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The Mediating Role of Spirituality in Delineating the Interconnection Between Self‐Efficacy and Resilience Among the Parents of Children With Newly Diagnosed Diabetes: A Community Nursing‐Led Cross‐Sectional Study

ABSTRACT

Aim

This study examined the interplay among spirituality, self-efficacy and resilience in this context.

Design

A cross-sectional study.

Method

A total of 178 parents of children newly diagnosed with diabetes mellitus; the instruments used for data collection were the Parental Self-Efficacy Scale for Diabetes Management, The Arabic version of The Walsh Family Resilience Questionnaire and the Spiritual Perspective Scale.

Results

Self-efficacy had a significant positive direct effect on family resilience. Spirituality also had a significant positive direct effect on family resilience. Additionally, self-efficacy had a significant positive indirect effect on family resilience through its effect on spirituality.

Conclusion

The findings underscore the impact of spirituality and self-efficacy on a family resilience.

Implications for the Profession

Nurses should prioritise self-care and personal reflection to enhance their spiritual well-being. This can help them better understand and empathise with their patients' spiritual needs, allowing for more effective and compassionate care.

Impact

Upon the initial diagnosis of diabetes in a child, parents undergo a profound emotional and psychological upheaval. They are faced with the daunting task of managing their child's condition while also coping with their feelings of distress, uncertainty and fear. Amidst these challenges, factors such as self-efficacy and resilience play pivotal roles in determining how parents adapt to and navigate this new reality.

Nurses can use spiritual care to give parents a sense of meaning, purpose and hope, bolstering their self-efficacy and resilience.

Reporting Method

The relevant reporting method has been adhered to, that is, STROBE.

Patient or Public Contribution

In our research, data collection is assisted by nurses working in community-based settings.

Organisation and support of orthopaedic and trauma services in Tanzania: a national cross-sectional survey

Por: Issa · S. A. · Muhamedhussein · M. S. · Njambilo · G. M. · Mgisha · W. R. · Mrita · F. S.

Objectives

To describe orthopaedic department-level organisational characteristics, the availability of multidisciplinary specialist support, the role of external support mechanisms, and the presence of in-hospital orthopaedic training opportunities across hospitals delivering orthopaedic and trauma services in Tanzania.

Design

National cross-sectional survey.

Setting

Hospitals delivering orthopaedic and trauma services across all levels of care and ownership categories in Tanzania.

Participants

Licensed orthopaedic and trauma surgeons practising in Tanzania served as key informants for their respective hospitals. A total of 171 surgeons provided data on 92 unique hospitals nationwide.

Primary outcome measures

Primary outcomes included orthopaedic departmental structural capacity, availability of multidisciplinary specialist support, external support mechanisms and in-hospital orthopaedic training activities.

Results

A response rate of 77.7% yielded data on 92 hospitals delivering orthopaedic and trauma services nationwide. Structural capacity varied widely, with only 19.6% of hospitals reporting more than 50 orthopaedic beds, 43.5% relying on a single orthopaedic surgeon, and 47.8% operating with one or two functional theatres. Access to specialist support was limited, with vascular trauma surgeons available in 9.8% of hospitals and plastic and reconstructive surgeons in 8.7%. Intensivists were available in 41.3% of facilities and anaesthesiologists in 57.6%, while physiotherapists were present in 90.2% of hospitals but occupational therapists in only 28.3%. External dependence was common, with 41.3% of hospitals relying on donated implants and 29.3% participating in outreach programmes. In-hospital orthopaedic training opportunities were limited, with seminars or workshops available in 25.0% of hospitals. Across domains, higher-tier hospitals demonstrated significantly greater structural capacity and specialist availability.

Conclusions

Orthopaedic and trauma services in Tanzania are available across multiple levels of the health system but are characterised by inequitable workforce distribution, limited capacity at lower-tier hospitals and substantial reliance on external assistance. Integrated strategies linking infrastructure development, multidisciplinary workforce expansion, sustainable procurement and decentralised training are essential to strengthen the organisation and resilience of orthopaedic and trauma services nationwide.

