Hamdi Lamine

Background/Objectives: While previous research has explored the effects of moral distress and the work environment separately, there is limited evidence on how these two factors are associated with nurses’ turnover intention. Therefore, in this study, we assessed the mediating role of moral distress in the correlation between nurses’ work environments and turnover intention. Methods: This study employed a multicenter cross-sectional design of emergency nurses from April to June 2025. The Measure of Moral Distress—Healthcare Professionals, Practice Environment Scale of the Nursing Work Index (PES-NWI), and Turnover Intention Scale were used to collect data. The mediating effect was analyzed using Hayes’ PROCESS macro (Model 4, Version 4.2) software with the bootstrap technique (5000 repetitions, 95% bias-corrected confidence interval). Statistical significance was set at a threshold of p < 0.05. Results: Mediation analysis revealed that work environment had a significant negative effect on moral distress (β = −0.251, B = −45.293, 95% CI [−70.376, −20.210], p < 0.001). Moral distress significantly increased nurse turnover (β = 0.202, B = 0.008, 95% CI [0.003, 0.012], p = 0.003), while the work environment had a significant negative direct effect on turnover (β = −0.391, B = −2.629, 95% CI [−3.507, −1.751], p < 0.001). The total effect of work environment on nurse turnover was also significant (β = −0.442, B = −2.970, 95% CI [−3.837, −2.102], p < 0.001). Bootstrapping confirmed a significant indirect effect of moral distress (β = −0.051, 95% CI [−0.092, −0.016]), indicating partial mediation. Conclusions: This study revealed that nurses’ work environment was significantly associated with turnover intention, both directly and indirectly, through moral distress. Moral distress acted as a statistically significant but modest partial mediator of the association between the work environment and turnover intention, suggesting that it may partially explain this relationship. Strategies by healthcare organizations should be organized to optimize proactive work environments and mitigate moral distress among nurses.

Background: The Operating Room Management Attitudes Questionnaire (ORMAQ) is widely used to assess operating room (OR) staff attitudes toward patient safety and teamwork across diverse contexts. However, no validated French version currently exists, limiting its use in francophone settings. This study aimed to translate and culturally adapt the ORMAQ into French and to evaluate its psychometric properties, while also reporting OR professionals’ attitudes explored during the validation process. Methods: A cross-sectional methodological study was conducted among OR professionals, including surgeons, anesthetists, anesthesia nurses, operating room nurses, and residents. The original ORMAQ was translated into French using a standardized forward–backward translation procedure and pretested with 20 OR professionals. Content and concurrent validity were examined. Reliability was assessed through internal consistency, test–retest reproducibility, and dimension-level consistency. Construct validity was examined using both exploratory and confirmatory factor analyses (CFA). Results: The overall response rate to the survey was 76.5% (n = 303). The French ORMAQ demonstrated good internal consistency, as evidenced by both Cronbach’s alpha (α = 0.842) and McDonald’s Omega (ω = 0.98). For the individual dimensions, reliability values ranged from 0.597 to 0.891 for alpha and from 0.75 to 0.89 for Omega. Test–retest analysis showed excellent reproducibility (ICC = 0.96; 95% CI: 0.92–0.98). Factor analyses supported the eight-factor structure, with the CFA confirming good model fit and meaningful item loadings across dimensions, with standardized loadings ranging from 0.40 to 0.83. Conclusions: The French version of the ORMAQ showed satisfactory psychometric properties. It represents a robust tool for assessing safety and teamwork attitudes among OR professionals in francophone countries.

Introduction: While short-term medical missions (STMMs) are widely used to deliver humanitarian healthcare in low- and middle-income countries, existing research has largely focused on one-off interventions and has highlighted ongoing concerns related to sustainability, continuity of care, ethical practice, and local capacity building. The emerging model of recurring, regular STMMs remains underexplored. This study investigates the perceived impact, challenges, and systemic contributions of such missions through a qualitative case study of Mission of Hope in Uganda. Materials and Methods: We employed a qualitative case study approach, combining semi-structured interviews with international medical volunteers (n = 6) and a focus group discussion with local partners (n = 10). The study adhered to EQUATOR guidelines for qualitative research, ensuring rigorous data collection and analysis. Results: Six themes and 21 subthemes were identified. Key barriers included financial constraints, infrastructural limitations, volunteer turnover, and resistance to new technologies. Participants reported perceived benefits including improvements in quality of care, local capacity building, and strengthened cross-cultural relationships. The role of trust, continuity, and humility in long-term effectiveness was emphasized. Ethical concerns related to patient autonomy, data privacy, and sustainability were also noted. Conclusions: Regular STMMs were perceived by participants to offer advantages over traditional one-off missions by enabling iterative learning, deeper local engagement, and potentially more sustainable contributions to healthcare delivery—provided they are ethically designed and collaboratively managed. Findings inform future policy, funding models, and ethical frameworks for humanitarian medical initiatives.

