Salutogenesis: A sense of coherence and health among British military veterans exposed to impactful life challenges - the emergence of post-traumatic growth and positive deviance within a life-story approach.

Background: This study sought to capture the perspectives and experiences of two sub-groups of military veterans, namely those who had previously been identified as offenders and those employed as practitioners within the criminal justice system in the United Kingdom. Methods: The lead author undertook narrative inquiry in the form of life story research. The life stories of 17 in-depth interviews were conducted across England and Wales, allowing for insight into the lived experiences of two life story trajectories of the health of military veterans. Existing literature on salutogenesis, health, post-traumatic growth, and positive deviance has also been investigated. Results: Life story interviews were transcribed verbatim and analyzed concurrently using thematic analysis to identify emergent themes. The researchers used thematic analysis as an analytical framework to allow descriptive themes from the literature on salutogenesis, health, post-traumatic, and positive deviance to be compared with those of life-story interviews. Conclusion: The study adopts a salutogenic approach, which suggests that an important indicator for a sense of coherence is enabled through the positive utilization of resilience through the reconstruction of military identity and experience. Notably, the concept of salutogenesis demonstrates the ability to draw from internal and external resources as circumstances require, to survive, and because of this, the participants' health is maintained or improved. Hence, adaptation was notable through the coherence identified by the identity of being a veteran noted between the two subgroups and represents a continuous and dynamic process. The study suggests that the development of a sense of coherence is not restricted to the early decades of life but is a continuous process as contexts, personal circumstances, and opportunities arise. This later point is realized through the presence of post-traumatic growth and positive deviance, as they aid in the nurturing and development of a renewed sense of coherence via the known identity of military service and life.

Exploring mental health stigma among Indonesian healthcare students towards individuals with mental illnesses: a qualitative study.

BACKGROUND: The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals. AIMS: This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia. METHODS: This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis. RESULTS: Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns. CONCLUSIONS: The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.

A multi-country mixed-method study identifying the association between perceived ethical work climate and problems among critical care nurses.

BACKGROUND: Given the grave ethical tension and dilemmas posed continuously which are aggravated in the intensive care unit context and its related caregiving provision, combined with their impact on critical care nurses' job satisfaction and work-related risks, exploring and analyzing these tensions and conflicts is crucial. This study was conducted to examine the relationship between perceived ethical work climate and problems among critical care nurses in addition to exploring their perspectives on the ethical work climates while caring for patients with infectious diseases. DESIGN AND METHOD: A mixed-method research design was used to conduct this study among 635 participants, comprising 170 from Egypt, 144 from Jordan, 161 from Saudi Arabia, and 160 from the United Arab Emirates. Online or paper-based survey forms were distributed to all eligible critical care nurses who agreed to take part in the study. The survey contained both quantitative and qualitative data that were analyzed separately and integrated during the discussion. The study was reported following the STROBE guidelines. FINDINGS: The overall ethical work climate was fairly good and was significantly associated with ICU nurses' personal and professional characteristics. The findings also identified three main themes: (1) an ethical sense of failure, (2) environmental condemnation, and (3) an instant action plan for resolving ethical conflicts. CONCLUSIONS: ICU nurses perceived that ICU ethical climate was fairly good. The results indicated that ICU nurses generally had a relatively fair perception of the ethical work climate, with implications for addressing ethical issues and conflicts in various settings. IMPACT: Mentorship and/or close supervision concerning ethical resilience, consultation, and decision-making is crucial in the ICU milieu. Metacognitive strategies to reinforce problem-solving and decision-making ICU nurses' skills could help them overcome the different ethical challenges. Adequate resources, teamwork, and organizational support are promising tactics to improve ICU nurses' ethical skills. TRIAL REGISTRATION: Not applicable.

Listening to the voices of mothers in Indonesia: Qualitative content analysis of experiences in parenting children with down syndrome.

