Body Image and Self-Esteem Among Female Nursing Students in Three Different Arab Countries Nabila Taha,1 Essmat Mansour,2 Amal Sobhy,3 Entisar Younis,4 1 Assiut University, 2 Tanta University, 3,4 Port-Said University, 3,4 Egypt E-mail: dr.essmat@hotmail.com Current Western culture promotes standards of beauty and success which focus on physical attractiveness. These standards can create feelings of inadequacy and body dissatisfaction. Traditionally, women have responded most strongly to cultural messages of bodily attractiveness, thereby experiencing greater body dissatisfaction than men. Failure to achieve the ideal has been shown to lead to decreased self-esteem which compounds body dissatisfaction and body image disturbance. This study aimed to investigate the level of body image and self-esteem among three community- based samples from Riyadh, Saudi Arabia;, Hadhramout, Yemen, and Assiut, Egypt. 300 students were recruited, 100 per country. The study was carried out in three different faculties of nursing: Riyadh Female Health Science College in Saudi Arabia, Hadhramout University of Science and Technology in Yemen, and at Assiut University in Egypt. Tools for data collection included the body image scale developed by El-Desouki. This scale consists of 20 statements about positive and negative sensations of body image. Also used was the Rosenberg self-esteem scale which consists of 10 statements about positive and negative self-esteem. Finally, an interview questionnaire, developed by the investigators, included information about students’ ages, residence, marital condition, economic condition, parents’ education level, number of brothers and sisters, and their sibling order. Results of this study revealed that 86% of students in Al-Riyadh, 84% from Assiut, and 73% from Hadhramout had positive self-images. The majority of the subjects had high self-esteem (78% in Al- Riyadh, 96% from Assiut and 84% from Hadhramout). It also found that 79.8% of the subjects with a positive body image had high self-esteem compared to only 20.2% of subjects with a negative body image had high self-esteem. In conclusion, a high level of self-esteem positively correlated with body image. Age, parents’ level of education, marital status, and number of brothers and sisters significantly correlated to body image and self-esteem. This study recommended that the importance of developing a positive body image and healthy diet habits is crucial. Nurses’ Orientation Towards Lifelong Learning: A case study of Uganda’s national hospital JK Muliira, C.Etyang, IB Kizza, RS Muliira E-mail: jkmuliira@gmail.com The quality of nursing care in developing countries is poor and improvements via continuing education programmes are underway. Nurses’ orientation towards lifelong learning (NOLLL) has not been explored despite its potential effect on the success of such programmes. The Jefferson’s Scale of Physician Lifelong Learning (JSPLLL) was used to measure NOLLL among 200 nurses at Uganda’s national hospital. Most of the participants had fair orientation (52%) towards lifelong learning (LLL), with a JSPLLL mean score = 36.8 ± 7.2, and rated their skills in self-directed learning as good or excellent (44%). Reported barriers to LLL were patient work-load, lack of mentors, library resources and computer skills. NOLLL was significantly associated with professional experience (P = 804; 0.05), age (P = 804; 0.05) and education level (P = 0.01). In Uganda, NOLLL is still sub-optimal and this has implications for successful implementation of continuing education programmes for nurses. مؤمتر ُعمان الدويل األول للتمريض االبتكارات يف جمال تعليم التمريض واملمارسة اليت تؤدي اىل الرعاية اجليدة جامعة ال�سلطان قابو�س، �سلطنة ُعمان; 29-28 نوفمرب 2011 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care Sultan Qaboos University, Oman, 28–29th November 2011 ABSTRACTS 250 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care Postnatal Exercise Programme on the Health Related Fitness of Omani Primi Postnatal Women Hashem Kilani, Raghda Shukri, Judith Noronha, Jothi Clara Sultan Qaboos University, Muscat, Oman E-mail: hakilani@yahoo.com Despite the fact that exercise is beneficial to the general population and pregnant women specifically, there is insufficient evidence regarding the effect of postnatal exercise on the well-being of Omani women. It may be beneficial to test the hypothesis that postnatal participation in a well-designed exercise programme will enhance Omani women’s health. However, there are vast differences between theory and practice in implementing such an experiment in Oman. This paper aims to elaborate the limitations and obstacles facing this type of project. Methods design is crucial to counteract the dilemma of Omani women; they want to be fit but have no sustainable commitment to an exercise programme. The study used a randomised controlled trial design. 50 postnatal women were recruited to the exercise group and 50 to the control group. Selection criteria were based on normal vaginal delivery, willingness to participate, and residence in the Muscat region. Health-related fitness components, both before and after implementation of the exercise programme, were to include handgrip and leg strength tests; aerobic stepping; lower trunk flexibility measurements; calculation of body mass index, and performance in push-up and sit-up tests. In addition, a standardised questionnaire was used to assess both psychological and social wellbeing in the subjects. An exercise programme was recorded and distributed to motivate subjects to work out in their homes. It was anticipated that the Omani women who participated regularly in the exercise programme would have greater health benefits than those women who failed to participate in an exercise regime. However, the investigators found that cultural barriers, plus husband and family customs, may have impeded their participation. Therefore we highlighted the difficulties and barriers faced in accomplishing a postnatal exercise programme. In conclusion, details of the project, its value, limitations, and the process will be presented. Dietary Intake of High School Students and Factors Affecting the Next Generation of Nurses in the United Kingdom: Findings from a qualitative study Peter Norrie, De Montfort University, UK E-mail: pnorrie@dmu.ac.uk From September 2012, all students who study to obtain a registration in nursing in the UK will undertake degree level programmes. Nursing in the UK is changing. First, there is a move to change health care, placing more emphasis on community-based care. Second, funding is changing, with budget-holding general practitioners being given more power and freedom to source care within their communities. A recent government paper has also proposed that nurses will coordinate and lead teams in a range of settings. Taken together these can be described as positive drivers for nursing education, allowing an expanded and developed nursing role. There are, however, also a number of negative drivers. In the UK it is likely that the number of students trained to full registration will decrease in the near future. This is worsened by between 25 and 30 percent of students not completing their studies, which is a significant financial drain. Using a grounded theory methodology, a set of semi-structured interviews was conducted throughout the UK with academics who are involved in student selection (N = 14). Enquiry focused on two main areas: personal qualities required for new student nurses and experiences of selection in comparison to procedures. Interviews were recorded, transcribed, and analysed using a constant comparative technique. A number of common themes emerged, the most vivid being a pragmatic concept we have entitled ‘Orientation for Professionalism’. This is composed of a number of conceptual elements which can be explored and evaluated during the selection process. These findings have been used within De Montfort University through a process of positive reflection to produce a new student selection process which allows sensitive and differentiated assessment of students at the selection phase. Perspectives will be shared regarding the implementation of this into practice. Serum Lipid Peroxides, Lipids, Antioxidant Defence System of Erythrocytes and Antioxidant Vitamins in Plasma of Urban and Rural Egyptian Men Yousif Elhassaneen1 and Amal El-Badawy2 1Minoufiya University, Shebin El-Kom, Egypt; 2Department of Nutrition & Food Science, College of Nursing, Sultan Qaboos University E-mail: yousif12@hotmail.com Lipid peroxides, which are produced inevitably from polyunsaturated fatty acids, may damage cell membranes and might accelerate cellular ageing. Research results to date indicate that increased levels of lipid peroxides are associated with premature ageing, atherosclerotic process, hypertension, and cancer. Serum lipid peroxides, thiobarbituric acid reactive substances (TBARS), lipids, enzymatic and vitamin antioxidants, blood pressure, body mass index, and dietary intake in 200 urban men were compared with the same number of rural men. The haematological analysis for all subjects indicated that significantly higher levels of TBARS, serum cholesterol and triglycerides (TG) were seen in urban men when compared with the rural men. The opposite was observed for the activities of antioxidant enzymes, glutathione peroxidase, superoxide dismutase, and catalase measured in the erythrocytes and antioxidant vitamins measured in plasma including A, C, and E. Also, significant correlations were observed between TBARS, serum cholesterol, and TG in the urban men. All of these findings suggest that significant elevation of TBARS and lipids and a decrease in antioxidant enzymes and vitamins in urban men may be the result of urbanisation, including exposure to environmental and food pollutants. Abstracts | 251 Sultan Qaboos University, Oman, 28–29th November 2011 A Descriptive Study to Determine the Relationship between Stress Coping Skills and Cognition Angel David and Dr. S. Kadhiravan, Aragonda Apollo College of Nursing, India E-mail: angeldanadavid@gmail.com Can the cognition of students be influenced to help them cope with stress? Nurses experience high rates of stress. College students, including nursing students, feel more overwhelmed and stressed than before. Are they equipped with adequate coping skills? This study aimed to assess and compare cognitive styles of nursing