Perceptions of Bedside Nurses Caring for Patients with Left Ventricular Assist Devices (LVAD): A Qualitative Study.

Introduction: Bedside nurses in the intensive care units are exposed to multiple challenges in their regular practice and recently have taken in ventricular assist device care in Lebanon since its introduction as a fairly new practice. Objectives: To explore the experiences of nursing staff who work in Lebanese hospitals with Left Ventricular Assist Devices (LVAD). Methods: This study employed a qualitative phenomenological research design, where semi-structured interviews were carried out among fifteen LVAD nurses in an acute care hospital. Results: The qualitative data analysis produced six main themes. The first theme prevalent was "LVAD incompetence and shortage" and it reflected the deficit in properly structured training and the number of specialized LVAD nurses. The second theme that resulted from the analysis was titled, "Patient and family knowledge", which indicated the misconceptions that families and patients usually hold about LVAD which usually sugarcoats the situation. This was followed by "Burden of complications", "LVAD patient selection", "Perception of the LVAD team as invulnerable", and "High workload and patient frailty" which reflected the perspectives of LVAD nurses. Conclusion: This study shows that the Lebanese LVAD nurses who participated in this study perceived inadequate competence, yet lacked proper training and induction. The nurses reported multiple challenges relating to care tasks, workload, and patient and family interactions which need to be addressed by coordinators.

The mediating effect of post-traumatic growth on the relationship between personality traits and resilience among a sample of Lebanese adults.

BACKGROUND: Resilience plays a crucial role in mental health promotion and prevention, and was shown to be more represented in individuals who exhibit high levels of extraversion, openness, agreeableness, and conscientiousness. However, there is a lack of studies that comprehensively investigate the association between personality traits and resilience in Lebanon and Arab countries more broadly. The purpose of the present study was to complement the literature by investigating the direct and indirect effects between the five personality traits and resilience among a sample of Lebanese adults through the intermediary role of posttraumatic growth. METHODOLOGY: A cross-sectional study was carried out between May and July 2022, and enrolled 387 participants, all aged above 18 years old and recruited from all Lebanon governorates. The questionnaire used included socio-demographic questions, and the following scales: Connor-Davidson Resilience Scale (CD-RISC) to assess resilience, post traumatic growth (PTG), and Big Five Inventory (BFI-2). The SPSS software v.25 was used for the statistical analysis. RESULTS: Post-traumatic growth mediated the association between extraversion / agreeableness / conscientiousness and resilience. Higher extraversion / agreeableness / conscientiousness was significantly associated with more post-traumatic growth. Higher post-traumatic growth was significantly associated with more resilience. Extraversion, but not agreeableness and conscientiousness, was significantly and directly associated with more resilience. CONCLUSION: Findings suggest that fostering PTG in individuals who experience adversity can help promote their resilience. Hence, it could be beneficial to design and apply programs aiming at supporting PTG among people who experience stressful and traumatizing situations, to consequently help them increase their sense of resilience.

The mediating role of learning motivation in the relationship among perceived stress and emotional regulation among Saudi nursing students in clinical practice.

BACKGROUND: Nursing students often face high levels of stress due to demanding responsibilities during clinical placement. Emotional regulation, the ability to manage and regulate one's emotions effectively, is crucial for nursing students in dealing with stress and maintaining their overall well-being. Additionally, learning motivation plays a vital role in students' engagement and academic success. The current investigation aimed at studying the link that exists among stress, learning motivation, and emotional regulation among Saudi undergraduate nursing students. The study also aimed at investigating the sequential mediating effects that motivation might perform in this association. METHODS: A quantitative cross-sectional methodology was used in the present research, which recruited 367 Saudi undergraduate nursing students. RESULTS: The results of the ANOVA showed that the level of perceived stress was linearly and negatively correlated with emotional regulation and motivation. Upon conducting structural equation modeling, significant direct and indirect effect pathways were identified between perceived stress, emotional regulation, and motivation, while only indirect pathways were identified between perceived stress and emotional regulation. CONCLUSIONS: This study provides evidence of the mediating role of learning motivation in the relationship between perceived stress and emotional regulation among Saudi nursing students. The results highlight the negative impact of stress on emotional regulation and learning motivation and emphasize the importance of addressing motivational factors in interventions aimed at enhancing emotional regulation among nursing students.

Stress and academic engagement among Saudi undergraduate nursing students: The mediating role of emotion regulation and emotional intelligence.

