Magda Bayoumi

Predictors of quality of life in hemodialysis patients.

Quality of Life (QoL) is a consistent and powerful predictor that affects the out-come in end-stage renal disease (ESRD) patients on dialysis. This study was undertaken to identify the factors that might predict QoL scores among ESRD patients on hemodialysis (HD). The study was conducted at three HD units in Saudi Arabia from January 2007 to January 2008. We studied 100 HD patients (53 males and 47 females) and used the SF-36 and KDQoL-SF forms covering six domains of QoL, namely physical, emotional, social, illness impact, medical and financial satisfaction, and overall general health. The mean age of the study patients was 47.5 ± 13.8 years and the mean duration of dialysis was 77.2 ± 75.5 months. The QoL scores were 45.8 ± 17.1 for general health, 53.1 ± 32.0 for physical QoL, 50.5 ± 14.8 for emotional QoL, 54.9 ± 18.1 for social QoL, 46.5 ± 13.7 for illness impact, and 45.9 ± 12.2 for the medical and financial domain. The total QoL score was 49.5 ± 13.7. The male patients had statistically significantly reduced QoL and younger patients had better QoL scores. The QoL scores revealed a decreasing trend with decreasing level of education; they were elevated among employed patients. Multiple linear regression analysis demonstrated that age, dialysis duration, and male sex were negative predictors of QoL score. We conclude from our study that QoL is reduced in all the health domains of HD patients. Older age, male gender, unemployment, and duration of dialysis adversely affected the QoL scores. Adequate management of some of these factors could influence patient outcomes.

Hemodialysis Patients Needs Priorities According to Maslows' Hierarchy and Quality of Life

Background: Patients on hemodialysis (HD) therapy increased suffering related to comorbidities, the patients’ quality of life (QoL) is an important indicator to reflect patients’ needs. Maslows’ needs classified to five basic needs as physiological, safety, belongingness, esteem and self actualization. Methods:The study was a cross-sectional study including of all the haemodialysis patient who had referred to haemodialysis centers of King Khalid University Hospital, and security Forces Hospital at Saudi Arabia. Data were collected by using a structured interview questionnaire, needs assessment sheet was developed according to Maslows’ hierarchy, and the Kidney Disease Quality of Life scale short form (KDQoL SF). Results: The correlation between the total score of QoL turned to be negatively correlated with patient age, dialysis duration, and positively correlated to the level of education in the hemodialysis patients. Conversely, the total needs score is positively correlated to age and negatively correlated with the education level. All these correlations are statistically significant. The strongest correlation is between QoL and age. The best fitting multiple linear regression model explain statistically significant independent predictors of QoL are age, sex, dialysis duration, and total needs score. Conclusion:Measuring quality of life help to consider patients’ needs more seriously, this study indicates statistically significant negative correlation, with decreasing total score of QoL as the total needs score increases.

Improvement Critical Care Patient Safety: Using Nursing Staff Development Strategies, At Saudi Arabia

Intensive care units (ICUs) provide lifesaving care for the critically ill patients and are associated with significant risks. Moreover complexity of care within ICUs requires that the health care professionals exhibit a trans-disciplinary level of competency to improve patient safety. This study aimed at using staff development strategies through implementing patient safety educational program that may minimize the medical errors and improve patient outcome in hospital. The study was carried out using a quasi experimental design. The settings included the intensive care units at General Mohail Hospital and National Mohail Hospital, King Khalid University, Saudi Arabia. The study was conducted from March to June 2012. A convenience sample of all prevalent nurses at three shifts in the aforementioned settings during the study period was recruited. The program was implemented on 50 staff nurses in different ICUs. Their age ranged between 25-40 years. Statistically significant relation was revealed between safety climate and job satisfaction among nurses in the study sample (p=0.001). The years of experiences in ICU ranged between one year 11 (16.4) to 10 years 20 (29.8), most of them (68%) were working in variable shift, while 32% were day shift only. Improvements were observed in safety climate, teamwork climate, and nurse turnover rates on ICUs after implementing a safety program. On the heels of this improvement; nurses’ total knowledge, skills and attitude were enhanced regarding patient safety dimensions. Continuous educational program for ICUs nursing staff through organized in-service training is needed to increase their knowledge and skills about the importance of improving patient safety measure. Emphasizing on effective collaborative system also will improve patient safety measures in ICUS.

