Exploring the lived experience of Arab male patients on intermittent catheterization after spinal cord injury: A phenomenological study.

BACKGROUND: Intermittent catheterization (IC) has been identified as one of the critical techniques used by spinal cord injury (SCI) patients to cope with emptying the bladder, despite several problems impeding this procedure. AIM: The study aimed accordingly to explore the lived experience of Arab male patients on IC after their SCI. DESIGN: This study was carried out by using a descriptive qualitative approach with a phenomenological analysis of data. METHODS: A qualitative study was carried out on 10 Arab male patients from the Rehabilitation Hospital at King Fahad Medical City (KFMC), Riyadh, Saudi Arabia who were utilizing intermittent catheters following SCI. The interviews were analysed using Husserl's phenomenology and the Colaizzi method of data analysis. RESULTS: Two major themes and six sub-themes were identified from exploring the patients experience. These themes are as follows: Theme 1: The Way to IC; with two sub-themes: (i) 'service provided and acceptance' and (ii) 'educational experience'; Theme 2: Lifestyle and self-adaptation; with four sub-themes: (i) 'Flexibility and freedom', (ii) 'Physical access to the community', (iii) 'Traveling' and (iv) 'Work and Social life balance'. CONCLUSION: It is evident that using an intermittent catheter among patients with SCI influenced almost all aspects of the participant's life, including their social lives and body image appearance.

Prevalence of stress and types of coping strategies among adolescents (14-18 years) in collectivist communities.

BACKGROUND: Stress is highly prevalent among adolescents and might lead to maladaptive coping. METHODS: This cross-sectional study assessed the prevalence of stress and determined the types of coping strategies used by adolescents; and identified the predictors of stress levels among this cohort. The study recruited 1344 participants, aged 14 to 18 years, in schools. The study used the DASS-42 and the Brief COPE Inventory Scale for data collection. The findings of this study showed that more than two-thirds of adolescents suffer from stress, and moderate, severe, and extremely severe were 22.8%, 43.0%, and 16.8%, respectively. The most used coping behaviors among these adolescents were religious factors, with a Mean ± SD of (Mean 6.28 ± 1.16), followed by instrumental support (Mean 6.17 ± 1.18). The stress level has a significant negative correlation at (p < 0.001) with active coping (r = -0.183**), self-distraction (r = -0.190**), acceptance (r = -0.140**) and religion (r = -0.097**; P < 0.001). Binary logistic regression analyses revealed that the whole model had R2 (0.232); p < 0.005 and shows that those aged 15 had an odd of 0.272 to develop stress more than those at 18. Fathers' and mothers' education levels strongly influenced adolescents' stress levels. Those with an income between <500 and 500-750 Jordanian Dinars had an odds ratio of 5.241 and 3.514 of developing stress, respectively, compared to their counterparts. APPLICATION TO PRACTICE: This study highlights the significance of developing health intervention programs and counseling services for managing adolescents' psychological well-being and provides valuable insights for policymakers on addressing mental health issues.

Self-Medication and its Associated Factors among University Students: A Cross-Sectional Study.

Background: Self-medication is a global concern among professionals and non-professionals, with a rapid increase in prevalence. The study aims to assess the prevalence of self-medication and its associated factors among university students. Materials and Methods: A cross-sectional, descriptive study was conducted in three universities, and a total of 817 college students participated in this study. Results: About 75.40% of the participants reported using medications without a professional prescription. The category of analgesics was the most commonly used in self-medication (82.80%), while the most common symptom was a headache (81.50%). Almost 74.10% percent of participants who have practiced self-medication stated that the reason was the "lack of time to consult a physician." Most participants who have used self-medication (90.30%) stated that the source of knowledge was "previous prescription." Conclusions: Health education programs concerning self-mediation should be held in university settings to improve attitudes and practices toward self-mediation.

Improving Venous Thromboembolism Prophylaxis Through Service Integration, Policy Enhancement, and Health Informatics.