Gompertz proportional hazards survival analysis of time to first birth among childbearing women in Somaliland (2020): a cross-sectional study

Por: Hussein · M. A. · Yousuf · A. M. · Muse · A. H. · Esse · A. A. · Abdi · A. N. · Osman · A. A. · Abdikarim · H. · Chesneau · C.
Background

The timing of a woman’s first birth is significantly associated with maternal and child health outcomes and socioeconomic opportunities. Delaying the first birth is associated with reduced risks of adolescent pregnancy complications, improved birth outcomes and enhanced interpregnancy intervals, all of which contribute to better maternal and child health. In Somaliland, early childbearing is prevalent, necessitating an understanding of its associated factors. Early childbearing, defined as a first birth before age 20, is prevalent in Somaliland, with 47.02% of women having their first birth by this age, significantly higher than the average for sub-Saharan Africa (approximately 30%) and global figures.

Objectives

This study aimed to identify the sociodemographic factors associated with age at first birth among married women in Somaliland.

Results

The median duration from marriage to first birth was 3 years, with a median age at first birth of 21 years. Women residing in the Sool (adjusted HR: 1.318, 95% CI 1.138 to 1.527) and Sanaag (adjusted HR: 1.265, 95% CI 1.095 to 1.462) regions had a significantly higher hazard of first birth compared with those in Awdal (reference). Conversely, women in the middle (adjusted HR: 0.821, 95% CI 0.685 to 0.985) and highest (Adjusted HR: 0.799, 95% CI 0.663 to 0.964) wealth quintiles had a significantly lower hazard of first birth compared with the lowest wealth quintile. Age at first marriage was a strong factor associated with the outcome; marrying at age 20 or older (adjusted HR: 0.699, 95% CI 0.644 to 0.759) was associated with a significantly lower hazard of first birth compared with those who married before age 20. After adjustment, other factors including residence, media exposure and husband’s employment status were not significantly associated with the timing of first birth.

Conclusions

Region, wealth quintile and age at first marriage are critical factors associated with first birth timing in Somaliland. Interventions should focus on addressing regional disparities and promoting delayed marriage to improve maternal and child health outcomes. Further research is needed to explore the complex social and cultural drivers of these findings.

Developing count regression techniques for predicting the number of new type 2 diabetes cases in Saudi Arabia

by Faten Al-hussein, Laleh Tafakori, Mali Abdollahian, Khalid Al-Shali

Type 2 diabetes (T2D) is a chronic condition affecting millions globally. A robust predictive model to estimate the number of new cases of T2D can facilitate precise monitoring and effective intervention strategies. This study aims to predict the number of new T2D cases per month in Saudi Arabia and identify the Key Performance Indicators (KPIs) associated with T2D, using count regression models, Poisson Regression (PR), Negative Binomial Regression (NBR), Poisson Inverse Gaussian Regression (PIGR), and Bell Regression (BR). De-identified data from 1,000 patients with T2D in Saudi Arabia were used to develop the models. The performance of the full models, which include recommended Key Performance Indicators (KPIs), is compared using metrics such as the coefficient of determination (R2), root mean squared error (RMSE), mean absolute error (MAE), 10-fold cross-validation (CV-10), Akaike information criterion (AIC), and Bayesian information criterion (BIC). The most significant KPIs identified by the full models were utilized to develop the reduced models. The full NBR model outperformed other models, achieving R² of 0.88, RMSE of 0.93, MAE of 0.69, CV-10 of 1.21, AIC = 873.23, and BIC = 880. The reduced NBR model, focusing solely on the five most influential variables (marital status, age, body mass index (BMI), total cholesterol (TC), and high-density lipoprotein (HDL)), with R² = 0.84, RMSE = 1.10, MAE = 0.86, CV-10 = 1.37, AIC = 899, and BIC = 910, also outperformed other reduced models. The Likelihood Ratio Test (LRT) did not show a significant difference between the full and reduced NBR models (p = 0.694), supporting the adequacy of the reduced model. The proposed reduced model, utilizing only five significant KPIs, can help healthcare providers develop effective, targeted strategies by monitoring a smaller number of KPIs to reduce the rising number of T2D cases in Saudi Arabia.

