Relationship Between Quality of Sleep and Psychological Well-being Among Frontline Nurses During the COVID-19 Pandemic in Saudi Arabia.

Background: The coronavirus 2019 (COVID-19) pandemic is a world health emergency crisis that challenges the global health system and healthcare providers, especially frontline nurses' physical and mental well-being. Objective: The aim of the study was to examine the association between depression, anxiety, and sleep quality among nurses working in Saudi Arabian hospitals during the COVID-19 pandemic. Methods: This is an quantitative cross-sectional study. An online self-reported data was collected from 187 nurses who were on duty during COVID-19 pandemic. Results: About 87.2% of the nurses were female nurses; not surprising that 88% had poor sleep quality; 44.4% had moderate anxiety, and 44% of the studied nurses had mild to moderate depression. The study revealed that there was an association between level of anxiety and poor sleep quality. Poor sleep quality and emotional stability of nurses play a major role in quality of care and patients' safety. Conclusion: We conclude that healthcare leaders should adopt an occupational wellbeing program for nurses that focuses on their psychological wellbeing and sleep quality.

Sleep quality and fatigue among nurses working in high-acuity clinical settings in Saudi Arabia: a cross-sectional study.

BACKGROUND: Poor sleep quality is prevalent among nurses worldwide. Around two-thirds of nurses doing shift work are known to experience sleep problems and fatigue. Fatigue and sleep problems are linked to poor performance, impaired alertness, injuries, chronic diseases, compromised healthcare quality, and medical errors, all of which detrimentally impact nurses and threaten patients' safety. This area of research has received insufficient attention in Saudi Arabia; therefore, the purpose of this study was to examine the levels of sleep quality and perceived fatigue and their association among nurses working in acute care settings in comprehensive hospitals in Saudi Arabia. METHODS: A descriptive cross-sectional study using the Pittsburgh Sleep Quality Index and Chalder Fatigue Scale. Data was obtained via an online questionnaire that was distributed to nurses using the QuestionPro platform through hospital administrators, social media (WhatsApp), and personal contact. RESULTS: A total of 173 nurses completed the online survey. Most participants reported poor sleep quality (n = 127, 73.4%) and severe perceived fatigue (n = 156, 90.2%). Furthermore, the study revealed a significant correlation between the overall sleep disturbance and fatigue global scores (r = 0.57, P < 0.001), indicating that poor sleep quality was significantly associated with higher fatigue levels among the study sample. CONCLUSIONS: The current study found a significant association between sleep quality and severe fatigue in nurses working in high acute care settings in Saudi Arabia. It is very clear from the results that nurses are experiencing poor sleep and severe fatigue, which in turn, will negatively impact the nurse's quality of life and patient safety.

Cut-off scores of the Depression Anxiety Stress Scale-8: Implications for improving the management of chronic pain.

AIM: Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management. DESIGN: This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13-71 years). METHODS: Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist. RESULTS: Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake. CONCLUSION: CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities. IMPLICATIONS FOR PATIENT CARE: At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.

Knowledge and Attitudes of Critical Care Nurses Regarding Pain Management in Saudi Arabia.

Background: Approximately five million patients on yearly basis are being admitted to the critical care unit around the world. Around (77%) of these patients suffer from pain during their stay in critical care units. Undertreated pain aggravates anxiety, sleep deprivation, agitation, delirium, and depression that often lead to a chronic condition. There are various barriers toward recognition and proper management of pain such as sedation, the presence of endotracheal tube, healthcare providers lack of knowledge etc. Therefore, it becomes essential for the nurses to have the required knowledge related to pain, valid pain assessment tools, and proper management. Objective: The present study aimed at investigating the critical care nurses' knowledge and attitude towards pain management at a university hospital in Saudi Arabia. Methods: A descriptive cross-sectional design of 112 nurses working at intensive care units and emergency department. The data collected using a knowledge and attitude regarding pain (KASRP) survey. Results: Majority of nurses had inadequate knowledge regarding pain management. Among 112 nurses, only 8 nurses (7.1%) were with good level of knowledge compared by 54 nurses (48.2%) with poor level of knowledge. Results showed significant association between knowledge and attitude and the current position in the ICU (p=0.043). Conclusion: It is mandatory to monitor nurses' pain management knowledge continuously. As well as to emphasis significance of an educational programs that serve nursing practice.

