Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction.

Objectives: This study aimed to estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in Oman. Methods: A cross-sectional retrospective study was conducted on all patients who presented to the emergency department at Sultan Qaboos University Hospital and Royal Hospital, Muscat, Oman, and underwent primary percutaneous coronary interventions during 2018-2019. Results: The sample included 426 patients and the median DTB time was 142 minutes. The result of the bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were 3 times more likely to have a delayed DTB time, when compared to patients who presented with typical symptoms (odds ratio [OR] = 3.003, 95% confidence interval [CI]: 1.409-6.400; P = 0.004). In addition, patients who presented during off-hours were 2 times more likely to have a delayed DTB time, when compared to patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284-4.087; P = 0.005). Conclusion: To meet the DTB time recommendation, it is important to ensure adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care.

Low back pain knowledge and associated disability among nursing staff in Oman.

BACKGROUND: Low back pain is a prevalent issue worldwide, impacting all healthcare professionals, in particular nurses, and leading to disability. OBJECTIVE: This study aimed to explore the predictive contribution of demographic factors, the presence of LBP, and knowledge about LBP in forecasting the level of disability among nurses in Oman. METHOD: A cross-sectional study was conducted using a paper-based questionnaire comprising two valid tools: the Low Back Pain Knowledge Questionnaire and the Oswestry Low Back Disability Questionnaire. A total of 236 nurses working in two tertiary hospitals in Oman participated in the study. RESULT: The findings indicate that 66.8% of nurses had low back pain. The low back pain knowledge score was 13.81(SD 4.42). The mean disability score was 9.13 (SD 8.56), indicating mild disability. There is a negative significant association between low back pain knowledge (r = -0.24, p < .004) and disability level. The low back pain presence was also significantly associated with disability level (t (233) = 4.606, p < .001). The results of the regression indicated the two predictors (i.e., knowledge level and low back pain) explained 13 % of the variation in nurses' disability level [F (3,230) = 11.447, p = .01]. CONCLUSION: Low back pain is prevalent among nurses in Oman, and it is associated with disability. Preventive strategies need to be implemented.

Professional identity and preparedness for hospital practice among undergraduate nursing students: A cross-sectional study.

BACKGROUND: Professional identity is a crucial characteristic that undergraduate nursing students must possess to ensure effective and safe clinical practice. It has been identified as a factor influencing nursing student retention and their intention to remain in the nursing profession. However, the influential factors that impact the development of professional identity among nursing students currently are not well known. OBJECTIVES: To identify factors determining professional identity among undergraduate nursing students and to confirm the relationship between nursing students' professional identity and their preparedness for hospital practice. DESIGN: A cross-sectional study. SETTINGS: The largest public nursing college in Oman. PARTICIPANTS: 180 full-time undergraduate nursing students in their third and fourth years who had completed at least one clinical course. METHODS: Students completed validated, self-administered paper questionnaires through convenience sampling, including professional identity and preparedness for hospital practice scales. RESULTS: The mean total score for professional identity was 63.3 (SD = 10.5), indicating a moderate level of professional identity. The findings showed a low level of preparedness for hospital practice among nursing students, with, a mean total score of 165.8 out of 246 (SD = 30.4). We found a significant positive association between professional identity and preparedness for hospital practice (r = 0.43, p < 0.001), the number of clinical courses taken (r = 0.15, p = 0.041), enrolment in fourth-year clinical courses (H (4) = 19.9, p = 0.001), grade (H (3) = 7.8, p = 0.049) and the selection of nursing profession as the first choice (H (3) = 28.0, p = 0.05). CONCLUSIONS: The study has implications for identifying students with lower readiness for hospital practice and providing them with the necessary training. Nursing educators should prioritize reinforcing professional identity among students who have chosen nursing as a secondary option or have a lower grade. This can be achieved by promoting a positive nursing image and fostering a supportive clinical learning environment.

Factors predicting medication adherence among Omani patients with chronic diseases through a multicenter cross-sectional study.

Management of chronic diseases is complex and requires a long-term commitment to therapeutic medications. However, medication adherence is suboptimal. There is limited understanding of factors predicting medication adherence in chronic diseases in Oman. This study aimed to examine predictors of medication adherence (i.e. patient clinical and demographic data, patient-physician relationship, health literacy, social support) among Omani patients with chronic diseases. This study used a cross-sectional correlation design. Data were collected from 800 participants using convenience sampling between December 2019 and April 2020. Arabic versions of the Brief Health Literacy Screening tool, Multidimensional Scale of Perceived Social Support, Patient-Doctor Relationship Questionnaire, and Adherence in Chronic Disease Scale were used to measure study variables. Descriptive statistics, independent t tests, one-way ANOVA, Pearson correlations, and multivariate linear regression were used for analysis. The study found that factors such as the patient-physician relationship, social support, disease duration, employment status, and medication frequency significantly predicted medication adherence. Medication adherence was higher among those who were unemployed, had a better patient-physician relationship, and greater social support. However, medication adherence was lower with longer disease duration and higher daily medication frequency. Additionally, medication adherence was positively associated with perceived social support and the patient-physician relationship, but not with health literacy. In conclusion, the study reveals that patient characteristics, social support, and patient-physician relationships are key factors in predicting medication adherence in patients with chronic diseases in the Middle East. It emphasizes the importance of improving these aspects, considering factors like employment status, disease duration, and medication frequency, and enhancing healthcare provider-patient relationships and social support systems to boost adherence.

