The role of human rhinovirus in COPD exacerbations in Abu Dhabi: molecular epidemiology and clinical significance.

This study aimed to describe the molecular epidemiology and seasonality of human rhinovirus (HRV) in chronic obstructive pulmonary disease (COPD) and its association with COPD exacerbations in Abu Dhabi, the United Arab Emirates (UAE). Sputum specimens were collected for analysis from all COPD patients who visited a medical center from November 2021 to October 2022. The real-time quantitative polymerase chain reaction (qPCR) test was used to detect HRV. Of the 78 COPD patients included in the study, 58 (74%) patients presented with one or more exacerbation episodes. The incidence of COPD exacerbation peaked over the winter and substantially decreased during the summer. HRV positivity in patients during exacerbation (E1) was 11/58 (19%) and 15/58 (26%) two weeks after the exacerbation episode (E2). There was no significant difference in the HRV load in these patients. No statistically significant difference was observed in the detection of HRV during exacerbation compared to patients with stable COPD. This is the first study to assess the association between HRV detection by qPCR and COPD exacerbations in the UAE. The high sensitivity of the detection technology helped collect reliable epidemiologic data. Few studies have provided similar Middle East data. This study's pattern of COPD exacerbations and HRV detection parallels that of temperate countries. This information can help with future, more extensive surveillance of respiratory viruses in the UAE and the Middle East and their association with COPD exacerbations.

Fear, stress, anxiety, depression and insomnia related to COVID-19 among undergraduate nursing students: An international survey.

The emergence of COVID-19 has produced unprecedented change in daily life activities leading to major impacts on psychological wellbeing and sleep among individuals worldwide. The study aimed to assess levels of fear, stress, anxiety, depression, and insomnia among undergraduate nursing students in four countries two years after the start of the pandemic. An international, multi-centre cross-sectional electronic survey was conducted between December 2021 and April 2022. An on-line questionnaire was distributed via Qualtrics® and JISC® software. Instruments included the Fear of COVID-19 Scale, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale and the Insomnia Severity Index, and a demographics and academic background questionnaire. The independent variables included demographic and academic backgrounds, while fear level, stress, anxiety, depression, and insomnia were the dependent variables. A total of 918 undergraduate nursing students from KSA, Oman, UK, and UAE were participants in the study. Students presented with stress (91.6%), anxiety (69.1%), depression (59.8%), and insomnia (73.2%). The participants' mean Fear of COVID-19 Scale score was 12.97 (SD = 6.14). There were significant positive relationships between fear of COVID-19, stress, anxiety, depression, and insomnia. Undergraduate nursing students experienced moderate to severe levels of Fear of COVID-19, stress, anxiety, depression, and insomnia two years after the onset of the COVID-19 pandemic. Psychological intervention and peer support are needed to reduce the long-term adverse outcomes of mental health problems and insomnia. It is important to introduce education about crisis management of infectious disease during pandemics into the nursing curriculum to increase student knowledge and improve their preparedness for such emergencies.

Mental health nurses' attitudes towards risk assessment: An integrative systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Risk assessment and risk management are considered to be important practices carried out by mental health nurses. Risk assessment can help keep mental health service users' safe, but some nurses see it as a 'tick the box' exercise. Some studies have looked at nurses' attitudes to risk assessment but no one has systematically described all the studies. WHAT THE ARTICLE ADDS TO EXISTING KNOWLEDGE?: Mental health nurses' attitudes towards risk assessment are diverse with regard to its legitimacy, conduct and value. This study provides an organised framework to help understand the areas in which these different attitudes occur. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Since attitudes can influence clinical practice, nurses need to reflect on how they view risk assessment. Further research is required to investigate whether particular attitudes are positive or negative and whether attitudes can be changed. ABSTRACT: INTRODUCTION: Understanding nurses' attitudes towards risk assessment could inform education and practice improvements. AIM/QUESTION: To explore mental health nurses' attitudes towards risk assessment. METHOD: An integrative systematic review (PROSPERO: CRD42023398287). Multiple databases (PubMed, CINAHL, MEDLINE, EMBASE and PsycINFO) were searched for primary studies of mental health nurses' attitudes towards risk assessment. Qualitative studies were subject to inductive coding and thematic analysis; quantitative data were integrated with emerging themes. RESULTS: Eighteen articles were included. Qualitative studies commonly lacked rigorous analyses. Four themes emerged: underlying purpose and legitimacy of risk assessment (philosophical orientation); use of structured approaches (technical orientation); value of intuition (intuitive orientation); and service user involvement (relationships orientation). There were contradictory study findings in each thematic category indicating different attitudes among mental health nurses. DISCUSSION: Mental health nurses' attitudes towards risk assessment vary in four key domains. Survey studies suggest they are more approving of structured approaches to risk assessment than many qualitative studies suggest. There is a need to develop a valid measure of attitudes to risk assessment. IMPLICATIONS FOR PRACTICE: This review could help health organisations to develop strategies to improve their risk assessment policies and practice. There is a need to develop structured training and education programmes.

