Burnout Among Nurses Working in Critical Care Units During the COVID-19 Pandemic.

Burnout is a state of emotional and physical depletion. Its occurrence among critical care nurses (CCNs) is a concept that has gained traction yet remains an issue with global consequences. Nurses are especially vulnerable to burnout due to the persistent stressors they are exposed to, which include the general work environment, biological factors, and emerging changes caused by COVID-19. This study aims to assess the severity of burnout among CCNs during the COVID-19 pandemic and its associated factors. A descriptive cross-sectional questionnaire was used in this study to measure the estimated burnout rate among CCNs in Palestine and establish associations with potential factors. Maslach Burnout Inventory questionnaire was used for the task. The results showed out of the 173 participants, more than 35% reported severe overall burnout. Per burnout domains, it was found that around 70% of participants suffered from low personal accomplishment, while 59.5% had severe levels of depersonalization, and finally, more than 65% of critical nurses had severe emotional exhaustion. Out of the various variables tested, gender, age, type of hospital, PPE, and fear of transmission were found to be associated with overall burnout. CCNs in Palestine were found to be severely burned out and should be dealt with before getting out of hand. The research found variables related to burnout contributed to burnout. Recommendations for further studies and prioritization should be made.

Assessment of immunoglobin G (spike and nucleocapsid protein) response to COVID-19 vaccination in Palestine.

Introduction: Many countries have begun immunization programs and established protocols to combat pandemics caused by the SARS-CoV-2 virus. Six months after vaccination, the antibody titers produced by the immunization begin to decline, and individuals whose first immunization (either one or two doses) did not provide adequate protection may require a booster dose. Methods: A quantitative cross-sectional survey of 18-year-olds and older was undertaken in the West Bank from June 15 to June 27, 2022. Each participant had 5 mL of blood drawn to be tested for IgG-S, IgG-N, and blood group. Results: All participants had positive IgG-S results; IgG-S values ranged between 77 and 40,000 AU/ml, with a mean value of 1254 AU/ml. The value of IgG-N ranged from 0 to 139.3 U/ml for all participants, with a mean value of 22.4 U/ml. 64 (37.2%) of the participants demonstrated positive IgG-N screening results, with mean values of 51.2 U/ml. Female participants' mean IgG concentration was higher than male participants. Furthermore, the results revealed that smokers had lower levels of vaccine-induced antibodies than nonsmokers. High significance was found in the time from the last vaccine till the blood sample test (T = 3.848, P < .001), and the group between 6 and 9 months was found to have higher mean values than the 9-months group (M = 15952). Conclusions: Participants vaccinated with a higher number of vaccines tend to have higher IgG-S. To elevate total antibodies, booster doses are essential. Additional researchers are needed to examine the positive correlation between IgG-S and IgG-N.

Quality of Life of Palestinian Patients on Hemodialysis: Cross-Sectional Observational Study.

Background: Hemodialysis is life-saving and life-altering, affecting patients' quality of life. The management of dialysis patients often focuses on renal replacement therapy to improve clinical outcomes and remove excess fluid; however, the patient's quality of life is often not factored in. Objective: This study aimed to explore the factors affecting the quality of life of patients on dialysis in Palestine using the Kidney Disease Quality of Life (KDQOL-SFTM) questionnaire. Methods: A multicenter cross-sectional observational study was conducted at multiple dialysis centers in Palestine, including 271 participants receiving renal replacement therapy. Demographics, socioeconomic, and disease status data were collected. The Arabic version of KDQOL-SFTM was used to assess dialysis patient quality of life. Statistical analysis was performed using SPSS to find correlations among patient factors and the questionnaire's three main domains, the kidney disease component summaries (KDCS), mental component summaries (MCS), and physical component summaries (PCS). Results: Mean KDCS, MCS, and PCS scores were 59.86, 47.10, and 41.15, respectively. KDC scores were lower among participants aged 40 years or older, with lower incomes, and with diabetes. PCS and MCS scores were lower among patients aged >40, less educated, and lower-income participants. There was a positive correlation between MCS and KDCS (r = 0.634, P-value <0.001), PCS and KDCS (r = 0.569, P-value <0.001), as well as MCS and PCS (r = 0.680, P-value <0.001). Conclusion: In this study, the KDQOL-SFTM questionnaire revealed lower PCS scores among hemodialysis patients in Palestine. Furthermore, the three domains of the questionnaire were adversely affected by patient income and education status. In addition, physical role, work status, and emotional role showed the lowest scores among the three main domains. Therefore, continuous assessment of patients' quality of life during their journey of hemodialysis using the KDQOL-SFTM along with the clinical assessment will allow the healthcare professionals to provide interventions to optimize their care.

