the effect of interventions in Arabic speaking patients with COPD who suffer from anxiety. The Arabic version of AIR assess only the anxiety.

Schizophrenia decreases guilt and increases self-disgust: Potential role of altered executive function

Our knowledge of how the more complex self-conscious emotions (SCEs) are affected in schizophrenia is sparse. SCEs, unlike basic emotions, involve sophisticated frontal-lobe-related cognition, impairment of which characterizes the neurocognitive profile of schizophrenia. We investigated, in a cross-sectional study, whether SCEs (shame, guilt and self-disgust) are affected in schizophrenia, and the relationship between changes in SCEs and executive (dys)function. Twenty-nine Greek and thirty Arabic patients with schizophrenia were recruited alongside twenty-two Greek and thirty Arabic matched controls. Participants were administered the Self-Disgust Scale (TOSCA for shame and guilt was also administered to the Greek sample), and the Trail Making and Verbal Fluency Tests to measure executive function (EF). Trait levels of self-disgust and guilt were found to be higher and lower, respectively, in patients with schizophrenia relative to control participants; and poorer EF was related with higher trait levels of SD, but lower trait levels of guilt. The pattern of findings was largely unaffected when controlling for anxiety and depression. Given that altered levels of SCEs are closely related to poorer EF, we suggest that the link between EF and emotion regulation, widely established in basic emotions but under-studied in SCEs, may explain the current findings.

Psychometric evaluation of the Arabic version of the Quebec user evaluation of satisfaction with assistive technology (A-QUEST 2.0) in prosthesis users.

The evaluation of patient satisfaction and perceptions plays a vital role in determining the quality of prosthesis users' devices and the competency of healthcare services. To evaluate the psychometric properties of the Arabic Quebec User Evaluation of Satisfaction with Assistive Technology (A-QUEST 2.0) with prosthetics users. A methodological study. Saudi Arabia, Turkey. A convenience sample of outpatient prosthesis users (N.=183). The A-QUEST 2.0 includes two subscales respectively evaluating the user's satisfaction with the device and the services provided. The data for each subscale were investigated using Rasch analysis to evaluate the item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF). Both subscales met the Rasch criteria for the functioning of rating scale categories. All items showed an acceptable fit to the Rasch model. The person separation indices for the Device and Services subscales were 2.21 (Cronbach's α=0.90) and 1.72 (Cronbach's α=0.85), respectively. Therefore, the two subscales are sensitive enough to distinguish between at least three different levels of satisfaction. The unidimensionality of each subscale was confirmed, and none of the items displayed differential item functioning across age, gender, location of amputation, country, and duration of use. Overall, the findings indicate the psychometric evaluation of A-QUEST 2.0 is effective with prosthesis users across different clinical contexts and cultures. Thus, the A-QUEST 2.0 allows for a comprehensive understanding of users' perceptions of prosthesis characteristics, particularly among subjects with lower limb amputations caused by traumatic injuries. Our paper provides clinicians dealing with Arabic patients a validated outcome measure for satisfaction with prosthesis. Besides providing information in the development of new products and service delivery. Further studies are necessary to improve the measure's metric quality in different contexts and for different prosthesis devices.

Repeatability and reliability of the diabetic foot self-care questionnaire in Arabic patients: A transcultural adaptation

PurposeThe diabetic foot self-care questionnaire is considered a self-care evaluation tool with 16 questions for assessing diabetic foot health disorders. To date, the DFSQ has been validated in different languages, but an Arabic version was lacking. Consequently, the purpose of this study was to translate and validate the Arabic version of the DFSQ (DFSQ-AR). MethodA suitable method was developed for the translation protocol and cross-cultural validation from Spanish to Arabic. Regarding the total marks from each sub-scale, agreement degrees and confidence were analyzed using Cronbach's α and intraclass correlation coefficient (ICC), respectively. In addition, the mean ± standard deviation differences between pre and post-tests were calculated and completed using Bland-Altman distribution plots. ResultsExcellent agreement between the two versions was demonstrated based on Cronbach's α. Three sub-scales consisting of knowledge of foot hygiene, the appropriate use of footwear and socks, and podiatric self-care were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for the self-care and shoe and socks sub-scales. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (P = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75–102.43] and 97.96 ± 13.88 [94.5–101.86] points, respectively). Bland-Altman plots or clinically pertinent variations were not statistically significantly different. ConclusionsThe DFSQ-AR is considered a strong and valid questionnaire with adequate repeatability in the Arabic language population.

