Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study.

BACKGROUND: Poor sleep quality is prevalent among nurses worldwide. Around two-thirds of nurses doing shift work are known to experience sleep problems and fatigue. Fatigue and sleep problems are linked to poor performance, impaired alertness, injuries, chronic diseases, compromised healthcare quality, and medical errors, all of which detrimentally impact nurses and threaten patients' safety. This area of research has received insufficient attention in Saudi Arabia; therefore, the purpose of this study was to examine the levels of sleep quality and perceived fatigue and their association among nurses working in acute care settings in comprehensive hospitals in Saudi Arabia. METHODS: A descriptive cross-sectional study using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale. Data was obtained via an online questionnaire that was distributed to nurses using the QuestionPro platform through hospital administrators, social media (WhatsApp), and personal contact. RESULTS: A total of 173 nurses completed the online survey. Most participants reported poor sleep quality (n = 127, 73.4%) and severe perceived fatigue (n = 156, 90.2%). Furthermore, the study revealed a significant correlation between the overall sleep disturbance and fatigue global scores (r = 0.57, P < 0.001), indicating that poor sleep quality was significantly associated with higher fatigue levels among the study sample. CONCLUSIONS: The current study found a significant association between sleep quality and severe fatigue in nurses working in high acute care settings in Saudi Arabia. It is very clear from the results that nurses are experiencing poor sleep and severe fatigue, which in turn, will negatively impact the nurse's quality of life and patient safety.

Development and Psychometric Evaluation of the Children's Illness-Related Concerns Scale.

BACKGROUND: Despite the effect of maternal breast cancer on many children, there is no valid or reliable quantitative measure of the concern that children attribute to their mothers' disease, which constrains both science and clinical practice. OBJECTIVES: This study aimed to develop and psychometrically evaluate the initial measures of child-reported, illness-related concerns associated with maternal cancer. METHODS: The study was conducted in three phases: scoping review, item extraction from a battery of items obtained from school-aged children about general issues related to their mothers' breast cancer, and testing of the three proposed structural models of these extracted items using confirmatory factor analysis. The scoping review yielded five categories of illness-related concerns: altered family routines, uncertainty, concerns about illness contagion, maternal death, and maternal well-being. To reflect these five categories, 18 items were extracted from a 93-item questionnaire completed by 202 school-aged children regarding their mothers' breast cancer. Next, three structural models were hypothesized to assess the construct validity of illness-related concerns: five-, three-, and one-factor models. Confirmatory factor analysis was used to test and compare the models. RESULTS: The five-factor model best fit the data, and each factor showed adequate internal consistency reliability. These findings align with the a priori five-factor model informed by the scoping review. CONCLUSION: The results provide initial evidence of the construct validity of the 18-item Children's Illness-Related Concerns Scale, which can be used to assess children's concerns and inform future intervention studies.

Adolescents' perceived stress of COVID-19 and self-compassion in Saudi Arabia: A cross-sectional study.

Objectives: Worldwide, the COVID-19 pandemic has significantly impacted mental health challenges for adolescent populations. The current study aims to examine the levels of perceived stress of COVID-19 and self-compassion and their relationship among adolescents in Saudi Arabia. Methods: This study employed a cross-sectional online survey of adolescents from secondary schools in Asir, Saudi Arabia. Instruments that we distributed online included the modified Perceived Stress Scale (PSS-10) and the Self-Compassion Scale (SCS), in addition to demographic and health-related questions. A total of 500 adolescents completed the survey. Results: Adolescents in the study reported an average moderate perceived stress level of 18.6 (SD = 6.67) and an average moderate self-compassion level of 3.22 (SD = 0.53). A significant correlation is also found between the two variables (r = -0.460, P < 0.001). This negative correlation indicates that lower levels of perceived stress are significantly correlated with higher levels of self-compassion. Conclusion: The study results show that the perceived stress of COVID-19 is inversely correlated with self-compassion in Saudi adolescents. Further research is needed to explore how to enhance adolescents' self-compassion. School nurses' role should be given full play in this area.

Impact of Educational Program on Critical Care Nurses' Knowledge of ICU Delirium: A Quasi-Experimental Study.

Background: Cat Intensive care unit (ICU) delirium is a significant complication that increases the mortality, morbidity, and length of stay for critically ill patient. Objective: The aim of this study was to assess the critical care nurse's knowledge of ICU delirium and the effectiveness of an educational program about the recognition and assessment of ICU delirium on critical care nurse's knowledge. Methods: A quasi-experimental single group pre-test-post-test design was conducted using delirium knowledge assessment questionnaires. Results: The median post test score of overall nurses' knowledge was 76.2 (range 19.1-95.2) compared to the median pre-test score of 38.1 (range 14.3 - 61.9) indicating a significant change in nurses' knowledge after conducting the educational program (p<0.001). Conclusion: Critical care nurses' knowledge of ICU delirium was low before the intervention and increased significantly after delivering an educational program.

