"Embracing the Inner Strength and Staying Strong": Exploring Self-Care Preparedness among Nurses for Enhancing Their Psychological Well-Being against the Long-Term Effect of COVID-19 Pandemic in Brunei Darussalam.

During three years of the unprecedented, massive COVID-19 pandemic that affected the world, nurse front liners faced substantial challenges and experienced long-term adverse mental health. This study explored psychological self-care practices undertaken by nurses to strengthen their mental health and develop resilience in their professional care role while addressing the challenges of the COVID-19 era. A qualitative descriptive exploratory study was conducted on 40 nurses who worked in providing COVID-19 care across Brunei using focus groups aided by semi-structured open-ended questions. Data were thematically analyzed using constructivist grounded theory. Four themes emerged: (1) 'Care of the mind, heart and soul'; (2) 'Physical care for the psychological well-being'; (3) 'Venting out and distraction'; (4) 'Have faith, think and stay positive'. The challenges of dealing with a worldwide pandemic unintentionally placed nurses' mental well-being at risk while the government strategized and prioritized containing and preventing the spread of and death from COVID-19. Health administrators, as well as nursing educators, need to promote and develop resources to strengthen nurses' psychological self-care practices. This will not only benefit individual nurses but will help promote the well-being of patients and employees, improve the health of all, and counteract any unintended stressful situations, even beyond the COVID-19 pandemic.

Mental Wellbeing and Health-Risk Behaviours of University Students in Brunei: A Cross-Sectional Study during COVID-19 Pandemic.

Background: The coronavirus disease discovered in 2019 (COVID-19) has impacted the health behaviour of university students in a range of western nations and had a number of detrimental effects on their mental wellbeing. However, little is known about the impact on university students in Southeast Asia, particularly in Brunei. This study aims to estimate the prevalence and factors related to poor mental wellbeing and engaging in health-risk behaviors among university students in Brunei during the COVID-19 pandemic. Methods: A cross-sectional online survey of students in all public universities was conducted from March to June 2021. Warwick-Edinburgh Mental Well-being Scale, Global Physical Activity Questionnaire, and WHO STEPs questionnaires were used to measure mental wellbeing, physical activity, and health behaviors, respectively. Logistic regressions were applied. Results: A total of 1020 university students participated in this study (57% response rate). Prevalence of poor mental wellbeing and physical inactivity were 30% and 42.8%, respectively. Excessive snacking (89.7%), sugar intake (81.7%), and salt intake (53.8%) were the most prevalent health-risk behaviors. Body mass index and participating in sports activities were the most common factors related to mental wellbeing and health-risk behaviors. Conclusions: Participating in certain sports activities appears to have protective effects against study outcomes. However, a high prevalence of physical inactivity and unhealthy diet among university students is a concern, as it could be indicative of future non-communicable disease trends.

Patient satisfaction of breast reconstructive surgery following mastectomy in Brunei.

OBJECTIVE: To evaluate the impact of Breast Reconstructive Surgery (BRS) on patients' satisfaction and quality of life following mastectomy for breast cancer. METHODS: A multi-method design study comprising quantitative and qualitative research was conducted between October to December 2019. The quantitative component consisted of a cross-sectional study using the Breast-Q questionnaire and the qualitative component involved in-depth interviews with eligible patients (N = 16) who underwent BRS following mastectomy for breast cancer. Quantitative analysis was performed including Fisher's exact test and One-way Analysis of Variance where a p-value of <0.05 was regarded as statistically significant. Qualitative data was thematically analysed using Braun and Clarke's thematic analysis. RESULTS: 14 out of 16 eligible patients participated in the study. We observed the lowest-scale score was for 'satisfaction with nipples' (mean score 32.7), followed by 'physical well-being: abdomen' (mean score 69.5). Despite a median score of 70 for 'satisfaction with breasts', patients were satisfied with the overall outcome of BRS (median score 80.5). Thematic analysis yielded three themes i.e. "I feel beautiful again" that described patients' satisfaction with aesthetic outcome with autologous reconstruction; "Striving for normality" that indicated BRS established back a sense of normality and improve their self-confidence and lastly, "I was well taken care of" highlighted the importance of providing 'well-informed' care to ensure overall satisfaction of their BRS journey. CONCLUSION: The uptake of BRS remains low since its availability in 2012, despite an overall increase in breast cancer cases in Brunei annually. Patients who underwent BRS have shown an increase BREAST-Q scores in breast satisfaction, psychosocial and sexual well-being after breast cancer treatment. Delivering high-quality patient-centred services and providing adequate information can influence the level of satisfaction for overall outcome. BRS should be considered as an important healthcare priority in Brunei and routinely be offered in the management of breast cancer.

