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  1. Nelwati, Abdullah KL, Chan CM
    Nurse Educ Today, 2018 Dec;71:185-192.
    PMID: 30293048 DOI: 10.1016/j.nedt.2018.09.018
    BACKGROUND: Peer learning experiences have been reported in previous qualitative studies, however individual findings could limit practical leverage due to small sample size. Thus it is necessary to integrate invaluable findings from various qualitative studies to consider appropriateness and acceptability of peer learning in professional nurse education.

    OBJECTIVE: To identify and synthesize qualitative evidence of peer learning experiences of undergraduate nursing students so as to understand their perceptions on peer learning experiences.

    DESIGN: A qualitative systematic review was conducted in accordance with the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement.

    DATA SOURCES: Database searching was conducted on electronic databases such as Cumulative Index to Nursing and Allied Health Literature (CINAHL), Science Direct, and MEDLINE that published from 2007 to 2017.

    REVIEW METHODS: Qualitative studies were appraised using the Critical Appraisal Skills Programme (CASP). Thematic analysis was used to analyse the data using line by line coding, organising coding into descriptive themes, and interpreting further to generate new insights.

    RESULTS: Six studies were included in this review. The most common themes identified were integrated into two new insights including personal development and professional development.

    CONCLUSION: This review has revealed that peer learning experiences contribute to the learning process of undergraduate nursing students in preparing them to become professional nurses through personal development and professional development.

  2. Nelwati, Abdullah KL, Chong MC
    Nurse Educ Pract, 2019 Nov;41:102648.
    PMID: 31707147 DOI: 10.1016/j.nepr.2019.102648
    BACKGROUND: Undergraduate nursing students are required to acquire professional values during professional nurse education to provide safe and high quality patient care. However, there was no documentation in professional values among Indonesian undergraduate nursing students and the factors influencing its development.

    PURPOSE: The purpose of this study was to determine professional values among Indonesian undergraduate nursing students and examine the relationship between students' demographic factors and professional values.

    DESIGN: A cross-sectional study using convenience sampling was applied to recruit 391 Indonesian undergraduate nursing students. The 26 items of Nurses Professional Values Scale Revision (NPVS-R) with five dimensions was employed to collect data. Descriptive and inferential statistics, independent samples t-test were applied to analyse and interpret data.

    RESULTS: The result showed that the total score of nurse professional values was high (95.80 ± 12.93). The most important professional value dimension was caring, while activism was the least important values. The NPVS-R total score had a significant association with length of professional clinical practice of the students (p 

  3. Lee Wan Fei S, Abdullah KL
    J Clin Nurs, 2015 Mar;24(5-6):672-82.
    PMID: 25319831 DOI: 10.1111/jocn.12712
    To determine the most effective position jaundiced neonates should assume during phototherapy from appraised randomised controlled trials.
  4. Atefi N, Abdullah KL, Wong LP
    Nurs Crit Care, 2016 Jan;21(1):8-17.
    PMID: 25270664 DOI: 10.1111/nicc.12100
    BACKGROUND: Job satisfaction is an important factor in health care settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care. However, there have not been any studies exploring the job satisfaction of Malaysian nurses.

    AIM: The main purpose of this qualitative descriptive study was to explore the factors related to feelings of job satisfaction as well as job dissatisfaction experienced by registered nurses in Malaysia.

    METHOD: A convenient sample of 46 Malaysian nurses recruited from a large hospital (number of beds = 895) participated in the study. A total of seven focus group discussions were conducted with nurses from surgical, medical and critical care wards. A semi-structured interview guide was used to facilitate the interviews, which were audio-recorded, transcribed verbatim and checked. The transcripts were used as data and were analysed using a thematic approach.

    FINDING: The study identified three main themes that influenced job satisfaction: (1) nurses' personal values and beliefs; (2) work environment factors and (3) motivation factors. Concerning the nurses' personal values and beliefs, the ability to help people made the nurses felt honoured and happy, which indirectly contributed to job satisfaction. For work environment factors, team cohesion, benefit and reward, working conditions play an important role in the nurses' job satisfaction. Motivation factors, namely, professional development and clinical autonomy contributed to job satisfaction.

