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.

Effectiveness of blended pedagogy for radiographic interpretation skills in operative dentistry - a comparison of test scores and student experiences at an undergraduate dental school in Pakistan.

BACKGROUND: Utilizing Blended pedagogy (BP) in radiographic skills may prove to be an effective teaching strategy. However, studies on the use of BP in dentistry are quite limited in Pakistan, where teaching has mostly been via traditional Didactic Lectures (DL); and radiographic interpretation skills of undergraduate dental students are suboptimal. Therefore, this study aims to assess whether utilizing BP to teach radiographic interpretation skills is an effective teaching methodology in Pakistan. METHODS: This mixed-method study was conducted on final year dental students at Jinnah Medical and Dental College (JMDC). Two groups of students were utilized for this study, one taught by traditional DL and the other taught by BP for the same module. BP was conducted over six weeks. A post-module test was conducted in both groups. Additionally, the BP group completed a modified Community of Inquiry (CoI) survey tool and volunteered to discuss their experiences through a focused group discussion (FGD). Descriptive statistics were computed and independent sample t-test was used to analyse the difference between the scores of the two groups. Thematic analysis was performed for the qualitative data. RESULTS: The mean post-test scores were found to be significantly higher in the BP group (61.0 ± 10.2) compared to the DL group (44.4 ± 12.3) (p = < 0.001, CI = 95%, Cronbach Alpha > 0.8). The mean scores for the modified CoI instrument were 4.0 ± 0.29 for the whole instrument; 4.25 ± 0.22 for Teaching Presence, 3.71 ± 0.23 for Social Presence and 3.97 ± 0.16 Cognitive Presence, with all three having a Cronbach's alpha > 0.75. Thematic analysis revealed that BP students mutually agreed that BP method was beneficial with the appreciation of strong support from the facilitator. However, challenges like interrupted power supply and increased effort requirement from students were pointed out. CONCLUSION: Students taught radiographic interpretation skills with BP in comparison to DL had higher test scores and expressed a positive experience demonstrated via a modified CoI survey and FGD. Considering the encouraging results found, dental schools should incorporate BP in their teaching methodology and follow-up studies are needed to further support the use of BP as an effective teaching methodology in Dentistry.

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.

The impact of cultural healthcare practices on Children's health in the United Arab Emirates: a qualitative study of traditional remedies and implications.

Aim: This qualitative study investigates the impact of cultural practices on children's health in the United Arab Emirates (UAE) by examining the use of traditional remedies and home treatments by mothers. Methods: Twenty-five participants, all mothers who had employed traditional treatments or home remedies for their children during periods of illness, were included in the study. The participants represented a diverse range of educational backgrounds, from school diploma holders to university degree graduates, with ages spanning from 20 to 50 years. Hailing from different Arabic countries and cultural subgroups, the majority of participating mothers were from the UAE. Results: Through in-depth interviews, three major themes emerged from the participants' experiences. Firstly, a strong connection between culture, religion, and healthcare practices was evident. Many mothers opted for cultural remedies as their first line of defense against illnesses due to the practices' strong foundations in their cultural heritage. Herbal remedies, Quranic healing, and other traditional methods were perceived to be both effective and spiritually comforting, reinforcing participants' sense of cultural identity. Secondly, participants highlighted unintended consequences of relying solely on traditional treatments. Some instances were reported where the use of ineffective remedies resulted in delays in seeking appropriate medical care for their children, potentially compromising their health. Additionally, certain misconceptions regarding the safety and efficacy of traditional remedies were identified, emphasizing the need for evidence-based healthcare education. Conclusion: This qualitative study sheds light on the intricate interplay between culture, traditional remedies, and children's health in the UAE. The incorporation of diverse participants from various Arabic countries and cultural subgroups enriches the study's applicability to broader Arabic cultures. By recognizing the significance of cultural healthcare practices and striking a balance with evidence-based care, healthcare providers can create a more inclusive and effective healthcare environment for children in the UAE. Future research should explore diverse samples and develop targeted interventions to further advance cultural awareness and understanding in healthcare practices.

Hearing the voices of adolescents: Evaluating the quality of care for young adults with chronic illnesses in the UAE.

