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   Table of Contents - Current issue
Coverpage
January-April 2022
Volume 11 | Issue 1
Page Nos. 1-81

Online since Monday, May 2, 2022

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SYSTEMATIC REVIEW  

International trends of nursing career path: A systematic review Highly accessed article p. 1
Moudi Albargawi, Noof Albaz, Sarah M Alyousif, Abdullah Mohammed Alzahem
DOI:10.4103/sjhs.sjhs_28_22  
Background: The Kingdom of Saudi Arabia needs a nursing career path to guide nurses to advancement in their profession. On-the-job professional development activities allow nurses to increase their knowledge and skills without needing to leave the work environment. However, a clear career path for nurses' professional development is still lacking. Aim: Our systematic review aims to identify the national and international trends regarding on-the-job training for nursing career path development. Methods: We conducted an electronic search for studies published from 2000 to 2019 using the Cumulative Index to Nursing and Allied Health Literature, PubMed, and Medline databases. We included studies in our review if they described on-the-job professional development activities for nurses, were written in English, and were published in indexed journals. We used the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines and the guideline for conducting systematic reviews in medical education. Results: We included a total of 18 studies. The sample size ranged from 2 to 1600 participants. The on-the-job professional development activities we conducted were of short, medium, and long durations. In all studies, the activities increased nurses' knowledge and skills. No data were reported about nurses' retention in most of the studies. Only one study reported that using e-learning and clinical training with nurse–mentors in a community setting for a long period of time increased their retention. Conclusion: Numerous on-the-job professional development activities are available for nurses. However, a clear career path for nursing professional development needs to be developed, especially for nurses holding diplomas. On-the-job professional development activities allow nurses to increase their knowledge and skills without needing to leave the work environment. However, a clear career path for nurses' professional development is still lacking. Our systematic review aims to identify the national and international trends regarding on-the-job training for nursing career-path development. We conducted an electronic search for studies published from 2000 to 2019 using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, and Medline databases. We included a total of 18 studies. The on-the-job professional development activities we included in the review were of short, medium, and long durations. In all studies, the activities increased nurses' knowledge and skills. No data were reported about nurses' retention in most of the studies. Only one study reported that using e-learning and clinical training with nurse–mentors in a community setting for a long period of time increased their retention. Accordingly, a clear career path for nursing professional development needs to be developed, especially for nurses holding diplomas.
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ORIGINAL ARTICLES Top

Dental interns' perceptions of their training experiences at different training centers p. 10
Ali Alenezi
DOI:10.4103/sjhs.sjhs_22_22  
Background: Investigating dental interns' perceptions of their learning experience is important for properly understanding potential difficulties and obstacles in training. Aims: The aim of this study was to explore dental interns' perceptions on their learning environment and supervision. Settings and Design: This survey was in a form of a questionnaire that includes 20 items and was divided into three main parts: The first part of the questionnaire evaluated the intern's perception toward the learning outcomes obtained from the field experience. The second part of the study assessed the interns' perceptions toward their supervisors. The third part of the questionnaire investigated the interns' perceptions toward training centers facilities. Methods: This questionnaire was presented in a Likert-type format. Respondents stated their agreement or disagreement with each item on a four-point scale; strongly agree (4), agree (3), disagree (2), and strongly disagree (1). Statistical Analysis Used: Descriptive analysis was conducted to illustrate the sample characteristics using Chi-square Test. The Mann–Whitney U-test was used test the differences between male and female interns. Results: A total number of 234 questionnaires were filled and submitted by interns in which 134 from male interns (57.3%) and 100 from female interns (42.7%). In general, the interns from both genders appeared very satisfied with their training experience. With all the questionnaire 20 items, more than 75% of the obtained answers were either agree or strongly agree with similarly obtained from both male and female interns. Conclusions: High level of satisfaction can be obtained when the field experience outcomes are clearly explained. In addition, the availability of supervisors with full awareness of learning outcomes will improve the learning experience of dental interns.
