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Explore and describe the triggers, preventive strategies, and sociocultural dynamics of violence in healthcare settings, focusing on the experiences and perspectives of nurses Damietta Governorate, Egypt.
A cross-sectional design.
A stratified random sampling approach was followed to ensure representation from all departments by recruiting 424 nurses from several hospitals in Egypt. Self-administered questionnaires were applied, using validated instruments such as the Hospital Safety Climate Scale, the Coping Strategies Inventory, the Maslach Burnout Inventory, the Perceived Causes of Workplace Violence Questionnaire, and the Workplace Violence Scale to collect data. Data analysis using SPSS version 26 was carried out with descriptive statistics including means and standard deviations. STROBE reporting guidelines were followed.
Nurses had a moderate level of verbal abuse (mean 3.50) and bullying/harassment (mean 3.00) and lesser incidences of physical violence (mean 2.80) and sexual harassment (mean 2.70). The most common cause was perceived as organisational factors (mean 3.80) and then environmental (mean 3.60) and sociocultural (mean 3.40). Problem-focused coping strategies, which were used mostly (mean 3.45), emotional exhaustion (mean 4.20), making the overall burnout level moderate (mean 3.83). The safety climate had positive perceptions concerning management support (mean 3.80), an area needing improvement in safety communication (mean 3.70) and staff training (mean 3.60).
The study underscores the prevalent issues of workplace violence and emotional exhaustion among nurses, highlighting the need for targeted interventions and support systems to address these challenges.
Implementing comprehensive support programs, enhancing safety protocols, and focusing on both problem-focused and emotional support strategies are essential for improving nurse well-being and reducing workplace violence. These measures will contribute to a safer working environment and better patient care outcomes.
What problem did the study address? The study explored and described the high incidence of workplace violence and its impact on nurses' emotional well-being and job satisfaction in Egyptian healthcare settings.
What were the main findings? Prevalent verbal abuse and bullying were noted in the study, with the organisational factors identified as the most important cause. High levels of emotional exhaustion and moderate burnout, coupled with positive but improvable perceptions of safety climate, were reported.
Where and on whom will the research have an impact? Impacts from the research would touch every nurse working in hospitals around the cities of Damietta Governorate in Egypt, including Damietta General Hospital, Central Hospital in Faraskour, Elzarqa General Hospital, and probably other healthcare settings in the locale. It is anticipated that the results will give way to new hospital policies and practices on improving nurse safety and job satisfaction, which could lead to enhanced overall patient care.
The STROBE checklist was followed.
No patient or public contribution.
Hospital falls persist as a major threat to patient safety. This study aimed to develop an interprofessional reference standard to prevent, manage and report hospital falls.
A Delphi consensus methodology, informed by the Conducting and Reporting Delphi Studies guideline, was used to design the reference standard. An interprofessional expert panel (n=47) of health professionals, researchers, policymakers and consumers participated in three Delphi rounds. Following the review of clinical guidelines, an e-Delphi survey was developed and piloted to derive 60 initial items for the standard. Two iterative rounds of e-Delphi surveys were distributed via Research Electronic Data Capture and included free-text questions and 9-point Likert scales. An online consensus meeting followed, to ratify the final standard.
In the first Delphi round, there was over 80% agreement for 44/60 items to be included in the reference standard. This increased to 48/60 items in Round 2. At the final consensus meeting, 12 items still did not reach consensus for inclusion and one was added, yielding 49 items. Items that replicated text according to falls with injury/without injury were combined, resulting in 42 items in the final reference standard. Agreed items included: (1) brief screening of falls risk on hospital admission; (2) comprehensive falls assessment for inpatients who are older, frailer or have complex conditions; (3) single interventions (such as environmental adaptations and exercise); (4) multifactorial interventions; (5) education of patients, families and staff; (6) optimising local falls hospital policies, procedures and leadership capability; (7) optimising documentation and reporting; (8) improving accreditation processes; (9) workforce redesign to augment falls education. Items that did not reach agreement (n=12) pertained to alarms, bed rails, grip socks, artificial intelligence, volunteers and care bundles.
This new reference standard provides a checklist for staff, patients, managers and policymakers to reduce unwanted variations in prevention, management and reporting of hospital falls.
ANZCTR 386960
Nurse-led education programs in childcare settings are critical for improving early childhood health outcomes and caregiver practices. Despite their potential, a systematic synthesis of their effectiveness is lacking.
To summarize the characteristics and evaluate the effectiveness of existing nurse-led education programs in childcare settings through a systematic review of experimental studies.