Validity and reliability of the Arabic version of the Back Pain Function Scale in patients with low back pain

Background: Patient-reported questionnaires offer valuable tools that can be used in clinics and research to determine the effectiveness of treatment. The aim of this research was the translation, cross-cultural adaptation and validation of the Back Pain Functional Scale (BPFS) into Arabic. Methods: According to standardized guidelines, the translation and adaptation of the scale was completed. Two panels of experts were asked to review the instrument for consistency and to evaluate all the elements of the scale for content relevance. A convenient sample of 65 patients complained of LBP, completed BPFS and recompleted it to test-retest reliability after 2 days.Results: The Arabic adapted version of the BPFS was produced and validated. The scale index of clarity was 99%. Index of Content Validity (ICV) = 98.3%. The Cronbach’α coefficient for internal consistency was 0.865. The Total score of Spearman’s correlation coefficients is 0.878. Conclusion: The BPFS presented excellent reliability and validity for assessing the functional status in Arabic speaking patients with LBP.

Arabic Translation and Validation of the Acceptance of Illness Scale and Person-Centered Dermatology Self-care Index.

To translate the Acceptance of Illness Scale (AIS) and Person-Centered Dermatology Self-care Index (PeDeSI) from English to Arabic and validate their use among Arabic-speaking patients with psoriasis. Forward-backward translation was used to translate AIS and PeDeSI from English to Arabic language. Validation of the developed Arabic versions was performed using a cross-sectional study design. Arabic-speaking psoriatic patients were asked to complete the Arabic AIS and PeDeSI tools. Patients were also asked to complete the Dermatology Life Quality Index (DLQI), which was used as a reference to study external validity. The correlation between questionnaires was tested using Spearman rank correlation test. Factor analysis was used to study the dimensionality of the various tools. Cronbach α coefficient was used to evaluate internal consistency of Arabic versions of AIS and PeDeSI. Floor or ceiling effects were detected if more than 15% of patients achieved the lowest or the highest possible scores, respectively. A total of 116 Arabic patients with psoriasis submitted the questionnaires. Both translated questionnaires were unidimensional. The internal consistencies of the AIS and PeDeSI were excellent (α coefficient = .90) and good (α coefficient = .87), respectively. There was a significant negative moderate correlation between the AIS and DLQI (ρ = -0.44), whereas the PeDeSI and DLQI were significantly weakly correlated (ρ = -0.23). No floor or ceiling effects were detected. The results suggest that the Arabic versions of the AIS and PeDeSI questionnaires fulfilled the criteria for validation and may be used in research and routine clinical practice with Arabic speakers.

Experiences with tailoring treatment modules in online versus face-to-face CBT

Guided self-help interventions are effective in treating symptoms of various mental disorders, including depressive, anxiety, and posttraumatic stress disorders. Research also suggests that these interventions may be effective for refugee populations. However, proportion of drop-out and non-response are substantial, especially in this highly vulnerable group of patients. Tailoring treatments to the individual patient may be an important step towards improving patient-treatment fit and may help to increase success rates. While tailoring can be easily realized in face-to-face treatments, it becomes more complex in Internet-based treatments where treatment sequences are usually defined in advance. In this talk, we will present our theoretical considerations and decisions regarding the tailoring process in a randomized-controlled comparison of transdiagnostic CBT for refugee patients in an online versus face-to-face format. The trial will include N=320 Arabic speaking patients suffering from an emotional disorder. The transdiagnostic treatment includes modules for symptoms of depression, anxiety, substance abuse, post-traumatic stress, aggression, and suicidal ideation. Modules are tailored to the specific patient. We will discuss who or what should inform the tailoring decision (patient, therapist, questionnaire data, diagnostic interview) and when tailoring decisions should be made (prior and/or early and/or later in treatment). We will present options of how tailoring decisions can be standardized and be kept comparable in different treatment formats. We will present our first experiences with tailoring treatment modules to severely impaired and highly comorbid patients.DisclosureNo significant relationships.

