Understanding breast health awareness in an Arabic culture: qualitative study protocol

AIM: To explore breast health awareness and the early diagnosis and detection methods of breast cancer from the perspective of women and primary healthcare providers in the Jizan region of the Kingdom of Saudi Arabia.

BACKGROUND: Although there is a high incidence of advanced breast cancer in young women in the Kingdom of Saudi Arabia, there is no standardized information about breast self-examination, or is there a national screening programme involving clinical breast examination and mammography available.

DESIGN: Qualitative exploratory study.

METHODS: Data collection will consist of 36 face-to-face semi-structured interviews: 12 with general practitioners; 12 with nurses at primary healthcare centres and with 12 women who attend the health centres. This study will be carried out in eight states across the Jizan region (four rural and four urban) to reflect the cultural diversity of Jizan. The data will be analysed using thematic content analysis. Research Ethics Committee approval was obtained in June 2015.

DISCUSSION: While we understand the enablers and barriers to breast health awareness outside of Saudi culture, in the Kingdom of Saudi Arabia, particularly in rural populations such as Jizan, there is a lack of research. This study will add positively to the international knowledge base of this topic. The findings will give evidence and inform policy about women and healthcare providers' experiences in Jizan, in a society where such topics are taboo.

Processing the Peace:An Interview with Teya Sepinuck

In this interview, Teya Sepinuck, the Artistic Director of Theatre of Witness reflects not only on her first two projects in Northern Ireland, but also vividly illustrates her way of working by evoking seminal moments in her previous practice. Although, she has resisted attempts to systematise the Theatre of Witness process, preferring to see it as a set of principles rather than a fixed methodology, these principles have given rise to clear guidelines that have come to govern the process through which she works. As the interview illustrates, Sepinuck, a Jewish Buddhist, has no hesitation in explaining her approach within the framework of a humanist ‘spirituality’ that explicitly deploys Judeo-Christian terminology. She invites discussion of each participant's ‘prayer-life’ and positions herself primarily as a listener rather than an interlocutor. The introduction to the interview contextualises Sepinuck's practice in relation to her previous work and other drama-based interventions in Northern Ireland. Concerns that the lack of critical distance between the tellers and their stories inhibits those who see it from freely engaging with it as they might with a fictionalised account, are also critiqued. In the interview, Sepinuck directly addresses the risk of the commodification of her work, explaining the safeguards in place to protect the participants, who have repeatedly asserted how beneficial they have found their involvement in the work to be. The sense of autonomy and empowerment that emerges from these responses represent a persuasive challenge to concerns that they are passive instruments of the Theatre of Witness process.