Co-infection of COVID-19 patients with atypical bacteria: A study based in Jordan

Objective: The aim of this work was to know the prevalence of Chlamydophila pneumoniae and Mycoplasma pneumoniae in coronavirus disease 2019 (COVID-19) patients in Jordan. Also, to assess a TaqMan real-time polymerase chain reaction (PCR) assay in detecting these two bacteria. Methods: This is a retrospective study performed over the last five months of the 2021. All nasopharyngeal specimens from COVID-19 patients were tested for C. pneumonia, and M. pneumoniae. The C. pneumoniae Pst-1 gene and M. pneumoniae P1 cytadhesin protein gene were the targets. Results: In this study, 14 out of 175 individuals with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (8.0%) were co‐infected with C. pneumoniae or M. pneumoniae. Co‐infection with SARS‐CoV‐2 and C. pneumoniae was reported in 5 (2.9%) patients, while 9 (5.1%) patients had M. pneumoniae and SARS‐CoV‐2 co-infection. The mean (± std) of the correlation coefficient of the calibration curve for real-time PCR analysis was –0.993 (± 0.001) for C. pneumoniae and –0.994 (± 0.003) for M. pneumoniae. The mean amplification efficiencies of C. pneumoniae and M. Pneumoniae were 187.62% and 136.86%, respectively. Conclusion: In this first study based in Jordan, patients infected with COVID-19 have a low rate of atypical bacterial co-infection. However, clinicians should suspect co-infections with both common and uncommon bacteria in COVID-19 patients. Large prospective investigations are needed to give additional insight on the true prevalence of these co-infections and their impact on the clinical course of COVID-19 patients. (AU)

Randomized controlled trials of mental health nurse-delivered interventions: A systematic review.

WHAT IS KNOWN ON THE SUBJECT?: Well conducted randomized controlled trials provide the highest level of evidence of effectiveness of healthcare interventions, including those delivered by mental health nurses. Trials have been conducted over the years but there has not been a comprehensive review since 2005, and never one including studies conducted outside the UK. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The paper provides a comprehensive overview of results from randomized controlled trials of mental health nurse-delivered interventions conducted in the UK, Ireland, US, Australia, New Zealand, or Canada and reported 2005 to 2020. It highlights that the trial evidence is limited and offers only partial evidence for interventions that are central to mental health nursing practice. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Much mental health nursing practice is not supported by the highest level trial evidence. Mental health nurses need to carefully select evidence on which to base their practice both from the mental health nursing literature and beyond. Mental health nurses and other stakeholders should demand greater investment in trials to strengthen the evidence base. ABSTRACT: INTRODUCTION: Nurses are the largest professional disciplinary group working in mental health services and have been involved in numerous trials of nursing-specific and multidisciplinary interventions. Systematic appraisal of relevant research findings is rare. AIM: To review trials from the core Anglosphere (UK, US, Canada, Ireland, Australia, New Zealand) published from 2005 to 2020. METHOD: A systematic review reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Comprehensive electronic database searches were conducted. Eligible studies were randomized controlled trials of mental health nurse-delivered interventions conducted in relevant countries. The risk of bias was independently assessed. Synthesis involved integration of descriptive statistics of standardized metrics and study bias. RESULTS: Outcomes from 348 between-group comparisons were extracted from K = 51 studies (N = 11,266 participants), Standardized effect sizes for 68 (39 very small/small, 29 moderate/large) statistically significant outcomes from 30 studies were calculable. All moderate/large effect sizes were at risk of bias. DISCUSSION: Trial evidence of effective mental health nurse-delivered interventions is limited. Many studies produced few or no measurable benefits; none demonstrated improvements related to personal recovery. IMPLICATIONS FOR PRACTICE: Mental health nurses should look beyond gold standard RCT evidence, and to evidence-based interventions that have not been trialled with mental health nurse delivery.

A comprehensive clinical guide for Pneumocystis jirovecii pneumonia: a missing therapeutic target in HIV-uninfected patients.

