November 2020 - Volume 14, Issue 2

 
A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor)

A. Abyad, MD, MPH, MBA, AGSF, AFCHSE (Editor)
Abyad Medical Center & Middle East Longevity Institute
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In this issue several themes were touched including knowledge about cancer pain management, effect of body weight on hypertension and cholesterol and burn out of nursing staff in ICU.

Yassin et al did a descriptive, cross-sectional design to explore nurse's knowledge and attitudes about cancer pain. The Nurses Knowledge and Attitude Survey Regarding Pain (NKASRP) survey was used. The NKASRP score differences were examined among nurses with varying demographics, levels of pain education and experience. The study aims to explore pain knowledge and attitudes of oncology nurses working in Qatar. The authors found that the mean NKASRP was 58% significantly below the passing score of 80%. Nurses in palliative care unit scored significantly higher (<0.01) than nurses in other units (Hematology/Oncology). No significant differences between sex, age, and educational level were found. The authors concluded that the study provides important information about knowledge deficit in pain management among oncology nurses and limited training regarding pain management. Palliative care nurses scores significantly higher than nurses in other (Hematology/Oncology) units and this was as result of specialized palliative care course given to them. Our results support the universal concern of inadequate knowledge and attitudes of nurses regarding cancer pain. There is a need for more effective evidence-based educational programs in cancer pain management. Evaluation of the current educational pain program is also needed.

Helvaci et al looked at the effect of body weight on blood pressure. The study was performed in the Hematology and Internal Medicine Polyclinics on patients with sickle cell diseases (SCD) and routine check up cases. The study included 122 patients with the SCD (58 females) and 176 age and sex-matched control cases. When we compared the patients and control groups, the mean body weight and body mass index were significantly retarded in patients with the SCD (71.6 versus 57.8 kg and 24.9 versus 20.7 kg/m2, respectively, p= 0.000 for both), whereas the mean body heights were similar in both groups (166.1 versus 168.5 cm, p>0.05). Parallel to the retarded mean body weight, mean values of the low density lipoproteins, high density lipoproteins, and alanine aminotransferase were also lower in patients with the SCD (p= 0.000 for all). Parallel to the retarded mean body weight again, mean values of the systolic and diastolic BP were significantly lower in patients with the SCD (113.3 versus 118.8 and 72.3 versus 83.6 mmHg, respectively, p<0.01 for both).
A second paper by Helvaci et al., looked at body weight and plasma lipoproteins. The study included 122 patients with the SCD (58 females) and 176 age and sex-matched control cases, totally. Mean age of patients with the SCD was 28.6 years. The mean body weight and body mass index were significantly retarded in patients with the SCD (71.6 versus 57.8 kg and 24.9 versus 20.7 kg/m2, respectively, p= 0.000 for both), whereas the mean body heights were similar in both groups (166.1 versus 168.5 cm, p>0.05). Parallel to the retarded mean body weight, mean values of the low density lipoproteins (LDL), high density lipoproteins (HDL), and alanine aminotransferase were also lower in patients with the SCD, significantly (p= 0.000 for all). The authors concluded that body weight may be the major determining factor of LDL and HDL values in the plasma.

Almubarak et al., attempt to evaluate the prevalence of burnout among nurses working in the ICU and ED in Saudi Arabia during COVID-19 crisis, and to investigate efforts that can be made to decrease the levels of burnout while the pandemic continues. This work presents an interim analysis of data from one clinical site belonging to a larger study. An online anonymous survey was developed to measure the following domains: personal factors, occupational factors, personal opinions related to COVID-19, and burnout level. A link to this survey was distributed to ICU and ED nurses at four clinical sites by the site principal investigator. Data from one site were obtained and a descriptive interim analysis was conducted using R software. The authors found that a majority (81%) of respondents worked in the pediatric ED, and 40% had worked over 80 hours in the past two weeks. Seventy percent of the subjects expressed they were afraid of infecting people at home with COVID-19, and 68% expressed fear of getting infected themselves. Overall, 30% of respondents were classified as having moderate burnout, while only 11% had high burnout levels. The authors concluded that although burnout was prevalent in many ICUs and EDs before COVID-19, it is now more important than ever to manage and prevent it to maintain a robust healthcare workforce. The numbers from our study indicate a high prevalence of burnout among Saudi Arabian nurses, and are comparable to studies among European HCWs during COVID-19 pandemic. A question is raised as to whether burnout is an inevitable response to working in healthcare and, in that case, what levels of burnout can be considered acceptable. A new approach is needed to monitor burnout among HCWs and implement policy interventions to reduce and prevent it.


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