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Abstract Background The ongoing global crisis of Higher Education (HE) institutions during the post-COVID-19 pandemic period has increased the likelihood of enduring psychological stressors for staff. This study aimed to identify factors associated with job insecurity, burnout, psychological distress and coping amongst staff working at HE institutions globally. Methods An anonymous cross-sectional study was conducted in 2023 with staff at HE institutions across 16 countries. Job insecurity was measured using the Job Insecurity Scale (JIS), burnout using the Perceived Burnout measure question, psychological distress using the Kessler Psychological Distress Scale (K10), and coping using the Brief Resilient Coping Scale. Multivariable logistic regression with a stepwise variable selection method was used to identify associations. Results A total of 2,353 staff participated; the mean age (± SD) was 43(± 10) years and 61% were females. Most staff (85%) did not feel job insecurity, one-third (29%) perceived burnout in their jobs, more than two-thirds (73%) experienced moderate to very high levels of psychological distress, and more than half (58%) exhibited medium to high resilient coping. Perceived job insecurity was associated with staff working part-time [Adjusted Odds Ratio 1.53 (95% Confidence Intervals 1.15–2.02)], having an academic appointment [2.45 (1.78–3.27)], having multiple co-morbidities [1.86 (1.41–2.48)], perceived burnout [1.99 (1.54–2.56)] and moderate to very high level of psychological distress [1.68 (1.18–2.39)]. Perceived burnout was associated with being female [1.35 (1.12–1.63)], having multiple co-morbidities [1.53 (1.20–1.97)], perceived job insecurity [1.99 (1.55–2.57)], and moderate to very high levels of psychological distress [3.23 (2.42–4.30)]. Staff with multiple co-morbidities [1.46 (1.11–1.92)], mental health issues [2.73 (1.79–4.15)], perceived job insecurity [1.61 (1.13–2.30)], and perceived burnout [3.22 (2.41–4.31)] were associated with moderate to very high levels of psychological distress. Staff who perceived their mental health as good to excellent [3.36 (2.69–4.19)] were more likely to have medium to high resilient coping. Conclusions Factors identified in this study should be considered in reviewing and updating current support strategies for staff at HE institutions across all countries to reduce stress and burnout and improve wellbeing.

Abstract Background Case analysis is a dynamic and interactive teaching and learning strategy that improves critical thinking and problem-solving skills. However, there is limited evidence about its efficacy as an assessment strategy in nursing education. Objectives This study aimed to explore nursing students’ perceived efficacy of case analysis as an assessment method for clinical competencies in nursing education. Methods This study used a mixed methods design. Students filled out a 13-item study-advised questionnaire, and qualitative data from the four focus groups was collected. The setting of the study was the College of Nursing at Sultan Qaboos University, Oman. Descriptive and independent t-test analysis was used for the quantitative data, and the framework analysis method was used for the qualitative data. Results The descriptive analysis of 67 participants showed that the mean value of the perceived efficacy of case analysis as an assessment method was 3.20 (SD = 0.53), demonstrating an 80% agreement rate. Further analysis indicated that 78.5% of the students concurred with the acceptability of case analysis as an assessment method (mean = 3.14, SD = 0.58), and 80.3% assented its association with clinical competencies as reflected by knowledge and cognitive skills (m = 3.21, SD = 0.60). No significant difference in the perceived efficacy between students with lower and higher GPAs (t [61] = 0.05, p > 0.05) was identified Three qualitative findings were discerned: case analysis is a preferred assessment method for students when compared to MCQs, case analysis assesses students’ knowledge, and case analysis assesses students’ cognitive skills. Conclusions This study adds a potential for the case analysis to be acceptable and relevant to the clinical competencies when used as an assessment method. Future research is needed to validate the effectiveness of case analysis exams in other nursing clinical courses and examine their effects on academic and clinical performance.

Introduction The COVID-19 outbreak disrupted the nursing education across the world. The nursing students faced many challenges in their learning process. Objective The study explored the experiences and challenges faced by nursing students who had virtual education in India. Methods The study adopted an exploratory sequential mixed-methods design. The study was conducted as two phases. Phase 1: Qualitative data were collected using direct focus group interview with 18 students. Phase 2: Quantitative data were collected from 477 students using a Likert scale prepared by the investigators of the study on challenges experienced by nursing students on their education. The analysis was done using the descriptive and inferential statistics and thematic analysis. Results Phase 1: The analyzed data produced seven themes and 10 sub-themes; (1) technical issues—a concern, (2) regular rhythm in educational training—but not complete, (3) stress and strain, (4) evaluation—a concern, (5) communication, (6) comfort zone, and (7) easy distraction. Phase 2: Majority of the students (54.71%) experienced high-level challenges with the nursing education during pandemic. The overall mean and SD of all the domain-wise challenges were 103.39 + 7.11 with the range from 30 to 150. The mean and SD with educational challenges were (20.27 + 3.04), environmental challenges (6.92 + 1.66), communication challenges (17.61 + 4.01), technical challenges (17.39 + 3.75), evaluation challenges (7.09 + 1.94), physical and mental challenges (20.47 + 4.33), career challenges (7.06 + 1.91), and financial challenges (6.61 + 2.1). The demographic variable gender ( P = 0.045) showed a statistically significant association with the challenges. Conclusion Considering the experiences and challenges faced by the nursing students, the nursing administrators shall design educational strategies to mitigate these challenges in nursing education during a pandemic. Implication Virtual nursing education offers flexibility in teaching and learning, self-paced learning opportunity, lower the costs, career advancement, comfortable learning environment, more opportunities for participation, easier to track documentation and improves skills in technology. Therefore, the challenges in virtual nursing education should be lessened to have successful teaching learning experiences.

