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Racine L, D'Souza MS, Tinampay C. Effectiveness of breast cancer screening interventions in improving screening rates and preventive activities in Muslim refugee and immigrant women: A systematic review and meta-analysis. J Nurs Scholarsh 2023; 55:329-344. [PMID: 36199240 DOI: 10.1111/jnu.12818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/22/2022] [Accepted: 09/09/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE To systematically assess the effectiveness of breast cancer (BC) interventions in improving breast self-examination (BSE), clinical breast examination (CBE), mammogram screening rates, and preventive activities in Muslim refugee and immigrant women. DESIGN Guided by the Health Belief Model, a mixed method systematic review and meta-analysis was performed using a sequential design. METHODS This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA), the Critical Appraisal Skill Program Checklists, and the Joanna Briggs Institute (JBI) methodology for systematic review and meta-analysis. A systematic search of English-language peer-reviewed articles was undertaken in multiple health and social sciences databases from January 1, 2015, to March 31, 2022. Randomized clinical trials and quasi-experimental studies focused on the uptake of BSE, CBE, and mammograms were selected. RESULTS Fourteen articles were included in the review. Most of the studies relied on quasi-experimental designs and were carried out in the United States of America. The qualitative analysis of BC screening interventions generated three themes: (1) education, (2) access-focused, and (3) cultural and faith-based. The meta-analysis included three randomized control trials and two quasi-experimental studies. The meta-analysis demonstrates the effectiveness of community-led cultural and faith-based interventions in facilitating the completion of CBE and mammography screening. Education on BC and patient navigator interventions are more effectively used in conjunction than standalone interventions, yet community-based cultural and faith-based interventions are the most effective. CONCLUSION This systematic and meta-analysis review provides evidence on the effectiveness of access-focused and cultural and faith-based interventions in improving BC screening in Muslim refugee and immigrant women. Future research should focus on designing and measuring the effectiveness of cultural and faith-based interventions to increase Muslim refugee and immigrant women's BC screening knowledge and practices. CLINICAL RELEVANCE This systematic and meta-analysis review demonstrates the need to explore Muslim refugee and immigrant women's cultural contexts for developing culturally sensitive BC screening interventions. Knowledge and practice of BC and religiosity intersect with financial, geographic, and linguistic barriers to decrease participation in screening and preventive activities in Muslim refugee and immigrant women.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Melba Sheila D'Souza
- School of Nursing, Thompson Rivers University, Kamloops, British Columbia, Canada
| | - Cindy Tinampay
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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D'Souza MS, O'Mahony J, Achoba A. Exploring Foot Care Conditions for People Experiencing Homelessness: A Community Participatory Approach. J Prim Care Community Health 2022; 13:21501319211065247. [PMID: 35090358 PMCID: PMC8801709 DOI: 10.1177/21501319211065247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: People experiencing homelessness are faced with complex challenges and are at high risk of illness due to inequities and disparities in access to health care services. Objective: To explore the health and foot care problems related to people experiencing homelessness in British Columbia. Methods: A community participatory research approach was used with a sample of 65 people experiencing homelessness. Data were collected using a survey questionnaire and face-to-face semistructured interviews. Results: Thematic findings shows risk of foot injuries, lack of foot care resources, and absence of family support. Barriers to equitable access to services for most participants experiencing homelessness were lack of housing (76.92%), inability to work (72.31%), and inability to afford the cost of living on their own (63.08%). Conclusions: There is a pressing need for early screening and detection by health care professionals and enhanced foot care services to reduce foot problems and improve foot care wellness of homeless people. Addressing foot-related care are necessary steps in promoting health, preventing illness, and improving access to health services among people experiencing homelessness.
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Affiliation(s)
| | | | - Alfred Achoba
- Executive Director, Canadian Mental Health Association, Kamloops
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Arjunan P, D'Souza MS. Efficacy of nurse-led cardiac rehabilitation on health care behaviours in adults with chronic heart failure: An experimental design. Clinical Epidemiology and Global Health 2021. [DOI: 10.1016/j.cegh.2021.100859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Sheila D'Souza M, Mirza NA, Nairy Karkada S. Development of a foot care model to determine the risk of foot problems among homeless adults in Canada. Health Soc Care Community 2021; 29:e214-e223. [PMID: 33491824 DOI: 10.1111/hsc.13271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/03/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
Foot care is a common problem for homeless adults in cities, who often receive fragmented foot care services, resulting in increased foot problems, health complications, hospitalisation, limb removal and disabilities. Among the health factors that negatively affect the homeless, foot health is essential, but often neglected. This study employed a descriptive, cross-sectional research design to assess the foot care of homeless people and develop recommendations for clinical practice. Using Inlow's 60-s foot screening method, the foot conditions of a purposive sample of 65 homeless adults were examined in British Columbia, Canada, in 2019-2020. Descriptive and inferential statistics were used to analyse the data. Determinants, such as sex and years of homelessness significantly contributed to homeless individuals' risk of developing foot problems. Differences in perceived and observed foot problems were influenced by equitable access to social health and healthcare services. Foot assessment is not well-covered by homeless health services and should be implemented as part of the standard medical review of homeless patients. Furthermore, foot assessment should be conducted by healthcare professionals, rather than relying on the standard practice of service users' self-report. Finally, foot care should be based on tailoring assessments and interventions for the individualised needs of homeless service users. Future research must seek ways to integrate homeless individuals' voices in the development, implementation and evaluation of foot care services.
