Hind Bint Maktoum College of Nursing and Midwifery (HBMCoNM)

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Association of contraception use and pregnancy intention with perinatal depression risk among Omani mothers-a longitudinal cohort study.
(2025) Khalaf, Atika
Unplanned pregnancy is significantly associated with an increased risk of perinatal depression (antenatal and postnatal depression), emphasizing its prevalence and its potentially detrimental effects on both maternal and child health. This study aimed to investigate the association of contraception use and pregnancy intention with the risk of perinatal depression among Omani mothers.
Breastfeeding transition in Oman: A generation shift or a product of social development? A qualitative study on three generations of Omani mothers
(Public Library of Science (PLoS), 2025-04-17) Khalaf, Atika
Background: Exclusive breastfeeding is essential for infant health, yet its practice varies across generations and cultures. Although the health benefits of breastfeeding have been well known for decades, the utilization of infant formula feeding worldwide and in Oman, in particular, continues to rise, most likely as a result of a lack of social support and the time limit faced by working mothers. Little is known about the factors affecting Omani mothers’ breastfeeding experiences and practices. Therefore, this study aims to gain an in-depth understanding of the experiences of breastfeeding practices among three generations of Omani mothers. Methods: This qualitative study investigated exclusive breastfeeding practices among three generations of Omani mothers. Participants were recruited using a selective approach followed by a snowball technique, resulting in a total of 50 women, which included 17 first-generation mothers, 18 grandmothers, and 15 great-grandmothers. Participants were characterized by varying ages and socio-demographic backgrounds. Semi-structured face-to-face interviews were conducted in Arabic, and data collection continued until data saturation was reached. Data were analyzed using qualitative content analysis methodology, ensuring robustness and credibility. Results: The analysis yielded two main categories reflecting the mothers’ experiences, three representing the grandmothers’ experiences, and two concerning the great-grandmothers’ experiences. While overarching themes like the significance of breastfeeding emerged across all generations, disparities were seen concerning challenges, beliefs, and support systems. Mothers highlighted contemporary hurdles such as work-life balance and societal pressures, whereas grandmothers emphasized inherited practices and cultural norms. Great-grandmothers reflected on the evolution of societal and familial dynamics impacting breastfeeding traditions. Despite these differences, a shared commitment to breastfeeding and recognition of its importance for maternal and child well-being was evident across generations. Conclusion: The findings underscore the importance of societal support, healthcare provider education, and workplace policies in promoting exclusive breastfeeding. Targeted interventions are needed to address barriers to breastfeeding and empower women to make informed feeding choices. By addressing these challenges, societal institutions can contribute to achieving higher rates of exclusive breastfeeding and improve maternal and child health outcomes in Oman.
Empathy, the scientific clinical gaze and contemporary practice: a critical reflection
(BMJ, 2025-09-18) Khalaf, Atika
This review essay critically examines a modern manifestation of the scientific clinical gaze, drawing upon Michel Foucault's foundational concepts. Using a Swedish medical case involving cultural bias and delayed diagnosis, the essay questions the strengths and vulnerabilities of the clinical gaze, highlighting its susceptibility to subjective distortions despite aspirations toward scientific objectivity. It situates this analysis within broader critiques of the sociopolitical entanglement of medicine, emphasising how implicit bias, institutional norms and power structures continue to influence clinical practice. The discussion further integrates recent scholarship from narrative medicine, cultural competence and reflexivity studies to propose an enriched model of clinical engagement. By advocating for the incorporation of empathy, narrative competence and reflexive awareness into clinical training and practice, the essay outlines strategies to mitigate the epistemic violence historically associated with the clinical gaze. These recommendations aim to advance medical humanities scholarship, foster more equitable healthcare delivery and prepare future practitioners for ethically attuned and culturally sensitive patient care. Through this critical reflection, the essay contributes to ongoing debates regarding the rehumanisation of modern medicine.