BACKGROUND: Quality care for adolescents and young adults with chronic illnesses has been under-explored in the United Arab Emirates (UAE) and internationally, especially from patients' perspectives. Most available international studies focused on quality of life and the transition to adulthood rather than service quality. AIM: This research assesses care quality for adolescents with chronic illnesses in the UAE, aiming to understand their perspectives, appraise current practices, and identify service gaps. METHODS: A cross-sectional survey employed a validated questionnaire examining 33 essential care components. Participants comprised 576 adolescents and young adults with chronic conditions from five UAE Emirates. RESULTS: Participant's reports indicated that none of the 33 care elements were received consistently. Most participants (80.6%) reported crucial care aspects were absent, and across most investigated items, 19.4%-46.5% of participants reported receiving the services they were supposed to receive only some or many of the times, indicating significant areas for improvement. CONCLUSIONS: Findings demonstrate significant care quality gaps for UAE's adolescents and young adults with chronic illnesses. These may critically affect their ability to manage their conditions and ensure holistic growth. These insights can guide healthcare enhancements tailored to this demographic. PRACTICE IMPLICATIONS: There is an urgency for enhanced patient-centered care in UAE healthcare, emphasizing clinicians' roles in supporting adolescents with chronic illnesses, especially during transitions. Healthcare managers should prioritize standardized care policies, improved communication, and training that emphasizes consistent patient feedback and transition readiness. Further research into care gaps and tailored interventions within the region's distinct sociocultural setting is essential.

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.

Experiences of a mental health promotion, prevention, and early-intervention training program targeted to school nurses in the United Arab Emirates.

AIM: To report participants' and facilitators' experiences of mental health promotion, prevention, and early-intervention training program targeted at school nurses in the United Arab Emirates (UAE). BACKGROUND: The UAE school healthcare service is staffed by full-time nurses and part-time doctors and linked to primary healthcare centers. This service supports children's physical and mental well-being. However, school nurses' capacity to realize the potential of this service, particularly regarding mental health, has not yet been explored. METHODS: We used an exploratory qualitative approach with data triangulation. Data were drawn from school nurses that participated in a targeted mental health promotion, prevention, and early-intervention training program. Data were gathered through focus group interviews with participating school nurses, written reflections, and notes recorded by the program designers and trainers. All school nurses who participated in the training program (N = 15) were included in this study. This study adhered to the consolidated criteria for reporting qualitative research. RESULTS: Nurses' narratives encompassed three main themes, which indicated the program was an enjoyable professional and personal journey that allowed professional discovery/development and personal growth. Program organizers/facilitators indicated the training program was important, but challenging to implement. Four themes emerged from their reflections that covered the structure of school nursing services, participants' competency and education, the UAE context, and teaching style. CONCLUSION: A well-structured professional development program can contribute to improving mental healthcare in schools. Improved service structure and regulations to support this goal are essential. IMPLICATIONS FOR NURSING PRACTICE, RESEARCH, AND POLICY: School nurses benefit professionally and personally from targeted mental health training, which also improves the care students receive. School healthcare service managers should consider increasing such training opportunities for nurses and focus on measuring service outcomes and evaluating effectiveness. It is also necessary to reassess the minimum qualification requirement for school nurses. Specific professional development programs for school nurses will improve their clinical practice and support the recruitment of competent and prepared staff.

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.

Undergraduate nursing students' mentoring experiences in the clinical practicum: The United Arab Emirates (UAE) perspective.

AIM: This study explored undergraduate nursing students' mentoring experiences during their final clinical practicum as they prepared to enter the workforce. METHODS: We used a qualitative case study design with data collected in two focus group discussions involving 19 students. Data were analysed using inductive thematic analysis. RESULTS: Students' descriptions of their mentoring experiences fell under three themes: 'great experience', 'being treated like part of the family', and 'gaining confidence and skills'. Students described their mentors as having critical roles in providing feedback and learning opportunities to interns. Students also reported that ungraded initial assessment, friendlier workplaces, and mentors with patience were required to strengthen their professional learning at the workplace. CONCLUSION: These results suggest that prompt and constructive feedback, warmer workplace environments, and passionate mentors' involvement may help enhance students' mentoring experiences during their clinical practicum. IMPLICATIONS FOR NURSING MANAGEMENT: Management and academia should work jointly to develop mentorship programs to achieve better student outcomes. Doing this will lead to role clarity, higher levels of satisfaction, and increased productivity. Management needs to consider compensating mentors for their time in student learning and select experienced nurses willing to mentor others to promote enjoyable relationships and effective mentoring engagements. Management needs to find creative ways to build mentoring into appraisals, for at present, it is considered a voluntary activity for educating the next generation of nurses. Management should ensure adequate training and ongoing support for mentors and mentees in clinical mentoring.

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.

The educational use of social networking sites among medical and health sciences students: a cross campus interventional study.

