Glycaemic control and its associated factors among adult Omanis with type 1 diabetes mellitus: a cross-sectional survey.

OBJECTIVES: This study aimed to investigate the relationship between glycemic control and diabetes self-management (DSM) and other associated factors among adult Omanis with Type-1 Diabetes Mellitus (T1DM). METHODS: A cross-sectional, descriptive design was used to collect data among 210 adult Omanis with T1DM who were conveniently recruited. All tools were self-reported, whereas the HbA1c was collected from the patient's electronic medical records. RESULTS: The HbA1c mean value was 8.6 (SD = 2.5), 30.5% had optimal glycemic control (<7.0). A significant negative relationship between HbA1c and DSM (r = - 0.191, p = 0.006) and diabetes knowledge (r = - 0.153, p = 0.026) was found. Furthermore, the mean HbA1c was significantly lower for persons with a single marital status, have higher education level, have children, are unemployed, were not admitted to the hospital in the last year, and have a health care professional as a family member. Additionally, marital status, level of education, DSM, and social support were significant predictors of glycemic control. CONCLUSIONS: The results suggested that better glycemic control could be achieved by optimizing DSM, social support, and diabetes knowledge. Sociodemographic factors should be considered when treating individuals with T1DM to reach good glycemic control.

Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury.

Objectives: This study aimed to explore the caregiving preparedness and caregiver burden among Omani family caregivers (FCs) of patients with acquired brain injury (ABI). Methods: This prospective observational study was conducted at the neurology clinic at Khoula Hospital, Muscat, Oman, from April 2019 to December 2021. Data were collected from 119 FCs and their patients at the time of discharge from the hospital and 16 weeks post-discharge during follow-up care. The questionnaire comprised the Zarit Burden Index, the Preparedness for Caregiving Scale, the Short-Form-12 Health Survey, and a patient symptom scale. Results: The FCs were predominantly female (53.8%), and the mean age was 38.27 ± 9.11 years. Most patients had moderate to severe ABI (95.8%) due to stroke (56.3%) and trauma (30.3%). The most common patient symptoms were loss of muscle strength, speech problems, mood problems, memory loss, and change in behaviour. Most FCs were found to have low caregiving preparedness (58%) at discharge, and 19.1% were found to have a high level of caregiver burden at 16 weeks post-discharge. The length of time post-injury (P <0.01), symptom severity (P <0.01) and the FCs' physical and mental health status (P <0.01 each) were found to be significant predictors of caregiving preparedness, whereas caregiver preparedness (P <0.01), symptom severity (P <0.01), and caregivers' mental health (P = 0.028) were seen as the predictors of caregiver burden. Conclusion: Omani FCs of patients with ABI tend to commence the caregiver role with inadequate preparation, and shortly after, a significant number suffer high caregiver burden. Interventions focusing on the caregiver's health and training in symptom management may improve the outcomes of FCs and patients.

Predictors of Quality of Life Among Omani Family Caregivers of Patients With Traumatic Brain Injury.

Objectives: This study aimed to explore the quality of life (QoL) of Omani family caregivers (FCs) of patients with traumatic brain injury (TBI). After acute care, the burden of caring for patients with TBI is mainly shouldered by FCs. Methods: This cross-sectional study was conducted at Khoula Hospital, Muscat, Oman. Patient data were collected at the time of discharge and 8 weeks post-discharge between April 2019 and December 2021. The SF-12 General Health Survey and Preparedness for Caregiving scale were used to measure the caregivers' QoL and preparedness, respectively. The Disability Rating and TBI Symptom scales were used to measure the patients' disability and symptoms, respectively. Results: A total of 36 FCs and patients with TBI were recruited. Most caregivers were the parent (41.7%) or child (27.8%) of the patient with TBI. Overall, the caregivers had good physical QoL (PQoL) and mental health QoL (MHQoL) but low caregiving preparedness at the time of discharge. At 8 weeks post-discharge, there were significant improvements in caregiving preparedness (P <0.01) and patient disability (P <0.05) but a depreciation in caregivers' MHQoL (P <0.05), with no change in their PQoL. The caregiver's employment status and the severity of the patient's sleep and mood problems were modifiable predictors of the caregivers' PQoL. Caregiver's preparedness, the patient's inability to live independently, and the severity of the patient's mood and behavioural problems were predictors of caregivers' MHQoL. Conclusion: Caring for patients with TBI negatively impacts the QoL of Omani FCs; this correlates with the physical, emotional, and mental health symptoms of the patient.