INTRODUCTION: Generally, mothers provide the majority of caring for children who have Down syndrome. They pose challenges not only with regard to the acceptability of the child situation but also with regard to the provision of care for children with DS. AIM: To explore the experiences of mothers parenting children with DS in Indonesia, to give a better understanding of their needs, which is necessary for the delivery of treatment. METHODS: A descriptive qualitative research with content analysis was used. Study participants (15 mothers) were purposively sampled from attendees of a State Special School for students with disabilities. Data was collected via semi-structure interviews and were audio recorded. Participant's statements underwent content analysis, and the principle of trustworthiness was subsequently applied. RESULTS: Five main themes describing participants' experiences were identified: (1) parenting experiences - the impacts, (2) special needs, (3) parenting barriers, (4) parenting facilitators, and (5) mothers' expectations. CONCLUSIONS: The study findings showed that the mothers viewed their situation in both positive and negative ways. Despite the limited sample size in this exploratory study, the results offer new insights into raising a child with DS in a particular cultural setting. IMPLICATIONS FOR PRACTICE: This study offers important information to families and healthcare providers to improve awareness of the disorder and its appropriate management methods. It is important that an exploration of the experiences of mothers will provide healthcare professionals and families with an understanding of the situation. This understanding is essential for the effective management and delivery of treatment.

Long-term care facilities' response to the COVID-19 pandemic: An international, cross-sectional survey.

AIMS: To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions. DESIGN: Cross-sectional survey. METHODS: Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines. RESULTS: The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work-life imbalance. CONCLUSIONS: Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks. IMPACT: This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

Prevalence of Undiagnosed Attention Deficit Hyperactivity Disorder (ADHD) Symptoms in the Young Adult Population of the United Arab Emirates: A National Cross-Sectional Study.

BACKGROUND: Attention deficit hyperactivity disorder (ADHD), a globally prevalent behavioural disorder, remains underdiagnosed, particularly among adults. This issue is exacerbated in the Arab region due to stigma and insufficient healthcare facilities and professionals. Despite the United Arab Emirates (UAE) efforts to improve mental healthcare, shortcomings persist. No studies in the UAE currently assesses the appropriateness of the screening system for ADHD and other behavioural issues. Furthermore, prevalence rates of ADHD, particularly within the young adult population, are absent. AIM: To estimate the prevalence of ADHD amongst young adults attending university in UAE and examine its relationship with gender and academic outcomes. METHODS: A cross-sectional, correlational design was used. Young adults in their first year at university were recruited from different academic institutions across the UAE. The study utilized the Adult ADHD Self-Report Scale (ASRS) for data collection. RESULTS: A sample of 406 young adults, aged between 18 and 20 years of age were recruited. Approximately, 34.7% (n = 141) reported symptoms suggestive of probable ADHD. Significantly lower grade point average marks were observed in participants with ADHD symptoms (M = 3.15) compared to those without (M = 3.35). Females reported symptoms of probable ADHD at higher rates than males, indicating possibly a potential screening deficiency and a potential stigma consequence. CONCLUSIONS: The study demonstrates a high prevalence of probable ADHD in young adults, particularly among females attending university in the United Arab Emirates. Implications for early screening, service provision, and greater professional health training on this disorder are required.

Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE.

OBJECTIVES: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice. DESIGN: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language. SETTING: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023. PARTICIPANTS: 14 purposively selected healthcare practitioners. INTERVENTION: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews. PRIMARY AND SECONDARY OUTCOMES: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being. RESULTS: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied. CONCLUSIONS: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

The Effect of Listening to Holy Quran Recital on Pain and Length of Stay Post-CABG: A Randomized Control Trial.

Background: Nearly, 75% of patients post-CABG complain of moderate to severe pain during their hospital stay. Nonpharmacological interventions have been investigated; however, the effect of Holy Quran recital post-CABG is still not well studied, especially in developing Islamic countries. Objective: To investigate the effect of listening to the Holy Quran recital on pain and length of stay post-CABG. Methods: This was a randomized control trial on 132 patients recruited from four hospitals in Amman, Jordan. The intervention group listened to the Holy Quran recited for 10 minutes twice daily while the control group received the usual care. Data were analyzed using paired and independent samples t-tests. Results: Paired t-test testing showed that there was a significant reduction in the pain level, (M [SD], 6.82 [2.27] vs. 4.65 [2.18], t = 23.65, p < 0.001) for the intervention group. In addition, the intervention group had shorter LoS in the ICU and in the hospital compared to the control group, (M [SD], 5.0 [4.02] vs. 6.58 [4.18], t = -2.1, p < 0.05), (M [SD], 10.15 [9.21] vs. 15.01 [13.14], t = -2.6, p < 0.05), respectively. Conclusions: Listening to the Quran was significantly effective in improving pain intensity among post-CABG patients and shortening their hospital/ICU stay. This trial is registered with NCT05419554.

