Eilean Rathinasamy Lazarus

Background: Secondary osteoporosis is common but remains understudied in various contexts. In Oman, public awareness of osteoporosis and its risk factors is low, and to date, few studies have specifically addressed secondary osteoporosis, despite its implications for healthcare costs, quality of life, health promotion, and well-being. Objective: To identify the common characteristics of patients with secondary osteoporosis in Oman to guide patient education and interventions for health promotion. Methods: This retrospective descriptive cross-sectional study analyzed data of patients diagnosed with secondary osteoporosis at a national referral center in Oman in February 2025. In a database of 500 patients, 112 eligible cases were included, and all met the inclusion criteria. The extracted data included demographic and lifestyle factors, laboratory results, and medical history pertinent to osteoporosis. Data were analyzed using descriptive statistics. Results: The mean age was 39.44 ± 7.50 years, and many participants reported regular physical activity and chronic conditions such as rheumatoid arthritis (17%), chronic kidney disease (14.3%), diabetes mellitus (13.4%), inflammatory bowel diseases (8.9%), and cancer (8%), among others. The commonly taken medications linked to osteoporosis were proton pump inhibitors (41%), glucocorticoids (35.7%), and thyroid hormones (12.5%). After the diagnosis of secondary osteoporosis, patients had a recorded diagnosis of chronic pain (75%), fractures (26.8%), and depression (17%). Follow-up bone mass density testing indicated low lumbar, hip, and femoral z-scores in patients with a history of cancer, chemotherapy, smokers, and thyroid hormone therapy. Conclusion: Chronic diseases were common among patients with secondary osteoporosis. Thus, patients with non-communicable diseases need comprehensive risk assessment, routine screening, and health promotion to enhance bone health maintenance. Nurses can play a critical role in providing patient education and guidance to promote bone health.

Background/Objectives: Hematopoietic cell transplantation (HCT) is increasingly used to treat malignant and non-malignant hematologic diseases and is associated with complex physical, psychological, and informational needs. Nurses play a central role in HCT care; however, the range, characteristics, and reported outcomes of nurse-led interventions have not been comprehensively synthesized. This review aimed to identify the types and outcomes of nurse-led interventions in adult HCT recipients and highlight gaps in evidence. Methods: The review was initially registered as a systematic review and was refined to a scoping review before final synthesis because of substantial heterogeneity in the available evidence. Studies involving adults undergoing or having received HCT were included if they evaluated interventions initiated, delivered, or coordinated by nurses and reported at least one clinical or patient-reported outcome. Multiple databases and grey literature (2015–2025) were searched. Study selection and data charting were performed independently by two reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool, and findings were synthesized narratively. Results: Ten studies met the inclusion criteria, mostly from high-income countries. Nurse-led interventions included pre-transplant preparation, education, symptom management, physical activity and nutrition support, psychosocial care, navigation, survivorship follow-up, and advance care planning. Several studies reported improvements in self-efficacy, physical activity, symptom burden, and advance care planning documentation; however, findings for overall quality of life, infection rates, and long-term recovery were limited or inconclusive. Conclusions: Evidence on nurse-led interventions across the HCT trajectory remains limited. The mapped studies provide promising preliminary findings in selected outcome domains but are insufficient to establish intervention effectiveness. Future research should develop and evaluate rigorously designed, adequately powered, longitudinal, and multicomponent nurse-led interventions, including in resource-limited settings.

