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☐ ☆ ✇ PLOS ONE Medicine&Health

Work-related musculoskeletal disorder among midwives, a threat for maternity care

by Osman Yimer Mohammed, Kerstin Erlandsson, Tewodros Seyoum, Solomon Hailemeskel, Lemma Derseh, Helena Lindgren

Background

Work-related musculoskeletal disorder is a limiting, painful condition that affects the muscular, skeletal, articular, and nervous tissues of the body. The condition is mainly associated with poor working conditions and awkward body positions. Health professionals, including midwives, are among the most affected workforce globally. The condition affects the health of the professionals and the quality of care that professionals are expected to provide. However, there is a scarcity of information on the magnitude of the condition, its effect on midwifery practice, and associated factors. Objectives: This study aimed to assess the magnitude of work-related musculoskeletal disorder, its effect on midwifery practice, and associated factors among midwives in North Shoa Zone, Amhara Regional State, Ethiopia.

Method

An institution-based cross-sectional study assessed the magnitude of work-related musculoskeletal disorder (WRMSD), the effect on midwifery practice, and associated factors. The Nordic Musculoskeletal Disorder Scale was used to assess the presence of WRMSDs in the nine regional body parts and its effect. A stepwise backward elimination logistic regression model was used, and significant association was declared at a p-value of less than 0.05.

Results

A total of 473 (252 (53.3%) female and 221 (46.7%) male) midwives participated in this study. Overall, in the last 12 months, 355 (75.05%, 95% CI: 71.15% − 78.95%) midwives were affected by WRMSD, which was seen in any one of the nine regional body parts. About 45% (162) of them reported being unable to perform their daily tasks while they were affected, and 27% (96) of them sought treatment for their condition. The lower back was the most affected axial body part, reported by 300 (63.4%, 95% CI: 59% − 68%) midwives. Working in awkward or uncomfortable positions was significantly associated with the development of WRMSD (AOR: 1.81, 95% CI: 1.15–2.87). Similarly, awkward positions significantly affected the development of area-specific WRMSD in the lower back, upper back, neck, and limbs. Working in the same position for a longer time, seeing clients daily, and moving heavy objects were among the risk factors associated with developing area-specific WRMSD among midwives.

Conclusion

The magnitude of work-related musculoskeletal disorders is high among midwives, and a significant number of them were unable to perform their daily tasks. The lower and upper back are the most commonly affected areas. Working in uncomfortable positions and attending to large clients daily were common risk factors. Therefore, training midwives about safe working positions and reducing the workload is commendable.

☐ ☆ ✇ PLOS ONE Medicine&Health

<i>Clostridioides difficile</i> infection in Saudi Arabia: Prevalence, risk factors, and outcomes in a tertiary hospital setting

Por: Abdullah M. Aldhaif · Mohammed A. Al-Garni · Ahmed A. Muyidi · Mohammed H. Makkawi — Diciembre 31st 2025 at 15:00

by Abdullah M. Aldhaif, Mohammed A. Al-Garni, Ahmed A. Muyidi, Mohammed H. Makkawi

Background

Clostridioides difficile infection (CDI) remains a major healthcare-associated infection with limited contemporary data from Saudi Arabia. This study evaluated CDI prevalence, risk factors, recurrence predictors, and treatment patterns in hospitalized patients at a tertiary teaching hospital.

Methods

Retrospective analysis of 1,054 hospitalized patients screened between March 2023 and February 2024. CDI was confirmed by positive toxin assay and/or nucleic acid amplification test (NAAT). Demographic, clinical, antibiotic, acid-suppressant, and treatment data were collected. Bivariate associations and multivariable logistic regression were used to identify predictors of recurrence.