Development of a hybrid LSTM with chimp optimization algorithm for the pressure ventilator prediction.

The utilization of mechanical ventilation is of utmost importance in the management of individuals afflicted with severe pulmonary conditions. During periods of a pandemic, it becomes imperative to build ventilators that possess the capability to autonomously adapt parameters over the course of treatment. In order to fulfil this requirement, a research investigation was undertaken with the aim of forecasting the magnitude of pressure applied on the patient by the ventilator. The aforementioned forecast was derived from a comprehensive analysis of many variables, including the ventilator's characteristics and the patient's medical state. This analysis was conducted utilizing a sophisticated computational model referred to as Long Short-Term Memory (LSTM). To enhance the predictive accuracy of the LSTM model, the researchers utilized the Chimp Optimization method (ChoA) method. The integration of LSTM and ChoA led to the development of the LSTM-ChoA model, which successfully tackled the issue of hyperparameter selection for the LSTM model. The experimental results revealed that the LSTM-ChoA model exhibited superior performance compared to alternative optimization algorithms, namely whale grey wolf optimizer (GWO), optimization algorithm (WOA), and particle swarm optimization (PSO). Additionally, the LSTM-ChoA model outperformed regression models, including K-nearest neighbor (KNN) Regressor, Random and Forest (RF) Regressor, and Support Vector Machine (SVM) Regressor, in accurately predicting ventilator pressure. The findings indicate that the suggested predictive model, LSTM-ChoA, demonstrates a reduced mean square error (MSE) value. Specifically, when comparing ChoA with GWO, the MSE fell by around 14.8%. Furthermore, when comparing ChoA with PSO and WOA, the MSE decreased by approximately 60%. Additionally, the analysis of variance (ANOVA) findings revealed that the p-value for the LSTM-ChoA model was 0.000, which is less than the predetermined significance level of 0.05. This indicates that the results of the LSTM-ChoA model are statistically significant.

Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan.

BACKGROUND: Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients' quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients' QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA. METHODS: One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews. RESULTS: There was a significant difference between QoL before (33.7±17.0) and 1 month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular nodal reentrant tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension. CONCLUSIONS: After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.

Floating to intensive care units: Nurses' messages for instant action to promote patient safety.

BACKGROUND: The overwhelming number of patients admitted to intensive care units (ICUs) combined with a nursing staff deficit sometimes requires the redeployment of nurses from other areas, meaning non-critical care nurses are asked to assist in treating critically ill patients. This may affect patient safety, especially in poorly resourced ICUs with financial constraints, such as in some developing countries. Nurses and nurse managers need specific strategies to address this issue and ensure patient safety. AIM: To explore ICU and floating nurses' perspectives of the floating experience and describe how the use of floating nurses could threaten the safety of patients in Egyptian ICUs. STUDY DESIGN: This was a qualitative descriptive study. Data were collected in in-depth interviews and analysed using Colaizzi's method of analysis. Forty-seven interviews were conducted, 22 with ICU nurses/managers and 25 with floating nurses. RESULTS: Two main themes were extracted: (1) Lived work experience of floating and ICU nurses during the floating period which included three subthemes: Being a floating nurse: living a double experience of a professional role, Being an ICU nurse: feeling overloaded, and small failures leading to bigger, more serious issuses; and (2) Messages for patient safety from floating and ICU nurses' perspectives which also comprised three subthemes: education and training, putting the patient in the safety zone, and poilcy reform. CONCLUSIONS: Promising strategies for ICUs to ensure patient safety when transferring nurses from other units include providing ongoing education and appropriate training for floating nurses to put patients in the safety zone. RELEVANCE TO CLINICAL PRACTICE: Our findings provide a foundation for nursing practitioners, managers, and policymakers to prevent medical errors and optimize nursing workforce allocation. Nursing managers should consider floating nurses' competence levels when assigning ICU patients. Moreover, teamwork and communication between ICU nurses/managers and floating nurses should be strengthened. Close supervision and use of technology to minimize medical errors are potential strategies to ensure patient safety when using floating nurses.

Barriers and facilitators to enrolling in nursing programs as perceived by male students: a qualitative study in the United Arab Emirates.