INTRODUCTION: Pneumocystis jirovecii is an opportunistic, human-specific fungus that causes Pneumocystis pneumonia (PCP). PCP symptoms are nonspecific. A patient with P. jirovecii and another lung infection faces a diagnostic challenge. It may be difficult to determine which of these agents is responsible for the clinical symptoms, preventing effective treatment. Diagnostic and treatment efforts have been made more difficult by the rising frequency with which coronavirus 2019 (COVID-19) and PCP co-occur. AREAS COVERED: Herein, we provide a comprehensive review of clinical and pharmacological recommendations along with a literature review of PCP in immunocompromised patients focusing on HIV-uninfected patients. EXPERT OPINION: PCP may be masked by identifying co-existing pathogens that are not necessarily responsible for the observed infection. Patients with severe form COVID-19 should be examined for underlying immunodeficiency, and co-infections must be considered as co-infection with P. jirovecii may worsen COVID-19's severity and fatality. PCP should be investigated in patients with PCP risk factors who come with pneumonia and suggestive radiographic symptoms but have not previously received PCP prophylaxis. PCP prophylaxis should be explored in individuals with various conditions that impair the immune system, depending on their PCP risk.

Psychometric Properties of the Insomnia Severity Index Among Arabic Chronic Diseases Patients.

Introduction: The Insomnia Severity Index (ISI) is a self-administrated questionnaire most frequently used to assess insomnia in clinical and non-clinical populations. Objective: To evaluate the psychometric properties of the Arabic ISI among patients diagnosed with chronic diseases. Methods: A cross-sectional and descriptive correlational design was used. A total of 1,005 patients with chronic diseases completed the seven items of the Arabic ISI version. The scale was assessed in terms of acceptability, internal consistency, and validity. Construct validity was explored with the use of principal factor analysis and confirmatory factor analysis, to examine the dimensional structure of the ISI. Results: The Cronbach's alpha coefficient for the Arabic ISI was 0.82, which shows good reliability. The total ISI score did not have floor or ceiling effects. There was evidence of discriminate validity. The Principal Component Analysis (PCA) indicated two factors (four items loading on Factor I and three items loading on Factor II). The construct validity of PCA in terms of two factors was explored by confirmatory factor analysis to examine the dimensional structure of the ISI. The confirmatory factor analysis showed an absolute fit for the two-factor model. Conclusion: The results support the two-factor structure of ISI. The Arabic version of the ISI demonstrated good reliability and validity for assessing insomnia in patients diagnosed with chronic diseases.

The first detection of Pneumocystis jirovecii in asthmatic patients post-COVID-19 in Jordan.

Pneumocystis jirovecii pneumonia (PCP), caused by fungal species named Pneumocystis jirovecii, is a frequent opportunistic infection in those with human immunodeficiency virus (HIV) infection. However, PCP has been documented in immunocompetent patients. This study aims to determine if P. jirovecii detection occurs in asthma patients following coronavirus disease 2019 (COVID-19) in a Jordanian cohort. Also, to evaluate a method of TaqMan quantitative polymerase chain reaction (qPCR) assay to detect P. jirovecii, from sputum samples. The nasopharyngeal swabs were used to detect SARS-CoV-2 and sputum samples were tested for P. jirovecii using real time qPCR assay. Beta-tubulin (BT) and Dihydrofolate reductase (DHFR) genes were the directed targets of P. jirovecii. The results showed that the mean qPCR efficiencies of BT and DHFR were 96.37% and 100.13%, respectively. Three out of 31 included patients (9.7%) had a positive P. jirovecii. All of the three patients had used oral corticosteroids (OCS) in the last two months due asthma exacerbation and were treated with OCS for COVID-19. This is the first study based in Jordan to demonstrate that P. jirovecii and COVID-19 can co-exist and that it is important to maintain a broad differential diagnosis, especially in immunocompromised patients. Chronic lung disease can be a risk factor for the P. jirovecii colonization possibly due to corticosteroid's immunosuppression.

Prevalence of Sleep Disturbance in Patients With Cancer: A Systematic Review and Meta-Analysis.

Sleep disturbance is one of the most common and troubling symptoms that harm the quality of life throughout all phases of treatment and stages of the illness among patients with cancer. The aim of this meta-analysis is to examine the present status of sleep disturbance prevalence in patients with cancer. The following databases were searched: PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, from inception to April 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. A total of 160 studies (N = 46,279) published between 1998 and 2021 met the inclusion criteria. The overall prevalence of sleep disturbance was 60.7% (26,448/46,279 participants, 95% CI 58.1-63.3%) with significant heterogeneity between studies (p < .000, τ2 = .0000, I2 = 96.4%). This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce sleep disturbance and improve the quality of life of cancer patients.