Results

CDI prevalence was 10.8% (114/1,054). Median age was 37 years (IQR 51.25); 32.5% had malignancy. Antibiotic exposure preceded CDI in 59.6% (meropenem 24.7%, ceftriaxone 16.5% of courses), and acid suppressants were used in 57.0% (omeprazole 92.3%). Recurrence occurred in 11.4% (13/114). On bivariate analysis, acid-suppressant use was significantly associated with recurrence (p = 0.041). In multivariable logistic regression, only metronidazole plus vancomycin combination therapy independently predicted recurrence (OR 11.29, 95% CI 1.13–112.42, p = 0.039). Trends were observed for malignancy (OR 2.94, p = 0.112) and acid-suppressant use (OR 1.85, p = 0.440), limited by the small number of recurrent events. Metronidazole monotherapy dominated treatment (64.8%).

Conclusion

CDI prevalence reached 10.8% with an 11.4% recurrence rate. Acid-suppressant exposure and combination therapy were key recurrence signals, while metronidazole remains overused despite international guideline shifts. Enhanced antibiotic and acid-suppressant stewardship, alongside improved access to guideline-recommended therapies, are critical to reducing CDI burden in Saudi tertiary hospitals.

☐ ☆ ✇ BMJ Open

Effectiveness of fresh frozen plasma in the resolution of coagulopathy in human patients following hemotoxic snakebites: a systematic review and meta-analysis

Por: Ganessane · E. · Mohammed Muthanikkatt · A. · Manu Ayyan · S. · Abraham · S. V. · Krishnamoorthy · Y. — Diciembre 18th 2025 at 10:31
Objective

To assess the effectiveness of fresh frozen plasma (FFP) as an adjunctive treatment to anti-snake venom (ASV) for resolving venom-induced consumption coagulopathy (VICC) in patients with hemotoxic snakebites.

Design

Systematic review and meta-analysis, reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

Data sources

MEDLINE, ScienceDirect, Embase, Scopus, Web of Science, Cochrane Central Register of Controlled Trials, Europe PubMed Central, Directory of Open Access Journals, Google Scholar, ClinicalTrials.gov and WHO ICTRP were searched from inception to 30 July 2025 using multiple terms, including ‘fresh frozen plasma’, ‘plasma transfusion’, ‘hemotoxic snakebite’, ‘vasculotoxic snakebite’, ‘coagulopathy in snake bite’ and ‘venom-induced consumption coagulopathy’.

Eligibility criteria

We included randomised controlled trials and observational studies in the English language comparing antivenom alone with antivenom with FFP in patients with hemotoxic snakebite-induced coagulopathy. Studies must have reported coagulopathy resolution as measured by international normalised ratio (INR) normalisation or 20 min whole blood clotting test (WBCT) correction. Non-English publications, case reports, case series, reviews, conference abstracts, preclinical studies and studies lacking full-text availability or without quantitative INR or WBCT outcome data were excluded.

Data extraction and synthesis

Two independent reviewers extracted data using standardised extraction forms and assessed risk of bias using the Cochrane Risk of Bias 2 tool for randomised controlled trials and the Newcastle–Ottawa scale for observational studies. Data were pooled using random-effects meta-analysis and expressed as ORs with 95% CIs. Statistical heterogeneity was assessed using I² statistics, and the certainty of evidence was evaluated using the Grades of Recommendation, Assessment, Development and Evaluation approach.

Results

Four studies involving 370 patients were included (two randomised controlled trials and two prospective observational studies). The pooled analysis demonstrated that adjunctive FFP significantly increased the likelihood of coagulopathy resolution compared with antivenom alone (OR=7.71, 95% CI 2.20 to 27.04, p=0.001). No evidence of a significant difference in mortality was observed between groups (OR=4.96, 95% CI 0.55 to 44.60, p=0.15). High heterogeneity was noted among the four studies (I² = 67%), but a subgroup analysis of three studies, which used INR as the outcome assessment method, showed lower heterogeneity (I² = 25%). Adverse events were inconsistently reported across studies.