Saudi cultural adaptation of the “compliance questionnaire of Rheumatology” for Rheumatoid arthritis patients on disease modifying anti-rheumatic drugs (DMARDs)

PurposeThis study aims to develop a valid and reliable Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) and to explore the impact of demographic factors on compliance. MethodsThis is a descriptive cross-sectional study carried out at the outpatient clinics of rheumatology in King Fahad hospital (KFH) in Madinah, Saudi Arabia, from May 2019 to October 2019. Initially, the original version was culturally adapted to an Arabic version by forward translation, backward translation, committee review of both the Arabic and the original versions, and lastly, pre-testing. Then, seventy-two rheumatoid arthritis patients were recruited to evaluate the reliability and validity of the CQR-A. Reliability was assessed by the test–retest method with a two-week interval through the intraclass correlation coefficient (ICC). The criterion validity of the CQR-A was assessed through Pearson correlation of pharmacy refill and CQR-A. The content validity index (CVI) was used to determine content validity. Multiple regression analysis was done to evaluate the effect of demographic factors on compliance. ResultsThe CQR-A has adequate reliability and validity. The ICC = 0.757 with a 95% CI ranging from 0.579 to 0.860, p < 0.001, Cronbach’s alpha coefficient = 0.788. Pearson correlation coefficient was found to be (r = 0.338, p = 0.013). The individual content validity index (I-CVI) ranged from 0.67 to 1.00, and the average scale content validity index (S-CVI/Ave) = 0.91. Education was the only significant predictor of compliance amongst the demographic factors with R2 of 0.158. ConclusionThe Arabic version of the Compliance Questionnaire on Rheumatology (CQR-A) is a reliable and valid clinical tool to assess compliance in Arabic speaking patients.

Validity and reliability of the Arabic quick disabilities of the arm, Shoulder and Hand (QuickDASH-Arabic)

BackgroundThe QuickDASH is a commonly used upper extremity region-specific outcome measure assessing activity limitation and symptoms. The Arabic version of QuickDASH is available in the official outcome measure website, but no prior studies have examined its psychometric properties. ObjectiveTo examine the psychometric properties of the Arabic QuickDASH in patients with upper extremity musculoskeletal disorders. MethodsParticipants with upper extremity musculoskeletal disorders were recruited (N = 109) using convenience sampling and completed the Arabic QuickDASH, Numeric Pain Rating Scale, Global Assessment of Function, and RAND 36-item Health Survey in two testing sessions (2–7 days apart). The Arabic QuickDASH structural validity, internal consistency, floor and ceiling effect, test-retest reliability, measurement error, and construct validity were examined. ResultsExploratory factor analysis indicated a one factor underlying the Arabic QuickDASH. The Arabic QuickDASH had Cronbach's alpha of 0.90 and ICC2.1 of 0.91 indicating excellent internal consistency and test-retest reliability. None of the participant reached the minimum or the maximum score. The scale's standard error of measurement and minimal detectable change were 7.0 and 16.3. Five out of the six construct validity predefined hypotheses were supported by the results. ConclusionThe Arabic QuickDASH is a unidimensional scale with excellent internal consistency, test-retest reliability and acceptable measurement error. The Arabic Quick DASH is a valid and reliable outcome measure that can be used in Arabic speaking countries with Arabic patients suffering from various upper extremity activity limitations and symptoms.

Translation and validation of the Arabic version of the osteoarthritis quality of life questionnaire (OAQoL) in Saudi patients with osteoarthritis

BackgroundOsteoarthritis (OA) is a debilitating multifactorial degenerative rheumatic disease affecting millions of people around the globe. The osteoarthritis quality of life scale (OAQoL), originally produced in the English language, is an important tool used to assess the overall impact of OA and its treatment on the patient’s quality of life.PurposeThe purpose of the study was to translate and validate the OAQoL in the Arabic language in order to use it on the Saudi population.MethodologyA bilingual panel comprising four healthcare professionals and one external certified medical translator translated the English version of the OAQoL to the Arabic language. A back translation was subsequently performed by two English-speaking translators and any differences were resolved by conferring with the original panel. The qualitative research was performed through cognitive debriefing interviews (CDIs) with 59 native Arabic patients who had clinically and radiologically confirmed osteoarthritis of any joint. The internal consistency of the 22 items was derived by leveraging the Cronbach’s Alpha coefficient.Results59 participants were included in the study, and more than half (52.5%) of them were men. The response rate was 100% and the mean time taken to answer the questionnaire was 10.5 min. The average Intraclass Correlation Coefficient (ICC) and Cronbach’s Alpha were determined to be 0.93 each, indicating that all the items in the OAQoL were significantly interrelated.ConclusionThe translated Arabic version of the OAQoL questionnaire used in this study is a reliable and consistent tool that showed good comprehensibility and internal consistency.

