Do academic advising and levels of support affect nursing students' mental health? A cross-sectional study.

AIM: The current study aimed to identify the association between social support, academic advising and mental health disorders among nursing students. BACKGROUND: Stress and workload can trigger multiple mental health disorders, especially for nursing students. Thus, academic advising and counselling help support students with academic and mental health problems. DESIGN: This cross-sectional study utilized online questionnaires in Egypt and Saudi Arabia. METHODS: Multidimensional Scale of Perceived Social Support (MSPSS), Patient Health Questionnaire (PHQ-4) and the Student Academic Advising and Counseling Survey (SAACS) were utilized to measure social support, depression and anxiety and evaluation of academic advising and counselling services, respectively. RESULTS: The study included 1134 nursing students (mean age of 20.3 years). Students with higher academic advising satisfaction were 37% less likely to experience depression (OR 0.63, 95% CI 0.46-0.85) and mental disorders (OR 0.68, 95% CI 0.50-0.94). Moderate family social support was associated with lower depression (OR 0.58, 95% CI 0.37-0.93) and mental disorders (OR 0.55, 95% CI 0.33-0.92). CONCLUSION: Academic advising and social support can mitigate mental health disorders among nursing students. These findings will help nurses and post-secondary providers develop strategies to support nursing students during difficult times.

Validation of student academic advising and counseling evaluation tool among undergraduate nursing students.

BACKGROUND: Academic advising and counseling services support students in achieving their educational outcomes. Unfortunately, there is a paucity of research on academic advising and student-support systems among nursing students. Therefore, the current study aims to develop a student academic advising and counseling survey (SAACS) and measure its validity and reliability. METHODS: Cross-sectional design was used to collect online self-administered data from undergraduate nursing students in Egypt and Saudi Arabia. The SAACS is developed based on relevant literature and tested for content and construct validity. RESULTS: A total of 1,134 students from both sites completed the questionnaire. Students' mean age was 20.3 ± 1.4, and the majority of them were female (81.9%), single (95.6%), and unemployed (92.3%). The content validity index (CVI) of SAACS overall score (S-CVI) is 0.989, and S-CVI/UA (universal agreement) is 0.944, which indicates excellent content validity. The overall SAACS reliability showed an excellent internal consistency with a Cronbach's Alpha of 0.97 (95% CI: 0.966 - 0.972). CONCLUSIONS: The SAACS is a valid and reliable tool for assessing students' experience with academic advising and counseling services and can be utilized to improve those services in nursing school settings.

Experiences of peer support workers supporting individuals with substance use disorders in Egypt: phenomenological analysis.

BACKGROUND: Peer support work for substance use disorders is widely implemented in high-income countries. More research is still needed to understand its applicability in settings which have proportionately low budgets allocated to mental health. Peer Support Workers are individuals who managed to achieve recovery from substance use disorders and help people remain engaged in their recovery and prevent relapse through shared understanding. AIM: To investigate the experience of peer support workers providing recovery support to people with substance use disorders in Egypt. METHODS: A qualitative phenomenological design was used in which 17 adults working as peer support workers for substance use disorders were recruited by means of purposive and snowball sampling. A semi-structured interview with participants was conducted by phone or video-call. Interviews were transcribed and thematically analysed based on descriptive phenomenology. RESULTS: Three superordinate themes were identified: role responsibility, Peer Support Workers' need for organizational and stakeholders' support, and challenges to the role integrity. CONCLUSION AND RECOMMENDATIONS: The findings indicate the need for national and governmental support to peer support workers engaged with people with substance use disorders in Egypt and educating families and the public about the role of peer support workers in substance use disorders.

Posttraumatic growth and recovery among a sample of Egyptian mental health service users: a phenomenological study.

BACKGROUND: Delivery of recovery-oriented mental health practice is fundamental to personal recovery. Yet, there is lack of service users' accounts on what constitutes mental health recovery in Egypt. OBJECTIVES: The aim of this study was to explore mental health recovery meaning informed by people with personal experience of recovery. METHODS: A phenomenological research design was used. Semi-structured qualitative interviews were conducted with 17 adult community-dwelling individuals who identified as recovered/recovering from mental health issues. An inductive thematic analysis approach was used to analyses participants' responses. RESULTS: Participants predominately reported personal and functional definitions of mental health recovery. Posttraumatic growth was the strongest theme comprising: relation to others, spirituality, new possibilities, identity & strengths, and appreciation of life. Themes of acceptance and forgiveness, functional and clinical recovery, and finding hope were also identified. CONCLUSIONS: This is the first study to explore mental health recovery meaning among a sample of people with lived experience of mental health issues in Egypt. Findings suggest that developing and implementing psychosocial interventions to support posttraumatic growth among people with mental health issues is a priority.