students, evaluate and compare their coping skills, and to explore the relationship between cognitive styles and stress coping skills. A cross- sectional descriptive correlational design was used with 443 students (214 first year and 229 final year students pursuing general nursing and midwifery [GNM]). Stress-coping skills were evaluated in its seven dimensions with the coping skills inventory. Six different styles of cognition were assessed with the personal style inventory (test-retest reliability). The difference between the intuitive mode of cognitive style used by the first-year and the logical mode of cognitive style used by the third-year (GNM) students was statistically significant. Also a statistically significant difference exists between first-year and third-year GNM students in some dimensions of coping skills such as reactivity to stress, the ability to relax, and self-reliance. Additionally, there is significant correlation between the cognitive styles and stress- coping skills of students. Stress-coping skills can be positively strengthened and stress can indeed be managed by means of cognitive strengthening. Teachers should try their best to innovatively strengthen the resilience of students. Jordanian Nurses’ Attitudes towards Organ Donation from Brain Dead Patients in the ICU Ashraf Hussein, Ammar Aroury, Alaa Dalal, Najwa Safi, Bilal Abdel Ghani Nursing Management and Critical Care Department, Saudi Arabia E-mail: ashraf_hussain2003@yahoo.com Intensive care unit (ICU) nurses play a major role in the transplantation process, and it is important to study their attitudes as Jordan is experiencing an increase in cadaveric organ donation. No research has been done to assess Jordanian ICU nurses’ attitudes which are influenced by cultural backgrounds, social norms, and religious beliefs. This study explored Jordanian nurses’ attitudes regarding organ donation from brain dead patients in the ICU. The researchers used a cross-sectional descriptive design with a self-report questionnaire, developed by Kim, Fisher & Elliott (2006), with convenience sampling to collect data from 216 ICU nurses from nine private hospitals in Amman, Jordan. The survey period was from March to April 2007. The majority of nurses in our sample (92.6%) accepted brain death as true death. Nevertheless, an obvious decrement (66.2%) is seen when it was related to supporting the donation from the brain dead patients. But when it was related to donating their organs and their family members’ organs, just 55.1% and 36.6%, respectively, agreed with the procedure. ICU experience positively affected nurses’ attitudes in the organ donation process. There is a misunderstanding of the Islamic point of view and following the fatwa of forbiddance among nurses. This research finding provided new insight into Jordanian ICU nurses’ attitudes towards organ donation from brain dead patients. They have, in general, some positive attitudes toward organ donation, but with mixed feelings, especially regarding themselves and their families. These findings could be effectively used in further research. General Social Function for Elderly in Geriatric Homes Nazar Ali Sheren Doski College of Nursing, Erbil, Iraq The study aimed to assess general social factors for the elderly in geriatric homes in Jordan.. A sample of 155 residents was selected. The Older Americans Resource and Services (OARS) social resource scale was used for data collection. The questions focused on the facilities’ residents’ family structure, patterns of friends and visiting, availability of a confidant, satisfaction with the degree of social interaction, availability of a helper in the event of illness or disability, and outing programmes. The findings revealed that the life expectancy for women is greater than for men. In respect to marital status, 38.1% of those surveyed were widows. Only 15.5% of them were visited by their family more than 5 times a year. Of respondents, 61.3% trust the home’s staff and 25.1% have friends in the home. In regard to loneliness, 66.5% feel lonely and need outside assistance. In regard to clients’ help, 42% did not know how to answer this question. Of those polled, 51.6% needed help from with bathing, eating, or taking medication. In relation to trips outside the home, 54.8% had opportunities to go outside for trips, mainly for visiting family, friends, or for religious purposes. The study recommended that the home managers must focus on increasing social relations within the facility through more communication, increase visiting times between residents and their families and friends, help residents get out of the house and meet other people, and find ways for residents to become more involved in activities. Pressure Ulcer Project Initiatives Shadya Hamyar Al-Yaarubi, Directorate General of Health Services, Oman E-mail: sh8687@hotmail.com This paper presents the pressure ulcers project initiatives at Khoula Hospital. It will highlight implementation of the evidence-based risk assessment tool used for the prevention of pressure ulcers. Within the complex and rapidly 252 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care changing health care environment, it is essential that the best available evidence is obtained to inform the practice. The European Pressure Ulcer Advisory Panel (EPUAP) definition is an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction and or a combination of these. They can develop within 2–6 hours as a result of a local breakdown of soft tissue due to compression between a bony prominence and an external surface. This presents a huge burden for families and the health care institutions in any country. The project is located at Khoula Hospital, a National Tertiary Trauma Centre with approximately 485 beds. There were reports of pressure ulcers in patients directly admitted from home, transferred from other institutions or had acquired them during the course of their treatment. Treatment and prevention use significant resources—disposables, equipment, surgery and nursing time. The project group comprised the author, plastic surgeon, dietician, clinical nurses, infection control nurse, social worker and physiotherapist. The main objective was to create awareness and train staff to assess, prevent and manage pressure ulcers. Quarterly workshops were conducted locally and then opened to for any interested institutions including private hospitals. Pressure ulcers are globally considered a quality of care indicator. A Comparative Study to Assess the Knowledge of Women in Reproductive Age Group Regarding Urinary Tract Infections Susan Thomas Blessy, Nursing Institue, Ministry of Health, Muscat, Oman E-mail: blessyvinu@yahoo.com Urinary tract infections (UTIs) affect women more frequently than men, and are among the most common bacterial infections encountered by primary care physicians affecting 20% of women between 15 and 45. 1 woman in 5 develops a UTI during her lifetime and 4 out of 5 women will experience a recurrence of UTI. For women, UTIs are significant health challenges at all stages of life. The study assessed the knowledge of women in urban and rural areas regarding UTIs and compared it to that of women in rural and urban areas, to identify the relationship between this knowledge and selected socio-demographic variables, and to develop a UTI health education module. A simple random sampling technique by lottery method was used. Participants included 75 women from rural areas and 75 from urban areas. Data were collected using a structured interview schedule and analysis done by using descriptive and inferential statistics. In urban areas, 36% of women were very knowledgeable, while in rural areas no women were highly knowledgeable. In urban areas, a significant relationship was found between women’s ages and their level of knowledge, education, occupation, religion, marital status and history of UTIs. In rural areas, there was a significant relationship between their knowledge and education, occupation, caste and marital status. This indicates the need for a health education module to support health awareness campaigns. It will focus on prevention, early detection, and management of UTIs and thus indirectly help reduce the incidence of UTIs. Fear of Death among Drug Addict Patients Fares Dardakeh, Hamdy Meslehy, Fatima College of Health Sciences, United Arab Emirates E-mail: faresdradkeh@yahoo.com The primary aim of this study was, to examine the level of death anxiety (thanatophobia) in drug-dependent individuals attending the outpatient clinic in a psychiatric hospital, and to examine the relationship of demographic variables to death anxiety. 85 patients were recruited from outpatients at The Psychiatric Hospital in Bahrain. The death anxiety scale was administered to assess death anxiety, and a clinical psychiatric interview was used to assess psychopathology. The mean age of the sample was 36.8 years (SD 8.8). All subjects who participated in the study were Arabic males; the majority of them were primary school educated (67%) and single (48; 56.5%). The total mean death anxiety score of the drug abusers was high (3.52 ±. 