    CONCLUSION: It is important for nurse leaders to provide more rewards, comfortable work environments and to understand issues that affect nurses' job satisfaction.

    RELEVANCE TO CLINICAL PRACTICE: Our findings highlight the importance of factors that can improve nurses' job satisfaction. The study provides basic information for hospital administrators in planning effective and efficient policies to improve nursing job satisfaction in order to increase the quality of patient care and decrease nursing turnover.

  5. Atefi N, Abdullah KL, Wong LP, Mazlom R
    Int Nurs Rev, 2014 Sep;61(3):352-60.
    PMID: 24902878 DOI: 10.1111/inr.12112
    AIM: The purpose of this qualitative descriptive study was to explore factors related to critical care and medical-surgical nurses' job satisfaction as well as dissatisfaction in Iran.
    BACKGROUND: Job satisfaction is an important factor in healthcare settings. Strong empirical evidence supports a causal relationship between job satisfaction, patient safety and quality of care.
    METHOD: A convenient sample of 85 nurses from surgical, medical and critical care wards of a large hospital was recruited. Ten focus group discussions using a semi-structured interview guide were conducted. Interviews were audio-recorded, transcribed verbatim and analysed using a thematic approach.
    FINDINGS: The study identified three main themes that influenced nurses' job satisfaction and dissatisfaction: (1) spiritual feeling, (2) work environment factors, and (3) motivation. Helping and involvement in patient care contributed to the spiritual feeling reported to influence nurses' job satisfaction. For work environment factors, team cohesion, benefit and rewards, working conditions, lack of medical resources, unclear nurses' responsibilities, patient and doctor perceptions, poor leadership skills and discrimination at work played an important role in nurses' job dissatisfaction. For motivation factors, task requirement, professional development and lack of clinical autonomy contributed to nurses' job satisfaction.
    CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nurse managers should ensure a flexible practice environment with adequate staffing and resources with opportunities for nurses to participate in hospital's policies and governance. Policy makers should consider nurses' professional development needs, and implement initiatives to improve nurses' rewards and other benefits as they influence job satisfaction.
    KEYWORDS: Environment; Iran; Motivation Factors; Qualitative
  6. Ramoo V, Abdullah KL, Piaw CY
    J Clin Nurs, 2013 Nov;22(21-22):3141-52.
    PMID: 24118518 DOI: 10.1111/jocn.12260
    AIMS AND OBJECTIVES: To assess Malaysian nurses' perceived job satisfaction and to determine whether any association exists between job satisfaction and intention to leave current employment.
    BACKGROUND: There is currently a shortage of qualified nurses, and healthcare organisations often face challenges in retaining trained nurses. Job satisfaction has been identified as a factor that influences nurse turnover. However, this has not been widely explored in Malaysia.
    DESIGN: Cross-sectional survey.
    METHODS: Registered nurses in a teaching hospital in Malaysia completed a self-administered questionnaire. Of the 150 questionnaires distributed, 141 were returned (response rate = 94%).
    RESULTS: Overall, nurses had a moderate level of job satisfaction, with higher satisfaction for motivational factors. Significant effects were observed between job satisfaction and demographic variables. About 40% of the nurses intended to leave their current employment. Furthermore, age, work experience and nursing education had significant associations with intention to leave. Logistic regression analysis revealed that job satisfaction was a significant and independent predictor of nurses' intention to leave after controlling for demographic variables.
    CONCLUSION: The results suggest that there is a significant association between job satisfaction and nurses' intention to leave their current employment. It adds to the existing literature on the relationship between nurses' job satisfaction and intention to leave.
    RELEVANCE TO CLINICAL PRACTICE: Methods for enhancing nurses' job satisfaction are vital to promote the long-term retention of nurses within organisations. Attention must be paid to the needs of younger nurses, as they represent the majority of the nursing workforce and often have lower satisfaction and greater intention to leave than older nurses do. Strategies to nurture younger nurses, such as providing opportunities for further education, greater management decision-making capabilities and flexible working environment, are essential.