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Affiliation(s)
| | - Noeman A Mirza
- Faculty of Nursing, University of Windsor, Toldo Health Education Centre, Windsor, ON, Canada
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D'Souza MS, Mirza NA. Towards Equitable Health Care Access: Community Participatory Research Exploring Unmet Health Care Needs of Homeless Individuals. Can J Nurs Res 2021; 54:451-463. [PMID: 34387510 PMCID: PMC9605994 DOI: 10.1177/08445621211032136] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Community and health services often overlook health care needs of persons experiencing homelessness, which leads to deterioration in health and increased utilization of emergency services. Since homeless people are underrepresented in health service research, little is known about their unmet health care needs, particularly in smaller cities where resources are limited. This community-based participatory research explored the experiences of small-city homeless service users (HSUs) with unmet health care needs and community service providers (CSPs) who work with them to determine barriers to health care access affecting them. Structured interviews were conducted with 65 HSUs and 15 CSPs in interior British Columbia, Canada. These interviews were audio-recorded, and the retrieved data were analyzed thematically. The three themes uncovered included: a lack of access to health care and risk of stigma, a lack of trust and fear of discrimination, and a need for community navigation and social support. The findings indicate that HSUs do not receive equitable care and face challenges in accessing appropriate and timely foot care, which contributes to increased foot-related emergency visits, loss of trust in the health care system, and disabilities due to worsening foot conditions. Various social determinants of health also impact HSUs, such as low socioeconomic status, lack of housing, decreased social support, unhealthy behaviors, and inequitable access to health services. By collaborating with HSUs, community and health services need to develop innovative outreach programs that provide better community resources as the first step toward equitable access to health care.
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Affiliation(s)
| | - Noeman Ahmad Mirza
- Faculty of Nursing, 8637University of Windsor, Toldo Health Education Centre, Windsor, ON, Canada
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Al Salmi I, Kamble P, Lazarus ER, D'Souza MS, Al Maimani Y, Hannawi S. Kidney Disease-Specific Quality of Life among Patients on Hemodialysis. Int J Nephrol 2021; 2021:8876559. [PMID: 33880190 PMCID: PMC8049780 DOI: 10.1155/2021/8876559] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Quality of life (QoL) of hemodialysis patients can be examined in two aspects: kidney-specific quality of life and general quality of life. OBJECTIVE To determine the QoL among patients undergoing hemodialysis, to assess patients' QoL on hemodialysis, and to determine the factors associated with QoL among hemodialysis patients in Oman. METHOD A cross-sectional study was carried out with 205 patients to measure the QoL across various demographic and clinical variables in Oman. The Arabic version of the KDQOL-SFtool was used to collect data from patients undergoing hemodialysis to give QoL quantitative measures. RESULTS The physical-QoL was 45.7 (95% CI, 44.3, 47.0), which is less than half that of a healthy human. The emotional-QoL is 53.33 (95% CI, 51.1, 55.5), slightly more than half in a healthy human-QoL. The difference between physical and emotional-QoL scores is -7.66 (95% CI, -10.3, -5.1), showing that physical QoL is significantly less than emotional-QoL. The overall general QoL score was 49.5 (95% CI, 47.8, 51.2), half the QoL score of a healthy human. Younger patients are also more likely to experience emotional problems compared with older patients. Patients with 5-8 mg/l levels of serum creatinine have lower emotional wellbeing. People on low incomes experienced social difficulties, while the maximum burden was found in physical activities and minimum social function. CONCLUSION Both physical (45.7) and emotional (53.3) QoL scores in dialysis patients are nearly half those of an average human. Hence, there is a poor QoL among dialysis patients like other studies, and therefore, further improvement of renal rehabilitation in dialysis patients is warranted to improve patients' QoL.
