Assessing Outcome Measurements and Impact of Simulation in Neurocritical Care Training: A Systematic Review.

ABSTRACT: AIM: The use of simulation training in neurocritical care is increasing. Yet, the pooled impact on patient and trainee outcomes remains unclear. This systematic review aims to determine the outcome measurements used after simulation training in neurocritical care and to synthesize the current evidence about the impact of simulation training on these outcomes. METHODS: A 3-step search was conducted in CINAHL, Cochrane, MEDLINE, PsychINFO, and Scopus. The inclusion criteria were composed of studies exploring simulation training in neurocritical care, published in English between 2000 and 2023. Two reviewers independently conducted screening, critical appraisal, and data extraction, using standardized Joanna Briggs Institute tools. Meta-analysis was precluded because of clinical, methodological, and statistical heterogeneity. RESULTS: Nine relevant studies were found: 1 quality improvement project and 8 quasi-experimental studies. The overall quality of the relevant studies was moderate to high (61.1%-77.8%). Three types of outcome measurements for simulation in neurocritical care were identified: knowledge and clinical performance; confidence and comfort; and teamwork, communication, and leadership skills. Simulation training was associated with a significant improvement in knowledge and clinical performance, and confidence and comfort, but not in communication and leadership skills. CONCLUSION: Significant improvement in trainees' outcomes was observed. The current literature includes significant heterogeneity in the methods of evaluating simulation outcomes, although no patient outcomes were observed. Investigating the effect of simulation in neurocritical care training on patient outcomes in future studies is warranted.

Workplace barriers and facilitators to nurses' healthy eating behaviours: a qualitative systematic review.

BACKGROUND: Globally, nurses and midwives have a higher rate of being overweight/obese than the general population, influenced by workplace environments that impact dietary habits. OBJECTIVE: This systematic review aimed to identify barriers/facilitators to healthy eating among nurses in clinical settings. DESIGN: This systematic review followed Joanna Briggs Institute's guidelines for qualitative systematic reviews. METHODS: Eight electronic databases: PROQUEST CENTRAL, SCIENCEDIRECT, MEDLINE, CINAHL, PsycINFO, WEB SCIENCE, PUB MED, and SCOPUS were searched. Articles were screened using JBI SUMARI®, and quality assessment was done using the JBI critical appraisal checklist. Data were extracted using the JBI data extraction tool. RESULTS: Nine qualitative studies were reviewed, involving 488 nurses, concluding 37 distinct findings. Two synthesised findings emerged: barriers, and facilitators to healthy eating, related to organisational (shift work/long working hours), personal, physical workplace environment, and social factors. CONCLUSIONS: The review emphasises the necessity of promoting attainable healthy eating practices at organisational, personal, environmental, and social levels within the workplace. REGISTRATION: PROSPERO International prospective register of systematic reviews, ID: CRD42022309259.

Mapping the supportive care needs and quality of life of adult survivors of childhood cancer at a comprehensive cancer center in the Middle East.

Assessing unmet needs is crucial to achieving quality care and patient satisfaction. Between September and December 2021, we assessed unmet supportive care needs in a consecutive sample of adult survivors of childhood cancer at KHCC (King Hussien Cancer Center). Two hundred and ninety-seven adult survivors of childhood cancer completed the study questionnaire. The average needs score across all domains was 24.80 (SD = 19.65), with the financial domain scoring the highest 30.39 (SD = 31.95) and sexuality scoring the lowest 7.67 (SD = 19.67). Using a multivariate linear regression model, female gender was independently associated with significantly high scores in all need domains (p < 0.001), except for sexuality. Monthly income, comorbidities, socioeconomic challenges, time since diagnosis, and age at diagnosis have emerged as predictors of needs in many domains. Mean quality of life (QoL) was significantly and inversely associated with the mean score in multiple domains: psychological (p < 0.001), sexuality (p = 0.038), financial (p < 0.001), and overall needs (p = 0.004). Following a content analysis of qualitative data, educational difficulties, and work-related challenges were identified as other unmet needs. Cancer experiences during childhood significantly influence supportive care needs in adulthood. There is a need for more tailored studies assessing different populations of cancer survivors and avoiding the one-size-fits-all survivorship care.