    KEYWORDS: Malaysian nurses; intention to leave; job satisfaction; nursing; teaching hospital; turnover
  7. Geok CK, Abdullah KL, Kee LH
    Int J Nurs Pract, 2013 Aug;19(4):381-9.
    PMID: 23915407 DOI: 10.1111/ijn.12083
    The purpose of this paper is to examine the quality of life (QOL) among mothers with a child with Down syndrome using The World Health Organization Quality of Life scale instrument. A convenience sample of 161 mothers was accessed through the various institutions which provide interventional or educational programmes to children with disabilities within two of the regions of the Borneo State of Malaysia (Sarawak). Nearly half of the group of mothers perceived their QOL as neither poor nor good (n = 73). An overall QOL score of 14.0 ± 1.84 was obtained. The highest and lowest domain scores were found for social relationship domain (Mean = 14.9 ± 2.1) and environmental support domain (Mean = 13.3 ± 2.1) respectively. Correlation analysis of selected background variables (i.e. locality, education, income and marital status) and overall QOL indicated rho (161) = 0.22-0.28 (P < 0.01). Inverse correlation between maternal age and overall QOL score was indicated, with rho (161) = -0.17 (P < 0.05). Linear regression analysis indicated that the combination of these few variables together accounted for 14.5% of the QOL variability in the sample. Findings point to implications for priorities of care provisions by policy-makers and care professionals in their practice.
  8. Lei CP, Har YC, Abdullah KL
    Asian Pac J Cancer Prev, 2011;12(3):797-802.
    PMID: 21627386
    BACKGROUND: Cancer and chemotherapy are sources of anxiety and worry for cancer patients. Information provision is therefore very important to empower them to overcome and adjust to the stressful experience. Thus, nurses should be aware of the informational needs of the patients throughout the course of their care.
    PURPOSE: The purpose of the study was to identify the important information required by breast cancer patients during the first and fourth cycles of chemotherapy from both the patients' and nurses' perceptions.
    METHODOLOGY: This is a longitudinal study used a questionnaire adapted from the Toronto Informational Needs Questionnaires-Breast Cancer (TINQ-BC). Some modifications were made to meet the specific objectives of the study. The study was conducted in the Chemotherapy Day Care at the University of Malaya Medical Centre (UMMC), Malaysia. A total of 169 breast cancer patients who met the inclusion criteria, and 39 nurses who were involved in their care were recruited into the study.
    RESULTS: The overall mean scores at first and fourth cycle of chemotherapy were 3.91 and 3.85 respectively: i.e., between 3 (or important) and 4 (or very important), which indicated a high level of informational needs. There was no significant difference in information needed by the breast cancer patients between the two cycles of chemotherapy (p=0.402). The most important information was from the subscale of disease, followed closely by treatment, physical care, investigative tests and psychosocial needs. Nurses had different views on the important information needed by breast cancer patients at both time points (p = 0.023).
    CONCLUSIONS: Breast cancer patients on chemotherapy have high levels of informational needs with no significant differences in information needed at first cycle as opposed to fourth cycle. There were differences between the perceptions of the breast cancer patients and the nurses on important information needed. A paradigm shift, with an emphasis on patients as the central focus, is needed to enhance the information giving sessions conducted by nurses based on the perceptions of the patients themselves.
  9. Nelwati, Abdullah KL, Chong MC, McKenna L
    J Prof Nurs, 2020 03 19;36(6):477-483.
    PMID: 33308543 DOI: 10.1016/j.profnurs.2020.03.008
    BACKGROUND: Peer learning has enabled undergraduate nursing students to develop competence and clinical skills. It is rare to find quantitative studies examining the effect of peer learning on professional competence development among undergraduate nursing students comprehensively.

    OBJECTIVE: To examine the effect of peer learning on professional competence development among Indonesian undergraduate nursing students.