Conclusions

FFP as an adjunct to antivenom significantly improves coagulopathy resolution in patients with hemotoxic snakebite-induced coagulopathy. However, the certainty of evidence is very low because of methodological limitations, small sample sizes and significant heterogeneity. Although FFP shows promise for rapid coagulopathy correction, mortality benefits are not established, and it should not replace timely antivenom administration or comprehensive supportive care.

Study registration

PROSPERO, CRD42023483336.

☐ ☆ ✇ PLOS ONE Medicine&Health

A Late Pleistocene archaic human tooth from Gua Dagang (Trader’s Cave), Niah national park, Sarawak (Malaysia)

Por: Darren Curnoe · Mohammed S. Sauffi · Hsiao Mei Goh · Xue-feng Sun · Roshan Peiris — Diciembre 10th 2025 at 15:00

by Darren Curnoe, Mohammed S. Sauffi, Hsiao Mei Goh, Xue-feng Sun, Roshan Peiris

The rarity of Late Pleistocene hominin remains from Insular Southeast Asia (ISEA) has hampered our ability to understand a crucial episode of human evolutionary history, namely, the global dispersal of Homo sapiens from Africa. Moreover, recent discoveries indicate a surprising level of taxic diversity during this time with at least two species—H. floresiensis and H. luzonensis—endemic to the region when H. sapiens first arrived. A third hominin dubbed the ‘Denisovans’ is shown from DNA evidence to have interbred with the ancestors of contemporary Indigenous populations across ISEA, New Guinea and Australia. Yet, the Denisovans have not been identified from the fossil record of the area despite recent breakthroughs in this regard on mainland East Asia. New excavations by our team at the Trader’s Cave in the Niah National Park (‘Niah Caves’), northern Borneo, have yielded an isolated hominin upper central permanent incisor dated with Optically Stimulated Luminescence dating of sediments to about 52 − 55 thousand years ago. Specimen SMD-TC-AA210 has a massive crown absolutely and relative to its root size, the crown is wide (mesiodistally) and relatively short (labiolingually). Morphologically, it exhibits a very strong degree of labial convexity, pronounced shovelling, and the bulging basal eminence exhibits several upward finger-like projections. Labial enamel wrinking on the enamel-dentine junction is expressed as two large ridges exhibiting numerous spine-like projections, and the lingual extensions on the enamel surface of the basal eminence are expressed as six extensions. This combination of crown size and morphological traits is not normally found in H. sapiens and instead characterises archaic members of Homo such as H. erectus, H. neanderthalensis and Middle Pleistocene hominins sharing a clade with H. heidelbergensis. The Trader’s Cave tooth suggests that an archaic hominin population inhabited northern Borneo just prior to or coincident with the arrival of H. sapiens as documented at the nearby West Mouth of the Niah Great Cave.
☐ ☆ ✇ Journal of Advanced Nursing

Strengths Mindset as a Mediator in the Relationship Between Paradoxical Leadership and Nurses' Positive Attitudes Towards Artificial Intelligence: A Cross‐Sectional Study

ABSTRACT

Aim

To assess the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence in hospital settings through a strengths mindset as a mediator.

Design

A cross-sectional survey conducted from January to March 2024.

Methods

The study included 239 nurses from four hospitals in Port Said, Egypt. To measure the study constructs, three well-established scales were utilised: the Paradoxical Leadership Scale, the Strengths Mindset Scale and the Positive Attitudes Towards Artificial Intelligence Scale. Structural equation modelling was applied for data analysis.

Results

The analysis revealed a significant positive relationship between nurse managers' paradoxical leadership and nurses' positive attitudes towards artificial intelligence. Additionally, a strengths mindset partially mediated the relationship between paradoxical leadership and nurses' positive attitudes towards artificial intelligence.

Conclusion

The study findings suggest that developing paradoxical leadership behaviours—such as managing current work processes while simultaneously driving the exploration of new initiatives—among nurse managers can foster a strengths mindset in nurses, which in turn promotes a more positive attitude towards the integration of artificial intelligence in healthcare.

