The Predictors of Perceived Barriers and Facilitators of Applying Sepsis Six Guidelines Among Critical Care Nurses.

BACKGROUND: Sepsis is a life-threatening condition that demands quick and cautious interventions from nurses, as they are the frontline caregivers, so they are essential in recognizing early signs of sepsis, initiating prompt healthcare interventions, and providing comprehensive care to improve patient outcomes. This study aimed to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses. METHODS: This cross-sectional descriptive study was conducted on a convenience sample of 180 nurses working in critical care settings (ICU, critical care unit, ED, burning unit, dialysis unit) at a university hospital. A valid and reliable questionnaire was used to examine the predictors of perceived barriers and facilitators of applying evidence-based sepsis guidelines among critical care nurses. RESULTS: This study revealed that the main barriers faced by critical care nurses are lack of sepsis recognition during observational rounds and delay in sepsis diagnosis by medical staff. For the most common facilitators of applying Sepsis Six guidelines, the participating nurses reported the presence of a written tool/protocol for sepsis identification and management. CONCLUSIONS: The study emphasized the importance of the presence of evidence-based protocols for sepsis assessment and management and nurses' compliance with guidelines. Ongoing education training for nurses and providing step-by-step written checklists are a cornerstone to improving nurses' knowledge and the practical skills of early identification and management of sepsis.

Changes in the Anxiety Levels of Patients Undergoing Percutaneous Coronary Intervention.

BACKGROUND: Anxiety is a predictor of a bad prognosis in patients with coronary heart disease. Patients with coronary heart disease undergoing percutaneous coronary intervention (PCI) reported high levels of anxiety, yet little is known about changes in anxiety levels after this procedure. OBJECTIVE: The aim of this study was to examine changes in anxiety levels of patients undergoing PCI and identify differences in anxiety levels based on patients' demographics and clinical details. METHODS: A convenience sample of patients undergoing first-time elective PCI (N = 165) completed the Generalized Anxiety Disorder Scale at baseline (discharge time) and 6 months later. Paired samples t test was used to assess the changes in anxiety levels. The χ2 test was used to examine the pattern of changes between the 2 time points. Patients did not have access to cardiac rehabilitation. RESULTS: Six months after PCI, the anxiety level scores decreased significantly; mean scores for the baseline versus follow-up were 10.84 ± 5.98 versus 4.29 ± 6.02, respectively (P = .001). Only 18.2% of the patients had normal levels of anxiety at the baseline compared with 71.5% 6 months later. History of hospitalization after PCI, being a smoker, younger age, and low level of education were associated with higher levels of anxiety at follow-up. CONCLUSIONS: Although anxiety levels were reduced 6 months after PCI, assessing patients' anxiety levels and implementing psychoeducational interventions at follow-up should be incorporated to optimize the care of PCI patients, particularly for those who are younger, who are smokers, or with a low educational level.

Factors associated with antenatal depression in the Kingdom of Jordan during the COVID-19 pandemic.

Fear of infection and measures taken to mitigate infection, such as social distancing, lockdown and isolation can lead to anxiety and depression across the life course, but especially in pregnancy. We set out to identify the prevalence of depression in pregnancy, using Edinburgh Postnatal Depression Scale (EPDS) during national quarantine and to examine women's knowledge, attitude, and practices (KAP) in regard to potential COVID-19-related depression. Following ethical approval, an observational design, with an online questionnaire and snowball sampling was used to recruit 546 pregnant women (231 primi and 315 multiparous) in Jordan via common social media platforms (facebook, WhatsApp). Over one third (36.7%) reported depressive symptoms. There were significantly lower depression scores among pregnant women who exhibited more knowledge about COVID-19 (in high [vs low] knowledge groups, mean EPDS = 10.8 [vs 12.2]; p = 0.007). Depression scores were not significantly associated with attitude nor with practice. This suggests that enhanced knowledge levels may protect pregnant women against depression. Our findings contribute to understanding of the experience of pregnant women in developing countries during the COVID-19 pandemic. Healthcare Professionals should provide health education to all pregnant women and timely services to pregnant women with depressive symptoms. This may lead to the prevention of serious symptoms and reduce negative consequences on the next generation, not only in Jordan, but worldwide.

Depression, anxiety and stress among undergraduate students during COVID-19 outbreak and "home-quarantine".