Background: Sickle cell disease in pregnancy is associated with high maternal and fetal mortality. However, studies reporting pregnancy, fetal, and neonatal outcomes in women with sickle cell disease are extremely limited. Objectives: The objectives of the study are to determine whether women with sickle cell disease have a greater risk of adverse pregnancy, fetal, and neonatal outcomes than women without sickle cell disease and identify the predictors of adverse pregnancy, fetal, and neonatal outcomes in women with sickle cell disease. Design: A retrospective pair-matched case-control study was conducted to compare 171 pregnant women with sickle cell disease to 171 pregnant women without sickle cell disease in Muscat, Sultanate of Oman. Methods: All pregnant Omani women with sickle cell disease who delivered between January 2015 and August 2021 at Sultan Qaboos University Hospital and Royal Hospital, who were either primipara or multipara and who had a gestational age of 24–42 weeks, were included as patients, whereas women who had no sickle cell disease or any comorbidity during pregnancy, who delivered within the same timeframe and at the same hospitals, were recruited as controls. The data were retrieved from electronic medical records and delivery registry books between January 2015 and August 2021. Results: Women with sickle cell disease who had severe anemia had increased odds of (χ 2 = 58.56, p

Summary: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).

Background Obesity management in young women necessitates interventions that include dietary modification and physical exercise. High-intensity lifestyle modification is effective in managing obesity in young women. Objectives The study determined the effectiveness of a nurse-led lifestyle modification intervention (NLLMI) on obesity among young women in India. Methods The study adopted a quasi-experimental pre- and post-interventional control group research design. The study was conducted among obese young women in the communities of Jabalpur, Madhya Pradesh, India. The participants were selected using convenient sampling technique. The sample included 150 women in the study group and 150 in the control group. The NLLMI comprising of exercises and dietary modifications were taught to the participants for 30 min three times a week for 24 weeks. Thereafter, they were encouraged to follow the diet and perform the exercises on their own for the next 12 weeks. Practice diary was maintained by the participants and they were encouraged to continue the intervention through the phone. The participants in the control group did not engage in the NLLMI until the post-test. However, they did receive the same NLLMI after the trial was over. Results There was a high statistically significant difference ( p = 0.001) between the study group and the control group the after 12th and 24th weeks of NLLMI. The study group had a significant reduction in BMI after the intervention. Conclusions Young obese women may benefit from a NLLMI if they regularly follow the healthy eating habits and physical exercise.

Introduction Surgical care has been a vital part of healthcare services worldwide. Several patient safety measures have been adopted universally in the operating room (OR) before, during, and following surgical procedures. Despite this, errors or near misses still occur. Nurses in the OR have a pivotal role in the identification of factors that may impact patient safety and quality of care. Therefore, exploring the OR nurses’ understanding of their roles and responsibilities for patient care and safety in the intraoperative practice, which could lead to optimal patient safety, is essential. Objective This study explored the understanding of OR nurses regarding their roles and responsibilities for patient care and safety measures in the intraoperative practice. Methods The study was conducted in one of the tertiary care hospitals in the United Arab Emirates. Qualitative, descriptive, exploratory research design was utilized. The data were collected using semi-structured face to face interviews. Purposive sampling included eight nurses. Data analysis was performed following Colaizzi's seven-step strategy. Results Seven emerging themes were identified. The main themes are: patient safety, preoperative preparation, standardization of practice, time management, staffing appropriateness, staff education and communication, and support to the patient in the OR. Conclusion OR nurse leaders may take into consideration the current findings as a reference for quality improvement projects in the hospital, considering the specific characteristics of each local setting. Although the participants consider that the environment is safe and the quality of care is high in the study setting, there is still room for improvement on workflows and processes. OR workflow should be improved especially by addressing the potential patient safety issues.