Implications for the Profession and/or Patient Care

This study enhances the understanding of how paradoxical leadership influences nurses' acceptance of artificial intelligence, underscoring the pivotal role of a strengths mindset in this process.

Impact

This study suggests that healthcare policymakers seeking smoother integration of artificial intelligence technologies among nurses should prioritise leadership development programmes that equip nurse managers with paradoxical leadership skills and implement training initiatives to strengthen nurses' mindsets.

Reporting Method

The study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ PLOS ONE Medicine&Health

Structural stability-guided scaffold hopping and computational modeling of tankyrase inhibitors targeting colorectal cancer

Por: Mohammed Merae Alshahrani — Septiembre 19th 2025 at 16:00

by Mohammed Merae Alshahrani

Colorectal cancer is one of the leading causes of cancer-related deaths worldwide, mainly due to aberrant Wnt/β-catenin signaling resulting from APC mutations. Tankyrase is a key regulator of this pathway and plays a crucial role in stabilizing AXIN, a negative regulator of β-catenin, and hence an attractive therapeutic target. The present study describes a comprehensive computational approach to discovering novel tankyrase inhibitors for CRC therapy. The reference (RK-582) for ligand-based screening and comparative analysis was taken from the crystal structure of tankyrase. A similarity search in the PubChem, applying an 80% cutoff, yielded 533 structurally similar compounds. These compounds were subjected to virtual screening using a drug-likeness filter. The top-ranking binding poses of three selected compounds (PubChem CIDs: 138594346, 138594730, and 138594428) were selected for DFT calculation and re-docking. DFT calculations revealed that compound 138594428 had the largest HOMO-LUMO gap (4.979 eV), indicating high electronic stability, while 138594346 exhibited a strong balance of stability and reactivity (4.473 eV). The MD simulations were conducted on all ns protein-ligand complexes for 500 ns, exploring their stability. MD simulations confirmed the conformational stability of these compounds, with 138594346 showing the lowest RMSD and RMSF fluctuations. Additionally, a machine learning model trained on 236 known Tankyrase inhibitors accurately predicted pIC₅₀ values, with compound 138594346 (pIC₅₀ = 7.70) closely matching the reference inhibitor (pIC₅₀ = 7.71), and 138594428 also exhibiting strong predicted activity (pIC₅₀ = 7.41). Collectively, these results highlight 138594346 and 138594428 as promising candidates for further experimental validation in the development of targeted CRC therapeutics.
☐ ☆ ✇ BMJ Open

Impact of diabetes mellitus and body mass index on long-term survival in chronic total occlusion patients: a nationwide cohort study from the SCAAR registry

Por: Mohammed · M. · Sundström · J. · Louca · A. · Hellsen · G. · Rawshani · A. · Olivecrona · G. K. · Mohammad · M. A. · Ioanes · D. · Jensen · U. · Erlinge · D. · Angeras · O. · Petursson · P. · Myredal · A. · Völz · S. · Dworeck · C. · Odenstedt · J. · Rawshani · A. · Ramunddal · T. — Septiembre 18th 2025 at 03:51
Objectives

To evaluate the effects of diabetes mellitus (DM) and body mass index (BMI) on long-term all-cause mortality in chronic total occlusion (CTO) patients.

Design

Retrospective, nationwide cohort study.

Setting

Swedish Coronary Angiography and Angioplasty Registry, between June 2015 and December 2021.

Participants

24 284 patients with angiographically confirmed CTO. Prior coronary artery bypass graft surgery excluded. Subgroups were defined by DM status and BMI categories (underweight, healthy weight, overweight, obesity).

Primary outcome measures

Long-term all-cause mortality, assessed by Kaplan-Meier analysis and multivariable Cox proportional hazards regression.

Results

DM was present in 30.3% of patients and conferred a 31% higher risk of mortality (HR: 1.31, 95% CI: 1.20 to 1.42; p2, lowest risk (nadir) at 32 kg/m2 and modest rise above 35 kg/m2.