Irritable Bowel Syndrome and Coping Strategies: A Cross-sectional Study for Identifying Psychological Alarms and Factors Related to Coping in Riyadh, Saudi Arabia.

Psychological alarms including severity of pain, functional impairment, depression, and impaired coping strategies have been correlated with (IBS); however, these attributes, particularly coping strategies, have not been well studied. The aim of this study was to assess psychological alarms, life stressors, and coping strategies of adults diagnosed with IBS. A total of 806 participants completed a self-administered survey consisting of socio-demographic data and life stressors, the Rome IV criteria to diagnose IBS, the Psychological Alarm Questionnaire, and the Coping Strategies Questionnaire (CSQ 24). IBS diagnosis was established among 372 (46.15%) participants. Anxiety (OR = 1.81; 95% CI: 1.35-2.45), severe pain (OR = 1.92; 95% CI: 1.42-2.63), financial life stressors (OR = 1.98; 95% CI: 1.33-2.40), and coping strategies such as reinterpretation (OR = 1.92; 95% CI: 1.39-2.68) and diversion (OR = 2.01; 95% CI: 1.05-3.89) were all significantly and independently associated with IBS diagnosis. Giving the chronic nature of IBS, future research should focus on coping as a potential treatment goal for IBS patients.

What Are the Saudi Community Attitudes Towards Domestic Violence Against Women? A Cross-Sectional Study From Riyadh.

INTRODUCTION: Culture and social norms shape attitudes towards domestic violence against women (DVAW). Attitudes accepting DVAW contribute to violence. There is scarce evidence about community attitudes towards DVAW in Saudi Arabia. The study explores the Saudi community attitudes towards DVAW. METHODS: The study utilized a descriptive cross-sectional design using a self-report structured questionnaire to collect socio-demographic data and participants' attitudes towards DVAW. RESULTS: The study sample included 831 Saudi participants, 414 females and 417 males, between 18 and 79 years old. The majority of participants (69.5%) showed rejection of DVAW. Women were five times more likely to reject DVAW than men (OR = 5.19, 95% CI [3.6-7.4]). Participants with pre-university education and lower living standards reported rejection of DVAW compared to their counterparts. DISCUSSION: The results can help stakeholders develop strategies and awareness campaigns targeting different educational and living levels to minimize DVAW.

Delirium-related distress in the ICU: A qualitative meta-synthesis of patient and family perspectives and experiences.

BACKGROUND: Better understanding of patient and family member experiences of delirium and related distress during critical care is required to inform the development of targeted nonpharmacologic interventions. OBJECTIVE: To examine and synthesize qualitative data on patient and family member delirium experiences and relieving factors in the Intensive Care Unit (ICU). DESIGN: We conducted a systematic review and qualitative meta-synthesis. Eligible studies contained adult patient or family quotes about delirium during critical care, published in English in a peer-reviewed journal since 1980. Data sources included PubMed, Embase, CINAHL, PsycINFO, Web of Science, Cochrane and Clinicaltrials.gov. METHODS: Systematic searches yielded 3238 identified articles, of which 14 reporting 13 studies were included. Two reviewers independently extracted data into a Microsoft Excel spreadsheet. Qualitative meta-synthesis was performed through line-by-line coding of relevant quotes, organization of codes into descriptive themes, and development of analytical themes. Five patients/family members with experience of ICU delirium contributed to the thematic analysis. RESULTS: Qualitative meta-synthesis resulted in four major themes and two sub-themes. Key new patient and family-centric insights regarding delirium-related distress in the ICU included articulation of the distinct emotions experienced during and after delirium (for patients, predominantly fear, anger and shame); its 'whole-person' nature; and the value that patients and family members placed on clinicians' compassion, communication, and connectedness. CONCLUSIONS: Distinct difficult emotions and other forms of distress are experienced by patients and families during ICU delirium, during which patients and families highly value human kindness and empathy. Future studies should further explore and address the many facets of delirium-related distress during critical care using these insights and include patient-reported measures of the predominant difficult emotions.

