"Embracing the Inner Strength and Staying Strong": Exploring Self-Care Preparedness among Nurses for Enhancing Their Psychological Well-Being against the Long-Term Effect of COVID-19 Pandemic in Brunei Darussalam.

During three years of the unprecedented, massive COVID-19 pandemic that affected the world, nurse front liners faced substantial challenges and experienced long-term adverse mental health. This study explored psychological self-care practices undertaken by nurses to strengthen their mental health and develop resilience in their professional care role while addressing the challenges of the COVID-19 era. A qualitative descriptive exploratory study was conducted on 40 nurses who worked in providing COVID-19 care across Brunei using focus groups aided by semi-structured open-ended questions. Data were thematically analyzed using constructivist grounded theory. Four themes emerged: (1) 'Care of the mind, heart and soul'; (2) 'Physical care for the psychological well-being'; (3) 'Venting out and distraction'; (4) 'Have faith, think and stay positive'. The challenges of dealing with a worldwide pandemic unintentionally placed nurses' mental well-being at risk while the government strategized and prioritized containing and preventing the spread of and death from COVID-19. Health administrators, as well as nursing educators, need to promote and develop resources to strengthen nurses' psychological self-care practices. This will not only benefit individual nurses but will help promote the well-being of patients and employees, improve the health of all, and counteract any unintended stressful situations, even beyond the COVID-19 pandemic.

Nurses' mental health and coping strategies throughout COVID-19 outbreak: A nationwide qualitative study.

This qualitative exploratory study explored nurses' mental health and coping strategies working with suspected and confirmed COVID-19 patients in Brunei Darussalam. Eleven focus group discussions were conducted between October 2020 and January 2021, involving 75 participants. Three themes emerged: 'COVID-19 roller-coaster transitional journey' explained the different psychological responses of the journey of the nurses from merely hearing about COVID-19 from far to the invasion of the virus and community outbreak in the country; 'Mind my mind and heart' share experiences of the nurses in terms of their mental health and emotional responses; and 'the psychosocial system' described the coping mechanisms of the nurses throughout the COVID-19 pandemic. Nurses' mental health and coping strategies during the COVID-19 pandemic influenced how they provided care and performed other tasks, which should not be taken for granted. Nurses employed psychosocial coping methods at the different phases of the COVID-19 pandemic and support from family, friends, the public, and the governmental level. This research is fundamental as a basis for other countries to design psychological interventions during this yet unsettled COVID-19 pandemic.

Mental health nurses' views of ward readmission: A focus group study in Brunei Darussalam.

Background: Readmission becomes inevitable with the vast development of mental health services worldwide and the challenges faced by mental health services. This readmission is often caused by a relapse from an illness whereby the psychiatric patient needs nursing care. Objective: This study aimed to explore psychiatric nurses' perceptions of reasons for readmission and nurses' further role in reducing readmission. Methods: In this descriptive qualitative study, thematic analysis of five focus group discussions (n= 24 nurses) in one psychiatric department in Brunei Darussalam was identified through purposive sampling. Results: The nurses perceived the role of family and non-adherence to medication as a significant reason for psychiatric readmission. Simultaneously, nurses viewed that it was necessary to implement systematic psychoeducation to strengthen the role of family and community service support to curb readmission rates. Conclusion: The phenomenon of mental health readmission impacts psychiatric nurses due to many stressful challenges with nurses wishing to respond personally, humanely and professionally. These challenges require suitable interventions, such as debriefing to ensure that nurses continuously strive to deliver quality care to psychiatric readmission patients.

Knowledge and attitude towards mental illness among primary healthcare nurses in Brunei: A cross-sectional study.

BACKGROUND: Mental Health problems are one of the leading disabilities worldwide. Individuals seeking help for their mental illness expect nurses to be cognisant of their needs without prejudice and discrimination. Existing evidences suggest a growing number of patient referral from primary healthcare to psychiatric consultations. This study aimed to explore primary healthcare nurses' knowledge and attitude towards mental illness and people with mentally illness. METHODS: A cross-sectional study using the Mental Health Problem Perception and the Community Attitudes to Mental Illness questionnaires. Descriptive and multivariate regression using maximum likelihood procedures were applied. RESULTS: Regression analysis showed significantly high correlation between knowledge and authotarianism (ß = 0.775, p = 0.007) and moderate inverse correlation with social restrictiveness (ß = -0.517, p < 0.001). However, no significant correlation with benevolence (ß = -0.057, p = 0.181) was detected. Nurses with higher educational level were significantly associated with authotarianism attitude. CONCLUSIONS: This is the first study examining knowledge and attitude of primary healthcare nurses in Brunei. The relationship between the study variables as well as demographic factors, in comparison to other countries, were discussed. Overall, negative attitude among nurses is still a challenging issue; therefore, developing re-education initiatives and increase contact time, especially for healthcare front liners with negative attitudes regardless of education level, to favour change of attitude, is important to foster holistic care to people with mental illness and promote mental health in the population.

Brunei epidemiological stroke study: patterns of hypertension and stroke risk.

OBJECTIVES: Hypertension is the most important known risk factor for cardiovascular diseases. A cross-sectional study was conducted in Brunei Darussalam to estimate the prevalence of hypertension and its association with socioeconomic and life-style factors and impact on stroke incidence. METHODS: Five thousand and sixty-three participants aged above 18 years from 2103 randomly selected households in the Brunei-Muara district of Brunei Darussalam were surveyed. Hypertension was defined as mean SBP at least 140 mmHg, DBP at least 90 mmHg, or taking antihypertensive medication and blood pressure was measured twice. Logistic regression models are used to analyze the association between hypertension/medication for hypertension and sex, age, overweight, education, smoking, family history of hypertension, and employment. RESULTS: A total of 48.3% [95% confidence interval (CI): 46.9-49.7%] of all respondents were identified as hypertensive. Prevalence of hypertension was higher in men (52.8%; 95% CI: 50.7-54.9%) compared to women (45.0%; 95% CI: 43.2-46.8%) and women seek treatment more often than men. Age, overweight, lower levels of education, and a family history of high blood pressure are positively associated with the prevalence of hypertension. The prevalence of overweight (57.3%) and obesity (23.7%) is high and the attributable risk of hypertension for stroke is large. CONCLUSION: The prevalence of hypertension in Brunei is high in both women and men. Information campaigns and prevention programs are needed to be able to cope with the increasing problem of hypertension and resulting diseases like stroke in Brunei in the near future.