    DESIGN: A quasi-experimental study with non-equivalent control group pre-test post-test design.

    PARTICIPANTS: Convenience sampling was used to recruit participants. Seventy-five students completed the study (37 in the intervention group and 38 in the control group).

    METHODS: The intervention group received the peer learning program, while the control group received conventional learning during clinical practice. The Nurse Professional Competence (NPC) was used to collect data at pre-test and post-test measurement. Data were analysed using descriptive and inferential statistics.

    RESULTS: Professional competence had significantly increased in the intervention group. A significant interaction effect of time (pre-test and post-test) and group on professional competence development was also found. The effect of peer learning on professional competence development was significantly greater than the conventional method.

    CONCLUSION: Peer learning was demonstrated as an innovative learning method to develop professional competence during clinical practice among Indonesian undergraduate nursing students. It is recommended for nurse educators to consider implementing peer learning during clinical education.

  10. Mansor M, Oo SS, Abdullah KL
    MyJurnal
    Family planning is an important practice for women as it can help to improve financial and social status. Unwanted pregnancy has negative effects for husband and financial. However, couples married at a late age may not practice family planning because they want to have kids. The aims of this study were to determine the prevalence, factors associated with
    husband’s socio demography and decision making in family planning practices among women in reproductive age who attended a polyclinic in Serdang, Malaysia. A cross sectional study was conducted on 245 women with a systematic random sampling. Descriptive analysis, Fisher exact and Chi-square tests were conducted to identify the influence of husband’s socio demographic factors and decision making in family planning practices. The prevalence of family planning practices among married women was moderate (53.9%). Family planning practices among women showed significant relationship with the husband’s socio demography which were husband’s race (p = 0.018), religion (p = 0.008) and making decision in family planning (p = 0.002). The husband’s socio demography showed a significant relationship with the prevalence of the wife practicing family planning. This clearly indicates that the husband is the individual that influence the wife to use contraceptive method. Decision making in family planning by both the husband and wife is important in choosing to use contraceptive method. Health promotion in the concept of health education for male contraceptive method such as pamphlet and booklet is important to promote husband involvement in family planning.
    Study site: Klinik Kesihatan Seri Kembangan, Serdang, Selangor, Malaysia
  11. Chen HY, Ahmad CA, Abdullah KL
    Chin J Traumatol, 2021 Jul;24(4):237-248.
    PMID: 34112591 DOI: 10.1016/j.cjtee.2021.04.002
    PURPOSE: Malaysian disaster relief volunteers have a long and proud history of participating in relief missions within and outside the country. Despite of a plethora of researches into the various areas of disaster relief, there has been a little scholarly activity looking into the experiences of the medical volunteers worldwide and even less research on the experiences of the relief volunteers in Malaysia. Therefore, the purpose of this study is to identify the effect of disaster relief works on volunteers in Malaysia.

    METHODS: This is a non-experimental cross-sectional design study, which was conducted using survey questionnaire to examine the incidence of burnout, posttraumatic stress disorder (PTSD) symptoms and the quality of life (QOL) among the disaster relief volunteers. And the study also examined the socio-demographic variables of the participants. In addition, the association between the sociodemographic variable and the preferred coping strategies was also investigated through self-reporting checklist.

    RESULTS: The findings of this study revealed that 90.9% volunteers (n = 312) experienced some levels of recurring stress throughout their lives, which led to burnout. Also, 96.8% (n = 332) of the participants were categorized as having at least some symptoms of PTSD. However, self-reporting QOL measurements indicated that the participants are, in general, satisfied with their lives. Significant associations between the incidence of burnout, incidence of PTSD and QOL were identified. Both positive coping measures and behavioral or avoidant coping measures were also identified. Furthermore, a number of socio-demographic factors were also seen to interact significantly with burnout, PTSD and QOL.

    CONCLUSION: This study provides some insights into the psychological challenges of disaster relief volunteers in Malaysia, and this impact can last a long time after the volunteers return to their hometowns. Several recommendations including practice development, policy and research were discussed in the study.

