Hind Bint Maktoum College of Nursing and Midwifery (HBMCoNM)

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Association Between Perceived Control and Acute Coronary Syndrome Symptom Severity: A Prospective Cohort Study
(2025) AbuRuz, Mohannad Eid
Aim: To determine whether there are differences in patterns of symptom severity in three major ACS symptoms (i.e., chest pain, fatigue, and dyspnoea) over the days of CCU stay between patients with higher and lower levels of perceived control. Design: A prospective cohort study with 3 days of follow- up. Methods: Hundred and thirty- five patients were followed prospectively for 3 days, collecting data on (1) perceived control, using the Arabic version of the Controlled Attitude Scale (CAS- R); and (2) symptom severity, using a symptoms diary. A mixed repeated measure design ANOVA was used for data analysis. Results: Comparative analysis of the high- and low- perceived control groups revealed that there was a significant reduction in chest pain, fatigue, and dyspnoea symptom severity over the course of the 3 days for both groups. Compared to the low- perceived control group, the high- perceived control group had significantly lower chest pain on day 3, fatigue on days 2 and 3, and dyspnoea on all days. Conclusion: Patients with high levels of perceived control have lower levels of symptom severity than those with low perceived control. Interventions to improve perceived control among this population are highly recommended.
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.
Cancer Cachexia in Clinical Practice: A Review of Treatment Barriers Among Cancer Patients
(Wiley, 2025-01) Alsharawneh, Anas; Ricardo Santiago Gomez
Background: Cancer cachexia is a multifactorial syndrome that affects patients’ quality of life and survival. It accounts for over 20% of cancer deaths. Despite its high incidence, there is no evidence-based standard of care for managing it. Early detection and management require preventative measures and multimodal therapy. Aim: The purpose of this study was to conduct an in-depth review of the literature on cancer cachexia and its barriers for effective assessment and management. Methods: The literature review was conducted through various electronic databases to identify studies published on cancer cachexia and its barriers for effective assessment and management of cancer cachexia. Results: The review indicated that barriers for effective assessment and management of cancer cachexia were on three levels: patients, health workers, and organizations. Also, there is a knowledge gap in understanding, assessing, and managing cancer cachexia among healthcare workers, patients, and family members. Conclusion: The research indicates that patients, family members, and healthcare professionals lack sufficient knowledge about how to identify, assess, and treat cancer cachexia. This gap has a lot of important barriers, both modifiable and nonmodifiable. Patients, healthcare professionals, and organizations are the three levels of those barriers.
Challenges faced when masking a single discoloured tooth - Part 1: aetiology and non-invasive management.
(2025-06) Aljanahi, May; Alhussin, Argwan; Elbishari, Haitham
Encountering a single discoloured tooth is a common occurrence in dentistry and it poses a significant concern affecting both aesthetic appearance of natural teeth and patient confidence. Management of tooth discolouration involves a wide variety of options and requires specific protocols for both the clinician and patient to achieve an aesthetic result. One of the toughest challenges in restorative dentistry is being able to mimic natural teeth. This review is the first of two articles that will broadly discuss the aetiology of discolouration and the challenges faced when masking a single discoloured tooth. It will also examine various approaches, encompassing the conservative options, such as scaling, microabrasion, air abrasion, vital and non-vital tooth whitening, and resin infiltration. By integrating current and clinical evidence, this review aims to identify the causes of single tooth discolouration, highlight the challenges/variables faced when masking discoloured teeth and appraise possible minimally invasive procedures.
Closing out 2022
(2022-12) Boyle, Breidge
Introduction: As we close out the final December 2022 issue of the Journal of Neonatal Nursing (JNN), we are happy to present a greater than ever volume of articles for perusing! We have been blessed with record numbers of submitted manuscripts in 2022 allowing us to publish more evidence in a timely fashion. This jam-packed issue includes 3 reviews and 10 original manuscripts. Our first review is from the University Hospital Waterford in Ireland and is presented by authors Cunningham, Patton, Moore, O’Connor, Bux, and Nugent. Kangaroo care has multiple physiological, developmental, and psychological benefits for neonates. The purpose of their Evidence Review was to review past and current kangaroo care practices and explore the literature relating to improving kangaroo care for preterm infants.
Culture, ethnicity, and socio-economic status as determinants of the management of patients with advanced heart failure who need palliative care: A clinical consensus statement from the Heart Failure Association (HFA) of the ESC, the ESC Patient Forum, and the European Association of Palliative Care
(2023) Hill, Loreena
Abstract: The delivery of effective healthcare entails the configuration and resourcing of health economies to address the burden of disease, including acute and chronic heart failure, that affects local populations. Increasing migration is leading to more multicultural and ethnically diverse societies worldwide, with migration research suggesting that minority populations are often subject to discrimination, socio-economic disadvantage, and inequity of access to optimal clinical support. Within these contexts, the provision of person-centred care requires medical and nursing staff to be aware of and become adept in navigating the nuances of cultural diversity, and how that can impact some individuals and families entrusted to their care. This paper will examine current evidence, provide practical guidance, and signpost professionals on developing cultural competence within the setting of patients with advanced heart failure who may benefit from palliative care.