The intersection of oncology and oral health: exploring nurses' insights and practices - a systematic review.

PURPOSE: Oral health care for cancer patients is essential but often overlooked. Nurses play a critical role in assessing and managing oral health in this population. This systematic review aims to examine nurses' knowledge, attitudes, and practices regarding oral healthcare in cancer patients. METHODS: A systematic review was conducted following the Joanna Briggs Institute methodology. Qualitative and quantitative studies focused on nurses' knowledge, attitudes, and practices in oral healthcare for cancer patients. Seven databases were searched for studies published between January 2000 and January 2023. The primary outcomes of interest were patient satisfaction, quality of life, and nurses' knowledge, attitudes, and practices related to oral healthcare. RESULTS: The review identified gaps in nurses' knowledge and training in oral healthcare for cancer patients. Insufficient understanding of oral diagnoses, treatment protocols, and pediatric oral care was noted. Lack of knowledge and skills posed barriers to implementation. Some healthcare providers demonstrated low awareness of oral health recommendations, including the use of fluoridated toothpaste and the need for dental referrals. Referrals to dental services and regular oral assessments were infrequent. Attitudes towards oral healthcare varied, with providers feeling more comfortable in certain areas than others. CONCLUSION: Enhancing nurses' knowledge, attitudes, and practices in oral healthcare for cancer patients is crucial. Targeted educational initiatives and interventions are needed to address these gaps. By improving nurses' understanding of oral complications and management approaches, patient outcomes and quality of life can be improved. REGISTRATION:  PROSPERO International prospective register of systematic reviews, ID: CRD42022368053.

Co-creating an educational resource to promote the uptake of Skin-to-Skin Contact in Saudi Arabia.

AIM: This paper focuses on the co-creation approach to develop culturally and linguistically appropriate educational interventions to promote the uptake of skin-to-skin contact. BACKGROUND: Skin-to-skin contact is beneficial to mothers and newborns, but it is rarely practised in Saudi Arabia. Co-creation involving service users to develop evidence-based resources about skin-to-skin contact relevant to the target population is an approach increasingly used to improve health outcomes. METHOD: A three-step method was used to develop the educational intervention including: (1) a systematic scoping review to identify the evidence-based information for education regarding skin-to-skin contact between mother and baby post-birth; (2) Co-creation of the resources using the Knowledge to Action Framework. The resource was developed collaboratively with academic staff from Australia and health care staff from Saudi hospital; and (3) Finalisation of the educational materials through a consensus development conference and Implementation. FINDINGS: The systematic scoping review generated useful information about the gaps in knowledge and barriers to skin-to-skin practice. Information was tailored and translated according to the needs of the Saudi population. A variety of educational materials including pamphlets, a PowerPoint presentation and a short video were co-created with the help of the stakeholders. Consensus was reached when 93% (87-100%) of the participants agreed about the mode of delivery and appropriateness of the PowerPoint and 100% agreed on the e-pamphlets and video. DISCUSSION: The skin-to-skin online educational resource was created by integrating co-creation principles and the Knowledge to Action framework with the aim of developing and customizing a culturally appropriate intervention using the best available evidence. By engaging in co-creation stakeholders gained a sense of ownership and were more willing to adopt and implement the intervention.

Empathy and ethical sensitivity among intensive and critical care nurses: A path analysis.

BACKGROUND: Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. AIM: To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. RESEARCH DESIGN: Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. ETHICAL CONSIDERATIONS: The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. FINDINGS: Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. CONCLUSIONS: Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses.

The impact of montessori-based programmes on individuals with dementia living in residential aged care: A systematic review.