Introduction The COVID-19 pandemic has resulted in an unanticipated shift in nursing practice to meet the sudden increase in demand for pandemic-related care, leaving nurses unable to provide acceptable services to patients in the way they were taught and expected to do. It put the nurses under more stress and most of them were dissatisfied with their work due to excessive burnout. Objectives The study determined the level of stress and burnout among front-line nurses working at the Ministry of Health Hospitals in Najran, Saudi Arabia during the COVID-19 pandemic. Methods A total of 1594 nurses were chosen using a convenience sampling approach. Google Forms were used to collect data from the nurses. COVID-19 stressors questionnaire and an abbreviated Maslach Burnout Inventory were used to assess stress and burnout among nurses. Results Our study reported that the majority of nurses experienced extreme levels of stress as their colleagues became ill; that they would spread COVID-19 infection to their family and friends; upsetting to see COVID-19 patients dying in front of them; not knowing when the COVID-19 pandemic will be under control; and emotional exhaustion and physical fatigue. A vast majority of nurses felt there were not adequate protective measures; there was a shortage of staff at times; were nervous and scared and thought of quitting their job; and they would quit their job if a COVID-19 outbreak recur and they would fall sick. Likewise, 41.9% of the nurses experienced a high level of burnout. A significant association was found between the area of working and the level of burnout among nurses. Conclusion As nurses experienced extreme levels of stress and severe burnout, it is vital to design regular programs to assist frontline nurses in maintaining their mental health.

Introduction Breast cancer (BC) is a most common and frequently occurring malignancy of women worldwide. Breast self-examination (BSE) is important for the early detection and prevention of BC and to limit the morbidity and mortality. Young students are ideal people to understand and motivate other women to perform BSE. Objective BSE behavior of undergraduate students was predicted using Champion's Health Belief Model Scale (CHBMS). Methods A descriptive cross-sectional design was adopted. This study was conducted in all nine colleges of Sultan Qaboos University, , Oman. Three-hundred eighty-one female undergraduate students were selected through convenient sampling technique. The health belief towards BSE was predicted using CHBMS. Results The mean and SD of beliefs about the benefits of performing BSE showed 10.84 and 3.2, respectively. Mean and SD of confidence in performing BSE indicated 56.24 and 10.8. Likewise, the mean and SD of barriers in performing BSE are 13.58 and 4.2. Source of information is found to be a statistically significant predictor of barrier in performing BSE at p

Summary: Background: The objective of this study is to investigate the trends of exposure and burden attributable to the four main metabolic risk factors, including high systolic blood pressure (SBP), high fasting plasma glucose (FPG), high body-mass index (BMI), and high low-density lipoproteins cholesterol (LDL) in North Africa and the Middle East from 1990 to 2019. Methods: The data were retrieved from Global Burden of Disease Study 2019. Summary exposure value (SEV) was used for risk factor exposure. Burden attributable to each risk factor was incorporated in the population attributable fraction to estimate the total attributable deaths and disability-adjusted life-years (DALYs). Findings: While age-standardized death rate (ASDR) attributable to high-LDL and high-SBP decreased by 26.5% (18.6–35.2) and 23.4% (15.9–31.5) over 1990–2019, respectively, high-BMI with 5.1% (−9.0–25.9) and high-FPG with 21.4% (7.0–37.4) change, grew in ASDR. Moreover, age-standardized DALY rate attributed to high-LDL and high-SBP declined by 30.2% (20.9–39.0) and 25.2% (16.8–33.9), respectively. The attributable age-standardized DALY rate of high-BMI with 8.3% (−6.5–28.8) and high-FPG with 27.0% (14.3–40.8) increase, had a growing trend. Age-standardized SEVs of high-FPG, high-BMI, high-SBP, and high-LDL increased by 92.4% (82.8–103.3), 76.0% (58.9–99.3), 10.4% (3.8–18.0), and 5.5% (4.3–7.1), respectively. Interpretation: The burden attributed to high-SBP and high-LDL decreased during the 1990–2019 period in the region, while the attributable burden of high-FPG and high-BMI increased. Alarmingly, exposure to all four risk factors increased in the past three decades. There has been significant heterogeneity among the countries in the region regarding the trends of exposure and attributable burden. Urgent action is required at the individual, community, and national levels in terms of introducing effective strategies for prevention and treatment that account for local and socioeconomic factors. Funding: Bill & Melinda Gates Foundation.