Evaluation of the effectiveness of educational medical informatics tutorial on improving pharmacy students’ knowledge and skills about the clinical problem-solving process

Objective: To investigate the effectiveness of an online tutorial and its impact on improving knowledge and skills of pharmacy students in the clinical problem-solving process that is necessary to implement pharmaceutical care. Methods: This is a prospective interventional study conducted during the COVID-19 pandemic restrictions using four novel templates. The first two levels of Kirkpatrick’s Model (Reaction and Learning) were used. Results: 129 participants completed all of the online training parts. The findings indicated a significant improvement in the students’ knowledge and skills. The participants achieved higher score following the tutorial than the baseline, with a statistically significant difference (p < 0.001). There was a significant improvement in the number of detected treatment-related problems. The majority of students were satisfied with the overall training process and stated a high evaluation score out of 10 (mean = 7.93 ± 1.42, median = 8.00). Conclusion: The educational intervention achieved a substantial positive impact on decision-making skills of participating students and was considered effective in helping them attain basic skills such as teamwork, peer assessment, communication and critical evaluation. Healthcare providers must work together to ensure accurate medication use during care transitions. Pharmacists, as medication experts, play an important role in the implementation process. Pharmacy educators must prepare pharmacy student to use pharmaceutical care in their future practice. (AU)

Investigating the human rhinovirus co-infection in patients with asthma exacerbations and COVID-19

Objective: To investigate the co-infections with human rhinovirus (HRV) among patients with asthma exacerbation and COVID-19 in Jordan. Also, to determine the frequency of acute asthma exacerbation before and during the COVID-19 pandemic on a matched basis. Methods: The data of this prospective cohort research consisted of clinical variables. During the first visit, and after 14-days, nasopharyngeal swabs were taken and the quantitative polymerase chain reaction was performed for HRV and SARS-CoV-2 detection. Results: Forty-seven out of 175 (26.9%) COVID-19 adult cases have been diagnosed with asthma. The number of asthma exacerbations among the study participants was higher during 2021 than in 2020 (p=0.035). Most of the included asthmatic participants (61.7%) were only positive for SARS-CoV-2 and 38.3% were co-infected with HRV. The SARS-CoV-2 cycle threshold value was lower in samples infected with both viruses compared to samples infected with SARS-CoV-2 alone, p<0.005. Conclusion: Our findings indicate that HRV and SARS-CoV-2 were significantly more prevalent in asthma exacerbations than stable asthma. Thus, HRV and/or SARS-CoV-2 infections were potentially cofactors or contributors to the asthma exacerbation in this cohort. This is the first study, in Jordan, to investigate the HRV co-infection in COVID-19 asthmatic patients and HRV could be related with a higher severity of COVID-19. (AU)

Clinical Features of COVID-19 Patients in the First Year of Pandemic: A Systematic Review and Meta-Analysis.

BACKGROUND: The new coronavirus disease (COVID-19) carries a high risk of infection and has spread rapidly around the world. However, there are limited data about the clinical symptoms globally. The purpose of this systematic review and meta-analysis is to identify the prevalence of the clinical symptoms of patient with COVID-19. METHODS: A systematic review and meta-analysis were carried out. The following databases were searched: PubMed, CINAHL, MEDLINE, EMBASE, PsycINFO, medRxiv, and Google Scholar, from December 1st, 2019 to January 1st, 2021. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS: A total of 215 studies, involving 132,647 COVID-19 patients, met the inclusion criteria. The pooled prevalence of the four most common symptoms were fever 76.2% (n = 214; 95% CI 73.9-78.5); coughing 60.4% (n = 215; 95% CI 58.6-62.1); fatigue 33.6% (n = 175; 95% CI 31.2-36.1); and dyspnea 26.2% (n = 195; 95% CI 24.1-28.5). Other symptoms from highest to lowest in terms of prevalence include expectorant (22.2%), anorexia (21.6%), myalgias (17.5%), chills (15%), sore throat (14.1%), headache (11.7%), nausea or vomiting (8.7%), rhinorrhea (8.2%), and hemoptysis (3.3%). In subgroup analyses by continent, it was found that four symptoms have a slight prevalence variation-fever, coughing, fatigue, and diarrhea. CONCLUSION: This meta-analysis found the most prevalent symptoms of COVID-19 patients were fever, coughing, fatigue, and dyspnea. This knowledge might be beneficial for the effective treatment and control of the COVID-19 outbreak. Additional studies are required to distinguish between symptoms during and after, in patients with COVID-19.