OBJECTIVES: This systematic review examined the effectiveness of Montessori-based programmes for individuals with dementia living in residential aged care. METHODS: Nine databases were searched between January 2010 to October 2021, including Scopus, CINAHL, MEDLINE, Web of Science, SocINDEX with Full Text, PubMed, PsycINFO, Cochrane library and Cochrane Registry. Publications were included if they used Montessori-based programmes as interventions for individuals with dementia living in residential aged care and were qualitative, quantitative, mixed-method, or pilot studies. The quality of eligible studies was assessed using Joanna Briggs Institute critical appraisal instruments and the Mixed Method Critical Appraisal Tool. The findings were tabulated and narratively synthesised. RESULTS: Fifteen studies were included in this review. The quality scores of the 15 studies ranged from 62 to 100 out of 100. Four key categories of outcomes were observed: (1) significantly improved engagement; (2) significantly improved mental health outcomes, including affect, depression, agitation, excessive eating and psychotropic medication prescriptions; (3) significantly improved feeding difficulty but mixed results regarding nutritional status; and (4) no significant changes in the activities of daily living and quality of life of individuals with dementia. CONCLUSION: Cognitive capacity, personal preferences, individual care needs and the design of Montessori-based activities are pivotal to tailoring personalised Montessori-based activities for individuals with dementia in residential aged care and to maximise intervention outcomes. The synergistic effect of integrating Spaced Retrieval with Montessori-based activities in improving the eating ability and nutritional status of individuals with dementia was also noticed. The study summarised evidence about the effectiveness of Montessori-based programmes for individuals with dementia and informed healthcare professionals about how to implement individualised Montessori-based programmes.

Sexual experiences of cancer survivors: A qualitative study in Jordan.

BACKGROUND: In Jordan, cancer is the second leading cause of death after cardiac disease. The impact of cancer on sexual relationships is a taboo subject and hence, such issues are underreported research among Jordanian people examining unmet needs. AIM: To examine the experiences and preferences of Jordanian cancer survivors related to communication regarding their sexual needs. METHODS: Qualitative study conducted between May and June 2020 using semi-structured face-to-face interviews using the snow-balling approach for recruitment. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis. RESULTS: Analysis of participants' interview data identified three main categories: 1) The psychological impact of cancer of sexual relationships; 2) Physician support; 3) Variations in sexual life and sexual experiences. CONCLUSION: The study revealed that there is a substantial psychological impact of cancer on sexual relationships among Arab Jordanian cancer survivors. Feeling powerless, being labelled as 'sexually disabled', and lack of communication with physicians were emphasized by participants as a barrier to discuss sexual needs with their physicians. Lack of physicians support negatively impact Jordanian cancer survivors sexual experience and led to increased their sense of powerlessness and loss of control over sexual relationships. IMPLICATIONS FOR PRACTICE: Overall, the study indicated a crucial need for physicians to encourage patients to disclose their sexual experience to help them maintain their sexual and mental health while in the fight against cancer. The physicians, nurses and allied health professionals should be engaged in the conversation with patients by taking an active role in the discussion. Additionally, the family and partners of the patients should also be approached and engaged by health professionals in the discussion to address their needs or sexual issues.

Sexual activity and cancer: A systematic review of prevalence, predictors and information needs among female Arab cancer survivors.