Knowledge, attitudes, and practices of healthcare professionals on oral care of pregnant women in Brunei Darussalam.

OBJECTIVE: To examine nationwide the knowledge, attitudes, and practices of healthcare professionals on oral/dental care of pregnant women in Brunei Darussalam. MATERIALS AND METHODS: A descriptive cross-sectional study conducted using an online survey of eligible healthcare professionals in all Government Maternal and Child Health Care Clinics, Dental Clinics and Obstetrics and Gynecological Clinics in four hospitals covering the whole of Brunei Darussalam. Participants were given seven days to complete the survey. Sub-group analysis using Chi-square test for independence and one-way Analysis of Variance (ANOVA) was used to determine the significant association between domains of oral care practices and demographic factors. P values less than 0.05 was considered statistically significant. RESULTS: A total of 346 healthcare professionals participated in this online study. Most participants (94.3%) responded that they perceived oral health to be of high importance. However, less than two thirds of the participants (59.0%) included oral health questions during antenatal health assessments. Moreover, only 16.2% of participants frequently discussed the importance of oral care with their antenatal patients. CONCLUSIONS: In this survey, most healthcare professionals viewed oral health to be of high importance for prenatal/antenatal patients. However, not all put those views into practice with regard to oral care in pregnant women.

Machine Learning-Based Prediction of Mental Well-Being Using Health Behavior Data from University Students.

BACKGROUND: Since the onset of the COVID-19 pandemic in early 2020, the importance of timely and effective assessment of mental well-being has increased dramatically. Machine learning (ML) algorithms and artificial intelligence (AI) techniques can be harnessed for early detection, prognostication and prediction of negative psychological well-being states. METHODS: We used data from a large, multi-site cross-sectional survey consisting of 17 universities in Southeast Asia. This research work models mental well-being and reports on the performance of various machine learning algorithms, including generalized linear models, k-nearest neighbor, naïve Bayes, neural networks, random forest, recursive partitioning, bagging, and boosting. RESULTS: Random Forest and adaptive boosting algorithms achieved the highest accuracy for identifying negative mental well-being traits. The top five most salient features associated with predicting poor mental well-being include the number of sports activities per week, body mass index, grade point average (GPA), sedentary hours, and age. CONCLUSIONS: Based on the reported results, several specific recommendations and suggested future work are discussed. These findings may be useful to provide cost-effective support and modernize mental well-being assessment and monitoring at the individual and university level.

A Preliminary Assessment of Health and Safety in the Automobile Industry in Brunei Darussalam: Workers' Knowledge and Practice of Organic Solvents.

Automobile industries worldwide extensively use organic solvents. Yet, limited studies have examined the health and safety of handling these solvents, which can only be assured if workers have appropriate knowledge and demonstrate safe practices. A cross-sectional study was conducted to preliminary explore the knowledge and practice among workers who are involved in handling organic solvents in the automobile industry in the largest urban district in Brunei Darussalam. Qualitative data were sourced from open-ended questions, observations, and pictorial evidence through still photographs. Quantitative analysis showed that 75% of the workers practice reading labels, 94.1% use fully covered clothes, 82.4% wear gloves, and 98.5% practice proper hand washing. Furthermore, 98.5% of workers cover container lids. The qualitative analysis illustrated that workers have general knowledge of materials containing solvents but could not identify the exact solvents, the harmful effects of the solvents, pathophysiology, and harmful effects on specific body systems. Health and safety were found to be practiced, albeit not consistently. Health and Safety Authorities in Brunei Darussalam must review and enforce specific policies on the use of organic solvents so that they can be practiced consistently and safely in the automobile industry. Cooperation and collaboration in adhering to the policies are mandatory to ensure health and safety at work.

The clusters of health-risk behaviours and mental wellbeing and their sociodemographic correlates: a study of 15,366 ASEAN university students.