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The role of emergency medical services providers during mass gathering: Hajj Season 2019 Highly accessed article p. 17
Ali S Al-Shareef, Majid S Al-Thaqafy, Ahmed A Almalki, Sarah S Alwael, Areej M Almetairi, Rana F Najmuldeen, Bader Hamza Shirah, Maher A Alsulami
DOI:10.4103/sjhs.sjhs_136_21  
Background: Mass gatherings are worldwide events, and the Hajj season is considered one of the significant mass gathering events that happen annually in Makkah city, Saudi Arabia. Medical preparation such as preparation for transportation, training, and medical staffing for mass gatherings at existing sites has been discussed. Aims: This study aimed to assess the role of emergency medical services (EMS) providers during Hajj Season 2019 and the preparedness of the EMS system through providers' perspectives. Settings and Design: A cross-sectional survey using a questionnaire has been conducted in Makkah during the Hajj season 2019, which took place in Mena valley and Arafat. Methods: Convenience sampling from two major institutions (the Saudi Red Crescent and the National Guards Hospital, EMS Department) was used. The inclusion criteria included emergency medical specialists and emergency medical technicians. Statistical Analysis Used: The data were analyzed using JMP. Data for continuous variables were presented as mean and standard deviation if normally distributed, otherwise median and interquartile range were used. Data for the categorical variables were presented as frequencies and percentages. Results: The majority of EMS providers were male in gender and almost half of them were emergency medical technicians with a diploma qualification. Most of them had specific training before Hajj such as basic life support. However, the majority reported the use of medications during transport and training are areas that require improvement. During Hajj, the majority of the EMS providers do ambulance decontamination. Busy shifts and lack of workforce were the main reasons for working more than 12 h per shift. Conclusions: This study offers important recommendations for improving the EMS system's preparedness during Hajj, which include more workforce coverage as well as improved providers' qualifications and level of training. Furthermore, this study provides a recommendation to change the scope of practice to treat and release in the majority of cases rather than unnecessarily transport to the hospital. This study urges the importance of collaboration between agencies to facilitate the EMS system.
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Prevalence of classified groups of health problems in the local, internally displaced persons, and Afghan people in the District Bannu, Khyber Pakhtunkhwa, Pakistan p. 23
Muhammad Ashraf Khan
DOI:10.4103/sjhs.sjhs_31_22  
Background: Health problems are one of the global concerns and affected mostly human well-being and performance. Aims: The current study determined the prevalence of different classified groups of health problems in the local, internally displaced persons, and Afghan people living in Bannu during 2016–2019. Settings and Design/Methods and Materials: This is a retrospective study. Data were taken from the official computerized record of all patients who visited the outpatient department in the Khalifa Gul Nawaz Teaching Hospital, Bannu, for diagnosis and treatment during the study period. Statistical Analysis: Pearson's Chi-square test and Fisher's exact test were used to determine the significant difference, followed by post hoc tests pairwise. Results: Aggregate data for the said period indicated medical category with 18.2% health cases, followed by children (11.4%), eye (10.7%), chest (9.4%), and orthopedic (7.9%). Each of the remaining health problems showed ≤5.7% prevalence. Men demonstrated 37.1% of health cases, followed by women (35.4%), and children (27.5%). The local population showed a less annual prevalence of cases in 2016 compared to the remaining years, while internally displaced persons contributed 29.5% and 9.8% of overall cases in 2016 and 2017, respectively. Afghans accounted for <0.2% annually and an aggregate of 0.15% of overall cases. The local population data also indicated health problems were highest in men (≥37.4%) followed by women (≤37.2%) each year from 2016 to 2019, while internally displaced person data showed children had the highest prevalence (≥39.8%) of health cases followed by women (≤30.3%) each in 2016 and 2017. Afghan men showed the highest prevalence (35.5%) of all Afghan cases, followed by Afghan children (33.2%) in 2016, while Afghan women showed the highest prevalence of ≥39.8% of all Afghan cases annually during 2017-2019, followed by Afghan children (≤36%). The local population accounted for 91.4% of cases, followed by internally displaced persons 8.5%, and Afghan people 0.1% of cases. Conclusions: Overall, medical group and men showed the highest number of cases. The local population showed higher cases during 2017–2019. Both Afghan men and women showed reduced prevalence and increased prevalence during 2018–2019 and 2019, respectively.