OBJECTIVES: Despite the cultural challenges and stigma associated with nursing in the United Arab Emirates, there has been an increase in male nursing students. It is therefore important to understand barriers and facilitators that influence their decision to choose nursing education. METHODS: This qualitative study used purposive sampling to recruit 30 male undergraduate students. Semi-structured interviews were conducted and data were analyzed with thematic analysis. RESULTS: Ten themes were identified that described barriers and facilitators to choosing nursing programs as perceived by male students. Four themes reflected barriers and six themes were identified that encompassed facilitators to choosing nursing programs. CONCLUSIONS: For international audiences, our findings could be helpful in enhancing both the recruitment and educational opportunities for male nursing students. Male students may be inspired to pursue the nursing profession by the presence of men in the profession and favorable male role models. Effort is needed to recruit male role models in nursing schools.

Quality of life as a mediating factor in the relationship between fatigue and perception of safety among critical care nurses in the United Arab Emirates.

BACKGROUND: A scientific understanding of the relationships between intensive care unit nurses' well-being and patient safety will allow nurse managers, administrators, and policymakers to simultaneously manage crucial organisational goals of nurses' health and patient safety. Understanding predictors of fatigue among intensive care unit nurses may help to balance personal and organisational impacts (e.g., turnover intention, sick leave) and provide a way to positively influence their safety perception. OBJECTIVE: The aim of this study was to explore the association between work fatigue and perception of patient safety among nurses working in critical care units and determine whether their quality of life levels mediated this relationship. METHODS: This study used a cross-sectional correlational comparative design. Participants were a sample of 250 intensive care unit nurses recruited conveniently from three large hospitals in the United Arab Emirates. The self-reported questionnaire included the Nursing Quality of Life Scale, the Fatigue Severity Scale, and the Safety Attitudes Questionnaire (SAQ)-ICU version, as well as sociodemographic characteristics and work-related information. RESULTS: Of the 250 participating nurses, 76.8 % reported low QoL. There was a statistically significant correlation between nurses' Quality of Life and fatigue levels (r = 0.234, P = 0.000). Overall, 52.8 % of the sample had high fatigue and 49.6 % had poor safety perception. Multiple regression analysis using the Baron and Kenny approach showed that QoL, marital status, gender, and work environment were predictors of nurses' perception of safety. CONCLUSION: Intensive care unit nurses had high levels of fatigue and poor Quality of Life. High Quality of Life and a favourable work environment were independent predictors of good patient safety perception. Efforts should be directed to maximize staffing resources that positively impact patient safety. These findings are comparable with international studies, suggesting that these issues may be ubiquitous. IMPLICATIONS FOR CLINICAL PRACTICE: Intensive care practitioners, managers and policymakers should adopt measures to modify intensive care nurses' exhausting working conditions and provide a supportive environment. these interventions might improve nurses' perception of patient safety and consequently prevent safety incidents.

Outcomes of family-centred auditory and tactile stimulation implementation on traumatic brain injured patients.

AIM: To determine the outcomes of Family-centred Auditory and Tactile Stimulation Implementation on Traumatic Brain Injured Patients in Egypt. BACKGROUND: Family engagement in the care of their relatives in the Intensive care units is limited due to patients' life-threatening conditions, in addition to the use of high technology in these settings. Auditory and tactile sensory stimulations are among the diverse sensory stimulations that have received more attention in brain injured patients than other senses as being considered safe, and effective measures. DESIGN: A Quasi-experimental design was used to test the hypotheses of this study. METHODS: A convenience sample of 60 adult patients suffering from Traumatic Brain Injury and admitted to the intensive care units of two University Hospitals in Egypt was included in the study. Patients were assigned into two equal groups: control and study groups (30 patients each). The auditory and tactile stimulations were provided by trained family members, once daily for 2 weeks for the study group. Whereas routine communication was provided by the family of traumatic brain injured patients in the ICU for the control group. Two tools were used for data collection; tool one, the "Glasgow Coma Scale" to assess patient's level of consciousness, and tool two the "Physiological Adverse Events Assessment" to monitor patients for the occurrence of physiological adverse events. DATA COLLECTION: January to October 2019. RESULTS: The implementation of an organized auditory and tactile stimulation by trained family members is associated with highly statistically significant positive effects . Patients in the study group showed a higher mean of consciousness, lower incidence rate of physiological adverse events, and a lower mean duration of ICU stay. CONCLUSIONS: Implementation of an organized auditory and tactile stimulation by trained family members enhanced the consciousness level of comatose Traumatic Brain Injured patients, decreased the occurrence of physiological adverse events, and ICU length of stay. Thus, it is recommended for use in the daily routine nursing care of comatose Traumatic Brain Injured patients. RELEVANCE TO CLINICAL PRACTICE: This study gives a deeper understanding of how family engagement in the care of their critically ill relative enhances their recovery and improve their level of consciousness.

