J Canc Educ DOI 10.1007/s13187-014-0653-7
Knowledge, Perception, and Attitudes About Cancer and its Treatment Among Healthy Relatives of Cancer Patients: Single Institution Hospital-Based Study in Saudi Arabia Bassem Eldeek & Jawaher Alahmadi & Maha Al-Attas & Khalid Sait & Nisrin Anfinan & Ettedal Aljahdali & Hamzah Ajaj & Hesham Sait
# Springer Science+Business Media New York 2014
Abstract This study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients who attended an outpatient cancer clinic with their relatives who suffer from cancers. The participants recruited in this cross-sectional, interview-based study were 846 (557 female and 289 male subjects) healthy relatives of cancer patients from the outpatient cancer clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Most of the participants answered that they believed the causes of cancer were genetic (44.90 %), followed by environmental factors (30.10 %), diet (26.90 %), other causes (26.90 %), envy (26.90 %), and black magic (17.60 %). Most of the healthy participants believed that doctors should tell patients the full truth about the diagnosis (83.57 %). More than half of the healthy population stated that cancer patients should accept all types of treatment (chemotherapy and/or radiotherapy and/or surgery), with more male subjects having this position than females (P=0.014). Most of the participants believed that cancer cannot be caught from another person who suffered from cancer (67.50 %). Most of
the participants believed that cancer education was sufficient (66.70 %), with a significant difference between male and female respondents (P=0.004). With regard to why cancer patients hide their disease, most of the participants in the age group 45 years, the reasons were job loss (47.10 %), followed by health insurance loss (41.20 %), and then social stigma (11.80 %), with a significant difference between groups (P=0.034). This study demonstrated that still a large number of healthy participants had deficient perceptions and poor attitudes about important issues concerning cancers such as different mode of treatments, alternative treatment, biological causes, and prognosis, particularly among male respondents. Prevention education strategies should be considered, including targeted approaches that aim to reduce disparities in cancer perception among the general population.
B. Eldeek Community Medicine in the Medical Education Department, King Abdulaziz University, Jeddah, Saudi Arabia
Keywords Attitude . Behavior . Knowledge . Cancer . Cross-sectional studies . Public education
J. Alahmadi Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Introduction
M. Al-Attas : K. Sait : N. Anfinan : E. Aljahdali : H. Ajaj : H. Sait Obstetrics and Gynecology Department, King Abdulaziz University, Jeddah, Saudi Arabia M. Al-Attas : K. Sait (*) : N. Anfinan : H. Sait Scientific Chair of Professor Abdullah Hussain Basalamah for Gynecological Cancer, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia e-mail: [email protected]
Cancer is a major public health problem, with significantly associated mortality and disability. It is the second leading cause of death in developed countries and is one of the three leading causes of death for adults in developing countries [1]. In the whole world, cancer rates are set to double by 2030, as reported by the World Health Organization [1]. The estimated number of new cases could rise from 12.3 million in 2007 to
J Canc Educ
16 million in 2020, and approximately 60 % of these new cases are likely to occur in low- and middle-income countries in the world [2]. However, approximately half of the 11 major cancer types are potentially preventable [3–5]. Currently, the major problems facing low- and mediumincome countries are the growth and increasing age of their populations and the westernization of their lifestyles. For these reasons, the role of cancer prevention programs in these countries is critical. However, to develop successful preventive programs, knowledge regarding cancer and awareness of early symptoms must be high. In addition, there should be positive attitudes toward screening programs [1]. Several factors, such as culture, false beliefs, and taboos, can affect early detection and proper treatment. Failure to identify these internal obstacles can impair the success of any cancer care program, even with adequate resources [1]. Patients will commonly turn to alternative healthcare strategies and traditional healers, believing them to have equal or superior ability to address difficult health problems [6]. In Saudi Arabia, few studies have been conducted to detect the perception of cancer and attitudes toward conventional and alternative therapies, and these studies have mostly focused on knowledge of and attitudes toward breast cancer [7–12]. According to the Saudi Cancer Registry, which was published in 2007, the total number of adult cancer Saudi cases reported was 11,437. Overall, the incidence of cancer was slightly higher in women than in men, as cancer affected 5,473 (47.9 %) men and 5,964 (52.1 %) women [13]. It is thus crucial to assess the general population’s behaviors, opinions, and perceptions regarding cancer. Therefore, this cross-sectional study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients, who were attendees of an outpatient cancer clinic with/for their sick relatives at King Abdulaziz University Hospital in Jeddah, Saudi Arabia.