Background: Nurse-led interventions play a vital role in cervical cancer care across the disease trajectory but are often underappreciated despite their impact on patient-reported outcomes. Objective: This review aimed to map current nurse‑led interventions for women with cervical cancer across the disease trajectory, identify key design gaps, reporting, and evaluation to guide practice and research Methods: The scoping review was guided by Arksey and O’Malley’s framework for conducting scoping studies. The included studies were published between 2015 and 2025 and were identified through searches of MEDLINE, Scopus, Embase, CINAHL, and ScienceDirect. The final database search was conducted on 31 December 2025. The studies were empirical studies on nurse-led interventions targeting management of cervical cancer patients. The primary results were organized by themes using a line-by-line coding method. Results: Of the 1,220 studies identified, twenty-two met the inclusion criteria. Most studies used quasi-experimental designs, with few randomized, mixed-methods, or qualitative studies. The nurse-led interventions emphasized health education and psychological support, and improved sexual function, mental health, disease knowledge, quality of life, self-efficacy, personal confidence, and body image. Important elements of cervical cancer care such as cost of care, financial burden, palliative and end-of-life care, and cancer recurrence were mostly not addressed by any intervention. Conclusion: The included studies frequently reported positive outcomes associated with nurse-led interventions such as improved patients’ sexual function, quality of life, mental health, emotional well-being, family functioning, symptom burden, self-management, knowledge, and satisfaction with care. Registry: PROSPERO [CRD420261277487]

Background: Patients on Peritoneal Dialysis (PD) experience substantial dialysis-related symptoms and medication non-adherence that negatively impact clinical outcomes, yet these remain understudied in Oman and other Middle East countries. Objectives: To determine the prevalence of dialysis-related symptoms and assess medication adherence among Omani adult patients on PD. Methods: A descriptive cross-sectional correlational study was conducted among 185 Omani adults receiving PD, recruited using stratified random sampling from government hospitals across Oman. Data were collected using a self-administered questionnaire comprising the researcher-developed Peritoneal Dialysis Symptoms and Life Impact Scale (PD-SLIS; Cronbach’s α = 0.97) and the Arabic version of the Adherence to Refills and Medications Scale (ARMS; Cronbach’s α = 0.71). Data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression. Results: The participants’ mean age was 51.54 ± 14.92 years, and 50.3% were female. The mean total symptom burden score was 82.56 ± 54.60. The most prevalent symptoms were limitations in general activities (85.9%), mood changes (85.9%), lack of energy (82.7%), and weakness (81%). All the 34 assessed symptoms were reported by ≥47% of the participants. Most participants (66.5%) reported low medication adherence (mean ARMS score = 19.73 ± 5.42). Regression analysis identified age (OR = 1.04, p = 0.02), high school education (OR = 4.68, p < 0.01), and daily number of medications (OR = 0.89, p = 0.04) as significant independent predictors of medication adherence. Conclusions: Omani patients on PD experience a pervasive symptom burden alongside predominantly low medication adherence. Routine symptom screening using the PD-SLIS, polypharmacy reduction strategies, and adherence interventions are recommended as standard components of PD clinical practice in Oman and other settings with similar contexts.

Background: Artificial intelligence (AI) is increasingly embedded in critical care nursing through monitoring, decision support, and documentation systems, yet nurses’ readiness to use it remains uncertain, particularly in the Middle East region. Critical care nurses are central to AI implementation at the bedside, and their AI-related literacy and fears can influence safe and ethical integration into clinical practice. Aim: To assess AI-related literacy and fears among critical care nurses in Oman and the associated factors. Methods: A nationwide cross-sectional survey was conducted among critical care nurses (N = 477) working in tertiary hospitals in Oman. The Multidimensional Artificial Intelligence Literacy Scale and the Fear towards AI Scale were used to measure AI literacy and fears, respectively. Results: The participants had low overall AI literacy (146.62 ± 84.03), and low AI self-efficacy and AI self-competency. The lowest level of literacy was related to creating AI (2.43 ± 2.63). On the other hand, participants reported moderate overall fear towards AI and moderate levels of fear related to job issues and humanity and ethics. Age, marital status, levels of education, receipt of prior computer or information technology, AI-related training, and work experience, were significant predictors of AI literacy. The predictors of AI self-efficacy and AI competence are presented. Conclusions: Nurses working in critical care settings in Oman reported low levels of AI literacy, but moderate fears related to AI, and this provides an opportunity to build AI competencies and capacity. There is need for deliberate and structured continuing education programs to build capacity for AI utilization, competence, and self-efficacy among critical care nurses. Structured, hands-on AI training that integrates ethical reflection for older nurses with more experience but limited professional education is needed and essential to support safe and equitable AI utilization by critical care nurses in Oman.