95). One-way analysis of variance (ANOVA) showed that there was no significant difference among the scores the drug dependents received on the death anxiety scale related to different groups of age, education, type of drug used, or the number of times of taking drugs per day. However, there was a significant difference in the level of control of use, marital status, duration of use, cigarette smoking, and level of religiosity. The results of this study indicated that the level of death anxiety is high, in general, among drug abusers and that being divorced, not actively practicing a religious faith, having at least 1–10 years or more than 20 years history of drug abuse, and smoking at least 20 or more cigarettes per day significantly increased the level of death anxiety. Evaluating the Effectiveness of a Clinical Preceptorship Program for RNs in Jordan Mahmoud Alhussami, Mohammed Saleh, Muhammad Darawad, University of Jordan, Ammam, Jordan E-mail: m.alhussami@ju.edu.jo A shortage of clinical nursing instructors and an absence of hospital staff in clinical teaching may lead to incompetent graduates and poor quality of patient care. This study aimed to design and implement a programme to train registered nurses (RNs) as preceptors, and to set up a nursing preceptorship education programme. True experimental design was utilised. The sample consisted of 68 RNs recruited randomly from governmental, private, and university hospitals. A socio-demographic data form and a questionnaire concerning nurses’ knowledge of preceptorship were developed for self-administration. The study results indicated that the difference between experimental (N=30, M=33/41, SD=4.5) and control (N=38, M=26/41, SD=4.6) groups after implementing Abstracts | 253 Sultan Qaboos University, Oman, 28–29th November 2011 the preceptorship programmeme is statistically significant (t=5.5, df=66, P <0.001). These results suggest the usefulness of implementing preceptorship educational programmes to improve preceptors’ knowledge regarding teaching strategies. The preceptorship programme significantle improved knowledge of clinical teaching. Transforming Education to Strengthen Health Systems: The Lancet Commission Report Gillian White, Directorate General of Education & Training, Ministry of Health, Oman E-mail: drgillianwhite@yahoo.co.nz In 1910, the Flexner Report led to a series of studies about the education of health professionals. Today, conspicuous gaps demonstrate a collective global failure in health systems as they struggle to manage complex and expensive demands on health professionals. Professional education in the health sector has not kept up with increasing challenges. Deficits can be seen in the disparity of abilities to meet health consumer needs, health worker shortages, the incongruent theory-practice nexus, a focus on tertiary rather than primary care, imbalances in the labour market, and a failure to improve health systems. Health professions resemble silos, often acting in isolation or even in competition with each other. Remote areas are underserved, and mass migration of health professionals is common, both away from their own countries and from the specialties they trained for. The Lancet Commission (20 professional academic leaders from around the world) took a global, interdisciplinary perspective, and a systematic approach to consider alliances between education and health systems. The Commission concluded that positive health outcomes require new instructional and institutional designs. This presentation discusses reforms in professional health education, as highlighted in the findings from the Lancet Commission’s report, with a specific focus on the impact for nurses, in order to develop a new vision to transform Omani health education. Preceptorship: A shared Journey between practice and education Amaal Saad Al Sabbagh, College of Health Sciences, Bahrain E-mail: a.khashaba@gmail.com Clinical teaching is a purposeful facilitation of learning in the clinical setting that includes the identification of learning needs, the establishment of curricular outcomes, arranging and planning learning opportunities, planning and delivering learning experiences, assessment, and feedback and evaluation. Preceptorship is an enabling process structured to support learners in clinical practice to achieve specified outcomes within a stated period of time. Preceptors help students develop a knowledge base and clinical skills, and are described as experienced nurses who facilitate and evaluate student learning in clinical work over a predetermined amount of time, in addition to their regularly assigned nursing functions. Serving as resource people and role models in one-to-one relationships, preceptors introduce students to the nursing role through direct involvement in the teaching-learning process. In 2004, the Nursing Division at the College of Health Sciences in Bahrain developed a preceptor programme that provided opportunities for reflection, critical thinking, and discussions between preceptors and preceptees. It also helped to strengthen clinical learning experiences for students. This presentation summarises the benefits of preceptorship, outlines preceptor responsibilities and qualities, discusses the process of preceptor selection and role preparation, and details the evaluation system in the Bahrain College of Health Sciences. First Year Student Nurses Experience a New Beginning through Problem Based Learning Anne Fahy, University of Limerick, Limerick, Ireland E-mail: anne.fahy@ul.ie Nursing education in Ireland and internationally is increasingly under pressure to focus on developing nurses who are equipped to work in a rapidly changing, multicultural environment influenced by fiscal constraints and technological advances. The delivery of health care is becoming more complex and requires that professional nurses are proficient critical thinkers, problem solvers and self-directed learners. Problem-based learning (PBL) is promoted as a means to nurture and facilitate critical thinking and self-directed learning skills among nursing students. The concept of PBL is well-established in the professions of medicine, engineering, law, and nursing in N. America and the UK, and is frequently referred to as a total approach to education. PBL is an innovative student-centred approach that teaches a multitude of strategies critical for success in the 21stcentury. Nurse educators must develop the necessary skills and knowledge to integrate the theory of PBL into the curriculum, and evaluate teaching strategies that successfully prepare knowledgeable, competent, and professional graduates. These qualities are reflected as sound clinical judgements that result in quality care administered by skilled practitioners. This presentation shares lessons learnt from introducing a PBL approach for first-year student nurses. Written case study scenarios presented to a class facilitated transformational learning as the students engaged in self-directed inquiry and critical thinking. Small groups organised the information and identified relevant concepts as they analysed and evaluated all viewpoints. Multiple perspectives from both personal experience and theory enhanced the discussion and students became actively involved with the case scenario, related to authentic professional practice. Nurse education programmes should provide opportunities for students to develop 254 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care these skills and abilities. Application of Cognitive Critical Thinking Skills in the Nursing Process by Nursing Students Chandrani Isac, Anandhi Amirtharaj, Anitha Thanka, Sheila Melba D’Souza, College of Nursing, Sultan Qaboos University, Oman E-mail: chandu@squ.edu.om Evidence-based nursing practice focuses on the need for nurses to demonstrate orderliness, diligence, patience, reasonableness, persistence, willingness, flexibility, and precision when dealing with health care issues. Student who aspire to become competent nurses are geared by nurse educators to overcome challenges and organise and implement patient care behaviours. Knapp states that ‘it is in the application of nursing process that a nurse becomes proficient at critical thinking’. Literature increasingly points at the need to infuse critical thinking into clinical education scenarios. In clinical nursing education the learner is able to marry the theoretical component with practice using the nursing process approach. This approach is a powerful scientific vehicle to facilitate critical thinking. This study was descriptive. Data were collected using a tool, adapted from Facione’s 1990 Core CCTS. The sub-skills investigated were inference, recognition of assumptions, deduction, interpretation, and evaluation. 60 nursing care plans were drafted by 2 levels of students. The results showed that there were significant differences in the use of CCTS by nursing students. A major theme was that the nursing process compels students to apply CCTS. There was a significant difference in the application of CCTS between the 2 levels of nursing students. When nursing students are helped to identify and integrate CCTS in nursing process, their critical thinking skills become functional and lead to sucessful implementation in clinical practice. The Influence of Academic Nurse Role Ambiguity and Role Conflict on Organisational claimant in Saudi Arabia Nazik MA Zakari, College of Nursing, King Saud University, Saudi Arabia E-mail: nzakari@ksu.edu.sa Higher education in Saudi Arabia (KSA) was established to enhance the nation’s growth and well-being. The KSA’s nursing faculty’s mission covers teaching, research, and community service. The interaction of these factors may influence the academic setting and impact teaching nurses’ roles. This study aimed to examine the influence of academic nurses’ roles, and the ambiguity and role conflicts within institutions in KSA. A non-experimental, descriptive, cross- action correlation was conducted in the KSA’s three oldest and largest universities. Full-time nursing instructors were recruited to participate in the study. All respondents completed the role conflict and role ambiguity scale. In addition, the organisational climate description questionnaire of higher education was used for data collection. Self- reported survey procedures were used to collect the study data. Descriptive procedures and Pearson‘s product-moment correlation coefficients were used. The majority of participants were expatriates with a mean age of 36.86 years. The results revealed that the role ambiguity mean of nursing teachers = 29.88 while the role conflict mean = 35.26. In addition, the results showed that intimacy received the lowest mean score in the category of organisational climate. Role ambiguity positively correlated with all dimensions of organisational climate. However, only role conflict positively correlated to disengagement. This result suggested that the nursing faculty faced role conflict and ambiguity. They also suggest that KSA’s nursing faculty have different perceptions of what their roles are compared to their colleagues or dean. Faculty members experience deliberation, disengagement, and lack of intimacy in the academic setting. These findings have negative implications for a healthy workplace. Deans should make an effort to match institutional and individual goals, and open discussions should take place between administrators and faculty about role expectations, criteria for promotion, and other institutional rewards. Critical Thinking: Teaching for Saliency and Priority Setting Loucine M. Huckabay, School of Nursing, California State University Long Beach, California, USA E-mail: huckabay@csulb@edu Implementation of critical