Chronic Myeloid Leukemia in Adolescents and Young Adults: Clinicopathological Variables and Outcomes.

INTRODUCTION: Adolescents and young adults (AYAs) diagnosed with chronic myeloid leukemia (CML) constitute a significant demographic group, particularly in regions with youthful populations like Qatar. Despite the global median age of CML diagnosis being 65 years, Qatar's age distribution reflects a younger cohort. This study investigates whether AYAs with CML exhibit distinct clinicopathological characteristics or outcomes compared to older age groups. METHODS: A total of 224 CML patients were enrolled, including 114 AYAs (defined as ages 15 through 39). Demographic and clinical parameters, including gender, BMI, BCR-ABL1 transcript type, white blood cell (WBC) count, hemoglobin level, platelet count, and spleen size, were compared between AYAs and older patients. Prognostic scoring systems (Sokal, Hasford, EUTOS, and ELTS) and molecular response rates (MMR and DMR) were also evaluated. RESULTS: AYAs demonstrated higher WBC counts at diagnosis (median 142.3 vs. 120; p = 0.037) and lower hemoglobin levels (10.5 vs. 11.40; p = 0.004) compared to older patients. Spleen size was significantly larger in AYAs (18.8 vs. 15.5; p = 0.001). While AYAs showed better prognostic scores by Sokal and Hasford criteria, EUTOS and ELTS scores indicated comparable risk stratification. However, AYAs exhibited lower rates of MMR (56.7 vs. 73.4%; p = 0.016) and achieved MMR at a slower pace (median time 130 vs. 103 months; p = 0.064). Similarly, the percentage of DMR was lower in AYAs (37.1 vs. 46.8%; p = 0.175). CONCLUSION: Despite their younger age, AYAs with CML displayed poorer prognoses compared to older patients. These findings underscore the importance of tailored management strategies for AYAs with CML to optimize outcomes in this distinct patient population. KEY POINT: AYAs are underrepresented in CML studies and risk scores, so this is the focus of this study.

Utilizing machine learning to facilitate the early diagnosis of posterior circulation stroke.

BACKGROUND: Posterior Circulation Syndrome (PCS) presents a diagnostic challenge characterized by its variable and nonspecific symptoms. Timely and accurate diagnosis is crucial for improving patient outcomes. This study aims to enhance the early diagnosis of PCS by employing clinical and demographic data and machine learning. This approach targets a significant research gap in the field of stroke diagnosis and management. METHODS: We collected and analyzed data from a large national Stroke Registry spanning from January 2014 to July 2022. The dataset included 15,859 adult patients admitted with a primary diagnosis of stroke. Five machine learning models were trained: XGBoost, Random Forest, Support Vector Machine, Classification and Regression Trees, and Logistic Regression. Multiple performance metrics, such as accuracy, precision, recall, F1-score, AUC, Matthew's correlation coefficient, log loss, and Brier score, were utilized to evaluate model performance. RESULTS: The XGBoost model emerged as the top performer with an AUC of 0.81, accuracy of 0.79, precision of 0.5, recall of 0.62, and F1-score of 0.55. SHAP (SHapley Additive exPlanations) analysis identified key variables associated with PCS, including Body Mass Index, Random Blood Sugar, ataxia, dysarthria, and diastolic blood pressure and body temperature. These variables played a significant role in facilitating the early diagnosis of PCS, emphasizing their diagnostic value. CONCLUSION: This study pioneers the use of clinical data and machine learning models to facilitate the early diagnosis of PCS, filling a crucial gap in stroke research. Using simple clinical metrics such as BMI, RBS, ataxia, dysarthria, DBP, and body temperature will help clinicians diagnose PCS early. Despite limitations, such as data biases and regional specificity, our research contributes to advancing PCS understanding, potentially enhancing clinical decision-making and patient outcomes early in the patient's clinical journey. Further investigations are warranted to elucidate the underlying physiological mechanisms and validate these findings in broader populations and healthcare settings.

Efficacy and safety of aspirin plus clopidogrel versus aspirin alone in ischemic stroke or high-risk transient ischemic attack: A meta-analysis of randomized controlled trials.