BACKGROUND: This study investigated, through cluster analysis, the associations between behavioural characteristics, mental wellbeing, demographic characteristics, and health among university students in the Association of Southeast Asian Nations (ASEAN) University Network - Health Promotion Network (AUN-HPN) member universities. METHODS: Data were retrieved from a cross-sectional self-administered online survey among undergraduate students in seven ASEAN countries. A two-step cluster analysis was employed, with cluster labels based on the predominant characteristics identified within the clusters. The 'healthy' cluster was assigned as the reference group for comparisons using multinomial logistic regression analysis. RESULTS: The analytic sample size comprised 15,366 university students. Five clusters of student-types were identified: (i) 'Healthy' (n = 1957; 12.7%); (ii) 'High sugary beverage consumption' (n = 8482; 55.2%); (iii) 'Poor mental wellbeing' (n = 2009; 13.1%); (iv) 'Smoker' (n = 1364; 8.9%); and (v) 'Alcohol drinker' (n = 1554; 10.1%). Being female (OR 1.28, 95%CI 1.14, 1.45) and being physically inactive (OR 1.20, 95%CI 1.04, 1.39) increased the odds of belonging to the 'High sugary beverage consumption' cluster. Being female (OR 1.21, 95%CI 1.04, 1.41), non-membership in a sports club (OR 1.83, 95%CI 1.43, 2.34) were associated with 'Poor mental wellbeing'. Obesity (OR 2.03, 95%CI 1.47, 2.80), inactively commuting to campus (OR 1.34, 95%CI 1.09, 1.66), and living in high-rise accommodation (OR 2.94, 95%CI 1.07, 8.07) were associated with membership in the 'Smoker' cluster. Students living in The Philippines, Singapore, Thailand, and Vietnam had a higher likelihood of being alcohol drinkers, compared with those who lived in Brunei. CONCLUSIONS: ASEAN university students exhibited health-risk behaviours that typically clustered around a specific health behaviour and mental wellbeing. The results provided support for focusing interventions on one dominant health-risk behaviour, with associated health-risk behaviours within clusters being potential mediators for consideration.

Predictors of Satisfaction With Life and Health Status of Older People in Brunei: A Gender Comparative Study.

Objective: To investigate predictors of life satisfaction and healthy aging with focus on gender differences among older people in Brunei Darussalam. Methods: A cross-sectional study on older people recruited by proportionate sampling. Multiple linear regression stratified by gender was applied. Results: 45.6% of life satisfaction of older women were strongly associated with self-perceived health, social relationship, and education level. For older men, 26.3% of the variance of life satisfaction was predicted by physical functioning or disability, and social relationship. For older women, 38.9% of the variance of health status can be explained with satisfaction with life, and difficulty to do daily tasks. For older men, 33.1% of the variance of health status can be accounted by income, number of children, presence of chronic illness, and diabetes. Conclusion: This paper discusses the unique gender differences of older people from a global perspective. Policymakers and stakeholders need to account for local and contextual differences before adopting international guideline. Particularly, on the maintenance or further promotion social interactions, active engaging elderly in health maintenance, and physical and mental functioning of the older population.

Prevalence of Health-Risk Behaviors and Mental Well-Being of ASEAN University Students in COVID-19 Pandemic.

The prevalence of epidemiological health-risk behaviors and mental well-being in the COVID-19 pandemic, stratified by sociodemographic factors in Association of South East Asian Nations (ASEAN) university students, were examined in the research. Data were collected in March-June 2021 via an online survey from 15,366 university students from 17 universities in seven ASEAN countries. Analyzed data comprised results on physical activity, health-related behaviors, mental well-being, and sociodemographic information. A large proportion of university students consumed sugar-sweetened beverages (82.0%; 95%CI: 81.4, 82.6) and snacks/fast food daily (65.2%; 95%CI: 64.4, 66.0). About half (52.2%; 95%CI: 51.4, 53.0) consumed less than the recommended daily amounts of fruit/vegetable and had high salt intake (54%; 95%CI: 53.3, 54.8). Physical inactivity was estimated at 39.7% (95%CI: 38.9, 40.5). A minority (16.7%; 95%CI: 16.1, 17.3) had low mental well-being, smoked (8.9%; 95%CI: 8.4, 9.3), and drank alcohol (13.4%; 95%CI: 12.8, 13.9). Country and body mass index had a significant correlation with many health-risk behaviors and mental well-being. The research provided important baseline data for guidance and for the monitoring of health outcomes among ASEAN university students and concludes that healthy diet, physical activity, and mental well-being should be key priority health areas for promotion among university students.

Nurses' mental health and coping strategies throughout COVID-19 outbreak: A nationwide qualitative study.