Effect of packed red blood cell transfusion on IL-8 and sICAM-1 in premature neonates at different postnatal ages.

BACKGROUND: Transfusion-related immunomodulation (TRIM) has been described in adults; however, its existence in neonates is not confirmed. The generation of TRIM is attributed to increased concentrations of IL-8, sICAM-1 and other pro-inflammatory cytokines. This study aimed to monitor changes in IL-8, sICAM-1 as markers for TRIM in premature infants at different postnatal ages. METHODS: Preterm infants with a gestational age between 28 and 32 weeks who were receiving PRBC transfusion during the first 28 days of life were included in the study. Infants were stratified into two groups according to their postnatal age: Group 1 with postnatal ages of (0-14) days and Group 2 of (15-28) days. The concentrations of IL-8 and sICAM-1 were measured by enzyme-linked immunosorbent assay (ELISA) before transfusion, 6 h after the end of transfusion and in the donor's PRBCs bag immediately before infusion into the baby. RESULTS: IL-8 concentration in the PRBCs bags correlated with post-transfusion level in Group 2 (r = 0.59, p = 0.002) but not in Group 1 (r = 0.39, p = 0.06). sICAM-1 concentration in the bag correlated with infants'concentrations in neither group. In Group 1, pre-transfusion concentrations of both cytokines (IL-8 and sICAM-1) did not correlate whereas post-transfusion concentrations did correlate (r = -0.09, p = 0.68 and r = 0.4, p = 0.05 respectively). In Group 2, the concentrations of both cytokines did not correlate with each other during pre-transfusion (r = 0.11, p = 0.58) as well as post-transfusion (r = 0.12, p = 0.56). There was no significant increase in either cytokines after transfusion in each group. CONCLUSION: This study showed positive correlation between IL-8 concentration in the transfusion bag and post transfusion in Group 2 infants which could be attributed to passive transmission from the bags. This study does not support an immune modulatory effect for packed RBC in preterm infants.

Oxidative Stress in Hemodialysis Pediatric Patients.

BACKGROUND: Oxidative stress may play a role in complications of hemodialysis patients as atherosclerosis, thrombosis, and inflammation. AIM: The aim of the study was to evaluate the oxidative stress in hemodialysis pediatric patients through measurement of oxidative stress enzymes as paraoxanase activity (PON), arylesterase activity (ASA), superoxide dismutase (SOD) and also non-enzymatic antioxidant vitamins as vitamins A, C and E levels. METHODS: The study included 50 hemodialysis pediatric patients with mean age 11.4 ± 5.4 years and 30 normal children of matched sex and age as a control group. Assessment of oxidative stresses was done using ELIZA technique. RESULTS: SOD, ASA, and vitamin C were significantly lower among hemodialysis patients in comparison to control group (p = 0.004, 0.004, > 0.001 respectively). CONCLUSION: The study concluded that oxidative stress was common finding in hemodialysis pediatric patients which may play a role in complications encountered among these patients.

The validity and reliability of the Arabic version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU): A prospective cohort study.

