Utilizing self-report diaries to explore task time distribution of school nurses in UAE.

OBJECTIVE: This study aims to evaluate the roles and tasks of school nurses in the UAE, quantify the time spent on each, and identify areas for improvement in school health services. This aligns with the UAE government's initiative to enhance primary healthcare, focusing on illness prevention and health promotion for children and adolescents. METHODS: The research adopts an observational study design, utilizing self-observation through diary recordings by school nurses to collect data on their daily tasks and time allocation. A sample of total of 2024 school nurse activities were recorded and analyzed over 126 days and 1084 h of observation by eight school nurses using self-report diaries. This method allowed for the collection of detailed information on how nursing time is allocated between core and noncore tasks. RESULTS: In this study a total of 2024 tasks were observed over 1084 h. The findings reveal that core nursing tasks accounted for 78% of activities but only 53% of the total 1084 h observed, while non-nursing tasks, making up 22% of activities, disproportionately consumed 47% of the hours. This discrepancy highlights the inefficiency of time allocation, with non-nursing tasks such as administrative duties taking significantly longer than core patient care tasks. CONCLUSIONS: The study highlights a significant opportunity to enhance school health services in the UAE by optimizing the allocation of nursing time towards more illness prevention and health promotion interventions. By addressing the identified challenges, including the gaps in nurse competencies and the lack of structured practice frameworks, school health services can be improved.

Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation.

AIM: To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs. BACKGROUND: Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care. METHODS: A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach. RESULTS: The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity. CONCLUSIONS: The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.

Experiences on health-related quality of life of Jordanian patients living with heart failure: A qualitative study.

BACKGROUND: Quantitative studies have provided valuable statistical insights into Health-Related Quality of Life (HRQoL) among patients with Heart Failure (HF), yet they often lack the depth to fully capture the nuanced, subjective experiences of living with HF particularly in the specific context of Jordan. This study explores the personal narratives of HF patients to understand the full impact of HF on their daily lives, revealing HRQoL aspects that quantitative metrics often miss. This is crucial in developing regions, where the increasing prevalence of HF intersects with local healthcare practices, cultural views, and patient expectations, providing key insights for tailored interventions and better patient care. METHODS: Utilizing a phenomenological qualitative design, this study conducted face-to-face semi-structured interviews with 25 HF patients to deeply explore their lived experiences. Thematic analysis was employed to identify major themes related to their perceptions of HF as a disease, its impact on various HRQoL domains, and their recommended strategies to enhance HRQoL. RESULTS: The study involved 25 participants (13 males, 12 females), aged 26-88 years (mean 63), with diverse education and heart failure (HF) severities. It revealed three themes: HF perceptions, its impact on health-related quality of life (HRQoL) across physical, psychosocial, spiritual, cognitive, and economic domains, and HRQoL improvement strategies. Participants had varied HF knowledge; some lacked basic understanding. The physical impact was most significant, affecting daily life and causing symptoms like breathing difficulties, coughing, edema, and fatigue. This physical aspect influenced their psychosocial and spiritual lives, cognitive functions, and economic stability, leading to fear, frustration, worry, social isolation, spiritual and cognitive challenges, and employment problems. CONCLUSIONS: The results underscores the need for holistic healthcare approaches, integrating medical, psychological, and social support. Key recommendations include integrated care models, comprehensive patient education, support networks, and policy interventions to enhance HF patient care.

Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan.

BACKGROUND: There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care. METHODS: A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data. RESULTS: We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type. CONCLUSIONS: ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE.

OBJECTIVES: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice. DESIGN: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language. SETTING: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023. PARTICIPANTS: 14 purposively selected healthcare practitioners. INTERVENTION: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews. PRIMARY AND SECONDARY OUTCOMES: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being. RESULTS: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied. CONCLUSIONS: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications.

