Implementation Science of Paediatric Palliative Care in Lower-Middle-Income Countries in Southeast Asia: An Integrative Review.

There is an ongoing development in the paediatric palliative care (PPC) program in Southeast Asia (SEA). However, the implementation process has not been clearly understood among lower-middle-income countries (LMICs) in this region. The purpose of this paper is to review and synthesise research about the implementation process of 7 identified LMICs in the SEA: Cambodia, Indonesia, Myanmar, Lao PDR, the Philippines, Timor-Leste, and Vietnam. An integrative review utilising Whittemore and Knafi's five-stage process was employed. Electronic searches of CINAHL, Web of Science, ProQuest, and Google Scholar (no year restriction) were conducted. From the 7599 articles retrieved, only 11 met the eligibility criteria. Each article was appraised for methodological quality (QualSyst tool and AACODS checklist) and constant comparison methods were used. Two overarching themes emerged in this review - the gaps in PPC standards, practice framework, and guidelines and the PPC challenges and implementation strategies. Understanding the implementation science of PPC among LMICs in the SEA region addresses the gap between idealism and realism. It provides reliable information in the development of strategic work plans that will improve the implementation process and promote the translation of EBIs into practice significant to the quality of paediatric patient outcomes.

Structural and psychological empowerment and its influencing factors among nursing students in Oman.

BACKGROUND: This study explored the empowerment of nursing students to contribute to nursing education and recommend ways of increasing the engagement of nursing students in their training. The development of empowerment among nursing students leads to the maximum achievement of learning competencies and enables them to eventually become competent nurses. PURPOSE: This study examined the relationship between student nurses' characteristics, structural empowerment, and psychological empowerment. METHODS: A total of 185 nursing students were recruited through systematic sampling at Sultan Qaboos University, with a 92% response rate. Nursing students' level of psychological empowerment, in terms of meaning, competence, self-determination, and impact, and their level of structural empowerment, in terms of access to opportunity, support, information, and resources were investigated using a self-designed questionnaire. RESULTS: The results showed that "access to support" was rated as the highest dimension by the students, followed by "access to information," "informal power," "access to opportunity," "access to resources," and "formal power." The global empowerment mean score was 3.64 (SD = 1.01), and the total structural empowerment score was 20.58 (SD = 3.62). The multivariate multiple regression analysis revealed that students' year level and involvement in school organizations had multivariate effects on the four dimensions of psychological empowerment. Students who were involved in school organizations had higher scores for the dimensions of "meaning," "competence," and "impact" than students who were not involved in any school organization. CONCLUSION: Power can be either developed or acquired, and its definition is expressed based on the achievement objective. Age is not a barrier, as it had little or no impact on nursing student experiences and no correlation with structural empowerment.

Predictors of quality of life of nursing internship students from five Saudi universities.

OBJECTIVES: This study investigated the quality of life (QoL) of nursing internship students (NISs) and the predictive variables for the QoL of NISs during the COVID-19 pandemic. The correlates of QoL of NISs with their gender, age, prior nursing experience, and grade point average (GPA) from the previous semester are also assessed. METHODS: This study used a quantitative cross-sectional design through an electronic survey form for the collection of required data. The 22-item Quality of Life Evaluation Scale (QOLES) was adopted as the survey instrument. A total of 283 NISs from five public universities in KSA completed the survey. RESULTS: The students' age, gender, and nursing-related experience prior to their internship were all found to be significantly associated with the overall QOLES score (p values of 0.001, 0.001, and 0.01, respectively). The NISs GPA was found to be marginally significant (p = 0.08). A significant difference was identified in the overall QOLES score based on age (p = 0.02), gender (p = 0.02), and GPA (p = <0.001). Finally, as estimated by the regression analysis, only age (p = 0.002) was found to be a significant predictor of NISs' QoL. CONCLUSION: In this study, the QoL of Saudi NISs was positively correlated with their age and gender. Male NISs had greater QoL than females, while a high QoL was observed among students with high GPAs before the internship year. Only the age of the NISs was found to be a reliable predictor of QoL.

Anxiety Symptoms Are Associated With Higher Psychological Stress, Poor Sleep, and Inadequate Sleep Hygiene in Collegiate Young Adults-A Cross-Sectional Study.