Barriers and enablers to effective collaboration and coordination mechanisms among humanitarian organisations delivering health and nutrition programmes in Somalia: an exploratory qualitative study

Por: Ibrahim · A. M. · Hussein · S. A. · Mohamed · M. O.
Background

The effectiveness of humanitarian health and nutrition programmes in Somalia is critically dependent on seamless collaboration and coordination among a diverse array of actors. While existing literature acknowledges broad challenges to coordination such as insecurity, resource competition and fragmentation, a significant gap remains in understanding how these barriers and their corresponding enablers actively manifest in the daily operations and decision-making processes of frontline practitioners.

Objectives

This study aims to provide a systematic, in-depth exploration of the barriers and enablers influencing collaboration and coordination mechanisms from the perspective of those directly involved in the response.

Design

A qualitative study was conducted using semi-structured, in-depth interviews. Data were analysed using a deductive thematic approach guided by the Consolidated Framework for Implementation Research.

Setting

The study was conducted across the entire territory of Somalia, encompassing its five member states, the capital city Mogadishu, and the self-declared independent state of Somaliland.

Participants

A total of 26 participants, including executive directors, health and nutrition programme managers, coordinators from international and national non-governmental organisations (NGOs), government officials and community members, were interviewed.

Results

Key barriers included poor adaptability and high complexity related to collaborative initiatives (intervention characteristics); armed conflicts, climatic shocks, deeply ingrained sociocultural practices and restrictive government policies (outer setting); inadequate information technology infrastructure and hierarchical communication (inner setting); high staff turnover (individual characteristics). Key enablers included strong inter-agency partnerships (outer setting); supportive organisational culture (inner setting); competent and motivated staff (individual characteristics); and robust planning, engaging and evaluation processes (process).

Conclusion

The study highlights the complex contextual factors that impact the effectiveness of collaboration and coordination mechanisms among humanitarianorganisations operating in Somalia. Policymakers should unify governance, agencies prioritise localisation and donors allocate quotas to local NGOs to enhance aid delivery.

The Climate‐Asthma Connection: Examining the Influence of Climate Change Anxiety on Asthma Control and Quality of Life: A Multi‐National Study

ABSTRACT

Aims

This study aims to identify the impact of climate change anxiety and asthma control on asthmatics' quality of life and examine the moderating role of climate change anxiety in this linkage.

Method

A multi-national cross-sectional study was conducted in four Arabian countries on 1266 asthmatics selected by convenience sampling. Data were collected from November 2023 to February 2024 using a climate anxiety scale, mini-asthma quality of life questionnaire, and an asthma control questionnaire.

Results

Climate anxiety was higher among middle-aged participants, as well as those with longer disease durations and previous hospitalisations. Climate anxiety showed strong negative correlations with asthma control (r = −0.704, p ≤ 0.05) and asthma quality of life (r = − 0.638, p ≤ 0.05). Climate anxiety and asthma control are powerful predictors of quality of life among asthmatics. Climate anxiety moderates the relationship between asthma control and quality of life, making it less positive (B = −0.094, p > 0.001). Covariates such as gender, age, comorbidities, employment status, disease duration, and previous hospitalisation showed significant associations with asthma quality of life.

Implications for Nursing Practice

Assessment and mitigation of climate anxiety among asthmatics is a key strategy for controlling asthma and improving the quality of life. So, nurses must incorporate climate anxiety assessment into the care plan for asthmatics.

Impact

Climate change is a global concern, and insights into how climate-related psychological stressors exacerbate asthma symptoms and overall health outcomes are necessary. The findings provide actionable data for healthcare professionals to underscore the need for integrated healthcare approaches considering environmental and psychological factors.

Reporting Method

This study adheres to strengthening the reporting of observational studies in epidemiology (STROBE) statement.

Patient or Public Contribution

Clients with asthma across multiple nationalities actively contributed to our paper.

The Association between Emotional Responses to Climate Change, Antenatal Anxiety and Maternal–Fetal Attachment in Primigravida Women

ABSTRACT

Aim

To investigate the association between emotional responses to climate change, antenatal anxiety, and maternal–fetal attachment in primigravida women.