Background: Learning styles vary among the students at the university level which has changed from traditional to more technology pervaded strategies involving digital gadgets. The Academic libraries are being challenged to upgrade from old fashioned hard copy resources to digital libraries including electronic books. Purpose: The main purpose of the study is to assess the preferences of using printed books versus e-books. Methods: A descriptive cross sectional survey design was used to collect the data. A total of 607 students were included in the study. Data collected was analyzed using descriptive and inferential statistics. Results: Results showed that 86.8% of the students were in undergraduate program with 48.9% students in the second year of the program, 95.6% in the age group of 17–26 years and 59.5% of them being females. The study concluded that 74.6% of students prefer e-books in terms of easy to carry and 80.6% of them spent more than 1 h reading from e-books, while 66.7% of the students preferred printed books due to the ease in studying and 67.9% favored as it is easy to make notes. However, 54% of them felt studying from the digital copies difficult. Conclusion: The study concludes that the students prefer e-books as they spent more time reading from e-books and are easy to carry; while traditional printed copy is comfortable to use and easy to take notes and study for exams. Implications for practice: As many changes are happening in the instructional design strategies with the introduction of hybrid methods of teaching and learning, the findings of the study will guide the stake holders and educational policy makers to design novel and modernized educational design that has a psychological, and social impact among the students.

Objective Urinary incontinence (UI) is defined by the International Continence Society as any complaint of involuntary urine leakage. This research study highlights the prevalence, types, and associated factors of UI among women in Oman. Methodology A descriptive cross-sectional design was used to collect data using purposive sampling technique from 400 women between 20 and 60 years; who were attending outpatient department of a referral hospital in Oman. Women were assessed using the Questionnaire for Urinary Incontinence Diagnosis to determine the type of UI. The severity and the impact of UI in women were assessed using the female urinary tract symptoms module (ICIQ-UI-SF). Descriptive statistics were used to determine the prevalence and type of UI, and the Chi-square test was used to find the association between UI and sociodemographic and obstetrical variables. Results In our study, 28.25% of the women belonged to the age of 50–59 years. The point prevalence (per 1000) of UI among Omani women who were between 20 and 60 years was 44%. In the women who had UI, the majority were having stress UI (41.6%). In the women who had UI, the severity of UI, according to the ICIQ-UI-SF scoring, 15.2% of the women had slight, 50.3% had moderate, 33.1% had severe, and only 1.3% had very intense. Conclusion Understanding the prevalence of UI in every community and associated factors is essential for the policy makers and healthcare providers to consider the early diagnosis, prevention, health promotion, and management of UI.

Background: Caring behavior is a major focus of the nursing profession and an important dimension of nursing practice that sets nurses apart from other healthcare professionals. Effective patient-centered care requires ensuring nurses have the emotional intelligence and happiness to address the daily demands of practice. The purpose of this study is to examine the emotional intelligence and happiness among nursing students and their relationship with caring behaviors. Methods: A cross-sectional, descriptive correlational study was conducted on nursing students (n = 363) from Riyadh, Kingdom of Saudi Arabia, via an online survey. Measures include demographic data survey, Oxford Happiness Questionnaire, Trait Emotional Intelligence Questionnaire, and Caring Behaviors Inventory scale. Descriptive and multiple regression analyses were conducted for this study. Results: Nursing students reported their highest degree of caring was in terms of ‘respectful differences to others’, while their lowest was in ‘knowledge and skills’. Emotional intelligence and happiness were significant predictors of caring behaviors and explained the variance in assurance of human presence (17.5%), knowledge and skills (17.5%), respectful differences to others (18%), and positive connectedness (12.9%). In the final regression model, emotional intelligence and happiness were significant predictors of caring behaviors and explained 19.5% of the variance. Conclusions: Emotional intelligence and happiness among nursing students were found to be important factors to improve their caregiving behaviors. Therefore, nursing educators should consider integrating emotional intelligence and happiness interventions for students into their curriculum.

Nurses experience high levels of stress as they deal with the patients having complex health care problems. Stress in nursing affects the practice of nursing profession worldwide. In response to this, the investigators explored the sources of work-related stress (WRS) among Omani Nurses. Samples were selected through proportionate population sampling from 5 selected tertiary care hospitals. Data were collected through self-administered nursing stress scale (NSS). The study included 383 Omani nurses. Descriptive and inferential statistics were used to analyze the data. The sources of WRS among nurses showed the percentage mean scores ranging from 8.5% to 21%. The overall mean score for the NSS was 42.85 ± 17.705. Out of 7 subscales, the highest level of WRS was on workload with a mean score of 8.99 (21%) followed by emotional issues related to death and dying 8.72 (20.4%). The lowest mean score was seen on the lack of support 3.65 (8.5%) and inadequate preparation to meet the emotional demands of patients and their families 3.86 (9%) of the total mean. WRS was associated with the nursing position as staff nurses, performing night shift and reduced job satisfaction. The study's results may help in developing human resource strategies aimed at minimizing nurses’ stress and improving quality of health care and task force performance.