Subjects and Methods After receiving ethical approval from the Unit of Biomedical Ethics and Research Committee, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, a descriptive, cross-sectional study was conducted among healthy relatives of cancer patients, who were attendees of an outpatient cancer clinic with/for their sick relatives at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. KAUH is the biggest governmental teaching hospital in Jeddah. It has 790 beds with a total number of 250,915 patients seen for the year 2012, and total admissions in the period were 41,923. The total number of cancer patients seen in 2012 was 1,453 patients. The total number of surgical procedures done in 2012 were 9,282, and 80 cases were done for cancer diagnosis. We
chose relatives of cancer patients who did not suffer from cancer to measure their knowledge, perception, and attitudes regarding cancer. The study was conducted from November 2012 to March 2013. The participants recruited for this study totaled 846 (557 female and 289 male subjects), and their ages ranged from 15 to 92 years old. It was noticed that the number of female participants (65.80 %) was higher than male participants (34.20 %). The participants were apparently healthy and their medical records were completely free from any medical or psychological illness. All of the participants were informed about the study and signed a written consent form, which was approved to be used by the ethical committee of King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Tools of the Study Interviews were conducted face to face, using a standardized questionnaire. The questionnaire was designed to measure the knowledge, perception, and factors influencing the perception and attitudes of healthy individuals toward cancer. The questionnaire was divided into four sections as follows: sociodemographic data, knowledge about the causes, knowledge about treatment, and support services for cancer. Sociodemographic variables included age, sex, marital status, and education. Knowledge about cancer causes was assessed with the following four questions: “What do you think are the causes of cancer?” The attitude of a healthy individual toward cancer was assessed with the following questions: “Should doctors tell patients the full truth about the diagnosis?,” with response categories of “yes,” “no,” and “do not know”; “What kind of treatment should cancer patients accept?,” with response categories of “all types of treatments (chemotherapy and/or radiotherapy and/or surgery),” “surgery,” “chemotherapy,” and “radiotherapy”; “Should cancer patients receive alterative treatment (e.g., hormonal, biological, and transplant)?,” with response categories of “yes,” “no,” and “not sure,” and if the answer was “yes,” the response categories were “alone” and “with other treatments”; and “Is cancer an infectious disease?,” with response categories of “yes,” “no,” and “do not know.” The factors influencing the perception of and attitudes toward cancer were assessed with the following seven questions: “Shouldn’t cancer patients tell anyone that they have been diagnosed?,” with response categories of “yes,” “no,” and “not sure”; “Shouldn’t genitalia cancer patients tell anyone that they have been diagnosed?,” with response categories of “yes,” “no,” and “not sure”; “Why do patients didn’t tell anyone that they have been diagnosed?,” with response categories of “loss of job,” “loss of health insurance,” and “social stigma”; “Is health education about cancer sufficient?,” with response categories of “yes,” “no,” and “not sure”; “Do you require more knowledge about cancer?,” with response categories of “yes” and “no”; “Do you know about alternative treatments (e.g., hormonal, biological,
J Canc Educ
transplant)?,” with response categories of “yes” and “no”; and “Do you require more information about alternative treatments (e.g., hormonal, biological, transplant)?,” with response categories of “yes” and “no.” Each question had a unique code to make entering and processing of the data easier. The sampling units were the working days of the clinics. The working days were 4 days, we chose Sunday and Tuesday by simple random samples, and any relatives of patients with cancer attending the clinic on those days were chosen. Statistical Analysis The statistical analysis was performed using the Statistical Package of Social Sciences computer program (SPSS), version 20. The data are presented in the forms of numbers and percentages or means±standard deviations (minimum–maximum). The chi-square test was used for comparisons of the quantitative data. The data were considered significant when the P value was less than 0.05.
