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Introduction Upsurge in life expectancy, filial responsibility of caring, and healthcare advances have increased the older adult population in Asia. The last decade has witnessed nuclear families' proliferation in Asia, leaving family caregivers with more accountability and responsibility. This review explores the pattern of caregiver burden among caregivers of older adults with chronic illness in Asia. Methods PRISMA guidelines serves as the framework for this systematic review. Studies from selected databases assessed caregivers' physical state, psychological dysfunction, and or burden as an outcome measure. The Newcastle - Ottawa Quality Assessment Scale appraised the quality of the selected studies. Results The review included 12 research articles. Caregivers consistently report mild to a moderate burden. Care recipient with functional dependency, comorbidities, memory, and sleep impairments, escalate caregiver burden. Caregiver variables intensifying burden were advancing age, male gender, spouse as a care recipient, longer care provision duration, and no assistance. Conclusion Optimal levels of emotional well-being, significant family/social support, and self-preparedness among caregivers are grounds for their empowerment. Practical Implications A paradigm shift from 'caregiver burden' to 'caregiver resilience' is advocated. Routine screening, preventive measures (skill-building and psychosocial empowerment), and restorative services (respite care and problem-based home visiting) for caregivers are forecasted.

Background Low birth weight (LBW) in infants is a critical issue worldwide. If the issue is not recognized early, it can lead to high mortality and morbidity rates. Mothers and caregivers of LBW newborns holds a great responsibility and need appropriate information and expertise in caring for the LBW newborns. This study aimed to evaluate the effectiveness of a Nurse led structured teaching program (NLSTP) on the knowledge and practice of mothers of LBW infants. Methods A quantitative pre-experimental one group pre-test post-test research study was conducted. A sample of 30 postnatal mothers of LBW babies meeting the inclusion criteria were selected. The knowledge and practices of postnatal mothers on the care of LBW babies was tested using a structured interview schedule and a checklist before the administration of NLSTP. Thereafter, the NLSTP was conducted using an educational booklet. After the NLSTP, the knowledge and practice were assessed on the 7th day. Results The findings of the study reflected poor knowledge and practice scores before the intervention in the pre-test. However, the mothers gained a good level of knowledge showing marked improvement in their practices after the NLSTP was implemented. The mean post-test knowledge score (17.6) was significantly higher than the mean pre-test knowledge score (10.8) with a SD of +1.33. Likewise, the mean post-test practice score (15.6) was significantly higher than the mean pre-test practice score (8.23) with a SD of +7.5. The paired ‘t’ test computed between pre-test and post-test knowledge scores (t = 67.6) and practice scores (t = 5.28) were highly significant at p ≤ 0.05 level. A significant association was found between the pre-test knowledge scores and monthly family income (p Conclusion This study highlights that post-natal mothers have a lack of expertise in caring for their LBW babies. The NLSTP targeted at improving the knowledge and practices of post-natal mothers regarding the care of their LBW babies can help reduce the morbidity and mortality rates of LBW babies.

Sickle cell disease (SCD) can significantly impair the health-related quality of life (HRQOL) of children and adolescents. This review aimed to assess current evidence regarding the HRQOL of children and adolescents with SCD in the Middle East and North Africa region. A systematic search of various databases was conducted to identify relevant articles, including MEDLINE® (National Library of Medicine, Bethesda, Maryland, USA), Scopus® (Elsevier, Amsterdam, the Netherlands), Cumulative Index to Nursing and Allied Health Literature®, Masader (Oman Virtual Science Library, Muscat, Oman) and EBSCOhost (EBSCO Information Services, Ipswich, Massachusetts, USA). A total of 533 articles were identified; however, only 10 were eligible for inclusion in the final analysis. Results from these studies showed that children and adolescents with SCD had compromised HRQOL compared to their healthy peers, particularly in terms of physical, psychosocial, familial, financial and academic functioning. Therefore, interventions are necessary to improve overall HRQOL outcomes for this population. Keywords: Sickle Cell Disease; Health-Related Quality Of Life; Infants; Children; Adolescents; Middle East; North Africa.