Introduction Emotional stress and anxiety during COVID-19 pandemic has gained a lot of attention. The capacity to withstand from the manipulated thinking and COVID-19 related stress and anxiety depends on the resilience level of an individual. Cognitive behavioral therapy (CBT) has patronizing benefits for people affected with altered mental health. Relieving COVID-19 related anxiety using CBT has beneficial impact on health and improves quality of life of people. Objective Aimed to relieve the anxiety of Omani population during COVID-19 pandemic using CBT. Methods This research utilized a pre-experimental one group pre-test post-test design. A non-probability convenient sampling technique was used to select 96 Omani people who fulfilled the inclusion criteria. The pre-anxiety level was assessed using CAS (Corona virus Anxiety Scale). The participants who scored above nine in the scale were given three sessions of CBT. Post-anxiety level was assessed using CAS after three CBT sessions. Results The study revealed that the level of anxiety reduced during post-test (6.35) after intervention when compared to pre-test (13.22). The CBT intervention was effective in reducing the anxiety in the post-test at p ≤ .000. Conclusion CBT is effective in reducing COVID-19 related anxiety among the Omani population. Therefore, this strategy is highly recommended in people having mental health issues.

Epidermolysis Bullosa (EB) is a very rare genetic skin disorder associated with skin fragility. It results in blister formation on the skin. The purpose of this paper is to update the progress of a child with Dystrophic EB (DEB) who survived from infancy to preschool years and later died with recurrent skin blisters, bone marrow transplantation, and life support measures. A case analysis was done to evaluate the progress of the child. The mother of the child signed the written informed consent and granted permission to publish the details of the child with images and without disclosing the identifying information. The management of EB requires a multidisciplinary team approach. The care of the child should be aimed at protecting the child’s skin from injury, nutritional support, meticulous wound care, and management of complications as required. The prognosis varies from case to case.

Introduction The COVID-19 pandemic significantly impacted the world in 2020. Every country adopted quarantine measures to prevent the transmission of the coronavirus infection. These measures resulted in dramatic changes in the daily lives of most people. In the academic world, students faced a shift from the traditional classroom-based teaching to virtual distance learning platforms. This shift in nursing education posed challenges both to the instructors and students as they were not fully prepared for this transition. Objective The study assessed the nursing students’ satisfaction with the virtual learning experience during the COVID-19 pandemic in selected nursing colleges in India. Methods The study was conducted in four nursing colleges in India. A total of 1,166 Diploma, Post Basic BSc (N), BSN, and MSN nursing students participated in the study. Ethical approval was obtained from all the nursing colleges included in the study. The Google Forms satisfaction survey included student, teacher, course, technology, environmental, and practical dimensions. Results The response rate was 86.31% (n = 1,166). The overall satisfaction with virtual theory and practical classes has a mean and SD score of 67.14 + 11 and 16.21 + 3.46, respectively. The results showed that overall 51% of the students had good satisfaction with virtual theory classes while 48% had moderate satisfaction. In terms of overall satisfaction with virtual practical classes, approximately 39% had good satisfaction, 58% had moderate satisfaction and nearly 3% had poor satisfaction. In addition, the students expressed that they had good satisfaction with Teacher dimension (64.3%), Student dimension (63%), and Course dimension (57.2%). On the contrary, they expressed poor satisfaction in the Technical dimension (11.3%) and Environmental dimension (5.6%). The results showed that the courses, the place of attending class, and health issues were significantly associated with the student's level of satisfaction with virtual learning. Conclusion Although the majority of the students rated their satisfaction level as being “good” in virtual theory classes and “moderate” in virtual practical learning, most of them were dissatisfied with the Technical and Environmental dimensions of virtual learning. This results calls for blended learning strategies to be designed to enhance better learning outcomes and, to ensure deepened level of satisfaction with virtual learning activities.

Knee osteoarthritis (KOA) is the most common type of arthritis affecting people of older age. The study assessed the effectiveness of nurse-led intervention on quality of life (QOL) of patients with KOA. A quasi-experimental pretest–posttest control group research design was adopted. Data was collected from 200 patients with KOA. The pre- and post-interventional QOL were assessed on the 15th day, 30th day, 60th day, and 90th day with a 36-item short-form health survey. A remarkable statistically significant improvement in QOL of patients with KOA in the study group was found in the IV test conducted on the 90th day ( P

Introduction. Caregivers of children with chronic illness are at risk of having impairment in their quality of life (QOL). We systematically reviewed the available literature related to the Health Related Quality Of Life (HRQOL) of caregivers of children with Phenylketonuria (PKU). Methods. We comprehensively searched in electronic databases including Scopus, Science Direct, CINAHL, Medline, PubMed, Google scholar, and ProQuest. The search criteria included studies with samples more than one, children suffering from PKU, exploring parents or primary caregiver’s HRQOL, published from 2010 to 2020, full article available for download and published in English. Eight studies including 5 cross sectional studies, 1 open label trial, and 2 surveys were systematically reviewed. Results. Seven out of 8 studies have established a negative correlation between PKU and parent’s HRQOL in at least 1 of the domains. In one study, the HRQOL of parents is higher than their population norms. Conclusion. Most of the caregivers had poor to moderate HRQOL. More studies are required to explore HRQOL of caregivers of children with PKU using similar tools and outcome measures addressing all the domains of HRQOL in order to have more clarity on the impact of PKU on caregiver’s HRQOL. Interventional studies might help in improving the HRQOL of caregivers.