Design

A multi-site cross-sectional research design study.

Methods

This study was conducted at four primary health care (PHC) facilities in Damanhur district, El-Behera, from February 2024 to April 2024. Two hundred eighty-five women completed a comprehensive questionnaire that included a Woman's Social and Reproductive Form, The inventory of climate emotions (ICE) scale, The Stirling Antenatal Anxiety Scale (SAAS) and the Maternal–Fetal Attachment Scale (MFAS-HU-20).

Results

The study revealed that emotional responses to climate change show strong positive correlations with each other, ranging from 0.689 to 0.840, all significant at p < 0.001 level. Additionally, antenatal anxiety demonstrates substantial positive correlations with emotional responses to climate change, albeit with associations ranging from 0.239 to 0.287, all significant at p < 0.001 level. Moreover, maternal–fetal attachment displays substantial negative correlations with emotional responses to climate change, indicating that as emotional responses to climate change increase, maternal–fetal attachment tends to decrease. The correlations range from −0.263 to −0.426, all significant at p < 0.001.

Conclusions

The emotional impact of climate change can adversely affect the bonding process between mother and fetus.

Implications for the Profession

Healthcare professionals, including obstetricians, midwives, and mental health counsellors, should integrate climate-related emotional distress into their assessments and interventions. Providing targeted psychological support for expectant mothers.

Impact

The study's findings highlight the need for nursing to integrate climate-related emotional distress screening into prenatal care and for research to explore long-term effects and intervention effectiveness. In practice, healthcare providers should adopt holistic approaches that combine environmental and psychological support, developing comprehensive guidelines and community-based programs to support pregnant women.

Reporting Method

The research adhered to that is STROBE.

Patient or Public Contribution

Public contributions by women in community health centers.

Video‐Based Climate Change Program Boosts Eco‐Cognizance, Emotional Response and Self‐Efficacy in Rural Nursing Students: Randomised Controlled Trial

ABSTRACT

Background

The Munich Security Conference 2024 highlighted the complex connections between climate change and global security risks. Engaging students in fighting climate change is a stepping stone to achieving the Sustainable Development Goals.

Aim

To investigate the effect of a video-based climate change program on revitalising eco-cognizance, emotional response, and self-efficacy among nursing students in rural communities.

Design

A randomised controlled trial research design was adopted.

Method

A total of 140 nursing students completed a survey related to the Climate Change Perceptions, the Climate Change Anxiety Scale, and the Environmental Self-Efficacy Scale. The study group engaged in the video-based climate change program, while the comparison group received flyers related to climate change across the globe.

Results

The intervention group significantly improved climate change perception and environmental self-efficacy compared to the control group, with large effect sizes. On the other hand, significantly lower levels of cognitive impairment due to climate change anxiety were recorded among the intervention group compared to the control group.

Conclusion

Our intervention improved nursing students' climate change literacy, pro-environmental attitudes, environmental self-efficacy, and anxiety. Future research may target a variety of university majors and use RCTs nested in a mixed-method design to capture the student experience with climate change before and after the RCT.

Impact

This study demonstrated that a comprehensive educational program significantly improved climate literacy, pro-environmental attitudes, and environmental self-efficacy among undergraduate nursing students while reducing climate anxiety. The findings of this study offer valuable insights for enhancing student nurses' ability to translate their scientific understanding into informed decision-making regarding issues like climate change.

Implications for Practice and/or Policy

Drastic natural disasters, including extreme temperatures, flooding, wildfires and snow and sandstorms, significantly affect populations, including nursing students. Early screening and management of climate change anxiety among university students is recommended as a buffer against upcoming mental health issues. Student counselling services are urged to consider the effect of climate change as a mental health parameter that significantly affects students' psychological and, consequently, academic life and progress. A video-based climate change program (VBCCP) is beneficial for equipping students with climate change literacy. The revitalization of the participant's overall eco-emotional response, pro-environmental behaviour and cognizance signalled the potential of VBCCP as a simulation teaching tool that might be integrated into nursing curriculums. Additionally, VBCCP is a cost-effective strategy that complies with International Nursing Association for Clinical Simulation and Learning (INACSL) requirements. The VBCCP can be delivered in the conventional classroom environment or through the digital platform without incurring additional costs and in alignment with the definition of simulation provided by the Agency for Healthcare Research and Quality.