Nurses perception toward using a new eight vital signs chart at ICUs

Background: Assessment of the traditional vital signs at ICUs as temperature, pulse, respiration, blood pressure and oxygen saturation are inadequate to determine patients’ clinical condition deteriorating; however assessment of eight vital signs should be included in a routine nursing assessment to improve patients’ outcomes for appropriate nursing diagnosis on proper time. Aim: To assess nurses’ perception toward using a new eight vital signs chart at ICUs Methods: Descriptive cross-sectional study design was used in this study composed of 45 nurses from all ICUs at the Beni-Suef University Hospital from November 2015 to January 2017, data were collected using structured interview to assess nurses’ perception toward using a new eight vital signs chart at ICUs. Results: The study findings demonstrate the distribution of all nurses’ perception items and found more than two third of the study sample (68.9%) were agreed to use eight vital signs, and almost all nurses had fantastic perception to eight vital signs, moreover about (84.4%) had adequate knowledge regarding assessment of pain, level of consciousness, urine output, as well as more than half of study sample reported the degree of importance is extremely important to assess additional three vital signs with basic vital signs (55.6%). However barrier may face nurses to assess pain, level of consciousness and urine output were reported high percentage (91.1%) and (97.8%) agreed to use the new eight vital signs chart at ICUs and defiantly it will help for better design of Nursing Diagnosis. Conclusion: ICUs’ nurses strongly agreed to apply new 8 vital signs chart at ICUs for meticulous designing of nursing diagnosis of patients’ clinically unstable. Recommendation: The study is recommended to consider the importance of application a new eight vital signs chart instead of traditional five vital signs and generalized it in the hospital documentation system.

Benefits of interdiayltic exercise program on quality of life for haemodialysis patients in Saudi Arabia