BACKGROUND: In recent years, social networking sites (SNSs) have evolved beyond connection and networking to become a powerful instructional tool. There is still a dearth of knowledge on the professional use of SNSs for education particularly among students from diverse backgrounds. This study examined the extent and pattern of SNSs usage for education across six institutions and then conducted an interventional workshop to fortify and regulate the educational use of SNSs. METHODS: This multicenter study was done in two phases. In the first phase, an online cross-sectional survey using a validated inventory was administered to determine the prevalence, extent, and preferences of SNSs usage by undergraduate students in medicine, health sciences and dentistry across five centers. Later, the second phase of the study was undertaken in a 75-min guided live workshop about the appropriate use of SNSs in academia. Additionally, pre- and post-test surveys were conducted to assess the impact and outcome of workshop. RESULTS: Of the 1722 respondents, 1553 (90%) reported using SNSs with the frequency of once a month to three to five times per day for education and to stay in touch with others. Most students agreed with the benefits of SNSs for education mainly in terms of information gathering, networking and collaboration. Twitter, Instagram, and Pinterest were noted as the most preferred SNSs for education. Nevertheless, 63% perceived that proper instruction was required for the efficient use of SNSs. Following the guided workshop, there was a significant improvement in web technology understanding, digital professionalism, skills and knowledge on the productive use of SNSs. Students rated the efficient for conceptual learning, connection to community practice, e-portfolio, and collaborative learning as the top four major teaching and learning strategies, respectively, in the post-workshop survey. CONCLUSION: Our study demonstrates that SNSs can be used as learning tools in medical education. However, SNSs usage should be regulated and guided for a more collegial and coherent learning climate in the digital realm. We urge medical educators to integrate SNSs into their courses for a technologically advanced and impactful curriculum.

Listening to the minority: A qualitative study exploring male students' perceptions of the nursing profession and reasons for choosing nursing as a career.

INTRODUCTION: Nursing is a rapidly growing profession that has traditionally been dominated by women. Research has highlighted various challenges associated with increasing the number of male nurses, such as cultural challenges and stigma related to nursing. The United Arab Emirates (UAE) has experienced an increase in male students enrolling in nursing programs. To ensure this is sustainable, it is important to understand how male students perceive nursing and clarify factors that influence their decision to choose nursing as a career. OBJECTIVES: To explore male nursing students' perspectives of the nursing profession and understand why they chose nursing as a career. METHODS: Participants in this qualitative analysis were 30 male students that were selected using purposive sampling. Semi-structured interviews were used to collect data about participants' experiences. We used a qualitative content analysis to guide the data analysis. RESULTS: Three main themes were identified that described male students' perspectives of and reasons for choosing nursing: (1) perceptions of nurses and nursing profession; (2) individuals as facilitators or role models in choosing the nursing profession; and (3) barriers to choosing the nursing profession. DISCUSSION AND CONCLUSION: Our results regarding barriers and facilitators for male students in choosing to study nursing may be useful to help improve the recruitment of and learning opportunities for male nursing students. Highlighting the male presence in the nursing profession and positive male role models may encourage males to enter the profession. Therefore, understanding the experiences of male nursing students in choosing nursing as a career has important implications for nursing practice and education.

Lessons learned and recommendations from the COVID-19 pandemic: Content analysis of semi-structured interviews with intensive care unit nurse managers in the United Arab Emirates.

AIM: This study aims to explore how nursing services were managed and provided in intensive care units during the COVID-19 pandemic and clarify the management lessons learned. BACKGROUND: The surge in the number of patients with COVID-19 worldwide and the unpredictability of new variants mean the voices of nurse managers who participated in fighting the pandemic in intensive care units must be considered. Health care systems need specific plans to face similar future crises. METHOD: This is a descriptive, qualitative, narrative study using indirect content analysis. RESULTS: We analysed 37 intensive care unit nurse managers' reflections on lessons learned from the COVID-19 pandemic. Four themes were extracted: restructuring organisations' resources, issues with family-centred care, education and training and policy reforms. CONCLUSIONS: Promising strategies for Emirati intensive care units in planning for responses to future crises include maximizing organisation resources, boosting family-centred care, providing in-service training for nurses and policy reform. IMPLICATIONS FOR NURSING MANAGEMENT: Our findings will support health care leaders, educators, policymakers and researchers to improve the management of similar pandemic situations. This study presents fundamental data concerning the subjective experiences of intensive care unit nurse managers. These experiences may inform development of multi-dimensional strategies including: ensuring the adequacy of projected supplies, space and nursing workforce; establishing communication protocols; and reforming existing policies.