The needs of families caring for patients with traumatic brain injury: a scoping review.

PURPOSE: This scoping review was conducted to synthesize existing literature into a map of the common needs of families caring for patients with traumatic brain injury (TBI) at home. MATERIALS AND METHODS: A systematic search of studies published between January 2012 and December 2022 was conducted across databases. The selected studies reported the needs or unmet needs of patients with TBI and/or their family caregivers (FCs). RESULTS: A total of 12 publications were identified. The results suggest that the common needs of families caring for patients with TBI at home include: information about TBI as a disease; information about the continuum of TBI healthcare services; information about adaptive technologies; education and skilling of FCs; psychological support and counseling; physical and occupational therapy services; follow-up care and transitional care management; respite care; peer support; financial assistance, advocacy, and legal services; emotional support from the family and community; and assistance with physical patient care and instrumental activities of daily living. CONCLUSION: The mapped needs provide insight into supportive interventions required to enhance the health outcomes of patients with TBI and their families during and after rehabilitation. The needs also highlight directions for research and healthcare services for patients with TBI.

The families caring for patients with traumatic brain injury at home end up living in situations characterized by multiple unmet needs, and these can be a source of poor health outcomes for the family and patients with traumatic brain injury.The identified needs of families caring for patients with traumatic brain injury reveal gaps in the discharge planning and care coordination after acute and rehabilitation care.Addressing these needs requires a multidisciplinary approach and planning.Interventions using a holistic approach to address the identified needs may significantly improve the health outcomes of patients with traumatic brain injury and their families.

A Countrywide Assessment of Omani Undergraduate Nursing Students' Palliative Care Knowledge and Attitudes Towards End-of-Life Care.

Palliative care (PC) is a vital part of the responses needed to address the outcomes of cancer and other non-communicable diseases such as chronic pain, terminal illnesses, and end-of-life situations. Until today, there is a significant lack of access to PC in most developing countries, where the majority of the global population lives. Deficiencies in nurses' knowledge and attitudes exacerbate the lack of access to PC and end-of-life care (EOLC) in these countries. This study was conducted in Oman to assess undergraduate nursing students' (NS) PC knowledge and attitudes towards EOLC. A cross-sectional design was used to collect data from 276 NS in all undergraduate programs in Oman. The PC knowledge and attitude towards EOLC were measured using the PEACE-Q and FATCOD-B. The NS had a borderline level of PC knowledge but favorable attitudes towards EOLC. The NS were least knowledgeable about the philosophy of PC, delirium, side effects of opioids, cancer pain, and dyspnea. There were differences in PC knowledge and attitudes across programs. The findings highlight potential deficiencies and opportunities that can be utilized to augment future nursing human resources for PC and EOLC in Oman. We recommend a national interdisciplinary PC education and training consortium (NIPCET-C) to dialogue, develop, promote, monitor, and evaluate PC and EOLC education in Oman.

A Multi-country Comparative Study on Palliative Care Knowledge and Attitudes Toward End-of-Life Care Among Undergraduate Nursing Students.

The global burden of human death after experiencing serious health-related suffering (SHRS) requiring palliative care (PC) and end-of-life care (EOLC) is increasing. The largest increase in SHRS, death situations, PC, and EOLC needs continues to be in developing countries with limited access to PC. It is critical that nursing human resources in countries with limited access to PC are well trained and have adequate knowledge, attitudes, and skills to provide PC and EOLC. This study aimed to compare the PC knowledge and attitudes toward EOLC of future nursing human resources in Oman, India, and the Philippines. A comparative, cross-sectional design and two standardized questionnaires (the PEACE-Q and FATCOD-B) were used to collect data from 547 undergraduate nursing students (NSs). Overall, the NSs had positive attitudes toward EOLC (102.5 ± 15.39), but moderate PC knowledge (20.99 ± 3.59). The NSs were least knowledgeable about dyspnea, cancer pain, delirium, and side effects of opioids. Most of the NSs reported that their program did not include specific content about PC (56.1%) and hospice care (54.1%). The differences between countries and the predictors of PC knowledge and attitude toward EOLC were identified. The findings reveal gaps that need to be addressed in order to enhance access to PC and EOLC through well-trained nursing human resources.