End-stage kidney disease (ESKD) is a growing public health concern in Oman, with an increasing number of adults requiring hemodialysis and facing complex dietary restrictions. Adequate nutrition knowledge and nutrition literacy are essential for effective dietary self-management, yet their relationship with dietary adherence in the Omani hemodialysis population remains underexplored. To determine the level of dialysis-specific nutrition literacy among Omani adults with end-stage kidney disease undergoing hemodialysis and to identify socio-demographic and clinical factors that predict acceptable nutrition literacy in this population. A cross-sectional study was conducted among 140 adults with ESKD receiving hemodialysis in Oman. Data were collected using a structured, self-administered questionnaire comprising socio-demographic and clinical items, the Dialysis-Specific Nutrition Literacy Scale (DSNLS), the Dialysis-Related Diet Knowledge Questionnaire (DDKQ), and adherence/health-belief subscales (perceived benefits, barriers, seriousness, susceptibility, and self-efficacy). Descriptive statistics summarized sample characteristics and scale scores. Correlation analyses assessed relationships between nutrition literacy, diet knowledge, and adherence-related perceptions. Multiple logistic regression identified independent predictors of acceptable nutrition literacy. Participants had a mean age of 48.19 years and a mean dialysis duration of 5.46 years. Overall, 60.7% had acceptable dialysis-specific nutrition literacy and 39.3% had limited literacy. Dialysis-related diet knowledge was low in 10.7%, moderate in 46.4%, and high in 42.9% of participants. Perceived benefits of dietary adherence were high, whereas perceived barriers, seriousness, and susceptibility were moderate and self-efficacy was relatively low. Nutrition literacy was positively correlated with perceived benefits, seriousness, susceptibility, and self-efficacy, while diet knowledge showed weaker associations with these beliefs. In the logistic regression model, living in the city (OR = 0.17, p = 0.01) and having diabetes mellitus as a comorbidity (OR = 0.17, p = 0.01) were associated with lower odds of acceptable nutrition literacy, whereas higher hemoglobin levels (OR = 1.51, p = 0.04) and self-rated “very good” overall health (OR = 5.80, p = 0.03) were associated with higher odds. Most Omani adults on hemodialysis demonstrated acceptable nutrition literacy and at least moderate renal-diet knowledge, but a substantial subgroup had limited literacy and low self-efficacy for dietary adherence. Nutrition literacy was more strongly linked to adherence-related beliefs than factual knowledge alone and was influenced by place of residence, comorbid diabetes, hemoglobin level, and perceived health. These findings highlight the need for culturally tailored, literacy-sensitive nutrition education in Omani dialysis units, with particular attention to urban patients and those with diabetes, to strengthen self-efficacy, address perceived barriers, and ultimately improve dietary adherence and clinical outcomes.

Background: Separation anxiety disorder (SAD) is a common childhood condition characterised by excessive distress related to separation from attachment figures, often leading to social, emotional, and academic difficulties. If untreated, SAD can increase the risk of future psychopathology, highlighting the importance of effective interventions. Aim: This scoping review systematically maps and analyzes the current evidence on intervention strategies to reduce separation anxiety and promote emotional and social well‐being in children. Method: Following Arksey and O'Malley's framework and PRISMA‐ScR guidelines, a comprehensive search was conducted across multiple databases (PubMed, PsycINFO, Scopus, etc.) for studies published from 2005 to 2025. Inclusion criteria focused on original peer‐reviewed research evaluating therapeutic, parental, or educational interventions targeting separation anxiety in children. Result: Eight studies from diverse settings demonstrated that interventions such as child‐centred group play therapy, attachment‐based play, art therapy, storytelling, laughter yoga, and schedule‐based paradoxical therapy effectively reduced separation anxiety symptoms. These approaches also improved social‐emotional skills, resilience, and parent‐child relationships. Combining therapies and involving parents enhanced outcomes, while the importance of school transition strategies was highlighted. Discussion: Findings suggest that multimodal, relationship‐focused interventions are most effective in alleviating separation anxiety and fostering broader emotional development. Incorporating expressive activities and strengthening attachment bonds are crucial, and tailored, culturally sensitive approaches are recommended. Conclusion: A comprehensive, developmentally sensitive framework integrating therapeutic, familial, and educational strategies holds promise for effective management of childhood separation anxiety. Further research with larger, diverse samples is needed to confirm long‐term benefits.