Background: Back pain (BP) could be present either as a pelvic girdle pain between the posterior iliac crest and the gluteal fold or as a lumbar pain over and around the lumbar spine. The management aims to reduce the discomfort and the impact on the pregnant woman’s quality of life. Purpose: The study aimed to determine the effect of back-stretch (BS) exercise on the perception of BP during pregnancy. Design and methods: A quasi-experimental pretest-posttest control group research design was used. The study was conducted in Gottigere health center, Bangalore, Karnataka, India. The BS exercise intervention was provided to the mothers of the study group. Data were collected from 60 antenatal mothers, 30 in the study, and control group, respectively who were in their 28-32 weeks of gestation by using a non-probability purposive sampling technique. The intensity of BP was estimated using the visual analogues scale. Findings: The comparison between the study and control group has proved a remarkable BP reduction among the antenatal mothers after BS exercise in the study group. The post-test mean intensity of BP was lesser than the pre-test mean intensity of BP (48.73< 54.83) among mothers of the study group (P≤0.001). The antenatal mothers of the control group did not have a statistically significant reduction in the level of BP. Conclusion: The BS exercise is effective in reducing BP among antenatal mothers during their antenatal period.

Background Providing adequate and quality clinical training to student nurses is a major issue in nursing education. In the Middle East, this issue is more prominent because providing intimate healthcare to women in maternity nursing, especially by male nursing students, remains a challenge. Purpose This study compared the effects of a combination of traditional clinical training with high-fidelity simulation (TCT+HFS) activities vs TCT alone on the clinical competency and knowledge among students enrolled in a maternity nursing course in a Middle Eastern public university. Method A quasi-experimental research design was adopted in the study. The sample consisted of 74 students (40 in the TCT group and 34 in the TCT+HFS group) from a cohort of nursing students in a Middle Eastern university. The Creighton Competency Evaluation Instrument and a 29-item, researcher-designed knowledge scale was used to measure the relevant outcomes. Results No significant difference was observed in the knowledge (F = 1.064, P = 0.306) or clinical competency scores (F = 0.168, P = 0.683) between the TCT+HFS group and the TCT group. Conclusion Substituting 25% of the clinical hours with HFS may yield similar learning outcomes (knowledge and clinical competency) as TCT.

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.

Background Inter Professional Education and Collaboration (IPEC) is grounded on mutual respect, enhances collaborative practice, and increases satisfaction among health care professionals. Purpose The study was conducted to assess the level of knowledge and readiness for IPEC among nursing students. Methods The student's level of knowledge was assessed using a 20 item questionnaire while their readiness for IPEC was measured using the Readiness for Interprofessional Learning Scale (RIPLS) comprising 19 items. A total of 125 nursing students participated in the study and data was analyzed using Statistical Package for the Social Sciences (SPSS) version 25 Discussion The mean level of knowledge was 44.41 with SD of 4.72. The mean readiness score was 79.09 with the SD of 11.77. There is no significant association between the knowledge and readiness of nursing students regarding IPEC and their demographic variables at 0.05 confidence level. Conclusions Majority of the students had moderately adequate knowledge about IPEC and high level of readiness towards IPEC. This implies that when appropriately implemented, the students will reap the benefits of IPEC, which has the potential to improve their ability to provide holistic nursing care to their patients.

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.

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Hearing loss affects access to spoken language, which can affect cognition and development, and can negatively affect social wellbeing. We present updated estimates from the Global Burden of Disease (GBD) study on the prevalence of hearing loss in 2019, as well as the condition's associated disability. Methods: We did systematic reviews of population-representative surveys on hearing loss prevalence from 1990 to 2019. We fitted nested meta-regression models for severity-specific prevalence, accounting for hearing aid coverage, cause, and the presence of tinnitus. We also forecasted the prevalence of hearing loss until 2050. Findings: An estimated 1·57 billion (95% uncertainty interval 1·51–1·64) people globally had hearing loss in 2019, accounting for one in five people (20·3% [19·5–21·1]). Of these, 403·3 million (357·3–449·5) people had hearing loss that was moderate or higher in severity after adjusting for hearing aid use, and 430·4 million (381·7–479·6) without adjustment. The largest number of people with moderate-to-complete hearing loss resided in the Western Pacific region (127·1 million people [112·3–142·6]). Of all people with a hearing impairment, 62·1% (60·2–63·9) were older than 50 years. The Healthcare Access and Quality (HAQ) Index explained 65·8% of the variation in national age-standardised rates of years lived with disability, because countries with a low HAQ Index had higher rates of years lived with disability. By 2050, a projected 2·45 billion (2·35–2·56) people will have hearing loss, a 56·1% (47·3–65·2) increase from 2019, despite stable age-standardised prevalence. Interpretation: As populations age, the number of people with hearing loss will increase. Interventions such as childhood screening, hearing aids, effective management of otitis media and meningitis, and cochlear implants have the potential to ameliorate this burden. Because the burden of moderate-to-complete hearing loss is concentrated in countries with low health-care quality and access, stronger health-care provision mechanisms are needed to reduce the burden of unaddressed hearing loss in these settings. Funding: Bill & Melinda Gates Foundation and WHO.