AIM: Many people including students affected physically and psychologically by coronavirus disease (COVID-19) outbreak and "home-quarantine." This study aimed at assessing the prevalence and predictors of depression, anxiety and stress among university students in Jordan during "home-quarantine" due to the outbreak of COVID-19. DESIGN: This is a cross-sectional descriptive study. METHODS: Data were collected from a convenience sample of 1,380 Jordanian university students. A web-based survey was used to collect data from the participants using the DASS-21. RESULTS: The prevalence of depression, anxiety and stress in different levels was 78.7%, 67.9% and 58.7%, respectively, which are higher during "home-quarantine." The mean scores of depression, anxiety and stress were at moderate levels. Strong correlations were found between depression, stress and anxiety, with demographic, health-related, lifestyle variables. Several variables also predicted depression, stress and anxiety.

The varied role, scope of practice, and education of cardiovascular nurses in ESC-affiliated countries: an ACNAP survey.

AIMS: Cardiovascular disease burden is increasing globally, pressuring nursing staff to deliver high-quality care across a diverse range of treatment areas. As such, an evaluation of the educational preparation of nurses is needed. To determine the current role, scope of practice, education level, and needs of cardiovascular nurses working across the European Society of Cardiology (ESC)-affiliated countries. METHODS AND RESULTS: A short survey was distributed in paper (EuroHeartCare 2018) or electronic format to nurses delivering cardiovascular care. A total of 876 cardiovascular nurses from 26 ESC-affiliated countries completed the survey. Most respondents (79%), were educated to at least bachelor level, with 46% having a masters or doctorate, and were highly motivated to continue their educational development. Despite this, a large number (44.3%) of respondents believed they were not fully prepared for their job. The main areas where further education was requested included acute care in cardiovascular disease (CVD) and CVD risk factor management. Face-to-face courses/training were the most requested delivery mode, followed by E-learning-which appears to be underutilized in this population. Awareness of the existing curricula for cardiovascular nurse education was minimal, and therefore these resources require further promotion and implementation. CONCLUSIONS: This international sample of cardiovascular nurses was generally educated to degree level and motivated to improve their cardiovascular knowledge. Many believed they were underprepared for their role, highlighting the need for increased investment in education. This should be focused on specific needs and delivered using a face-to-face, E-learning, or blended-learning format. Furthermore, increased signposting of existing resources is required.

Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis.

CONTEXT: Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer. OBJECTIVES: The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer. METHODS: The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS: A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ2 = 0.0000; I2 = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue. CONCLUSION: This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.

An evaluation of the effectiveness of self-management interventions for people with type 2 diabetes after an acute coronary syndrome: a systematic review.

BACKGROUND: Type 2 diabetes is highly prevalent in patients with acute coronary syndrome and impacts negatively on health outcomes and self-management. Both conditions share similar risk factors. However, there is insufficient evidence on the effectiveness of combined interventions to promote self-management behaviour for people with diabetes and cardiac problems. Identifying critical features of successful interventions will inform future integrated self-management programmes for patients with both conditions. OBJECTIVES: To assess the evidence on the effectiveness of existing interventions to promote self-management behaviour for patients presenting with acute coronary syndrome and type 2 diabetes in secondary care settings and postdischarge. DESIGN: We searched MEDLINE, PubMed, CINAHL Plus, PsycInfo, Cochrane Library and AMED for randomised controlled trials published between January 2005-December 2014. The search was performed using the following search terms of 'acute coronary syndrome', 'type 2 diabetes' and 'self-management intervention' and their substitutes combined. RESULTS: Of 4275 articles that were retrieved, only four trials met all the inclusion criteria (population, intervention, comparison and outcome) and were analysed. Overall, the results show that providing combined interventions for patients with both conditions including educational sessions supported by multimedia or telecommunication technologies was partially successful in promoting self-management behaviours. Implementation of these combined interventions during patient's hospitalisation and postdischarge was feasible. Intervention group subjects reported a significant improvement in self-efficacy, level of knowledge, glycated haemoglobin, blood pressure and fasting glucose test. However, there are many threats have been noticed around internal validity of included studies that could compromise the conclusions drawn. CONCLUSION: With limited research in this area, there was no final evidence to support effectiveness of combined interventions to promote self-management behaviour for patients with type 2 diabetes and acute coronary syndrome. Sufficiently powered, good quality, well-conducted and reported randomised controlled trials are required.