  12. Mortell M, Abdullah KL, Ahmad C
    Br J Nurs, 2017 Sep 28;26(17):965-971.
    PMID: 28956990 DOI: 10.12968/bjon.2017.26.17.965
    AIM: To explore the perceptions of patient advocacy among Saudi Arabian intensive care unit (ICU) nurses.

    BACKGROUND: Despite advocacy being a crucial role for nurses, its scope is often limited in clinical practice. Although numerous studies have identified barriers to patient advocacy, their recommendations for resolution were unclear.

    METHOD: The study employed a constructivist grounded theory methodology, with 13 Saudi Arabian registered nurses, working in critical care, in a tertiary academic teaching hospital. Semi-structured interviews, with broad open-ended questions, and reflective participant journals were used to collect data. All interviews were concurrently analysed and transcribed verbatim.

    RESULTS: Gender, culture, education, subjugation, communal patronage, organisational support and repercussions, and role-associated risks were all revealed as factors affecting their ability to act as advocates for critically ill patients.

    CONCLUSION: Saudi Arabian ICU nurses in the study believed that advocacy is problematic. Despite attempting to advocate for their patients, they are unable to act to an optimal level, instead choosing avoidance of the potential risks associated with the role, or confrontation, which often had undesirable outcomes. Patient advocacy from a Saudi Arabian nursing perspective is contextually complex, controversial and remains uncertain. Further research is needed to ensure patient safety is supported by nurses as effective advocates.

  13. Daghash H, Abdullah KL, Ismail MD
    Qual Manag Health Care, 2022 02 16;31(3):114-121.
    PMID: 35180731 DOI: 10.1097/QMH.0000000000000336
    BACKGROUND AND OBJECTIVES: A care pathway is a structured care plan based on best clinical practice for a particular patient group. It reorganizes a complex process by providing structured, standardized care and supportive multidisciplinary teamwork. Although care pathways are used worldwide, the impact and benefit of a care pathway for coronary care practices have been minimally debated. This preliminary study aimed to examine the effect of a care pathway on the autonomy, teamwork, and burnout levels among coronary care nurses in a tertiary hospital.

    METHODS: A preliminary study was conducted using a pre/posttest one-group quasi-experimental design. A self-administered questionnaire was provided to 37 registered nurses from the cardiac ward of a tertiary hospital. The care pathway was developed on the basis of the current literature, local guidelines, and expert panel advice. The autonomy, teamwork, and burnout levels at the beginning and 4 months after disseminating the care pathway were measured. Implementing the care pathway included educational sessions, training in using the care pathway, and site visits to monitor nursing practices.

    RESULTS: Most of the respondents were female (94.6%; n = 35), the median age of the respondents was 26.5 years (interquartile range [IQR] = 23-31), and the median length of the clinical experience was 4 years (IQR = 2-8). A statistically significant reduction in the mean burnout score was observed (mean of 58.12 vs 52.69, P < .05). A slight improvement in autonomy level was found, although it was not statistically significant. No statistically significant improvement was found in the teamwork levels.

    CONCLUSION: The care pathway was associated with reduced nurse burnout. The results showed a slight improvement in autonomy level among coronary care nurses after implementing the care pathway. From a practical viewpoint, the current study can help policy makers and managers reduce burnout. This study highlights the importance of using care pathways as a tool to reorganize the care process and improve the working environment. Managers must support nursing decisions and provide continuous education to enhance nurses' autonomy, which may increase understanding of respective roles, leading to higher levels of teamwork. However, with a small sample size, caution must be applied, as the findings might not be generalizable.

  14. Salleh NS, Abdullah KL, Chow HY
    J Pediatr (Rio J), 2024 Nov 04.
    PMID: 39510130 DOI: 10.1016/j.jped.2024.07.012
    OBJECTIVE: There is a pressing need for public health practitioners to understand cultural values influencing parents on the uptake of human papillomavirus (HPV) vaccination for their daughters, which is presenting a growing challenge to close the immunization gap worldwide. Parental decisions were predominantly shaped by cultural norms and values. This systematic review encompasses parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters.