Determinants of quality of life among Omani family caregivers of adult patients with cancer pain.

OBJECTIVES: The study aimed to explore the determinants of quality of life (QoL) among Omani family caregivers (FCGs) of adult patients with cancer pain. METHODS: A descriptive cross-sectional design, measures of caregiver reaction, knowledge about cancer pain, self-efficacy for cancer pain and other symptom management, QoL, and patient functional status were used to collect data from 165 FCGs and patients. Descriptive, correlation, and regression analyses were performed. RESULTS: Most patients had intermittent (83%) and severe (50.9%) cancer pain. The FCGs had low QoL (58.44 ± 17.95), and this mostly impacted support and positive adaptation (55.2%). Low QoL was associated with low self-rated health, low confidence in the ability to control the patient's pain, low self-efficacy, high perceived distress due to patient pain, and a high impact of caregiving on physical health. The level of caregiver distress due to the patient's pain (p < 0.01), patient's functional status (p < 0.01), and perceived impact of caregiving on health (p < 0.05) were significant predictors of overall QoL. CONCLUSION: Omani FCGs of patients with cancer pain suffer a negative impact on their QoL, and this is related to the patient's level of pain and functional status, caregiver's health, and self-efficacy in cancer pain and symptom management. The FCGs' QoL may be enhanced by augmenting their skills and self-efficacy in cancer pain and symptom management and by health promotion programs.

Family Caregivers of Adult Cancer Patients in Oman: Predictors of Caregivers' Self-efficacy for Cancer Pain and Related Symptom Management at Home.

BACKGROUND: Family caregivers (FCGs) contribute significantly to the management of pain and other symptoms experienced by their family member with cancer and may not receive preparation to meet the changing patient needs. OBJECTIVE: The aim of this study was to identify the predictors of FCG self-efficacy (SE) for pain and related symptom management of adult family members with cancer. METHODS: Data were collected from 165 Omani FCGs. The questionnaire comprised the caregiver cancer pain and related symptom management SE scale, the Katz index, Caregiver Reaction Assessment, and Family Pain Questionnaire. Electronic medical records provided data on patients' cancer diagnosis, pain, and symptoms. Predictors of SE were examined using linear regression analysis. RESULTS: Most FCGs were female (58.2%) and children of the patient (53.9%). Most patients were on chemotherapy or palliative care (82.4%) and had at least stage 3 cancer (58.8%). Family caregivers reported average SE. The predictors of SE were as follows: patients' functional status (ß = 40.90, P = .001), patients' pain intensity (ß = -15.10, P = .036), FCGs' confidence in controlling the patients' pain (ß = 28.80, P = .000), FCGs' self-rated health (ß = -25.90, P = .038), and interaction of FCGs' knowledge level with patients' pain intensity (ß = -1.31, P = .008), caregiving hours (ß = -0.10, P = .025), and impact of caregiving on FCGs' physical health (ß = 1.29, P = .031). CONCLUSION: Family caregivers' health status, knowledge, caregiving demands, patient functional status, and pain intensity have a significant effect on caregivers' symptom management. IMPLICATIONS FOR PRACTICE: A deliberate model of care that includes supportive interventions to enhance the abilities of FCGs with symptom management is needed in Oman.

Effect of triage nurse-led application of the Ottawa Ankle Rules on number of radiographic tests and length of stay in selected emergency departments in Oman.

AIM: Ankle injuries are commonly seen in the emergency department (ED) and contribute to overcrowding. In Oman, injuries are a leading cause of years of life lost, disability-adjusted life years, and pose a burden to the healthcare system. This study aimed to evaluate the effectiveness of ED triage nurse-led application of the Ottawa Ankle Rules (OARs) toward improving the healthcare outcomes of ankle injury patients. METHODS: A quasi-experimental design was used to collect data (demographic characteristics, waiting time, length of stay, and number of radiographic tests) from 96 patients. The intervention group (n = 46) received ED triage nurse-led assessment and initiation of radiographic tests based on the OARs. The control group (n = 50) received usual care. RESULTS: The participants' mean age was 26.4 ± 7.90 years. The main causes of ankle injuries were football (36%), falls (31%) and twisting while walking (24%). There was a significant difference in number of ankle X-rays (t = 6.19; p < .001); length of stay (U = 549; p < .001); and waiting time (U = 167; p < .001) between the control and intervention group. The intervention reduced the mean waiting time and length of stay by 25.09 and 41.01 min, respectively. CONCLUSION: Application of the OARs by the ED triage nurse can decrease the number of unnecessary radiographic tests, waiting time and length of stay in the ED. Nurses' utilization of evidence-based clinical decision-making tools can improve ED care outcomes of common acute conditions such as ankle injuries.