Role of Health Literacy, Social Support, Patient-Physician Relationship, and Health-Related Quality of Life in Predicting Medication Adherence in Cardiovascular Diseases in Oman.

Purpose: Cardiovascular diseases (CVDs) remain a global health threat, and medication adherence remains low. Medication adherence is a complex phenomenon and is affected by many factors that require investigation. Oman has limited literature examining medication adherence and influencing factors among patients with CVDs. This study examined the influence of health literacy, social support, the patient-physician relationship, and health-related quality of life on medication adherence among patients with cardiovascular diseases. Patients and Methods: This cross-sectional study used a correlation design. The study included 360 participants with CVDs. Descriptive statistics, independent t-test, one-way ANOVA, and multiple regression analysis were utilized for data analyses. Results: Findings revealed that higher social support (B=0.117; p=0.033), good patient-physician relationship (B=0.124; p < 0.01), better mental health (B=0.045; p < 0.01), more bodily pain (B=0.030; p < 0.01), and unemployment (B=1.297; p < 0.01) were predictors of higher adherence. High school education and above predicted lower medication adherence (B= -1.255; p= 0.019), while health literacy was not a significant predictor of medication adherence (B= 0.061; p= 0.289). Conclusion: To improve medication adherence, healthcare providers and researchers should consider improving patients' social support, mental health, and the patient-physician relationship. In addition, patients' socioeconomic status should always be considered and examined as an influencing factor of medication adherence.

Readiness for interprofessional education among healthcare students in Oman: Results of a cross-sectional survey.

Interprofessional education (IPE) is a promising educational strategy to strengthen the healthcare system in Oman. This study aimed to evaluate the perception and readiness of nursing and medical students for IPE in Oman. Students enrolled in medical and nursing programs at Sultan Qaboos University were invited to participate in this study by completing the Readiness for Interprofessional Learning Scale (RIPLS). A total of 390 (180 nursing and 210 medical) students completed the survey. The RIPLS scores of nursing and medical students were high. Medical students had significantly higher scores in the Negative Professional Identity subscale. Gender and GPA correlated with total scores. Medical and nursing students demonstrated positive perceptions and readiness for IPE. Efforts should be directed to facilitate its implementation in the curriculum.

Predictors of health-related quality of life in patients with non-communicable diseases: A national cross-section study.

BACKGROUND: Non-communicable diseases (NCDs) are responsible for 74% of global deaths and contributed to significant disabilities, worsening health-related quality of life (HRQoL). In NCDs, poor medication adherence, social support, patient-physician relationship, and health literacy decrease HRQoL. Unfortunately, there is a shortage of literature examining the predictors of HRQoL among patients with different types of NCDs. AIMS: This study aimed to examine the predictors of Health-Related Quality of Life (HRQoL), including health literacy, social support, patient-physician relationship, and medication adherence, among patients with NCDs. METHODS: This national cross-sectional study used a correlational design and included 800 Omani participants with six NCDs. Self-reported questionnaires were used to measure HRQoL, health literacy, patient-physician relationship, social support, and medication adherence. Multiple linear regression analysis was used to examine predictors of HRQoL. RESULTS: Participants' mean age was 56 years (SD = 15.60). The results revealed that more medication adherence was linked to better physical and role functioning (ß = 0.08, p = .017, ß = 0.07, p = .021, respectively) and mental health (ß = 0.19, p = .000). Social support was independent predictor of physical (ß = 0.19, p = .000), social (ß = 0.09, p = .009), role (ß = 0.07, p = .029) and mental (ß = 0.30, p = .000) functioning. Patients with good health literacy had better social (ß = 0.51, p = .001) and role (ß = 0.10, p = .011) functioning. CONCLUSION: This study holds implications for future efforts to implement interventions improving HRQoL. The study suggested that health literacy, social support and medication adherence are significant predictors, positively influencing physical functioning, social functioning, role functioning, and mental health dimensions of HRQoL among patients with NCDs.

Determinants of health-related quality of life among Omanis hospitalized patients with cancer: a cross-sectional study.