Sleep disturbance among frontline nurses during the COVID-19 pandemic.

The main objective of this study is to assess the prevalence of sleep disturbance and related psychological factors (stress, anxiety and depression) among frontline nurses in Oman during the COVID-19 pandemic. A cross-sectional and descriptive correlational design using Qualtrics® software was used in this research. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), the Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS). Logistic regression was performed to identify factors associated with poor sleep quality. Of the 987 frontline nurses who participated, 58.8% (n = 580) reported poor sleep quality. In an examination of PSQI components the mean sleep duration was 7.04 (SD = 1.59) hours per night, and the sleep latency mean was 38.18 min (SD = 31.81). Poor sleep (p < .05) was significantly associated with age, marital status, years of experience, comorbidity, and whether family members or relatives were suspected or confirmed with having COVID-19. Logistic regression showed that poor quality of sleep was significantly associated with stress, anxiety and depression symptoms. Sleep disturbance is a significant problem for frontline nurses working in Oman during the COVID-19 pandemic. Appropriate interventions to maintain the health conditions and reduce sleep disturbance among frontline nurses are needed in order to help support nurses' work during contagious disease outbreaks. These can be implemented through online workshops and training to enhance nurses' responses to the pandemic or to any further disease outbreaks.

Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis.

OBJECTIVE: Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. METHODS: A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. RESULTS: Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31-40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. CONCLUSION: Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.

Psychological impact of the coronavirus 2019 (COVID-19) pandemic on nurses.

AIM: The new coronavirus disease (COVID-19) pandemic has laid unprecedented stress on healthcare workers and especially nurses. The main objective of this study is to determine the prevalence of stress, anxiety, depression and sleep disturbance among nurses in Oman during the COVID-19 pandemic, and to explore the contributing factors. METHODS: A cross-sectional and descriptive correlational design using Qualtrics® software was performed. Data were collected using the Pittsburgh Sleep Quality Index, the Hospital Anxiety and Depression Scale and the Perceived Stress Scale. RESULTS: Of the 1,130 nurses who participated, 75.6% (n = 854) reported stress, 44.2% (n = 499) reported anxiety, 38.5% (n = 435) reported depression and 73.7% (n = 833) reported poor sleep. Stress, anxiety, depression and sleep disturbance (p < .05) were significantly associated with age, marital status, comorbidity and whether family members or relatives were suspected or confirmed with COVID-19. The stress, anxiety, depression and sleep disturbance were significantly positively corelated with each other. Logistic regression showed nurses in the age group between 18 and 30, who worked at the frontline, were at a higher risk of stress, anxiety, depression and sleep disturbance. CONCLUSIONS: Stress, anxiety, depression and sleep disturbance are significant problems for nurses working in Oman during the COVID-19 pandemic. Appropriate interventions to monitor and reduce psychological problems and sleep disturbance among nurses are needed, which can help to support nurses' work during contagious disease outbreaks.

Cancer-related fatigue: an overview.

A diagnosis of cancer is a major life stressor that can affect the physiological, psychological and physical state of the person concerned. Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness. The aim of this review is to provide background information on cancer-related fatigue. This review discusses cancer-related fatigue (CRF) in terms of the definition, prevalence, risk factors, aetiology, and the measurement scales used. The differences between definitions of symptoms and relevant theories will be explored and discussed to help explain the variety of instruments used in its measurement. The prevalence of fatigue will be assessed by looking critically at the evidence of fatigue and the factors that affect it. Potential treatment and management strategies for CRF will also be discussed. Finally, there will be an overview of the instruments used to measure fatigue. This review also provides important evidence for measuring and managing CRF that can help nurses to understand fatigue among patients with cancer. Assessing CRF should be routinely undertaken in clinical settings to help identify the proper interventions, treatments and management to reduce fatigue among cancer patients.

Sleep disturbance among Arabic breast cancer survivors.