    METHOD: This systematic review was registered on PROSPERO CRD42020211324. Eligible articles were selected from CINAHL, PsycINFO, EMBASE, PubMed and Science Direct. Original qualitative studies exploring parental perspectives on the influence of cultural values on the uptake of HPV vaccination by their daughters under the age of 18, published in the English language with no restriction dates were reviewed. Two authors independently screened abstracts, conducted the fill-text review, extracted information using a standardized form, and assessed study quality. A third author is needed to resolve the disagreements if necessary.

    RESULTS: Of the 1552 citations, 22 were included, with information on 639 parents. Five themes emerged from the data: sexuality-related concerns; upbringing and moral values; obligation to protect; external influences; and vaccine-related concerns.

    CONCLUSION: This systematic review is beneficial to identify and understand the culturally related facilitators and barriers to HPV vaccination among young women for the development of strategies to optimize HPV vaccine coverage among this population group by the policymakers.

  15. Chong MC, Francis K, Cooper S, Abdullah KL
    Nurs Res Pract, 2014;2014:126748.
    PMID: 24523961 DOI: 10.1155/2014/126748
    Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements.
  16. Chong MC, Sellick K, Francis K, Abdullah KL
    PMID: 25029948 DOI: 10.1016/S1976-1317(11)60012-1
    PURPOSE: A cross sectional descriptive study, which involved government hospitals and health clinics from Peninsular Malaysia sought to identify the continuing professional education (CPE) needs and their readiness for E-learning. This paper focuses on the first phase of that study that aimed to determine the factors that influence nurses' participation in CPE.
    METHODS: Multistage cluster sampling was used to recruit 1,000 nurses randomly from 12 hospitals and 24 health clinics from four states in Peninsular Malaysia who agreed to be involved. The respondent rate was 792 (79.2%), of which 562 (80%) had participated in CPE in the last 12 months.
    RESULTS: Findings suggested that updating knowledge and providing quality care are the most important factors that motivate participation in CPE, with respective means of 4.34 and 4.39. All the mean scores for educational opportunity were less than 3.0. Chi-square tests were used to test the association of demographic data and CPE participation. All demographical data were significantly associated with CPE participation, except marital status.
    CONCLUSIONS: Implementation of mandatory CPE is considered an important measure to increase nurse's participation in CPE. However, effective planning that takes into consideration the learning needs of nurses is recommended.
  17. Ng CJ, Lee YK, Lee PY, Abdullah KL
    Australas Med J, 2013;6(2):95-9.
    PMID: 23483776 DOI: 10.4066/AMJ.2013.1655
    Patient decision aids (PDAs) help to support patients in making an informed and value-based decision. Despite advancement in decision support technologies over the past 30 years, most PDAs are still inaccessible and few address individual needs. Health innovation may provide a solution to bridge these gaps. Information and computer technology provide a platform to incorporate individual profiles and needs into PDAs, making the decision support more personalised. Health innovation may enhance accessibility by using mobile, tablet and Internet technologies; make risk communication more interactive; and identify patient values more effectively. In addition, using databases to capture patient data and the usage of PDAs can help: developers to improve PDAs' design; clinicians to facilitate the decisionmaking process more effectively; and policy makers to make shared decision making more feasible and cost-effective. Health innovation may hold the key to advancing PDAs by creating a more personalised and effective decision support tool for patients making healthcare decisions.
  18. Lee WL, Abdullah KL, Bulgiba AM, Zainal Abidin I
    Eur J Cardiovasc Nurs, 2013 Dec;12(6):512-20.
    PMID: 23283569 DOI: 10.1177/1474515112470056
    Poor adherence is a significant nursing and public health concern because it affects patients' quality of life. It compounds the disease burden of the growing coronary heart disease population. Promoting optimal patient adherence to cardiac-health enhancing recommendations by healthcare providers can reduce mortality and morbidity risk after acute coronary syndrome (ACS).
  19. Chui PL, Abdullah KL, Wong LP, Taib NA
    PLoS One, 2015;10(10):e0139952.
    PMID: 26451732 DOI: 10.1371/journal.pone.0139952
    BACKGROUND: Complementary and alternative medicine (CAM) use has become increasingly popular among patients with cancer. The purposes of this study were to compare the QOL in CAM users and non-CAM users and to determine whether CAM use influences QOL among breast cancer patients during chemotherapy.