thinking in caring for patients and their families comes through determining what the needs are, and then prioritising those needs based on saliency, meaning, and determining what is of most importance, or is most urgent now. Setting priorities based on saliency is an acquired behaviour that teachers can teach and students can learn. Teaching strategies that enable the acquisition of these behaviours include building upon prior knowledge, conducting guided inquiry, and reflecting on practice. This session is devoted to expanding and implementing these strategies through case studies and interactive small group discussions. Perceptions of Nursing Science Students regarding Factors which Hamper their Motivation Jacoba Johanna van der Colff, College of Nursing, SQU, Muscat, Oman E-mail: drjj@squ.edu.om This research originated from the observation that the motivation of nursing science students gradually declines during the course of their training. According to the literature, nursing science lecturers play a vital role in motivating their Abstracts | 255 Sultan Qaboos University, Oman, 28–29th November 2011 students. A qualitative research design was applied. Purposeful voluntary samples were taken. The focus group technique was the research method. Factors which hamper the motivation of nursing science students are presented: the overload of the nursing training programmes; unsatisfactory relationships with nursing science lecturers, and unsatisfactory relationships and circumstances in the clinical situations. Recommendations regarding solutions are offered. The Influence of a BSc. in Nursing on Professional Practice Dianne Watkins, School of Nursing and Midwifery Studies, Cardiff University, Wales, UK E-mail: watkinssd@cf.ac.uk Cardiff University, the Ministry of Health in Oman, and the Oman Specialised Nursing Institute developed a bachelor of science (BSc) in nursing studies for qualified nurses, delivered in Oman. The first cohort commenced in May 2009; a second cohort in September 2010, and a third in September 2011. A longitudinal research study was established to explore nurses’ and managers’ perceptions of the effects of a BSc in nursing on professional development and practice, and to identify factors that influenced the implementation of new learning. Preliminary findings from phase 1 are presented. This qualitative study collected data through focus groups and interviews. One focus group consisted of students nearly having completed the course. Interviews with a random selection of ten students and ten managers took place six months later. Data were transcribed using a ‘template approach’ and emerging themes and findings were agreed upon by a research team. Early results indicate that the BSc has developed the evidence-based practitioner, who is able to search for evidence, critique research, and apply findings to practice. Confidence, leadership, and change management skills improved and many nurses were promoted to senior positions. Factors that inhibited the implementation of new learning were time, staff shortages, the culture of nursing, and resistance by other staff. Facilitating factors included support of managers and a thirst by self and others to further professionalise nursing. Nurses felt able to stand up for the profession and to talk with doctors on the same professional standing. Educating nurses at degree level will develop the individual and further develop nursing as a profession in Oman as well as improve care to patients by evidence-based practice. Assessing Clinical Learning Environment for Baccalaureate Nursing Students in Muscat Melba Sheila D’Souza, Ramesh Venkatesaperumal, Anandhi Amirthraj, Anitha Thanka, Chandrani Isac, College of Nursing, Sultan Qaboos University, Muscat, Oman E-mail: melba@squ.edu.com The quality of the clinical learning environment/placement is an essential factor in determining the quality of nursing students’ clinical experience/ learning. This paper reports an evaluation of the clinical learning environment for baccalaureate nursing students in Oman based on the cognitive and socio-emotional aspects of the learning process. An exploratory study of nursing students’ perceptions of their learning environment was carried out using the clinical learning environment inventory (CLEI) derived from a comprehensive review of literature. After a pilot study, the instrument was administered to 100 undergraduate nursing students from 2 cohorts of the nursing programme in 2011 in Sultan Qaboos University. Inferential statistics and multiple regressions were computed. The students perceived their clinical learning environment as good. Some students were extremely satisfied (90%) with activities done on the ward, while others reported less satisfaction (80%). Most of the students (92%) agreed that practical work experience was useful. Providing an effective and productive clinical experience is vital in preparing nursing students to become competent clinicians. The CLEI offers a useful measure to explore nursing students’ satisfaction with 2 aspects of clinical experience: clinical facilitator support of learning and the clinical learning environment, and is considered useful for assessing learning environments in clinical settings. Writing-to-Learn as a Learning Strategy: attitude of Omani nursing students Clara JJ, Shreedevi B, Venkatesaperumal R, Shukri R College of Nursing, Sultan Qaboos University, Muscat, Oman; E-mail: shreedev@squ.edu.om Writing-to-learn (WTL) is considered an important learning strategy in all disciplines. The nursing curriculum requires documentation in clinical practice, expression of ideas in examination, completion of assignments and projects, and contributing to publications and presentations. The aim of this study was to assess the attitude of Omani nursing students towards writing, and to investigate the relationship between certain demographic variables and attitudes towards writing. This study used a modified WTL attitude scale to generate data on Sultan Qaboos University nursing students’ attitudes towards writing. A convenience sampling technique was used. Quantitative data was generated using a structured questionnaire. The scores on writing as a whole, the writing process, and self-efficacy were generated using SPSS. The results indicate that senior and junior students had a more positive attitude whereas middle level students had negative attitudes towards writing. Although 52% of students had a negative attitude to the writing process, the median was higher in the writing process as compared to the median for self-efficacy. There was a positive co-relation between the scores for the writing process and self-efficacy. The findings of this study suggest that students have a negative attitude towards WTL. Attitudes are learned or organised through experiences; hence, negative attitudes towards writing can be transformed with structured interventions. Through WTL, faculty can help nursing students improve their writing skills and understand the course material, thus encouraging critical thinking. 256 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care Evidence and Clinical Decision Making in Nursing Lubna Hamed Al-Hasani, Training and Staff Development, Royal Hospital, Ministry of Health, Muscat, Oman E-mail: lubna128@gmail.com Evidence based practice (EBP) can be defined as “the practice of health care in which the practitioner systematically finds, appraises, and uses the most current and valid research findings as the basis for clinical decisions”. Nursing is a challenging profession that requires the ability to make critical decisions every day while taking into consideration many factors, such as the patients’ values and beliefs along with the work environment, the current situation and time factors. Integrating clinical decisions with evidence requires a lot of commitment by nurses. They should be aware of current research and this requires a lot of reading and updating. The majority of nurses have a positive attitude about EBP; however, not all of them are actually applying it for a variety of reasons. First, due to time constraints, nurses lack reading time and claim that they do not have the time to conduct research, or that they have not been provided with proper research resources such as Internet or a library. Second, research shows that nurses lack confidence and initiative. Finally, although many nurses are aware of research related to specific information, they tend to follow old methods unless they have been informed to do otherwise by the nursing administration. Portfolio in Nurse Education Muna Ramadhan Baitsaad, Oman Specialized Nursing Institute, Oman E-mail: mbaitsaad@hotmail.com Recently, there has been an acceleration of changes in the nursing profession and so nurses find themselves confronted with an explosion of nursing knowledge and increasing complexities in their dynamic profession. Therefore, a significant change is occurring in nursing education as institutions attempt to deal with these complexities. In response, nurses need to integrate theory and practice, and current nursing curricula do encourage self-directed learning, where nurses seek and analyse information that they use. Naturally, portfolios are considered to be the device of choice to prove growing competency and encourage students to take an active role in their learning. The use of portfolios in nursing education is increasing and has become a transferable teaching and learning method that demonstrates students’ progress. This presentation will explore the current conceptualisation of the portfolio in nursing education, its advantages for students, and the challenges for nurse educators. Paradigm Shift in Nursing Education: An imperative change for the future Jayanthi Radhakrishnan and Regina Xavier, College of Nursing, Sultan Qaboos University, Oman E-mail: jayanthi@squ.edu.om Innovation in nursing education entails nurse educators being challenged to think in new ways and explore new possibilities to prepare the future generation of nurses. In the past 25 years, reforms in nursing education have taken place without changing the substance of the curriculum or the educational paradigm. Studies show evidence of nursing school graduates with limited inferential thinking skills and inadequately prepared in pharmacology, clinical practice, leadership, and the use of patient electronic medical records. Often nurse educators are asked to