AIM: To assess the mediating role of emotion regulation and emotional intelligence in the relationship between stress and academic engagement among Saudi undergraduate nursing students. DESIGN: This study employed a quantitative cross-sectional research design. METHODS: The study recruited 367 Saudi undergraduate nursing students at a major Saudi university. Structural equation modelling was used to explore the mediational model. RESULTS: The results of the ANOVA and Welch F-test demonstrated that the emotional intelligence, emotional regulation and academic engagement scores were statistically significantly different according to stress levels (p-values <0.01). Perceived stress has a statistically significant moderate negative correlation with academic engagement and emotional intelligence and a strong negative correlation with emotional regulation. The results also showed that academic engagement had a statistically significant moderate positive association with emotional intelligence and emotional regulation. Results indicate that stress and academic engagement are negatively correlated among Saudi undergraduate nursing students. It focuses on the balancing functions of emotional regulation and emotional intelligence, highlighting their ability to lower stress levels and improve academic engagement. No Patient or Public Contribution.

Profiles of intuitive eating in adults: the role of self-esteem, interoceptive awareness, and motivation for healthy eating.

OBJECTIVE: Intuitive eating is an eating behavior that has recently come to use mainly in the young population. Knowing that the Lebanese cultural diet differs from other countries, the purpose of this study was to investigate if there is a relationship between self-esteem, interoceptive awareness, and motivation for healthy eating in a sample of Lebanese adults using a Latent Profile Analysis approach. DESIGN: Cross-sectional study. SETTING: Lebanese governorates. PARTICIPANTS: 359 Lebanese participants enrolled in this study (mean age: 22.75 ± 7.04 years, 40.1% males), through convenience sampling in several Lebanese governorates. Participants were asked to fill anonymously the following scales: The Intuitive Eating Scale (IES-2), the Rosenberg Self-Esteem Scale, the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA), and the Motivation for Healthy Eating Scale (MHES). RESULTS: Our findings revealed four profiles: profile 1 (n = 67; 18.66%) characterized by high SE and intermediate interoceptive awareness and motivation for healthy eating; profile 2 (n = 86; 23.97%) presented high SE, interoceptive awareness, and motivation for healthy eating; profile 3 (n = 86; 23.96%) characterized by high SE, interoceptive awareness, and motivation for healthy eating; class 4 (n = 108; 30.08) described by low SE, intermediate interoceptive awareness, and motivation for healthy eating One-way analysis of variance did not observe a significant difference between the four profiles based on intuitive eating (F = 1.810; p = 0.145; ɳp2 = 0.015). CONCLUSIONS: Among a sample of Lebanese people, four profiles of interoceptive awareness, motivation for healthy eating, and self-esteem were observed, with no difference concerning intuitive eating.

Lebanese nursing students' perceptions of barriers to the implementation of person-centered care in clinical settings: A qualitative study.

AIM: This study aims to investigate how Lebanese nursing students perceive the challenges of implementing person-centered care in clinical settings. DESIGN: A qualitative descriptive design was adopted for this study. METHODS: At one of Lebanon's top universities, a qualitative descriptive study design was used with 18 nursing students from various academic levels. Content analysis was used to generate the results after three focus group discussions. The Consolidated Criteria for Reporting Qualitative Research were used to report this study. RESULTS: The content analysis gave rise to four main themes, namely, "overload", "challenges with education", "unawareness", "establishing connection", and "lack of initiatives related to policy". The results showed a number of obstacles that Lebanese nursing students believed were in the path of providing person-centered care. These obstacles included organisational issues like time restraints and an intense workload, as well as interaction difficulties with patients and healthcare teams, and educational issues like insufficient instruction in person-centered care concepts during nursing programs.

The Lived Experiences of Saudi Nursing Students in Digital Clinical Experience: A Phenomenological Study.

Background Novel digital methods of simulation are gaining popularity in nursing education in light of the limited access to clinical placement and expensive high-fidelity simulation technologies. Aim The aim of this study is to explore the lived experiences of Saudi nursing students in digital clinical experiences (DCEs). Methods A qualitative phenomenological research design, grounded in Husserlian phenomenology, was employed. Purposive sampling was utilized to select 21 participants actively involved in DCEs. In-depth interviews were conducted to collect rich, narrative data. Results The thematic analysis has yielded four themes, namely, "comfort and safety", "critical thinking and problem solving", "appraisal of knowledge", and "transition to practice." Conclusions The findings contribute to ongoing discussions about leveraging technology in nursing education, emphasizing the need for educators and policymakers to integrate digital tools that enhance the learning experiences of nursing students.