Digital Disruption: Investigating the Effects of Nighttime Technology Use on Researchers’ Sleep Quality and Psychological Wellbeing
(IEEE, 2025-07-08) AbuRuz, Mohannad
This study investigates the effects of nighttime technology use on researchers’ sleep quality and psychological wellbeing at the University of Sharjah, UAE. Utilizing a descriptive qualitative research design, the study engaged participants through semi-structured interviews to explore their perspectives on nighttime technology use. Thematic analysis of the interview data revealed three main emergent themes: (1) "Risk and Protective Factors of Nighttime Technology Use and Sleep Disturbances," (2) "Technostress and Psychological Wellbeing," and (3) "Protective Strategies: Researchers’ Perspectives." The findings offer some insights into the effects of nighttime technology use on researchers’ sleep quality and psychological wellbeing. These insights can help develop programs aimed at improving work-life balance for researchers, emphasizing the importance of mental health and self-care in high-pressure academic environments.
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.
An Exploration of the Day to Day Professional Experiences of School Nurses Globally: A Narrative Review
(2024-07) Boyle, Breidge
Abstract To explore school nurses roles globally through their own perceptions of what they do and how they do it and to compare the realities for the role its representation in professional literature. A comprehensive narrative literature review, using ENTREQ guidelines, with "qualitizing" of the quantitative literature, and athematic analysis was carried out. Findings were reviewed in relation to established theory. CINAHL, Medline, Cochrane Library, and Embase were systematically searched from 2000-2021. Included studies focused on school nurses perceptions of their own practice. Five themes: direct care, health promotion, collaboration, support from school and health authorities and promoting the school nurses role were found. These themes were closely aligned to the National Association for School Nurses' framework for 21st century practice. However, the school nurses signposted areas where they need support in carrying out their job to the highest standard. School nurses are important to support the health needs of students while at school. They also, particularly in areas like the United Arab Emirates where resources are being invested in the role, have a unique role to play in health promotion, leading to improved health literacy, as positive health behaviors tend to be learned young. However, worldwide, the potential for the school nursing role needs to be recognized and supported by health and education providers, by families and within the schools for its full potential to be achieved.
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.
Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis
(2021) Gormley, Kevin
Objective: Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. Methods: A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. Results: Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31–40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. Conclusion: Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.
Impact of self-directed e-learning on nurses' competency in arrhythmia interpretation in cardiology
(2025) Al Nsair, Nezam
Accurate electrocardiogram (ECG) interpretation is an essential competency for nurses, particularly in cardiology, where the timely identification of arrhythmias can be lifesaving and significantly impact patient outcomes. Nurses often serve as the first line of clinical observation, making their ability to interpret ECGs critical for early intervention and safe patient care. However, numerous studies have highlighted persistent gaps in ECG interpretation skills among nursing staff, emphasizing the urgent need for effective, accessible educational strategies. This study aimed to assess the effectiveness of a self-directed e-learning (SDL) package in improving nurses' knowledge and competency in arrhythmia interpretation within the cardiology department of Rashid Hospital, Dubai. A quasi-experimental, one-group pre-test/post-test design was utilized with a sample of 50 nurses working in Coronary Care Units. Data were collected using a validated, structured questionnaire that included demographic data and ECG interpretation tests. The SDL package covered foundational ECG knowledge, rhythm analysis, and arrhythmia management. Results showed a statistically significant 15.92% improvement in knowledge following the intervention (t = -6.668, p < .001). A notable correlation was observed with years of experience; nurses with 1-5 years of experience demonstrated the highest improvement (p = .020). No significant differences were found based on gender (p = .234) or area of practice (p = .139). This study highlights the critical need to strengthen nurses' arrhythmia interpretation skills and demonstrates that SDL is an effective, flexible, and scalable approach to bridging competency gaps in high-acuity clinical areas such as cardiology.