teach more content, but this simple additive curriculum model that we have followed since the time of Nightingale is not enough to ensure that learning has taken place. There is a strong urge to shift instructional emphasis from content coverage to student learning. The ‘curriculum revolution’ should change the way nursing is taught and learned. In short, a ‘paradigm shift’ is needed to prepare future nurses. Transformations taking place in nursing and nursing education are driven by major socioeconomic factors, and by developments in health care delivery and professional issues unique to nursing. Nurse educators need a deeper understanding of trends in health care and their impact on the nursing education/practice in order to facilitate the paradigm shift in nursing education. Predictors of Pain Management Satisfaction among Jordanian ICU Patients: An exploratory study Muhammd Darawad, Mahmoud Al-Hussami, Ali Saleh, Manal Al-Sutari, School of Nursing, University of Jordan, Amman, Jordan E-mail: m.darawad@ju.edu.jo Many studies have reported the problem of undertreating pain among hospitalised patients especially among ICU patients who experience higher pain levels. Despite patients’ pain management satisfaction receiving significant attention, it has not been fully explored among Jordanian ICU patients. The study aimed to: 1) assess Jordanian ICU patients’ pain characteristics (intensity and interference) and levels of pain management satisfaction, and 2) determine predictors of pain management satisfaction among ICU patients. A descriptive cross-sectional design was utilised using the American Pain Society-Patient Outcome Questionnaire to survey 139 Jordanian ICU patients from different health care sectors in Jordan. Higher levels of pain and pain interferences were reported. However, participants were relatively satisfied with pain management approaches. Also, the results showed a predictive model of three predictors, which accounted for 41% of the variance in participants’ satisfaction with pain management. Time needed to get analgaesia had the highest predictive power (Beta = -.480, P = .000), followed by average pain interference (beta = .218, P = .02), and being told about the importance of reporting pain (beta = .198, P = .006). Jordanian ICU patients reported pain levels higher than those reported by previous studies in other countries, but comparable levels of pain management Abstracts | 257 Sultan Qaboos University, Oman, 28–29th November 2011 satisfaction. This supports the need for a caring attitude in managing patients’ pain reports. The study is among the first pain management studies in Jordan aimed at setting the stage for future research studies. Finally, results can be included in planning pain management strategies and protocols within Jordanian hospitals. Needs Assessment of Cancer Patients and Development of a Standardised Palliative Care Plan to improve Quality of Life Nagwa Elkateb, Mona Elshater, Souad Hashem, National Cancer Institute, Cairo University, Cairo, Egypt E-mail: nelkateb@link.net Palliative care is a concept of holistic care for patients who need symptom relief during their illness. It seeks to maximise quality of life for patients and families. Perception and level of experience of health care professional may affect the continuity of care. Nurses need written guidelines to enhance their performance and provide quality palliative care. The aim of this study was to develop a standardised care plan based on assessment of palliative needs of cancer patients and evaluate the impact of the implemented care on the quality of care. A convenient sample of adults and paediatric cancer patients were recruited from the palliative care unit and assessed before and after implementation of the care plan at the National Cancer Institute, Cairo University, Egypt. Patients participated in a structured interview completed by the researchers, and were given problems assessment tools, and nursing guidelines and patient self-care instructions. The presentation describes the results of patients’ responses before and after implementation of the care plan, as well as the significant differences in the care provided after using the guidelines in spite of the shortage of staff and workload. Palliative care is important and nursing guidelines and educational resources have a great impact on improving the quality of care provided during the various stages of illness. Teaching tools for patients and families should be adapted to individuals’ needs. Compliance with Infection Prevention and Control Protocols at Governmental Paediatric Hospitals in the Gaza Governorates Ashraf Eljedi, Shareef Dalo, Islamic University of Gaza, Palestine E-mail: ajedi@iugaza.edu.ps Nosocomial infection is a significant burden for both patients and health systems. The Palestinian Ministry of Health has adopted the National Infection Prevention and Control (IPC) protocol in 2004, aiming to combat infections among health care providers, clients, and community. However, compliance with the IPC protocols has been poorly assessed. The aim of this study was to assess compliance of health care providers with the IPC protocols in the governmental paediatric hospitals in Gaza in order to decrease childhood morbidity and mortality. The study is a descriptive cross- sectional one that included a self-administered questionnaire for all doctors, nurses, and physiotherapists (N=334); an observation checklists for health care providers’ practices, and for the health facility. The reliability of the instruments was assured and the response rate was 92%.The study revealed the most important reasons for non-compliance with the IPC protocol were absence of education or training programmes (61.5%), lack of knowledge (52.4%), and scarcity of the required supplies (46.9%). Only 2.3% of respondents had a copy of the IPC protocol, while 65.8% did not know about its existence. Only 16.9% of respondents had participated in training sessions about IPC. Of those polled, 66.1% had been exposed to an injury from used needles. The observation checklist for the respondents’ practices revealed lower levels of compliance in the areas of wearing uniforms (86.6%); hand washing (45.9%); wearing gloves (40.7%), and using antiseptic and disinfectant (49.16%). Health facility checklists indicate a lack of some essential equipment and materials such as covered waste containers and heavy duty gloves. The study recommended making IPC protocols available in all hospital departments; intensifying education and training programmes by a highly qualified team, and providing the needed equipment and facilities. Understanding the Sexuality Issues and Queries of the Adolescent Students of Pune Rekha Jaiprakash Ogale, Assistant Professor, College of Nursing, Sultan Qaboos University, Muscat, Oman Email: The adolescent period is a most important phase, marked by various developmental changes. The adolescent becomes capable of reasoning and abstraction for the first time. This period is marked by rapid physical growth, social and emotional development, and a heightening of sexual and romantic interest in others. Adolescents become more aware of themselves and the world around them. This phase is also marked by changes in the reproductive system, which makes them capable of reproduction. Several studies have indicated that adolescents lack knowledge of sexuality and reproduction. How do adolescents address their own sexuality? What are the different issues that worry them and what type of questions really bother adolescent groups? The aims of this study were to assess the perception of the adolescent students about their sexuality and reproductive health, and to analyse the issues faced by the students about their own sexuality. The cluster random sampling method was used to select adolescent students from four schools in Pune City. The sample selected was 119 students in the 8th standard and divided into 8 focus groups. The findings suggested that the majority of the boys (70%) ask more about sexuality than girls (30%). The issues identified by the students were related to understanding sex and its importance, problems related to sex, homosexuality, reproduction, menstruation, 258 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care contraception, and problems related to them including HIV/AIDS and its prevention. There is a great need to address sexuality issues among adolescents to help promote their physical, social, emotional and mental health. Pre-Hospital Delays, Cognitive Representations, and Coping Responses to Symptoms of Acute Coronary Syndrome in Male and Female Patients of Oman Mousa Al Taani and Jahara Hayudini, College of Nursing, Sultan Qaboos University, Oman E-mail: hayudini@squ.edu.om Although women in the Arab Gulf Region have shown greater acute coronary symptoms (ACS) events risk scores and hospital mortality than men, no research attention has been given to how men and women cognitively process and cope with symptoms of ACS to make health care seeking decisions. The aim of this study was to examine differences between men and women in cognitive presentation and coping responses to symptoms of ACS. Data from 131 hospitalised patients for ACS (81 men and 50 women) about pre-hospital delays, cognitive representations of and coping responses to the symptoms of ACS were collected by structured interview. Questions were developed based on the response to a symptoms questionnaire. Women reported longer pre-hospital delays than men but the difference was not statistically significant. They were more likely to have hypertension, perceive themselves as less susceptible to ACS and report a greater number of symptoms than men. The women were also more likely to report dyspnoea, nausea/vomiting, and stomach pain than men. Coping responses used by women were similar to men’s. Men who reported shorter pre-hospital delays were more likely to approach their symptoms in a “wait-and-see” fashion, be free from diabetes, experience neck pain and left arm pain, identify the symptoms as cardiac in origin, not use coping responses, and attempt to relax. In contrast, women who reported shorter pre-hospital delays were more likely to experience sweating, perceive greater overall intensity of symptoms, and report fear of diagnostic procedures as a barrier to early health care seeking. Factors contributing to pre-hospital delays in men are thus different to women. Counselling-educational