Exploring nurses' experiences of providing spiritual care to cancer patients: a qualitative study.

PURPOSE: This study aims to explore nurses' experiences of delivering spiritual care in an oncology setting. METHODS: An exploratory- descriptive qualitative design. Focus groups were conducted to gather data. The discussions were recorded and transcribed verbatim to ensure accuracy, credibility, and reliability. Inductive thematic analysis was performed to analyze the narratives, and the study's reporting followed the Consolidated criteria for reporting qualitative studies. RESULTS: The study revealed four major themes: the spirituality from the perspective of oncology nurses, recognition of patients' spiritual needs, delivery of spiritual care to patients with cancer, and barriers in implementing spiritual care. The participants identified insufficient staff, lack of time, and insufficient knowledge and skills as obstacles to delivering spiritual care. CONCLUSION: This study offers a thorough understanding of how nurses provide spiritual care in an oncology setting. It is recommended that organizational interventions, such as increasing staff numbers, be implemented to enable nurses to provide more compassionate care. Furthermore, nursing curriculums should incorporate purposeful engagement and focused debriefing related to spiritual care to better equip nurses in identifying and meeting the spiritual needs of their patients.

Experiences, barriers and expectations regarding current patient monitoring systems among ICU nurses in a University Hospital in Lebanon: a qualitative study.

Purpose: The aim of the study is to assess the experiences, barriers, and expectations regarding current patient monitoring systems among intensive care unit nurses at one university hospital. Methods: A qualitative exploratory study approach was adopted to test the research questions. Results: Intensive care unit personnel placed a high value on practical criteria such as user friendliness and visualization while assessing the present monitoring system. Poor alarm handling was recognized as possible patient safety hazards. The necessity of high accessibility was highlighted once again for a prospective system; wireless, noninvasive, and interoperability of monitoring devices were requested; and smart phones for distant patient monitoring and alert management improvement were required. Conclusion: Core comments from ICU personnel are included in this qualitative research on patient monitoring. All national healthcare involved parties must focus more on user-derived insights to ensure a speedy and effective introduction of digital health technologies in the ICU. The findings from the alarm control or mobile device studies might be utilized to train ICU personnel to use new technology, minimize alarm fatigue, increase medical device accessibility, and develop interoperability standards in critical care practice.

Psychometric properties of an Arabic translation of the 10-item Connor-Davidson resilience scale (CD-RISC-10), the 8- and 10-item post-traumatic growth inventory-short form (PTGI-SF) scales.

BACKGROUND: Given their clinical significance and impact on stress response and their potential malleability, resilience and posttraumatic growth (PTG) should receive greater attention as relevant constructs in clinical and research practice in the Arab context. We aimed through the present study to test the psychometric properties of Arabic translations of the 10-item Connor-Davidson Resilience scale (CD-RISC-10), the 10-item and the 8-item Post-Traumatic Growth Inventory-Short Form (PTGI-SF) in a sample of Lebanese adults from the general population. METHODS: Three hundred eighty-seven Arabic-speaking participants (mean age = 26.17; 58.4% females) responded to a self-report web-based questionnaire. The forward and backward translation method was applied with the approval of the original developers of the scales. RESULTS: Confirmatory factor analysis indicated that fit of the one-factor model was acceptable, and all indices suggested that configural, metric, and scalar invariance was supported across gender for all the three scales. The CD-RISC-10, the 10-item and the 8-item PTGI-SF yielded a good internal consistency, with a McDonald's ω of .89, .95, and .93, respectively. Higher resilience and higher PTG were significantly and positively associated with greater cognitive reappraisal and lower emotion suppression, supporting convergent validity. CONCLUSION: We preliminarily suggest that these Arabic instruments are appropriate for use in Lebanese community adults to assess different positive responses after life crises, identify people with lack or low levels of resilience and growth who might need intervention, and monitor their response to therapy. Further cross-cultural validations should seek to extend their use in broader Arabic-speaking populations and settings.

Sexual Satisfaction among Lebanese Adults: Scale Validation in Arabic and Correlates Following Two Cross-Sectional Studies.