BACKGROUND: Sleep disturbance is the most common and distressing cancer symptom that negatively affects the quality of life (QoL). The main objective of this study is to determine the prevalence of sleep disturbance among Arabic women with breast cancer, post-treatment, and assess their sleep disturbance in relation to health-related QoL, demographics and treatment characteristics. METHODS: In this study, cross-sectional data were collected using the Pittsburgh Sleep Quality Index (PSQI: 19-items) and the Functional Assessment of Cancer Therapy-General (FACT-G: 27 items). Demographic information and treatment characteristics were also collected. RESULTS: A total of 133 women who had been diagnosed with breast cancer agreed to participate in the study. Approximately three-quarters (73.7%; n = 98) of the participants was reported as poor sleepers (PSQI ˃ 5). The worse mean score of the PSQI component was the sleep latency with the highest score (M = 1.71, SD = 0.93). There were significant relationships between poor sleep and treatment (patients receiving both chemotherapy and radiotherapy) and with comorbidities (asthma, anaemia, hypertension/heart failure, diabetes/heart diseases) (P < 0.05). Those experiencing poor sleep had the lowest QoL among the cancer patients. CONCLUSION: Sleep disturbance is a significant problem for Arabic patients diagnosed with breast cancer. The result suggests that sleep disturbance should be routinely assessed in clinical settings. Further research should develop an intervention for management to reduce sleep disturbance and improve sleep quality in cancer patients.

Fatigue and Sleep Disturbance in Arabic Cancer Patients After Completion of Therapy: Prevalence, Correlates, and Association With Quality of Life.

BACKGROUND: Fatigue and sleep disturbance are 2 of the most common and distressing cancer symptoms that negatively affect quality of life. OBJECTIVE: The aim of this study was to assess the prevalence of, and factors contributing to, fatigue and sleep disturbance in Arabic-speaking cancer patients in Oman after completion of their cancer treatment. METHODS: A cross-sectional and descriptive correlational design was used. Data were collected using the Pittsburgh Sleep Quality Index where a score of >5 indicated as poorer sleep, the Functional Assessment of Cancer Therapy-Fatigue a score of ≤34 indicating clinically significant fatigue, and the Functional Assessment of Cancer Therapy-General. RESULTS: Of the 369 patients who participated, 77.5% (n = 286) reported clinically significant fatigue, and 78% (n = 288) reported poor sleep. Fatigue (P < .05) was significantly associated with age, cancer site, months since diagnosis, type of treatment received, and comorbidity. Those experiencing fatigue and poor sleep had the lowest quality of life among the cancer patients studied. CONCLUSION: Fatigue and sleep disturbance are significant problems for the Arabic patients diagnosed with cancer. Both fatigue and sleep disturbance should be routinely assessed in the case of such patients. IMPLICATIONS FOR PRACTICE: Routine assessments of fatigue and sleep disturbance are recommended so that appropriate interventions and treatment management plans can be introduced to reduce fatigue and improve sleep quality among patients with cancer.

Prevalence of stress, depression, anxiety and sleep disturbance among nurses during the COVID-19 pandemic: A systematic review and meta-analysis.

BACKGROUND: The new coronavirus disease's (COVID-19) high risk of infection can increase the workload of healthcare workers, especially nurses, as they are most of the healthcare workforce. These problems can lead to psychological problems. Therefore, the aim of this systematic review and meta-analysis to ascertain the present impact of the COVID-19 outbreak on the prevalence of stress, anxiety, depression and sleep disturbance among nurses. METHODS: A systematic review and meta-analysis were conducted. The following databases were searched: PubMed, CHINAL, MEDLINE, EMBASE, PsycINFO, MedRxiv and Google Scholar, from January 2020 up to 26th October 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS: A total of 93 studies (n = 93,112), published between January 2020 and September 2020, met the inclusion criteria. The overall prevalence of stress was assessed in 40 studies which accounted for 43% (95% CI 37-49). The pooled prevalence of anxiety was 37% (95% CI 32-41) in 73 studies. Depression was assessed in 62 studies, with a pooled prevalence of 35% (95% CI 31-39). Finally, 18 studies assessed sleep disturbance and the pooled prevalence was 43% (95% CI 36-50). CONCLUSION: This meta-analysis found that approximately one third of nurses working during the COVID-19 epidemic were suffering from psychological symptoms. This highlights the importance of providing comprehensive support strategies to reduce the psychological impact of the COVID-19 outbreak among nurses under pandemic conditions. Further longitudinal study is needed to distinguish of psychological symptoms during and after the infectious disease outbreaks.

Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis.

CONTEXT: Fatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer. OBJECTIVES: The objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer. METHODS: The following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. RESULTS: A total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45-53) with significant heterogeneity between studies (P < 0.000; τ2 = 0.0000; I2 = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue. CONCLUSION: This meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.