INTRODUCTION: The objective of this review is to synthesise and present the best available evidence on the prevalence, predictors and information needs about sexual health among female Arab cancer survivors. METHODS: The databases searched included MEDLINE, Embase and CINAHL from inception of the database until March 2020. The review was undertaken according to the JBI guidelines. Proportional meta-analysis using a random effects model was used for statistical pooling through JBI SUMARI. RESULTS: Seven studies involving female Arab cancer survivors were included in the review. The overall prevalence of sexual dysfunction ranged from 16.7 to 67% (pooled estimate 51%, 95% CIs 21.7% to 80.2%). Dyspareunia and erectile dysfunction were the two main types of sexual dysfunction reported after diagnosis, and the overall prevalence ranged from 42.5% to 65% and 38% to 61%, respectively. The prevalence of vaginal dryness was ranged from 19.8% to 54.2%, and dyspareunia ranged from 22.2% to 65%. The lack of sexuality information and communication with health care providers (HCPs) was also reported in the included studies. CONCLUSION: Cancer and its treatment may result in significant difficulties with sexual activity and sexual functioning among cancer survivor. Communication between the health care professionals and cancer survivors is essential to overcome this problem and improve the quality of life of female Arab cancer survivors.

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students.

BACKGROUND: Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. OBJECTIVE: To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale. DESIGN: Cross-sectional survey. METHODS: Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. RESULTS: Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. CONCLUSION: The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students. IMPACT STATEMENT: Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

Association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID-19 pandemic.

OBJECTIVE: The aim of this study is to explore the association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID-19 pandemic. DESIGN: A cross-sectional study via SurveyMonkey was conducted in Australia between August 2020 and October 2020. Descriptive and inferential statistics were used to analyze the data. RESULTS: A total of 1211 individuals responded to the survey. Income loss was significantly associated with those from low socioeconomic status (OR = 1.65; 95% CI 1.01-2.68). Access of superannuation was significantly associated with those in outer regional (OR = 3.61; 95% CI 0.81-16.03) and low socioeconomic status (OR = 2.72; 95% CI 1.34-5.53). Financial inability to pay for services was significantly associated with living in remote areas (OR = 2.26; 95% CI 0.88-5.80). CONCLUSIONS: The economic wellbeing of people who identify as Aboriginal and Torres Strait Islander, live in regional or remote areas, and reside in low socioeconomic areas have been substantially impacted during the pandemic. Findings call for policies to address the underlying social determinants of health.

The effectiveness of spiritual intelligence educational interventions for nurses and nursing students: A systematic review and meta-analysis.

AIM: To synthesize the best available research evidence regarding the effectiveness of spiritual intelligence educational interventions on spiritual intelligence and professional outcomes in nurses and nursing students. BACKGROUND: Spiritual intelligence is a form of intelligence with which individuals can deal with a crisis, alter situations, solve problems and achieve goals through a set of capacities and abilities. Possessing spiritual intelligence contributes to professional practice and competence in the workplace and has been seen to be beneficial for nurses and nursing students. Nursing interventions to teach and increase understanding of spiritual intelligence have been explored in the literature, but the effectiveness of spiritual intelligence training for nurses and nursing students remains uncertain. DESIGN: A systematic review and meta-analysis. DATA SOURCES: A three-step systematized search of sixteen electronic English and Persian databases was conducted to identify randomized and non-randomized trials published in English and Persian from January 2000 to November 2021. METHODS: The methodological quality of eligible studies was undertaken by two independent reviewers using the Medical Education Research Study Quality Instrument. Meta-analyses were undertaken where appropriate using STATA v16. RESULTS: Seven studies involving 512 participants were included. Pooled results demonstrated that those who received the educational intervention had significantly higher spiritual intelligence scores at 2 weeks (MD 13.38, 95 % CI: 5.76, 20.99) and one month follow up (MD 20.03, 95% CI: 6.61, 33.45) compared with those who did not. No difference in spiritual intelligence scores was observed among those who received spiritual intelligence education or life skills training (MD 7.52, 95 % CI -1.78, 16.82). Significantly higher communication skills (MD 5.41, 95 % CI: 2.16, 8.66), job satisfaction (MD; 11.30, 95 % CI: 8.63, 13.97) and spiritual care competence (MD; 28.55, 95 % CI: 26.08, 31.02) and decrease in overall stress (MD; 10.30, 95 % CI: 6.84, 13.76) among those who received the educational interventions were reported at the one-month follow-up. Significantly higher job satisfaction levels were also reported at 2-month follow-up among those who received the educational interventions (MD; 16, 95 % CI: 11.06, 20.94). CONCLUSIONS: The evidence from this review demonstrates that spiritual intelligence educational interventions have a positive effect on spiritual intelligence and professional outcomes in nurses and nursing students. We noted that the outcomes in the studies included were mostly measured at one-month follow-up and with subjective measures. Longer trials with objective measures are required to provide higher levels of evidence. The results of this review are largely based on single trials and were limited in terms of the number of outcomes. Conducting further trials is warranted to identify the influence of such education on various professional outcomes in nursing practice. TWEETABLE ABSTRACT: Systematic review and meta-analysis shows spiritual intelligence educational interventions have a positive effect on nurses' and nursing students' spiritual intelligence, work-related stress and professional practice.