(1) Background: Sexual satisfaction (SS) is an essential component of quality of life. There is a scarcity of research about sexual satisfaction in Lebanon, a country where discussing sexual issues is still considered a taboo. The present study aimed to assess the reliability and validity of responses to the items in the Arabic version of the Sexual Satisfaction Questionnaire (SSQ), as well as the correlates of sexual satisfaction, among a sample of Lebanese adults. (2) Methods: Two cross-sectional studies were conducted between June and September 2022 with 270 and 359 participants, respectively. (3) Results: The results showed that the Sexual Satisfaction Questionnaire is adequate to be used in Lebanon (McDonald's ω = 0.90 and 0.86, respectively). Multivariate analysis showed that higher waterpipe dependence (Beta = -0.17) was substantially linked to lower sexual satisfaction, while better emotional intelligence (EI) (Beta = 0.27) and physical activity (Beta = 0.17) were significantly associated with greater sexual satisfaction. (4) Conclusions: The reliability and validity of the responses to the Arabic version of the Sexual Satisfaction Questionnaire were supported by our findings. Also, practical implications for sexual satisfaction enhancement strategies in the Lebanese population might be beneficial since many associated factors are considered to be modifiable.

Video-Based Simulation Among Saudi Undergraduate Nursing Students During COVID-19: A Qualitative Study.

Background Because of university closures due to COVID-19 confinement, video-based simulation, a training technique based on high-fidelity simulations, was introduced in reaction to the need to adapt high-fidelity clinical simulation experiences to digital platforms. Purpose This study aims to evaluate the perceptions of nursing students in Saudi Arabia regarding the shift from face-to-face simulation experiences to video-based simulation during the COVID-19 pandemic. Methods This study employed a phenomenological exploratory qualitative research design among 32 nursing students from various academic levels. Results The thematic analysis gave rise to five themes namely, "Enhanced Learning and satisfaction", "Improved communication skills", "Lack of hands-on experience", "More comfortable experience", and "Technical Barriers". Conclusion The students in this study have indicated that they were satisfied with video-based simulation, where they reported enhanced learning, better communication skills, and more perceived comfort, while concerns regarding technical issues and nursing skills were raised.

Psychometric properties of an Arabic translation of the multidimensional assessment of interoceptive awareness (MAIA-2) questionnaire in a non-clinical sample of Arabic-speaking adults.

BACKGROUND: Interoception refers to processes through which the nervous system identifies, analyzes, and integrates the information generated by the physiological state of the body (e.g., from internal organs such as the stomach, heart, or lungs). Despite its potential interest for clinical research and its wide use globally, no Arabic adaptation and validation of the Multidimensional Assessment of Interoceptive Awareness (MAIA-2) questionnaire exists to date. The goal of this study was to examine the psychometric properties of an Arabic translation of the MAIA-2 in a sample of Arabic-speaking community adults from Lebanon. We hypothesized that the Arabic version of the MAIA-2 would yield adequate internal consistency coefficients; the 8-factor structure model would show a good fit to our data, with measurement invariance and good convergent validity. METHOD: The Arabic adaptation of the MAIA-2 was developed using the forward-backward translation method. A non-clinical sample of Arabic-speaking adults (n = 359, 59.9% females, mean age = 22.75 years (SD = 7.04)) took part of this validation study. To check if the model was adequate, several fit indices were calculated: the normed model chi-square (χ²/df), the Steiger-Lind root mean square error of approximation (RMSEA), the Tucker-Lewis Index (TLI) and the comparative fit index (CFI). Values ≤ 3 for χ²/df, and ≤ 0.08 for RMSEA, and 0.90 for CFI and TLI indicate good fit of the model to the data. RESULTS: Confirmatory Factor Analyses corroborated the validity of the original 8-factor structure of the MAIA-2 [χ2/df = 1603.86/601 = 2.67, RMSEA = 0.068 (90% CI 0.064, 0.072), SRMR = 0.058, CFI = 0.903, TLI = 0.892]. Reliability estimates in our sample revealed good internal consistency, with McDonald's ω coefficients for the subscales ranging from 0.86 to 0.93. Our analyses also revealed measurement invariance of the Arabic MAIA-2 for gender. No statistically significant difference between men and women in all dimensions, except for the not worrying and attention regulation subscales where men scored significantly higher than women. Finally, the Arabic MAIA-2 dimensions showed positive correlations with the intuitive eating dimension "Reliance on Hunger and Satiety Cues", thus providing support for convergent validity. CONCLUSION: We contribute the literature by providing the first Arabic adaptation and validation of a measure assessing the multidimensional construct of self-reported interoception. The Arabic MAIA-2 demonstrated good psychometric properties. We thus preliminarily recommend its use to measure the interoceptive awareness construct among Arabic-speaking communities worldwide.

