Post COVID-19 mucormycosis in critical care settings: A prospective cohort study in a tertiary care center in Egypt.

BACKGROUND: The emergence of mucormycosis as a life-threatening fungal infection after the coronavirus disease of 2019 (COVID-19) is a major concern and challenge, but there is limited information on the risk factors for mortality in patients. METHODS: We conducted a prospective cohort study from May 2021 to April 2022 to determine the in-hospital outcomes of post-COVID-19 mucormycosis during the intensive care unit (ICU) stay. The sample of the study was collected as consecutive sampling using all accessible patients in the study period. The Statistical Package for Social Sciences (SPSS), version 25 (IBM, Chicago, Illinois, USA) was used for statistical analysis. RESULTS: Among 150 patients with post-COVID-19 mucormycosis, the majority had a primary sinus infection (86.0 %), while 11.3 % had both sinus and ocular infections, and 2.7 % had sinus and cutaneous infections. Around 21 % (n = 31) of patients deceased after staying in the ICU for a median (range) of 45.0 (10.0-145.0) days. The majority of the patients who deceased had pneumonia patches on computed tomography (CT) (90.3 %) while none of the patients who were discharged had pneumonia patches (p < 0.001). The deceased group had higher rates of pulmonary embolism (93.5 %) compared to the surviving groups (21.8 %). In a multivariate Cox regression analysis, the risk of death was higher in older patients above 60 years old (hazard ratio (95 %CI): 6.7 (1.73-15.81)), increase among patient with history of steroid administration (hazard ratio (95 %CI): 5.70 (1.23-10.91)), who had facial cutaneous infection with mucormycosis (hazard ratio (95 %CI): 8.76 (1.78-25.18)), patients with uncontrolled diabetes (hazard ratio (95 %CI): 10.76 (1.78, 65.18)), and total leukocytic count (TLC>10 ×103 mcL) (hazard ratio (95 %CI): 10.03 (3.29-30.61)). CONCLUSIONS: Identifying high-risk patients especially old diabetic patients with corticosteroid administration and detecting their deterioration quickly is crucial in reducing post-COVID-19 mucormycosis mortality rates, and these factors must be considered when developing treatment and quarantine strategies.

Family-centred care as a mediator in the relationship between parental nurse support and parental stress in neonatal intensive care units.

BACKGROUND: Within the NICU, there is a delicate equilibrium between providing assistance to parents by nurses and prioritising family-centred care (FCC). The FCC assumes the role of a mediator, effectively conveying compassion. The intricate dynamics between FCC, parental nurse support, and parental stress in neonatal intensive care units (NICUs) necessitate comprehensive investigation. OBJECTIVE: This study examines the mediating effect of FCC on the relationship between parental nurse support and parental stress in NICUs. METHODS: This cross-sectional observational study used convenience sampling to select 223 parents (202 mothers) from Mansoura City hospitals in Egypt. Data were collected using the Nurse Parent Support Tool (NPST), Family-Centered Care Self-Assessment Tool (FCCS-NICU), and the Parental Stressor Scale: NICU (PSS: NICU). Mediation analysis was used to examine the relationships between variables. RESULTS: Nurse support was positively associated with FCC (ß = 0.81, p < 0.001) and negatively related to parental stress (ß=-1.156, p < 0.001). FCC was found to reduce parental stress (ß=-0.18, p < 0.001). Mediation analysis confirmed that FCC partially mediated the relationship between nurse support and parental stress (indirect effect ß = 0.145, 95% CI: 0.055-1.007). CONCLUSIONS: This study highlights a significant association in the mediating role of FCC between nurse support and parental stress. Strengthening FCC practices can be an effective strategy for nurses to support parents and alleviate their stress in NICU settings. IMPLICATIONS TO PRACTICE: NICUs should implement FCC-oriented training for nurses, foster a culture that supports FCC principles, and develop policies to establish FCC as a cornerstone of neonatal care.