Aim: This qualitative study investigates the impact of cultural practices on children's health in the United Arab Emirates (UAE) by examining the use of traditional remedies and home treatments by mothers. Methods: Twenty-five participants, all mothers who had employed traditional treatments or home remedies for their children during periods of illness, were included in the study. The participants represented a diverse range of educational backgrounds, from school diploma holders to university degree graduates, with ages spanning from 20 to 50 years. Hailing from different Arabic countries and cultural subgroups, the majority of participating mothers were from the UAE. Results: Through in-depth interviews, three major themes emerged from the participants' experiences. Firstly, a strong connection between culture, religion, and healthcare practices was evident. Many mothers opted for cultural remedies as their first line of defense against illnesses due to the practices' strong foundations in their cultural heritage. Herbal remedies, Quranic healing, and other traditional methods were perceived to be both effective and spiritually comforting, reinforcing participants' sense of cultural identity. Secondly, participants highlighted unintended consequences of relying solely on traditional treatments. Some instances were reported where the use of ineffective remedies resulted in delays in seeking appropriate medical care for their children, potentially compromising their health. Additionally, certain misconceptions regarding the safety and efficacy of traditional remedies were identified, emphasizing the need for evidence-based healthcare education. Conclusion: This qualitative study sheds light on the intricate interplay between culture, traditional remedies, and children's health in the UAE. The incorporation of diverse participants from various Arabic countries and cultural subgroups enriches the study's applicability to broader Arabic cultures. By recognizing the significance of cultural healthcare practices and striking a balance with evidence-based care, healthcare providers can create a more inclusive and effective healthcare environment for children in the UAE. Future research should explore diverse samples and develop targeted interventions to further advance cultural awareness and understanding in healthcare practices.

Hearing the voices of adolescents: Evaluating the quality of care for young adults with chronic illnesses in the UAE.

BACKGROUND: Quality care for adolescents and young adults with chronic illnesses has been under-explored in the United Arab Emirates (UAE) and internationally, especially from patients' perspectives. Most available international studies focused on quality of life and the transition to adulthood rather than service quality. AIM: This research assesses care quality for adolescents with chronic illnesses in the UAE, aiming to understand their perspectives, appraise current practices, and identify service gaps. METHODS: A cross-sectional survey employed a validated questionnaire examining 33 essential care components. Participants comprised 576 adolescents and young adults with chronic conditions from five UAE Emirates. RESULTS: Participant's reports indicated that none of the 33 care elements were received consistently. Most participants (80.6%) reported crucial care aspects were absent, and across most investigated items, 19.4%-46.5% of participants reported receiving the services they were supposed to receive only some or many of the times, indicating significant areas for improvement. CONCLUSIONS: Findings demonstrate significant care quality gaps for UAE's adolescents and young adults with chronic illnesses. These may critically affect their ability to manage their conditions and ensure holistic growth. These insights can guide healthcare enhancements tailored to this demographic. PRACTICE IMPLICATIONS: There is an urgency for enhanced patient-centered care in UAE healthcare, emphasizing clinicians' roles in supporting adolescents with chronic illnesses, especially during transitions. Healthcare managers should prioritize standardized care policies, improved communication, and training that emphasizes consistent patient feedback and transition readiness. Further research into care gaps and tailored interventions within the region's distinct sociocultural setting is essential.

Health professionals and family members during cardiopulmonary resuscitation: A qualitative study on the experience of witnessing resuscitation in Jordanian critical care units.

