Samar Noureddine

Gender differences in the psychosocial and cognitive correlates of physical activity among taiwanese adolescents: A structural equation modeling approach

This study examined gender differences in the factors related to physical activity in 832 Taiwanese adolescents. Differences in psychosocial and cognitive correlates were noted by gender group. Taiwanese adolescent girls reported lower physical activity self-efficacy and less perceived benefits and more perceived barriers to being active than boys. Girls compared to boys reported significantly more positive social support, modeling, and norms from parents to be active but significantly less social support and norms from their peers. Structural equation modeling was used to test the direct and indirect paths of a model of proposed correlates and physical activity. The results indicated that peer influences had both direct and indirect paths to physical activity for both genders. Among all examined variables, perceived self-efficacy was the strongest correlate of physical activity for these adolescents. The findings of this study provide information relevant to designing physical activity interventions targeted to Taiwanese adolescents.

Delay in seeking health care for acute coronary syndromes in a Lebanese sample

Early treatment of patients with acute coronary syndromes (ACS) is crucial to reduce morbidity and mortality. The purpose of this study was to examine delay in seeking care for ACS symptoms in a Lebanese sample and identify predictors of delay. Medical record reviews and interviews using the Response to Symptoms Questionnaire were conducted with 204 ACS patients in coronary care within 72 hours of admission. Median time from symptom onset to hospital arrival was 4.5 hours. Higher education, presence of dyspnea, intermittent symptoms, and waiting for symptoms to go away predicted longer delays, whereas intensity of symptoms and active response (going to the hospital) predicted shorter delays. The findings suggest lack of knowledge of ACS symptoms and the need for public education in this regard.

Research in cardiovascular care: a position statement of the Council on Cardiovascular Nursing and Allied Professionals of the European Society of Cardiology

To deliver optimal patient care, evidence-based care is advocated and research is needed to support health care staff of all disciplines in deciding which options to use in their daily practice. Due to the increasing complexity of cardiac care across the life span of patients combined with the increasing opportunities and challenges in multidisciplinary research, the Science Committee of the Council on Cardiovascular Nursing and Allied Professionals (CCNAP) recognised the need for a position statement to guide researchers, policymakers and funding bodies to contribute to the advancement of the body of knowledge that is needed to further improve cardiovascular care. In this paper, knowledge gaps in current research related to cardiovascular patient care are identified, upcoming challenges are explored and recommendations for future research are given.

Quality of life in people living with HIV/AIDS in Lebanon.

Abstract The aim of the study was to determine the impact of HIV/AIDS on the quality of life (QoL) in Lebanese adult patients living with HIV/AIDS. The study design was a cross-sectional descriptive survey, using self-administered questionnaires. A convenience sample of 41 Lebanese adults (aged 18 years and above) living with HIV/AIDS was recruited from outpatient departments at two major medical centers in Lebanon. The instruments included the Multidimensional Quality of Life HIV (MQoL-HIV), the HIV Symptom Index and a stigma scale, and a demographic section. The majority of the sample were male and single. The mean age was 38 years (SD=9.93). The mean MQoL-HIV score was 176.85, with the highest scores for the cognitive functioning, social functioning, and medical care; the lowest domain scores were for financial status, sexual functioning, and mental health. A single item measuring overall QoL was rated by 47.5% as neither poor nor good. Mean stigma score was 2.05 (SD=0.62) and mean HIV Symptom Index score was 0.6. Prevalence of symptoms and perceived stigma were negative predictors of QoL, being married was a positive predictor of QoL. The results of this study, which is the first to look at the QoL in people living with HIV/AIDS in Lebanon and the Middle East and North Africa region, showed that these mostly asymptomatic well-functioning individuals reported a fair level of QoL. The strongest determinants of QoL revolved around psychosocial aspects of life, namely social relationships, mental health, and medical care.

Bereaved Parental Evaluation of the Quality of a Palliative Care Program in Lebanon

Palliative care (PC) is important in Pediatric Oncology as more than 20% of children with cancer still die despite modern treatment. As a significant number of children reside in countries with limited resources; more research in PC is needed there. This study aimed at evaluating the quality of care provided to children with cancer at the Childrens Cancer Center of Lebanon (CCCL) during their last month of life as perceived by the bereaved parents.

Raising awareness and providing free screening improves cervical cancer screening among economically disadvantaged Lebanese/Armenian women.

Women need to practice cervical screening regularly to reduce morbidity and mortality. The purpose of this study was to examine the impact of an intervention program on knowledge, attitude, and practice of cervical screening in the population of Lebanese/Armenian women. The design was a cross-sectional, quasi-experimental posttest survey following a yearlong intervention program. The sample included 176 women, who were members of the Armenian Relief Cross in Lebanon. Interventions consisted of educational classes, media messages, and free screening. The instrument was a self-administered questionnaire. Knowledge of women with intervention was higher (p > .05) and practice rate increased between intervention and comparison groups. No difference in attitude was noted. The study was successful in raising awareness and increasing screening in the sample. It is recommended to continue helping women to overcome barriers for cervical screening.