BACKGROUND: Accurate diagnosis for Arabic speaking critically ill patients suffering from delirium is limited by the need for a valid/reliable translation of a standardized delirium instrument such as the Confusion Assessment Method for the ICU (CAM-ICU). OBJECTIVE: To determine the validity and reliability of the Arabic version of the CAM-ICU. DESIGN: A prospective cohort study design was used to conduct the current study. SETTINGS: Data collection took place in Geriatric, Emergency and Surgical intensive care units. PARTICIPANTS: Fifty-eight adult patients met the inclusion criteria and participated in the study. Among the participants 22(38%) patients were on mechanical ventilation. METHODS: After translating the CAM-ICU into Arabic language, the Arabic CAM-ICU was administered by two well-trained critical care nurses and compared with reference standard assessments by delirium experts using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM -IV-TR), along with assessment of severity of illness using Sequential Organ Failure Assessment (SOFA). Concurrent validity was assessed by calculating sensitivity, specificity and positive and negative predictive value (PPV and NPV) for the two Arabic CAM-ICU raters, where calculations were based on considering the DSM-IV-TR criterion as the reference standard. The convergent validity of the Arabic CAM-ICU was explored by comparing the Arabic CAM-ICU ratings and the total score of SOFA (severity of illness) and MMSE (cognitive impairment). RESULTS: A total of 58 ICU patients were included, of whom 27 (47%) were diagnosed with delirium during their ICU stay via DSM-IV criteria. Interrater reliability for the Arabic CAM-ICU, overall and for mechanically ventilated patients assessed using Cohen's kappa (κ) were 0.82 and 1, respectively, p < 0.001. The sensitivities (95% CI) for the two critical care nurses when using the Arabic CAM-ICU compared with the reference standard were 81% (60%-93%) and 85% (65%-95%), respectively, whereas specificity (95% CI) was 81%(62%-92%) for both nurses. High sensitivity and specificity measures were also observed across subgroups; 100% for mechanically ventilated patients, 88% (60%-98%) and 79% (49%-94%) for those aged 65 years or older and 82% (56%-95%) and 75% (43%-93%) for those with SOFA scores at or above the median value. CONCLUSIONS: The Arabic CAM-ICU appeared to be valid and reliable tool for diagnosing delirium. Future investigations may lead to a better understanding of the prevalence, predictors, and consequences of delirium among critically ill Arabic speaking patients.

Study of Visfatin Level in Type 1 Diabetic Children and Adolescents.

BACKGROUND: Visfatin is an intracellular enzyme, known as nicotinamide phosphoribosyltransferase (Nampt) and pre-B-cell colony-enhancing factor (PBEF-1). It has insulin-mimetic effects and lowers plasma glucose levels. AIM: The aim of the work was to assess serum concentration of Visfatin in type 1 diabetic children and adolescents and study its relationships with duration of diabetes, body mass index (BMI), glycemic control, insulin dosage, lipid profile and microvascular complications. MATERIAL AND METHODS: Fifty children and adolescents with type 1 diabetes mellitus were recruited with 30 ages and gender-matched healthy subjects. They were subjected to history taking; anthropometric measurements and chronic diabetic complications were recorded if present. Laboratory analysis included urinary microalbumin, serum triglycerides, HDL, LDL, cholesterol, fasting blood glucose, glycosylated Hb (HbA1c) and serum visfatin which was measured with enzyme-linked immunosorbent assay. RESULTS: Diabetic patients showed highly significant decrease in the level of visfatin compared to the control group (P = 0.0001). There was significant further decrease in visfatin level in diabetics with microalbuminuria (n = 13) compared to normoalbuminuric patients (n = 37) (P = 0.015). There was highly significant inverse correlation between visfatin level with age (r = -0.379, p = 0.007), BMI (r = -0.418, p = 0.003), waist circumference (r = -0.430, p = 0.002), hip circumference (r = -0.389, p = 0.005) and microalbuminuria (r = -0.323, p = 0.022). CONCLUSIONS: Type 1 diabetic children and adolescents had a significantly lower visfatin level compared to controls. A marked decrease in the level of visfatin was shown in patients with microalbuminuria with an inverse correlation with BMI suggesting an important role of visfatin in the pathogenesis of type 1 diabetics and type 1 diabetic nephropathy.

Delirium the under-recognised syndrome: survey of healthcare professionals' awareness and practice in the intensive care units.

AIMS AND OBJECTIVES: To survey intensive care unit healthcare professionals' awareness and practice related to delirium. BACKGROUND: Despite the current evidence revealing the risks linked to delirium and advances in practice guidelines promoting delirium assessment, healthcare professionals show little sensitivity towards delirium and evident training needs. DESIGN: The study had a cross-sectional survey design. METHODS: A sample of 168 intensive care unit healthcare professionals including nurses and physicians completed a semistructured questionnaire to survey their awareness, screening and management of delirium in intensive care units. The survey took place at 11 intensive care units from academic (university) and nonacademic (nonuniversity) governmental hospitals in Mansoura, Egypt. RESULTS: The mean score of delirium awareness was 64·4 ± 14·0 among intensive care unit healthcare professionals. Awareness of delirium was significantly lower when definition of delirium was not provided, among diploma nurses compared to bachelor degree nurses and physicians, among those who did not attend any workshop/lecture or read an article related to delirium and lastly, those who work in an intensive care unit when <50% of patients develop delirium. The survey found that only 26·8% of the healthcare professionals screen for delirium on a routine basis, and 14·3% reported attending workshops or lectures or reading an article related to delirium in the last year. In screening delirium, healthcare professionals did not use any tools, nor did they follow adopted protocols or guidelines to manage delirium. To manage delirium, 52·4% of the participants reported using sedatives, 36·9% used no drugs, and 10·7% reported using antipsychotics (primarily haloperidol). CONCLUSION: Intensive care unit healthcare professionals do not have adequate training or routine screening of delirium. There is an evident absence of using standardised tools or adapting protocols to monitor and manage delirium. RELEVANCE TO CLINICAL PRACTICE: This study has the potentials to shed some lights on the variables that might explain the problem of underdiagnosing delirium by healthcare professionals at intensive care units in Mansoura.