Roles of Family Caregivers and Perceived Burden When Caring for Hospitalized Adult Cancer Patients: Perspective From a Low-Income Country.

BACKGROUND: Family caregivers (FCGs) of adult cancer patients (ACPs) are typically involved in the entire trajectory of cancer disease, from diagnosis to survivorship or end of life. In developing countries, FCGs are more intensely involved in the process of providing care to the hospitalized ACPs because of lack of adequate cancer care resources. Active performance of tasks to meet the needs of ACPs in the hospital setting is likely to elicit significant caregiver burden. OBJECTIVE: The aim of this study was to explore the tasks performed and the caregiver burden experienced by FCGs of hospitalized ACPs in a sub-Saharan country. METHODS: A cross-sectional descriptive design was used to collect data from 168 FCGs of ACPs. The Caregiver Burden Scale was used to measure burden. RESULTS: The most common cancer diagnosis in male and female ACPs was Kaposi's sarcoma (32.1%) and breast cancer (37.9%), respectively. The tasks regularly performed by most FCGs for the ACPs were providing emotional support (79.8%), feeding (68.5%), transporting to other appointments (62.5%), preparing meals (55%), and giving medications (46.4%). Most FCGs (75%) were experiencing severe or very severe general caregiver burden. The dimensions of caregiver burden that were most severely impacted were general strain (70.6%), disappointment (85.8%), and isolation (72%). Predictors of caregiver burden are reported. CONCLUSION: Family caregivers of hospitalized ACPs experience severe caregiver burden. The main forms of burden experienced were general strain, disappointment, and isolation. IMPLICATIONS FOR PRACTICE: Cancer care services in developing countries should be strengthened with services that address FCGs' emotional needs and human resources to curtail the strain imposed on FCGs.

Nursing faculty academic incivility: perceptions of nursing students and faculty.

BACKGROUND: Incivility in nursing education can adversely affect the academic environment, the learning outcomes, and safety. Nursing faculty (NF) and nursing students (NS) contribute to the academic incivility. Little is known about the extent of NF academic incivility in the Middle East region. This study aimed at exploring the perceptions and extent of NF academic incivility in an undergraduate nursing program of a public university in Oman. METHODS: A cross sectional survey was used to collect data from 155 undergraduate NS and 40 NF about faculty academic incivility. Data was collected using the Incivility in Nursing Education Survey. RESULTS: The majority of NS and NF had similar perceptions about disruptive faculty behaviors. The incidence of faculty incivility was low (Mean = 1.5). The disruptive behaviors with the highest incidence were arriving late for scheduled activities, leaving schedule activities early, cancelling scheduled activities without warning, ineffective teaching styles and methods, and subjective grading. The most common uncivil faculty behaviors reported by participants were general taunts or disrespect to other NF, challenges to other faculty knowledge or credibility, and general taunts or disrespect to NS. CONCLUSION: The relatively low level of NF academic incivility could still affect the performance of some students, faculty, and program outcomes. Academic institutions need to ensure a policy of zero tolerance to all academic incivility, and regular monitoring and evaluation as part of the prevention strategies.

Barriers to infant and child-feeding practices: a qualitative study of primary caregivers in Rural Uganda.