Results Demographic Details of the Study Population Table 1 shows the demographic characteristics of the patients. Most of the patients involved in this study were in the age group 45 years with a significant difference between them (P
Knowledge, Perception, and Attitudes About Cancer and its Treatment Among Healthy Relatives of Cancer Patients: Single Institution Hospital-Based Study in Saudi Arabia Bassem Eldeek & Jawaher Alahmadi & Maha Al-Attas & Khalid Sait & Nisrin Anfinan & Ettedal Aljahdali & Hamzah Ajaj & Hesham Sait
# Springer Science+Business Media New York 2014
Abstract This study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients who attended an outpatient cancer clinic with their relatives who suffer from cancers. The participants recruited in this cross-sectional, interview-based study were 846 (557 female and 289 male subjects) healthy relatives of cancer patients from the outpatient cancer clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Most of the participants answered that they believed the causes of cancer were genetic (44.90 %), followed by environmental factors (30.10 %), diet (26.90 %), other causes (26.90 %), envy (26.90 %), and black magic (17.60 %). Most of the healthy participants believed that doctors should tell patients the full truth about the diagnosis (83.57 %). More than half of the healthy population stated that cancer patients should accept all types of treatment (chemotherapy and/or radiotherapy and/or surgery), with more male subjects having this position than females (P=0.014). Most of the participants believed that cancer cannot be caught from another person who suffered from cancer (67.50 %). Most of
the participants believed that cancer education was sufficient (66.70 %), with a significant difference between male and female respondents (P=0.004). With regard to why cancer patients hide their disease, most of the participants in the age group 45 years, the reasons were job loss (47.10 %), followed by health insurance loss (41.20 %), and then social stigma (11.80 %), with a significant difference between groups (P=0.034). This study demonstrated that still a large number of healthy participants had deficient perceptions and poor attitudes about important issues concerning cancers such as different mode of treatments, alternative treatment, biological causes, and prognosis, particularly among male respondents. Prevention education strategies should be considered, including targeted approaches that aim to reduce disparities in cancer perception among the general population.
B. Eldeek Community Medicine in the Medical Education Department, King Abdulaziz University, Jeddah, Saudi Arabia
Keywords Attitude . Behavior . Knowledge . Cancer . Cross-sectional studies . Public education
J. Alahmadi Family and Community Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Introduction
M. Al-Attas : K. Sait : N. Anfinan : E. Aljahdali : H. Ajaj : H. Sait Obstetrics and Gynecology Department, King Abdulaziz University, Jeddah, Saudi Arabia M. Al-Attas : K. Sait (*) : N. Anfinan : H. Sait Scientific Chair of Professor Abdullah Hussain Basalamah for Gynecological Cancer, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia e-mail: [email protected]
Cancer is a major public health problem, with significantly associated mortality and disability. It is the second leading cause of death in developed countries and is one of the three leading causes of death for adults in developing countries [1]. In the whole world, cancer rates are set to double by 2030, as reported by the World Health Organization [1]. The estimated number of new cases could rise from 12.3 million in 2007 to
J Canc Educ
16 million in 2020, and approximately 60 % of these new cases are likely to occur in low- and middle-income countries in the world [2]. However, approximately half of the 11 major cancer types are potentially preventable [3–5]. Currently, the major problems facing low- and mediumincome countries are the growth and increasing age of their populations and the westernization of their lifestyles. For these reasons, the role of cancer prevention programs in these countries is critical. However, to develop successful preventive programs, knowledge regarding cancer and awareness of early symptoms must be high. In addition, there should be positive attitudes toward screening programs [1]. Several factors, such as culture, false beliefs, and taboos, can affect early detection and proper treatment. Failure to identify these internal obstacles can impair the success of any cancer care program, even with adequate resources [1]. Patients will commonly turn to alternative healthcare strategies and traditional healers, believing them to have equal or superior ability to address difficult health problems [6]. In Saudi Arabia, few studies have been conducted to detect the perception of cancer and attitudes toward conventional and alternative therapies, and these studies have mostly focused on knowledge of and attitudes toward breast cancer [7–12]. According to the Saudi Cancer Registry, which was published in 2007, the total number of adult cancer Saudi cases reported was 11,437. Overall, the incidence of cancer was slightly higher in women than in men, as cancer affected 5,473 (47.9 %) men and 5,964 (52.1 %) women [13]. It is thus crucial to assess the general population’s behaviors, opinions, and perceptions regarding cancer. Therefore, this cross-sectional study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients, who were attendees of an outpatient cancer clinic with/for their sick relatives at King Abdulaziz University Hospital in Jeddah, Saudi Arabia.