Cardiovascular Abnormalities in Egyptian Children with Mucopolysaccharidoses.

INTRODUCTION: The Mucopolysaccharidoses (MPS) are rare inherited metabolic disorders. They are characterized by the progressive systemic deposition of Glycosaminoglycans (GAGs). GAGs accumulate in the myocardium and the cardiac valves. Enzyme Replacement Therapy (ERT) is available for MPS I, II, and VI. However, ERT does not appear to improve cardiac valve disease in patients with valve disease present at the start of ERT. AIM: To evaluate the cardiac involvement in Egyptian children with MPS. MATERIALS AND METHODS: Echocardiograms (ECG) were done for 34 patients. Both quantitative and qualitative Glycosaminoglycans (GAGs) in urine and enzyme assay confirmed the diagnosis. Mitral, tricuspid and aortic valves were evaluated for increased thickness, regurgitation and/or stenosis, left ventricular chamber dimensions, septal and posterior wall thicknesses. RESULTS: The patients' age ranged from 0.9-16 years (median age 4 years). They included 19 cases of MPS I (55.9%), 3 cases of MPS II (8.8%), 2 cases of MPS III (5.9%), 6 cases of MPS IV (17.6%) and 4 cases of MPS VI (11.8%). Heart murmur was heard in 9 of the participants (9/34) (26%). However, 15 patients (15/34) (44%) revealed cardiac lesions on ECG examinations. Mitral regurge (47%), followed by pulmonary hypertension (40%), were the most frequent findings. CONCLUSION: The absence of Cardiac murmurs does not exclude the heart involvement. Cardiac valve dysfunction may not be reversible. Regular ECG should be routinely warranted in children with MPS and early ERT are recommended.

Objective structured video examination in psychiatric and mental health nursing: a learning and assessment method.

In the current study, the Objective Structured Video Examination (OSVE) was conducted to assess undergraduate nursing students' knowledge, observation, and clinical reasoning related to clinical psychiatric nursing competencies. The OSVE showed acceptable reliability and validity (Cronbach's α = 0.714, r = 0.6, respectively). Students highly appraised the OSVE because it covered a wide area of knowledge and clinical skills; the examination instructions were clear, concrete, and easily understood; the sounds and pictures of the videos were clear; and the videos simulated real patients. The examination was fair, well-administered, well-structured, and well-sequenced. The OSVE reflected learned skills, it provided opportunities for learning, grades were clearly identified, and it eliminated personal bias. Overall, the OSVE provided a practical and useful experience. On the other hand, some students negatively perceived the OSVE as being stressful and requiring more time.

Using Objective Structured Clinical Examination (OSCE) in undergraduate psychiatric nursing education: is it reliable and valid?

UNLABELLED: While there is widespread use of OSCE in general nursing specialties, psychiatric nursing has been slow to adopt this evaluation method and it has only recently been introduced to psychiatric nursing education. AIM: The main aim of the present study is to test the first application, validity and reliability of the OSCE in undergraduate psychiatric nursing education. METHOD: OSCE was developed to assess undergraduate psychiatric nursing students' clinical skills. The students' evaluation of the OSCE process was obtained after the completion of each OSCE circuit. RESULTS: The psychiatric nursing OSCE proved to be a reliable and valid method in assessing psychiatric nursing clinical competencies. In general, the students perceived OSCE as a positive experience and stressful on the other hand. CONCLUSION: OSCE is a reliable and valid method of assessing the students' psychiatric nursing competency skills. It has been shown to have many advantages over traditional methods of assessment and has the ability to objectively assess psychiatric nursing skills.