This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted in five databases from inception to December 9, 2024. Two reviewers independently screened articles, extracted data, and assessed study quality. Due to methodological heterogeneity, a narrative synthesis was performed. The review was registered with PROSPERO (CRD42024618983).
Twelve studies met the inclusion criteria, involving 900 childcare workers and 920 families. The programs targeted two main areas: prevention of child health issues and management of child health issues. Lectures and group discussions were the most frequently used strategies. Nurses assumed diverse roles, including educators, consultants, and facilitators. The findings revealed several benefits, including reduced rates of upper respiratory illness, improved family health practices—such as appropriate medication use—and enhanced childcare worker competencies in first aid knowledge.
Nurses play a critical role in implementing education programs in childcare settings. Their contributions should be fully integrated into program planning and delivery. Future research should adopt rigorous methodologies to strengthen evidence-based practices and improve child health outcomes and caregiver competencies.
Carbapenem-resistant Pseudomonas aeruginosa exacerbates the healing of chronic leg ulcer among patients. Further, production and dissemination of the carbapenemase genes are associated with P. aeruginosa high-risk sequence types. Hence, understanding the population structure of these organisms is essential for healthcare personnel to establish effective leg ulcers care management, prevention interventions and control strategies particularly in regions with poor diagnosis. A cross-sectional study included inpatients and outpatients with chronic leg ulcers was conducted from August 2022 to April 2023 in 2 hospitals in Kilimanjaro region. Antimicrobial susceptibility testing was done by using the disc diffusion method. Further, whole genome sequencing was performed to study the genotypic characteristics of the isolates. Ten of 92 participants were positive for genus Pseudomonas isolates upon culture during the study period. Ambler class D carbapenemase genes were carried in all 8 isolates, and class B (blaVIM−2$$ {\mathrm{bla}}_{\mathrm{VIM}-2} $$, blaDIM−1$$ {\mathrm{bla}}_{\mathrm{DIM}-1} $$) in 2 isolates. The tree topology showed that all 8 P. aeruginosa isolates that carried any of the Ambler carbapenemase genes were in one clade with the reference strain PAO1. This study sheds light on different carbapenemase gene types (VIM-2, DIM-1, and OXA-types) harboured in the denominated global high-risk and endemic sequence types in 2 tertiary hospitals in northern Tanzania, alarming the possibility of a prolonged healing process and a high risk of treatment failure among patients because of the increased spread of antimicrobial resistance. Further, the findings underscore the need for antimicrobial surveillance to guide healthcare personnel in managing chronic leg ulcers for better patient outcomes and the implementation of antimicrobial stewardship programs.
by Dima Alhomsi, Mhd Khaled Tello, Dania Abdalsalam, Majd Barmo, Hamzeh Al Asadi, Hasan Najjar, Bayan Alsaid
IntroductionBasic medical sciences form the cornerstone of any medical knowledge and are essential for understanding various diseases. This study aims to shed light on students’ viewpoints toward those sciences while delving into their motivations and hindrances and investigating individual subjects.
MethodsThis cross-sectional study was carried out at Damascus University in Syria, targeting final-year medical students. Data collection occurred on a designated clerkship day, during which students were invited to complete an anonymous, self-administered questionnaire. The questionnaire evaluated students’ overall perception and academic interest in studying basic medical sciences in pre-clinical years and their willingness to pursue these sciences as a prospective career.
ResultsThe study surveyed 350 medical students, with 40% rating their interest as good/very good. The extensive content was perceived as a major hindrance by 76.9%. Anatomy was perceived as the easiest subject while pharmacology and biochemistry were considered the hardest. The majority acknowledged the value of basic sciences for further medical education (75.1%) and good physician (77.4%), but only 20.9% indicated their relevance for practical training. Furthermore, 68.6% of students were not interested in pursuing these sciences as a career, primarily due to their preference for clinical fields (55.8%) and concerns about low-income potential (41.3%).
ConclusionThis study highlighted students’ positive views on Basic Medical Sciences, emphasizing their essential role in understanding disease pathophysiology for medical education and practice. Nonetheless, it pointed out a lack of practical training. The findings underscore the importance of decreasing content intensity and enhancing retention through practical approaches aligned with clinical practice.
by Eugénie M. Kamabu, Justin L. Paluku, William P. Howlett, Abid M. Sadiq, Eliada B. Nziku, Doreen T. Eliah, Ibrahim Ali Ibrahim Muhina, Fuad H. Said, Tumaini E. Mirai, Elifuraha W. Mkwizu, Furaha S. Lyamuya, Elichilia R. Shao, Kajiru G. Kilonzo, Venance P. Maro, Sarah J. Urasa, Nyasatu G. Chamba
BackgroundAmong acute stroke patients (ASPs), diabetes mellitus (DM) is associated with a higher risk of death, functional dependency, and recurrence. This study aimed to determine the impact of DM on the 30-day mortality among admitted ASPs in northern Tanzania.
