Fadi Khraim

Background: Type 2 diabetes (T2D) frequently co-occurs with other chronic conditions, yet population-based evidence on multimorbidity prevalence, patterns, and determinants remains limited in Gulf Arab populations, and existing diabetes care in this region still largely follows single-disease consultation models. We examined multimorbidity among adults with T2D in Qatar using a Cardiovascular-Kidney-Metabolic (CKM)-aligned framework to test whether a reproducible burden gradient could support risk-stratified, integrated care. Methods: This cross-sectional analysis used Qatar Biobank data from 5144 adults with T2D. Prevalence of nine chronic conditions was estimated with 95% CIs; hierarchical and k-means cluster analysis characterized co-occurrence patterns; and hierarchical linear and logistic regression identified determinants of a Chronic Illness Count outcome. Findings: Dyslipidemia (61·3%), obesity (57·0%), and hypertension (42·2%) were the most prevalent conditions; 57·2% of participants met the threshold for high multimorbidity burden (diabetes plus two or more comorbidities). K-means clustering identified three groups corresponding to a CKM severity gradient; the highest-burden cluster (20·5% of the sample) concentrated 40·0% of all chronic kidney disease cases. The fully adjusted regression model explained 31·9% of variance in multimorbidity burden, with age, body-mass index, and waist-hip ratio as the dominant predictors; a significant sex × body-mass index interaction indicated that obesity was more prevalent but less prognostic of additional comorbidity in men. Interpretation: Multimorbidity was near-universal among adults with T2D in this Qatari cohort and organized into a reproducible, CKM-aligned severity gradient concentrated in an identifiable minority of patients. These findings support replacing single-disease diabetes review with CKM-stage-informed risk stratification and consolidated multi-condition visits, and provide a practical framework other Gulf Arab health systems could adopt directly.

Background/Objectives: Palliative care education is a core component of undergraduate nursing preparation; however, many nursing students report limited exposure and confidence in providing end-of-life care. Digital and web-based educational approaches have increasingly been adopted to address gaps in palliative care training and to provide flexible, scalable learning opportunities. This mixed-methods systematic review examined the use of digital and web-based approaches in palliative care education for pre-registration nursing students. The aim was to synthesize existing evidence on educational outcomes, confidence development, practice preparation, and acceptability to guide future design and implementation of technology-enhanced learning in this field. Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. The search was conducted across Medline (Ovid), Embase, CINAHL, Scopus and PsycINFO in October 2025. Studies employing qualitative, quantitative, or mixed-methods designs were eligible if they evaluated fully digital or web-based palliative care educational interventions for nursing students. Screening, quality appraisal, and data extraction were undertaken independently by multiple reviewers. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Extracted data were synthesized narratively to integrate qualitative and quantitative findings. Results: The search yielded 1826 records; after removing duplicates and applying eligibility criteria, 12 studies were included in the final synthesis. Considerable heterogeneity in design and outcomes was observed. Most included studies reported improvements in students’ knowledge, self-efficacy, and reflective capacity, alongside high levels of acceptability. Conclusions: Digital and technology-enhanced learning appears feasible and acceptable for palliative care education; however, the current evidence base is limited by methodological heterogeneity, reliance on self-reported outcomes, and predominantly short-term evaluations. Further rigorous, large-scale studies with objective outcome measures are required to determine sustained educational and practice impact.

Background: Parents of children treated in rehabilitation settings are required to have heightened health literacy (HL) skills due to the complexity of healthcare provision among this patient population. This novel mixed-method study explores HL among parents of children treated in a pediatric rehabilitation specialty clinic in Qatar, focusing on both Arabic and English-speaking parents. The primary objective is to assess HL among parents of children attending pediatric rehabilitation clinics in Qatar, examining key domains such as functional HL, critical HL, empowerment, and communicative HL. Methods: Participants were recruited through a self-selected sampling method, with data collected via the All Aspects of Health Literacy scale and qualitative interviews. The study was conducted between November 2021 and May 2022. The study analyzes the congruence between quantitative and qualitative findings to provide a comprehensive view of HL among caregivers. Results: The study highlighted the diverse demographics, including caregivers’ educational backgrounds, age distribution, income, and children's diagnoses. While the English-speaking sample demonstrates nuanced comprehension and minimal reliance on external resources, the Arabic sample exhibits challenges in functional and critical HL, with some turning to Google for information. Both groups emphasized empowerment and communicative HL. The study underscores the need for tailored interventions, considering the diverse caregiver landscape, to optimize pediatric healthcare outcomes. The outcomes reveal a convergence of quantitative and qualitative data, indicating elevated HL levels among participants. Communicative HL emerges as a strength, while critical HL displays variability, particularly among Arabic-speaking parents. Conclusion: This research significantly contributes to understanding HL in pediatric rehabilitation, highlighting the need for tailored interventions considering the diverse parents’ landscape.

