Exploring the prognostic significance of β-HCG levels in cervicovaginal secretions and maternal risk factors for early birth

Preterm birth is one of the leading causes of death in the perinatal period, this study was conducted to investigate the predictive value of β-HCG Levels in cervicovaginal secretions and maternal risk factors in preterm delivery. This cross-sectional study was conducted over a six-month period from January 1 to June 30, 2021, in  Baghdad hospitals. The data were collected and used from the mothers who went to the hospital for delivery. Demographic information of patients and some risk factors were investigated. Vaginal secretions were sampled with a cotton swab. β-HCG level in weeks 29, 31, 33, and 35 was measured by ELISA method. Data were analyzed with SPSS Ver 25 software and a significance level of less than 0.05 was considered. The mean age of the study participants was 28.29 ± 5.68 years. There was a significant difference in the level of β-HCG between women with full-term delivery and pre-term women in weeks 29, 31, 33, and 35 of pregnancy (P ≤ 0.001). Maternal factors such as age older than 35 years, BMI, history of thyroid disease, blood pressure, premature rupture of the amniotic sac, parity, twin and multiple births, and decreased amniotic fluid volume have been identified as factors affecting preterm delivery. The β-HCG level can also be a helpful marker for preterm birth.

Predictors of nursing students' intention to receive COVID-19 vaccination: A multi-university study in Saudi Arabia

AIMS

This study examined the predictors of student nurses' intention to vaccinate against COVID-19. We measured the nursing students' risk perceptions, anxiety, fears and beliefs on COVID-19 vaccine; attitudes towards it and vaccine literacy (VL).

DESIGN

This study is a multi-university study utilizing the quantitative, cross-sectional and predictive approach.

METHODS

Using convenience sampling (n = 1170), we surveyed 10 Saudi universities from November 26, 2020, to December 31, 2020. Forward stepwise multinomial logistic regression was performed in identifying the factors predicting student nurses' intention to vaccinate against COVID-19.

RESULTS

The overall mean in the risk perception, anxiety and fear was 9.59 (SD = 2.82, possible range = 1-15), 3.95 (SD = 4.77, possible range = 0-20) and 18.17 (SD = 6.65, possible range = 7-35) respectively. They also reported a mean of 29.90 (SD = 6.56, possible range = 8-40) on COVID-19 belief. COVID-19 positive and negative attitudes mean score was 3.64 (SD = 0.92) and 2.72 (SD = 0.90) in a 1-4 range of scores respectively. The functional and interactive-critical COVID-19 VL of the students were at moderate levels. More than half of the respondents (55.9%) intended to be vaccinated against COVID-19, 17.6% did not intend to do so and 26.5% were unsure. High-risk perceptions, low levels of COVID-19 anxiety, positive beliefs and attitudes towards COVID-19 vaccine, and high levels of interactive-critical COVID-19 VL were significant predictors of student nurses' intentions to vaccinate against COVID-19.

CONCLUSION

Policymakers could consider the factors identified in this study and why the students did not intend to receive the vaccine in planning a nationwide vaccination program. The colleges of nursing could also utilize the findings in developing educational programs that aim to improve VL and beliefs and attitudes towards COVID-19 vaccine.

Nurse–Patient/Relatives Conflict and Patient Safety Competence Among Nurses

Nurse–patient/relatives conflicts may adversely impact the well-being and work performance of nurses, which could prelude to the possibility of unwanted errors thereby threatening patient safety. This descriptive and cross-sectional study aimed to examine the association between nurses’ perceived nurse–patient/family conflicts and their perceived patient safety (PS) competence. Nurse–patient/relatives conflicts are critical issues that may adversely impact the nurses’ well-being, which could prelude to unwanted errors, thereby threatening PS. The study surveyed 320 nurses in Saudi Arabia using the “Healthcare Conflict Scale” and “Health Professional Education in Patient Safety Survey” from December 2019 to January 2020. The subscale “mistrust of motivations” was perceived to have the greatest conflict, whereas “contradictory communication” was rated as the lowest conflict. A significant difference was observed between the perceived conflict and the different hospital units where nurses worked. Saudi nurses reported higher nurse–patient/family conflicts than Filipino and Indian nurses. The highest PS competence was reported in “communicating effectively,” whereas “working in teams with other health professionals” had the poorest safety competence. The nurses’ perceived “mistrust of motivations” and “contradictory communication” were associated with poorer self-reported PS competence. Perceived conflicts between nurses and their patients/relatives had negative association with the perceived confidence of nurses in the difference patient safety competencies. The results can become the basis for formulating hospital policies geared toward the elimination of healthcare conflicts to help ensure the patient safety competence of nurses. Policies on mitigating conflicts between healthcare workers and patients/relatives must be created and implemented.

miRNA Let-7a-5p targets RNA KCNQ1OT1 and Participates in Osteoblast Differentiation to Improve the Development of Osteoporosis