Prevalence and mortality rate of healthcare-associated infections among COVID-19 patients: a retrospective cohort community-based approach.

Background: The prevalence of HAI among COVID-19 patients ranged between 4.8% and 42.8% with the highest occurrence observed in critically ill patients. The present study aimed to evaluate the clinical features of HAI in severe and critical COVID-19 patients, their microbiological characteristics, and the attributable risk factors. Methods: This is an analytical observational, retrospective single-center, cohort study that included 723 patients with severe-critical COVID-19 admitted to Saint George Hospital between September 2020 and February 2021. Data collection included demographic variables (sex, age), comorbidities, laboratory findings, HAI types and agents, COVID-19 treatment modalities, hospitalization settings, length of stay, and mortality rate. Data was analyzed using SPSS version 25. Results: The prevalence of patients developing HAI was 7.3% (53 of 723). Five types of nosocomial bacterial infections were tracked noting ventilator-associated pneumonia (41.26%), catheter-associated urinary tract infection (28.6%), hospital-acquired pneumonia (17.44%), catheter-related bloodstream infection (6.35%), and bloodstream infection (6.35%). Binary logistic analysis showed that HAI are statistically affected by four factors noting patients' age (p = 0.039), Length of Stay (p < 0.001), BIPAP (p = 0.019), and mechanical ventilation (p < 0.001). The risk of having HAI increases 3.930 times in case of mechanical ventilation, 2.366 times in case of BIPAP, 1.148 times when the LOS increases 1 day, and 1.029 times when the age is higher with 1 year. Conclusion: Since the prevalence of HAI is high among severe and critical COVID-19 patients, it is important to prepare a treatment with diagnostic, preventative, and control measures for this infection.

Mental illness stigma as a moderator in the relationship between religiosity and help-seeking attitudes among Muslims from 16 Arab countries.

BACKGROUND: Determining the potential barriers responsible for delaying access to care, and elucidating pathways to early intervention should be a priority, especially in Arab countries where mental health resources are limited. To the best of our knowledge, no previous studies have examined the relationship between religiosity, stigma and help-seeking in an Arab Muslim cultural background. Hence, we propose in the present study to test the moderating role of stigma toward mental illness in the relationship between religiosity and help-seeking attitudes among Muslim community people living in different Arab countries. METHOD: The current survey is part of a large-scale multinational collaborative project (StIgma of Mental Problems in Arab CounTries [The IMPACT Project]). We carried-out a web-based cross-sectional, and multi-country study between June and November 2021. The final sample comprised 9782 Arab Muslim participants (mean age 29.67 ± 10.80 years, 77.1% females). RESULTS: Bivariate analyses showed that less stigmatizing attitudes toward mental illness and higher religiosity levels were significantly associated with more favorable help-seeking attitudes. Moderation analyses revealed that the interaction religiosity by mental illness stigma was significantly associated with help-seeking attitudes (Beta = .005; p < .001); at low and moderate levels of stigma, higher religiosity was significantly associated with more favorable help-seeking attitudes. CONCLUSION: Our findings preliminarily suggest that mental illness stigma is a modifiable individual factor that seems to strengthen the direct positive effect of religiosity on help-seeking attitudes. This provides potential insights on possible anti-stigma interventions that might help overcome reluctance to counseling in highly religious Arab Muslim communities.

Psychometric properties of an Arabic translation of the multidimensional social support scale (MSPSS) in a community sample of adults.