Application of Public Health Precautionary Guidelines Before Contracting COVID-19: Lessons Learned from a Qualitative Descriptive Study.

Background: The COVID-19 pandemic has affected the Saudi population despite early efforts taken by officials. This study aimed to describe the precautionary measures taken by patients prior to their diagnosis with COVID-19. Methods: A qualitative descriptive design was employed to collect data from a convenience sample of 26 participants who had COVID-19 and recovered. Data was collected through conducting telephone interviews and was then transcribed and analyzed using inductive content analysis methods adapted from grounded theory. Results: Data analysis yielded six categories of precautionary measures participants reported using to minimize their risk of contracting COVID-19: (1) wearing a mask, (2) staying at home and avoiding crowds, (3) washing hands and wearing gloves, (4) following social distancing, (5) using sanitizers, and (6) not interacting with anyone. Conclusion: The discrepancy found between the participants' reported precautionary measures and their actual behavior, as well as the consistency and specificity with which they implemented some and not all measures raise concerns about existing public health messages. The study findings support the importance of well-structured and detailed communication when designing future public health campaigns and data-driven policies.

Losing Her: Children's Reported Concerns in the First 6 Months of Their Mother's Breast Cancer Diagnosis.

BACKGROUND: Maternal breast cancer has a significant impact on the well-being of school-aged children, but we know very little about the concerns these children attribute to their mother's illness. OBJECTIVE: The aim of this study was to describe child-reported illness-related concerns experienced in the initial 6 months of their mother's diagnosis and to identify any differences by age and gender of the child. METHODS: Data were obtained from 140 school-aged children (7-12 years) within 6 months of their mother diagnosis with stage 0 to III breast cancer. Children's written responses to an open-ended question were analyzed: "Think about a situation that has bothered you during the last month that had to do with your mom's breast cancer." Inductive content analysis was used to analyze the data using methods adapted from grounded theory. Trustworthiness of results was protected by coding to consensus, formal peer debriefing, and maintaining an audit trail. RESULTS: "Losing Her", the core construct, was identified and organized the children's concerns in 4 domains: (1) her being away from me, (2) worrying about her, (3) seeing my mother be different, and (4) changing how things work. CONCLUSION: All children reported illness-related concerns about which they were bothered. Even seemingly short-term treatment-related absences from the child were interpreted as difficult. IMPLICATION FOR PRACTICE: Findings from the current study add to nurses' awareness and knowledge about the concerns of school-aged children during their mother's initial treatment of breast cancer. Nurses are in a key position to provide services directly to the child or through the mother.

Enhancing Connections-Palliative Care: A Quasi-Experimental Pilot Feasibility Study of a Cancer Parenting Program.

Background: In 2018, >75,000 children were newly affected by the diagnosis of advanced cancer in a parent. Unfortunately, few programs exist to help parents and their children manage the impact of advanced disease together as a family. The Enhancing Connections-Palliative Care (EC-PC) parenting program was developed in response to this gap. Objective: (1) Assess the feasibility of the EC-PC parenting program (recruitment, enrollment, and retention); (2) test the short-term impact of the program on changes in parent and child outcomes; and (3) explore the relationship between parents' physical and psychological symptoms with program outcomes. Design: Quasi-experimental two-group design employing both within- and between-subjects analyses to examine change over time and change relative to historical controls. Parents participated in five telephone-delivered and fully manualized behavioral intervention sessions at two-week intervals, delivered by trained nurses. Behavioral assessments were obtained at baseline and at three months on parents' depressed mood, anxiety, parenting skills, parenting self-efficacy, and symptom distress as well as children's behavioral-emotional adjustment (internalizing, externalizing, and anxiety/depression). Subjects: Parents diagnosed with advanced or metastatic cancer and receiving noncurative treatment were eligible for the trial provided they had one or more children aged 5-17 living at home, were able to read, write, and speak English, and were not enrolled in a hospice program. Results: Of those enrolled, 62% completed all intervention sessions and post-intervention assessments. Within-group analyses showed significant improvements in parents' self-efficacy in helping their children manage pressures from the parent's cancer; parents' skills to elicit children's cancer-related concerns; and parents' skills to help their children cope with the cancer. Between-group analyses revealed comparable improvements with historical controls on parents' anxiety, depressed mood, self-efficacy, parenting skills, and children's behavioral-emotional adjustment. Conclusion: The EC-PC parenting program shows promise in significantly improving parents' skills and confidence in supporting their child about the cancer. Further testing of the program is warranted.