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Influence of nursing care intervention on quality of sleep in hospitalized patients at Riyadh, Saudi Arabia p. 34
Jazi Shaydied Alotaibi, Babu Dharmarajan, Moattar Raza Rizvi
DOI:10.4103/sjhs.sjhs_7_22  
Background: In clinical practice, patients' sleep is disrupted by medical professionals' care or evaluations both at night and during the day. Multiple factors contribute to this sleep disruption resulting in poor clinical outcomes. Aims: This study aims to determine the quality of sleep perceived by patients admitted to various hospital settings, as well as the factors affecting sleep quality. Settings and Design: Descriptive explorative design involving purposive convenient sampling of 90 hospitalized admitted at King Khalid General Hospital, Al Majmaah, and General Hospital, Zulfi. Methodology: St. Mary's Hospital Sleep Questionnaire used to assess patients' sleep and sleep-disturbing scale. Statistical Analysis Used: The Chi-square test was used to compare the different parameters related to sleep. Results: Subjective conclusions suggested that 38 (26.4%) patients slept lightly, 67 (46.5%) were moderately satisfied with their last night's sleep, and only 9 (6.3%) were mildly dissatisfied. Continuous light, uncomfortable Pillow, strange fragrances (P = 0.004), hearing frequent sound (P = 0.018), telephone (P = 0.046), and machine alarms (P = 0.006) were the elements impacting sleep pattern connected to the patient themselves. Tubings, monitor leads, pain, and fear of death all significantly influenced sleep pattern. Many of the healthcare workers' behaviors such as awakening by doctors and nurses (χ2 = 13.08, P = 0.02), making loud noise (χ2 = 15.85, P = 0.007), assessing vitals (χ2 = 12.90, P = 0.02), hygiene care (χ2 = 5.24, P = 0.14), feeding (χ2 = 9.82, P = 0.09), tubing and drain (χ2 = 17.92, P < 0.002), and suctioning (χ2 = 21.30, P = 0.0001) had significant influence on sleep pattern. Conclusion: Based on the results, nurses can minimize the factors that cause sleep interference in hospitalized patients and avoid the possible negative effects caused by sleep deprivation.
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Demographical and clinical features of suspected cases of rotavirus gastroenteritis at Al-Baha region, Saudi Arabia p. 43
Shaia Saleh Rajab Almalki, Waled A M Ahmed, Yagoub Hamadt Allah Elhaj, Naseem Akhter, Raed A Alharbi, Hanan E Alyahyawi, Saleha Kheder Alatawi, Hamdi Katar
DOI:10.4103/sjhs.sjhs_38_22  
Background/Objective: Rotavirus is the main reason of diarrhea with gastroenteritis during childhood. This study aims to identify the demographical and clinical features of rotavirus (RV) suspected cases at Al-Baha Region. Materials and Methods: This is a cross-sectional study, it was conducted on selected 298 suspected cases with RV gathered from three noteworthy hospitals in Al-Baha area (King Fahd Hospital, Prince Meshari Hospital, and Aqiq General Hospital). The selected cases had been included based on case definition of the World Health Organization for rotavirus gastroenteritis. The data were collected from existing data in the selected hospitals' records, it was then analyzed using SPSS software. Results: The findings of this study expressed that male children are somewhat more than females (55% to 45%), the majority of them are under 2 years and most commonly are at infancy period (53.4%) and the greater part of them were admitted to Aqiq General Hospital (56.4%). The study showed that the clinical features of the hospitalized children with suspected rotavirus as 65.5% had stool motions at least twice a day, about 66.5% had no vomiting, while 59.1% with mild dehydration and 30.5% with moderate dehydration, 42.3% with lethargy, 35.2% with irritability, 53.4% with sunken eyes, and 48.3% unable to drink water. The children of the age group (≤2 years old) had significantly severe dehydration and diarrhea and were more febrile compared to other children. Conclusion: The rotavirus is a major reason of diarrhea with gastroenteritis among under 5 years children in Al-Baha region. Rotavirus suspected cases have been featured by severe diarrhea, vomiting, fever, and mild dehydration among suspected case in the governmental hospitals at Al-Baha region.
