Optimizing geriatric palliative care in Egypt: Comprehensive patient and family perspectives.

OBJECTIVES: In Egypt, palliative care for geriatric patients is understudied, necessitating exploration for service optimization. Amidst rising chronic illnesses and aging, understanding perspectives of geriatric patients and families is crucial for targeted improvements. This study aims to explore geriatric patients' and their families' perspectives on palliative care in Egypt, seeking opportunities to optimize service delivery for the elderly. METHODS: Employing a cross-sectional design with 110 geriatric patients and an equal number of family caregivers from the Damietta Oncology Institute and the pain treatment clinics for cancer patients at Zagazig University Hospital, the study focuses on a specialized pain clinic. Validated tools (Palliative Care Outcome Scale, Family Satisfaction with End-of-Life Care [FAMCARE] Scale, Edmonton Symptom Assessment System [ESAS], Caregiver Strain Index [CSI]) assess quality of life, family satisfaction, symptom severity, and caregiver strain. RESULTS: Geriatric patients (mean age: 65.0 ± 8.1 years; 45.5% male, 55.5% female) have diverse diagnoses (e.g., breast cancer 22%). Palliative care outcomes reveal challenges: low emotional well-being (2.6 ± 0.0) and alarming overall quality of life (1.8 ± 0.0). Family dissatisfaction (FAMCARE) is pervasive (total mean score 2.6 ± 0.5). Symptom severity (ESAS) is high, and caregiver strain (CSI) is notable (8.5 ± 2.2). SIGNIFICANCE OF THE RESULTS: The findings underscore the significance of the challenges faced by geriatric patients and caregivers in palliative care. Patients confront considerable symptom burdens and emotional distress, while caregivers experience notable strain. Urgently needed are targeted interventions designed to enhance patient well-being, alleviate caregiver burden, and elevate satisfaction. The critical importance of implementing these interventions promptly is highlighted, as they are instrumental in improving the overall care experience for geriatric patients and their caregivers. Moreover, the results underscore the imperative of developing comprehensive support mechanisms to address the intricate dimensions of palliative care, ultimately contributing to a more compassionate and effective care continuum.

Healthcare workers' compliance with the catheter associated urinary tract infection prevention guidelines: an observational study in Yemen.

BACKGROUND: Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter. METHODS: An observational study using a descriptive cross-sectional design was conducted at Sana'a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study. RESULTS: The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education. CONCLUSION: Yemeni healthcare workers' overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.

Nursing Students' Knowledge, Attitude, and Practice Regarding Disaster Preparedness: A Cross-Sectional Study.

Background: Nations are considered to be within at hazard of crises, which create greater challenges for healthcare systems and healthcare workers. Nursing staff and student nurse play a critical role in responding to disasters, and having knowledge and a skill on disasters preparedness is crucial. The aim of the current study was to investigate the nursing students' knowledge, attitude, and practice regarding disaster preparedness. Methods: A cross-sectional study included a sample of 206 nursing students at College of Applied Medical Sciences in Al-Kharj, Saudi Arabia. Undergraduate students from all years were asked to complete an online questionnaire on knowledge, attitude, and practices regarding disaster preparedness. Results: The results/findings showed that more than two thirds of the participants had adequate knowledge (69%) and positive attitude (72%) regarding disaster preparedness; however, most of them had inadequate practice (84%). There were statistically significant relations between nursing students' knowledge and their GPA (p = 0.003), students' attitude and their gender (p = 0.014), and students' practice and their age (p = 0.008). Moreover, nursing students' knowledge was positively correlated with their attitude (r = 0.194). Conclusion and Recommendations: Most of participated students had adequate knowledge and a positive attitude toward disaster preparedness; most of them had inadequate practice. Continuing education and training of student nurse on disaster preparedness is critical to enhance their knowledge and practices; and to be proficient in preparation for and management of any potential disasters or risks. The findings of the current study offer data that would help in the creation of educational policies for student nurse about disaster preparedness.

Respiratory Infections Prevention in Rural Older Adults: An Interventional Study.

Respiratory tract infections are one of the major causes of morbidity and mortality in older adults. This quasi-experimental study aimed to evaluate the effect of an educational intervention on respiratory infections prevention (RIP) in rural older adults. The study sample composed of 80 older adults from a rural area, randomly assigned into two groups. The intervention group (n = 40) received ten 1-hour twice-weekly sessions and the control group (n = 40) received no intervention. Pre- and post-intervention assessments were done using measures of knowledge, attitudes, and practices regarding RIP. Chi-square test, Fisher's exact test, independent samples t-test, and paired t-test were used for data analysis. The study findings showed that the study intervention resulted in statistically significant improvements in the intervention group's knowledge, attitudes, and practices regarding RIP compared with the control group (p < .01). The educational intervention was effective and could be used to help rural older adults prevent respiratory infections.

Nutritional Status and Its Contributing Factors among Older Adults with Cancer Receiving Chemotherapy.

The study aimed to assess nutritional status and its contributing factors among older adults with cancer receiving chemotherapy so, a descriptive study design was used. The study was conducted at Zagazig University Hospitals, Egypt. The study's sample was selected purposively which composed of 194 older adults. Nutritional status was measured by the Arabic version of the Mini-Nutritional Assessment (MNA). Contributing factors were identified by examining the relationship of nutritional status with demographic and clinical variables. Study results revealed that 33% of the older patients were malnourished and 51.5% were at risk for malnutrition. Statistically significant relations were found between nutritional status and advanced age, illiteracy, insufficient monthly income, comorbidities, cancer stage four at diagnosis, and receiving ≥4 chemotherapy cycles. High prevalence of malnutrition and many contributing factors were identified among older patients with cancer receiving chemotherapy. So, continuous malnutrition screening along chemotherapy courses with special concern for contributing factors assessed in this study is recommended.