Conclusions

In this nationwide CTO cohort, DM independently predicted higher long-term mortality, accompanied by more severe comorbidities and greater CTO complexity, and insulin therapy further elevated hazard. Overweight and obese patients had better survival, while underweight individuals had the poorest prognosis. These findings underscore the importance of individualised risk assessment and management strategies in CTO patients, particularly those with DM or low BMI.

☐ ☆ ✇ PLOS ONE Medicine&Health

DXA-derived visceral adipose tissue reference values and metabolic syndrome risk threshold in an Algerian adult population

by Mohammed Hadi Bestaoui, Ali Lounici, Amar Tebaibia, Latifa Henaoui, Nawal Brikci-Nigassa, Houssem Baghous, Amel Bensefia

Background

Visceral adipose tissue (VAT) is associated with several cardiometabolic risk factors, particularly metabolic syndrome and insulin resistance. Reference values for VAT vary across populations, genders, and ages. Data on visceral fat in the Algerian population are lacking. This study aimed to establish reference values for VAT in a general adult population. The secondary objectives were to determine cardiometabolic consequences and to propose suggested threshold values for VAT to predict metabolic syndrome.

Materials and methods

This cross-sectional, analytical study randomly selected participants from the electoral list of Tlemcen, Algeria. VAT was measured using dual-energy X-ray absorptiometry (DXA) General Electric Healthcare© Lunar iDXA.

Results

A total of 301 adults (147 men and 154 women) with a mean age of 49.3 ± 15.1 years participated. The median (25th-75th percentiles) VAT mass was 1364 g (690–2049) in men and 1060 g (585–1590) in women. Binary logistic regression analyses demonstrated that cardiometabolic risk factors, including hypertension, type 2 diabetes, dyslipidemia, metabolic syndrome, insulin resistance according to HOMA2-IR, hepatic steatosis, and sleep apnea syndrome, were significantly dependent on VAT mass. Threshold values for VAT to predict metabolic syndrome (according to International Diabetes Federation) were ≥ 1369 g in men (sensitivity: 86.2%, specificity: 74.2%, Youden’s index: 0.604) and ≥ 1082 g in women (sensitivity: 76.3%, specificity: 76.9%, Youden’s index: 0.532).

Conclusion

This study provides reference values for VAT in an urban Algerian adult population and highlights its importance in assessing cardiometabolic risk.

☐ ☆ ✇ Journal of Nursing Scholarship

Artificial Intelligence Applications in Healthcare: A Systematic Review of Their Impact on Nursing Practice and Patient Outcomes

Por: Sahar A. Abdelmohsen · Mohammed Musaed Al‐jabri — Agosto 21st 2025 at 07:06

ABSTRACT

Background

Artificial Intelligence is revolutionizing healthcare by addressing complex challenges and enhancing patient care. AI technologies, such as machine learning, natural language processing, and predictive analytics, offer significant potential to impact nursing practice and patient outcomes.

Aims

This systematic review aims to assess the impact of Artificial Intelligence applications in healthcare on nursing practice and patient outcomes. The goal is to evaluate the effectiveness of these technologies in improving nursing efficiency and patient care and to identify areas requiring further research.

Methods

This review, conducted in August 2024, followed PRISMA guidelines. We searched PubMed, GOOGLE SCHOLAR, and Web of Science for studies published up to August 2024. The inclusion criteria were original research on AI in nursing and healthcare practice published in English. A two-stage screening process was used to select relevant studies, which were then analyzed for their impact on nursing practice and patient outcomes.

Results

A total of 5975 studies were surveyed from the previously mentioned databases, which met the inclusion criteria. Findings show that AI applications, including machine learning, robotic process automation, and natural language processing, have improved diagnostic accuracy, patient management, and operational efficiency. Machine learning enhanced disease detection, reduced administrative tasks for nurses, NLP improved documentation accuracy, and physical robots increased patient safety and comfort. Challenges identified include data privacy concerns, integration into existing workflows, and methodological variability.