The lived experiences of fatigue among patients receiving haemodialysis in Oman: a qualitative exploration
(2024-07) Gormley, Kevin
Abstract Background: Fatigue among patients with end-stage kidney disease (ESKD) receiving haemodialysis imposes a substantial burden on patients' quality of life and expected treatment outcomes. This study explores the perspective on ESKD-related fatigue and contributing factors among Omani patients receiving haemodialysis. Methods: An exploratory qualitative design was used. Participants (N = 25) were recruited from two Omani haemodialysis centres, and data were collected through semi-structured interviews, which were transcribed and analysed using a thematic analysis approach. NVivo 11 is used to manage qualitative data and create memos, nodes, and codes. Results: Findings highlighted three themes: (i)"Inevitability of fatigue," (ii)"Contributors to physical fatigue," and (iii)"Contributors to mental fatigue." Theme one alluded to the inevitability of fatigue and the unique experience encountered by patients. Theme two addressed the physical fatigue associated with ESKD-related factors, such as chronically low haemoglobin levels, and the exhausting impact caused by the frequency and travelling distance for treatment sessions. Theme three, mental fatigue, was notably driven by heightened emotional disturbance, encompassing frustration, guilt, anxiety, and distress, that in turn impacted family interactions, frequently triggering anger and remorse. Moreover, mental fatigue is a result of disturbances in expressing physical sexuality in marriage, as physical fatigue was found to be a significant contributor to unsatisfactory sexual experiences and, thus, straining the relationships between couples. Conclusions: This study offers an explanation of fatigue among Omani patients with ESKD who are receiving haemodialysis. The study emphasises close links between physiological change, the haemodialysis process, and mental tiredness, together with their contribution to supporting the need for a holistic approach and care strategies in managing these patients and promoting patient and family well-being.
Neonatal research: A reflection on the impact of patient and public involvement (PPI) on the Neo-SILT study
(Elsevier BV, 2025-01) Boyle, Breidge
Integrating parental input into neonatal research development is crucial for producing ethically sound, practi cally applicable, studies with real-world context based on lived experiences. Parents, as primary caregivers, offer invaluable insights into the daily realities and emotional aspects of neonatal care that healthcare professionals may overlook. Their lived experiences can highlight subtle, yet significant, impacts of medical conditions and treatments on their children, thereby enriching the research with a deeper understanding of infant’s needs. Parental involvement ensures that research questions and outcomes are aligned with family priorities, enhancing the relevance and applicability of the studies. Moreover, the ethical design of studies benefits greatly from parental input, as it grounds the research in the lived experiences of those most affected, fostering greater empathy and sensitivity. This approach also helps build trust between researchers and the study participants, which is essential for improving recruitment and retention rates. The Neo-SILT study demonstrated this by significantly revising its Post Traumatic Stress Disorder (PTSD) measurement timelines, shaping the research question, adjusting the methodology and highlighting potential barriers and facilitators to participation based on parental feedback, ensuring a more accurate depiction of symptom onset and trajectory. Additionally, the co design of recruitment materials and parent information leaflets resulted in resources that were not only infor mative but also emotionally mindful and visually appealing, further facilitating parental engagement. Reflective practice has provided the nurse researcher with the framework to share the value and importance of integrating parental perspectives into neonatal research that can address potential oversights and biases, ensuring that studies are scientifically rigorous, ethically sound, and practically relevant.
On family-centred and child-centred care - And the moral distress therein
(2022) Boyle, Breidge
On family-centred and child-centred care - And the moral distress therein
Players' and parents' perceptions of injury in elite Northern Irish schools’ rugby — A qualitative study
(2023) Wilson, Iseult
Objectives: To explore schools' rugby players' and their parents’ perceptions of injury. Design: A qualitative study using focus groups. Setting: Schools who compete in the Ulster Schools’ Cup competition. Participants: 13 players and 9 parents. Outcome measures: A thematic analysis approach was used to examine players' and parents’ beliefs and attitudes towards injury, return to play and injury risk. Results: Findings suggest schools' rugby players and their parents are aware of injury risk in the schoolboy game. They are aware of concussion injury but are less aware of musculoskeletal injury. Parents' perceptions of injury are based on their experience of their sons’ injuries. Parents are unaware of return to play strategies for musculoskeletal injury. Conclusions: Schools' rugby players and their parents are aware of injury to some extent, however players' and parents’ knowledge and understanding of injury is based on and informed by personal experience, not the evidence base. Whist they are aware of injury, many players will seek to push their fears to the back of their mind. However, for those players who have suffered severe injury, they are concerned about the risk of reinjury.
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.
Risk and Management of Patients with Cancer and Heart Disease
(2023) Hill, Loreena
Abstract: Cancer and cardiovascular disease are two of the leading causes of global mortality and morbidity. Medical research has generated powerful lifesaving treatments for patients with cancer; however, such treatments may sometimes be at the expense of the patient’s myocardium, leading to heart failure. Anti-cancer drugs, including anthracyclines, can result in deleterious cardiac effects, significantly impacting patients’ functional capacity, mental well-being, and quality of life. Recognizing this, recent international guidelines and expert papers published recommendations on risk stratification and care delivery, including that of cardio-oncology services. This review will summarize key evidence with a focus on anthracycline therapy, providing clinical guidance for the non-oncology professional caring for a patient with cancer and heart failure.

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