    METHODOLOGY: A cross-sectional survey was conducted at two outpatient chemotherapy centers. A total of 546 patients completed the questionnaires on CAM use. QOL was evaluated based on the European Organization for Research and Treatment of Cancer (EORTC) core quality of life (QLQ-C30) and breast cancer-specific quality of life (QLQ-BR23) questionnaires.

    RESULTS: A total of 70.7% of patients were identified as CAM users. There was no significant difference in global health status scores and in all five subscales of the QLQ C30 functional scales between CAM users and non-CAM users. On the QLQ-C30 symptom scales, CAM users (44.96±3.89) had significantly (p = 0.01) higher mean scores for financial difficulties than non-CAM users (36.29±4.81). On the QLQ-BR23 functional scales, CAM users reported significantly higher mean scores for sexual enjoyment (6.01±12.84 vs. 4.64±12.76, p = 0.04) than non-CAM users. On the QLQ-BR23 symptom scales, CAM users reported higher systemic therapy side effects (41.34±2.01 vs. 37.22±2.48, p = 0.04) and breast symptoms (15.76±2.13 vs. 11.08±2.62, p = 0.02) than non-CAM users. Multivariate logistic regression analysis indicated that the use of CAM modality was not significantly associated with higher global health status scores (p = 0.71).

    CONCLUSION: While the findings indicated that there was no significant difference between users and non-users of CAM in terms of QOL, CAM may be used by health professionals as a surrogate to monitor patients with higher systemic therapy side effects and breast symptoms. Furthermore, given that CAM users reported higher financial burdens (which may have contributed to increased distress), patients should be encouraged to discuss the potential benefits and/or disadvantages of using CAM with their healthcare providers.

  20. Ghawadra SF, Abdullah KL, Choo WY, Phang CK
    J Clin Nurs, 2019 Nov;28(21-22):4087-4097.
    PMID: 31294501 DOI: 10.1111/jocn.14993
    AIM AND OBJECTIVES: To determine the prevalence of psychological distress and its association with job satisfaction among nurses in a teaching hospital in Malaysia.

    BACKGROUND: Nurses constitute the majority of health care workers, and, compared with other professions, nursing profession is highly stressful and, hence, a cause of anxiety and depression. This may affect nurses' job satisfaction.

    METHOD: Using self-administered questionnaires, Depression Anxiety and Stress Scale (DASS-21) and Job Satisfaction Scale for Nurses (JSS), a cross-sectional study of 932 nurses from the inpatient departments of a teaching hospital was conducted in December 2017. Descriptive analyses and multiple logistic regressions were used for the analysis. The STROBE guideline was used in this study.

    RESULTS: The overall prevalence of psychological distress was 41%. The prevalence of stress, anxiety and depression were 14.4%, 39.3% and 18.8%, respectively. It was found that single and widowed nurses had a higher level of stress, anxiety and depression compared with married nurses. In addition, nurses in the age of 26-30 years had a higher level of depression than nurses in other age groups. Also, nurses who worked in the paediatric departments had a higher level of depression compared with nurses in other departments. The majority of the nurses were satisfied with their job at 92.0%. Those nurses who were not satisfied were found to be significantly associated with a high level of stress and depression.

    CONCLUSION: This study revealed that the level of stress, anxiety and depression is high. Stress and depression were found to be associated with nurses' low job satisfaction.

    RELEVANCE TO CLINICAL PRACTICE: Stress and depression can affect nurses' job satisfaction, it is important for nursing managers to institute strategies to address this issue.

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