Pain is a human experience that affects overall quality of life. Nurses play a crucial role in assessing and managing patients’ pain. Effective pain management requires precise knowledge, attitudes and competent assessment skills. Knowledge deficits andT recent dramatic explosion in the US geriatric population is associated with increased complications, cost and trauma death rates. Geriatric trauma management strategies which had been previously developed during an era when the census of the elderly was comparatively low are now seen by many as woefully inadequate to meet present-day challenges. Presented with this challenge we must now cease the opportunity to develop innovative interventions designed specifically to address the enormous unmet health quality and economic needs of the elderly. Innovation in geriatric trauma will require thought leaders who are not only prepared to lead but must champion the cause of the elderly and function as catalysts to transform the New Trauma Culture. This presentation will describe services we developed in response to intervention gaps we identified in geriatric trauma care through research. Several of these projects include: Geriatric G-60 service, falls and deaths, rib plating, femoral iliaca nerve blocks for hip fractures. We have tested-driven a number of these strategies to see how well they perform and we plan to share these findings with you including lessons learned. Finally we suggest research needs to advance the field of geriatric trauma. We believe these plans may improve outcomes for the ever increasing number of geriatric patients.Introduction: Asthma affects an estimated 300 million people worldwide. The estimated prevalence of asthma among adults in Malaysia is 4.2%. One of the important factors in poor asthma control is non-adherence to treatment. Evidence has indicated prevalence and severity of symptoms and rates of hospital admission for adults with asthma are increasing in many countries due to non-adherence to prescribed medication.B Disease (BD) is a chronic, relapsing, systemic vasculitis of unknown aetiology with clinical features of mucocutaneous lesions, ocular, vascular, articular, gastrointestinal, urogenital, pulmonary and neurologic involvement. In BD, symptoms are varied and all these symptoms negatively affect the biopsychological and social life of the patients and reduce their quality of life. In a study by Canbolat et al. (2010), it was determined that, of the patients, 75.5% had pain, 31.9% had sleep problems and 23.4% suffered from fatigue. While bodily pains affected the daily lives of 59.6% of the patients, fatigue affected the daily lives of 69.1% of them. In a study conducted by Karlidag et al. (2001) it was determined that patients with Behcet’s disease experienced fear, sadness, anxiety, hopelessness and ambiguity (74.9%), that they often used active relaxation strategy (36.1%), distraction strategy (25%) and avoidance strategy in order to cope with the disease and that those who had difficulty in coping suffered psychiatric symptoms. Nursing care is for these people who need a qualified nursing care team available to them 24 hours a day. That might include people who need intensive rehabilitative care, for example, people who need oral care, people with physical disabilities and people with long-term conditions. Nursing care is based on the use of personalized care plans. Individual nursing care plan is important for these patients.W bullying has become increasingly prevalent in healthcare and there is significant data to support bullying befalls and carries destruction. The zone of silence that surrounds and insulates this surreptitious behavior is real. In an environment in which bullying is not addressed, it often spreads. Many ramifications of workplace bullying affect employees as well as patients and can lead to decreased reimbursement, unsafe conditions and increases in errors in addition to an overall negative reputation for an organization. Recently, studies have suggested there is a direct correlation between professional nursing educational programs and decreased incivility in the workplace. Research studies support that when bullies in the workplace are held accountable, staff are more empowered to come forward and report these events. Through education, prevention and awareness, nursing educational programs can be instrumental in eradicating this behavior both in the academic world and hospital based settings. Undergraduate nursing students in the academic arena could benefit from evidence-based education on ramifications of buying and how to address it in their practice. Hospital based nursing education programs outlining policies and acceptable behaviors are another forum that could help to prevent workplace violence. Researchers agree additional studies are needed in order to examine the effectiveness of nursing educational programs on eliminating covert bullying.Collaboration in Student’s Simulated Clinical Practice Presentation Objectives: Share strategies for collaborative education of students in health Industries. Reinforce the concept and value of experiential learning in education. Highlight ways of including Inter-professional collaboration in simulation. Abstract: Background /Rationale: For many undergraduate students in the health industry, limited numbers of quality clinical placements and variable placement experiences limit learning opportunities. In order to introduce students to the collaborative care and develop communication skills, social work, occupational therapy and nursing students in undergraduate health programmes at Wintec in New Zealand took part in a simulated Inter-professional meeting which was part of a simulated nursing practice programme. Method/Methodology: Self-selecting participants completed a questionnaire answering five open ended questions and responded to an opportunity to take part in a focus group. Research findings were analysed through a process of thematic analysis whereby each sentence of data was analysed in the first instance and categorised. Categories were then analysed and merged where appropriate to form the overall themes. Kolb’s (1984) Experiential Learning Theory provided a theoretical framework to guide this study. Results: Of the 72 participants, (54 nursing students, 8 occupational therapy students and 10 social work students) (n=48) responded to the questionnaire. Nine of these students also took part in the focus group. Themes identified from overall participant responses were: professional role clarification and awareness, preparedness, safety and realism. Conclusions: Results in this study suggest that the simulated collaborative meeting overall provided a valuable learning experience for students. The study also highlighted the need to ensure that all students involved, receive the same information and are well prepared for the simulated meeting. Further research is required within the professional group to establish the value of including this type of experiential learning into undergraduate health and social practice programmesMethods: Data was derived from 244 pregnant women admitted to the obstetrics and gynecology department of a tertiary care centre for their routine follow-up. Two questionnaires consisting of “Personal Introductory Form” and “Health Practice Questionnaire-II” were applied to gather information about demographics and health related knowledge and attitudes. Cronbach’s alpha has yielded a coefficient of 0.644 indicating a satisfactory level of reliability.I November 2009, during an ice storm in Cleveland an autistic mother brought her two autistic daughters to our Clinic for help. I decided to investigate further on how to help her. The consensus among autism researchers was that genetic and environmental factors were the main causes. Vaccines containing thimersol with mercury were also suspected because parents noticed symptoms around the time of vaccination. With thimersol removal the autism rate increased. Reliable statistics were not available. The CDC set up stations in 14 states to monitor incidence and found an 18% yearly increase. Use of the statistic of 8 year olds was found to be more reliable because by that time the diagnosis of autism has been established. However, dietary intake could not be established and a process called nutritional epidemiology was used. Results showed that the greater the percentage of breast feeding the higher the number of autism cases in the states and the counties of 4 of these states. The amounts of milk that babies drank were determined from the USDA and the amounts of B-vitamins consumed were calculated. Results showed that the minimal daily requirements were not met. Sugar was significantly related directly to the autism rate of eight year olds. In conclusion, it appears that autism may be related to inadequate intake of B-vitamins.The current practice of neonatal medicine has been carved with recent findings based on studies and prospective or follow-up studies of potentially very severe patients who, at birth, are more likely to not survive than grow and develop normally. Thanks to a better understanding of the pathophysiology of specific diseases of the immature newborn and technical and scientific improvements in the care and treatment of these patients. Especially the introduction of antenatal corticosteroids, parenteral nutrition, synchronized mode of ventilations which are patient triggered and non-invasive ventilation, like CPAP (Continous Positive Airway Pressure) for newborns. The better resuscitation care, the knowledge about the golden hour approach and the exogenous surfactant was a dramatic reduction in mortality of these patients over the past 3 decades. Having reached a low neonatal mortality, the focus of Perinatology now also addressing the quality of life in the medium and long-term patients discharged from the Maternity Hospital.Methods: A quasi-experimental intervention design was used, pre-post assessment of the effect of implementation of exercise program for hemodialysis patients at Mohail General Hospitalsouthern of Saudi Arabia. The questionnaires were used to collect data: Physical Fitness Measurement, KDQoL-SFTM 1.3, Borgs 15-point scale for rating of perceived exertion (RPE), vital signs and lab investigation (Hemoglobin, Serum phosphates, Serum albumin, Creatinine, Fasting blood sugar, Kt/v and Urea).