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Background: Adequate knowledge of the metabolic syndrome is essential for mental health nurses as it enhances their ability to recognize and address the physical needs of individuals diagnosed with serious mental illnesses. Aims: This study investigated the factors influencing the level of metabolic syndrome knowledge among mental health nurses. Methods: A cross‐sectional study was conducted with 208 mental health nurses recruited from four hospitals in northern Taiwan, including two regional hospitals, one medical center, and one mental health hospital. Nurses' knowledge was assessed using a validated 20‐item self‐administered questionnaire covering key aspects of metabolic syndrome, including pathophysiology, diagnostic criteria, and management. The questionnaire demonstrated satisfactory reliability (KR‐20 = 0.702) and content validity. Data analysis involved descriptive statistics, independent t‐tests, one‐way analysis of variance, Pearson correlation coefficient, and generalized linear models to identify predictors of knowledge levels. Results: The overall correct answer rate was 60.1%. Generalized linear modeling demonstrated that nurses' knowledge was significantly associated with their sources of information (B = 1.371, 95% CI = 0.458–2.285, p = 0.003), the type of hospital they worked in (B = −1.027, 95% CI = −2.015 to −0.039, p = 0.042), and working in a community unit (B = 1.975, 95% CI = 0.067–3.883, p = 0.042). Conclusions: Our results indicate that mental health nurses possessed a moderate level of knowledge concerning metabolic syndrome in people diagnosed with serious mental illness. Addressing this gap requires targeted education programs that integrate physical health education into psychiatric care and promote the use of diverse, evidence‐based resources tailored to the specific needs of mental health nurses in different settings. Organizational efforts should focus on fostering a supportive culture that enhances access to high‐quality resources, encourages interdisciplinary collaboration, and supports continuous professional development. [ABSTRACT FROM AUTHOR]

Background: Fluid management can reduce mortality, severe comorbidities, and debilitating symptoms in patients on hemodialysis. Therefore, a restricted fluid intake plan is crucial for patients with chronic kidney disease (CKD). Little evidence has been found to date on exploring the experience in fluid management of CKD patients in Indonesia. Purpose: This study aimed to explore the fluid management experience of adults with chronic kidney disease participating in hemodialysis treatment in Indonesia. Methods: A qualitative study with a phenomenological approach was conducted. Purposive sampling was used to recruit 14 adults patients with CKD undergoing hemodialysis in a tertiary hospital in Padang between July and September 2020. Manual content analysis using the Colaizzi approach was used to identify themes. Results: Data analysis revealed four themes with 12 sub-themes. The four major themes include the challenge of thirst control, fluid/diet restriction management, inadequate information, and the support system. Conclusion: The result showed the severe suffering and sadness experienced by CKD patients who conform to fluid restrictions. It is important to provide clear information on the fluid prescription or the exact consumable amount per day. Structured education with a personal approach is recommended to ensure detailed information regarding "fluid prescribing". The support obtained from family, friends, and dialysis staff is a significant factor in promoting acceptance and adherence. [ABSTRACT FROM AUTHOR]

The Internet has opened pathways for youth to find sexual health information which was not easily available to them in the past. Studies have shown that seeking sexual health information online may potentially influence an individuals' decision-making to change their sexual health behaviours. However, there is a gap in research on the associations of seeking online sexually transmitted infection (STI) information with STI prevention among young people, particularly in Malaysia. This study investigated the associations of seeking STI information online with the intentions of condom use among young adult online users in Malaysia. A cross-sectional online survey was conducted among Malaysian youth aged 18–25 years old who were recruited through Facebook. In total, 1530 respondents completed the survey, identifying 874 respondents who had sought STI information online. The majority of respondents had intentions to use condoms as protection against STI. Respondents who sought online STI information were significantly more likely to have the intention to use condoms compared to respondents who did not seek online STI information (OR = 1.33, 95% CI = 1.01–1.76, p = 0.040). Online STI information has the potential to increase access to STI information among young online users in Malaysia amid the stigma surrounding sex-related issues. Providing accurate STI information online from reliable sources may equip young people who have Internet access with awareness of sexual health protective behaviours such as condom use. It is recommended to facilitate Internet access to reach sectors of the population that currently do not have access, as the Internet is useful in STI prevention. [ABSTRACT FROM AUTHOR]

Background: Previous studies of nurses' critical thinking skills that included demographic characteristics as determinants have been inconclusive. This study explored demographic determinants of critical thinking skills among nurses from public hospitals in Peninsular Malaysia. Method: This cross-sectional study included 549 nurses recruited via multistage cluster sampling. Nurses completed the demographic questionnaire and Health Sciences Reasoning Test (HSRT). Results: The majority of respondents failed to demonstrate critical thinking skills with a mean overall HSRT score of 13.8 (The majority of respondents failed to demonstrate critical thinking skills with a mean overall HSRT score of 13.8 (SD = 3.4). Educational qualifications (p =.003) and clinical specialties (p =.022) were significantly related to nurses' critical thinking skills. Years of clinical experience, age, and job ranking were not significant Conclusion: The findings indicate a need to address the present curriculum in nursing education and to reinforce critical thinking skills in the nursing workforce. Future research on how nurses in Malaysia acquire critical thinking skills is needed. The findings indicate a need to address the present curriculum in nursing education and to reinforce critical thinking skills in the nursing workforce. Future research on how nurses in Malaysia acquire critical thinking skills is needed. [[J Contin Educ Nurs. 2020;51(3):109–117.] [ABSTRACT FROM AUTHOR]