It is known that miRNA mediates the formation of osteogenesis, but the mechanism by which miRNA let-7a-5p regulates osteogenesis in osteoporosis (OP) is not yet understood. This paper aims to probe into the regulatory mechanism of miRNA let-7a-5p in the development of OP. Fresh femoral trabecular bones of patients with osteoporotic fracture (OP group, n = 25) and non-OP osteoarthritis (Non-OP group, n = 23) who underwent hip replacement in our hospital from December 2016 to December 2019 were collected. The expression and protein levels of miRNA let-7a-5p and V-AKT murine thymoma viral oncogene homolog 3 (RNA KCNQ1OT1) were detected. C2C12 cells were purchased and osteogenic differentiation model was constructed by BMP2 induction. After miRNA let-7a-5p up-regulation or down-regulation by transfection of corresponding mimics and inhibitors, the impacts of miRNA let-7a-5p and RNA KCNQ1OT1 on osteogenic differentiation-related factors (OC, ALP, COL1A1) in C2C12 cells were analyzed. The determination of targeting correlation of miRNA let-7a-5p with RNA KCNQ1OT1 was performed by dual-luciferase reporter (DLR). In OP samples, miRNA let-7a-5p was notably declined while RNA KCNQ1OT1 were remarkably up-regulated. MiRNA let-7a-5p reduced in C2C12 cells as BMP2 treatment proceeded. MiRNA let-7a-5p up-regulation or RNA KCNQ1OT1 down-regulation increased OC, ALP, COL1A1 levels and ALP activity. RNA KCNQ1OT1 was directly targeted to miR-497-5p. RNA KCNQ1OT1 up-regulation weakened the promoting effect of miRNA let-7a-5p up-regulation on osteoblast differentiation. MiRNA let-7a-5p up-regulation can target to reduce RNA KCNQ1OT1 and promote osteoblast differentiation, thereby improving the development of osteoporosis.

Professional quality of life and caring behaviours among clinical nurses during the COVID-19 pandemic

AIMS AND OBJECTIVES

To investigate the professional quality of life and caring behaviours among clinical nurses in Saudi Arabia during the COVID-19 pandemic. We also examined the influence of the nurses' socio-demographic and professional characteristics on the professional quality of life. Moreover, the study examined the influence of professional quality of life on caring behaviour among the nurses amid the COVID-19 pandemic.

BACKGROUND

Caring is the core of the nursing profession and considered the heart of the humanistic clinical nursing practice. However, the work nature of the clinical nurses, especially during the COVID-19 pandemic, continues to challenge their professional quality of life and caring behaviours. The factors influencing the professional quality of life and caring behaviours of clinical nurses have not been extensively explored.

DESIGN

Cross-sectional, descriptive study.

METHODS

A purposive sample of 375 clinical nurses in three academic medical centres in Saudi Arabia were surveyed using the professional quality of life version 5 and the short-form 24-item Caring Behavior Inventory from May-August 2020. A standard multiple regression analysis was performed to investigate the predictors of the professional quality of life and caring behaviour. This study adhered to the recommendations of the Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

RESULTS

The majority of the respondents reported average level of compassion satisfaction (57.9%), burnout (54.4%) and secondary traumatic stress (66.9%) in the professional quality of life domains. The result also showed highest degree of caring in terms of 'assurance of human presence' while lowest in the 'knowledge and skills' in four subscales of caring behaviour. The following variables significantly predicted compassion satisfaction: education, area of assignment and position. Age, education and religion were identified as significant predictors of burnout while religion, nationality and position were significant predictors of secondary traumatic stress. Positive and negative domains of professional quality of life influenced the caring behaviours among clinical nurses.

CONCLUSIONS

Based on the results of the study, clinical nurses exhibited moderate level of professional quality of life and correlates to their caring behaviours. Moreover, clinical nurses' demographic characteristics predicted their professional quality of life and caring behaviours.

RELEVANCE TO CLINICAL PRACTICE

The importance of ensuring good professional quality of life and caring behaviour among clinical nurses during the COVID-19 pandemic is underscored. Nursing leaders can utilise this baseline evidence and apply programmes for clinical nurses to tackle professional quality of life issues and enhance caring behaviours.

Nursing Students' Knowledge, Competence and Attitudes towards Vital Signs Monitoring during Clinical Practice

AIM AND OBJECTIVE

This study assessed the perceived knowledge and competence, and the attitude of Saudi nursing students towards vital signs monitoring for detecting patient deterioration during clinical rotation. It also examined the predictors of students' attitudes.

BACKGROUND

One of the most important uses of vital signs monitoring is the early detection of deterioration. Vital signs monitoring is one of the most frequently assigned tasks to students during clinical rotation. However, the attitudes of nursing students towards vital signs monitoring for detecting clinical deterioration remain unexplored.

