Ostomy-related problems and their impact on quality of life of Saudi ostomate patients: A mixed-methods study.

AIM AND OBJECTIVE: The aim of this study is to explore the health-related quality of life outcomes and ostomy-related obstacles among patients with ostomy in Saudi Arabia. BACKGROUND: Negative effects on quality of life for patients following ostomy creation are a globally important health concern. Paucity of understanding factors that influenced quality of care after ostomy surgery hinders the ability of healthcare providers to offer appropriate care to improve patient's quality of care. METHODS: This mixed-methods study was undertaken through survey (COHQOL-Q Arabic version) for collecting the quantitative data (n = 421) and semi-structured interview for collecting qualitative data (n = 12). This study employed STROBE and GRAMMS checklists. RESULTS: Multiple health-related quality of life challenges was indicated by Saudi patients with intestinal stomas. Ostomy surgery interferes with religious practice in Muslim people, particularly obtaining Hajj worship and fasting for Ramadan. The overall QOL mean score was moderate level (M = 7.57) for ostomy patients in Saudi Arabia. The highest domain mean score was the social well-being (M = 7.84) and the lowest in the physical well-being (M = 7.18). Reshaping of religious practices, apprehension and adaptation to living with a stoma were the most common themes that participants discussed related to ostomy issues they experienced following ostomy surgery. CONCLUSION: The study findings reported a greater understanding of challenges that patients with stoma experience in Saudi Arabia. The process of the adaptation and the change of their lifestyle also affects patient's quality of life. The healthcare providers can use the study results to create a supportive intervention strategy that needed for maximise QOL for people with stoma. RELEVANCE TO CLINICAL PRACTICE: This study identifies issues associated with stoma creation among Saudi people and can help in planning and providing the required nursing care which may support in the reduction of predictable problems. Recommendations for future studies related to nursing professional practice are indicated.

Health-related quality of life among patients with an ostomy regarding sex, disease diagnosis, health care provider, and ostomy type: a descriptive cross-sectional study.

BACKGROUND: Ostomy surgery can negatively affect quality of life; however, the lived experiences of individuals with ostomies in Saudi Arabia are not well understood. PURPOSE: To examine how sex, ostomy type, disease diagnosis, and health care provider shape health-related quality of life (HRQOL) in individuals with ostomies in Saudi Arabia. METHODS: A descriptive cross-sectional study was conducted based on self-reported data of a convenience sample of 421 patients (239 male, 182 female) with ostomies (206 temporary, 211 permanent, 4 unknown) from 5 hospitals in Riyadh, Saudi Arabia. Data were collected using the City of Hope-Quality of Life-Ostomy Questionnaire (Arabic version) and analyzed by univariate and multiple regression analyses to identify predictors of physical, psychological, social, spiritual, and overall HRQOL. RESULTS: HRQOL scores correlated significantly with ostomy type (temporary vs permanent), sex, and health care provider. There were no significant differences in HRQOL scores by disease diagnosis (cancer vs non-cancer). CONCLUSION: Several potential predictors of HRQOL among patients with ostomies in Saudi Arabia were identified, which may assist in developing intervention strategies to improve patients' HRQOL. Additional studies are needed to understand the specific barriers in each group.

City of Hope-Quality of Life Questionnaire-Arabic Version: assessment of reliability and validity.