approaches to shorten pre-hospital delays in women should focus on ACS symptoms, and helping them explore their emotional reactions to the symptoms. Leadership and its Effect on Institutional Culture: The cornerstone of the changing context of nursing and midwifery in Oman Carol Moss, College of Nursing, Royal Hospital, Ministry of Health, Oman E-mail: Moss_Squad@msn.com Nurses in hospitals and health care institutions in Oman are challenged like never before. There has been a seismic shift in the level of clinical experience at the staff nurse level, coupled with a rapid expansion of the outpatient sector, and a demand on hospitals to provide for growing numbers of higher acuity inpatients. The nursing leadership at all health care organisations has been placed under enormous pressure to resolve complex staffing issues, continue Omanisation, and assure clinical competence. The nursing workforce in most institutions is close to 50% of total staff. This creates an opportunity to impact significantly the culture of the organisation. Long standing research shows that leadership excellence has a a direct correlation with the institutional culture, employee satisfaction and achievement of high levels of patient safety. This presentation seeks to explore the major research findings and determine their applicability to the situation in Oman. With properly planned and executed training and development, nursing leaders can significantly improve the culture of health care within Oman’s institutions. With proper leadership, the transformation can lead to the highest levels of career satisfaction, clinical competence and patient safety. Nursing Staffing in Oman: An approach for estimating the requirements of the 8th health system Moeness Moustafa Alshishtawy, Ministry of Health, Oman E-mail: drmoness@gmail.com At the beginning of the 21st century, it was found that conspicuous gaps and inequities in health still persisted despite the positive outcomes of patients and population health achieved in Oman. New infectious, environmental, and behavioural risks, at a time of rapid demographic and epidemiological transitions, now threaten all the achievements of a health system which still has to struggle to keep up, placing additional demands on health workers. In light of this, health planners and decision makers have to ensure that an adequate number of suitably skilled medical professionals are in place to meet health needs. Although the number of nurses working in health institutions in Oman increased by about 27-fold within the last 35 years to reach 12,102 in 2009, the nursing profession still suffers from acute shortages, skill-mix imbalances, and misdistribution of personnel. This poses a new challenge for decision makers in Oman, and the question of having the right number, the right skills and the right distribution of nurses to meet the requirements of the 8th 5-year plan for health development is one with which planners are struggling. Various approaches have been proposed, all of which have different assumptions, data requirements, and costs. This paper gives an overview of various approaches for planning nursing staffing, with their advantages and limitations. Moreover, it proposes an integrated approach to estimating nursing requirements in Oman to achieve the goals of the 8th Health Plan, besides estimating several scenarios for future requirements, and identifying efficient ways of providing for them. Abstracts | 259 Sultan Qaboos University, Oman, 28–29th November 2011 Job Satisfaction among Nurses working in the Maternity Hospital in Judah, Saudi Arabia Salma Moawed, Sahar M. Yakout, King Saud University, Saudi Arabia E-mail: saharyakout@yahoo.com Saudi Arabia (KSA) is a fast-developing country with a shortage of well-trained Saudi health personnel, especially females. Overcoming this shortage may take some time. Nursing has traditionally been an unacceptable career option for Saudi nationals. The reasons suggested are the low image/status of nurses, and traditional, cultural, and social values. There is no doubt that the present psycho-sociological conditions militate against the entry of young Saudi women into nursing. This unfavourable situation can be ameliorated by improving the working conditions of nurses and increasing their job satisfaction. This research aimed to study the job satisfaction levels of maternity nurses in Judah Azizia, KSA. A descriptive study was undertaken on a convenience sample of 120 maternity nurses. Data were collected through a self-administered questionnaire from December 2010 to March 2011. The questionnaire consisted of two parts. Part I was comprised of five demographic items. Part II was the Mueller-McCloskey Satisfaction Scale, providing information on job satisfaction among nurses and consisting of 31 items to measure the satisfaction of nurses with administrative services, and with their surrounding circumstances. The response rate was 83%.The maternity nurses were highly satisfied with following aspects: the head nurse, their co-workers, respect of their supervisors, and their capability to control the work. Least satisfaction was expressed regarding maternity leave, writing, research, and publication opportunities, and childcare facilities. There was no statistically significant difference between the degree of satisfaction of nurses working in the maternity hospital and the variables of age, nationality, experience, education level, and marital status. The study concluded that maternity nurses are generally satisfied with nursing as a career choice and they are highly committed to the health care system, but some issues may lead to emotional exhaustion and, possibly, job dissatisfaction. Dignity: The challenge for nurses in long stay older adult units Jill Murphy, Department of Nursing and Midwifery, University of Limerick, Ireland E-mail: jill.murphy@ul.ie Dignity is seen by health care professions and older people as a basic right. However, the literature highlights the effects of situations where the dignity of older people in long term care settings is compromised. From frequent news reports it would appear that older people suffer from poor care. All nurses who work with older people would claim that they treat them with dignity. Why then does poor practice exist? The challenge of this study was to describe the maintenance and compromising of dignity in older adult long term care settings. Although dignity is a central tenet of nursing, it has not been operationally defined and there is only one tool to measure dignity. Evidence suggests that the health care system has failed to maintain dignity in long stay units for older adults, a factor attributed to the abstract concept of dignity and its precise definition. If nurses are to maintain a patient’s dignity, then nurses must have knowledge of the concept and an awareness of how to deliver care whilst maintaining an older adult’s dignity. The aim of this study was to describe how dignity is evidenced by nurses in older adult units. A quantitative descriptive study of 120 registered general nurses’ perceptions of dignity working in 8 long stay units for the older adult in Ireland. The author completed a preliminary concept analysis resulting in three attributes of dignity being used to develop the questionnaire. The study was analysed using the SPSS Package. Nurses maintained patient’s dignity on long stay units for older adults. However, areas where nurses compromised older patient’s dignity were also highlighted, including dignity being compromised when administering medication, feeding, and toileting and maintaining hygiene. Three intended learning outcomes were featured: 1) Describe how dignity is evidenced by nurses in older adult units; 2) Identify attributes of the concept of dignity; 3) Demonstrate how dignity is maintained and compromised when administering medication, nutrition, and toilet care, and maintaining hygiene in older adult units. Impact of In-Service Training Program on Operating Room Nurses for Reducing Incidence of Infection Nagwa Mohamad Ahmad, Zeinab Abdeltief, Amal Mohammed, Hala Ganam, Faculty of Nursing, Assuit University, Egypt E-mail: menah21@yahoo.com Infection control nurses are qualified experienced nurses who have taken further courses on infection control. They are there to advise staff on how to prevent cross-infection, care for patients with infectious disease, and to assist in the interpretation of hospital policies and procedures dealing with infection control. They are involved in finding and implementing the latest research on infection control, advising on new products, and updating procedures. They work closely with the microbiology department and the health and safety officer. The aim of this study was to investigate the impact of in-service training programmes on operating room nurses in reducing the incidence of infection at Elmbara Hospital, Egypt. A quasi-experimental research design was utilised in this study which was conducted over 2 months. Data were collected from 200 nurses working in operating rooms. The following were used in data collection: 1) a questionnaire to assess nurses’ knowledge; 2) an observation checklist sheet for the nurses to assess their practice, and 3) a training programme. An improvement in mean knowledge and practice scores were found after implementing the training programme. A positive correlation between nurses’ knowledge and practice scores was found immediately and 2 months after implementation of the training programme (P <0.0). A significant relationship was found between complications and patients’ sociodemographic characteristics in regards to age and sex. Implementation of an infection 260 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care control training programme resulted in a significant improvement in nurses’ knowledge and practice. Improving nurses’ knowledge and practice can favourably affect infections. Continued nursing education and in-service training programmes should be organised at Elmbara Hospital. It should be equipped with the necessary educational facilities and materials to improve nurses’ knowledge and skills which will result in better patient services and outcomes. Infection Control: Effect of a Designed Teaching Protocol on Nurses’ Knowledge and Practice Regarding to Haematemesis Patients Warda Youssef Mohamed, Fatema Abu-Baker Abdel’Moez, Samia Youssef Sayed, Ghada Thabet Mohammed, Faculty