Conclusion

AI technologies have substantially improved nursing practice and patient outcomes. Addressing challenges related to data privacy and integration, as well as standardizing methodologies, is essential for optimizing AI's potential in healthcare. Further research is needed to explore the long-term impacts, cost-effectiveness, and ethical implications of Artificial Intelligence in this field.

Clinical Relevance

Artificial Intelligence (AI) is revolutionizing healthcare by enhancing nursing practices and improving patient outcomes. Tools such as Clinical Decision Support Systems (CDSS), predictive analytics, robotic process automation (RPA), and remote monitoring empower nurses to make informed decisions, optimize workflows, and monitor patients more effectively. AI enhances decision-making, boosts efficiency, and facilitates personalized care, while aiding in early detection and real-time data analysis. It also contributes to better nurse education and patient safety by minimizing errors and enabling remote consultations. However, for AI to be successfully integrated into healthcare, it is essential to tackle challenges related to training, ethical considerations, and data privacy to guarantee its effective implementation and positive impact on the quality and safety of healthcare.

☐ ☆ ✇ Journal of Clinical Nursing

Climate Anxiety and COPD: Unveiling Its Impact on Patients' Quality of Life Through a Multivariate Lens

ABSTRACT

Objective

To examine the impact of climate anxiety on the quality of life (QoL) of patients with COPD. It also explores how climate anxiety interacts with clinical factors, such as disease severity and comorbidities, to influence QoL.

Design

Cross-sectional.

Methods

A total of 270 COPD patients were recruited using a convenience sampling method. Data were collected through structured interviews and clinical assessments, incorporating the Climate Anxiety Scale, the St. George's Respiratory Questionnaire and the BODE Index. Hierarchical multiple regression analysis was performed to determine the predictors of QoL.

Results

The study found a statistically significant association between climate anxiety and both QoL (r = 0.81, p < 0.01) and COPD severity (r = 0.76, p < 0.01). COPD severity (B = 4.68, p < 0.01) and climate anxiety (B = 0.28, p < 0.01) were predictors of QoL. Among the covariates, former smokers, older patients and multiple comorbidities reported significantly worse QoL (B = 4.80, p = 0.03; B = 0.43, p < 0.01; B = 0.85, p = 0.02, respectively). Collectively all predictors explained 86% of the variance in QoL.

Conclusion

Climate anxiety significantly contributes to reduced QoL in COPD patients, beyond disease severity and demographic factors. Addressing psychological distress in COPD management is essential to improving patient outcomes.

Implications for Practice

Nurses should recognise climate anxiety as a key variable influencing COPD management. Incorporating climate anxiety screening into nursing assessments and providing targeted interventions can enhance patient support and improve overall COPD care.

Impact

Climate anxiety is an emerging concern in COPD. While previous research has focused on physical and clinical determinants of COPD-related QoL, climate anxiety remains underexplored. This study provides new evidence that climate anxiety is a predictor of poorer QoL, highlighting the need for holistic nursing interventions that address both physical and psychological health.

Reporting Method

This study was reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).

Patient or Public Contribution

Patients with COPD were involved in this study.

☐ ☆ ✇ Journal of Clinical Nursing

Pediatric Nurses' Challenges in Implementing and Sustaining Clinical Handover in Intensive Care Units: Advocating for the Safety of Critically Ill Paediatric Patients

ABSTRACT

Aim

This study aimed to examine the challenges faced by pediatric nurses in implementing and sustaining clinical handover in intensive care units (ICUs), focusing on identifying key barriers affecting the handover process in these specialised environments.

Background

Pediatric nurses encounter several challenges that hinder the effective implementation of clinical handover in intensive care settings. These challenges can compromise patient safety and care continuity. Understanding these obstacles is essential for identifying areas for improvement and enhancing handover practices in pediatric intensive care units (PICUs) and neonatal intensive care units (NICUs).