Materials and methodsThis was a hospital-based prospective cohort study performed among ASPs with and without DM who were admitted to Kilimanjaro Christian Medical Centre from November 2022 to May2023. ASPs were followed for 30 days after the onset of an acute stroke to identify the primary outcome, which was all-cause mortality. Descriptive statistics, logistic regression, and survival analysis were conducted,
ResultsOut of 213 ASP, 82 (38.5%) had DM. The overall crude mortality rate was 46.9%. ASPs with DM had a higher mortality rate of 53.7% compared with those without DM (42.7%). A higher proportion of acute stroke patients with DM (84.1%) had a poor outcome (mRS 3-6) (p = 0.038). DM was statistically non-significant for 30-day mortality (aHR 1.56; 95% CI: 0.73–3.32; p = 0.252). However, fever (p = 0.005), severe admission Glasgow coma scale (p = 0.005), severe stroke (p = 0.008), elevated serum creatinine (p = 0.008), and an abnormal respiratory pattern (p = 0.042), were predictors of 30-day mortality,
ConclusionThis study demonstrated a high mortality in ASPs. Although DM did not have a significant impact on 30-day mortality, other factors, such as altered mental state, stroke severity, fever, elevated creatinine, and abnormal respiration, need to be accounted for that may have a significant impact on the mortality in ASPs. These findings highlight the significant burden of DM in stroke patients and underscore the importance of early diagnosis and treatment of ASPs, in the hopes of improving clinical practice and guidelines and reducing morbidity and mortality in Tanzania.
To address: What are the experiences of 2SLGBTQQIA+ parents using parenting supports and services to meet their children's early childhood development needs (<5 years of age)?
Whittemore and Knafl's (2005) integrative review methodology.
Electronic databases were searched from 2000 to October 14, 2022 for empirical studies or reviews addressing the research question. The title and abstract of 12,158 articles were screened for inclusion in the review by two independent researchers; 175 of these articles underwent full-text review. Studies selected were critically appraised using a Joanna Briggs Institute Critical Appraisal tool. Relevant key findings were extracted from each study and entered into N-VIVO-12. Thematic content analysis was employed and PRISMA guidelines were adhered to.
A total of 18 articles (15 qualitative and three multi-method studies) met the inclusion criteria and were selected for the review. Seven themes were revealed from analysis of the studies: (1) 2SLGBTQQIA+ Status kept a secret; (2) Forced to come out; (3) Heteronormative messaging; (4) Feeling excluded; (5) Stigmatised; (6) Parents act as educators; and (7) Positive experiences.
This integrative review provides nurses with insight into the experiences of 2SLGBTQQIA+ parents using health care services for their young child.
This article highlights what changes nurses need to make to their practice to ensure appropriate, inclusive care for clients of diverse sexual and gender identities and their families.
Health care providers, especially nurses, have an opportunity to improve the experiences of these families and positively impact their health and well-being. Additionally, there is a need for research with the 2SLGBTQQIA+ parent community and the use of rigorous methodological techniques, including clearly linking participants' gender and sexual identities with study findings, to improve our understanding of 2SLGBTQQIA+ parent experiences.
Although there was no direct patient contribution to the work since it was an integrative review of the literature, indirectly patient contributions are incorporated from the original research results of studies incorporated into this review.
Justificación: la pandemia por Covid-19 ocasionó interrupción de los servicios dirigidos a atender las enfermedades crónicas provocando reajustes en el cuidado de los pacientes. Objetivo: Describir los cuidados populares empleados por los indígenas Pijao para el tratamiento y control de enfermedades crónicas, en contexto de pandemia, en Bogotá (Colombia). Metodología: Estudio cualitativo de tipo micro–etnográfico. Participaron 16 indígenas Pijao. Los datos, recolectados por medio de entrevistas y observación, fueron analizados temáticamente. Resultados: emergieron tres categorías, (1) del territorio de origen a la ciudad: cuidados populares para el tratamiento de las de enfermedades, (2) viviendo con la enfermedad: signos y síntomas de las de enfermedades, y (3) procura de otros recursos para el cuidado: autoatención y apoyo familiar. Conclusión: la trayectoria de cuidado de los Pijao con enfermedades crónicas fue permeada por la pandemia, convirtiendo los cuidados populares, caracterizados por un sincretismo de saberes, en parte fundamental de su rutina de cuidados.
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