The purpose of this study was to explore the barriers to the use of appropriate infant and young child-feeding practices by primary caregivers living in a rural Ugandan district. A community-based qualitative design and focus group discussions were used for collecting data from primary caregivers of children aged 0 to 24 month(s). On an average, each of the four focus group discussions had 11 participants. The focus group discussions were conducted using a structured interview guide and were tape-recorded. The recorded data were later transcribed and analyzed using qualitative thematic analysis techniques. All the participants were females, and the majority had low levels of education and at least one child in the age-group of 0-24 month(s) in their household. The findings show that the main barriers to the use of appropriate infant and young child-feeding practices fall under four themes: caregiver's knowledge about breastfeeding, caregiver's knowledge about complimentary feeding, influence of culture custodians on the caregivers, and patterns and burden of other responsibilities the caregivers have in the household. The four categories of barriers imply that there are various missed opportunities to implement hospital and community-based interventions to improve infant and young child-feeding practices, which is one way of preventing malnutrition. Therefore, in rural areas of Uganda, the major factors responsible for the high prevalence of malnutrition among infants and children are still those related to knowledge, culture, and social status of the primary caregivers.

Determinants of Uptake of Cervical Cancer Screening Services at a No-cost Reproductive Health Clinic Managed by Nurse-Midwives.

BACKGROUND: The incidence of cervical cancer (CC) has been rising in sub-Saharan Africa, and health authorities in this region have responded by increasing the availability of cheap or no-cost CC screening services (CCSS), public health education, and others. However, the efforts have not yet resulted into the expected uptake of CCSS. OBJECTIVE: The aim of this study was to examine the determinants of uptake of CCSS at a no-cost reproductive health clinic managed by nurse-midwives. METHODS: A descriptive design and a structured interview questionnaire were used to collect data from 236 women attending the reproductive health clinic. Logistic regression statistics were used to examine the determinants of uptake of CCSS. RESULTS: The mean age of participants was 28.7 years, and only 29% had received CC screening. The significant determinants of uptake of CCSS were concern about the gender of the healthcare professional (HCP) (odds ratio [OR], 5.03; P = .001), age older than 25 years (OR, 3.09; P = .005), contraceptive use (OR, 0.28; P = .02), encouragement by HCPs (OR, 0.16; P = .00), and perceived quality of CCSS (OR, 0.08; P = .00). CONCLUSIONS: Gender of the HCP and encouragement or reminders by the HCP influence uptake of CCSS. Because nurse-midwives have successfully led strategies to promote other integrated reproductive health services, they can also play a key role in enhancing uptake of CCSS in resource-poor settings. IMPLICATIONS FOR PRACTICE: Interventions to enhance service quality and deliberate policies requiring HCP to recommend encourage and remind clients may help to enhance uptake of CCSS in resource-poor settings.

A review of potential Muslim organ donors' perspectives on solid organ donation: lessons for nurses in clinical practice.

BACKGROUND: Transplantation is increasingly being used to treat patients with end-stage organ disease. However, when potential organ donors involved are Muslims, religious beliefs and culture have a strong influence on clinical decision making and nursing care. PURPOSE: To establish basic aspects that nurses working with potential Muslim organ donors need to know in order to provide culturally sensitive care. METHODS: Studies were retrieved from four databases (Cumulative Index to Nursing and Allied Health Literature, SCOPUS, Medline, and PubMed). RESULTS: Findings of available studies show that health education, family involvement, and collaboration with religious leaders are good strategies for ensuring culturally sensitive care for Muslim patients in this situation. CONCLUSION: Nurses need to know that organ donation is compatible with Islam and that religious leaders, family, sociocultural beliefs, legal requirements, informed decision making process, and Ramadan are important aspects that need to be considered in order to be able to provide culturally senstive care.

Sexual Health for Older Women: Implications for nurses and other healthcare providers.

This article presents findings from a review of the evidence regarding sexual health for older women from MEDLINE, SCOPUS and the Cumulative Index to Nursing and Allied Health (CINHAL) databases. A total of 10 articles based on primary studies, reporting about the sexuality or sexual health of older women (and older people), and published between 2002-2012, were deemed suitable. The major themes that emerged from the available literature suggest that the sexual health of older people is affected by factors such as physical changes, mental health, changes to their relationship with their husband, chronic ill health and other psychosocial situations. It is concluded that nurses and other healthcare providers have a range of interventions that can be adopted to promote sexual health among older women. These interventions may focus on improving the older woman's sexual health assessment; increasing awareness and knowledge about sexuality in later life; pharmacological and psychotherapeutic therapies; using alternative techniques to achieve better sexual functioning; addressing partner and relationship issues, and advocating the importance of sexual health through media and policy development.