Patient or Public Contribution

No public or patient contributions.

Trial Registration

RCT registration: NCT06223412, on 23rd January 2024

Challenges and Opportunities Faced by Migrant Nurses in the Receiving Country: A Mixed‐Methods Study on Cultural Adaptation and Professional Integration

ABSTRACT

Aim

To provide a comprehensive understanding of the cultural adaptation and professional integration experiences of migrant nurses in the receiving country.

Design

A convergent parallel mixed methods design with concurrent sampling was employed.

Methods

Professional nurses who migrated from various Middle Eastern and North African countries, including Egypt, Syria, Palestine, Yemen, Jordan, Iraq and Saudi Arabia, were enrolled. The Quantitative data was collected through an online questionnaire involving open-ended questions for the qualitative data. Data was collected from November 2023 to March 2024.

Findings

One hundred five nurses responded to the quantitative questionnaire, and 32 answered the open-ended questions. The findings revealed that mean scores for cultural competence and professional self-concept were 83.41 ± 12.90 and 76.28 ± 11.16, respectively. Migrant nurses experienced challenges such as language barriers (91.4%), social interaction (82.9%) and difficulties adapting to daily living activities (100%). The majority of them reported positive outcomes as better working conditions (91.4%), higher standard of living (89.5%) and professional development opportunities (94.3%). Nurses emphasised accepting cultural diversity, participating in cultural competency training, building relationships with local colleagues and utilising support mechanisms and mentorship for cultural adaptation.

Conclusion

This study highlighted the importance of support systems, cultural competency training and integration initiatives to facilitate successful adaptation and professional integration.

Implications for Profession

Orientation programs and cultural competency training should be developed to support migrant nurses. Initiatives should include language acquisition support, financial assistance for certification programs and promotion of diversity and inclusion in healthcare settings.

Impact

This study addressed the challenges migrant nurses face when transitioning to a new cultural and professional environment. It found that migrant nurses experience difficulties with language, social interaction and daily living activities. The research impacted healthcare institutions by guiding the development of orientation programs and cultural competency training, supporting policymakers in addressing systemic barriers and empowering migrant nurses with practical strategies for adaptation.

Reporting Method

This study adhered to the Good Reporting of A Mixed Methods Study (GRAMMS).

Patient or Public Contribution

No patient or public involvement.

HIV self-testing uptake and associated factors among adolescent girls and young women in certificate and diploma colleges, Dodoma, Tanzania: a cross-sectional study

Por: Osima · D. J. · Hussein · A. K. · Anasel · M. G. · Ngasala · B.
Objectives

To determine the prevalence and factors associated with the uptake of HIV self-testing (HIVST) among adolescent girls and young women (AGYW) attending middle learning institutions in Dodoma City, Tanzania, in 2024.

Design: A cross-sectional study design was employed.

Setting

The study was conducted in five randomly selected colleges in Dodoma City, Tanzania.

Participants

A total of 771 female students aged 15–24 years who provided informed consent were enrolled. Students who declined participation or were reported by the college matron as medically unfit were excluded. In this study, ‘sick’ referred to participants with a clinically diagnosed illness rendering them unable to participate.

Primary outcome

The primary outcome was the uptake of HIVST among participants.

Results

The mean age of participants was 20.78 years (SD=1.85). Overall, 360 participants (46.7% (95% CI 43.2% to 50.2%) reported having used HIVST. Among those who had not tested, the most commonly reported barriers included cultural resistance 392 (95.4%), fear of judgement from healthcare providers, 372 (90.5%); legal restrictions on kit provision, 360 (87.6%); fear of testing procedures, 291 (70.8%); concerns about test reliability, 286 (69.6%); fear of test results, 283 (68.9%); limited accessibility to HIVST kits, 280 (68.1%); fear of others discovering they had tested, 273 (66.4%); low awareness of HIVST, 193 (47.0%); and a perceived low risk of HIV infection, 73 (17.8%).