This qualitative exploratory study explored nurses' mental health and coping strategies working with suspected and confirmed COVID-19 patients in Brunei Darussalam. Eleven focus group discussions were conducted between October 2020 and January 2021, involving 75 participants. Three themes emerged: 'COVID-19 roller-coaster transitional journey' explained the different psychological responses of the journey of the nurses from merely hearing about COVID-19 from far to the invasion of the virus and community outbreak in the country; 'Mind my mind and heart' share experiences of the nurses in terms of their mental health and emotional responses; and 'the psychosocial system' described the coping mechanisms of the nurses throughout the COVID-19 pandemic. Nurses' mental health and coping strategies during the COVID-19 pandemic influenced how they provided care and performed other tasks, which should not be taken for granted. Nurses employed psychosocial coping methods at the different phases of the COVID-19 pandemic and support from family, friends, the public, and the governmental level. This research is fundamental as a basis for other countries to design psychological interventions during this yet unsettled COVID-19 pandemic.

Competency assessment for community health nurses: a focus group expert panel discussion.

BACKGROUND: General Practice setting in the Primary Health Care Services are the utmost visited by the public. It is important that the nurses' competencies in this area be assessed to ensure provision of safe and quality services. AIM/OBJECTIVE: To explore perceptions and experiences of competencies assessment tool for community health nurses working at the General Practice setting in the Primary Health Care Services. METHODS: An exploratory qualitative study utilizing focus group discussions were conducted on purposive sample of 12 officers with expertise in competency assessment and community health nursing from higher nursing education institutions, the Nursing Training and Development Centre, the Nursing Board and the Community Health Nursing Services in Brunei Darussalam. The existing competencies assessment tool was revised, the participants were divided into two groups of expert panel review team and two focus group discussions were held with each team. The focus group discussions encompassed components and methods of assessment; methods of grading; and overall organization and structure of the revised competency assessment tool. FINDINGS: Four themes emerged: 1) International equivalent core competencies components; 2) Multi-methods approach to assessment; 3) Definitive guidelines as framework for assessment; and 4) Understanding and acceptability of the competency assessment tool. CONCLUSIONS/IMPLICATIONS TO PRACTICE: The expert panel reviews provide practical input that were inculcated in the preliminary developed competencies assessment tool. Identification of eligible assessors were recommended based on standardized criteria, and socialization and training held to set direction and guidance for implementing the utilization of the competencies assessment tool. Further studies are deemed important to critically evaluate and validate the preliminary competencies assessment tool for development of a more robust assessment instrument.

Prediction Modeling of Mental Well-Being Using Health Behavior Data of College Students.

Background: Since the onset of the COVID-19 pandemic in early 2020, the importance of timely and effective assessment of mental well-being has increased dramatically. Due to heightened risks for developing mental illness, this trend is likely to continue during the post-pandemic period. Machine learning (ML) algorithms and artificial intelligence (AI) techniques can be harnessed for early detection, prognostication and prediction of negative psychological well-being states. Objective: Studies using machine learning classification of mental well-being are scarce in Asian populations. This investigation aims to develop reliable machine learning classifiers based on health behavior indicators applicable to university students in South-East Asia. Methods: Using data from a large, multi-site cross-sectional survey, this research work models mental well-being and reports on the performance of various machine learning algorithms, such as generalized linear models, k-nearest neighbor, naïve-Bayes, neural networks, random forest, recursive partitioning, bagging, and boosting. Prediction models were evaluated using various metrics such as accuracy, error rate, kappa, sensitivity, specificity, Area Under the recursive operating characteristic Curve (AUC), and Gini Index. Results: Random forest and adaptive boosting algorithms achieved the highest accuracy of identifying negative mental well-being traits. The top five most salient features associated with predicting poor mental well-being include body mass index, number of sports activities per week, grade point average (GPA), sedentary hours, and age. Conclusions: Based on the reported results, several specific recommendations and suggested future work are discussed. These findings may be useful to provide cost-effective support and modernize mental well-being assessment and monitoring at the individual and university level.

What Mother, Midwives, and Traditional Birth Helper Said About Early Initiation of Breastfeeding in Buginese-Bajo Culture.