PURPOSE: This study aimed to examine the difference in HRQoL by participants' characteristics and to investigate the determinants of health-related quality of life HRQoL among Omani hospitalized patients with cancer. METHODS: This cross-sectional study was conducted in two oncology centers in Oman. Omani hospitalized patients with breast, thyroid, colorectal, stomach, and prostate cancer were recruited using convenience sampling. Participants completed Arabic versions of Pittsburgh Sleep Quality Index to measure sleep quality, Brief Fatigue Inventory scales to measure fatigue, and Functional Assessment of Cancer Therapy to measure HRQoL. Descriptive and inferential statistics were performed. T-test, ANOVA, and multiple linear regression analysis were utilized to determine predictors of HRQOL. RESULTS: In total, 275 participants were recruited (Meanage = 52 years). About 64% of the participates reported poor sleep and 18.5% reported severe cancer-related fatigue. Younger patients who had good sleep quality and less cancer-related fatigue and had prostate and thyroid cancer demonstrated better HRQoL [F (5, 269) = 26.26, p < 0.000]. The model explained 33% of the variances in the HRQoL (R2 = .328). CONCLUSIONS: This study highlights the impact of age, cancer type, sleep quality, and cancer-related fatigue on the HRQoL in hospitalized patients with cancer. Thus, sleep quality and cancer-related fatigue should be assessed routinely during the hospitalization of oncology patients with unique attention to patients' age and cancer type.

Psychometric Properties of the Arabic Version of Medication Adherence Self-Efficacy Scale-Revised in Hypertension.

BACKGROUND AND PURPOSE: Cultural adaptation of Medication Adherence Self-Efficacy Scale-Revised is lacking in the Arab population. This study tested the psychometric properties of the Arabic version of the Medication Adherence Self-Efficacy Scale-Revised. METHODS: The study included 199 Omani hypertensive patients. The scale was translated into Arabic. Reliability and construct and convergent validity were examined. RESULTS: Scale's reliability was α = .93. One factor was identified and explained about 57.5% of the variance. A new modified model with covariance suggested a better model fit. A significant relationship between the scale and Morisky medication adherence scale was found (r = .53, p < .001). CONCLUSIONS: The Arabic version scale is reliable, valid, and could be applied in the clinical settings to improve medication adherence.

Medication Adherence and Patients' Characteristics in Chronic Diseases: A National Multi-Center Study.

Chronic diseases constitute a significant threat to health. Worldwide, medication adherence in chronic diseases remains unsatisfactory. Understanding factors affecting adherence is essential. This study examined medication adherence by characteristics of patients with chronic diseases. This cross-sectional study included 800 patients. The Adherence to Chronic Diseases Scale was used to measure adherence. Descriptive statistics and logistic regression was used to examine factors influencing medication adherence. Low adherence was found in 19.5% of the patients, 45% had medium adherence, and 35.5% had high adherence. Logistic regression showed that retired (OR 0.496, 95% CI [0.33-0.75]), having COPD (OR 0.460, 95% CI [0.32-0.67]) and duration of disease ≤5 years (OR 1.554, 95% CI [1.11-2.17]) remain independent predictors for high adherence. Mixed findings regarding the relationship between medication adherence and patients' characteristics were noticed. Patients' characteristics should be examined with the individual population when examining and attempting to improve medication adherence in clinical practice.

Patients' and Nurses' Demographics and Perceived Learning Needs Post-Coronary Artery Bypass Graft.

Worldwide, the number of coronary artery bypass grafts (CABG) surgeries significantly increased. To develop effective discharge planning and avoid complications, patients learning needs are essential to be examined. The study examined the difference between patients' and nurses' perceptions of post-CABG learning needs and the relationship between patients' and nurses' demographic variables and the perceptions of the learning needs. This study included 180 participants (90 nurses, 90 patients). Data were collected from two cardiac centers in Oman using a modified cardiac patient learning need inventory and analyzed using descriptive and inferential statistics. The findings showed: (1) there was a significant difference in perceived learning needs between nurses and patients, and (2) patients' learning needs differed significantly by gender, marital status, education, and occupation. This study highlights that post-CABG patients' learning needs should be assessed despite patients' demographical characteristics to individualize education planning and prevent complications.

Patients' and Nurses' Perceptions of Post-Coronary Artery Bypass Graft Learning Needs in Two Omani Hospitals.