BACKGROUND: Arabic is spoken as a native language by more than 400 million people worldwide. However, there is no specific Arabic language instrument to measure stoma-related quality of life. PURPOSE: This study was designed to assess the validity and reliability of the City of Hope-quality of life-Ostomy Questionnaire (COH-QOL-OQ) Arabic version. METHODS: A cross­sectional design was used. Intra-class correlation coefficients were calculated to measure reliability, and Pearson's correlations of an item with its own scale and other scales were scored to evaluate convergent and discriminant validity. Content validity was reviewed by a panel of 5 experts. RESULTS: There were 421 participants with colostomy, ileostomy, or urostomy (239 [56.8%] male and 182 [43.2%] female). All COH-QOL-OQ subscales for the Arabic version demonstrated a high level of internal consistency (Cronbach's α = 0.71-0.87). The initial administration of the confirmatory factor analysis model showed inadequate goodness-of-fit indices (χ² /df = 3.902, NFI = .845, CFI = .880, RMSEA = 0.083). However, after removing item 2 in the social dimension, the final administration of the confirmatory factor analysis model showed significant goodness-of-fit indices (χ² /df = 2.663, NFI = .900, CFI = .935, RMSEA = 0.063). CONCLUSION: The findings suggest that the COH-QOL-OQ Arabic version is a valid and reliable tool to measure quality of life among patients with an ostomy in Saudi Arabia.

Nurses' Perceived Facilitators of Research Utilisation in a Multicultural Setting in Saudi Arabia: Observational Study.

Facilitators of research utilisation are important in the implementation of evidence-based practice. Numerous facilitators for nursing practice have been identified, but knowledge of the impact of demographic characteristics on these enablers of research utilisation is limited. The study's aim was to determine nurses' perceptions of the facilitators of research utilisation and assess differences in the facilitator of research utilisation score based on nurses' demographic characteristics. A total of 2650 registered nurses from five hospitals in Riyadh, Saudi Arabia, were recruited for participation. A facilitator scale and self-designed demographic survey were used for data collection. The number of completed questionnaires was 1824 (69%). The results showed that many of the participants were female, aged between 20 to 40 years, and were expatriates mainly from the Philippines. Most respondents were clinical nurses with 6 to 10 years of experience. Many of the nurses had a bachelor's degree and a qualification from the Asian region. The mean total facilitator score was 26.1, with strong facilitators of research, including advanced education, providing colleague support, more clinically focused research and employing nurses with research skills. Recommendations for the facilitation of research utilisation include a strengthening of the research curriculum in nursing education programs as well as through continuing professional education.

Confidence, skills and barriers to ostomy patient care by nursing staff in Saudi Arabia.

AIM: This study examined the confidence level and perceived barriers to providing ostomy care among staff nurses in Saudi Arabia. BACKGROUND: Patients with ostomies experience increased comfort and satisfaction when nurses are confident in their knowledge and skills. DESIGN: A descriptive, cross-sectional design was used to conduct the research. The study included a convenience sample of 214 staff nurses from five hospitals in Riyadh, Saudi Arabia. The researchers used a survey questionnaire to gauge participants' confidence in their knowledge and skills, as well as identify any perceived barriers to ostomy care. RESULT: Overall, 95.1% of participants worked in adult care and 82.2% worked in surgical areas. There were significant relationships between the nurses' confidence in their ostomy care knowledge and skills and their years of nursing experience and having received ostomy care training in nursing school (p < .05); however, the nurses' level of education had no correlation (p > .05). CONCLUSION: While the majority of nurses were confident in their ability to care for patients with ostomies, they were concerned about causing stoma problems. This suggests that improving the quality of ostomy care provided by nurses may result in fewer negative outcomes for patients with ostomies.

Challenges Facing the Nursing Profession in Saudi Arabia: An Integrative Review.

There is a paucity of recent literature identifying the issues facing the nursing profession in Saudi Arabia. The aim of this integrative review is to highlight the ongoing challenges facing the nursing profession in Saudi Arabia despite attempts to make a difference and suggests recommendations for the future. Literature published from 2000 to 2020, inclusive, relevant for nursing challenges in Saudi Arabia was accessed and reviewed from multiple sources. In Saudi Arabia, inadequate numbers of Saudi nurses have prompted an increase in recruitment of expatriate nurses. This has created its own issues including, retention, lack of competency in English and Arabic, as well as Arabic cultural aspects, insufficient experience, and a high workload. The result is job dissatisfaction and increased attrition as these nurses prefer to move to more developed countries. For national nurses, the issues are the need to recruit more and retain these nurses. There are a range of cultural factors that contribute to these issues with national nurses. There is a need to improve the image of nursing to recruit more Saudi nurses as well as addressing issues in education and work environment. For expatriate nurses there is a need for a better recruitment processes, a thorough program of education to improve knowledge and skills to equip them to work and stay in Saudi. There is also a need for organizational changes to be made to increase the job satisfaction and retention of nurses generally. Healthcare in Saudi Arabia also needs leaders to efficiently manage the various issues associated with the nursing workforce challenges.