of Nursing, Assuit University, Egypt E-mail: samia-yusuf2012@yahoo.com The aim of this study was 1) to design a teaching protocol for nurses working with patients with haematemesis, and 2) to evaluate the effect of implementing the protocol on nurses’ knowledge and practice regarding haematemesis patients. The study’s hypothesis was that 1) the post-mean knowledge scores of nurses who are exposed to a designed teaching protocol will be higher than their pre-mean knowledge scores; 2) the post-mean practice scores of nurses who are exposed to a designed teaching protocol will be higher than their pre-mean practice scores; 3) a positive relationship will exist between knowledge and practice scores obtained by nurses receiving the designed teaching protocol. The study was conducted at the emergency unit of Assiut University Hospital. Data were collected from 50 nurses working in the emergency unit. Tools utilised were a questionnaire sheet to assess nurses’ knowledge in addition to some sociodemographic data; an observation check list sheet to assess nurses’ skills, and a designed teaching protocol. The first and second hypotheses were supported by a sharp improvement in the mean knowledge and practice scores after the application of the teaching protocol. The third hypothesis was supported by a positive correlation between the nurses’ knowledge and practice scores immediately after and 2 months after application of the teaching protocol. Patients with haematemesis and their nurses are at high risk for infection. Effective measures to prevent and reduce infection are needed. Improving nurses’ knowledge and practice can favourably affect the incidence and outcome of haematemesis. Quality of Life, Stress, and Coping of Nurses Working in Selected Hospitals of Karnataka, India: A pilot study Tessy Treesa Jose, College of Nursing, Manipal University, Manipal, India E-mail: tejo1994@yahoo.com Nurses make up the largest single group of health care professionals and are trained to consider patients’ quality of care and life, but seldom their own. They rarely consider that they themselves or others in the profession may need care. Lerner found a significant association between job strain and components of health-related quality of life (QOL). The aim of this study was to determine the QOL, stress, and coping of nurses. Instruments used in this study were a descriptive survey of 100 nurses, a demographic proforma, the WHOQOL-BREF, and the nursing stress scale and ways of coping questionnaire. The majority (83%) were 21–30years. Of those polled, 86% of the subjects were female, 69% were single, and 70% were from nuclear families. Most subjects were working in intensive care units (17%). The majority (64%) had 1–5 years’ of experience while 85% had 1–3years’ experience in their current area of work. The environmental domain of QOL obtained the highest score (26.61) while social domain obtained the lowest score (11.76). A total of 65% of the subjects had mild stress, while moderate stress was experienced by 34%. The mean stress score (6.87 + 3.09) was high for the nurses in the sub-area of death and dying, followed by workload (6.23 + 3.19). The lowest mean stress score was (2.7 + 1.63) in the area of inadequate preparation. The participants’ mean coping score was high (12.3) for positive reappraisal. No significant association was found between QOL, stress, and selected variables. A significant association was found between stress and area of work, coping and marital status, and monthly income, and area of work. A weak but statistically significant negative relationship was found between QOL and stress. A weak but significant relationship was found between stress and coping. No significant relationship was found between QOL and coping of nurses. QOL is affected by stress experienced by the nurses. Application of Infection Control Measures to Reduce Maternal Sepsis & Gynaecology in a Teaching Hospital, Wad Medani, Sudan Ietmad Ibrahim Abd. Elrahman Mohamed Kambal, Gazira University, Sudan E-mail: Ietimadkambal@yahoo.com This interventional study was conducted in the Obstetrics and Gynaecology Teaching Hospital in Wad Medani, Sudan. This study assessed the effect of a programme targeting the application of infection prevention and control measure on the knowledge, attitudes, and practices of nursing staff, and on the occurrence of sepsis among patient admitted to the hospital between 2003 and 2007. Hospital records were reviewed to identify the leading cause of maternal deaths. Knowledge, attitude, and practices of nursing staff were identified through their standardised pre-test question and observation checklist. The results of the study identified that sepsis, a leading cause of maternal deaths, was responsible for 34% of maternal deaths. The knowledge of respondents related to the standard precautions of hospital infection prevention and control measures improved significantly after a training programme. Prior to the training programme, 15% of respondents indicated having knowledge about hand washing techniques, whereas the percentage of those with proper knowledge about hand washing technique increased to 91% post-training. Respondents’ attitudes towards Abstracts | 261 Sultan Qaboos University, Oman, 28–29th November 2011 infection control measures and their willingness to use them was positively changed. Shortages of necessary supplies and equipment often impeded the achievement of safe levels of infection control. This shortage could also be due to the absence of supervision by an infection control committee. This study recommended periodic refreshers in the form of in-service training courses for nurses in order to update infection control knowledge and practices. Blended Teaching & Learning Mode - A success story to address the critical shortage in the nursing industry Vijaya Kumaran K.K.Nair and Michelle Zhong Yi, University Malaya, Malaysia E-mail: vknair1@yahoo.com In most parts of the world, nursing education has progressed to higher education; nursing education in Malaysia should head in the same direction. Malaysia needs nurses with critical thinking abilities and the motivation for life-long learning, and with skills in technology, communication, management, collaboration and leadership. Malaysia’s progress from hospital-based training to higher education has been rather slow compared with other countries. The Ministry of Health has mandated that in the future, 10% of nurses will have received tertiary education. Higher education for nurses is not a luxury nowadays, but a necessity. Nurses need to be educated at a higher level in order to equip themselves with the knowledge and skills that will empower them to practice innovatively, creatively, and autonomously. There is a need in Malaysia to establish an institution of higher learning to address these issues. Further there is a need to establish and develop a national capacity for retraining and upgrading registered nurses, medical assistants, and student nurses through blended learning, combining self- and face-to-face instruction delivered in a university-based learning environment supported by remote learning centres (RLC). This means establishing a new, distance education based mode for training/retraining registered nurses and medical assistants. Apart from conventional teaching and training methodologies, the varied modes of distance education technology should be explored to ensure that the right match is found. To ensure success, the approach should bring the education/training to the clients rather than expecting clients to be on campus. The vehicle to ensure success will be the integration of conventional teaching-learning methodology with state of the art technology without compromising the quality of education/training provided. Action learning, constructive learning, project-based learning and also problem-solving learning methods will be helpful. JIGSAW – An innovative approach to teaching students about cancer in children Lakshmi Renganathan, Oman Nursing Institute, Ministry of Health, Oman E-mail: lakshmirenganathan@yahoo.com A trial study was conducted to teach students about paediatric cancer through the JIGSAW method, a form of collaborative learning. The objective of the study was to incorporate an innovative approach to make the information more student-friendly. Twenty-six 3rd year nursing students were divided into 5 groups of 5–6 members each. “Cancer– Essential Concepts” was divided into 5 segments: a definition and general characteristics of cancer; classification of cancer; staging of cancer; assessment and lab diagnostic tests, and psychosocial implications. Each group was assigned one segment. The level of knowledge on cancer concepts was assessed through a quiz. On average, 95% of the students scored more than 60% in the post test. They also expressed that this method was very useful, enabled decision making, encouraged group discussion, and that they benefited by sharing knowledge. The students also said that it inculcated in them critical thinking. Therefore it can be concluded that this method is beneficial and can enhance the performance of nursing students. Study to Assess the Prevalence and Knowledge of Diabetes and Hypertension Among Adults Suja Karkada, Navaneetha, Ansuya, Manipal College of Nursing, Manipal, India E-mail: suja77@yahoo.com The aim of this study was to assess the prevalence and knowledge of diabetes and hypertension among adults, and to find the association between knowledge level and variables were conducted in selected villages of Udupi district. The study subjects were interviewed with a questionnaire tested for validity and reliability. Blood pressure was measured by using a calibrated mercury sphygmomanometer and each individual was screened for diabetes mellitus through the Benedict test. A total of 385 adults were selected by non-probability convenient sampling technique. Data was analysed using descriptive and inferential statistics. Of 385 adults, 27.8% were females and 72.2% had been educated up to the primary level. The majority (82.2%) of the adults were unskilled workers and 96% of them had exposure to mass media. The majority (50.4%) had average knowledge on diabetes mellitus and prevalence was found to be only 5%. The majority (50.6%) of the sample had an average level of knowledge about hypertension and the prevalence of hypertension was 19.5%. Results show that there is no significant association between knowledge and selected variables. 