Factors significantly associated with HIVST uptake included having multiple sexual partners adjusted prevalence ratio (aPR 1.23, 95% CI 1.05 to 1.45), studying health-related courses (aPR 1.14, 95% CI 1.04 to 1.27), availability of kits (aPR 2.83, 95% CI 2.21 to 3.62), previous HIV testing experience (aPR 2.65, 95% CI 2.05 to 3.43) and perceiving oneself at risk of HIV infection (aPR 1.29, 95% CI 1.11 to 1.50).

Conclusion

The uptake of HIVST among AGYW in Dodoma City remains below the national target of 95% HIV awareness among people living with HIV. Uptake was influenced by factors such as multiple sexual partnerships, study discipline, kit availability, prior testing experience and perceived risk of infection. Addressing the identified barriers and improving awareness and accessibility of HIVST could enhance testing rates among AGYW.

The Role of Virtual Reality in Supporting Daily Spiritual Practices Among Muslim Patients Undergoing Haemodialysis Treatment: A Fuzzy Delphi Study

ABSTRACT

Aim

This study explores' perceptions and expectations of experts regarding the role of VR in supporting daily spirituality practices among Muslim patients undergoing haemodialysis treatment.

Methods and Design

The Fuzzy Delphi Method (FDM) is utilised to gather insights from a panel of experts in nephrology, psychology, Islamic studies, and VR technology. A total of 11 experts was selected based on their expertise and experience in relevant domains to ensure the credibility and validity of the findings.

Results

Key themes emerging from the study include VR's potential to create immersive and meaningful spiritual experiences, alleviate psychological distress, and enhance coping mechanisms. Factors concerning accessibility, cultural sensitivity, and integration into clinical settings are also highlighted as important considerations.

Conclusion

The study explores how VR technology can aid Muslim haemodialysis patients in spiritual routines. It underscores the significance of holistic healthcare methods in addressing patients' spiritual and psychological needs. Future research should aim to develop VR-based therapies tailored for these patients while considering practical and ethical challenges in medical settings.

Implications for the Profession and/or Patient Care

The findings of this study have significant practical implications for designing and implementing VR interventions in healthcare settings. Developing VR content that is culturally sensitive and aligned with Islamic practices is crucial for its acceptance and effectiveness. Integrating VR into the spiritual practices of Muslim haemodialysis patients also raises ethical and pragmatic considerations.

Patient or Public Contribution

No patient or public contributions were made in this study.

Career Growth as a Mediator Between Scope of Practice, Importance of Practice and Emergency Nursing Competency Among School Nurses

ABSTRACT

Background

School nurses are sometimes the sole healthcare professionals in schools, highlighting their significant role in delivering emergency care and the vital necessity of their competence in emergency nursing care. The scope of practice and ongoing professional development are hypothesized to play significant roles in enhancing these competencies.

Aim

Investigate the direct and indirect effects of the scope of current practice and the importance of training on the emergency nursing care competency of school nurses, with career growth serving as a potential mediator.

Methods

A multi-center cross-sectional study was conducted with a convenient sample of 219 school nurses. Data were collected using the career growth of nurses' scale, the emergency nursing care competency scale for school nurses and the scope of school nursing practice tool. Mediation analysis was used to explore the direct and indirect effects of studied variables.

Results

Mediation analysis indicated that the scope of current practice had a significant direct effect on career growth (β = 0.179) and emergency nursing care competency (β = 0.389). The importance of practice also had significant direct effects on career growth (β = 0.164) and emergency nursing care competency (β = 0.220). Additionally, career growth significantly mediated the relationship between both the scope of current practice (β = 0.110) and the importance of practice (β = 0.120) with emergency nursing care competency.

Conclusions

The findings emphasis the critical role of career growth as a mediator between the scope and importance of practice and emergency nursing care competency among school nurses. Expanding the scope of practice and emphasising the importance of professional activities can enhance career growth and improve emergency nursing care competencies.