Electrolyte Imbalance Among Patients With and With No ST-Elevation Myocardial Infarction: A Cohort Study.

Electrolytes imbalances are highly prevalent and have shown a high impact on mortality in patients with acute myocardial infarction. These electrolytes imbalance have prognostic value in predicting mortality in patients with acute myocardial infarction. The purpose of this study was to assess the prognostic value of electrolyte imbalances in predicting 1-month mortality among patients with myocardial infarction with and with no ST-elevation. This cohort study was conducted in a referral hospital in the West Bank, Palestine. All patients with confirmed medical diagnosis of acute myocardial infarction and admitted to the medical coronary care unit in the hospital were eligible participants. A convenience sample of 186 participants was obtained. These participants were followed up for 1 month to assess their survival (alive or dead). Demographic and clinical data were recorded by reviewing their health records. The derived data were analyzed using SPSS version 19. About 36% of all patients were found to be hyponatremic, 15% of them have hypokalemia, and 9% of patients had hypocalcemia. There was a significant difference between STEMI and non-STEMI in sodium (t = 4.7, P < .001). A multivariate logistic regression analysis was performed to predict 1-month mortality for patients with myocardial infarction with and with no ST-elevation. The predictors that were found to be significant are sodium (odds ratio [OR] = 0.789, P = .010), calcium (OR = 0.221, P = .014), diastolic blood pressure (OR = 0.933, P = .047), and blood urea nitrogen (OR = 0.821, P = .005). Electrolyte imbalance was highly prevalent among patients with acute myocardial infarction. Hyponatremia and hypocalcemia were present and associated significantly with predicting 1-month mortality. Health care providers should take into consideration the electrolytes of patients with acute myocardial infarction from the first moment of admission and correct them early to maximize the clinical outcomes and survival for patients.

Awareness of Delirium by ICU Nurses.

Delirium is a critical issue in the intensive care unit (ICU), and the correct diagnosis and treatment of this disorder by the ICU team are doubtful on many occasions due to a lack of information. This research is intended to test the awareness and control of ICU delirium by the ICU nurses. A nonexperimental, quantitative, descriptive, cross-sectional study was conducted using a previously adopted and translated to Arabic and validated questionnaire. The sample include nurses who work in ICUs of 10 Palestinian hospitals (private and public) located in the West Bank and Jerusalem participated in this study; each gave consent to be part of this study. Approval was received from the Palestinian Ministry of Health and the Ethical Committee at Birzeit University. Version 19 of the Social Sciences Statistical Package (SPSS) software was used to analyze the data. The results showed that ICU nurses hold moderate to low levels of knowledge and lack of adequate clinical experience to handle delirium. Delirium is a common complication in the ICU that increases morbidity and mortality and increases the length of ICU stay, therefore the cost of health care rise and the quality of life is decreased. In clinical practice, there are no assessment guidelines and protocols for patients with delirium.

Nurses' Attitude, Behavior, and Knowledge Regarding Protective Lung Strategies of Mechanically Ventilated Patients.

The management of critically ill patients is complicated and often involves complex devices including mechanical ventilators (MVs), which may be associated with many complications. Protective lung strategies (PLSs) are used to prevent complications associated with MVs, but nurses may not possess adequate knowledge to optimize the efficacy of PLSs. This article reports findings from what is thought to be the first study in Palestine that explores critical care nurses' knowledge about PLSs. The purpose of this study was to assess the critical care nurses' attitude, behavior, and knowledge regarding PLSs of mechanically ventilated patients. This descriptive, cross-sectional study was conducted at both public and private hospitals in Palestine. The sample included nurses who worked in intensive care units and cardiac care units and utilized a previously developed and validated questionnaire. The result of the study concludes that the majority of the Palestinian critical care nurses agree with the utilization or application of PLSs but have a severe lack of knowledge about the strategies. This highlights the need to provide additional educational programs related to the optimum use of mechanical ventilation.