Introduction: Health literacy is a critical factor in improving healthcare outcomes and patient self-care practices. Healthcare providers play a vital role in supporting patients with diverse health literacy levels. Objective: This cross-sectional study aims to explore the factors influencing health literacy knowledge and experience among healthcare providers in Qatar. Methods: A structured questionnaire, including sociodemographic and work-related data, was administered to a diverse sample of healthcare providers, including physicians, nurses, and other allied health practitioners from a single institution in Qatar. The Health Literacy Knowledge and Experience Scale-2 was used to evaluate participants’ health literacy knowledge and experience. The study employed a web-based survey and involved 121 healthcare providers. Descriptive statistics, t-tests, and analysis of variance were utilized for data analysis. Results: The study revealed that age and profession significantly influenced health literacy knowledge among healthcare providers. Healthcare providers in the age group 20– 39 years had higher health literacy knowledge scores. In contrast, nationality/race significantly affected health literacy experience, with Arabic participants reporting higher scores of health literacy experience. The study also found that healthcare providers who had taken formal courses related to health literacy demonstrated higher health literacy experience scores. Conclusion: This study contributes to the understanding of factors influencing health literacy knowledge and experience among healthcare providers in Qatar. The findings emphasize the importance of addressing age, nationality/race, and formal training in health literacy to enhance the capacity of healthcare providers in supporting patients with varying health literacy levels. Healthcare policies should aim to integrate formal health literacy training among healthcare providers in order to enhance healthcare delivery and improve patient self-care practices.

Depression is a mood disorder that is highly prevalent and is characterized by cognitive, emotional, and physical symptoms. This study aimed to describe the physical health status of individuals with depressive symptoms in Qatar and examine the relationships between physical health indicators and depressive symptoms. A cross-sectional correlational design was used, and data were extracted from the Qatar Biobank. Depression was measured using the Patient Health Questionnaire (PHQ-9). The physical health measurements included heart rate, blood pressure, lung capacity, body mass index (BMI), waist-to-hip ratio, and a self-reported questionnaire. The sample included 687 participants with an average age of 35.39 ± 9.82 years old. The comorbidities reported by participants included diabetes, hypertension, and hypercholesterolemia, and their prevalence ranged from 10 to 26.2%. The BMI data revealed that 38.6% of the participants were either overweight or obese. Approximately 29% of females and 22% of males had an abnormally high waist-to-hip ratio. The percentage of individuals who complained of recurrent chest pain, headache/migraine, or body pain ranged between 12.2 and 43.2%. The mean score of the PHQ-9 was 10.07 ± 4.05, and 43.1% of the sample reported having moderate to severe depression. Several factors were significantly related to depression scores: heart rate, waist-to-hip ratio, headache/migraine, chest pain, body pain, and recent weight change. Healthcare professionals should screen individuals for both depressive symptoms and physical symptoms. This may help in the earlier detection of mental illness and/or physical disease, and thus may ensure better recovery or prognosis and may prevent serious complications.

Background: People of all ages, genders, social classes, income levels, and geographical regions can be affected by mental illness. Families of individuals diagnosed with mental illnesses face significant burdens, particularly due to their role as family caregivers. Aim: This integrative review aims to characterize the interventions that support family caregivers to reduce their burden of caregiving. Methodology: Whittemore and Knafl’s methodology guided this integrative literature review. CINAHL, MEDLINE, and PsycINFO were searched for articles published between 2014 and 2023. Eighteen articles were identified as eligible studies to identify supportive interventions. These articles were then critically appraised and relevant data analyzed and synthesized to formulate the results. Findings: The included studies reported interventions focused on family caregivers of relatives with mental illnesses. The two main themes of these studies are (a) interventions to offset the burden of caregiving and (b) outcomes related to these interventions. These interventions include psychoeducation, adaptive cognitive-behavioral strategies, peer support, and religious support. Conclusion: Caring for a mentally ill family member is an extremely stressful situation for family caregivers. Supportive interventions found in this integrative review could help these family caregivers overcome their burdens.

Aim: The aim of this study was to validate a job satisfaction scale among acute care nurses in the context of Qatar.Design: Cross‐sectional correlational survey.Methods: A convenience sampling technique was used to recruit 295 acute care nurses between June 2021–September 2021. Exploratory factor analysis followed by confirmatory factor analysis was used for item reduction and convergent and discriminant validity evaluation. Pearson's correlations were conducted to evaluate the concurrent and convergent validity of the revised scale. Reliability was tested using several internal consistency indicators.Results: A revised scale was proposed, the Acute Care Nurses Job Satisfaction Scale‐Revised (ACNJSS‐R) scale; it is composed of 13 items loaded on five factors. The composite reliability and the maximal reliability were >.7 for all factors. The study provides empirical support for the validity and reliability of the ACNJSS‐R scale.

This study aimed to translate to Arabic language and culturally adapt the Self-Efficacy for Managing Chronic Diseases Scale (SEMCD) and The Perceived Medical Condition Self-Management Scale (PMCSMS). The translation of the two scales was conducted according to the framework by Beaton et al. Then, these scales were tested in a cross-sectional correlational study with 85 Arabic-speaking participants with multimorbidities in Qatar. Psychometric tests to assess the reliability and validity of the translated scales were done. The internal consistency reliability (α) for the Arabic version of both PMCSMS and SEMCD scales was 0.953 and 0.949, respectively. Correlation coefficient (r) used to assess convergent validity between the PMCSMS and the SEMCD was 0.76 (p < 0.5). Number of morbidities negatively correlated with scores of self-management self- efficacy scores of the PMCSMS and the SEMCD (r = −0.50 and −0.51, respectively). The translated PMCSMS and SEMCD are valid and reliable scales that can be used by researchers and healthcare providers to assess levels of self-efficacy among individuals with multimorbidities. The translated scales can be employed in research or interventional programmes that aim to improve self-management or self-efficacy among individuals with multimorbidities.