BACKGROUND: The interaction between healthcare professionals (HCPs) and family members during cardiopulmonary resuscitation (CPR) in critical care units (CCUs) has received significant attention. In the Arabic region, family members are typically excluded from participating in critical care treatments, despite the cultural and religious significance of their presence. This highlights a lack of policies and research addressing the cultural factors related to family involvement in CPR within this context. OBJECTIVES: The purpose of this study was to explore the nature of the relationship between HCPs and family member relations during CPR in Jordanian CCUs. METHODS: This study employed a qualitative research design. Data were collected through semi-structured interviews with 45 participants, including 31 HCPs and 14 family members of patients who had undergone CPR in Jordan. Data was managed, organized, and thematically analyzed using NVivo. RESULTS: The study revealed three main themes: Family-Witnessed Resuscitation (FWR) through the eyes of HCPs, FWR through the eyes of family members, and the relationship between HCPs and family members during CPR. The last theme has three subthemes: "Looking out for the Patient," "Looking out for Ourselves," and "Looking out for Each Other." These themes highlighted the complex and dynamic relationships between HCPs and family members during CPR in Jordan. Participants emphasized the importance of clear communication, mutual respect, and a collaborative approach to decision-making during CPR. CONCLUSION: The resultant study model uniquely explains the relationship between Jordanian health professionals and family members during CPR, with important implications for clinical practice and healthcare policies regarding family involvement during resuscitation in Jordan. Further research is needed to explore the cultural and societal factors influencing family involvement in resuscitation in Jordan and other Arab countries.

Perceived barriers to effective use of telehealth in managing the care of patients with cardiovascular diseases: a qualitative study exploring healthcare professionals' views in Jordan.

BACKGROUND: The use of telehealth in the management of care and care delivery has been increasing significantly during the COVID-19 pandemic. Telehealth is an emerging technology used to manage care for patients with cardiovascular diseases (CVDs) in Jordan. However, implementing this approach in Jordan faces many challenges that need to be explored to identify practical solutions. PURPOSE: To explore the perceived challenges and barriers to using telehealth in managing acute and chronic CVDs among healthcare professionals. METHODS: A qualitative, exploratory study was conducted by interviewing 24 health professionals at two hospitals in different clinical areas in Jordan. RESULTS: Several barriers were reported by participants that affected the utilization of telehealth services. The barriers were categorized into the following four themes: Drawbacks related to patients, Health providers' concerns, Procedural faults, and telehealth To complement the service only. CONCLUSIONS: The study suggests that telehealth can be instrumental in supporting care management for patients with CVD. It means that understanding the advantages and barriers to implementing telehealth by the healthcare providers in Jordan can improve many aspects of the healthcare services for patients with CVD within the healthcare settings in Jordan.

Experience of Health Professionals in Caring for Patients With Chest Trauma: A Qualitative Study.

BACKGROUND: The variation in the implementation of chest trauma (CT) management's guidelines led to inconsistent and mixed experiences toward CT management by the health care team. Moreover, there is a scarcity of studies exploring factors that enhance CT management experiences worldwide and in Jordan. OBJECTIVES: The aims of this study were (1) to explore emergency health professionals' attitudes and experiences toward CT management and (2) to understand factors that affect the care for patients with CTs among emergency health professionals. METHODS: A qualitative exploratory approach was adopted in this study. Individual, semistructured, face-to-face interviews were conducted with 30 emergency health professionals (physicians, nurses, and paramedics) from government emergency departments, military, private hospitals, and paramedics from the Civil Defense in Jordan. RESULTS: The results showed that emergency health professionals had negative attitudes toward caring for patients with CTs due to a lack of knowledge and clarity in their job description and duties assigned to them. Moreover, some organizational and training factors were discussed for their impact on the attitudes of emergency health professionals toward caring for patients with CTs. CONCLUSIONS: Lack of knowledge, absence of clear guidelines and job descriptions for dealing with traumas, and lack of continuous training on caring for patients with CTs were the most common reasons for negative attitudes. These findings can assist stakeholders, managers, and organizational leaders in understanding health care challenges and provoke a more focused strategic plan to diagnose and treat patients with CT.

Quality of life as a mediating factor in the relationship between fatigue and perception of safety among critical care nurses in the United Arab Emirates.