DESIGN

Quantitative, cross-sectional design.

METHOD

A convenience sample of 529 baccalaureate nursing students in two universities in Saudi Arabia was surveyed using the V-scale from October 2019-December 2019. A multivariate multiple regression was implemented to examine the multivariate effect of the predictor variables on the five subscales of the V-scale. This study adhered to the STROBE checklist.

RESULTS

The overall attitudes of the students towards VS monitoring can be interpreted as poor to modest. The highest mean was reported in the subscale 'communication'. The subscales 'workload', 'key indicators' and 'technology' received low mean scores. The university, age, gender, academic year level and perceived knowledge had significant multivariate effects on the five subscales of the V-scale.

CONCLUSIONS

The Saudi nursing students had poor attitudes towards vital signs monitoring, specifically towards the use of technology in vital signs monitoring, the workload associated with vital signs monitoring and vital signs as key indicators of patient deterioration.

RELEVANCE TO CLINICAL PRACTICE

The findings reveal the need to improve the curricular content and training of nursing students regarding vital signs and the physiological indicators of clinical deterioration. This study also identified areas that require improvement to ensure positive attitudes among students.

Influence of Religiosity on the Saudi Nursing Students' Attitudes Toward Older People and Perceptions on Elderly Care

This cross-sectional study examined the influence of Saudi nursing students' religiosity on their attitudes toward older people and on their perceptions of elderly care. A sample of 175 nursing students of a government university in Saudi Arabia was surveyed using the Kogan's Attitudes toward Older People Scale, the Perspectives on Caring for Older Adults Scale, and the Muslim Religious Index. The students reported they are religious, they have modest attitudes toward older people, and they have neutral perception about elderly care. Religiosity showed a positive influence on the students' attitudes toward older people and on their perceptions about elderly care.

Influence of workplace incivility on the quality of nursing care

AIMS AND OBJECTIVES

To examine the influence of workplace incivility on the quality of nursing care.

BACKGROUND

Recent evidence describes workplace incivility as a serious concern in the healthcare setting worldwide. Exposure to workplace incivility can alter a nurse's behaviour, thought process and perspective towards the nursing profession. However, there is insufficient evidence to determine whether workplace incivility might be associated with the quality of nursing care in Saudi Arabia.

DESIGN

A quantitative and cross-sectional study.

METHOD

A survey was carried out amongst 378 nurses in two government hospitals in Saudi Arabia from February 2018-May 2018 using the Nurse Incivility and quality of nursing care scales. Multivariate multiple regression was performed to investigate the influence of the uncivil experiences of nurses from different sources on the different aspects of quality of nursing care. The study adhered to STROBE guideline (see Appendix S1).

RESULTS

The overall mean of the quality of nursing care scale was 3.14 (SD = 0.66) from a scale of 1-5, with patient satisfaction receiving the highest mean dimension (mean = 3.27, SD = 0.72) and health promotion the lowest mean dimension (mean = 3.08, SD = 0.74). Experience in the present hospital and the hospital were associated with the overall quality of nursing care. General and nurse incivility exerted a multivariate effect on overall quality of nursing care and its different dimensions.

CONCLUSION

General incivility and nurse incivility were found to negatively impact quality of nursing care and its different dimensions.

RELEVANCE TO CLINICAL PRACTICE

Stronger policies geared towards eliminating workplace incivility should be implemented as uncivil acts can lead to poor quality of nursing care. Nurse administrators and nurses should be pro-active in recognising, preventing, approaching, reporting and intervening with uncivil acts in the hospital to protect these workers from these types of behaviours and avoid their negative impacts on patient care.

Culture of quality in infection prevention of a hospital as perceived by health care workers

AIM

This research aimed to assess the culture of quality in infection prevention (CQIP) of a university hospital as perceived by health care workers (HCWs).

BACKGROUND

Health care-associated infections are serious concerns in hospitals in Saudi Arabia. Hence, assessing their CQIP is necessary.

METHOD

An investigation employing a descriptive and cross-sectional design was carried out among 623 HCWs (doctors, nurses and nursing assistants) in a university hospital in Saudi Arabia by using the Leading a Culture of Quality in Infection Prevention (LCQ-IP) scale.

RESULTS

The overall mean in the LCQ-IP was 3.86 (SD = 0.62). The subscale "prioritization of quality" (M = 4.11, SD = 0.79) was rated the highest dimension, whereas "supportive work environment" was perceived as the poorest dimension (M = 3.56, SD = 0.54). Gender, nationality, highest education and job title affected the four factors of the HCWs' perceptions of the hospital's CQIP.

CONCLUSION

HCWs modestly perceived their hospital's CQIP. The study highlighted the need for improving CQIP based on the four dimensions.

IMPLICATIONS FOR NURSING AND HOSPITAL MANAGEMENT

This study provided valuable implications for hospital and nursing management to ensure high-quality culture of infection prevention.