Pregnancy and child birth are common and highly important aspects of women’s life. The focus of midwifery is on the care of essentially healthy women, and the care extends to women with social, medical or obstetric risk factors. A descriptive study to assess the knowledge of antenatal mothers on selected health problems complicating pregnancy was conducted. 100 antenatal mothers were selected through simple random sampling method. Among 100 antenatal mothers, 83% had inadequate knowledge and 17% had moderately adequate knowledge. There was highly significant association between the knowledge of antenatal mothers and their demographic variables such as educational status, occupation, and monthly income. It is reported that many of the antenatal mothers were having poor knowledge of selected health problems complicating pregnancy and its clinical manifestation and risk factors. Hence, it is necessary to create awareness among antenatal mothers which might improve their health seeking behaviors. This can be achieved by giving health education to the antenatal mothers. So the researcher had given instructional manual to improve knowledge regarding selected health problems complicating pregnancy which included iron deficiency anemia, gestational diabetes mellitus and pregnancy induced hypertension.

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.

The study was conducted to assess the health related quality of life of the parents of children with inborn errors of metabolism (IEM). The study was conducted at the Genetic and metabolic outpatient department of Sultan Qaboos University Hospital, Oman. The parents of children with metabolic diseases who were accompanying their children to the outpatient clinics were the samples. An explorative descriptive survey design and Convenient sampling technique were used to select the sample. Study included 72 parents of children with metabolic diseases aged between 20 and 55 years. The RAND 36-Item Health Survey version was used to assess the health related quality of life of parents. The results shows lower mean scores in subscales of 'general health' and vitality. Parents with higher educational levels showed higher levels of PCS and MCS scores than parents with lower educational levels. Parents with higher monthly income and younger age showed higher quality of life. A significant association was found between supporting persons and HQoL in the dimensions of the "role limitations due to physical" (p

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<0.05. The control group did not show any significant difference in the pretest and post-test. Discussion. Therefore nurse led intervention is effective in improving HRQOL among children with SCD.

Background Caring is the core and essence of the nursing profession. Nurse educators, are in a key position to role model for perspective nurses the role of caring while including caring as a vital component in a nursing curriculum. Objectives This paper is a report on students' perceptions of instructors' caring behavior in four countries: India, Greece, Nigeria, and the Philippines. Methods This study utilized a quantitative, cross-sectional, comparative approach. A total of 450 nursing students participated with an almost equal nursing student frequency distribution. The main instrument used in this study was the Nursing Students' Perceptions of Instructor Caring (NSPIC). The study was conducted during the months of September 2013 to January 2014. Descriptive statistics, correlations analysis, linear regression model and one-way analysis of variance (ANOVA) were used to analyze the data collected. Findings The highest rated subscale in the NSPIC was “instills confidence through caring” (M = 4.268, SD = 0.964), while the lowest ranked subscale was for the subscale “Control versus flexibility” (M = 3.609, SD = 1.076). No significant correlations were found between the NSPIC scale and gender (F = 0.060, p = 0.807), age (F = 3.220, p = 0.073), educational level (F = 0.100, p = 0.752) and family status of students (F = 1.417, p = 0.235), except the country of origin (F = 3.703, p = 0.012, η2 = 0.024). Conclusion With this study as an initial investigation into ascertaining nursing instructors caring focused on a cross-country approach, nurse educators can utilize this information to better portray their role as a nurse educator when being perceived by their nursing students.

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: The risk factors of obesity changes around the world. Adolescence is identified as a critical period for the development of obesity related metabolic derangements. This study evaluated the predisposing factors of obesity among adolescent students in kancheepuram district, South India. Methods: This case control study was conducted in Kancheepuram district between July 2017 to September 2017. A total of 1656 adolescent boys and girls between the age group of 12 to 15 years were randomly selected from 12 schools (4 public schools, 4 matriculation schools and 4 government schools). The cases were obese adolescents and the controls were non obese adolescents. Univariate and Multivariate logistic regression analysis was conducted, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results: Various lifestyle factors including behavioral, dietary and family factors were identified as predisposing factors also for obesity. Conclusion: There is an urgent need to educate adolescents on the aspects of healthy food habits and desired lifestyles to prevent overweight/obesity and its associated ill effects.