This study aimed to describe how frequently registered nurses (RNs) in Oman provide spiritual care therapeutic interventions in referral hospitals. A nationwide cross-sectional design was employed using the Nurse Spiritual Care Therapeutics Scale (NSCTS) to collect data from 1,469 RNs working in referral hospitals across Oman, excluding operating theater and psychiatry units. Descriptive and correlational analyses were conducted to assess the use of spiritual care interventions and their association with nurses’ religiosity and spirituality. All 17 spiritual care therapeutic interventions were reported in practice. On average, RNs provided each intervention at least three times within their most recent 72 to 80 working hours. The most frequently used interventions included actively listening to patients’ stories, facilitating quiet time, engaging in conversations about spiritual concerns, assessing patients’ spiritual beliefs, and maintaining a caring presence. The least frequently used were documenting spiritual care, arranging clergy visits, and discussing spiritual needs during shift reports. NSCTS scores showed small negative correlations with self-rated religiosity ( r = −.101, p < .001) and spirituality ( r = −.135, p < .001), indicating higher religiosity/spirituality associated with more frequent spiritual care provision. Findings highlight that RNs in Oman routinely provide various forms of spiritual care, though documentation and interprofessional communication remain less frequent. Enhancing education, institutional support, and system-level integration may strengthen nurses’ competencies and optimize the delivery of holistic spiritual care in Oman.

Background: Pressure injuries are a preventable source of morbidity, mortality, and excess healthcare costs among hospitalized adults. They represent a significant burden in acute and critical care settings in the Eastern Mediterranean region, yet data from Oman remain limited. This study aimed to determine the prevalence and burden of pressure injuries and to identify their clinical determinants among adult hospitalized patients in Oman. Methods: A multicenter, descriptive correlational cross-sectional study was conducted in four tertiary hospitals in Oman. A total of 169 adult inpatients were assessed using standardized pressure injury definitions and staging criteria. Point and periodic prevalence of pressure injuries, including hospital- and community-acquired cases, were calculated over a three-month data collection period. Demographic and clinical data (comorbidities, hemoglobin levels, prior pressure injury history, ventilator use) were extracted from medical records. Chi-square tests and multiple logistic regression were used to identify factors independently associated with the presence of pressure injuries. Results: The overall point prevalence of pressure injuries was 8.7%, including 4.2% hospital-acquired and 4.7% community-acquired cases; periodic prevalence over the three-month study period was also estimated to capture pressure injuries occurring at any time during hospitalization. Most lesions were located over bony prominences and ranged from stage 1 to stage 4. In multivariable analysis, lower hemoglobin levels (odds ratio [OR] 0.059, p = 0.019), prior pressure injury history (OR 0.156, p = 0.003), cancer diagnosis (OR 4.328, 95% CI: 1.225–15.291, p = 0.023), and ventilator use (OR 0.211, p = 0.001) were significantly associated with pressure injury development. Conclusions: Pressure injuries represent a considerable burden among adult hospitalized patients in Oman, with almost half of cases being hospital-acquired and therefore potentially preventable. Identified determinants particularly anemia, cancer, previous pressure injury, and mechanical ventilation highlight the need for targeted risk stratification and intensified preventive measures in high-risk groups. Integrating routine risk assessment, nutritional optimization, and device-related pressure relief into standard care may reduce pressure injury occurrence and improve patient outcomes.