262 | SQU Medical Journal, May 2012, Volume 12, Issue 2 First International Nursing Conference Oman Innovations in Nursing Education and Practice Leading to Quality Care Overweight and Obesity and their Correlates among Jordanian Adolescents Shaher H. Hamaideh, Reham Y. Al-Khateeb, Ahmad B. Al-Rawashdeh, Zarqa University, Jordan E-mail: saharyakout@yahoo.com The aims of this study were to provide current estimates of the prevalence of overweight and obesity among Jordanian adolescents 14 to 17 years of age living in Irbid Governorate, and to determine the factors that are associated with overweight and obesity by using a descriptive correlation cross-sectional design. Body mass index, perceived stress, dietary habits, physical activity, and demographics of 824 Jordanian adolescents living in Irbid were measured through a multistage cluster sampling method. The overall prevalence of overweight and obesity was 19.1% and 6.3%, respectively. The prevalence of overweight and obesity among boys was 17.2% and 5.7%, respectively, and among girls was 21.0% and 7.0%, respectively. Both overweight and obesity rates were higher among girls. Physical activity, mother’s educational level, and number of family members were negatively correlated with overweight and obesity. On the other hand, eating breakfast regularly, mother’s weight, consumption of fried food, and perceived stress level were positively correlated with overweight and obesity. Overweight and obesity are becoming a health problem among both boys and girls in Jordan. Detecting the prevalence and the associated factors of overweight and obesity among adolescents is the first step toward proposing intervention strategies Developing an Enquiry Based Learning Template for Higher Education Rasha Ahmed, College of Nursing, Sultan Qaboos University, Oman E-mail: rasham@squ.edu.om There are no basic, clear guidelines for academics to realise criteria for enquiry-based learning (EBL). The aim of this study was to develop an EBL template in order to facilitate conversion from traditional didactic teaching to EBL. An extensive literature review was conducted to extract the critical key elements of a universal template. A qualitative approach of one-to-one interviews with experienced staff in developing/coordinating EBL modules at the University of Manchester (UM) was conducted. Twenty-two staff representing different faculties across UM were interviewed. The questions included: a) motivation for developing EBL (i.e. the decision to convert the course and the process of converting from conventional teaching to EBL); b) development and preparation (i.e. stimulating the students’ enquiry or trigger types); c) evaluation and feedback (i.e. maintaining good practice of the process), and d) the use of a universal template (i.e. what elements would make a useful template). All data was treated anonymously and subjected to content analysis. The template is an innovative approach to higher education teaching, and may enable academics to move easily and conveniently to EBL. Additionally, it will aid the university’s major strategy of enabling EBL methods to be developed widely across higher education institutes. Effectiveness of Computer Assisted Patient Education on Knowledge and Self- Efficacy Jayasree. R, Suja Karkad, Mariamma, Salalah Nursing Institute, Ministry of Health, Oman E-mail: jayasreebibi@gmail.com The aim of this study was to describe how much patients know about rheumatoid arthritis (RA) and what kind of self- efficacy they undertake. The aim was also to evaluate the effectiveness of computer-assisted patient education in terms of knowledge and self-efficacy. An evaluative, one group pre-test/post-test design was used. Data were collected from 76 patients who attended the rheumatology polyclinic at Sultan Qaboos Hospital, Salalah. The Arabic version of the patient knowledge questionnaire (PKQ) and the arthritis self-efficacy scale (ASES) were used at baseline, and after 30 days of teaching. Of the 76 patients studied, 90.8% were females, 29% were between 40 and 49 years, 41% were illiterate, and 79% were unemployed. The mean pre-test score of the PKQ was 10.61 ± 4.16.Tthe subscale of RA general knowledge had a better mean, at 3.58 ± 1.70 than that of the knowledge of drugs (1.74 ± 1.14). The mean pre-test scores of subscales exercise were 2.65 ± 1.28 and that of joint protection and energy conservation was 2.64 ± 1.75. 50% of the sample had average knowledge and 48.6% poor knowledge. The mean pre-test self-efficacy scores for pain, function, and other symptoms were 4.60 ±1.71, 4.99 ± 1.76, and 4.81 ± 2, respectively. The post-test score of knowledge was 21.69 ± 4.04 and self- efficacy was 7.25 ±1.46. The Wilcoxon-matched pairs signed-rank test showed that knowledge and self -efficacy improved with patient education (Z = -7.44, P <0.0001; Z = -7.19, P <0.0001, respectively). Correlation of knowledge and self-efficacy was significant (r = 0.31, P = 0.007). Education helps patients become accustomed to living with RA. A Systematic Review Regarding the Effectiveness of High-Fidelity Computerised Simulation in Nursing Education Asiya Said Saif Al-Hasni, Oman Specialised Nursing Institute, Oman E-mail: ondeal@hotmail.com Despite the recent move towards the use of high-fidelity simulation (HFS) in nursing education, it has been available since 1960. The current interest in HFS is due to several factors. Policies towards ‘fitness for practice’, advanced technology, nursing shortages, an increase in the number of nursing students, and patient safety concerns are motivating educators to look for new alternatives. Therefore, the aim of this review is to identify the best evidence for the effectiveness of Abstracts | 263 Sultan Qaboos University, Oman, 28–29th November 2011 HFS on the knowledge, skill, confidence and critical thinking of pre- and post-registration nursing students. The review includes randomised and non-randomised controlled trials which investigated the effects of simulation on nursing students in their education and learning processes between 2000 and 2009. The participants included pre-registered and post-registered nursing students. The interventions included any study evaluating HFS, all of which were considered for inclusion in the review. The search strategy employed defined search and retrieval methods, with MEDLINE, CINAHL, PubMed, British Nursing Index, Psyc INFO and EMBASE accessed for the period of 2000–2009. Nine papers were assessed by two independent reviewers for methodological quality prior to inclusion in the review. For this purpose, the standardised critical appraisal instruments for evidence of effectiveness were used. Differences of opinion were dealt with by consulting with a third reviewer. Six papers were finally included in the review and were analysed using narrative analysis. HFS could significantly affect the knowledge, skill, and confidence of pre-registered nursing students. In addition, the systematic review indicated HFS can increase the confidence of post-registered nursing students. However, there was no evidence to show that HFS can significantly change the critical thinking of students. Additionally, no evidence was found which investigated the effectiveness of HFS on the knowledge and skill of post-registered nursing students. Q-Methodology: A combination of qualitative and quantitative methods in Nursing Research Noori Akhtar-Danesh, McMaster University, Canada E-mail: daneshn@mcmaster.ca Q-methodology is a research method where qualitative data are analysed using quantitative techniques. Although it was introduced by William Stephenson in 1935, it is only now emerging as a widely used method in health research, mainly because of advances in its statistical analysis component. It has the strengths of both qualitative and quantitative methods and can be regarded as a bridge between these two approaches. Q-methodology is usually used where the outcome variable involves assessment of subjectivity, including attitudes, perceptions, feelings and values, life experiences such as stress and quality of life, and intra-individual concerns such as self-esteem, body image, and satisfaction. It is used to identify unique and salient viewpoints as well as shared views, thereby providing unique insights into the richness of human subjectivity. In this workshop, different steps of Q-methodology in health research are explained as applied to a research topic. Participants will have the opportunity to participate actively in the different steps of the research process. Also, some common issues in Q-methodology such as sample size, reliability and validity, and interpretation of the statistical analysis will be discussed. The Health Research Strategy at the Research Council Ahmed Al-Shukaili, The Research Council, Oman E-mail: ahmed.alshukaili@trc.gov.om The Research Council (TRC) was established by a Royal Decree in June 2005. In November 2006, work began to prepare the organisational structure and develop a national research strategy for Omani science and technology; this was accomplished in 2007. The objectives of TRC are to build research capacity mechanisms, achieve research excellence, build knowledge transfer and value capture, and to provide an enabling environment for research and innovation. The TRC’s overall health research mission is to build research capabilities in a responsive, evidence-based, cost-effective health care system that promotes healthy lifestyles, encourages preventive medicine, and ensures delivery to all citizens. Also, TRC strives to develop collaborative and multi-disciplinary research in genetics, nanotechnology and biotechnology. The health research strategy at TRC is divided into 8 fields. The first, health care delivery systems research, covers health care systems management; primary, secondary and tertiary health care; pharmaceutical health care and nursing care; and quality assurance and patient care. The second covers human resource development research, while the third covers epidemiological research such as disease and injuries tracking; prevention and control; communicable and non-communicable diseases; environmental and occupational health; accidents and injuries, and public health. The remaining fields are health care financing and economic research, health policy research, medical sciences research, and health studies and medical science research.