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Affiliation(s)
- Issa Al Salmi
- The Royal Hospital, 23 July Street, P. O. Box 1331, Code 111, Muscat, Oman
| | - Pramod Kamble
- Senior Specialist Nephrologist, Royal Hospital Ministry of Health, Muscat, Oman
| | | | | | - Yaqoob Al Maimani
- Senior Nephrologist & Superintendent, Bowsher Dialysis Unit, Muscat, Oman
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D'Souza MS, O'Mahony J, Karkada SN. Effectiveness and meaningfulness of breast cancer survivorship and peer support for improving the quality of life of immigrant women: A mixed methods systematic review protocol. Clinical Epidemiology and Global Health 2021. [DOI: 10.1016/j.cegh.2020.100678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Seeley SL, D'Souza MS, Stoops TS, Rorabaugh BR. Short term methylphenidate treatment does not increase myocardial injury in the ischemic rat heart. Physiol Res 2020; 69:803-812. [PMID: 32469230 DOI: 10.33549/physiolres.934368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Methylphenidate is commonly used for the treatment of attention deficit hyperactivity disorder. The cardiovascular safety of methylphenidate has been a subject of debate with some studies indicating that methylphenidate increases the likelihood of experiencing a myocardial infarction. However, it is unknown whether methylphenidate worsens the extent of injury during an ischemic insult. The purpose of this study was to determine whether short term exposure to methylphenidate increases the extent of myocardial injury during an ischemic insult. Male and female rats received methylphenidate (5 mg/kg/day) or saline for 10 days by oral gavage. Hearts were subjected to 20 min of ischemia and 2 h of reperfusion on a Langendorff isolated heart apparatus on day 11. Cardiac contractile function was monitored via an intraventricular balloon and myocardial injury was assessed by triphenyltetrazolium chloride staining. Methylphenidate significantly increased locomotor activity in male and female rats, confirming absorption of this psychostimulant into the central nervous system. Male hearts had significantly larger infarcts than female hearts, but methylphenidate had no impact on infarct size or postischemic recovery of contractile function in hearts of either sex. These data indicate that methylphenidate does not increase the extent of injury induced by an ischemic insult.
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Affiliation(s)
- S L Seeley
- Marshall University School of Pharmacy, Huntington, WV, USA.
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9
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Labrague LJ, McEnroe-Petitte D, D'Souza MS, Cecily HSJ, Edet OB, Ibebuike JE, Venkatesan L. Capability beliefs and the intention to adopt evidence-based practices in the future among nursing students: An international study. J Prof Nurs 2020; 36:301-307. [PMID: 33039062 DOI: 10.1016/j.profnurs.2020.01.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 01/08/2020] [Accepted: 01/10/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Capability beliefs and the intention to adopt EBP in future nursing practice have been identified as strong antecedents of subsequent utilization of EBP. Despite this, a multicountry comparison may yield interesting findings that can be useful in designing empirically based and culturally tailored strategies to facilitate and enhance students' capability beliefs as well as their intentions to integrate evidence into nursing practice. AIMS AND OBJECTIVES This report sought to compare capability beliefs and intentions to adopt EBP in the future among student nurses from four countries-specifically, Oman, India, Nigeria, and Saudi Arabia-and to identify specific variables that predict the intention to adopt EBP. METHODS This study employed a descriptive, cross-sectional, comparative research design to gather data from a convenience sample of 1387 nursing students from four countries using self-report questionnaires that captured their EBP capability beliefs and their intention to adopt EBP in clinical practice upon graduation. This study adhered to STROBE guideline for cross-sectional studies. RESULTS Overall, nursing students reported a high intent to adopt EBP in their future nursing practice; however, the exact rate varied according to the country of origin. Students' gender, student track, education, country of origin, access to the internet, and capability beliefs were seen as important in explaining the likelihood of future implementation of evidence in clinical nursing practice. Capability beliefs among students were moderate, with large differences observed between countries. CONCLUSIONS Although the surveyed nursing students reported moderate capability beliefs, their intention to adopt and integrate EBP in their future nursing practice was relatively high. RELEVANCE TO CLINICAL PRACTICE The findings of this study highlight the critical role of nurse educators and nurse administrators in fostering EBP capability beliefs and future intentions to adopt among students through curricular review, implementation of evidence-based strategies, and the promotion of EBP culture within the clinical learning sites.