Exploring clinical empathy among maternal healthcare providers in Zambia: Does the heart meet the mind? Insights from a qualitative study
(SAGE Publications, 2025-10-15) Khalaf, Atika
Empathy is crucial for enhancing interpersonal interactions in healthcare. While provider empathy improves health outcomes, studies focused on this concept in Zambia are limited. This qualitative study utilized a hermeneutic phenomenological approach, employing qualitative content analysis as the analysis method, to explore clinical empathy through the perspectives of 14 maternal healthcare providers recruited via purposive and snowball sampling. Participants varied in age, experience, and professional roles. The study identified three primary themes: (1) the multifaceted nature of empathy in maternal healthcare, (2) dual aspects of empathy—patient care and professional boundaries, and (3) contextual dynamics—balancing challenges in maternal empathy. Findings highlight that while empathy enhances patient experiences, providers often struggle to maintain emotional boundaries. The study highlights the need for targeted training programs in strengthening empathy in clinical practice and recommends further research on culturally specific expressions of empathy in healthcare settings.
Exploring symptom clusters across the menopausal stages - systematic review and meta-analysis.
(2025-08-12) Khalaf, Atika
This study aimed to identify and compare symptom clusters and their severity among perimenopausal and postmenopausal women using a systematic literature review on publications from 1996 to 2023 across PubMed, Medline, Cochrane Library, and APA PsycINFO. The meta-analysis followed the PRISMA guideline, initially screening 425 articles, with 14 articles meeting the criteria of relevance, scientific rigor, and a focus on symptom clustering in climacteric women. Data from the 14 selected studies (n = 14,760) were extracted, including study characteristics, participant demographics, methods for identifying symptom clusters, specific symptoms within each cluster, and associations with lifestyle factors, genetics, or psychosocial elements. The findings were synthesized to quantify relationships between different symptom clusters, identifying four distinct groups: somatic, vasomotor, psychological, and sexual symptoms. The overall standardized mean difference (SMD) of -0.89 [95 % CI = -1.70, -0.07] was found for somatic symptom clusters, indicating significant differences. However, no conclusive distinctions were observed in vasomotor, sexual, and psychological symptoms, highlighting variability in symptom presentation. Despite this heterogeneity, the overall effect for somatic symptoms remained statistically significant (Z = 2.14, P = 0.03). The findings emphasize the complexity of symptomatology in climacteric women and underscore the need for tailored person-centered interventions and longitudinal studies.
Professional Competence and Spiritual Care Provision Among Zambian Maternal Healthcare Providers: Through the Lens of Watson's Theory of Human Caring.
(2025-02-27) Khalaf, Atika
Purpose: Spiritual care is a multifaceted and integral part of holistic health within the medical standard of care, and it is a crucial component of healthcare providers' (HCPs) job descriptions. This study aimed to investigate Zambian HCPs' professional competence and practice of spiritual care in maternal healthcare settings, with a comparative focus on nurses. Methods: A cross-sectional design was applied among 311 maternal HCPs using an online survey with two validated instruments: Professional Competence in Spiritual Care (PCSC) and the Nurse Spiritual Care Therapeutics Scale (NSCTS). Results: Most participants were females (63.0%) and nurses or midwives (25.1% each). The mean PCSC score was 135.4 (SD = 26.5), indicating excellent competence in spiritual care. The mean NSCTS score was 24.5 (SD = 14.2), indicating that HCPs seldom provide spiritual care. No significant differences were found in PCSC scores across different HCPs ( = 0.065). However, midwives and medical practitioners scored significantly higher on NSCTS compared to nurses ( < 0.001). Conclusions: Zambian HCPs demonstrate excellent competence in spiritual care but seldom provide it. Nurses appear to provide inadequate spiritual care compared to other HCPs. These findings highlight the need for further investigation to identify barriers preventing nurses from delivering comprehensive spiritual care.

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