Fibrolamellar hepatocellular carcinoma treated with atezolizumab and bevacizumab: two case reports

BackgroundFibrolamellar hepatocellular carcinoma is a unique tumor of the liver that differs from the classical hepatocellular carcinoma in diagnosis, behavior, and possibly treatment. There is usually absent underlying liver disease, and it usually occurs in young patients. The survival outcomes in localized fibrolamellar hepatocellular carcinoma are perhaps better than in classical hepatocellular carcinoma if treated early and radically. On the other hand, the prognosis remains poor for locally advanced and metastatic fibrolamellar hepatocellular carcinoma. Many reports suggested a limited benefit from systemic chemotherapy. Sorafenib also did not show major effects on fibrolamellar hepatocellular carcinoma. Given the rarity of fibrolamellar hepatocellular carcinoma, lack of large studies, and absence of standard treatment, the treatment decisions rely on case reports, previously reported cases series, and expert opinions. Recent studies have shown promising effects of immunotherapy with checkpoint inhibitors in the first- and second-line therapy of hepatocellular carcinoma. Atezolizumab with bevacizumab regimen has been approved recently as a first-line treatment for classical hepatocellular carcinoma. Currently, there are no reports yet on the use of atezolizumab with bevacizumab for fibrolamellar hepatocellular carcinoma.Case reportIn this article, we present two Arabic patients with advanced fibrolamellar hepatocellular carcinoma who received atezolizumab and bevacizumab combinations but did not show any clinical benefits.ConclusionWhile atezolizumab and bevacizumab combinations had shown benefits in classical hepatocellular carcinoma, the current data showed a lack of benefit and tumor response in fibrolamellar hepatocellular carcinoma.

Arabic Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12)

Our study aimed to translate the chronic otitis media questionnaire-12 (COMQ-12) into the Arabic language, evaluate the internal consistency of the test and test-retest reliability, and validate the adaptation for further use in Arabic studies. A prospective observation monocenter cohort study. This study was done at Kafrelsheikh University Hospital, Egypt. One hundred twenty five ear pathology-free patients were asked to complete the questionnaire forming group A. One hundred twenty five patients with different forms of COM completed the questionnaire 2 weeks before the planned ear surgery and the same day of the operation, forming group B. Those patients who underwent the ear surgery, completed the questionnaire again 6 months after the operation forming group C. We did an Arabic forward and backward translation of the original COMQ-12. The patients in group B underwent ear surgery (tympanoplasty with or without mastoidectomy). After fulfilling the questionnaire in different groups, we assessed the psychometric properties of the Arabic version of COMQ-12: internal consistency, reliability, reproducibility, validity, and responsiveness. Cronbach's α was 0.973. The Spearman's rank correlation coefficient was 0.981, while the Intraclass correlation coefficient was 0.973. A statistically significant difference was present between group A (average total score 2.38 ± 1.543) and group B (average total score 35.86 ± 5.98). Also, there was a statistically significant difference between group B and group C (average total score 7.46 ± 8.294). The calculated cut-off point of the total score was more than or equal to eight. The cross-culturally Arabic adaptation of COMQ-12 was reliable, valid with strong internal consistency and responsiveness. It can detect the significant effect of COM on the quality of life of Arabic patients. This effect would be improved obviously after surgical management that markedly enhanced the preoperative hearing problem.

The impact of the English medical curriculum on medical history taking from Arabic speaking patients by medical students.