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D'Souza MS, Labrague LJ, Karkada SN, Kamble P. Relationship between socio-demographic, clinical factors, and quality of life in adults living with diabetic nephropathy. Clinical Epidemiology and Global Health 2020. [DOI: 10.1016/j.cegh.2019.08.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Labrague LJ, McEnroe‐Petitte DM, D'Souza MS, Hammad KS, Hayudini JNA. Nursing faculty teaching characteristics as perceived by nursing students: an integrative review. Scand J Caring Sci 2019; 34:23-33. [DOI: 10.1111/scs.12711] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Accepted: 04/14/2019] [Indexed: 12/30/2022]
Affiliation(s)
| | | | | | - Karen S. Hammad
- College of Nursing and Health Sciences Flinders University Adelaide Australia
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12
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Labrague LJ, McEnroe-Petitte D, D'Souza MS, Cecily HSJ, Fronda DC, Edet OB, Ibebuike JE, Venkatesan L, Almazan JU, Al Amri M, Mirafuentes EC, Cayaban ARR, Al Yahyaei A, Bin Jumah JA. A Multicountry Study on Nursing Students' Self-Perceived Competence and Barriers to Evidence-Based Practice. Worldviews Evid Based Nurs 2019; 16:236-246. [PMID: 31025477 DOI: 10.1111/wvn.12364] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Nursing education and training are essential in the attainment of evidence-based practice (EBP) competence in nursing students. Although there is a growing literature on EBP among nursing students, most of these studies are confined to a single cultural group. Thus, cross-cultural studies may provide shared global perspectives and theoretical understandings for the advancement of knowledge in this critical area. AIMS This study compared self-perceived EBP competence among nursing students in four selected countries (India, Saudi Arabia, Nigeria, and Oman) as well as perceived barriers to EBP adoption. METHODS A descriptive, cross-sectional, and comparative survey of 1,383 nursing students from India, Saudi Arabia, Nigeria, and Oman participated in the study. The Evidence-Based Practice Questionnaire (EBP-COQ) and the BARRIERS scale were used to collect data during the months of January 2016 to August 2017. RESULTS Cross-country comparisons revealed significant differences in EBP competence (F = 24.437, p < .001), knowledge (F = 3.621, p = .013), skills (F = 9.527, p < .001), and attitudes (F = 74.412, p < .001) among nursing students. Three variables including nursing students' gender (β = .301, p < .001), type of institution, (β = -0.339, p = .001), and type of nursing student (β = .321, p < .001) were associated with EBP competence. Barriers to EBP adoption included having no authority to change patient care policies (M = 1.65, SD = 1.05), slow publication of evidence (M = 1.59, SD = 1.01), and paucity of time in the clinical area to implement the evidence (M = 1.59, SD = 1.05). LINKING EVIDENCE TO ACTION Both academe and hospital administration can play a pivotal role in the successful acquisition of EBP competence in nursing students.
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Labrague LJ, McEnroe-Pettite D, Tsaras K, D'Souza MS, Fronda DC, Mirafuentes EC, Yahyei AA, Graham MM. Predictors of evidence-based practice knowledge, skills, and attitudes among nursing students. Nurs Forum 2018; 54:238-245. [PMID: 30582630 DOI: 10.1111/nuf.12323] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PROBLEM Evidence-based practice (EBP) competence is one of the most desirable outcomes in nursing education. Assessment of knowledge, skills, and attitudes of nursing students regarding EBP is vital in examining the extent to which current approaches to EBP teaching is effective. PURPOSE This study examined the predictors of knowledge, skills, and attitudes regarding EBP among Omani nursing students. METHODS This study utilized a descriptive, cross-sectional approach. Two hundred and forty-eight nursing students enrolled in one of the universities in Oman participated in the study during the months of May 2016 to August 2017. The evidence-based practice questionnaire (EBP-COQ) was used for data collection. Descriptive and inferential statistical tools were used to analyze the data. FINDINGS The mean values for the three EBP domains (knowledge, skills, and attitudes) were 3.41 (SD = 0.66), 3.62 (SD = 0.51), and 3.41 (SD = 0.68), respectively. Nursing students' sex (being female), classification (being a registered nurse to Bachelors of Science degree in Nursing nursing student), and access to the internet and to nursing journals strongly predicted the knowledge, skills, and attitudes regarding EBP. Overall, 79.0% of Omani nursing students intended to adopt EBP in the future. CONCLUSIONS Omani nursing students possessed moderate knowledge, skills, and attitudes on EBP; however, more efforts are needed to ensure that future Omani nurses are competent and confident to apply EBP in the actual clinical area. Both academe and the hospital administration play a pivotal role in the acquisition and achievement of EBP competence in student nurses.
