Exploring the experiences of female undergraduate nursing students in providing home healthcare to older adults.

BACKGROUND: In light of the growing ageing population in Saudi Arabia and Saudi nurses' hesitation to work with the older population, it is important to understand the experiences of nursing students on their clinical placement in home healthcare. METHODS: This study is a descriptive qualitative study based on five focus groups of 3-5 students each. Data were collected from female senior baccalaureate nursing students at a female governmental university in Saudi Arabia, and during their placement in home healthcare. Data were analysed using thematic analysis. RESULTS: Five main themes emerged : struggling with their own family; struggling with cultural and social beliefs; struggling during clinical training; struggling with domestic caregivers; and reflections for the future were considered important impressions in clinical experience. CONCLUSION: The culture of Saudi Arabian society is an important factor in shaping the training experience of female nursing students either positively or negatively, specifically in the context of home healthcare nursing for older patients. The results of this study show how important it is for students to be prepared for the clinical environment, the nature of the work, and the role of the home healthcare nurse in order to improve their clinical learning.

Psychological Distress and Concerns of In-Home Older People Living with Cancer and Their Impact on Supportive Care Needs: An Observational Survey.

(1) Background: Cancer patients are experiencing psychological problems after diagnosis, such as emotional distress and social anxiety, which may increase their demands for emotional and supportive care. This study aimed to assess the influence of both emotional distress and concerns on the supportive care needs of cancer patients receiving home-based healthcare. (2) Methods: In this door-to-door screening program, 97 cancer patients were approached, with a mean age of 73 years old (mean = 73.43; SD = 6.60). (3) Results: As expected, 42.3% of patients highlighted their treatment as their main psychological priority, with 20.6% identifying concerns about the future of their family in this regard. No significant associations with respect to sex were identified in terms of focus, though females reported the need for more frequent psychological support (58.7% vs. 37.3%, respectively, p = 0.035) compared to males. Patients who had experienced an increased number of concerns during the last weeks (IRR = 1.02; 95% CI: 1.00-1.03, p = 0.007) had a significantly greater risk of presenting an increased rate of supportive care needs. Notably, male patients with bone cancer presented a significantly greater number of supportive care needs (mean rank 45.5 vs. 9.0, p = 0.031) respectively, in comparison to those with other types of cancer. (4) Conclusions: Supportive care needs arise from a greater concern and specific type of cancer, highlighting the need for supportive care, such as psychosocial and psychological support. This may have significant implications for treatment and patient outcomes in home care settings.

Indicators of Healthcare Services Utilization among the Syrian Refugee Population in Jordan: An Observational Study.

BACKGROUND: Sufficient healthcare services utilization among the Syrian refugee population is one of the most important human rights. Vulnerable populations, such as refugees, are often deprived of sufficient access to healthcare services. Even when healthcare services are accessible, refugees vary in their level of utilization of these services and their health-seeking behavior. PURPOSE: This study aims to examine the status and indicators of healthcare service access and utilization among adult Syrian refugees with non-communicable diseases residing in two refugee camps. METHODS: The cross-sectional descriptive design was conducted by enrolling 455 adult Syrian refugees residing in the Al-Za'atari and Azraq camps in northern Jordan, using demographical data, perceived health, and the "Access to healthcare services" module, which is a part of the Canadian Community Health Survey (CCHS). A logistic regression model with binary outcomes was used to explore the accuracy of the variables influencing the utilization of healthcare services. The individual indicators were examined further out of 14 variables, according to the Anderson model. Specifically, the model consisted of healthcare indicators and demographic variables to find out if they have any effect on healthcare services utilization. RESULTS: Descriptive data showed that the mean age of the study participants (n = 455) was 49.45 years (SD = 10.48), and 60.2% (n = 274) were females. In addition, 63.7% (n = 290), of them were married; 50.5% (n = 230) held elementary school-level degrees; and the majority 83.3% (n = 379) were unemployed. As expected, the vast majority have no health insurance. The mean overall food security score was 13 out of 24 (±3.5). Difficulty in accessing healthcare services among Syrian refugees in Jordan's camps was significantly predicted by gender. "Transportation problems, other than fee problems" (mean 4.25, SD = 1.11) and "Unable to afford transportation fees" (mean 4.27, SD = 1.12) were identified as the most important barriers to accessing healthcare services. CONCLUSION: Healthcare services must imply all possible measures to make them more affordable to refugees, particularly older, unemployed refugees with large families. High-quality fresh food and clean drinking water are needed to improve health outcomes in camps.