Purpose The aim of this study was to identify perceptions of caring behaviors in student nurses from four countries. Methods This study employed a descriptive, comparative survey design. Four hundred sixty-seven students were recruited from four countries (Nigeria, India, Greece, and the Philippines) to participate in the study during the months of September 2013 to January 2014. Data were collected using the Caring Behavior Inventory. Findings The highest ranked subscale was “assurance of human presence” (4.827 ± 0.927), while “positive connectedness” (4.610 ± 0.949) was the lowest ranked subscale. There were no statistically significant correlations between the Caring Behavior Inventory scale and gender (F = 0.215, p = .643), educational level (F = 0.396, p = .529), and family structure of students (F = 0.680, p = .410), except for age (F = 9.380, p = .002, η2 = 0.141) and the country of origin (F = 5.772, p = .001, η2 = 0.036). Conclusion Students from four countries possess positive caring behaviors, specifically on physically based caring interventions, while there is a need to emphasize expressive caring behaviors during nursing education and training. Implication for Nursing Practice Caring interventions should be carried out in order to help students build or enhance their caring behaviors that can be adapted to clinical situations.

Key wordsCaring, caring behavior, nursing education, nursing instructors, nursing studentsAbstractPurpose: The aim of this study was to identify the correlation between instructors' and students' caring behaviors and to explore the impact of instructors' caring on students' perceptions of their own caring behaviors.Design: A descriptive, nonexperimental design was used in this study.Methods: A total of 586 student nurses from four countries (Greece, the Philippines, India, and Nigeria) were recruited to participate in this study during the months of September 2013 to January 2014. Data collection was based on interviews using two standardized questionnaires: the Nursing Students' Perception of Instructor Caring (NSPIC) and the Caring Behavior Inventory (CBI). Inferential statistics such as the Pearson r correlation and regression analysis were used to determine correlations between relevant variables.Findings: Student nurses perceived "instills confidence through caring" (mean = 4.275, SD = 0.755) as the most frequently demonstrated subscale, while "control vs. flexibility" (mean = 3.469, SD = 0.701) was the least demonstrated subscale. The highest self-reported subscale in the CBI was "assurance" (mean = 4.796, SD = 0.949), while "connectedness" (mean = 4.541, SD = 0.985) was the lowest self-rated subscale. The NSPIC correlated significantly with the CBI (r = .587, p Conclusions: Instructors' caring behaviors influenced nursing students' caring behaviors positively. Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competence of caring.Clinical Relevance: The knowledge generated from this study provides direction in developing useful and effective caring strategies and curricular programs for nursing students. Understanding this concept in a cross-cultural context is necessary in order to develop an international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.Nursing education plays an important role for the acquisition of and advancement of students' caring attributes. As a central value of the nursing profession, it is believed that human caring can be learned, taught, and measured through nursing education and, when introduced early, modeled and reinforced throughout the curriculum (Alpers, Jarrell, & Wotring, 2013 The future for these students will be that of becoming more aware of the importance of caring and of developing into caring practitioners (Carlson, Kotze, & Van Rooyen, 2003; Gramling & Nugent, 1998; Noddings, 1984). Through positive faculty modeling and role modeling, nursing students can be professionally trained to develop the competency of caring (McEnroe-Petitte, 2014). Moreover, when the climate of nursing education is perceived as caring, students acquire a professional way of being and learn to care as a professional nurse (Beck, 2001; Kelly, 2007; Labrague, 2012; Woodrow, 2003). However, currently no studies exist exploring the impact of instructors' caring on students' caring behaviors. In this study, the researchers were interested in exploring the effect of instructors' caring on students' caring behaviors from four countries: Greece, the Philippines, India, and Nigeria. Understanding this concept in a cross-cultural context is necessary in order to develop a common international perspective about caring, which is necessary in developing and formulating effective teaching and clinical strategies.BackgroundCaring is a core component of the nursing profession and has been considered an important indicator and the foundation of quality nursing education (Labrague, 2012; Watson, 2002). …

Background: The sustainable development goals (SDGs) aim to end HIV/AIDS as a public health threat by 2030. Understanding the current state of the HIV epidemic and its change over time is essential to this effort. This study assesses the current sex-specific HIV burden in 204 countries and territories and measures progress in the control of the epidemic. Methods: To estimate age-specific and sex-specific trends in 48 of 204 countries, we extended the Estimation and Projection Package Age-Sex Model to also implement the spectrum paediatric model. We used this model in cases where age and sex specific HIV-seroprevalence surveys and antenatal care-clinic sentinel surveillance data were available. For the remaining 156 of 204 locations, we developed a cohort-incidence bias adjustment to derive incidence as a function of cause-of-death data from vital registration systems. The incidence was input to a custom Spectrum model. To assess progress, we measured the percentage change in incident cases and deaths between 2010 and 2019 (threshold >75% decline), the ratio of incident cases to number of people living with HIV (incidence-to-prevalence ratio threshold