Background: Assessing the current landscape of nurses’ knowledge and attitudes is a critical first step in facilitating a smooth and effective transition toward artificial intelligence (AI)–enhanced critical care. Objective: This study aimed to assess the levels of and factors affecting the knowledge of and general attitudes toward AI in critical care among nurses. Methods: A cross-sectional correlational design was used with 203 critical care nurses in Hail, Saudi Arabia, using the Nurses’ AI Knowledge Questionnaire and the 20-item General Attitudes Toward Artificial Intelligence Scale from May 2025 to July 2025. Data were analyzed using 2-tailed t tests, ANOVA, Pearson correlation, and multivariable linear regression. Statistical significance was set at P <.05. Results: Critical care nurses demonstrated moderate knowledge of (mean score 4.93, SD 1.78) and positive attitudes toward AI (mean score 64.39, SD 8.26). A moderate positive correlation was found between knowledge of and attitudes toward AI ( r =0.45; P <.001). In multivariable analyses, older age was associated with lower knowledge (≥40 years: β=−1.29, 95% CI −2.12 to −0.45; P =.003) and less positive attitudes (β=−8.97, 95% CI −12.49 to −5.44; P <.001). Female nurses reported lower knowledge (β=−0.69, 95% CI −1.20 to −0.19; P =.007) and less positive attitudes (β=−2.65, 95% CI −4.78 to −0.52; P =.02) than male nurses. Greater experience (>5 years) was positively associated with knowledge (β=1.20, 95% CI 0.65‐1.75; P <.001) and attitudes (β=8.08, 95% CI 5.76‐10.41; P <.001). Conclusions: Critical care nurses in Hail demonstrated moderate knowledge of and positive attitudes toward AI, which varied based on their demographic and professional characteristics. These findings highlight the need to strengthen AI literacy and provide targeted support to groups with lower scores, which may enhance readiness for AI integration in critical care settings.

Background: Despite the recognized importance of hospital disaster preparedness (HDP), efforts to improve it have been limited. Improvement in HDP will need an in-depth comprehension of the prevailing gaps in addition to evidence of the best practices. However, a comprehensive review that synthesizes the findings from HDP assessments across diverse contexts and translates them into actionable insights is currently lacking. Considering these gaps, this scoping review aims to examine current practices, identify recurring gaps, consolidate best practices, and provide actionable recommendations through an in-depth literature review. Methods: A scoping review was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. A comprehensive search strategy using keywords related to HDP was carried out in three databases: PubMed, Scopus, and Web of Science. Eligibility criteria were defined according to the population, intervention, comparison, and outcome. The search included studies from January 2015 to December 2024. Screening and data extraction were done by two independent reviewers, and the extracted data were subjected to a narrative synthesis. Data extraction and analysis were manually performed using Excel. Results: 46 eligible articles were identified from 10,656 records, the majority from Iran and Saudi Arabia. Cross-sectional studies dominated, and the majority utilized the hospital safety index tool. Two-thirds of hospitals reported a moderate level of preparedness. Substantial variability in hospital safety scores was observed, with structural safety ranging from 28% to 76.16%, nonstructural safety from 17.02% to 73.2%, and functional preparedness from 11.35% to 95%. Most hospitals lacked adequate structural safety, backup communication systems, proper safety measures for furniture and medical equipment, training programs, comprehensive emergency planning, staff welfare strategies, and adequate logistics and supplies. Conclusions: HDP should be viewed as an evolving, ongoing process, requiring a balanced HDP framework that addresses all aspects of preparedness, region-specific guidelines tailored to the unique needs and risks of the hospital, and context-driven interventions to enhance hospital resilience.