Background: Anxiety symptoms, stress, poor sleep, and inadequate sleep hygiene are common in university students and these affect their learning and increase attrition. However, limited knowledge exists about the inter-relationship between these factors among university students in low-middle income countries. Therefore, this study aimed to investigate the prevalence of anxiety symptoms and their relationship with sleep quality, sleep hygiene practices, and psychological stress. Materials and Methods: A cross-sectional study was conducted with a randomly selected sample of students in Mizan-Aman, Ethiopia. Participants completed a self-administered questionnaire, which included questions about socio-demographics, socio-economic factors, the Leeds Sleep Evaluation Questionnaire-Mizan, Sleep hygiene index, Perceived stress scale-10 (PSS-10), and Generalized anxiety disorder-7 scale (GAD-7). Results: The prevalence of anxiety symptoms was about 22%. Multivariate regression analysis showed that both anxiety status χ2[(13, N = 480) = 82.68, p < 0.001], and increasing levels of anxiety (model adjusted R2 = 0.204, p < 0.001) were associated with greater psychological stress, inadequate sleep hygiene practices, and poor sleep quality scores after adjusting for age, gender, attendance, substance use, years of university education, time spent in athletic activity every day, and frequency of tea/coffee consumption. Conclusion: There was a high prevalence of anxiety symptoms in this study population, and this condition was associated with psychological stress, poor sleep, and inadequate sleep hygiene parameters. These results suggest a need to address the various aspects of mental health and its diverse sleep correlates in university students.

Nurses' competency in Saudi Arabian healthcare context: A cross-sectional correlational study.

AIM: To measure the competence and characteristics of nurses in Saudi Arabia delivering health care with significant correlations. DESIGN: A cross-sectional correlational study. METHODS: Data were collected in 2019 using a standardized questionnaire, Competency Inventory for Registered Nurses (CIRN), that included a purposive sample of 621 nurses working in Saudi Arabia. RESULTS: A positive evaluation of nurses' overall core competency components is recognizably measured with greater competency levels in their workplace, scoring highest in "legal/ethical practice" while "critical thinking and research aptitude" represented the lowest dimension. Nurses' marital status, years of graduation, length of service, duty hours and nurse-patient ratio affect their competency level. Nurses' competence and their sociodemographic characteristics are significantly correlated attributes. Medical ward nurses are likely to have the greatest competence in delivering safe nursing care within training's legal borders.

Barriers in performing physical assessment among nursing students: An integrative review.

OBJECTIVES: This study aimed to identify barriers in performing physical assessments among nursing students through integrative review study. METHODS: The literature were searched in Medline, CINAHL, ScienceDirect, Web of Science, ProQuest, and Taylor & Francis Online using the descriptors barrier, physical assessment, nursing student et al. Only English-language and peer-reviewed journal articles were included, and there were no year restrictions. RESULTS: Twelve articles were selected for review. Two aspects were extracted: the barriers included personal challenges, challenges related to nursing education, challenges related to clinical practice; establishing competency-based education learning as a method to reduce physical assessment barriers. Student competencies and experiences were influenced by various factors that collectively hindered their successful performance of physical assessments. CONCLUSIONS: The review findings provide valuable insights into the complex issues involved in the performance of physical assessments and guidance for improvement in practice. A collaborative effort should be made to address the issues often faced by nursing students in performing routine physical assessments. Also, more constructive and competency-based teaching methods should be integrated into academic and clinical settings.

Nurses' Kangaroo Mother Care practice implementation and future challenges: an integrative review.

BACKGROUND: Nurses play a crucial role in Kangaroo Mother Care practice, but their application in specific policies and practices involves challenges. A comprehensive literature review is needed to improve understanding of specific barriers that are most relevant to nurses and the improvement of this practice. This review investigates nurses' barriers in implementing Kangaroo Mother Care, in order to illustrate directions for future research. METHODS: This study was based on integrative review method and exploring nurses' barriers in implementing Kangaroo Mother Care, strategies to reduce its barriers. CINAHL, Medline, Web of Science, ProQuest Nursing and Allied Health Database, PubMed and Science Direct Taylor & Francis databases were searched for the following: (i) studies with no year restrictions, (ii) peer-reviewed journal articles, (iii) original research and (iv) articles written in English. Each article was appraised for methodological validity review using critical appraisal checklist. RESULTS: The search revealed 19 articles from diverse countries. Four main themes were generated from the synthesis of the findings: (i) barriers related to nurses' perspective and emotion towards KMC, (ii) healthcare institution barriers towards KMC, (iii) barriers related to parental experience in providing KMC and (iv) strategy to improve KMC implementation. CONCLUSIONS: Nurses experience several barriers in successfully implementing KMC in healthcare settings. This review reported strategies to reduce KMC barriers and to improve its utilisation in healthcare settings. Hospitals should establish adequate manpower, clear guidelines, sufficient supplies and equipment, capacity building among staff and proper Kangaroo Mother Care information dissemination for patients.