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Affiliation(s)
| | | | - Konstantinos Tsaras
- Nursing Department, Technological Educational Institute of Thessaly, Larissa, Greece
| | | | | | | | - Asma Al Yahyei
- College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Marleise McBean Graham
- The UWI School of Nursing, Faculty of Medical Sciences, University of the West Indies, Mona Campus, Kingston, Jamaica
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Ammouri AA, Abu Raddaha AH, Natarajan J, D'Souza MS. Perceptions of risk of coronary heart disease among people living with type 2 diabetes mellitus. Int J Nurs Pract 2017; 24. [PMID: 29119639 DOI: 10.1111/ijn.12610] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 09/20/2017] [Accepted: 10/07/2017] [Indexed: 02/02/2023]
Abstract
AIMS Our aim is to assess perception of risk of developing coronary heart disease and to examine its associations with individuals' characteristics and health behaviours among Omani people with type 2 diabetes mellitus (T2DM). BACKGROUND Evaluating perceptions of being at risk of developing a disease may give insight into health promotion behaviours. People with diabetes are at high risk of coronary heart disease. The management of diabetes mellitus should include prevention and control of coronary heart disease. DESIGN A cross-sectional correlational study was conducted. METHODS A convenience sample of 160 adults with T2DM was invited to participate in this study between November 2014 and March 2015. Descriptive and regression analyses were performed to examine associations between study variables. RESULTS Perception of risk of developing coronary heart disease was significantly associated with low educational level (β = 0.191, P < .05), low income (β = 0.201, P < .05), and high level of knowledge about diabetes mellitus (β = 0.200, P < .05). People with T2DM who perceived coronary heart disease as having few moderate known outcomes and consequences reported consuming healthy diet more frequently. CONCLUSION Teaching people with T2DM about the risk of developing coronary heart disease is essential as it could motivate them to perform health promotion behaviours, which may assist in controlling and reducing coronary heart disease.
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Affiliation(s)
| | - Ahmad H Abu Raddaha
- College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
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D'Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R, Achora S, Cayaban ARR. Self-efficacy and self-care behaviours among adults with type 2 diabetes. Appl Nurs Res 2017; 36:25-32. [PMID: 28720235 DOI: 10.1016/j.apnr.2017.05.004] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 05/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Type 2 Diabetes Mellitus (T2DM) has an impact on an individuals' health and is influenced by glycemic control. AIM To examine the relationship between glycemic control, demographic and clinical factors on self-efficacy and self-care behaviours among adults with T2DM. DESIGN A correlational, descriptive study was used. One hundred and forty Omani adults with T2DM were recruited from a public hospital. METHODS Data on self-efficacy, self-care behaviours and glycemic control were collected between April and July 2016. The study was approved by the College Ethics Committee and Hospital Board. Bivariate and multivariate analyses were conducted. RESULTS Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating 'uncontrolled' or poor HbA1c of >8% (65%). Variance of self-care behaviour (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. CONCLUSIONS Adults with T2DM with poor glycemic control were more probable to have poor self-efficacy and self-care behaviours. Glycemic control has an effect on improving diet, exercise, medication, foot care efficacy and behaviours. CLINICAL RELEVANCE The study recommends using these findings to plan self-efficacy and self-care behaviour to improve glycemic control among adults with T2DM.
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Affiliation(s)
- Melba Sheila D'Souza
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | | | - Kader Parahoo
- School of Nursing University of 3Ulster, Coleraine campus, Londonderry, BT52 1SA, United Kingdom.
| | | | - Susan Achora
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Arcalyd Rose R Cayaban
- Fundamentals and Administration, College of Nursing, Sultan Qaboos University, Muscat, Oman.
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D'Souza MS, Ruppert SD, Parahoo K, Karkada SN, Amirtharaj A, Jacob D, Balachandran S, Al Salmi NMD. Foot care behaviors among adults with type 2 diabetes. Prim Care Diabetes 2016; 10:442-451. [PMID: 27282830 DOI: 10.1016/j.pcd.2016.04.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 12/18/2022]
Abstract
AIM The aim of the study was to determine factors influencing foot care behaviors among adults with type 2 diabetes. METHODS A correlational descriptive study was conducted with a random sample of 160 adults with type 2 diabetes from the public hospital between April and July 2014. RESULTS Just over 15% of the sample had a history of foot ulcers and almost 42% had numbness/tingling and pain in their feet. Positive foot care behaviors were correlated with higher income, higher educational attainment, lower body weight, positive attitude and higher awareness of diabetes and its management. CONCLUSION Targeting type 2 diabetes people with low level of education, low income and overweight may help to enhance their foot care and reduce foot complications in similar populations, Implications. Those most at risk of foot problems should be targeted for education to increase their awareness of ways to prevent and to manage foot problems.
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Affiliation(s)
- Melba Sheila D'Souza
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Susan D Ruppert
- Adult/Gerontology Primary Care Nurse Practitioner Program, Department of Acute & Continuing Care, The University of Texas Health Science, Oman.
| | - Kader Parahoo
- Nursing and Health Research, School of Nursing University of Ulster - Coleraine Campus, Londonderry, United Kingdom.