Medication Adherence Rate in Arab Patients With Cardiovascular Disease: A Systematic Review.

BACKGROUND: Cardiovascular disease (CVD) is one of the most common chronic illnesses in the Eastern Mediterranean. There have been few studies on medication adherence in Arab patients with CVD. AIM: To investigate the rates and the reasons for medication adherence in Arab patients with CVD. METHODOLOGY: The Joanna Briggs Institute methodology for prevalence systematic reviews was used. MEDLINE, EMCARE, CINAHL, Scopus, Science Direct, PsychINFO, and the Cochrane Central Register of Controlled Trials were searched. RESULTS: Thirteen quantitative studies on medication adherence in Arab adult CVD patients were included.Pooled data from nine studies demonstrated that 53.2% (95% confidence interval = [51.2%, 55.1%]) of patients were adherent to their medications. Reasons for nonadherence to medication include personal factors, understanding, and complexity of treatment regimes, medication knowledge and structural barriers. CONCLUSION: Medication adherence appears to have a social gradient, and families should be actively involved in future strategies to increase medication adherence.

Supportive Care Needs Assessment for Cancer Survivors at a Comprehensive Cancer Center in the Middle East: Mending the Gap.

BACKGROUND: Cancer survivors are often underprepared for what to expect post-treatment, and there are knowledge gaps regarding cancer survivors' supportive care needs in Jordan and neighboring Arab countries. This study aimed to identify gaps in supportive care needs among adult cancer survivors seen at King Hussein Cancer Center in Amman, Jordan, and explore predictors of unmet needs. METHODS: This was an observational cross-sectional study using a modified version of the Supportive Care Needs Survey 34 item short form (SCNS-SF34). RESULTS: Two hundred and forty adult cancer survivors completed the study questionnaire. The assessed needs were highest in the financial domain, including covering living expenses, managing cancer treatment adverse effects and co-morbidities. The least prevalent reported needs were in sexuality and reproductive consultations. Late-stage diagnosis was independently associated with higher physical, psychological, health system/information, financial and overall need scores, with p-values of 0.032, 0.027, 0.052, 0.002 and 0.024, respectively. The overall quality of life score was independently and inversely associated with physical, psychological, health system/information, financial and overall need domains, with p-values of 0.015, <0.0001, 0.015, 0.004 and 0.0003, respectively. CONCLUSIONS: This needs assessment identified problem areas for targeting interventions across the Jordanian cancer survivor population, and understanding these findings highlights opportunities for intervention to address gaps in care.

The Adherence to Healthy Lifestyle Among Arab Patients With Cardiovascular Disease: Mixed-Method Review.

INTRODUCTION: Cardiovascular disease (CVD) accounts for 25% to 45% of deaths among Arab people. The purpose of this review was to investigate the level, predictors, motivators, and barriers to adherence to lifestyle recommendations among Arab patients with CVD. METHOD: A systematic search of the literature was conducted and reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, EMCARE, CINAHL, Scopus, and the Cochrane Central Register of Controlled Trials were searched. Studies that explored adherence to a healthy lifestyle among Arab adult patients with CVD were included. RESULTS: Twelve studies were included. Quantitative results showed low adherence among Arab people with CVD. Qualitative synthesized results revealed that internal motivators, personal desire as well as structural drivers impact the patient's ability to adhere to a healthy lifestyle. DISCUSSION: Multidimensional solutions that consider religion and culture and include active involvement of families are required to improve adherence.