BACKGROUND: A scientific understanding of the relationships between intensive care unit nurses' well-being and patient safety will allow nurse managers, administrators, and policymakers to simultaneously manage crucial organisational goals of nurses' health and patient safety. Understanding predictors of fatigue among intensive care unit nurses may help to balance personal and organisational impacts (e.g., turnover intention, sick leave) and provide a way to positively influence their safety perception. OBJECTIVE: The aim of this study was to explore the association between work fatigue and perception of patient safety among nurses working in critical care units and determine whether their quality of life levels mediated this relationship. METHODS: This study used a cross-sectional correlational comparative design. Participants were a sample of 250 intensive care unit nurses recruited conveniently from three large hospitals in the United Arab Emirates. The self-reported questionnaire included the Nursing Quality of Life Scale, the Fatigue Severity Scale, and the Safety Attitudes Questionnaire (SAQ)-ICU version, as well as sociodemographic characteristics and work-related information. RESULTS: Of the 250 participating nurses, 76.8 % reported low QoL. There was a statistically significant correlation between nurses' Quality of Life and fatigue levels (r = 0.234, P = 0.000). Overall, 52.8 % of the sample had high fatigue and 49.6 % had poor safety perception. Multiple regression analysis using the Baron and Kenny approach showed that QoL, marital status, gender, and work environment were predictors of nurses' perception of safety. CONCLUSION: Intensive care unit nurses had high levels of fatigue and poor Quality of Life. High Quality of Life and a favourable work environment were independent predictors of good patient safety perception. Efforts should be directed to maximize staffing resources that positively impact patient safety. These findings are comparable with international studies, suggesting that these issues may be ubiquitous. IMPLICATIONS FOR CLINICAL PRACTICE: Intensive care practitioners, managers and policymakers should adopt measures to modify intensive care nurses' exhausting working conditions and provide a supportive environment. these interventions might improve nurses' perception of patient safety and consequently prevent safety incidents.

Experiences of a mental health promotion, prevention, and early-intervention training program targeted to school nurses in the United Arab Emirates.

AIM: To report participants' and facilitators' experiences of mental health promotion, prevention, and early-intervention training program targeted at school nurses in the United Arab Emirates (UAE). BACKGROUND: The UAE school healthcare service is staffed by full-time nurses and part-time doctors and linked to primary healthcare centers. This service supports children's physical and mental well-being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored. METHODS: We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early-intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research. RESULTS: Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style. CONCLUSION: A well-structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential. IMPLICATIONS FOR NURSING PRACTICE, RESEARCH, AND POLICY: School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff.

Perception of nursing students from the Middle East about caring: A descriptive, comparative, cross-sectional study.

AIM: To investigate the perception of undergraduate nursing students in different countries in the Middle East about caring. DESIGN: A cross-sectional, descriptive, comparative design. METHODS: A total of 1,582 nursing students from six different countries in the Middle East completed the Caring Dimensions Inventory. RESULTS: The total mean score of caring was 138.8 (± 15.8), indicating a high level of caring. The highest mean score was for nursing students from Egypt (M = 145.37 ± 15.97), whereas the lowest was for nursing students from Palestine (M = 135.36 ± 13.48). The caring perception was more significant for female students than male students, and no significant correlation was found between students' ages and caring scores. CONCLUSIONS: The high level of caring among nursing students reflects the involvement of caring behaviour in the nursing curricula, which motivates nursing schools to continue stressing the importance of caring and to enhance this behaviour among their graduates. PATIENT OR PUBLIC CONTRIBUTION: Improving the students' caring competencies as recommended by the study will influence the caregiving quality in the future that will be reflected in nurse-patient caring relationships and raise the patients' and public satisfaction with nursing care.

Level and predictors of caring behaviours of critical care nurses.