Method

A descriptive, cross-sectional study was conducted in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU) of the specialised university hospital for children in Alexandria, Egypt. The sample included 127 nurses who provided direct care to critically ill children. Participants were selected using convenience sampling. Data were collected using a self-administered questionnaire designed to assess various challenges encountered during the clinical handover process. The questionnaire covered five key areas: nurse-related challenges, handover quality-related challenges, organisational challenges, environmental challenges and communication challenges. Data were analysed using descriptive and inferential statistical methods, including multivariate regression analysis. The study adhered to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines.

Results

The study found that the most significant challenges during clinical handover were nurse-related (mean = 74.7, SD = 5.6), followed by organisational challenges (mean = 69.2, SD = 16.7). Statistically significant differences were observed in nurses' characteristics, such as gender, age, marital status, years of experience and the place and duration of handover. Nurses who conducted longer handovers or performed them at the bedside reported fewer challenges compared to those who performed handovers at the nursing station or those with shorter durations.

Conclusion

Pediatric nurses in critical care settings face significant challenges in clinical handover, with barriers such as resistance to change, non-standardised language, time constraints and outdated reports being prominent. Female nurses, older nurses and those working in settings with less standardised handover practices reported more difficulties. Addressing these challenges is critical for improving handover processes, ensuring better patient safety and enhancing care outcomes.

Implications for Nursing Practice and Policy

Standardised handover protocols tailored to intensive care workflows, along with targeted training for nurses, are essential to address the identified challenges. These measures will enhance communication, improve handover efficiency and promote patient safety in pediatric ICUs. No patient or public contribution.

☐ ☆ ✇ Journal of Clinical Nursing

Enhancing Communication and Empathy Skills in Geriatric Care: Nurses' Reflections on Simulation‐Based Training for Patient Interaction and Education

Por: Sobhia Ahmed Abdel Kader Mohammed · Mostafa Shaban — Enero 15th 2025 at 04:11

ABSTRACT

Aim

To explore the impact of simulation-based training on communication and empathy skills among nurses working with elderly patients in the Abha region of Saudi Arabia. The study also aimed to identify the barriers and facilitators to applying these skills in real-world clinical practice.

Design

A qualitative study.

Method

Semi-structured interviews were conducted between June and July 2024 with 17 nurses from urban and rural healthcare settings in the Abha region. Data were analysed using both deductive framework analysis, guided by social support theory, and inductive thematic analysis to identify key themes related to communication, empathy, and the application of simulation-based skills in practice. We adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.

Results

The study involved 17 participants aged 22–50 years, with diverse educational backgrounds and work experience. The findings indicated that simulation-based training significantly improved nurses' confidence in delivering difficult news and their ability to empathise with elderly patients. Nurses working in urban settings with regular access to simulation training reported better outcomes compared to those in rural settings with less frequent training opportunities.

Conclusion

Simulation-based training has a positive impact on enhancing communication and empathy skills among nurses, but challenges in real-world application remain. Efforts should be made to improve the accessibility of simulation training and address the barriers preventing its effective implementation in clinical practice.

Implication for the Profession and/or Patient Care

Healthcare practitioners and policymakers should prioritise simulation-based training in nursing education and professional development to improve the quality of care for elderly patients.

Reporting Method

The Consolidated Criteria for Reporting Qualitative Research (COREQ).

Patient or Public Contribution

The engagement and interview data from nursing participants provided valuable insights into the impact of simulation-based training on communication and empathy in elderly care.

☐ ☆ ✇ Journal of Clinical Nursing

Psychological Distress, Antipsychotic Medications and Cardiovascular Risk Factors Among Patients With Schizophrenia

ABSTRACT

Aims

This study aims to assess the correlation between antipsychotic drug use, psychological distress and cardiovascular risk factors among patients with schizophrenia.