Impact of Educational Program on Critical Care Nurses' Knowledge of ICU Delirium: A Quasi-Experimental Study.

Background: Cat Intensive care unit (ICU) delirium is a significant complication that increases the mortality, morbidity, and length of stay for critically ill patient. Objective: The aim of this study was to assess the critical care nurse's knowledge of ICU delirium and the effectiveness of an educational program about the recognition and assessment of ICU delirium on critical care nurse's knowledge. Methods: A quasi-experimental single group pre-test-post-test design was conducted using delirium knowledge assessment questionnaires. Results: The median post test score of overall nurses' knowledge was 76.2 (range 19.1-95.2) compared to the median pre-test score of 38.1 (range 14.3 - 61.9) indicating a significant change in nurses' knowledge after conducting the educational program (p<0.001). Conclusion: Critical care nurses' knowledge of ICU delirium was low before the intervention and increased significantly after delivering an educational program.

Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia.

Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.

Assessment of Pain and Anxiety During Arteriovenous Fistula Cannulation Among Hemodialysis Patients: A Cross-Sectional Study in Saudi Arabia.

Background: The number of hemodialysis patients has dramatically increased over the years. The cost of healthcare provision to those patients has been rising as well. In addition, pain management during arteriovenous fistula (AVF) cannulation is an important aspect of nursing care. Patients' outcomes and appropriate pain control are one of the most critical issues in healthcare. Purpose: To measure the level of pain and anxiety associated with arteriovenous fistula cannulation among hemodialysis patients. Methods: A correlational cross-sectional research design was used in this study at the Hemodialysis Unit at King Fahad Hospital of the university, Al-Khobar, in the Eastern region of the Kingdom of Saudi Arabia using a self-administered questionnaire. Ethical approval was obtained. A convenience sample of 117 HD patients from the previous mentioned setting were included in the study. The data were collected using three tools: sociodemographic characteristics, Numerical Analogue Scale (NAS), and Hospital Anxiety and Depression Scale (HADS). Using IBM SPSS software package version 25.0, statistical significance of the obtained results was judged at the 5% level. Results: According to the results, most of the participants experienced a mild to moderate level of pain and anxiety during arteriovenous fistula cannulation. Furthermore, there was a positive association between the level of pain and anxiety, with statistical significance (p<0.001). Conclusion: Based on the results of the study, most of the study participants' level of pain and anxiety during AVF cannulation ranged between mild and moderate.

Nurses' Knowledge and Practices Regarding the Prevention of Deep Vein Thrombosis in Saudi Arabia: Descriptive Cross-Sectional Study.

Background: Deep venous thrombosis (DVT) is a prevalent fatal problem and a major cause of avoidable death among morbid hospitalized patients. It is estimated that up to 900,000 people in the United States are affected each year. Additionally, around 60,000 to 100,000 Americans die annually of DVT. Objective: To assess studied nurses' knowledge and practice regarding Deep venous thrombosis prevention. Methods: A descriptive cross-sectional research design was used in this study at King Fahad Hospital of the University in the Kingdom of Saudi Arabia, using a self-administered questionnaire. A total of 67 nurses from medical and surgical units were included in the study. Data were coded and analyzed using SPSS 23.0 version. Results: According to the results, the knowledge and practice of nurses were found to be high. Total knowledge score regarding prevention of deep venous thrombosis (72.8±9.6), regarding studied nurses, score for each subcategory: general knowledge category (70.6±15.5), deep venous thrombosis risk factors category (66.5±13.1), and deep venous thrombosis prevention category (90.1±10.5). in addition, a statically significance association between nurses' years of experience (p=0.026), previous Deep venous thrombosis education (p=0.012), and total knowledge score regarding the prevention of deep venous thrombosis. Concerning the self-reported practice, the majority of the studied nurses have shown a very high practice score. Yet, there was no statically significant association between the sociodemographic characteristic and practice. Furthermore, a positive association between total knowledge and reported practice score but statically insignificant (p=0.075). Conclusion: Based on the result of the study, most of the studied nurses' level of knowledge and practice concerning the prevention of deep vein thrombosis ranged between high and very high.