Challenges Experienced by Nurses in Providing Pediatric Palliative Care: An Interpretive Phenomenological Analysis.

Objectives: Pediatric leukemia is the most common cancer among children younger than 14 years of age. Children with leukemia require palliative care as additional support from the health care team. Providing palliative care to children is challenging. Thus, this study explored the challenges experienced by nurses in providing pediatric palliative care to children with leukemia. Methods: Semi-structured face-to-face interviews were conducted on a purposive sample of 11 nurses in the hematology-oncology units of a tertiary care hospital in Oman. Results: Interviews were transcribed and analyzed using interpretive phenomenological analysis, which revealed three main themes and seven subthemes related to challenges in providing pediatric palliative care: Personal challenges: Nurses were unable to neutralize their emotions, which burdened them emotionally; due to multitasking, nurses were unable to manage their tasks within the expected time frame; nurses were stressful when they participated in explaining the diagnosis to the parents; and nurses felt powerless when the health condition of some children deteriorated. Educational challenges: Nurses felt unprepared to meet the physical/psychosocial aspects of caring for children with leukemia. Organizational challenges: Nurses stated that families and nurses required rooms to pray, rest, and read Quran, and they needed a private place to speak to families; and nurses mentioned that there are limited number of psychologists to meet the psychological and social needs of children and their families. Conclusion: Prioritizing and implementing strategies for a supportive workplace, guided clinical practice, and maximizing nurses' satisfaction are crucial.

The Lived Experiences of Mothers Who Are Parenting Children With Leukemia.

BACKGROUND: Mothers parenting children with leukemia face innumerable challenges in meeting their own personal needs, as well as the needs of their ill child. OBJECTIVE: To explore the lived experiences of Omani mothers who are parenting children with leukemia, using interpretative phenomenological analysis design. METHODS: Data were collected from 10 mothers who were parenting children with leukemia who shared their experiences through a face-to-face recorded interview. Data were analyzed using the interpretative phenomenological analysis approach methods. RESULTS: Three main themes emerged from the mothers' experiences: (1) unexpected shocking diagnosis; (2) life is not the same anymore; and (3) viable support systems. Mothers found their child's diagnosis to be shocking and terrifying. The diagnosis and treatment cast a shadow on the mothers' lives. Mothers abandoned their work and left their healthy children to their spouses. Mothers relied on other mothers also parenting children with cancer and on the support of the extended family and health team members to cope and prayed to God to help them overcome the calamity. CONCLUSION: The mothers perceived their life as changing immediately upon hearing their child's cancer diagnosis as they experienced a plethora of emotions. They sought support at various points during their child's illness to cope and overcome the challenges during the cancer treatment journey. IMPLICATIONS FOR PRACTICE: Pediatric oncology nurses can support mothers during their transition to caring for a child with leukemia and can provide the needed support to reduce maternal distress and increase effective coping with the challenges.

Awareness and Attitude Towards the Premarital Screening Programme Among High School Students in Muscat, Oman.

OBJECTIVES: This study aimed to explore high school students' awareness and attitude towards premarital screening (PMS). METHODS: This cross-sectional study was conducted in 10 public high schools in Muscat, Oman from May to July 2016. A three-part self-administered questionnaire was used to collect data from grade 12 students. The first part focused on respondents' sociodemographic characteristics, while the second part dealt with awareness of the national PMS programme and the third part explored attitudes towards the national PMS programme. RESULTS: A total of 1,541 participants (response rate: 91.1%) completed the questionnaire. Most participants (78.1%) were aware of the availability of the PMS programme and their main source of information was family and friends (34.3%). The majority of students (87.4%) believed that PMS is important and most students (87.2%) indicated that they would undergo PMS. Over half of the students (55.3%) agreed that PMS should be mandatory before marriage and approximately one-third (38.3%) were in favour of having laws and regulations to prevent consanguineous marriages. Females were significantly more in favour of making PMS mandatory (P = 0.002) and enforcing PMS laws (P = 0.010) compared to males. CONCLUSION: Most respondents had good levels of knowledge about the PMS programme and half thought it is important to be tested. However, some students were not in favour of PMS. Increasing awareness about Oman's PMS programme is important and motivating students could contribute significantly to increasing the utilisation of the PMS programme and to limiting genetic blood disorders.

Parenting a child with metabolic diseases: Impact on health related quality of life of parents.

The study was conducted to assess the health related quality of life of the parents of children with inborn errors of metabolism (IEM). The study was conducted at the Genetic and metabolic outpatient department of Sultan Qaboos University Hospital, Oman. The parents of children with metabolic diseases who were accompanying their children to the outpatient clinics were the samples. An explorative descriptive survey design and Convenient sampling technique were used to select the sample. Study included 72 parents of children with metabolic diseases aged between 20 and 55 years. The RAND 36-Item Health Survey version was used to assess the health related quality of life of parents. The results shows lower mean scores in subscales of 'general health' and vitality. Parents with higher educational levels showed higher levels of PCS and MCS scores than parents with lower educational levels. Parents with higher monthly income and younger age showed higher quality of life. A significant association was found between supporting persons and HQoL in the dimensions of the "role limitations due to physical" (p<0.03), and social functioning (p<0.04). Empowering the parents by helping them to actively seek and maintain social support is an important step in improving the health related quality of life.

Evidence-Based Practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman.

OBJECTIVES: The aim of this study was to describe nurses' practices, attitudes, knowledge/skills and perceived barriers in relation to evidence-based practice (EBP) in Oman. METHODS: This descriptive cross-sectional study was conducted between February and November 2012. A self-reported 24-item questionnaire was used to measure EBP practices, attitudes and knowledge/skills among a convenience sample of 600 nurses working in four governmental hospitals in Muscat, Oman. Responses were scored on a one to seven rating scale. Barriers to EBP were measured on a five-point Likert scale using two subscales. Descriptive statistics and general linear regression were used to analyse the data. RESULTS: A total of 414 nurses were included in the study. The greatest barriers to developing EBP among nurses were insufficient time for research (3.51 ± 0.97) and insufficient resources to change practices (3.64 ± 0.99). Nurses with more years of experience reported increased use of EBP (P <0.01), more positive attitudes towards EBP (P <0.001) and fewer barriers to research (P <0.01). Significant positive correlations were found between years of experience and practice (r = 0.16) and attitudes (r = 0.20). Nurses with a baccalaureate degree reported fewer barriers to research than those qualified at a diploma level (P <0.001). Nurses who perceived more barriers to research reported less use of EBP (P <0.001), less positive attitudes towards EBP (P <0.001) and limited EBP knowledge/skills (P <0.001). CONCLUSION: These findings provide a basis for enhancing nursing practices, knowledge and skills. Continuing education for nurses and minimising barriers is crucial to increasing the use of EBP in Oman.