BACKGROUND: There is a lack of methodologically strong measure to assess perceived social support among Arabic-speaking populations. Our main objective was therefore to examine the psychometric properties of an Arabic translation of the Multidimensional Social Support Scale (MSPSS) in a sample of Arabic-speaking Lebanese adults from the general population. METHODS: We adopted a cross-sectional design involving a convenience sample of 387 non-clinical Lebanese adults aged 26.17 ± 11.47 years (58.4% females). Participants were administered a web-based anonymous questionnaire containing the MSPSS, the 10-item Connor-Davidson Resilience Scale, and the Post traumatic growth Inventory-Short Form. The forward-backward translation method was applied. Confirmatory factor analysis (CFA) and gender invariance in the MSPSS were examined. McDonald's ω coefficients were calculated as internal consistency indicators. RESULTS: The Arabic MSPSS and its subscales have a high internal consistency with McDonald's ω values between 0.94 and 0.97. CFA indicated that fit of the three-factor model was acceptable. All indices suggested that configural, metric, and scalar invariance was supported across gender. Both genders exhibited no significant difference in all MSPSS dimensions. Convergent validity was supported by showing that all three MSPSS sub-scores and total score correlated significantly and positively with resilience and posttraumatic growth scores. CONCLUSION: Although further cross-cultural validations involving other Arab countries and communities are still needed, we preliminarily suggest that this scale is applicable to the broad Arabic-speaking people for the measurement of perceived social support in clinical and research contexts.

Suicide literacy mediates the path from religiosity to suicide stigma among Muslim community adults: Cross-sectional data from four Arab countries.

BACKGROUND: The majority of research attention has been devoted to the link between religiosity and suicide risk, and a considerable amount of studies has been carried out on how stigma impacts individuals with mental health problems of different kinds. However, the interplay between religiosity, suicide literacy and suicide stigma has seldom been empirically researched, especially quantitatively. We sought through this study to redress the imbalance of research attention by examining the relationship between religiosity and suicide stigma; and the indirect and moderating effects of suicide literacy on this relationship. METHOD: A cross-sectional web-based survey was conducted among Arab-Muslim adults originating from four Arab countries (Egypt: N = 1029, Kuwait: N = 2182, Lebanon N = 781, Tunisia N = 2343; Total sample: N = 6335). The outcome measures included the Arabic Religiosity Scale which taps into variation in the degree of religiosity, the Stigma of Suicide Scale-short form to the solicit degree of stigma related to suicide, and the Literacy of Suicide Scale explores knowledge and understanding of suicide. RESULTS: Our Mediation analyses findings showed that literacy of suicide partially mediated the association between religiosity and stigmatizing attitude toward suicide. Higher religiosity was significantly associated with less literacy of suicide; higher literacy of suicide was significantly associated with less stigma of suicide. Finally, higher religiosity was directly and significantly associated with more stigmatization attitude toward suicide. CONCLUSION: We contribute the literature by showing, for the first time, that suicide literacy plays a mediating role in the association between religiosity and suicide stigma in a sample of Arab-Muslim community adults. This preliminarily suggests that the effects of religiosity on suicide stigma can be modifiable through improving suicide literacy. This implies that interventions targeting highly religious individuals should pay dual attention to increasing suicide literacy and lowering suicide stigma.

Psychological Reactions of Lebanese Nurses to Workplace Violence in Critical Care Units.

Introduction: Workplace violence (WPV) is a growing concern that constitutes a major threat to occupational health and safety, thereby comprising a priority issue for policymakers. Given the increasing prevalence of chronic diseases and comorbidities among the Lebanese population, nurses working in critical care settings encounter intense workloads and high-risk interactions, potentially increasing the risk of WPV. Objectives: This study aimed to investigate the traumatic and psychological reactions of Lebanese critical nurses who have been exposed to WPV, and the risk factors for depression and anxiety. Methods: The study utilized a cross-sectional descriptive correlational design; 112 critical care nurses from diverse departments took part in this study during the period of June to July 2021. Results: A positive, significant correlation between WPV exposure and self-reported anxiety was observed, p = .03 with high levels of WPV, especially among patients and their families. Although verbal abuse was found to be more prevalent among critical care nurses in Lebanon compared to physical and sexual violence, the severity of the situation and its impact on the nurses' mental health and well-being cannot be ignored. Conclusions: WPV for critical care nurses is a serious issue that needs to be considered. Policy-makers should develop the politics of regulating the nursing profession, especially for critical care nurses in Lebanon.

Psychometric properties of the Arabic version of the Intuitive Eating Scale-2 (IES-2) in a sample of community adults.