Methods

A cross-sectional correlational design was used to obtain data from 143 patients with schizophrenia who were conveniently selected. Data were collected by assessing selected cardiovascular risk indicators blood pressure (BP), random blood sugar (RBS), body mass index (BMI), waist-to-height ratio (WtHR) and waist circumference (WC). A self-administered questionnaire was used to collect sociodemographic data, clinical history and the 18-item Psychological Stress Index for patients with schizophrenia.

Results

The use of antipsychotics was associated with increased cardiovascular risk factors including BP, BMI and WtHR. Atypical antipsychotic medications were associated with weight gain and obesity which increase the risk of diabetes and cardiovascular diseases. Age was significantly correlated with systolic BP (r = 0.31), diastolic BP (r = 0.30) and RBS (r = 0.26). Furthermore, significant correlations were found between the duration of diagnosis with systolic (r = 0.26) and diastolic (r = 0.21) BP. None of the correlations between stress and the other study variables were significant.

Conclusion

Screening of antipsychotic side effects is needed in the early phases, and attention must be paid to the cardiovascular risk in patients with schizophrenia, particularly BP, glucose level and BMI. In addition, clinicians should be informed of this evidence to set guidelines for regular monitoring of metabolic parameters.

Reporting Method

STROBE guidelines were followed in this study.

Patient or Public Contribution

Actively involving patients in data collection, this study ensured that their voices were heard and their experiences were central to informing the research findings. In addition, involving patients in the study would enhance the relevance and applicability of the study's conclusions to real-world contexts, promoting patient-centered care and improved health outcomes for patients with schizophrenia.

☐ ☆ ✇ Journal of Clinical Nursing

The Association of Health Literacy With the Quality of Discharge Planning and Readiness for Hospital Discharge in Jordanian Acute Myocardial Infarction Patients

ABSTRACT

Aim

To examine the relationship between health literacy with the quality of discharge planning and readiness for hospital discharge in acute myocardial infarction patients in Jordan.

Background

Acute myocardial infarction is a major heart disease caused by plaque formation in coronary arteries. Complications after acute myocardial infarction include readmission and physical complications such as chest pain, and limited health literacy increases the risk of complications. Improving the health literacy of patients can improve postdischarge outcomes and decrease complications.

Methods

This study was conducted using a cross-sectional design. Data were collected from 123 patients who were recruited from three hospitals in Jordan. A demographics questionnaire and three valid and reliable instruments (Health Literacy Questionnaire, Readiness for Hospital Discharge Scale and Quality of Discharge Teaching Scale) were used to collect the data. The authors adhered to the STROBE checklist during the preparation of this study.

Results

The results demonstrated that the Readiness for Hospital Discharge had weak to moderate positive correlations with health literacy scales (r = 0.24–0.36, p < 0.05). The content subscale of the Quality of Discharge Teaching Scale showed weak positive correlations with navigating the healthcare system, finding good health information and understanding health information scales of the Health Literacy Questionnaire.

Conclusion

The results reported here indicate that health literacy positively correlates with readiness for hospital discharge and quality of discharge teaching.

Relevance to Clinical Practice

Improving the health literacy of acute myocardial infarction patients can enhance their discharge planning outcomes. The findings of this study are beneficial for healthcare providers in designing targeted interventions that correspond to health literacy among acute myocardial infarction patients.

Patient or Public Contribution

No patient or public contribution.

☐ ☆ ✇ Journal of Clinical Nursing

Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review

ABSTRACT

Background

Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions.

Objective

To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients.

Design

A systematic review of interventional studies was established to meet the PRISMA guidelines.

Methods

PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023.

Results

The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery.

Conclusions

Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

☐ ☆ ✇ Journal of Clinical Nursing

Cut‐off scores of the Depression Anxiety Stress Scale‐8: Implications for improving the management of chronic pain

Abstract

Aim

Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.

Design

This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13–71 years).

Methods

Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.

Results

Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.

Conclusion

CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.

Implications for patient care

At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.

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