Open visitation policy in intensive care units in Jordan: cross-sectional study of nurses' perceptions.

INTRODUCTION: Intensive care unit patients and families experience significant stress. It creates frustrations, nervousness, irritability, social isolation for patients, anxiety, and depression for families. An open visitation policy with no time or duration limits may assist in reducing these negative experiences. However, most Jordanian and regional hospitals within the Middle-East and Northern Africa (MENA) have not implemented this strategy. PURPOSE: To evaluate nurse managers' and nurses' perspectives on the effects of an open visitation policy at intensive care units (ICUs) on patients, families, and nurses' care. METHOD: A cross-sectional, descriptive, and comparative survey design was used. RESULTS: A total of 234 nurses participated in the study; 59.4% were males, and 40.6% were females. The mean of their age was 28.6 years, with a mean of 4.1 years of experience. Nurses generally had negative perceptions and attitudes toward the open visitation policy and its consequences on the patient, family, and nursing care. CONCLUSIONS: ICU managers and staff nurses did not favor implementing an open visitation in their units despite its known benefits, international recommendations, and relevance and compatibility with the local religious and cultural context. A serious discussion regarding this hesitation from the side of the healthcare professionals should be started to find a suitable solutions that consider the benefits of the open visitation policy and the challenges that prevent its implementation in the Jordanian and Arabic cultures.

Level and predictors of caring behaviours of critical care nurses.

BACKGROUND: Advanced technologies in intensive care units, including artificial intelligence and digitization, has implications for psycho-emotional aspects of caring in terms of communication, involvement, and holistic provision in a safe, effective, and efficient manner. Critical care nurses must maintain a balance between their technological and humanistic caring behaviours during the provision of individualized holistic patient care. Therefore, this study was conducted to examine level and predictors of caring behaviours among critical care nurses in two Arab countries. METHODS: A cross-sectional design was used to achieve the objective of this study, whereby a quantitative online questionnaire survey was administered to 210 adult intensive care unit nurses at two government hospitals in Sharjah (United Arab Emirates), and two university hospitals in Amman (Jordan). Based on G* Power analysis, 200 participants were adequate to run the analysis. RESULTS: On average, 49% of the whole sample had 'good' caring behaviours. Among nurses who were working in Emirati intensive care units, 48.5% had good caring behaviours, compared to 47.4% of Jordanian intensive care unit nurses. Additionally, the results showed that predictors of caring behaviours among nurses include female gender, holding a master's degree, interest in nursing profession, and a 1:1 nurse-to-patient ratio. CONCLUSIONS: About half of the ICU nurses in this study had low levels of caring behaviours. The present study highlights the requirement for integrating the concept of holistic and patient-centred care as the essence of the nursing profession in nursing curricula to improve the level of care provided by all nurses working in intensive care units. Continuing education programs and specific interventional programs should be directed toward predictors of caring behaviours among each specific group of nurses. Future research is needed using qualitative methods to understand what the perception of intensive care unit nurses is about caring.

Managing during the COVID-19 pandemic: A cross-sectional study of health care workers' perceived organizational support and its consequences on their compassion, resilience and turnover intention.