Post-traumatic stress disorder among Syrian refugees in Greece.

Background: Post-Traumatic Stress Disorder (PTSD) is a psychiatric entity developed by those who have been through a traumatic experience. The civil wars in Syria and neighboring countries during the past few years might trigger such experiences, and the same could be argued for the difficult journey from the actual war zones to Europe. Purpose: To determine the level of PTSD among Arabic-speaking refugees in a Greek refugee camp, who originate primarily from Syria. Methods: This study involves (N = 73) Syrian refugees, all located in Greek camp. Data were gathered using the civilian version of PTSD CheckList (PCL-C). The Arabic version of the PCL-C was used. Individual scores were evaluated via use of DSM-IV criteria. Results: PTSD was found in 58 participants, afflicting both genders (72% of men and 45% of women). In addition, the severity score was recorded to be significantly elevated for the majority of the participants. Finally, the most vulnerable age group was the same for both genders, featuring those between the ages of 35 and 44 years. Conclusions: The findings of this study demonstrated that the traumatic experiences, suffered by these refugees either before and/or on their journey to Greece, had a severe mental impact. It is imperative that all refugees suffering from this disorder be diagnosed in time and receive appropriate support.

Perceptions and Patterns of Dietary Supplements' Use during COVID-19 among Undergraduate Female Students in Saudi Arabia.

(1) Background: During the COVID-19 pandemic, the use of Dietary Supplements (DSs) has increased for health promotion purposes. Few data records were found on the safe use of DSs among university students in Saudi Arabia, during COVID-19. This study aimed to assess the perceptions and patterns of DSs during COVID-19 among students at a selected female university. (2) Methods: A descriptive cross-section design was used. A convenient sample of undergraduate students (n = 651) were recruited via email, to fill in an online validated questionnaire: The nutrition and intake of DSs during COVID-19. Data were analyzed using descriptive and inferential statistics. (3) Results: Among the 509 students who did not have chronic diseases, 85% of them had taken DSs. About 35.5% of the students had not changed their dietary habits since the beginning of COVID-19, but 78.6% thought that they needed to improve their immunity by taking DSs. Half of the students 51.2% believed that healthy habits may reduce the chance of being infected with COVID-19. The most used DSs were vitamin C (84.3%), followed by honey (65.3%), and vitamin D (47.7%). At the top of students' references for DSs was personal judgment or previous knowledge of the benefits (27.3%). (4) Conclusion: The usage and patterns of DSs were impacted by the COVID-19 pandemic. Taking DSs without a doctor's prescription may lead to several complications. DSs users should be educated effectively about the proper use of DSs as an external supplementation.

Measuring Nurses' and Physicians' Attitudes and Perceptions of the Appropriate Interventions towards Intimate Partner Violence in Saudi Arabia.

