Nursing Economics

Background: Sleep is a fundamental and essential process that has a significant impact on our physiological and cognitive functioning. Adequate sleep quality and quantity are crucial for improving attention, memory, insight, concentration, decision-making, speech, and, most importantly, learning and memory.Objectives: This study aimed to evaluate sleep quality and identify associated factors among undergraduate nursing students.Methods: A cross-sectional survey was conducted with 237 nursing students recruited from a selected university in Ras Al Khaimah, UAE, using a convenience sampling technique from February to October 2022. Data were collected using a structured sociodemographic and lifestyle questionnaire, along with the Pittsburgh Sleep Quality Index (PSQI). Descriptive statistics were employed to summarize the data, while independent sample t-tests and one-way analysis of variance were used to examine differences in mean sleep quality scores between groups.Results: The global PSQI scores ranged from 0 to 21, with a mean of 6.54±3.2. Nearly three-fourths (73%) of the participants were classified as poor sleepers based on their global PSQI scores. The average duration of self-reported nighttime sleep was 6.61±1.76 hours. More than one-third (36.7%) of participants reported a sleep efficiency of less than 85%, and only 33.8% felt sufficiently enthusiastic to complete their tasks. Poor sleep quality was significantly associated with watching television for more than two hours on weekends (p=0.044).Conclusion: A substantial proportion of undergraduate nursing students experience poor sleep quality. It is essential to raise awareness about the importance of adequate sleep and the consequences of poor sleep among this population.

Background: The neonatal period, which encompasses the first 28 days of life, is characterized by increased vulnerability to significant health challenges, resulting in elevated mortality rates.Objectives: This study aimed to identify the causes of mortality among neonates in the Neonatal Intensive Care Unit (NICU) at Karbala Teaching Hospital for Children in Iraq.Methods: A retrospective study was conducted to extract data on the causes of neonatal mortality from medical records in the Neonatal Intensive Care Unit (NICU) at Karbala Teaching Hospital for Children, covering the years 2017 to 2022. The collected data included the neonate's gender, gestational age, time of death, medical history, and cause of death.Results: The total mortality rates varied from 9.5% to 12.03% across different years. In 2017, the mortality rate was higher among full-term neonates; however, starting in 2018, the mortality rate for preterm infants significantly exceeded that of term infants. The trends in causes of mortality changed over the years. Septicemia was the leading cause of neonatal mortality in 2017 (42.1%), followed by asphyxia (19.7%) and congenital heart disease (CHD) (10.5%). By 2022, the most common causes of neonatal mortality included prematurity (21.3%), septicemia (17.5%), and CHD (16.3%).Conclusion: Septicemia, CHD, and asphyxia were the primary causes of mortality in NICUs over the years. Tailored interventions are essential for developing effective healthcare strategies.

Background: Preoperative anxiety can have a negative impact and is associated with several adverse postoperative outcomes, including pain, slow recovery, impaired wound healing, prolonged hospital stay, and risk of complications. Virtual reality (VR) technology has become an increasingly popular alternative approach to managing preoperative anxiety. VR allows patients to experience the surgical environment virtually, making it part of their memory through personal involvement and relevance. Objective: This study aimed to measure the effect of 360° VR-based education in reducing preoperative anxiety and hemodynamic parameters in patients undergoing primary brain tumour surgery.Method:A quasi-experimental study using consecutive sampling was conducted to recruit patients aged 18-65 years, ASA 1, 2 and 3, without vision, hearing, reading problems, psychiatric disorders and drug dependence, who were scheduled for first-time elective primary brain tumour surgery under general anaesthesia at the National Brain Centre Hospital Jakarta, Indonesia. The study was conducted from October to December 2023. 54 patients were equally divided into intervention and control groups and received 360° VR-based and the hospital-based preoperative education, respectively. Preoperative anxiety was measured using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and physiological responses to anxiety such as changes in SBP, DBP, HR, RR and SpO2 were measured before and after the intervention. Descriptive statistics, paired and independent samples t-tests and ANCOVA were used for data analysis.Results: Results showed a significant reduction in preoperative anxiety scores (APAIS) in the intervention group compared to the control group (F = 25.13, p < 0.001, partial eta squared = 0.348), indicating a strong intervention effect. No significant differences were found in SBP, DBP, HR, RR, and SpO₂ between the two groups after the intervention (p > 0.05). Conclusion: Compared with the hospital-based preoperative education, 360° VR-based education can reduce preoperative anxiety before primary brain tumour surgery. We therefore recommend the use of similar 360° VR-based methods to educate patients before primary brain tumour surgery.

Background & Aim: Students of anesthesiology complete their theoretical, practical, and field courses in classrooms and bedsides of patients and prepare to play a professional role in their future careers. Failure to comply with professional requirements and ethics during academic studies in various fields can cause ethical challenges among them. The present study aimed to identify the challenges of professional ethics facing students of anesthesiology.Methods: This study was conducted using conventional qualitative content analysis. The students were selected using purposive sampling and the sampling process continued until the data were saturated. The data were collected through semi-structured interviews, and data analysis, codification, and categorization were performed with MAXQDA-10 software.Findings: We have conducted 16 interviews with an average time of 30 to 45 minutes. In this research 437 primary codes, 26 subcategories, and 14 categories were extracted from the conducted interviews. Data analysis revealed 5 main themes, including “antecedents of challenges”, “academic challenges”, “clinical challenges and complexities”, “three aspects of professional ethics”, and “consequences”.Conclusion: Based on the results of the study, individual and social factors lead to the emergence of various challenges. There are some challenges in university and hospital environment such as Repressive/blaming interactions between students and teachers/mentors. Our research showed three aspects of professional ethics including responsibility, confidentiality and effective communication and interactions. Negative consequences of ethical professional challenges such as discouragement and demotivation, anger and isolation affect students. By recognizing these challenges, it is possible to devise novel ethical codes and educational programs to provide a better environment.

Background: Curative treatment for Alzheimer's and other dementias has not been found, so risk factor reduction and primary prevention strategies are needed.Objective: This study aims to determine the factors that influence the incidence of Alzheimer's compared to other dementias.Materials and Methods: An unpaired retrospective case-control study was conducted on a case group of caregivers of Alzheimer's patients (n= 60) and a control group of other dementias (n= 60) registered from January 2018 to December 31, 2023 at one of the hospitals in Yogyakarta, at November until December 2023. An online questionnaire consisting of 62 questions was collected using Zoho form, processed using IBM SPSS Statistics 25.0. Descriptive categorical data scale analysis, chi-square test, and logistic regression were used to identify factors influencing the incidence of Alzheimer's compared with other dementias.Result: Adequate dietary pattern (p=0.02; AOR= 3.665; 95% CI= 1.219—11.11) and age ≥60 years (p= 0.06; AOR= 2.34; 95% CI= 0, 95—5.73) is a risk factor for Alzheimer's. Adequate sleep quality (p= 0.03; AOR= 0.24; 95% CI= 0.07—0.87) and history of stroke (p= 0.00; AOR= 0.07; 95% CI= 0, 02—0.26) is a protective factor in the incidence of Alzheimer's compared to other dementias. A poor diet will cause systemic inflammation and oxidative stress which triggers neuroinflammation including stroke. An increase in tau load due to age ≥ 60 years and poor sleep quality can result in neuronal dysfunction and end in brain atrophy.Conclusions: Risk factors include a moderate diet and age ≥ 60 years and protective factors for Alzheimer's include adequate sleep quality and a history of stroke are factors that influence the incidence of Alzheimer's compared to other dementias. It is hoped that this research can become basic data for further research as well as guidelines for preventing the incidence of Alzheimer's.