Introduction: Telenursing during the COVID-19 pandemic with an emphasis on self-care is an effective approach to help patients, hospitals, as well as community. Despite the many challenges and benefits, tele-nursing can be used to help COVID 19 patients with new technologies. This study aimed to explore the challenges and opportunities of using tele-nursing in the COVID 19 Pandemic for helping patients with COVID 19 to gain better care. Material and Methods: An integrative review was conducted from December, 2019 to January, 2021. Databases of PubMed, MEDLINE, Web of Science, Scopus, CINHAL, and google scholar were searched on the concept of tele-nursing by using the following keywords, of COVID-19, Coronavirus, Telenursing, nurse roles, technology, Pandemics and Internet. DaA ta were analyzed according to Broome method. Results: The main results of tele-nursing in COVID 19 includes: implementation problems, insurance coverage, prevention of nurses, the problem of continuing care, and changing the roles of nurses’ infections, development of nursing knowledge, the emergence of technological care providing, emphasis on patient independence and transmission cycle control. Conclusion: Tele-nursing, this, despite the challenges, has many benefits that are effective in the current situation and effective, and reliable measure, through effective planning and implementation, help control COVID-19.

Background: Case study analysis is an active, problem-based, student-centered, teacher-facilitated teaching strategy preferred in undergraduate programs as they help the students in developing critical thinking skills. Objective: It determined the effectiveness of case study analysis as an effective teacher-facilitated strategy in an undergraduate nursing program. Methodology: A descriptive qualitative research design using focus group discussion method guided the study. The sample included undergraduate nursing students enrolled in the Maternal Health Nursing Course during the Academic Years 2017 and 2018. The researcher used a purposive sampling technique and a total of 22 students participated in the study, through five (5) focus groups, with each focus group comprising between four to six nursing students. Results: In total, nine subthemes emerged from the three themes. The themes were “Knowledge development”, “Critical thinking and Problem solving”, and “Communication and Collaboration”. Regarding “Knowledge development”, the students perceived case study analysis method as contributing toward deeper understanding of the course content thereby helping to reduce the gap between theory and practice especially during clinical placement. The “Enhanced critical thinking ability” on the other hand implies that case study analysis increased student's ability to think critically and aroused problem-solving interest in the learners. The “Communication and Collaboration” theme implies that case study analysis allowed students to share their views, opinions, and experiences with others and this enabled them to communicate better with others and to respect other's ideas which further enhanced their team building capacities. Conclusion: This method is effective for imparting professional knowledge and skills in undergraduate nursing education and it results in deeper level of learning and helps in the application of theoretical knowledge into clinical practice. It also broadened students’ perspectives, improved their cooperation capacity and their communication with each other. Finally, it enhanced student's judgment and critical thinking skills which is key for their success.

Introduction Communication with hospitalized patients is crucial to improve the quality and safety of health care. Methods The study assessed the communication methods used by nurses while communicating to non-speaking critically ill patients. The participants included staff nurses working in ICU, CICU, HD units of neuro- surgical, orthopedic, medical and oncology wards. Purposive sampling technique was used to recruit a total number of 194 nurses. The communication methods used were assessed by a questionnaire comprised of a list of 21 strategies used to communicate with non-speaking patients. Results The most commonly used strategies were reading the patient’s mouthing words, encouraging the patient by telling them that they are doing well and nurses helping them to get better, assessing the patients for their communication ability, “thumps up” to indicate “yes”, “shake head” indicating “no”, use OK, or point to body parts, speaking slowly and waiting for the patient’s response, spending time to listen patiently to what the patient say and touching the non-speaking critically ill patient when the nurse speaks with the patient. Conclusion The study reported that the nurses used variety of communication strategies while communicating to non- speaking critically ill patients. However very few nurses used Augmentative and alternative communication strategies to communicate to non-speaking critically ill patients. The study recommends the importance of establishing Augmentative and Alternative Communication strategies in the hospitals.