Spiritual intelligence and professional nursing practice: A systematic review and meta-analysis.

Background: The concept of spiritual intelligence was developed in 1997 based on philosophical theories and neurological evidence and introduced as the ultimate intelligence. Spiritual intelligence has been considered as one of the skills required by professionals and has recently gained traction within nursing practice. Understanding the role of spiritual intelligence and its association with professional nursing practice is crucial to creating knowledge in this area of inquiry. Objective: To identify the best available evidence of the spiritual intelligence level and its correlation with professional practice among nurses. Design: A systematic review and meta-analysis of observational studies were reported according to the PRISMA and MOOSE guidelines. The protocol for this systematic review was registered with PROSPERO with the identification CRD42021254881. Data Sources: Ten electronic English and Persian databases [Cochrane Library, Web of Science, Scopus, PubMed, CINAHL, Science Direct, Wiley Online Library, Magiran, SID, IranDoc] were searched to identify eligible studies, published in the English and Persian languages from January 2000 to May 2020. Review Methods: A systematized search strategy was used to include eligible published and unpublished observational studies that examined the spiritual intelligence level and its correlation with professional practice among nurses. Screening, quality assessments, data extractions, and analysis were undertaken using Joanna Briggs Institute methodology and carried out by two independent reviewers. Results: Thirty-five studies, with a total of 7301 nurses, were included. The mean score for spiritual intelligence in 29 studies and 5853 nurses was 0.63 (95% CI: 0.57-0.69, I2 = 99.97%). The Spiritual Intelligence Self-Report Inventory was the most frequently used instrument to measure spiritual intelligence. Most of the professional nursing outcomes represented a positive association with nurses' spiritual intelligence. The pooled positive correlation coefficients between spiritual intelligence and a professional nursing practice components including the art of nursing, competence, attributes of practice and, personal commitment were 0.34 (95% CI: 0.24, 0.43, I2 = 63.4%, 5 studies), 0.42 (95% CI: 0.25,0.56, I 2 = 62.2%, 2 studies), 0.32 (95% CI: 0.11, 0.50, I 2 = 92.2%, 5 studies) and 0.41 (95% CI: 0.34, 0.49, I 2 = 74.3%, 8 studies) respectively. Conclusions: The findings of this systematic review indicated a relatively high level of spiritual intelligence among nurses that was moderately associated with professional nursing practice. implementing strategies to promote spiritual intelligence levels among nurses is warranted.

A systematic review: Sexual well-being and perceived barriers to seeking professional help among Chinese adults living with cancer.

OBJECTIVE: Sex and intimacy are basic needs and important aspects of quality of life among humans. This focus of this review was to synthesise and present the best available qualitative evidence on the sexual life experiences and needs of Chinese adults living with cancer. Moreover, the first-hand experience, meaning and perspective about the sexual life changes and support needs during the survival and extended treatment period were synthesised in this study. METHODS: A systematic review of qualitative studies was undertaken using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI-SUMARI). A comprehensive search of five databases: CINAHL, MEDLINE, PubMed, Scopus and Google Scholar were undertaken from 2010 until February 2020 using defined criteria. Methodological quality and data extraction were undertaken using JBI-SUMARI. RESULTS: Eight studies were included in the review. A total of 39 findings were extracted and aggregated into eight categories based on similarity of meaning. Three synthesised themes were generated: (i) misconceptions and lack of education or information regarding sexual activity exists for patients with cancer, (ii) concerns for overall health and well-being as well as physical and psychological changes can alter sexual desire and behaviours in patients with cancer and (iii) lack of sexual activity and intimacy can create relationship problems. CONCLUSIONS: Sexual relationships are intimate, personal and private in Chinese culture and beliefs. Chinese adults living with cancer report many neglected issues on sexual well-being in various domains. Adequate and consistent education about sexual intimacy issues from health care providers was identified as an important need. Unaddressed needs might affect adults' coping strategies in managing their sexual relations during various stages of cancer treatment and beyond. It must be noted that there are many Chinese ethnic minorities living with cancer outside the Greater China region. The evidence provides valuable recommendations to health care providers globally to consider the specific sexual needs and initiate culturally sensitive sexuality education and care support for Chinese adults living with cancer.