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The prevalence and factors affecting the use of contraceptive methods among Saudi women in Sabya, Jazan, Saudi Arabia p. 48
Hind Abdallah Modawi Elamin, Iman Khalifa Abdel Gadir, Mashael Hassan Ahmad Alhazmi, Najla Hassan Owisi
DOI:10.4103/sjhs.sjhs_135_21  
Context: The socioeconomic changes in the Saudi community with an increase in women's education and employment resulted in changes in the concept of birth spacing and contraceptives use. Aims: The goal of this study was to evaluate the prevalence of contraception usage among Saudi women in Sabya City in Jazan, as well as the socioeconomic, demographic, and reproductive variables that impact contraception use. Settings and Design: This was a cross-sectional descriptive study, conducted between January and October 2020. Subjects and Methods: Data were collected by direct interview of 220 Saudi married women at reproductive age, during their routine visit to primary care centers in Sabya City_Jazan, Saudi Arabia. Statistical Analysis Used: A Chi-squared test was performed to evaluate the factors associated with contraceptive use. P < 0.05 was considered statistically significant. Results: The prevalence of contraceptive use was 75%. Pills were the most used method, most of the users obtain their contraceptives from the Pharmacy. The majority of participants (84%) had poor knowledge regarding contraceptive methods, however, the acceptance rate for using contraception was high (82.3%). History of having an abnormal child and experience of unintended pregnancy were the only factors significantly associated with the use of contraceptives, all the investigated sociodemographic factors were not significantly associated with contraceptive use. The most important reason for not using contraception was the husband's disagreement. Conclusions: This study revealed that a high percentage of Saudi women in the Jazan region are using contraceptives, though their knowledge is poor. This indicates the need for greater efforts to improve the quality of family planning services in the region.
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Medication reconciliation – Responsibilities and barriers facing physicians, pharmacists, and nurses in Saudi Arabia p. 55
Najah Saud Alanazi, Wafa A Alatawi, Kousalya Prabahar
DOI:10.4103/sjhs.sjhs_82_21  
Background: Patient safety can be adversely affected by medication errors. The medication reconciliation process plays a critical role in the prevention of medication discrepancies and adverse drug events. Aims: This study aimed to investigate the perceptions of Saudi Arabian physicians, pharmacists, and nurses regarding their functions in the medication reconciliation process and to elucidate the barriers to implementing this process. Materials and Methods: A cross-sectional survey was performed for 4 months targeting pharmacists, physicians, and nurses who work at various hospitals in Saudi Arabia. An online survey was used to collect all data. Data gathered were statistically analyzed using SPSS24. Results: In all, 447 participants completed the survey. Physicians considered their profession to be the primary health-care providers responsible for every step of the medication reconciliation process. Pharmacists believed that their profession was the main one among health-care providers responsible for all steps in the process, apart from interviewing patients during admission and taking a correct medication history. They assigned those tasks to physicians by a margin of 53.3%. Nurses viewed themselves as responsible for more roles than physicians, except for two steps, in which they considered pharmacists to be the responsible person: reconciling medications while transferring a patient to the next level of care (54.1%) and sending the patient's discharge medication list to his or her next provider (56.5%). Conclusions: Participants revealed the insufficiency of a clear understanding of the functions of health-care providers in every step of the medication reconciliation process.
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Evaluation of dental intern's satisfaction and self-competence in treating emergency cases during the first year of the coronavirus pandemic p. 62
Albraa B Alolayan, Yaser A M Alsahafi, Ahmed Ibrahim Hassan Ghibban, Khuloud Mohammed Misbahammar Aljazaeri, Shadia Abd-Elhameed Elsayed
DOI:10.4103/sjhs.sjhs_23_21  
Background: The study aimed to identify the level of satisfaction and confidence of dental intern students in emergency care emergency room (ER) during COVID-19 Pandemic in order to determine factors that influence their satisfaction such as patient's age, gender, and ethnicity. Materials and Methods: A cross-sectional survey-based study was conducted at Al-Madinah Al-Munawwarah-Taibah University Dental-College and Hospital. The overall sample included in analysis was 105 dental interns with an average age of 24.7 years who were treating patients between July 2019 and August 2020 in emergency dental clinics at TUCDH. Results: The survey response rate was 100% and 51.4% of the participants felt comfortable and 80% felt confident on emergency days. However, male interns were significantly more comfortable and confident than females (P = 0.001 and 0.022 respectively). Endo-emergency constituted 77% of dental emergencies followed by surgery. 81.9% believe that age is the most challenging factor affecting their ER work, and most of them do not believe that patient's gender and ethnicity affect their performance. Stock shortages were the biggest challenge for their supervisor-led management. Conclusion: Majority of interns feel satisfied with their management of emergency cases during COVID-19 Pandemic with superior male significant meaning. More emergency training programs should be established in the educational dental curriculum to improve their satisfaction and confidence rate, especially for females during pandemics.