OBJECTIVES: Little is known about nurses' and patients' perceptions of learning needs following coronary artery bypass graft (CABG) surgery in Oman. This study aimed to identify patients' and nurses' perceptions of post-CABG learning needs. METHODS: This cross-sectional study was conducted in two cardiac units in Oman between February and April 2018. Participants were from step-down units and perceptions of post-CABG learning needs were collected using a modified version of the Cardiac Patients Learning Need Inventory (MCPLNI) questionnaire. Data were analysed using descriptive and inferential statistics. RESULTS: A total of 90 patients and 90 nurses were included in this study (response rate: 100%). Nurses perceived information about chest and leg wound care, medications and complications as patients' most important learning needs (4.89 ± 0.31, 4.84 ± 0.33 and 4.78 ± 0.45, respectively). Similarly, patients perceived a need for post-CABG learning related to chest and leg wound care, complications and medication, while learning related to physical activity received a moderate priority (4.92 ± 0.20, 4.80 ± 0.45, 4.85 ± 0.26 and 3.50 ± 1.34, respectively). CONCLUSION: Before discharging patients, they should be provided with specific information related to post-CABG care. It is essential to assess patients' learning needs and incorporate those learning needs into discharge plans.

Health beliefs and medication adherence in patients with hypertension: A systematic review of quantitative studies.

OBJECTIVE: This review synthesizes findings of quantitative studies examining the relationship between health beliefs and medication adherence in hypertension. METHODS: This review included published studies in PubMed, CINHAL, EMBASE, and PsycINFO databases. Studies were included if they examined beliefs of patients with hypertension. Quality of the studies was evaluated using the Quality Assessment Tool for Systematic Review of Observational Studies. RESULTS: Of the 1558 articles searched, 30 articles were included in the analysis. Most beliefs examined by studies of this review in relation to medication adherence were beliefs related to hypertension severity and susceptibility to its consequences, medication effectiveness or necessity, and barriers to medication adherence. Higher medication adherence was significantly related to fewer perceived barriers to adherence (e.g, side-effects) was fairly consistent across studies. Higher self-efficacy was related to higher medication adherence. Patients' beliefs and their relationship to medication adherence appear to vary unpredictably across and within countries. CONCLUSION: Clinicians should assess beliefs for individual patients. When individual beliefs appear likely to undermine adherence, it may be useful to undertake educational interventions to try to modify them. PRACTICAL IMPLICATIONS: Clinicians should explore individual patients' beliefs about hypertension and blood pressure medications, discuss their implications for medication adherence, and try to modify counterproductive beliefs.

Health Beliefs and Medication Adherence in Omanis With Hypertension.

BACKGROUND: Patients' health beliefs are essential to improve medication adherence among patients with hypertension. OBJECTIVE: Our objective was to examine the relationship between (1) patients' beliefs about hypertension, medication, and self-efficacy and medication adherence and (2) medication adherence and blood pressure control in Oman. METHODS: This cross-sectional study included 215 participants with hypertension. Participants completed 4 questionnaires (Arabic version) to measure medication adherence, beliefs about hypertension severity, beliefs about medication, and self-efficacy. Bivariate and multivariate logistic regression was used to conduct the analyses. RESULTS: Higher self-efficacy (odds ratio [OR], 2.59; 95% confidence interval [CI], 1.54-4.37), stronger beliefs about medication necessity (OR, 1.98; 95% CI, 1.21-3.23), increased age (OR, 1.06; 95% CI, 1.03-1.10), and fewer medication concerns (OR, 0.34; 95% CI, 0.20-0.57) were related to high medication adherence. Moreover, uncontrolled blood pressure was less likely in participants with high medication adherence (OR, 0.47; 95% CI, 0.24-0.93). CONCLUSIONS: Patients' beliefs are important consideration to improve medication adherence. Clinically, patients' beliefs should be assessed, and strategies to improve medication adherence should incorporate beliefs as a key component to improve antihypertensive medication adherence. Patient education and counseling regarding hypertension and necessity and side effects of medications are important to maximize positive beliefs and improve medication adherence.

Relationship Between Medication Adherence and Health Beliefs Among Patients with Hypertension in Oman: Pilot study.

OBJECTIVES: The prevalence of hypertension (HTN) in Oman is alarmingly high and patient adherence to antihypertensive medications is inadequate. This study aimed to assess the relationship between medication adherence and health beliefs among Omani patients with HTN. METHODS: This descriptive cross-sectional pilot study was conducted in December 2015 and included 45 patients with HTN recruited from four primary health centres in Al Dakhiliyah and Muscat governorates, Oman. Medication adherence and health beliefs were assessed using the Morisky Medication Adherence Scale (MMAS), Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire and the revised Medication Adherence Self-Efficacy Scale. RESULTS: The mean MMAS score was 5.3 ± 2.0, with 48.9% of patients reporting high adherence. Higher self-efficacy and stronger beliefs regarding medication necessity were significantly related to adherence (P = 0.012 and 0.028, respectively). CONCLUSION: The findings of this pilot study emphasise the role of health beliefs with regards to Omani patients' adherence to antihypertensive medications.