| | | | - Anandhi Amirtharaj
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Devakirubai Jacob
- Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
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Muliira JK, D'Souza MS, Ahmed SM. Contrasts in Practices and Perceived Barriers to Colorectal Cancer Screening by Nurses and Physicians Working in Primary Care Settings in Oman. J Cancer Educ 2016; 31:15-25. [PMID: 25739678 DOI: 10.1007/s13187-015-0806-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Colorectal cancer (CRC) is the fourth most common type of cancer worldwide and it is responsible for 610,000 deaths annually, despite availability of screening tests that ensure early detection. Predictions specific to the Middle East show that this region will experience a significant increase in cancer mortality over the next 15 years. This study explored the practices and perceived barriers to CRC screening from the perspective of health care providers (HCPs) working in primary care settings in Muscat, Oman. A cross-sectional design and self-administered questionnaires were used to collect data from 142 HCPs. The HCPs were nurses (57.7 %) and physicians (42.3 %) with average age and clinical experience of 32.5 and 9.5 years, respectively. The majority of the HCPs (64.8 %) rarely ordered, referred, health educated, or recommended CRC screening to eligible patients. The only major patient-related barrier to CRC screening reported by HCPs was lack of awareness about CRC tests (63.7 %). There were significant differences between nurses' and physicians' rating of patient-related barriers such as fear of cancer diagnosis (p = 0.037), belief that screening is not effective (p = 0.036), embarrassment or anxiety about screening tests (p = 0.022), and culture (p = 0.001). The major system barriers to CRC screening were lack of hospital policy or protocols, lack of trained HCPs, lack of CRC screening services, and timely appointments to get CRC screening. The findings indicate a need for interventions to enhance patient awareness, HCPs CRC screening practices, and strategies to ameliorate patient and system barriers to CRC screening.
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Affiliation(s)
- Joshua Kanaabi Muliira
- College of Nursing, Department of Adult Health and Critical Care, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman.
| | - Melba Sheila D'Souza
- College of Nursing, Department of Adult Health and Critical Care, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman
| | - Samira Maroof Ahmed
- College of Nursing, Department of Community Health and Psychiatric Mental Health, Sultan Qaboos University, P. O. Box 66, 123, Al Khod, Muscat, Oman
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Muliira JK, D'Souza MS, Ahmed SM, Al-Dhahli SN, Al-Jahwari FRM. Barriers to Colorectal Cancer Screening in Primary Care Settings: Attitudes and Knowledge of Nurses and Physicians. Asia Pac J Oncol Nurs 2016; 3:98-107. [PMID: 27981145 PMCID: PMC5123546 DOI: 10.4103/2347-5625.177391] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Objective: Healthcare providers (HCPs) play a critical role in reducing colorectal cancer (CRC) related morbidity and mortality. This study aimed at exploring the attitudes and knowledge of nurses and physicians working in primary care settings regarding CRC screening. Methods: A total of 142 HCPs (57.7% nurses and 42.3% physicians) participated in a cross-sectional survey. Data were collected using a Self-administered Questionnaire. The participants were clinically experienced (mean = 9.39 years; standard deviation [SD] = 6.13), regularly taking care of adults eligible for CRC screening (62%) and had positive attitudes toward CRC screening (83.1%). Most participants (57%) had low levels of knowledge about CRC screening (mean = 3.23; SD = 1.50). The participants were most knowledgeable about the recommended age for initiating screening (62.7%) and the procedures not recommended for screening (90.8%). Results: More than 55% did not know the frequency of performing specific screening procedures, the upper age limit at which screening is not recommended, and the patients at high-risk for CRC. There were no significant differences between nurses’ and physicians’ attitudes and knowledge. The participants’ perceptions about professional training (odds ratio [OR] = 2.17, P = 0.003), colonoscopy (OR = 2.60, P = 0.014), and double-contrast barium enema (OR = 0.53, P = 0.041), were significantly associated with knowledge about CRC screening. Conclusions: The inadequate knowledge levels among nurses and physicians may be one of the barriers affecting CRC screening. Enhancing HCPs knowledge about CRC screening should be considered a primary intervention in the efforts to promote CRC screening and prevention.