Anxiety and depression among healthcare workers during the COVID-19 pandemic: a systematic umbrella review of the global evidence.

OBJECTIVES: To summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic. DESIGN: An umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods. DATA SOURCES: The Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English. ELIGIBILITY CRITERIA: Systematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated. RESULTS: Ten systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 21.3% to 23.1%) to 33.0% (95% CI 31.9% to 34.1%). The prevalence of anxiety among physicians (n=5820) was reported to be between 17% and 19.8% and for nurses (n=14 938) between 22.8% and 27%. The prevalence of depression among all HCWs ranged from 17.9% (95% CI 17.1% to 18.8%) to 36% (95% CI 34.9% to 37.1%). The prevalence of depression among physicians (n=643) and nurses (n=8063) was reported to be 40.4% and 28%, respectively. CONCLUSIONS: There is wide variation evident in the presence of anxiety and depression among HCWs. In particular, the prevalence of depression among physicians was high. Strategies to reduce the incidence of anxiety and depression are urgently required. PROSPERO REGISTRATION NUMBER: CRD42021238960.

The impact of mastectomy on Iranian women sexuality and body image: a systematic review of qualitative studies.

PURPOSE: Mastectomy in women is perceived as losing feminine identity and reducing sexual attraction. The aim of this review is to explore the perception and impacts of mastectomy on Iranian women with breast cancer on their sexuality and body image. METHODS: The review used a systematic literature search that followed the guidelines of the Joanna Briggs Institute (JBI). The data sources PubMed, Scopus, Web of Science, Google Scholar, SID, ProQuest, MEDLINE, and CINAHL (via the EBSCOhost) were systematically searched. Quality appraisal, data extraction, and findings from the included studies were pooled using meta-aggregation with the Qualitative Assessment and Review Instrument (JBI-QARI). RESULTS: Eight studies involving 163 women aged from 31 to 65 years, who had mastectomy, were included. A total of 31 findings were extracted and were aggregated into 4 categories and then further grouped into two synthesized findings: (1) fear of losing spouse's sexual monopoly and (2) overcoming the challenges of losing femininity. CONCLUSIONS: This review found even in Muslim countries such as Iran women's breasts are perceived as sexually attractive, and changes in body shape can lead to subsequent challenges in marital relationships.

Social Support for Arab People with Chronic Conditions: A Scoping Review.

Social support can play a crucial role in psycho-social well-being of people with chronic conditions. There is limited information about the experiences, barriers and sources of social support of Arab people affected by chronic conditions. The purpose of this review is to explore the experiences, barriers and sources of social support of Arab people affected by chronic conditions. A scoping review of the literature, based on Preferred Reporting Items for Scoping Reviews and Meta-Analyses (PRISMA) guidelines. Articles (n = 13) were identified for appraisal based on a group of inclusion and exclusion criteria. Eight articles were included in the final analysis. Three broad themes were identified: (a) Social support benefits-physical, emotional and financial benefits; (b) Source of social support-family and friends support, and (c) Support services utilization-cultural barrier, Arab migrants language and unfamiliarity with the health system barriers. Appropriate future support programs should be tailored based on Arab cultural beliefs and the inherent responsibility of the family together inside the Arab community.