Introduction Utilizing simulation in nursing education is increasingly becoming a popular teaching pedagogy. Simulation provides opportunity to the nursing students to practice the clinical skills through various real life like situational experiences. Simulation improves the clinical decision making skills of the nursing students. Objective A descriptive, cross sectional, correlational study was conducted to evaluate the efficacy of simulation using NLN/Jeffries Nursing Education Simulation Framework on satisfaction and self-confidence of Undergraduate nursing students. Methods 370 undergraduate nursing students participated in the study. Educational practices, Simulation design, Student satisfaction and Self-confidence questionnaires were used. Results Majority of the nursing students perceived agreement on various domains of student satisfaction, self-confidence, educational practices and simulation design used in the curriculum. The students were self-confident to care for similar patients in the clinical area and satisfied with this instructional method. Satisfaction and self-confidence were correlated with educational practices and simulation design. Conclusion Developing simulations using NLN/Jeffries Nursing Education Simulation framework will provide meaningful, engaging, and pedagogically sound experiences for the students. Pre-briefing and de-briefing are meaningful strategies to enhance the learning of students.

Introduction Osteoarthritis (OA) is one of the emerging health issues in Asian countries in elderly population. Knee osteoarthritis (KOA) is a major age related public health issue characterized by progressive loss of articular cartilage resulting in pain, functional impairment, disability and diminished quality of life. The aim of this study was to assess the effectiveness of Isometric exercise and counseling on level of pain among patients with KOA. Methods Quantitative research approach and a quasi-experimental pretest-posttest control group research design was utilized. The study was conducted at MIOT hospital and Devadoss Hospital, Madurai, Tamil Nadu, India. Data was collected from a total of 200 patients with KOA, 100 in the study and 100 in the control group. These patients were clinically diagnosed to have Grade I, II and III KOA. The demographic variables and clinical profile were recorded for both groups. The self-administered WOMAC questionnaire was used to assess the level of pain of KOA patients. Post-test assessment was carried out on Day 15, Day 30, Day 60 and Day 90. The data was analyzed using SPSS windows 16. Results The comparison of level of pain between the study and control group has showed a remarkable reduction in level of pain among patients with KOA in the study group. The post-test level of pain in the study group was 14.9% (13.3% -16.5% with 95% CI) and was 2.1% (1.2% -3.0% with 95% CI) in the control group. It showed that the reduction in the level of pain was higher in the study group than the control group. Conclusion The study found that a 12-week Isometric exercise and counseling program has significantly reduced pain, stiffness and improved physical function. Therefore, the Isometric exercise and counselling should be adopted as a routine care in the hospitals treating patients with KOA.

Interprofessional education (IPE) is an integral educational outlook that is necessary to make sure that the graduates of an allied health care education are able to be valuable members or leaders of collaborative healthcare practices. Literature and resources are available about various models that have been used by different institutions to integrate IPE as part of their curriculum. With the growing need for collaborative practice, the curriculum must be designed to foster competencies required for IPE. There are challenges present, but with the concerted effort of the administration, faculty, and students, the benefits of IPE can be enjoyed by the institution and eventually by patients.

Background Simulation is the most adopted teaching methodology in nursing education. Objectives This article investigated the outcome of repeated simulation experience on self-confidence, critical thinking, knowledge, competence, and satisfaction of nurses and nursing students. Methods The Scholarly literature published in English for the period of 2011 to 2019 was reviewed. Results Repeated simulation enhances students’ self-confidence, knowledge, competence, critical thinking, and satisfaction. Conclusions Repetitive simulation experience is valued by the nurse educators as a valuable teaching methodology to reinforce the student's learning outcomes.

Introduction During 100 BC, the world perceived that the nurses are meant for rendering care to the sick individuals. During 600 to 700 BC, the nurse was considered as the one who attends to the patient, is pleasant in his or her demeanor, does not speak ill of anybody, is attentive to the requirements of the sick, and follows the instructions of the physicians. The men who were wise and passionate to help the sick were trained by a medical teacher for years together who later became a doctor. India is the pioneer country in developing the formal nursing curriculum. With the emergence of British and establishment of East Indian Company and Imperial Government, the nursing education became more formalized. No men came forward to nursing. Only women have opted nursing and were employed as nurses. Very few men were trained as nurses informally and were sent for war field to take care of the injured soldiers. It took several years to elevate the standards of male nurses. Methods The data were retrieved from the records of Tamil Nadu Archives and Historical Research, Chennai, Tamil Nadu, India. The written permission was obtained from the commissioner for collecting the data retrospectively. All the collected data were checked for its consistency by matching the data again with the retrieved database. Results Great British Government has brought the reformations in bringing up the working standards of male nurses. The reformation and renaissance of male nurses started in 1938, and it reached a level of recognition in 1950. The male nurses were recruited in 1938, but they reached the position of a head nurse by 1950. Conclusion The male nurses had a long journey to overcome the hurdles in their practice and professional advancement. In recent years, the male nurses are identified for their extraordinary contribution in the delivery of health care.