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Knowledge, attitude, and blood donation practices among medical students of Taif University, Saudi Arabia p. 68
Farzana Arain Rizwan, Razan Othman Al-Amri, Azzah A Al-Harthi, Nada A Al-Otaibi, Rawa F Al-Otaibi
DOI:10.4103/sjhs.sjhs_77_21  
Background: People's need for blood increases every day. That is very important to assess knowledge, attitude, and practice (KAP) toward blood donation especially on medical students. Objectives: The objective of the study is to determine the KAPs about blood donation among medical students of Taif university. Subjects and Methods: A cross-sectional study with a sample of 300 medical students of Taif university in Taif Saudi Arabia conducted from September 29, 2020, to April 29, 2021. A pre–designed questionnaire was used to collect data about their KAP toward blood donation. Results: The analysis of 318 medical students showed that 33.0% had a good, 30.5% had average, and 36.5% had poor knowledge related to blood donation. Of them, 28.3% had good attitude, 53.5% had fair, and 18.2% had poor attitudes toward blood donation. The scores of practices were also classified into “Good,” “Fair” and “Poor” based on the percentage obtained > 75%, 60%–75%, <60%, respectively. About 17% (17.3%) of students had demonstrated good practices, whereas most students (76.7%) showed poor practices. There was no statistically significant difference observed between female and male students except in 1st medical students the attitude was good in males (30.1%) compared to females (12%). Relationship of knowledge with practices found about 49.1% of the students who had demonstrated good knowledge showed good practices. Conclusion: About one-third of the participants had shown good knowledge about blood donation and the majority had a positive attitude toward future donation.
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CASE REPORTS Top

Challenges in managing postoperative pulmonary embolism after cesarean section p. 74
Manish Kumar Tiwary, Abhijit Sukumaran Nair
DOI:10.4103/sjhs.sjhs_24_22  
Postoperative acute pulmonary embolism (APE) can be a life-threatening emergency and is associated with very high mortality. Approximately two-thirds of patients, who died of pulmonary embolism, die within the first hour after the presentation. We report a case of APE following an emergency lower segment cesarean section (LSCS) because of severe fetal distress. This 37-year-old female with no previous medical or surgical history underwent LSCS under general anesthesia. The surgery was uneventful and she was extubated uneventfully at the end of surgery. Six hours after surgery, there was a sudden drop in oxygen saturation on pulse oximetry, tachypnea which raised the suspicion of APE. An urgent chest radiograph computed tomographic pulmonary angiography (CTPA) and transthoracic echocardiogram along a sample for D-dimer were ordered immediately. CTPA was consistent with APE involving the main pulmonary artery. Given immediate postoperative status, therapeutic anticoagulation was done using low-molecular-weight heparin. The patient was discharged 10 days later. APE is a potentially high-risk event that can be challenging in the postoperative period. A high index of suspicion and therapeutic anticoagulation with meticulous monitoring is required in such cases to reduce morbidity.
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Neuropsychiatric presentation of coronavirus disease 2019 p. 77
Yafa Abdulrahman Alshamlan, Salman Aljarallah, Omar Alzuman, Nuha M Alkhawajah
DOI:10.4103/sjhs.sjhs_39_22  
Coronavirus disease 2019 (COVID-19) pandemic has caused more than 1,000,000 deaths worldwide. Neurological manifestations are increasingly being recognized, mostly with severe systemic illness. Here, we describe two previously healthy males who developed encephalopathy with psychosis, fever, and headache. Investigations were remarkable only for severe acute respiratory syndrome coronavirus 2 RNA in the nasal swab without cerebrospinal fluid pleocytosis or brain imaging abnormalities. Patients received supportive management. One recovered in a short period, while the other deteriorated and passed away. The latter had elevated inflammatory blood markers, which can be useful prognosticators even in patients with neuropsychiatric manifestations.
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LETTERS TO EDITOR Top

Letter to the Editor: Communicating while wearing personal protective equipment: A challenge during the COVID-19 era p. 80
Satvinder Singh Bakshi, Vinoth Kumar Kalidoss
DOI:10.4103/sjhs.sjhs_12_22  
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Breastfeeding knowledge, attitude, and practice among mothers in Al-Taif region, Saudi Arabia p. 81
Ravi Rohilla, Ravneet Kaur
DOI:10.4103/sjhs.sjhs_143_21  
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