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Affiliation(s)
- Joshua Kanaabi Muliira
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Samira Maroof Ahmed
- Department of Community and Mental Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
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D'Souza MS, Venkatesaperumal R, Ruppert SD, Karkada SN, Jacob D. Health Related Quality of Life among Omani Men and Women with Type 2 Diabetes. J Diabetes Res 2016; 2016:8293579. [PMID: 26682234 PMCID: PMC4670671 DOI: 10.1155/2016/8293579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2014] [Revised: 04/04/2015] [Accepted: 05/06/2015] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to explore predictors of health related quality of life (HRQoL) among men and women with type 2 diabetes. This cross-sectional descriptive study consisted of a random sample of 300 adults with type 2 diabetes in a selected public hospital. Euro-QoL and Revised Summary of Diabetes Self-Care Activities scales were used to collect data between January and June 2010. Schooling and ability to manage positively were highly significant predictors of quality of life (QoL) among women as compared to men. Age, prevention of activities of daily living and knowledge/management of diabetes were significant predictors of Health state among women as compared to men. Findings demonstrate that 30.6% (versus 35.7%) of the variance in the total QoL and 14% (versus 23%) of the variance in health state could be explained by personal and clinical characteristics among women and men, respectively. The study underlines the importance for nurse educators to assess HRQoL among men and women and to develop effective self-care management strategies based on personal and clinical characteristics.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
- *Melba Sheila D'Souza:
| | - Ramesh Venkatesaperumal
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
| | - Susan D. Ruppert
- The University of Texas Health Science Center at Houston School of Nursing, Houston, TX 77030, USA
| | | | - Devakirubai Jacob
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, 123 Muscat, Oman
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Muliira JK, D'Souza MS. Effectiveness of patient navigator interventions on uptake of colorectal cancer screening in primary care settings. Jpn J Nurs Sci 2015; 13:205-19. [DOI: 10.1111/jjns.12102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 08/17/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Joshua Kanaabi Muliira
- College of Nursing, Department of Adult Health and Critical Care; Sultan Qaboos University; Muscat Oman
| | - Melba Sheila D'Souza
- College of Nursing, Department of Adult Health and Critical Care; Sultan Qaboos University; Muscat Oman
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D'Souza MS, Karkada SN, Parahoo K, Venkatesaperumal R. Perception of and satisfaction with the clinical learning environment among nursing students. Nurse Educ Today 2015; 35:833-40. [PMID: 25729010 DOI: 10.1016/j.nedt.2015.02.005] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 01/20/2015] [Accepted: 02/06/2015] [Indexed: 05/27/2023]
Abstract
BACKGROUND Clinical nursing education provides baccalaureate nursing students an opportunity to combine cognitive, psychomotor, and affective skills in the Middle East. OBJECTIVE The aim of the paper is to assess the satisfaction with and effectiveness of the clinical learning environment among nursing students in Oman. DESIGN A cross-sectional descriptive design was used. SETTING AND PARTICIPANTS A convenience sample consisting of 310 undergraduate nursing students was selected in a public school of nursing in Oman. METHODS Ethical approval was obtained from the Research and Ethics Committee, College of Nursing in 2011. A standardized, structured, validated and reliable Clinical Learning Environment Supervision Teacher Evaluation instrument was used. Informed consent was obtained from all the students. Data was analyzed with ANOVA and structural equation modeling. RESULTS Satisfaction with the clinical learning environment (CLE) sub-dimensions was highly significant and had a positive relationship with the total clinical learning environment. In the path model 35% of its total variance of satisfaction with CLE is accounted by leadership style, clinical nurse commitment (variance=28%), and patient relationships (R(2)=27%). Higher age, GPA and completion of a number of clinical courses were significant in the satisfaction with the CLE among these students. CONCLUSIONS Nurse educators can improvise clinical learning placements focusing on leadership style, premises of learning and nursing care, nurse teacher, and supervision while integrating student, teacher and environmental factors. Hence the clinical learning environment is integral to students' learning and valuable in providing educational experiences. RELEVANCE TO PRACTICE The CLE model provides information to nurse educators regarding best clinical practices for improving the CLE for BSN students.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman.
| | | | - Kader Parahoo
- School of Nursing, University of Ulster, Londonderry, Northern Ireland.
| | - Ramesh Venkatesaperumal
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Sultanate of Oman.
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D'Souza MS, Karkada SN, Hanrahan NP, Venkatesaperumal R, Amirtharaj A. Do Perceptions of Empowerment Affect Glycemic Control and Self-Care Among Adults with Type 2 Diabetes? Glob J Health Sci 2015; 7:80-90. [PMID: 26156908 PMCID: PMC4803921 DOI: 10.5539/gjhs.v7n5p80] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/23/2014] [Indexed: 12/17/2022] Open
Abstract
Background: The Arab adult with T2DM is understudied with less known facts about the perception of empowerment and its relationship with self-care and glycemic control. Purpose: The purpose of this study was to determine the extent to which perception of empowerment by Arab adults living with Type 2 Diabetes Mellitus (T2DM) was associated with better glycemic control and self-care management. Methods: A cross-sectional descriptive study was led among 300 Arab adults living in Oman with T2DM in an outpatient diabetes clinic. The Diabetes Empowerment Scale (DES), glycosylated haemaglobin (HbA1c) and Body mass index was assessed. The DES was found to be valid and reliable for the population. ANOVA, Regression analysis, and Structural equation modeling was used for analysis. Results: The composite score and three subscales of DES were a significant and strong predictor of good glycemic control among Omani adults with T2DM (p<0.001). Age, education, duration of DM, prior DM education program and medications were significantly associated with DES. Conclusion: Diabetes nurse educators engaged in the care of adults with T2DM should assess self-empowerment and tailor interventions to increase empowerment for better glycemic control. Patient empowerment plays an essential role in maintaining self-care behaviours and HbA1c.
