Incorporating gerontological content in the nursing curriculum. The case of AUB School of Nursing.

In Lebanon, the proportion of older adults (over 65 years) is on the rise. This rise is associated with increased morbidity rates and the need for age-specific medical and nursing care. The number of nurses specializing in geriatric care remains very small despite the increased need for this specialty. The nursing curriculum at the Hariri School of Nursing at the American University of Beirut (AUB) has integrated gerontological content in both undergraduate and graduate programs as an essential step to prepare future nurses for the care of the growing population of older adults and consequently to support the health care system. In line with the essential competencies proposed by the American Association of Colleges of Nursing (AACN), the school of nursing at AUB is preparing entry level and advanced practice nurses to care for the geriatric population. Furthermore, developing specialists in the field of gerontology and launching an interdisciplinary graduate program on 'Care of the Older Adult' is more and more becoming a desired development for the future.

Exploring resident-staff relationships in nursing homes in Lebanon.

Objectives: To explore the prevailing relationships between residents and staff in nursing homes in Lebanon, and to elicit factors that influence these relationships.Method: Using a qualitative phenomenological design, this study was conducted to explore the lived experience of residents, especially pertaining to their relationships with staff. The study included 13 residents aged 65 and above with no cognitive impairment. Data were collected using semi-structured interviews and were analysed using the Giorgi method.Findings: Two main themes representing resident perceptions about their interactions with the nurses emerged: (1) relationships to satisfy the need for physical care, (2) relationships that foster a bond of caring and trust.Discussion: Reflecting about resident-nurse relationships and examining factors that promote trust and stronger bonding help caregivers understand the importance of fostering a stronger relationship with residents. These findings have implications for developing policy and practice in nursing homes in Lebanon and elsewhere.Conclusion: This is the first study conducted by a nurse researcher in Lebanon that has explicitly explored the nature of relationships between caregivers and care-receivers in nursing homes. The contribution of this study is not solely restricted to experiences and outcomes of care, but also includes implications for policy and practice.

Response to signs and symptoms of acute coronary syndrome: differences between Lebanese men and women.

BACKGROUND: Signs and symptoms of acute coronary syndromes differ between men and women, but whether men and women respond differently to these indications is not well understood. Such responses influence health outcomes because success of treatment depends on how quickly healthcare is sought. OBJECTIVE: To explore differences between Lebanese men and women in cognitive, emotional, and behavioral responses to signs and symptoms of acute coronary syndromes. METHODS: A convenience sample of 149 men and 63 women with unstable angina or acute myocardial infarction were interviewed within 72 hours of admission to coronary care in a tertiary center by using the Response to Symptoms Questionnaire. Demographic and clinical data were obtained from medical records. RESULTS: Women were older, less educated, and more often widowed than men. More women had hypertension but more men were current smokers. Women had shoulder pain, dyspnea, nausea and vomiting, and palpitations more often than men did. Women's signs and symptoms were rated more severe by the women than men's were by the men. Women were less likely to know signs and symptoms of myocardial infarction than were men and delayed coming to the hospital longer than men did. Delay correlated with the characteristics of the signs and symptoms and not realizing their importance in men and with dyspnea and taking the "wait and see" approach in women. CONCLUSION: Factors related to promptness in seeking care for acute coronary syndromes differ between Lebanese men and women.

Delay in seeking health care for acute coronary syndromes in a Lebanese sample.

Early treatment of patients with acute coronary syndromes (ACS) is crucial to reduce morbidity and mortality. The purpose of this study was to examine delay in seeking care for ACS symptoms in a Lebanese sample and identify predictors of delay. Medical record reviews and interviews using the Response to Symptoms Questionnaire were conducted with 204 ACS patients in coronary care within 72 hours of admission. Median time from symptom onset to hospital arrival was 4.5 hours. Higher education, presence of dyspnea, intermittent symptoms, and waiting for symptoms to go away predicted longer delays, whereas intensity of symptoms and active response (going to the hospital) predicted shorter delays. The findings suggest lack of knowledge of ACS symptoms and the need for public education in this regard.

Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

AIM: Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. BACKGROUND: Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. METHOD: The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. FINDINGS: Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. CONCLUSION: The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. IMPLICATIONS FOR PRACTICE: Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care.

Risk factors for coronary artery disease (CAD) in Lebanese-Armenian women.

Coronary artery disease (CAD) is the leading cause of death among women over 50 years of age. Preventive measures through lifestyle modification and management of CAD risk factors have contributed to a decrease in mortality from heart disease. The purpose of this article is to assess risk factors for CAD among the population of Lebanese-Armenian women, so that appropriate intervention strategies for risk reduction could be planned and implemented. A descriptive study to explore risk factors for CAD was conducted in a convenience sample of 83 women who attended a series of panel discussions about risk factors for CAD. Data collection was done using structured interviews and clinical/laboratory studies. Analysis of data was done using frequency distributions. The results indicated that a significant proportion of the sample manifested risk factors for CAD including age, menopausal status, hypertension, hypercholesterolemia, high levels of low-density lipoproteins (LDL), low levels of high-density lipoproteins (HDL), and being overweight. In addition, hypertension was associated positively with age, total cholesterol, LDL and triglyceride levels, lack of physical activity, propensity to anger, and family history of hypertension. The findings suggest the need for further research and health risk reduction programs.