AIM: The aim of this study is to evaluate health care professionals' perceived organizational support and its effect on their compassion, resilience and turnover intention in the United Arab Emirates. BACKGROUND: The COVID-19 pandemic exerted unprecedented pressure on health care systems, professionals and management systems. Health care organizations begin to explore their roles and function in relation to risks and resilience, in addition to ascertain what level of organization support they are providing to their workers. METHODS: A cross-sectional study was conducted with a questionnaire administered to 538 health care workers, to examine their personal resources and organizational support during the pandemic. RESULTS: A total of 37.7% of nurses were found to have a moderate level of resilience, logistic regression showed that being married is a protective factor against resigning from the profession (OR = 0.462, P = .012, 95% CI: 0.254-0.842), and health care workers who perceived higher organizational support were approximately 50% less likely to have a turnover intention (OR = 0.506, P = .009, 95% CI: 0.303-0.845). Multiple linear regression model indicated significantly higher resilience among physicians (ß = 0.12, P < .05) and allied health care practitioners (ß = 0.12, P = .022). Organizational support had a significant positive relationship with resilience scores (ß = 0.20, P < .001); adequate training was significantly related to higher compassion levels (ß = 0.11, P < .05) and high organizational support scores were associated with increased compassion scores (ß = 0.27, P < .001). CONCLUSIONS: Front-line health care workers reported moderate organizational support during the pandemic, commensurately reflected in moderate levels of personal resilience and self-compassion. Continued and better support is vital for employee sustainability and the increased health system performance, including quality of care and patient outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should help health care workers improve self-care strategies by strengthening personal resources, including shortened duty hours, offering adequate break time, providing a safe work climate and purveying adequate personal protective equipment and supplies to combat infections. They should build an empathetic work environment through understanding the needs of staff, helping tackle their work stress and sustaining cultures of compassion through promoting rewarding and flexibility strategies. Moreover, policymakers and nurse mangers should create a rewarding culture for nurses and other health care workers to increase their commitment to their jobs.

Psychological distress among the nursing workforce in the United Arab Emirates: Comparing levels before and during the COVID-19 pandemic.

BACKGROUND: Nurses make up the majority of the healthcare workforce. They contribute to the development of healthcare systems and the provision of high-quality, effective, and patient-centered healthcare services. However, nurses need good mental and emotional well-being to provide adequate care and the necessary physical and mental health support for their clients. This study aimed to determine the level of generalized psychological distress among nurses in the United Arab Emirates. As this study was initiated before the coronavirus disease 2019 (COVID-19) pandemic, we were able to compare data gathered before and during the pandemic. METHOD: This study used a cross-sectional correlational design. The Kessler Psychological Distress Scale (K10) was used to measure generalized psychological distress. Nurses' distress levels were measured and compared before and during the COVID-19 pandemic. RESULTS: In total, 988 participants completed the questionnaire. The majority (n = 629, 63.7%) were employed in hospitals and the remainder worked in primary healthcare settings (n = 359, 36.3%). The mean distress score was 27.1 ± 13.7; 42.1% (n = 416) of participants had a severe level of distress, and only 36.4% (n = 360) reported no distress. More participants had severe stress levels before COVID-19 (59.5%, n = 386) compared with during COVID-19 (10.9%, n = 30). CONCLUSIONS: Participants' K10 scores suggest that nurses experience significant distress, which may compromise their ability to care for their clients. This study emphasizes the importance of supporting nurses as a preliminary step to improving patient care. Despite the pressure of working during the COVID-19 pandemic, participants' general distress scores were lower during than before the pandemic. Organizational, governmental, and global support and appreciation may have contributed to relieving the distress nurses experienced. This may be a useful ongoing approach for enhancing healthcare systems.

Traditional, religious, and cultural perspectives on mental illness: a qualitative study on causal beliefs and treatment use.

PURPOSE: Limited information is known from studies regarding traditional, religious, and cultural perspectives on mental illness and the use of traditional and alternative therapies by mentally ill people in Indonesia. This study explored traditional, religious, and cultural beliefs about causes of mental illness and the use of traditional/alternative treatments for mentally ill patients. METHOD: We adopted a qualitative content analysis method as proposed by Schreier. This study was conducted at a mental Hospital in Indonesia. We interviewed 15 nurses and 15 patients. Data were analysed using qualitative content analysis method. RESULTS: Five discrete but interrelated themes emerged: 1) Possessed illness and belief in supernatural forces; 2) Sinful or cursed illness; 3) Witchcraft or human-made illness; 4) traditional/alternative treatments; and 5) Barriers to treatment of mental illness. CONCLUSION: Traditional/alternative treatments play an important role in meeting the need for mental health treatment. The findings are relevant for mental health nurses who provide direct to their patients, and for other areas of mental health practice. We also found a lack of knowledge about the causes of mental illness among patients and families. Education should be at the heart of mental health promotion to raise the level of mental health literacy in Indonesia.