Religiosity and adherence to antiretroviral therapy among patients attending a public hospital-based HIV/AIDS clinic in Uganda.

In Uganda, the prevalence of non-adherence to antiretroviral therapy (ART) by HIV/AIDS patients remains high and sometimes this is blamed on patients' religious behavior. A descriptive design was used to examine the relationship between religiosity and ART adherence in a sample of 220 patients attending a HIV/AIDS clinic in a Ugandan public hospital. Participants who self-identified as Pentecostal and Muslim had the highest percentage of members with high religiosity scores and ART adherence. Among Muslim participants (34), 82% reported high religiosity scores and high levels of ART adherence. Of the fifty Pentecostals participants, 96% reported high religiosity scores and 80% reported high levels of ART adherence. Correlation analysis showed a significant relationship between ART adherence and religiosity (r = 0.618, P ≤ 0.01). Therefore, collaboration between religious leaders and HIV/AIDS healthcare providers should be encouraged as one of the strategies for enhancing ART adherence.

Relationship between methods of coping, social support and receipt of preventive care procedures by primary grandmother caregivers.

The purpose of this study was to examine the relationship between receipt of preventive care procedures, social support and methods used by primary grandmother caregivers to cope with the demands of caregiving. A self-administered questionnaire comprised of items on preventive procedures and standardized measures of social support and methods of coping was used to collect data from a sample of 86 primary grandmother caregivers (56 ± 8 years). Results show that blood pressure check ups (94%) and general physical examination (89%) were the preventive care procedures received by most participants. The average adherence score for the nine preventive care procedures was 6.60 ± 2.10 and 50% of the participants had received each of the nine preventive care procedures considered by this study. Significant relationships were found between avoidance coping and receiving a general physical examination and eye or vision examination; between coping by minimizing the situation and receiving eye or vision examination; and between active coping and receiving a cholesterol check. Subjective and instrumental social supports were both significantly associated with receiving a gynecological examination or Pap smear and blood pressure check up. In conclusion, findings of this study show that primary grandmother caregivers have a high propensity towards preventive care. However healthcare providers providing preventive care to primary grandmother caregivers and other informal caregivers should assess the social supports and methods of coping used to cope with the demands of caregiving because both affect receipt of preventive care.

Continuing education in geriatrics for rural health care providers in Uganda: A needs assessment

Population trends in developing countries show an increasing population of older adults (OAs), especially in rural areas. The purpose of this study was to explore the geriatrics continuing education needs of health care providers (HCPs) working in rural Uganda. The study employed a descriptive design to collect data from HCPs working in Apac district, a rural district in northern Uganda. The 240 HCPs (mean age 33.8±10.5 years) from whom data were collected were nurses (52%), physician assistants (17%), social workers (12%), laboratory technologists (10%) and physicians (10%). Self-administered questionnaires composed of the Palmore's Facts on Aging Quiz (FAQ1) and Kogan's attitude towards old people (KAOP) scale were used for data collection. Results. Most HCPs (63%) regularly cared for OAs but their professional education did not include geriatric-specific courses (69%). The majority of HCPs had a poor or fair geriatric knowledge (88%) (FAQ1 mean score 11.6±2.3), but had a positive attitude towards OAs (80%) (KOAP mean score 115.9±11.5). Positive attitude was associated with personal experiences with OAs and a desire for a future career in geriatrics (p≤0.05). Conclusion. In Uganda training curricula for health professionals have not evolved to address the changing demographic trends showing increasing numbers of OAs. Consequently, there is a significant knowledge gap in certain aspects of health care, such as geriatrics, among currently practising HCPs. There is need for tailored geriatrics continuing education programmes to bridge the knowledge and skill gaps to ensure quality health care for OAs

A case study: inappropriate use of amitriptyline in the elderly.

In 1999, nearly 7 million elderly persons were prescribed potentially inappropriate medications as identified by Beer's Criteria. Amitriptyline is among the most frequently inappropriately prescribed drugs according to Beer's Criteria. Interventions to educate prescribers on Beer's Criteria are indicated to improve appropriate prescribing to the elderly population. Nurses also need to be aware of the potential adverse effects of these drugs when providing care to geriatric patients.