Background: Intimate partner violence (IPV) is considered the most common form of violence against women worldwide, concerning public health, safety, and human rights. However, little to no studies in Saudi Arabia have explored the attitude and perception of health care providers working in emergency departments toward IPV. This study aimed to measure the attitude and perception of Emergency Room (ER) health care providers towards the appropriate intervention for IPV. Methods: This is a cross-sectional quantitative study. Data was collected from a convenient sample of nurses (n = 88) and physicians (n = 18) working in ER, using Readiness to Manage Intimate Partner Violence Survey (PREMIS). Data was collected from two hospitals in Riyadh, Saudi Arabia, and descriptive analysis was used to analyze the data. Results: The majority of the respondents were aged 18−40 (n = 106, 78%), while 22% were 41−60 years old, 69% were female, and 31% were male. Eighty-five percent were nurses and 15% were physicians. The majority of the respondents did not have any training on IPV and had gained knowledge or skills mostly during their medical/nursing classroom and clinical training. The analysis revealed that the participants had moderate levels of overall preparedness, knowledge about IPV, and perceived knowledge, with a mean score of 2.30, 18.62, and 2.18, respectively. The respondents had low scores in practice issues in new diagnosis (0.91), current screening (1.69), and actions when IPV is identified (0.91). The perceived preparedness and knowledge have a significant positive correlation, as shown by an r value of 0.8476 and a p-value of <0.05. Conclusion: The study shows that participants stated minimal previous IPV knowledge and training. It is necessary to put in place adequate resources and specific training programs to overcome this issue for both ER nurses and physicians.

"Your Ovaries Are Expired, Like an Old Lady" Metaphor Analysis of Saudi Arabian Women's Descriptions of Breast Cancer: A Qualitative Study.

Background: Assessing and understanding the language that women use to express physical, emotional, and social concerns of breast cancer experiences can often be overlooked, even though there is evidence that effective communication between cancer patients and health care providers improves quality of life. This study aims to assess the use of metaphors in conceptualizing breast cancer experience lived by Saudi Arabian women. Materials and Methods: This is an interpretative phenomenological qualitative study, a purposeful sample of 18 breast cancer patients at an oncology outpatient's clinic in Saudi Arabia were invited to engage in face-to-face interviews. Data was analyzed using Metaphor Identification Procedure (MIP). Results: Four themes were constructed: dark hidden force, battling imminent death, dreaming and awakening calls, and inner and outer transformation. Conclusion: Identifying metaphors may be beneficial toward improving communication between health care providers and breast cancer patients, who often experience difficulties expressing their needs.

The Impact of Frailty and Geriatric Syndromes on the Quality of Life of Older Adults Receiving Home-Based Healthcare: A Cross-Sectional Survey.

Purpose: To identify the effect of frailty and geriatric syndromes on the quality of life (QoL), of older adults receiving home care, taking into consideration their socioeconomic and homebound status, including multi-comorbidities. Patients and Methods: This cross-sectional study enrolled elders aged (≥65) years old, registered members of "Help at Home" programs in the Reference Region of Crete, from March to May 2019. Participants were screened using the WHOQOL-BREF for Quality of Life, geriatric syndromes such as frailty using the SHARE-Frailty Index (SHARE-Fi), the Montreal Cognitive Assessment (MoCA), for cognitive function and the Geriatric Depression Scale (GDS), for the assessment of depression. Results: The mean age of the 301 participants was 78.45 (±7.87) years old. The prevalence of frailty was 38.5%, severe depression 13.6%, cognitive dysfunction 87.8% and severe comorbidity 70.6%. Intriguingly, none of the participants (0%) was identified as free of comorbidity (CCI = 0−1). The overall QoL (ranging from 4−20) of the study participants was 13.24 (±4.09). The bivariate analysis showed that overall QoL significantly differed among older adults with frailty (15.91 vs. 11.56, p < 0.001), cognitive dysfunction (15.42 vs. 12.90, p < 0.001), depression (14.90 vs. 9.31, p < 0.001), and disability in Activities of Daily Living (13.67 vs. 10.67, p = 0.002), compared to non-frail, normal cognition and depression, and independent elders, respectively. Multiple linear regression models revealed that frail and depressive elders reported significantly lower QoL (ß = −2.65, p < 0.001 and (ß = −5.71, p < 0.001), compared to non-frail and older adults with no depressive symptoms, respectively, despite the fact that this association was not significant for older adults with dementia (ß = −2.25, p = 0.159), even after adjusting for potential confounding effects (age, gender, comorbidity, homebound status, etc.). Conclusion: frailty and geriatric syndromes including comorbidities are important risk factors for "poor" QoL among older adults receiving home-based healthcare.