Objective: This study aims to determine maternal stress and anxiety as perceived by mothers whose premature infants were admitted to the neonatal intensive care unit (NICU) and to identify maternal stress and its relationship with maternal and infant characteristics and anxiety. Background: Vulnerable premature infants commonly require special care in the NICUs. In most cases, prolonged hospitalization results in stress and anxiety for the mothers. Methods: A non-probability convenience survey was used in a public hospital, with 180 mothers completing the 26-item Perceived Stress Scale (PSS) and a 40-item State-Trait Anxiety Inventory (STAI). Results: 56.5% of mothers had high levels of stress, 85.5% of mothers had a high level of state-anxiety and 67.8% of mothers had a high level of trait-anxiety. The stress experienced by these mothers had a significant relationship with anxiety, and was found to be associated with state and trait anxiety levels, but not with maternal and infant characteristics. Conclusion: Mothers in this setting revealed high levels of stress and anxiety during their premature infants' NICU admission. An immediate interventional programme focusing on relieving mothers' anxiety and stress is needed to prevent maternal stress and anxiety at an early stage. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate the effectiveness of a structured nursing intervention program on maternal stress and NICU‐related maternal ability after the admission of premature infants to a neonatal intensive care unit (NICU). Background: Mothers of premature infants may face stress having premature infants, and their infants may be admitted to the NICU for a few weeks or months. The mothers' experience of stress would be worse if they have low knowledge and poor NICU‐related maternal ability. Mothers of infants admitted to the NICU require well‐planned interventions to cope with psychological matters arising after an infant hospitalisation. Design: Quasi‐experimental design. Methods: A total of 216 mothers were consecutively assigned to control and intervention groups. Each group consisted of 108 mothers. The mothers in both groups received questionnaire concerning maternal stress and NICU‐related ability during their first visit to NICU (within 48 hr of admission). A structured nursing intervention was implemented for 10 days on mothers in the intervention group. The control group continued to receive existing practice nursing care. Mothers of both groups were again given the questionnaire on maternal stress and NICU‐related ability after 14 days of admission. Results: In the intervention group, the difference between the mean total score of maternal stress and parental role and relationship subscale decreased significantly, compared to the control group (p = 0.04; p = 0.01) respectively. Maternal ability improved significantly in mothers in the intervention group 2 weeks postintervention, p < 0.001. Conclusion: A structured nursing intervention for mothers could significantly reduce maternal stress and promote maternal NICU‐related abilities. Relevance to clinical practice: The results of the study could help neonatal nurses to develop an appropriate nursing intervention for parents with premature infants in the NICU. [ABSTRACT FROM AUTHOR]

Incidence rate and patterns of physical restraint use were examined based on a cross-sectional study in 22 wards of a large teaching hospital in Malaysia. Results indicated that the highest rate of physical restraint (19.7%) was reported from neurology–neurosurgery wards. “Un-cooperative for electroconvulsive therapy” and “trying to pull out catheters” were the most commonly reported reasons to use restraint in psychiatric and non-psychiatric wards, respectively. There were some relationships between patterns of physical restraint in this study. Exploring the incidence rate and patterns of physical restraint is important so that effective strategies can be formulated to minimize using restraint in hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore whether there is a correlation between critical thinking ability and clinical decision-making among nurses. Background Critical thinking is currently considered as an essential component of nurses' professional judgement and clinical decision-making. If confirmed, nursing curricula may be revised emphasising on critical thinking with the expectation to improve clinical decision-making and thus better health care. Design Integrated literature review. Methods The integrative review was carried out after a comprehensive literature search using electronic databases Ovid, EBESCO MEDLINE, EBESCO CINAHL, PROQuest and Internet search engine Google Scholar. Two hundred and 22 articles from January 1980 to end of 2015 were retrieved. All studies evaluating the relationship between critical thinking and clinical decision-making, published in English language with nurses or nursing students as the study population, were included. No qualitative studies were found investigating the relationship between critical thinking and clinical decision-making, while 10 quantitative studies met the inclusion criteria and were further evaluated using the Quality Assessment and Validity Tool. As a result, one study was excluded due to a low-quality score, with the remaining nine accepted for this review. Results Four of nine studies established a positive relationship between critical thinking and clinical decision-making. Another five studies did not demonstrate a significant correlation. The lack of refinement in studies' design and instrumentation were arguably the main reasons for the inconsistent results. Conclusions Research studies yielded contradictory results as regard to the relationship between critical thinking and clinical decision-making; therefore, the evidence is not convincing. Future quantitative studies should have representative sample size, use critical thinking measurement tools related to the healthcare sector and evaluate the predisposition of test takers towards their willingness and ability to think. There is also a need for qualitative studies to provide a fresh approach in exploring the relationship between these variables uncovering currently unknown contributing factors. Relevance to clinical practice This review confirmed that evidence to support the existence of relationships between critical thinking and clinical decision-making is still unsubstantiated. Therefore, it serves as a call for nurse leaders and nursing academics to produce quality studies in order to firmly support or reject the hypothesis that there is a statistically significant correlation between critical thinking and clinical decision-making. [ABSTRACT FROM AUTHOR]