Quality of life among ostomy patients: A narrative literature review.

AIM AND OBJECTIVE: This study aims to identify and summarise factors related to ostomy patients' experiences and how these impact the perceived quality of life for those patients. BACKGROUND: Ostomy formation is a common therapeutic technique used to treat different colorectal diseases such as colorectal cancer. Although surgical intervention and ostomy formation may prolong a patient's life, it may cause many problems in their daily lifestyle and affect their quality of life. The surgical creation of an ostomy has a significant impacts on a patient's quality of life from multiple perspectives, including physical, psychological, social and spiritual aspects. DESIGN: A narrative literature review, using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline). METHODS: This review analysis of search filters was conducted in the following databases: PubMed (MEDLINE), CINAHL, Embase, ProQuest, Science Direct, Scopus, and PsycINFO. A validation data set of 283 research articles between January 2000 and December 2019 were used to identify the impact of stoma surgery on patients' quality of life. RESULT: Thirty-seven studies were identified as suitable for inclusion in this literature review. The results of the review indicate that quality of life (QoL) in patients who have an ostomy is influenced by many modifiable factors. Exercise, preoperative stoma site identification, family support, maintenance of social networks, education, spirituality and financial stability are all potentially modifiable factors that can improve the QOL for ostomy patients. CONCLUSION: This review has identified multiple challenges that ostomy patients experience, which were clustered according to physical, psychological, social and spiritual challenges. RELEVANCE TO CLINICAL PRACTICE: This study identifies issues associated with stoma creation and can help in planning and providing the required nursing care which may assist in the reduction of predictable challenges. Recommendations for future research related to nursing practice are stated.

The global summit on the efficacy and effectiveness of spinal manipulative therapy for the prevention and treatment of non-musculoskeletal disorders: a systematic review of the literature.

BACKGROUND: A small proportion of chiropractors, osteopaths, and other manual medicine providers use spinal manipulative therapy (SMT) to manage non-musculoskeletal disorders. However, the efficacy and effectiveness of these interventions to prevent or treat non-musculoskeletal disorders remain controversial. OBJECTIVES: We convened a Global Summit of international scientists to conduct a systematic review of the literature to determine the efficacy and effectiveness of SMT for the primary, secondary and tertiary prevention of non-musculoskeletal disorders. GLOBAL SUMMIT: The Global Summit took place on September 14-15, 2019 in Toronto, Canada. It was attended by 50 researchers from 8 countries and 28 observers from 18 chiropractic organizations. At the summit, participants critically appraised the literature and synthesized the evidence. SYSTEMATIC REVIEW OF THE LITERATURE: We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health, and the Index to Chiropractic Literature from inception to May 15, 2019 using subject headings specific to each database and free text words relevant to manipulation/manual therapy, effectiveness, prevention, treatment, and non-musculoskeletal disorders. Eligible for review were randomized controlled trials published in English. The methodological quality of eligible studies was assessed independently by reviewers using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for randomized controlled trials. We synthesized the evidence from articles with high or acceptable methodological quality according to the Synthesis without Meta-Analysis (SWiM) Guideline. The final risk of bias and evidence tables were reviewed by researchers who attended the Global Summit and 75% (38/50) had to approve the content to reach consensus. RESULTS: We retrieved 4997 citations, removed 1123 duplicates and screened 3874 citations. Of those, the eligibility of 32 articles was evaluated at the Global Summit and 16 articles were included in our systematic review. Our synthesis included six randomized controlled trials with acceptable or high methodological quality (reported in seven articles). These trials investigated the efficacy or effectiveness of SMT for the management of infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. None of the trials evaluated the effectiveness of SMT in preventing the occurrence of non-musculoskeletal disorders. Consensus was reached on the content of all risk of bias and evidence tables. All randomized controlled trials with high or acceptable quality found that SMT was not superior to sham interventions for the treatment of these non-musculoskeletal disorders. Six of 50 participants (12%) in the Global Summit did not approve the final report. CONCLUSION: Our systematic review included six randomized clinical trials (534 participants) of acceptable or high quality investigating the efficacy or effectiveness of SMT for the treatment of non-musculoskeletal disorders. We found no evidence of an effect of SMT for the management of non-musculoskeletal disorders including infantile colic, childhood asthma, hypertension, primary dysmenorrhea, and migraine. This finding challenges the validity of the theory that treating spinal dysfunctions with SMT has a physiological effect on organs and their function. Governments, payers, regulators, educators, and clinicians should consider this evidence when developing policies about the use and reimbursement of SMT for non-musculoskeletal disorders.