Objectives: We conducted this study to assess the risk factors of gestational anemia and evaluate the effectiveness of a culturally-tailored nutrition educational intervention on hemoglobin (Hb) status among pregnant Omani women. Newborn birthweight was used as a birth outcome. Methods: The study was conducted in two phases. The first phase investigated the risk factors associated with gestational anemia in 206 Omani women who were ≥ 20 years old and had at least completed 12 weeks of gestation. A suitable sample was recruited at a tertiary teaching hospital in Muscat, Oman. Hb status was recorded, and backward linear regression was used to analyze the demographic and obstetric variables associated with Hb levels. In the second phase, a specially designed culturally-tailored nutrition educational intervention was delivered to women in the study group by trained research assistants whereas women in the control group received routine care only. The Hb levels of the pregnant women and birth weight of newborns after the intervention were evaluated in the second phase of the study. Results: The prevalence of gestational anemia among 206 pregnant Omani women was 41.7%. A significant negative relationship was found between Hb and parity whereas a positive relationship was found between Hb and gestational age. The Hb level increased as the gestational age advanced (β = 0.31, p < 0.050) and decreased as the parity increased (β = -0.22, p < 0.050). The pre-post mean difference of Hb levels in the study group was 11.0 g/dL and in the control group was 10.7 g/dL. The difference between the pre- and post-test Hb levels for the study group was significant (t = 3.58, p = 0.001), indicating that the culturally-tailored nutrition education intervention was effective in improving the Hb level in pregnant Omani women. No significant difference was found between the study and control group with respect to birth outcomes. Conclusion: The prevalence of gestational anemia is high in pregnant Omani women. The use of a specially designed culturally-tailored nutrition education intervention for pregnant women supplemented with follow-up reminders can reduce the occurrence of gestational anemia. Such programs are ultimately necessary in light of the high prevalence of gestational anemia in developing countries.

Optimal breastfeeding practices entail the early initiation of breastfeeding soon after delivery of the baby, exclusive breastfeeding for the first six months of life and the continuation of breastfeeding complemented by solid food up until two years of age. Breastfeeding has wide-ranging health benefits for both the mother and her child; however, many factors contribute to low rates of exclusive breastfeeding. This article highlights the benefits of optimal breastfeeding as well as trends and determinants associated with breastfeeding both worldwide and in Gulf Cooperation Council (GCC) countries. Strategies to optimise breastfeeding and overcome breastfeeding barriers in the GCC region are recommended, including community health and education programmes and ‘baby-friendly’ hospital initiatives. Advocates of breastfeeding are needed at the national, community and family levels. In addition, more systematic research should be conducted to examine breastfeeding practices and the best strategies to promote breastfeeding in this region.

Introduction. The children with Sickle Cell Disease (SCD) generally have poor Health Related Quality of Life (HRQOL). The study aimed to evaluate the effectiveness of nurse led intervention on HRQOL among children with SCD. Methods. A total of 30 samples were selected using convenient sampling. Children with SCD and their caregivers completed Pediatric Quality of Life Inventory (PedsQL) SCD-Module version 3.0. The nurse led intervention was given to the study group for 10 consecutive weeks. The control group received the routine medical care. On completion of 10 weeks, the post-test was conducted. Results. The participants in study group had poor HRQOL scores P>0.05 in pre-test. After nurse led intervention, the HRQOL score in the study group significantly improved P

Introduction: Theoretically, caring relationship between faculty – student generates a caring moment. However, there is a scarcity of empirical evidence about how caring interactions with faculty can enhance students’ caring outcomes. Aim: The aim of this study was to identify the levels of students’ and instructors’ caring behavior and to explore the correlations between instructors’ and students’ caring behavior. Methods: A descriptive, non – experimental design has been used in this study. Data collection was based on interviews using two standardized questionnaires; the Nursing Students’ Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Respondents were consisting of nursing students from identified schools and colleges of nursing in different countries. Data were analyzed with SPSS version 21.0. Results: The sample was consisted of 368 nursing students (91% female, 9% male) from seven countries (26% Philippines, 31.5% Greece, 1% Kenya, 0.5 Oman, 35.5% India, 5% Nigeria, 0.5% Saudi Arabia). Forty two percent of students are in the second year of studies, 13% in the third year and 45% in the fourth year. The mean score of NSPIC was 4.02±0.30 and the mean of CBI was4.56±0.13. The mean for each factor of NSPIC was 4.39±0.13 for the factor “instills confidence through caring”, 3.92±0.212 for “supportive learning climate”, 4.06±0.06 for “appreciation of life’s meaning”, 3.66±0.11 for “control versus flexibility” and 4.01±0.48 for “respectful sharing”. The mean for each factor of CBI was 4.63±0.11 for the factor “assurance”, 4.58±0.06 for “knowledge and skills”, 4.55±0.18 for “respectful” and 4.47±0.14 for “connectedness”. Correlation analysis showed statistically significance between relevant variables. Conclusions: Instructors’ caring behavior affects nursing students’ caring behavior. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.