Introduction: Venous thromboembolism (VTE) prevention and management are susceptible issues that require specific rules to sustain and oversee their functioning, as preventing VTE is a vital patient safety priority. This paper aims to investigate and provide recommendations for VTE assessment and reassessment through policy enhancement and development. Methods: We reviewed different papers and policies to propose recommendations and theme analysis for policy modifications and enhancements to improve VTE prophylaxis and management. Results: Recommendations were set to enhance the overall work of VTE prophylaxis, where the current VTE protocols and policies must ensure high levels of patient safety and satisfaction. The recommendations included working through a well-organized multidisciplinary team and staff engagement to support and enhance VTE's work. Nurses', pharmacists', and physical therapists' involvement in setting up the plan and prevention is the way to share the knowledge and paradigm of experience to standardize the management. Promoting policies regarding VTE prophylaxis assessment and reassessment using electronic modules as a part of the digital health process was proposed. A deep understanding of the underlying issues and the incorporation of generic policy recommendations were set. Conclusion: This article presents recommendations for stakeholders, social media platforms, and healthcare practitioners to enhance VTE prophylaxis and management.

Factors influencing gestational diabetes self-care among pregnant women in a Syrian Refugee Camp in Jordan.

AIM: The main objective of this study is to identify the level of self-care practices and the determinants of Gestational Diabetes Mellitus (GDM) among pregnant women residing in one of the refugee camps in Jordan. METHOD: A cross-sectional study was conducted on a convenient sample of forty women diagnosed with GDM from the high-risk maternity clinic in one of the Syrian refugee camps in Jordan. The study used the Gestational Diabetes Management Self-Efficacy Scale (GDMSES), Diabetes Knowledge (DMK) assessment, and Diabetes Self-Care Activities Questionnaire (SDSCA) to measure the variables of interest. Descriptive analysis and Multiple logistic regression were used to assess for significant factors. RESULTS: Significant associations were found between the subcategories of diet, exercise, and blood sugar control in both the self-efficacy and self-activity scales (p < 0.01, p < 0.01, p < 0.05), respectively. Two factors were associated with higher GDM self-care: diabetes knowledge and higher self-efficacy toward GDM self-care (p < 0.05). CONCLUSION: The findings of this study highlight that pregnant women with GDM who have higher levels of self-efficacy and diabetes knowledge are more likely to achieve higher levels of GDM self-care. Beside developing health promotion programs to enhance women's self-efficacy in adhering to GDM care, adequate support and relevant resources to facilitate GDM management among refugee women are recommended. Future research for identifying other potential factors affecting GDM self-care among refugees is highly recommended.

Knowledge, attitudes, practices and barriers of medical research among undergraduate medical students in Jordan: a cross-sectional survey.

BACKGROUND: Integrating medical students in research at an early stage of their program is a crucial step to enhance the ability of future physicians to employ critical thinking and problem-solving processes, which in turn improves patients' health outcomes. METHODS: A cross-sectional questionnaire-based survey was administered to medical school students at Al-Balqa Applied University. This study aims to analyze the attitudes, practices, and barriers faced by medical students in regard to engaging in medical research. RESULTS: A total of 333 students participated in the study with a mean age of 21.2 ± 1.5 years. A total of 60.1% were females. Female students had significantly higher knowledge scores (µ = 3.97, SD ± 1.81, P = 0.009) than males (µ = 3.44, SD ± 1.69). As students progress to higher academic years of their clinical program, their knowledge in research significantly increases in comparison to their knowledge in basic medical years (P < 0.001). Student age and academic year significantly correlated with the knowledge scores; each additional year of study increased the knowledge score by 0.25 (ß = 0.25, P < 0.001, R2 = 0.63). The percentage of students who correctly answered each question on the knowledge scale was 37.5% (SD ± 12.5%). The most reported barriers to research participation were insufficient training in medical research, lack of sufficient research opportunities, and lack of stimulation and support from faculty. CONCLUSIONS: Medical students demonstrated a positive attitude toward research starting from their second year of study, despite having limited knowledge on the topic. They identified barriers that could be utilized to promote greater involvement of students in research. The implications for clinical practice suggest that policymakers and educators should consider the outcomes of this study and implement improvements in medical education, specifically by encouraging the early participation of students in the research process.

The Use of Posterior Auricular Fascia Graft (PAFG) for Slight Dorsal Augmentation and Irregular Dorsum Coverage in Primary and Revision Rhinoplasty: A Prospective Study.