Associations Between Components of Self-Management Theory and Falls Among Older Adults.

PURPOSE: To examine the relationship of key individual and family self-management theory (IFSMT) components, including self-management process variables on proximal (self-management behaviors) and distal (falls) outcomes in older adults. METHOD: A secondary data analysis was conducted using data of 99 older adults living in continuing care retirement communities in the U.S. Midwest. Descriptive statistics, multiple regression, and logistic regression were performed to analyze the data. RESULTS: The multiple regression model demonstrated a positive association between self-efficacy for physical activity and steps per day. The logistic regression model showed that high expectations regarding aging are associated with reduced likelihood of meeting daily protein intake. CONCLUSION: Key components of the IFSMT, such as self-efficacy, steps per day, and expectations regarding aging, are important when designing self-management interventions to prevent falls. [Journal of Gerontological Nursing, 50(8), 19-28.].

Using a flipped teaching strategy in undergraduate nursing education: students' perceptions and performance.

BACKGROUND: Flipped teaching is an interactive learning strategy that actively engages students in the learning process. Students have an active role in flipped teaching as they independently prepare for the class. Class time is dedicated to discussion and learning activities. Thus, it is believed that flipped teaching promotes students' critical thinking, communication, application of knowledge in real-life situations, and becoming lifelong learners. The aim of this study was to describe the students' perception of flipped teaching as an innovative learning strategy. And to assess if there was a difference in students' academic performance between those who participated in a traditional teaching strategy compared to those who participated in flipped teaching intervention. METHOD: A quasi-experimental design with intervention and control groups. A purposive sampling technique of undergraduate nursing students was used. RESULTS: A total of 355 students participated in both groups, and 70 out of 182 students in the intervention group completed the survey. The students perceived a moderate level of effectiveness of the flipped teaching classroom as a teaching strategy. The result revealed that there is a statistically significant difference in the mean students' scores for the intervention group (M = 83.34, SD = 9.81) and control group (M = 75.57, SD = 9.82). CONCLUSION: Flipped teaching proves its effectiveness in improving students' learning experience and academic performance. Also, students had a positive perception about flipped teaching as it allowed them to develop essential nursing competencies. Future studies must consider measuring the influence of flipped teaching on students' ability to acquire nursing competencies, such as critical thinking and clinical reasoning.

The perception and association between depression and academic stress among female undergraduate nursing students: a cross-sectional study.

Introduction: Academic demands and stressors put nursing students at increasing risk of depression. The aims of the study examine the perceived level of depression and academic stress and investigate the association between these variables among nursing students in Saudi Arabia. Methods: A cross-sectional design was used in this study. Data was collected using depression subscale from DASS-21 scale and the Academic Stress Inventory scale. Results: A total of 237 students participated in the study. Nursing students perceived normal to mild levels of depression. Students perceived moderate levels of academic stress in all subscales, except for time management and test stress which were high. All academic stress subscales had a positive statistically significant correlation with depression. The regression model explains 49.0% of the variance in the depression scale and indicated that the main significant predictor of depression is studying in group stress, followed by self-inflected stress, study year, and sleep problem. The mean score of depression for first year students was significantly different than students in other study years. Discussion: Nurse educators should facilitate group formation and teach students about time-management, problem-solving, negotiation, and coping strategies to deal with academic expectations and demanding situations. Understanding the causes, limiting the exposure to negative influences, and seeking support as needed are important. To enhance the quality of sleep, students should maintain a consistent sleep schedule, while avoiding stimulating activities before bedtime. Future research should focus on a longitudinal study and other variables such as quality of life, satisfaction with the quality of teaching, and support from others.

Psychological Distress, Academic Stress, and Burnout among Saudi Undergraduate Nursing Students.

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students' demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students.

The Association between Nursing Students' Happiness, Emotional Intelligence, and Perceived Caring Behavior in Riyadh City, Saudi Arabia.

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.