Background/Objectives: General-self efficacy (GSE) is a substantial element during pregnancy that promotes healthy decision-making and prevents complications. Information on predictive factors of GSE among pregnant women is limited. This study aimed to assess the GSE among pregnant women and identify its relationship with family quality of life (FQOL) domains in a lower-middle-income community. Methods: This cross-sectional analytical study was conducted in nine antenatal care centers from July 2024 to March 2025. Pregnant women were enrolled through the multiple stage sampling method. GSE in pregnant women was assessed using the General Self-efficacy Scale. FQOL was assessed using the Beach Center Family Quality of Life Scale. Univariable and multivariable linear regression analyses were performed to assess predictors of GSE among pregnant women. Results: A total of 417 pregnant women participated in the study. The prevalence of low GSE was 12.2%. Multivariable linear regression showed that older age (p = 0.02), rural area (p = 0.007), and planned pregnancy (p = 0.03) were predictors of GSE among pregnant women. The total score of FQOL (p = 0.0001), parenting (p = 0.004), and material well-being (p = 0.043) were positive determinant factors of GSE in pregnant women who have at least one child. Conclusions: The prevalence of low general self-efficacy (GSE) among pregnant women was notably high, particularly among those with at least one child. Education regarding family planning, parenting, and financial management through multidisciplinary, family-centered care teams is essential to address the complex needs of expectant families.

Purpose: This study aims to explore the perspectives of hospital incident command system (HICS) members to identify key gaps in hospital disaster preparedness and set recommendations to enhance hospital resilience and disaster response capacity in Nepal. Methods: A qualitative case study method was employed, involving semi-structured in-depth interviews as a sole method of data collection, with HICS members purposively selected based on their active involvement in hospital disaster preparedness. The interviews were conducted in person in Nepali, transcribed verbatim, translated into English, and analyzed using an inductive thematic approach. Results: Three themes arose from the results. The first theme highlighted the need for policy and systemic reforms, including revising staffing quotas based on an updated organization and management survey, developing standardized national guidelines for hospital nonstructural safety, revising tender policies to allow greater flexibility in emergency resource procurement, and updating hospital disaster preparedness and response plans to adopt a more comprehensive, all-hazards approach. The second theme entailed strategic partnerships and community engagement, demanding formal collaboration with external stakeholders, establishing a local coordination hub to streamline disaster response efforts, and pre-disaster coordination meetings with relevant partners. The third theme was concerned with hospital-level operational reforms, suggesting capacity-building efforts like cross-training and mentoring programs, extending training to alternative HICS focal persons, aligning stockpiling strategies with local hazard risks, and assessing triage areas to ensure their functionality during actual emergencies. Conclusion: Hospitals in Nepal need a coordinated effort among policymakers, healthcare administrators, frontline hospital personnel, and local stakeholders to bridge existing gaps and build a resilient healthcare system.

Objective: To investigate the impact of knowledge gained during the coronavirus disease 2019 (COVID-19) pandemic on hospital disaster preparedness plans in the hospitals of Region Sjaelland, Denmark. Design: This is a multimethod qualitative study that uses both qualitative semistructured interviews and qualitative document analysis. Participants: Two members from each of the hospitals of Region Sjaelland’s disaster preparedness committees. Main outcome: A qualitative assessment of knowledge gained by members of the four participating hospitals’ disaster preparedness committees, and the impact this knowledge had on the hospitals’ disaster preparedness plans at the end of the COVID-19 pandemic. Results: Key areas of new knowledge are described based on the analysis of semistructured guided interviews. Disaster plans from the four hospitals before and after the COVID-19 pandemic are compared with respect to the areas identified in the interview analysis; no changes were made in the plans. Conclusion: This paper demonstrates that although much was learned during the COVID-19 pandemic, less was written down and very little was put into future plans for the next pandemic in the hospitals of Region Sjaelland in Denmark.

Background/Objectives: General self-efficacy (GSE) is a substantial element during pregnancy that promotes healthy decision-making and prevents complications. Information on predictive factors of GSE among pregnant women is limited. This study aimed to assess the GSE among pregnant women and identify its relationship with Family quality of life (FQOL) domains in a lower-middle-income community. Methods: This cross-sectional analytical study was conducted in nine antenatal care centers from July 2024 to March 2025. Pregnant women were enrolled through a multiple-stage sampling method. GSE in pregnant women was assessed using the General Self-efficacy Scale. FQOL was assessed using the Beach Center Family Quality of Life Scale. Univariable and multivariable linear regression analyses were performed to assess predictors of GSE among pregnant women. Results: A total of 417 pregnant women participated in the study. Prevalence of low GSE was 12.2%. Multivariable linear regression showed that older age (p=.02), rural area (p=.007), and planned pregnancy (p=.03) were predictors of GSE among pregnant women. Total score of FQOL (p< .001), parenting (p=0.004), and material well-being (p=0.043) were positive determinant factors of GSE in pregnant women who have at least one child. Conclusion: This magnitude of low GSE in pregnant women was relatively high, especially in those who have at least one child. This study supports researchers and clinicians to develop multidisciplinary prenatal family-oriented programs addressing FQOL, material wellbeing, and parenting accordingly to the family needs.