INTRODUCTION: Augmentation and coverage of irregularities of the nasal dorsum remain a challenge in rhinoplasty. Different techniques have been described in the current literature for this purpose. The aim of this study is to assess and illustrate the author experience and outcomes using the posterior auricular fascia graft (PAFG) for dorsal camouflage and augmentation in primary and revision rhinoplasty. MATERIAL AND METHODS: A prospective bicentric study was conducted, including patients with slight dorsal deficiencies and/or with dorsal irregularities following hump resection, trauma or previous rhinoplasty receiving PAFG to improve the rhinoplasty outcome. To objectively assess the graft resorption rate, MRI was performed 2 weeks and 18 months after surgery. To investigate patient satisfaction, the preoperative and 1-year postoperative scores obtained using the rhinoplasty outcomes evaluation (ROE) scale were compared. The scores following a normal distribution obtained for each patient were compared using a paired t-test. RESULTS: Forty-five patients were enroled in this study. Average follow-up duration was 35.4 months. Patients' age ranged from 17 to 57 years. No cases of infection or major graft resorption were observed. No postoperative scars were visible at the donor site. All patients were satisfied after surgery, and a statistically significant difference between pre- and postoperative scores (p<0.0001) was observed. CONCLUSION: This study showed that PAFG is a reliable technique for dorsal camouflage and slight augmentation in primary and revision rhinoplasty. The procedure is safe, easy and quick and only requires a small learning curve. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Platelet-Rich Plasma for Treating Androgenic Alopecia: A Systematic Review.

PRP contains growth factors that promote tissue repair. The authors conducted a meta-analysis comparing PRP treatment to a control group. However, there are concerns about the lack of standardized protocols and specific details about PRP preparation. Factors such as platelet counts, leukocyte concentration, and the use of activated or non-activated platelets can affect treatment outcomes. Further analysis is needed to establish more reliable conclusions about the effectiveness of PRP for androgenic alopecia. LEVEL OF EVIDENCE V: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Critical Care Nurses' Knowledge of Tracheostomy Care.

Background: Tracheostomy care is a standard procedure that nurses perform in Critical Care Units (CCUs) to reduce complications from tracheostomy. The literature indicates a clear variety of care and practice in managing tracheostomy patients within the healthcare system. This study was conducted to assess the knowledge level of tracheostomy care among nurses in CCUs in Jordanian hospitals. Materials and Methods: A cross-sectional descriptive design was used for this study. A convenience sample of 260 nurses working in the CCUs of four government hospitals completed a self-reported structured questionnaire. Data were collected from January 2021 to March 2021. A t-test and one-way Analysis of Variance (ANOVA) were used to assess the differences among socio-demographic variables in terms of knowledge score. Results: The result revealed that the level of knowledge was suboptimal. There was a statistically significant difference in the mean level of knowledge regarding tracheostomy care (in all dimensions) by age (F = 22.595, p < 0.001), educational level (F = 355.30, p < 0.001), and work experience (F = 13.63, p < 0.001). For gender, there was a statistically significant difference in knowledge of the tracheostomy suctioning dimension (p = 0.001). Conclusions: The level of knowledge among nurses regarding tracheostomy care was moderate, indicating an urgent need for education.

Moral Injury and its Correlates among Iranian Nurses in the Second Year of the COVID-19 Pandemic: A Multicenter Cross-Sectional Study.

The COVID-19 pandemic has been associated with various health-related issues among nurses, including mental health problems such as moral injury. This study aimed to evaluate the relationship between moral injury, general health, post-traumatic stress disorder (PTSD), and type of hospital among Iranian nurses working in different clinical settings during the COVID-19 outbreak. This cross-sectional study employed convenience sampling to recruit 334 nurses working in various clinical settings, including teaching and referral hospitals, in Kerman, Southeastern Iran from October 2021 to February 2022. The study used three measures, including the General Health Questionnaire (GHQ-12), the Impact of Event Scale-Revised (IES-R), and The Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP). Data analysis was conducted using SPSS25. The results indicated that moral injury was highly prevalent among Iranian nurses, with 47% of the participants reporting experiencing it. A total, 26.9% of the participants reported experiencing mental health disorders and 57.2% of the participants reported experiencing this disorder. Significant correlations were found between moral injury, general health, and PTSD. Specifically, moral injury levels were higher among female nurses with a history of mental disorders and those designated to treat all kinds of cases, compared to other participants. The results suggest that Iranian nurses are at a high risk of experiencing moral injury during the COVID-19 pandemic. Policymakers and health authorities should establish related health educational programs, provide counseling services to promote general health, and pay particular attention to moral injury and PTSD. Additionally, nurse educators should integrate materials related to moral injury into the nursing curriculum.

Accelerated transformation programme for healthcare services: structure, function and the lessons learnt.