Aims and objectives To investigate the knowledge, attitude, intention and practice of nurses towards physical restraint and factors influencing these variables. Background A literature review showed a lack of studies focused on the intention of nurses regarding physical restraint throughout the world. Considering that very little research on physical restraint use has been carried out in Malaysia, assessment of nurses' knowledge, attitude, intention and practice is necessary before developing a minimising programme in hospitals. Design A cross-sectional study was used. Methods A questionnaire to assess the knowledge, attitude, intention and practice was completed by all nurses ( n = 309) in twelve wards of a teaching hospital in Kuala Lumpur. Results Moderate knowledge and attitude with strong intention to use physical restraint were found among the nurses. Less than half of nurses considered alternatives to physical restraint and most of them did not understand the reasons for the physical restraint . Nurses' academic qualification, read any information source during past year and nurses' work unit showed a significant association with nurses' knowledge. Multiple linear regression analysis found knowledge, attitude and intention were significantly associated with nurses' practice to use physical restraint. Conclusion This study showed some important misunderstandings of nurses about using physical restraint and strong intention regarding using physical restraint. Findings of this study serve as a supporting reason for importance of educating nurses about the use of physical restraint. Relevance to clinical practice Exploring the knowledge, attitude, intention and current practice of nurses towards physical restraint is important so that an effective strategy can be formulated to minimise the use of physical restraints in hospitals. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Inappropriate sedation assessment can jeopardize patient comfort and safety. Therefore, nurses' abilities in assessing and managing sedation are vital for effective care of mechanically ventilated patients. Aims and objectives This study assessed nurses' sedation scoring and management abilities as primary outcomes following educational interventions. Nurses' perceived self-confidence and barriers to effective sedation management were assessed as secondary outcomes. Design A post-test-only quasi-experimental design was used. Data were collected at 3 and 9 months post-intervention. Methods A total of 66 nurses from a 14-bed intensive care unit of a Malaysian teaching hospital participated. The educational interventions included theoretical sessions, hands-on sedation assessment practice using the Richmond Agitation Sedation Scale, and a brief sedation assessment tool. Nurses' sedation scoring and management abilities and perceived self-confidence level were assessed at both time points using self-administered questionnaires with case scenarios. Sedation assessment and management barriers were assessed once at 9 months post-intervention. Results Median scores for overall accurate sedation scoring (9 months: 4·00; 3 months: 2·00, p = 0·0001) and overall sedation management (9 months: 14·0; 3 months: 7·0, p = 0·0001) were significantly higher at 9 months compared to 3 months post-intervention. There were no significant differences in the perceived self-confidence level for rating sedation level. Overall perceived barrier scores were low ( M = 27·78, SD = 6·26, possible range = 11·0-55·0). Patient conditions ( M = 3·68, SD = 1·13) and nurses' workload ( M = 3·54, SD = 0·95) were the greatest barriers to effective sedation assessment and management. Demographic variables did not affect sedation scoring or management abilities. Conclusions Positive changes in nurses' sedation assessment and management abilities were observed, indicating that adequate hands-on clinical practice following educational interventions can improve nurses' knowledge and skills. Relevance to clinical practice Educational initiatives are necessary to improve ICU practice, particularly in ICUs with inexperienced nurses. [ABSTRACT FROM AUTHOR]

Background: Malaysia is an Asian country with population of diverse culture and health perceptions. Patient decision aid (PDA) is a new tool in Malaysia. Patients' and health‐care professionals' (HCPs) expectation of a PDA is unknown. Aim: We aimed to explore patients' and health‐care professionals'(HCPs) views on the information needed in a patient decision aid (PDA) on insulin initiation developed for patients with type 2 diabetes mellitus (T2DM). Design: We used a qualitative design and thematic approach. Setting: Three main primary health‐care settings in Malaysia: public university‐based primary care clinics, public health‐care clinics and private general practices. Method: We conducted focus groups and one‐to‐one interviews with a purposive sample of health professionals and patients with type 2 diabetes. Results: We interviewed 18 patients and 13 HCPs. Patients viewed the content of the PDA as simple and clear. However, HCPs felt the PDA might be difficult for patients with low literacy to understand. HCPs thought the PDA was too lengthy. Nevertheless, patients would prefer more information. HCPs tended to focus on benefits of insulin, while patients wanted to know the impact of insulin on their quality of life and practical issues regarding insulin and its side‐effects. Patients preferred numbers to weigh the risks and benefits of treatment options. HCPs' views that presenting numbers in a PDA would be too complex for patients to understand. Conclusion: It is important to consider including issues related to psycho‐social impact of treatment to patients when developing a patient decision aid. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]