INTRODUCTION: The aim of this study is to investigate how mothers, families, midwives, and traditional birth attendants in the Buginese-Bajo culture understanding breastfeeding and early initiation of breastfeeding (EIBF). Also to assess what support mothers receive from families, midwives, and traditional birth attendants during pregnancy, birth, and EIBF. METHODS: This qualitative study included 21 subjects (11 pregnant women, three midwives, and seven traditional birth attendants). Recorded interviews with the three groups of participants were transcribed verbatim and analyzed separately, using latent content analysis. The study started in December 2014 and ended in July 2015. RESULTS: Some mothers understood the meaning of EIBF, but engaged in it for different reasons. The midwives interpreted the principle of EIBF differently from a duration perspective. Traditional birth attendants explained it as a way to strengthen the relationship between mothers, and babies; they believed that prolonging breastfeeding until 2 years would change babies into caring children. According to them, this skin-to-skin contact has been practice for a century by traditional birth helpers. The philosophy of breastfeeding, according to the Buginese-Bajo, is creating "peru" relationships for mothers and babies each other for their whole lives. CONCLUSION: These findings show a connection between established science and cultural beliefs. The concept of peru is the central philosophy to be achieved in EIBF. Breast-feeding's psychological value is known and passed from generation to generation; this essential fact needs to be preserved as local capital for changing breastfeeding behavior. The government should pay more attention to this opportunity to increase awareness and promote breastfeeding behavior changes.

Academic experiences, physical and mental health impact of COVID-19 pandemic on students and lecturers in health care education.

BACKGROUND: In keeping with nation-wide efforts to contain the spread of COVID-19, Universiti Brunei Darussalam (UBD) transformed fully its pedagogical delivery to online mode, where we investigated teaching and learning experiences, physical and mental health of undergraduate students and lecturers during the COVID-19 pandemic. METHODS: We conducted a cross-sectional study on undergraduate students and lecturers in a health science faculty using a self-developed pretested questionnaire through anonymous online data collection method. RESULTS: Fifty-six lecturers (100% response rate) and 279 students (93.3% response rate) participated. The positive experiences reported by students include becoming independent (72.8%) and adapting to online learning (67.4%), while lecturers learned new teaching techniques (50.0%) and became more innovative (50.0%) by learning new tools (48.2%). However, studying at home caused students to feel more distracted (72.0%) with a feeling of uncertainty towards examinations (66.7%), while lecturers felt that students' laboratory skills were compromised (44.6%). Even though online delivery of assessments enabled lecturers to explore all options (50.0%), they found it difficult to maintain appropriate questions (41.1%) and fair assessments (37.5%). Majority of students missed eating out (68.8%) and felt a lack of participation in extracurricular activities (64.9%), while lecturers reported more time for exercise (51.8%), despite having more screen time (50.0%) and computer-related physical stress (44.6%). In terms of mental health, increased stress in students was reported (64.9%), though they had more time for self-reflection (54.8%). Although lecturers reported a closer relationship with family (44.6%), they also felt more stressed due to deadlines, unexpected disruptions and higher workloads (44.6%) as well as concerns related to work, family and self (39.3%). CONCLUSION: In this abrupt shift to online teaching, students and lecturers in our study identified both positive and negative experiences including the impact on their physical and mental health. Our findings are important to provide the evidence for online pedagogical benefits and can serve to promote the enhancement and adaptation of digital technology in education. Our findings also aim to promote the importance of addressing physical and mental health issues of the university community's well-being through provision of emotional and mental health support and appropriate programs.

Work-family conflict, health status and job satisfaction among nurses.

OBJECTIVE: Research studies have demonstrated that nurses face difficulty balancing family roles and responsibilities with work. This study aimed to explore the relationship between work-family conflict and health status and job satisfaction among nurses. METHODS: This was a cross-sectional study of 426 nurses working in high-dependency and general settings in a large referral hospital in Brunei Darussalam. RESULTS: Work-family conflict inversely affects health status and job satisfaction for nurses working in high-dependency and general settings. However, general nurses experienced higher work-family conflict albeit better job satisfaction and health status compared to high-dependency nurses. Older, single and non-smoker nurses reported higher job satisfaction. CONCLUSION: This study further informs healthcare and nursing administrators and policymakers, who should foster effective strategies and interventions to support the balance of nurses' work and family life.

Non-fatal occupational accidents in Brunei Darussalam.

Globally, ILO estimates 374 million non-fatal and 380,500 fatal by occupational accidents annually. Slips, trips, falls and contact with objects are the leading mode of injury, with extremities being the most common body part involved. Occupational accidents are of major concern for high risk occupational groups such as migrant workers, or work areas e.g. construction, manufacturing, wholesale, and retail industries. This study was aimed to determine the prevalence of non-fatal occupational injuries and its trends among industry workers in Brunei Darussalam. A retrospective cross-sectional review of occupational accidents notified to the Occupational Health Division, Ministry of Health, over a five-year period from January 2014 until December 2018 was conducted. A total of 424 non-fatal occupational accidents were notified, with increasing trend from 44 in 2014 to 132 in 2018. Accidents were more common in males (98%), migrant workers (86%), in the 30-39 age group (42.5%), and in the construction industry (56.4%). Struck by object (37.7%) was the commonest cause and upper limb (43.9%) was the commonest body part involved. There is a need for workplaces to develop capabilities and support mechanisms for risk assessments, as well as auditing and reviewing performances to minimize occurrence of preventable occupational injuries.