The Kingdom of Saudi Arabia's (KSA) Ministry of Health's (MOH) healthcare transformation strategy aims to improve the quality of life of Saudi citizens in line with the 'Vision 2030' strategic objectives. The MOH is reforming the way healthcare will be managed in the future and is in the process of transferring healthcare service delivery responsibilities to clusters with ratified boards, while also moving the MOH from a provision of service model to a regulatory one. Several early pathfinding clusters were initiated in the eastern central and western regions. To ensure northern and southern regions were not left behind, the early innovation, while awaiting cluster nomination status, the northern and southern business units of Health Holding Company implemented the accelerated transformation programme (ATP). The ATP's remit was to develop capabilities and stimulate local engagement and ownership in the healthcare transformation process. This paper summarises the process of healthcare transformation undertaken in the northern and southern regions of KSA to date. It reviews the success in engaging with local healthcare professional communities in a standardised way and the learning from previous clusters, and elaborates on emerging implementation issues and how we may overcome them and introduce the lessons learnt from this journey.

Three Pedicles-Based Nipple-Sparing Skin-Reducing Mastectomy (TP-NSSRM) combined with Pre-Pectoral Implant-Based Breast Reconstruction.

INTRODUCTION: Nipple-sparing mastectomy (NSM) and immediate breast reconstruction have demonstrated positive aesthetic outcomes and high patient satisfaction. However, challenges arise when performing NSM on patients with large and ptotic breasts due to the higher risk of nipple-areolar complex (NAC) necrosis. This study proposes a new technique: the three pedicles-based nipple-sparing skin-reducing mastectomy (TP-NSSRM), combined with direct-to-implant (DTI) breast reconstruction, aimed at reducing complications. MATERIALS AND METHODS: A prospective study was conducted from November 2021 to April 2022, enrolling patients with large and drooping breasts requiring mastectomy for breast cancer treatment or risk reduction. Patient selection criteria included a sternal notch to nipple distance of ≥ 23 cm, Grade 3 ptosis, and eligibility for immediate prepectoral DTI breast reconstruction. Patient satisfaction was assessed using BREAST-Q modules. RESULTS: Seventy-two TP-NSSRM procedures combined with immediate DTI-based breast reconstruction were performed on a total of 45 patients. High patient satisfaction was observed, and statistically significant improvements were noted in postoperative BREAST-Q scores (p=0.001). The complication rate was low, and preservation of the nipple-areolar complex was achieved in all cases. CONCLUSION: The TP-NSSRM technique offers a potential solution for patients with large and drooping breasts undergoing NSM. It aims to minimize complications and achieve satisfactory outcomes. This study demonstrates favorable results in terms of patient satisfaction and quality of life. Further research and long-term follow-up are necessary to validate these findings and evaluate the long-term outcomes of this technique.

Use of complementary and alternative medicine for reducing fear of cancer recurrence among cancer survivors: Does it work?

Objective: Fear of cancer recurrence among cancer survivors is a psychosocial concern that affects recovery and quality of life. They use complementary and alternative medicine to prevent the side effects of drugs and relieve anxiety and fear of cancer recurrence. This study aimed to examine the correlation between the use of complementary and alternative medicine and the fear of cancer recurrence in cancer survivors. Methods: This cross-sectional descriptive correlational study enrolled 280 cancer survivors referred to oncology centers and medical offices in Kerman using convenience sampling. The research tools included complementary and alternative medicine questionnaire and the fear of cancer recurrence inventory. IBM SPSS Statistics version 25 was used to analyze the data. Results: The study findings revealed that 78.2% of the participants used at least one type of complementary and alternative medicine in the last year; 71.8% used medicinal herbs, 19.6% used nutritional supplements, 7.5% used relaxation and meditation, 7.1% used dry cupping, and 5.7% used wet cupping. The mean score of fear of cancer recurrence was 80.72 â€‹± â€‹18.46, which was almost near the midpoint of the inventory score (84). The fear of cancer recurrence and its dimensions did not differ between users and nonusers of complementary and alternative medicine. Conclusions: Our results suggested that most of the survivors used at least one type of complementary and alternative medicine in the past year, and medicinal herbs and nutritional supplements were the most used types. Patients with cancer must be aware of the effects of different kinds of complementary and alternative medicine. A moderate level in the mean score of fear of cancer recurrence was found, and no difference was noted between users and nonusers of complementary and alternative medicine. Health managers and planners should conduct effective psychological interventions and strategies to minimize the fear of cancer recurrence among cancer survivors.