BACKGROUND: There is a growing attention on intuitive eating (IE) styles in the Western world that has not yet reached Arab countries, which is likely due to the lack of psychometrically sound measures of the IE construct for Arabic-speaking people. The current study aims to examine the psychometric properties of an Arabic translation of the most widely used measure of IE-the Intuitive Eating Scale-2 (IES-2), in an Arabic-speaking community population from Lebanon. METHODS: Two samples of Arabic-speaking community adults from Lebanon (sample 1: n = 359, 59.9% females, age 22.75 ± 7.04 years; sample 2: n = 444, 72.7% females, age 27.25 ± 9.53 years) were recruited through online convenience sampling. The translation and back-translation method was applied to the IES-2 for linguistic validation. Factorial validity was investigated using an Exploratory Factor Analysis & Confirmatory Factor Analysis strategy. Composite reliability and sex invariance were examined. We also tested convergent and criterion-related validity through correlations with other theoretically plausible constructs. RESULTS: Nine out of the original 23 items were removed because they either loaded below 0.40 and/or cross-loaded too highly on multiple factors. This resulted in four domains (Unconditional Permission to Eat, Eating for Physical Rather than Emotional Reasons, Reliance on Hunger and Satiety Cues, and Body-Food Choice Congruence) and 14 items retained. Internal reliability estimates were excellent, with McDonald's ω values ranging from 0.828 to 0.923 for the four factors. Multigroup analysis established configural, thresholds, metric, scalar, strict invariance across gender. Finally, higher IES-2 total scores were significantly correlated with lower body dissatisfaction scores and more positive eating attitudes, thus attesting to convergent and criterion-related validity of the scale. CONCLUSIONS: The current findings provide preliminary evidence for the appropriate psychometric qualities of the Arabic 14-item, four-factor structure IES-2; thereby supporting its use at least among Arabic-speaking community adults.

Diet restriction has proven costly and ineffective in promoting long-term weight loss. As an alternative, innovative behavioral approaches have been proposed, such as intuitive eating (IE) practices. IE focuses on enhancing intrinsic motivation for eating healthily, thus creating effective, sustainable lifestyle changes. The Intuitive Eating Scale-2 (IES-2) is the most widely used measure to assess IE in patients and the general population. This scale explores four components of IE: Unconditional Permission to Eat (i.e., not trying to stave off hunger and refusing to label certain foods as forbidden), Eating for Physical Rather than Emotional Reasons (i.e., eating when physically hungry rather than for emotional reasons), Reliance on Hunger and Satiety Cues (i.e., trusting one's own internal satiety and hunger cues and relying on them to guide eating behaviors), and Body-Food Choice Congruence (i.e., the extent to which individuals make food choices that promote their body functioning and performance). Since its development, the IES-2 has been translated into different languages and validated in different countries and populations. However, no Arabic version of the IES-2 is yet available. We proposed in the current study to examine the psychometric properties of an Arabic translation of the IES-2 in an Arabic-speaking community population from Lebanon. Findings provided preliminary evidence for the appropriate psychometric qualities of the Arabic IES-2; thereby supporting its use at least among Arabic-speaking community adults.

The moderating effect of emotion regulation in the association between social support and religiosity and psychological distress in adults.

BACKGROUND: Lebanese adults face daily obstacles due to their numerous responsibilities and non-ending external pressures to the extent that Lebanon has been ranked second among highest negative experiences countries worldwide. A sparse number of international studies showed that positive social support, religiosity and cognitive reappraisal would decrease psychological distress, but none in Lebanon. This study aimed to evaluate the association between social support, religiosity and psychological distress among Lebanese adults, taking into consideration the moderating role of emotion regulation. METHODS: 387 adult participants enrolled in this cross-sectional study between May and July 2022. Participants were chosen from five different governorates in Lebanon, using the snowball sampling technique, and were asked to complete a structured questionnaire, which included the following scales: the Mature Religiosity Scale, the Emotional Regulation Scale, the Depression Anxiety Stress Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: The interaction social support by cognitive reappraisal was significantly associated with psychological distress; at high levels of cognitive reappraisal and low levels of expressive suppression, higher social support (Beta = - 0.07; p = .007) was significantly associated with lower psychological distress. The same was found at high levels of cognitive reappraisal and moderate levels of expressive suppression (Beta = - 0.08; p = .021). Social support alone was not significantly associated with psychological distress in the model (Beta = 0.15; t = 1.04; p = .300; 95% CI - 0.14; 0.44). CONCLUSION: This cross-sectional study has provided evidence that the adequate use of emotional regulation skills such as high level of cognitive reappraisal and low level of expressive suppression with presence of social support would remarkably decrease psychological distress. This result casts a new light on clinical approaches to tackle this association between the emotional regulation of a patient in interpersonal psychotherapy.