Willingness of university nursing students to volunteer during the COVID-19 pandemic in Brunei Darussalam.

Background: Volunteering among nursing students has become a valuable resource during an outbreak to help alleviate the strain in nursing staff shortages. However, evidence of willingness to volunteer is scarce, particularly in Asian countries. Objective: To study Bruneian university nursing students' willingness to volunteer during a pandemic in Brunei. Methods: An online cross-sectional study was conducted at Universiti Brunei Darussalam from January to February 2021. A self-administered questionnaire was used to measure willingness factors, including motivational factors, barriers, enablers, and level of agreement to volunteer during the COVID-19 pandemic. Sub-group inferential analysis was applied. Results: 72 participants were included in this study. 75.0% of whom were willing to volunteer during the COVID-19 pandemic. Factors that influenced the willingness of nursing students to volunteer were marital status (p <0.001), year of study (p <0.001), altruism (p <0.001), personal safety (p <0.001), and knowledge level (p <0.001). Conclusion: Nursing students are an invaluable resource, and they are highly willing to be part of disaster management. Training and planning should prepare the nursing students for disaster or pandemic readiness and integrated them into the undergraduate nursing curriculum. Align with this, safety aspects of nursing students during volunteering should also be considered, including the provision of childcare assistance, sufficient personal protective equipment, vaccination, and prophylaxis to the volunteers.

Psychosocial factors and burnout among oncology nurses in Brunei Darussalam: A pilot study.

Background: Existing evidence showed that adverse psychosocial factors contribute to burnout in oncology nurses and impose profound implications to nursing practice. Due to the complexity of this relationship, more studies are still needed. Objective: To investigate the prevalence and relationship between burnout and psychosocial factors among oncology nurses. Methods: A descriptive cross-sectional study design was conducted in 2018 using the Maslach Burnout Inventory and the Copenhagen Psychosocial Questionnaire to measure burnout and psychosocial factors, respectively. Descriptive and multivariate regression using maximum likelihood procedures were used for analysis. Results: Out of three burnout variables, emotional exhaustion demonstrated a highly significant relationship towards psychosocial factors, particularly quality of leadership (p <0.001), justice and respect (p <0.001), and rewards (p <0.001) - congruent to a high prevalence of emotional exhaustion reported. Conclusion: Improvement in leadership quality, rewards, justice and respect could minimise emotional exhaustion among oncology nurses. These findings further inform management and policymakers to target these specific psychosocial factors in addition to using other interventions to counter the harmful effects of burnout. A positive psychosocial workplace would consequently decrease the risk of nurses' intention to leave, reduce nurse shortages, and increase the quality of patient care.

Practice of Postpartum Warming Among Mothers in Brunei.

Introduction: Postpartum warming is widely practiced among women in Asian countries despite unsubstantiated health claims. This study aimed to identify sources of knowledge and explore the practices of postpartum warming among mothers in Brunei. Methods: A cross-sectional study using a self-administered questionnaire was conducted on 124 mothers who had experience in postpartum warming. Results: Coal was commonly used for heat. Main source of knowledge came from family members. Older women had significantly lower intention to perform the practice in future pregnancies. Women who lived in nuclear families practiced it to a significantly higher frequency compared with those living in extended families. Discussion: Women still practice warming to adhere with family expectations and traditions although noticeable changes have been observed as society modernizes. It still poses a risk of carbon monoxide poisoning and fire hazard from burning coal. Future studies should focus on health and safety aspects to provide evidence on the actual health benefits and ameliorate risk factors.

Spiritual Coping with Stress Among Emergency and Critical Care Nurses: A Cross-Sectional Study.

A cross-sectional study using Spiritual Coping Questionnaire (SCQ) to explore the spiritual stress coping among Muslim Emergency and Critical Care nurses. 113 Participants were recruited. SCQ demonstrated good validation estimates. Positive religious behavior was the main spiritual coping with job stress. Likewise, spiritual coping was highly perceived as religious. Critical care nurses reported significantly higher positive social coping. Nurses with longer work experiences were significantly better in positive spiritual coping. Spiritual coping practices are highly prevalent in healthcare settings despite still lacking integration of spiritual components in its physical infrastructure, health policy and management.