Subjects and Methods After receiving ethical approval from the Unit of Biomedical Ethics and Research Committee, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia, a descriptive, cross-sectional study was conducted among healthy relatives of cancer patients, who were attendees of an outpatient cancer clinic with/for their sick relatives at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia. KAUH is the biggest governmental teaching hospital in Jeddah. It has 790 beds with a total number of 250,915 patients seen for the year 2012, and total admissions in the period were 41,923. The total number of cancer patients seen in 2012 was 1,453 patients. The total number of surgical procedures done in 2012 were 9,282, and 80 cases were done for cancer diagnosis. We
chose relatives of cancer patients who did not suffer from cancer to measure their knowledge, perception, and attitudes regarding cancer. The study was conducted from November 2012 to March 2013. The participants recruited for this study totaled 846 (557 female and 289 male subjects), and their ages ranged from 15 to 92 years old. It was noticed that the number of female participants (65.80 %) was higher than male participants (34.20 %). The participants were apparently healthy and their medical records were completely free from any medical or psychological illness. All of the participants were informed about the study and signed a written consent form, which was approved to be used by the ethical committee of King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Tools of the Study Interviews were conducted face to face, using a standardized questionnaire. The questionnaire was designed to measure the knowledge, perception, and factors influencing the perception and attitudes of healthy individuals toward cancer. The questionnaire was divided into four sections as follows: sociodemographic data, knowledge about the causes, knowledge about treatment, and support services for cancer. Sociodemographic variables included age, sex, marital status, and education. Knowledge about cancer causes was assessed with the following four questions: “What do you think are the causes of cancer?” The attitude of a healthy individual toward cancer was assessed with the following questions: “Should doctors tell patients the full truth about the diagnosis?,” with response categories of “yes,” “no,” and “do not know”; “What kind of treatment should cancer patients accept?,” with response categories of “all types of treatments (chemotherapy and/or radiotherapy and/or surgery),” “surgery,” “chemotherapy,” and “radiotherapy”; “Should cancer patients receive alterative treatment (e.g., hormonal, biological, and transplant)?,” with response categories of “yes,” “no,” and “not sure,” and if the answer was “yes,” the response categories were “alone” and “with other treatments”; and “Is cancer an infectious disease?,” with response categories of “yes,” “no,” and “do not know.” The factors influencing the perception of and attitudes toward cancer were assessed with the following seven questions: “Shouldn’t cancer patients tell anyone that they have been diagnosed?,” with response categories of “yes,” “no,” and “not sure”; “Shouldn’t genitalia cancer patients tell anyone that they have been diagnosed?,” with response categories of “yes,” “no,” and “not sure”; “Why do patients didn’t tell anyone that they have been diagnosed?,” with response categories of “loss of job,” “loss of health insurance,” and “social stigma”; “Is health education about cancer sufficient?,” with response categories of “yes,” “no,” and “not sure”; “Do you require more knowledge about cancer?,” with response categories of “yes” and “no”; “Do you know about alternative treatments (e.g., hormonal, biological,
J Canc Educ
transplant)?,” with response categories of “yes” and “no”; and “Do you require more information about alternative treatments (e.g., hormonal, biological, transplant)?,” with response categories of “yes” and “no.” Each question had a unique code to make entering and processing of the data easier. The sampling units were the working days of the clinics. The working days were 4 days, we chose Sunday and Tuesday by simple random samples, and any relatives of patients with cancer attending the clinic on those days were chosen. Statistical Analysis The statistical analysis was performed using the Statistical Package of Social Sciences computer program (SPSS), version 20. The data are presented in the forms of numbers and percentages or means±standard deviations (minimum–maximum). The chi-square test was used for comparisons of the quantitative data. The data were considered significant when the P value was less than 0.05.
Results Demographic Details of the Study Population Table 1 shows the demographic characteristics of the patients. Most of the patients involved in this study were in the age group 45 years with a significant difference between them (P