BACKGROUND: Advanced technologies in intensive care units, including artificial intelligence and digitization, has implications for psycho-emotional aspects of caring in terms of communication, involvement, and holistic provision in a safe, effective, and efficient manner. Critical care nurses must maintain a balance between their technological and humanistic caring behaviours during the provision of individualized holistic patient care. Therefore, this study was conducted to examine level and predictors of caring behaviours among critical care nurses in two Arab countries. METHODS: A cross-sectional design was used to achieve the objective of this study, whereby a quantitative online questionnaire survey was administered to 210 adult intensive care unit nurses at two government hospitals in Sharjah (United Arab Emirates), and two university hospitals in Amman (Jordan). Based on G* Power analysis, 200 participants were adequate to run the analysis. RESULTS: On average, 49% of the whole sample had 'good' caring behaviours. Among nurses who were working in Emirati intensive care units, 48.5% had good caring behaviours, compared to 47.4% of Jordanian intensive care unit nurses. Additionally, the results showed that predictors of caring behaviours among nurses include female gender, holding a master's degree, interest in nursing profession, and a 1:1 nurse-to-patient ratio. CONCLUSIONS: About half of the ICU nurses in this study had low levels of caring behaviours. The present study highlights the requirement for integrating the concept of holistic and patient-centred care as the essence of the nursing profession in nursing curricula to improve the level of care provided by all nurses working in intensive care units. Continuing education programs and specific interventional programs should be directed toward predictors of caring behaviours among each specific group of nurses. Future research is needed using qualitative methods to understand what the perception of intensive care unit nurses is about caring.

Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study.

INTRODUCTION: Telemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched. PURPOSE: To explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems. METHOD: A qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014). RESULTS: The analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services. CONCLUSION: The current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.

Psychological distress among the nursing workforce in the United Arab Emirates: Comparing levels before and during the COVID-19 pandemic.

BACKGROUND: Nurses make up the majority of the healthcare workforce. They contribute to the development of healthcare systems and the provision of high-quality, effective, and patient-centered healthcare services. However, nurses need good mental and emotional well-being to provide adequate care and the necessary physical and mental health support for their clients. This study aimed to determine the level of generalized psychological distress among nurses in the United Arab Emirates. As this study was initiated before the coronavirus disease 2019 (COVID-19) pandemic, we were able to compare data gathered before and during the pandemic. METHOD: This study used a cross-sectional correlational design. The Kessler Psychological Distress Scale (K10) was used to measure generalized psychological distress. Nurses' distress levels were measured and compared before and during the COVID-19 pandemic. RESULTS: In total, 988 participants completed the questionnaire. The majority (n = 629, 63.7%) were employed in hospitals and the remainder worked in primary healthcare settings (n = 359, 36.3%). The mean distress score was 27.1 ± 13.7; 42.1% (n = 416) of participants had a severe level of distress, and only 36.4% (n = 360) reported no distress. More participants had severe stress levels before COVID-19 (59.5%, n = 386) compared with during COVID-19 (10.9%, n = 30). CONCLUSIONS: Participants' K10 scores suggest that nurses experience significant distress, which may compromise their ability to care for their clients. This study emphasizes the importance of supporting nurses as a preliminary step to improving patient care. Despite the pressure of working during the COVID-19 pandemic, participants' general distress scores were lower during than before the pandemic. Organizational, governmental, and global support and appreciation may have contributed to relieving the distress nurses experienced. This may be a useful ongoing approach for enhancing healthcare systems.

The impact of online teaching on stress and burnout of academics during the transition to remote teaching from home.