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D'Souza MS, Karkada SN, Somayaji G, Venkatesaperumal R. Women's well-being and reproductive health in Indian mining community: need for empowerment. Reprod Health 2013; 10:24. [PMID: 23602071 PMCID: PMC3640931 DOI: 10.1186/1742-4755-10-24] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Accepted: 04/04/2013] [Indexed: 11/24/2022] Open
Abstract
This paper is a qualitative study of women’s well-being and reproductive health status among married women in mining communities in India. An exploratory qualitative research design was conducted using purposive sampling among 40 selected married women in a rural Indian mining community. Ethical permission was obtained from Goa University. A semi-structured indepth interview guide was used to gather women’s experiences and perceptions regarding well-being and reproductive health in 2010. These interviews were audiotaped, transcribed, verified, coded and then analyzed using qualitative content analysis. Early marriage, increased fertility, less birth intervals, son preference and lack of decision-making regarding reproductive health choices were found to affect women’s reproductive health. Domestic violence, gender preference, husbands drinking behaviors, and low spousal communication were common experiences considered by women as factors leading to poor quality of marital relationship. Four main themes in confronting women’s well-being are poor literacy and mobility, low employment and income generating opportunities, poor reproductive health choices and preferences and poor quality of martial relationships and communication. These determinants of physical, psychological and cultural well-being should be an essential part of nursing assessment in the primary care settings for informed actions. Nursing interventions should be directed towards participatory approach, informed decision making and empowering women towards better health and well-being in the mining community.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, PO 66, College of Nursing, Sultan Qaboos University, Al-Khoud, Muscat 123, Sultanate of Oman.
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D'Souza MS, Somayaji G, Subrahmanya Nairy K. Determinants of reproductive health and related quality of life among Indian women in mining communities. J Adv Nurs 2011; 67:1963-75. [PMID: 21507045 DOI: 10.1111/j.1365-2648.2011.05641.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM This article is a report of a mixed method to examine the determinants of reproductive health and quality of life among Indian women. BACKGROUND Reproductive health among married women in stressed regions of industrialized countries is an increasingly important consideration, but little is known about the important factors influencing reproductive health and quality of life. METHODS A descriptive correlational research design was used between January and April 2006 with 145 randomly selected married women in a rural mining region of India. The instruments used were the Reproductive Health Index Questionnaire and Interview and Ferrans and Power's Quality of Life Index. Inferential statistics were done using anova and manova. Thematic content analysis was used to analyse qualitative data. RESULTS Reproductive health and quality of life was low among Indian women in mining communities. Higher age groups, better economic status, higher age at menarche, fewer number of children, absence of long-term illness, reproductive illness and domestic violence were important determinants of reproductive health and quality of life among these women in mining communities. CONCLUSION The findings suggest that physical, psychological, sexual, family, socio-economic, energy level and cognitive domains of reproductive health and quality of life need to be assessed and are influenced by important determinants among women. These domains reflected in the theory of goal attainment should be an essential part of nursing process for providing women's reproductive health care in the mining community.
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Affiliation(s)
- Melba Sheila D'Souza
- Department of Adult Health and Critical Care, Sultan Qaboos University, Muscat, Sultanate of Oman.
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Al Attia HM, D'Souza MS. Antitopoisomerase I antibody in patients with systemic lupus erythematosus/sicca syndrome without a concomitant scleroderma: two case reports. Clin Rheumatol 2003; 22:70-2. [PMID: 12605324 DOI: 10.1007/s10067-002-0657-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We describe two female patients with classic systemic lupus erythematosus (SLE) and secondary sicca syndrome associated with topoisomerase I (topo-I, Scl-70) antibody, a specific marker for scleroderma (SSc), which is rarely found in other collagen diseases. During the course of the disease, the sera of these two patients were repeatedly found to be positive for topo-I antibody following a positive screening by ANA-EIA. Neither patient had clinical evidence of scleroderma. One patient remains well nearly 4 years from the first positive serological test. The progression to sicca syndrome in that patient occurred 2 years after having tested positive for antitopo-I antibody. Her frozen serum also tested positive for anti-Scl-70 by the Western blot technique. The other patient, however, died after developing renal and cardiopulmonary complications of lupus, including Libman Sachs endocarditis and pulmonary hypertension. Contrary to the previous patient, the onset of sicca syndrome in this case had preceded the expression of positive antitopo-I antibody. The present cases and other similar previously reported ones are therefore unique in the sense of being a serological challenge to the high specificity of antitopo-I to scleroderma. In addition, they may also represent a new subset of SLE with or without sicca syndrome, which is characterised by the absence of features of scleroderma despite the presence of antitopo-I antibody.
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Affiliation(s)
- H M Al Attia
- Consultant Physician in Internal Medicine, Mafraq Hospital, PO Box, 2951, Abu Dhabi, United Arab Emirates.
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