Implications

Nurses scope of practice and clear career advancement through mentorship, advanced certifications, further education and enforcing policies mandating regular emergency care is crucial. Establishing a regulatory framework to define and expand the scope of practice for school nurses is also important.

Patient or Public Contribution

No patient or public contribution.

Effectiveness of a Nurse‐Led HeartMath Training Program on Resilience, Emotional Adjustment, and Treatment Motivation Among Patients With Substance Use Disorder: A Randomized Control Trial

ABSTRACT

Background

Although multimodal rehabilitation programs are effective for substance use disorders and widely used, addiction is still a global socioeconomic problem. Providing practical strategies, such as the HeartMath intervention for managing stress at the moment, helps mitigate the physical, emotional, and psychological impacts associated with substance use disorder, promotes resilience, and enhances treatment motivation.

Aim

To investigate the effects of the nurse-led HeartMath Training Program on resilience, emotional adjustment, and treatment motivation among patients with substance use disorder.

Method

A randomized controlled trial (RCT) was used to carry out this study. This study was conducted at the inpatient unit for patients with addiction at Elmaa'mora Hospital for Psychiatric Medicine in Alexandria, Egypt. The subjects were 130 patients with substance use disorders (65 in each group). Researchers used three tools to collect the necessary data: Tool I Resilience Scale, Tool II Brief Adjustment Scale–6, and Tool III Treatment Motivation Questionnaire.

Result

The difference in resilience, emotional adjustment, and treatment motivation between the study and control groups after the Nurse-Led HeartMath training intervention was statistically significant.

Linkage Evidence to Action

The HeartMath Training Program is efficacious in improving resilience and emotional adjustment among patients with substance use disorder and increasing their treatment motivation.

Trial Registration

ClinicalTrials.gov identifier: NCT06437366

Cardiovascular disease risk and its determinants among hypertensive patients in Eastern Ethiopia: an institution-based cross-sectional study

Por: Ali · S. Y. · Shegere · M. M. · Abdulahi · A. · Hussein · A. A. · Abdinur · A. H. · Muhumed · A. A. · Ayele · Z. A. · Abebe · D. · Abdu · S. M. · Gemechu · W. D.
Objectives

This study aims to assess the level of cardiovascular disease (CVD) risk and its associated determinants among hypertensive patients in Jigjiga, Somali Region, Ethiopia using the WHO 10-year CVD risk score.

Design

An institution-based cross-sectional study design was employed.

Setting

Hypertensive patients aged 40–74 years in two public hospitals in Jigjiga, Somali Region, Ethiopia, from 20 December 2023 to 20 February 2024.

Participants

Randomly selected 344 hypertensive patients aged 40–74 years with a duration of 1 year or more from the time of diagnosis and at least having 6-month follow-up.

Primary outcome measures

10-year CVD risk level was assessed by using WHO 10-year CVD risk score. Risk levels were categorised as low (

Secondary outcome measures

Associated factors influencing CVD risk.

Results

The study included 341 hypertensive individuals, with a 99.1% response rate. Of the respondents, 58.9% were men. The overall prevalence of CVD risk within the coming 10 years was 134 (39.3%; 95% CI: 34.1% to 44.5%). Multivariable logistic regression analysis identified age, khat chewing, smoking and comorbid conditions as significant independent predictors of CVD risk. Specifically, individuals aged 60–69 years had an adjusted OR (AOR) of 3.97 (95% CI: 1.94 to 8.16) and those aged 70–74 years had an AOR of 2.99 (95% CI: 1.57 to 5.71). Khat chewers had an AOR of 2.58 (95% CI: 1.22 to 5.46), smokers an AOR of 3.44 (95% CI: 1.59 to 7.48) and individuals with comorbidities an AOR of 2.42 (95% CI: 1.47 to 3.99).

Conclusion

There is a significant increase in 10-year CVD risk among hypertensive patients in the study area. Age, khat chewing, smoking and comorbidities were independent predictors. Regular CVD risk screening for older patients, focused health education to reduce khat and tobacco use and integrated management of comorbidities are essential to lower future cardiovascular risk.

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