Introduction:Medical education in Saudi medical colleges is delivered to students through a completely English language curriculum, whereas the practice that students face in the hospital is generally conducted in Arabic language settings. We suggest that the linguistic gap between the adopted medical curriculum and actual practice could influence students' confidence and level of difficulty in history taking in Arabic. The study aimed to identify the effects of learning history taking in the English language on applying it in the medical student's native language.Methods:This cross-sectional design study was held in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). The targeted sample size was 377 medical students from the fourth to the sixth year, and stratified random sampling was used. The questionnaire used was self-developed, validated, and pilot tested in other medical colleges. The questionnaire asked about students' confidence, the difficulty of Arabic history taking, and suggested strategies to improve the current curriculum.Results:The response rate was 290 participants (76.9%), males were 205 (71%), and 136 (47%) were in the fourth year. Agreement on feeling confident while taking history taking in Arabic was 98 (33.8%), 102 (35.2%) were neutral, and 90 (31%) disagreed. Moreover, 138 (47.6%) of students preferred training for Objective Structured Clinical Examination (OSCE) in Arabic more than English, 86 (29.7%) were neutral, while 66 (22.8%) disagreed. The mean level of difficulty was 2.1 ± 0.7 (range 1- 5). Additionally, 198 (68%) of students suggested adding short Arabic history courses.Conclusion:Students considered history taking in Arabic as easy, even though they were not completely confident. Further efforts are needed to uplift students' of confidence to optimal levels.Advances in Knowledge:Communication is the cornerstone of medical education as well as clinical practice. The study explores the impact of instruction language on the physician-patient communication dynamic, providing better infrastructure for evidence-based educational practice.Application to Patient Care:This study gives insight into the students' level of preparation to practice in their local community and language. Furthermore, the study addresses strategies to enhance students communication skills and alleviate linguistic barriers in the physician-patient encounter.

Assessing the impact of chemotherapy-induced nausea and vomiting on patients' quality of life: An Arabic version of the Functional Living Index-Emesis.

Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients' quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients' quality of life. Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. One-hundred cancer patients who received chemotherapy were enrolled. The participants' mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

Sleep disturbance among Arabic breast cancer survivors.

Sleep disturbance is the most common and distressing cancer symptom that negatively affects the quality of life (QoL). The main objective of this study is to determine the prevalence of sleep disturbance among Arabic women with breast cancer, post-treatment, and assess their sleep disturbance in relation to health-related QoL, demographics and treatment characteristics. In this study, cross-sectional data were collected using the Pittsburgh Sleep Quality Index (PSQI: 19-items) and the Functional Assessment of Cancer Therapy-General (FACT-G: 27 items). Demographic information and treatment characteristics were also collected. A total of 133 women who had been diagnosed with breast cancer agreed to participate in the study. Approximately three-quarters (73.7%; n = 98) of the participants was reported as poor sleepers (PSQI ˃ 5). The worse mean score of the PSQI component was the sleep latency with the highest score (M = 1.71, SD = 0.93). There were significant relationships between poor sleep and treatment (patients receiving both chemotherapy and radiotherapy) and with comorbidities (asthma, anaemia, hypertension/heart failure, diabetes/heart diseases) (P < 0.05). Those experiencing poor sleep had the lowest QoL among the cancer patients. Sleep disturbance is a significant problem for Arabic patients diagnosed with breast cancer. The result suggests that sleep disturbance should be routinely assessed in clinical settings. Further research should develop an intervention for management to reduce sleep disturbance and improve sleep quality in cancer patients.

Psychometric properties of the Arabic version of the medical outcomes study social support survey in cancer survivors post-HSCT

ABSTRACT The purpose of this study was to evaluate the reliability and validity of the Arabic version of the Medical Outcomes Study Social Support Survey (MOS-SSS) in Arabic cancer survivors post-Hematopoietic Stem Cell Transplantation (HSCT). This study of existing cross-sectional data was conducted using data from 63 Arabic patients who were at least three months post-HSCT. The data demonstrated that the Cronbach’s alphas for the Arabic version of the MOS-SSS subscales were strong, indicating good internal consistency. Factorial validity of the Arabic version was supported using confirmatory factor analysis; the MOS-SSS had a four-factor, multidimensional structure as hypothesised. Convergent validity with the EORTC QLQ-C30 also was supported. In conclusion, this study showed that the Arabic version of the MOS-SSS demonstrated excellent evidence of convergent and factorial validity as well as strong internal consistency reliability in this sample of Arabic HSCT survivors.