BACKGROUND: The higher education institutions worldwide have been transformed unexpectedly to online teaching. This sudden movement from blended learning or traditional face-to-face teaching has severely disrupted university activities and posed many challenges for teaching staff, who were asked to develop online versions of their courses overnight. This study explores the effect of the current changes in education style and working from home on the stress and burnout levels of teaching staff. METHODS: This study utilized a cross-sectional design, whereby 278 participants (faculty and course instructors) from 17 campuses of one of the largest colleges in United Arab Emirates completed a web-based survey. Numerous instruments were utilized to obtain the following data: participants demographics; their perceived stress during online teaching; their perception of the impact of teaching from home on their family's daily life, physical health, mental health and ability to cope with stress; burnout level; and their satisfaction with online teaching. RESULTS: Around 60% of participants reported moderate stress level during online teaching (moderate stress = 5 to 8) under COVID-19 (M 6.21 ± 2.26). An independent sample t-test and ANOVA tests revealed that participants with 7-10 years of online teaching experience reported more stress than participants who have 4-6 years online teaching experience (M 7.29, ±1.11 Vs. 5.30, ±2.69; P = 0.04). Moreover, multiple regression analysis showed that higher stress levels and lower satisfaction with the online teaching experience were associated with more significant personal and working burnout. Married participants with school-age children were at greater risk of personal burnout. CONCLUSION: The transition to remote education imposed mental burdens and stress on faculty members. Supportive professional development strategies to enrich faculty with online teaching skills are urgently required.

Assessing sense of coherence as an element of primary-focused health services in schools for children and adolescents with complex health care needs.

AIM: This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools. BACKGROUND: The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development. METHODS: This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes. RESULTS: A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems. CONCLUSION: Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population. IMPLICATIONS FOR NURSING MANAGEMENT: Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.

Missing the point: Quality-driven healthcare institutions may mistakenly disregard their role in nursing and medical education.

Aligned with international standards, the UAE Government and many other developing countries in the region (GCC and MENA) have started to implement strict quality improvement initiatives to develop their healthcare systems. Most of these initiatives are geared toward meeting patient satisfaction and avoiding circumstances or events that would dissatisfy patients. It is also used to measure healthcare institution performance, assess efficiency and determine their funding and reimbursement. With this emphasis on quality, it is also important for healthcare organizations to fulfill their other functions. Among the most important is performing their teaching role to prepare future healthcare professionals, and attracting and retaining healthcare professionals. These roles are also a paramount for a quality, sustained healthcare system. However, clinical educators and managers reflect on how these roles seem to be frequently missed or at least compromised while applying the quality assurance measures in the region developing countries. This reflective paper discusses this concern and suggests possible strategies that may help overcome this challenge and thus contributing to the achievement of the quality goal of the service in a more comprehensive and sustainable manner. The similarities between the UAE healthcare system and neighboring Gulf Cooperation Council and the Middle East/North African countries mean these challenges and solutions may resonate with these countries and support the implementation of effective health services in these countries as well.

The Effect of Benson Relaxation Technique on Depression, Anxiety, and Stress of Jordanian Patients Diagnosed with Multiple Sclerosis: A Cross-Sectional Study.

Depression, anxiety, and stress (DAS) are common symptoms of multiple sclerosis (MS) patients and are highly correlated with poor quality of life. Managing DAS among such patients can improve their quality of life (QoL), empowering them with improved autonomy, self-care, independency, and ability to perform daily activities. This study is aimed at examining the effectiveness of the Benson Relaxation Technique (BRT) on reducing DAS among patients diagnosed with MS in Jordan. This quasiexperimental study of 105 Jordanian patients diagnosed with multiple sclerosis tested an intervention group (60 patients) who received BRT and a control group (45 patients) who received normal treatment. Data were collected from January 2021 to April 2021, using the Arabic version of the Depression Anxiety Stress Scale (DASS21). The intervention group was instructed to perform the BRT two times a day for 10 minutes at home for eight weeks at two specific times, with 7-8-hour intervals between each episode. STROBE guidelines were followed in reporting the review. At the baseline comparison, there was no statistical difference between the interventional and control groups with regard to DAS. The levels of DAS between the two groups after three months of the last sessions of the intervention (postintervention) were compared. The results showed that the intervention group had significantly lower levels of DAS compared to the control group. The levels of the DAS were significantly lower for the intervention group postintervention. Adding relaxation techniques to the therapeutic routine is a cost-effective complementary treatment to decrease DAS among MS patients and improve their QoL. Relevance to Practice. This study provides a baseline of data that could facilitate further investigations in the future to improve the quality of services delivered to such patients and thus their QoL and satisfaction.