Response to a cardiac event in relation to cardiac knowledge and risk perception in a Lebanese sample: A cross sectional survey

BACKGROUND Heart disease is the leading cause of morbidity and mortality in many countries, including Lebanon. The continuing advances in the treatment of heart disease have improved patient outcomes significantly over the years. Nevertheless, prompt treatment remains essential to treatment success, which depends on the persons early recognition of cardiac symptoms and quick seeking of care. OBJECTIVE The purpose of the study was to examine the relationship between knowledge of symptoms of heart disease, perceived cardiac risk and the potential response to a heart attack in a sample of Lebanese adults. DESIGN A cross sectional descriptive survey design was used. A convenience sample of 399 adult hospital visitors who did not have heart disease were interviewed in two major referral hospitals in Beirut. MEASURES The Illness Perception Questionnaire and the Behavioral Risk Factor Surveillance System were used; in addition an open-ended question was asked to elicit what the visitor would do in case he/she experienced cardiac symptoms. RESULTS While most participants (94%) correctly recognized major symptoms of heart disease (like chest pain and dyspnea), they also reported irrelevant symptoms to be associated with heart disease (like irritability by 68% and muscle cramps by 52%). Only 21% of participants reported that they would seek emergency care as their first response if they were experiencing a heart attack. Knowledge of symptoms and perceived cardiac risk were not associated with the response to a heart attack. Being single was the only significant predictor of choosing the appropriate response when experiencing a cardiac event. CONCLUSION The findings suggest lack of adequate knowledge of cardiac symptoms and a high potential for inappropriate responses when symptoms occur. Public health heart health campaigns are needed to raise awareness about heart disease in Lebanon.

A Survey of Knowledge, Attitude, and Practice of Cervical Screening Among Lebanese/Armenian Women

A 1995 KAP survey of 290 female members of the Armenian Relief Cross in Lebanon revealed strong associations between educational level and Papanicolaou cervical cancer screening. 70% of respondents were over 41 years of age; 37.7% had a secondary school education or higher and 92% rated their economic status as average or above average. Both educational level and economic status were positively associated with knowledge about the purpose of the Pap smear. Among the 174 respondents who were aware of the Pap test the percentage who wanted to undergo screening increased significantly with educational level but was unaffected by economic status. A significantly higher number of women with poor and average perceived economic status compared with good or very good status cited embarrassment and cost as obstacles to seeking screening. 62.4% of respondents had actually received a Pap smear. Practice was significantly associated with educational level but not economic status. Overall 88.4% of women with very good levels of knowledge and a favorable attitude toward screening scored above average on the practice index while 87.2% of women with poor levels of knowledge and attitude had poor practice scores. Among women with average levels of knowledge and attitude 64.2% had poor practice scores 24.7% had average scores and 11.1% had very good scores. Since poor women with low levels of formal education are at increased risk of cervical cancer health education campaigns targeted at this group are recommended to promote awareness and uptake of Pap screening.

Surviving testicular cancer: the Lebanese lived experience.

Background:Testicular cancer is thought to have a great impact on its survivors, yet there has been limited literature on the topic globally and no literature on the topic in Lebanon and the Arab region. Objective:The purpose of this study was to explore the lived experience of Lebanese testicular cancer survivors and gain an in-depth understanding of the psychosexual aspect of their experience. Methods:A hermeneutic phenomenological approach with semistructured digitally recorded interviews and observational field notes was utilized. A purposive sample of Lebanese testicular cancer survivors, aged between 18 and 50 years, in remission for at least 3 years, and willing to share personal information was recruited. Interviews were transcribed verbatim in Arabic. Data saturation was achieved at the seventh interview; a total of eight informants were recruited. The opening question was, “Tell me about your life since you got treated for testicular cancer,” and was followed by probing questions. Two to three weeks after the initial interview, informants were called to validate the investigators’ primary analysis. Results:Six core themes emerged: cancer perception in the Lebanese culture; “do not show, do not tell”; cancer experience is a turning point; fertility, manhood, and relationships; coping with cancer; and preserved aspects of life. Discussion:The findings provide an in-depth understanding of the experience of Lebanese testicular cancer survivors with a focus on the psychosexual aspect of this experience. The results suggest the need to educate patients about testicular cancer and its effect on their fertility.

Beliefs Related to Breast Cancer and Breast Cancer Screening Among Lebanese Armenian Women

Our purpose of this article was to investigate womens beliefs about breast cancer, breast cancer screening, and intervention programs. We designed the study using a cross-sectional/descriptive correlation. The participants were drawn from a convenience sample (N = 94). The instrument included Champions Revised Health Belief Model Scale (CHBMS). Analysis was performed using SPSS (2005), 15.0. More than sixty-four percent (64.8%) of women surveyed were over 41. Results showed that 80.9% of women surveyed had heard of breast self-exams (BSEs), while 76.6% had heard of mammography. However, 53.2% never practiced breast self-examinations, and 79.6% never underwent mammography. Mean belief scores follow: low susceptibility (14.32), barriers to BSE (15.24), barriers to mammography (14.85), high seriousness (23.42), benefits to breast self-examination (22.7), confidence (36.45), health motivation (27.27), and benefits to mammography (24.28). Significant relationships included the relationship between barriers to breast self-examination and whether women had heard about breast self-examinations (p = .02); the relationship between susceptibility and whether women had heard of or underwent mammography (p = .027); the relationship between confidence and whether women had heard of mammography (p = .056); the relationship between confidence and perceived financial status (p = .05); and benefits of mammography (p = .05). Appropriate interventions are developed.