Are Councils on Chiropractic Education expectations of chiropractic graduates changing for the better: a comparison of similarities and differences of the graduate competencies of the Chiropractic Council on Education-Australasia from 2009 to 2017.

BACKGROUND: The Council on Chiropractic Education Australasia (CCE-A) is tasked with assessment and accreditation of chiropractic programs (CPs) in the Australasian community. To achieve this process the CCE-A has developed educational standards and graduate competencies which include minimum expectations of graduates prior to entry into the workforce. We sought to explore if these are changing overtime, and if so are these changes for the better. METHOD: The CCE-A 2009 and 2017 Competency Standards were located and downloaded. The competencies were placed into tables for a comparative analyses in a systematic manner to enable the identification of similarities and differences. In addition, word counts were conducted for the most commonly occurring words and this took place in December 2019. RESULTS: The 2017 competency standards were over three times smaller than the previous standards 2009 standards. More similarities than differences between the old and the new standards were found. There were 18 additions to the 2017 graduate competencies with many that were in unison with contemporary aspects of healthcare such as patient centred-care, respect for practitioner-patient boundaries and patient sexual orientation, transitioning patients to self-management, and consideration of improving lifestyle options. Some competencies were not bought forward to the new standards and included, among others, students being competent in screening for mental health conditions, an expectation to discuss cost of care, re-evaluating and monitoring patients at each visit, and knowing when to discharge patients. The competencies continued to be silent on known issues within the chiropractic profession of a lack of a definition for chiropractic that would inform scope of practice and the presence of vitalism within CPs. CONCLUSION: There have been positive changes which reflect contemporary mainstream health care standards between CCE-A graduate competency revisions. The absence of a clear definition of chiropractic and its attendant scope of practice as well as continued silence on vitalism reflect known issues within the chiropractic profession. Recommendations are made for future accreditation standards to inform the required competencies and aid the integration of chiropractic into the broader health care community.

Use of the measure your medical outcome profile (MYMOP2) and W-BQ12 (Well-Being) outcomes measures to evaluate chiropractic treatment: an observational study.

BACKGROUND: The objective was to assess the use of the Measure Yourself Medical Outcome Profile (MYMOP2) and W-BQ12 well-being questionnaire for measuring clinical change associated with a course of chiropractic treatment. METHODS: Chiropractic care of the patients involved spinal manipulative therapy (SMT), mechanically assisted techniques, soft tissue therapy, and physiological therapeutic devices.Outcome measures used were MYMOP2 and the Well-Being Questionnaire 12 (W-BQ12). RESULTS: Statistical and clinical significant changes were demonstrated with W-BQ12 and MYMOP2. CONCLUSIONS: The study demonstrated that MYMOP2 was responsive to change and may be a useful instrument for assessing clinical changes among chiropractic patients who present with a variety of symptoms and clinical conditions.