Background: Antiplatelet therapy plays an important role in reducing the risk of stroke recurrence in patients with mild ischemic stroke or high-risk transient ischemic attack (TIA). However, data regarding the effectiveness and safety of using aspirin plus clopidogrel in dual antiplatelet therapy (DAPT) compared to aspirin alone in mild ischemic stroke is limited. Methods: PubMed/MEDLINE, Embase, Cochrane Library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) that compared DAPT to aspirin alone started within 72 hours in mild ischemic stroke or high-risk TIA. We used a random effects model to pool risk ratios (RRs) along with 95% CIs for clinical outcomes. Results: Four RCTs with 16,547 patients were included in this study. DAPT significantly reduced the risk of recurrent stroke by 26% (RR: 0.74; 95% CI: 0.67-0.83; p < 0.00001), ischemic stroke by 28% (RR: 0.72; 95% CI: 0.65-0.80; p < 0.00001), and major adverse cardiovascular events (MACE) by 24% (RR: 0.76; 95% CI: 0.68-0.84; p < 0.00001) compared to aspirin monotherapy. However, DAPT was associated with a significantly increased risk of moderate or severe bleeding (RR: 1.88; 95% CI: 1.10-3.23; p = 0.02) compared to aspirin alone. No significant differences were observed for hemorrhagic stroke (RR: 1.77; 95% CI: 0.96-3.29; p = 0.07), all-cause mortality (RR: 1.25; 95% CI: 0.87-1.80; p = 0.23), cardiovascular mortality (RR: 1.38; 95% CI: 0.81-2.33; p = 0.23), and myocardial infarction (RR: 1.63; 95% CI: 0.77-3.46; p = 0.20). Conclusion: DAPT involving aspirin plus clopidogrel reduces stroke recurrence and MACE but can lead to an increased risk of moderate or severe bleeding compared to aspirin monotherapy. (PROSPERO ID: CRD42024499310).

Quercetin for the treatment of COVID-19 patients: A systematic review and meta-analysis.

Currently approved therapies for COVID-19 are mostly limited by their low availability, high costs or the requirement of parenteral administration by trained medical personnel in an in-hospital setting. Quercetin is a cheap and easily accessible therapeutic option for COVID-19 patients. However, it has not been evaluated in a systematic review until now. We aimed to conduct a meta-analysis to assess the effect of quercetin on clinical outcomes in COVID-19 patients. Various databases including PubMed, the Cochrane Library and Embase were searched from inception until 5 October 2022 and results from six randomized controlled trials (RCTs) were pooled using a random-effects model. All analyses were conducted using RevMan 5.4 with odds ratio (OR) as the effect measure. Quercetin decreased the risk of intensive care unit admission (OR = 0.31; 95% confidence interval (CI) 0.10-0.99) and the incidence of hospitalisation (OR = 0.25; 95% CI 0.10-0.62) but did not decrease the risk of all-cause mortality and the rate of no recovery. Quercetin may be of benefit in COVID-19 patients, especially if administered in its phytosome formulation which greatly enhances its bioavailability but large-scale RCTs are needed to confirm these findings.

The experience of patients with hematological malignancy in their terminal stage: a phenomenological study from Jordan's perspective.

BACKGROUND: Patients diagnosed with hematological malignancies residing in low-middle-income countries undergo significant physical and psychological stressors. Despite this, only 16% of them receive proper care during the terminal stages. It is therefore crucial to gain insight into the unique experiences of this population. AIM: To have a better understanding of the needs and experiences of adult patients with advanced hematological malignancy by exploring their perspectives. METHODS: A qualitative interpretive design was employed to collect and analyze data using a phenomenological approach. The study involved in-depth interviews with ten participants aged between 49 and 65 years, utilizing a semi-structured approach. RESULTS: Two primary themes emerged from the participants' experiences of reaching the terminal stage of illness: "Pain, Suffering, and Distress" and "Spiritual Coping." The first theme encompassed physical and emotional pain, suffering, and distress, while the second theme was centered on the participants' spiritual coping mechanisms. These coping mechanisms included seeking comfort in religious practices, relying on spiritual support from family and friends, and finding solace in their beliefs and faith. CONCLUSION: Patients with hematological malignancies in the terminal stages of their disease experience severe pain, considerable physical and psychosocial suffering, and spiritual distress. While they require support to cope with their daily struggles, their experiences often go unnoticed, leading to disappointment and loss of dignity. Patients mainly rely on their spirituality to cope with their situations. Healthcare providers must acknowledge these patients' needs and provide more holistic and effective care.

Artificial intelligence-enhanced electrocardiography for accurate diagnosis and management of cardiovascular diseases.

Electrocardiography (ECG), improved by artificial intelligence (AI), has become a potential technique for the precise diagnosis and treatment of cardiovascular disorders. The conventional ECG is a frequently used, inexpensive, and easily accessible test that offers important information about the physiological and anatomical state of the heart. However, the ECG can be interpreted differently by humans depending on the interpreter's level of training and experience, which could make diagnosis more difficult. Using AI, especially deep learning convolutional neural networks (CNNs), to look at single, continuous, and intermittent ECG leads that has led to fully automated AI models that can interpret the ECG like a human, possibly more accurately and consistently. These AI algorithms are effective non-invasive biomarkers for cardiovascular illnesses because they can identify subtle patterns and signals in the ECG that may not be readily apparent to human interpreters. The use of AI in ECG analysis has several benefits, including the quick and precise detection of problems like arrhythmias, silent cardiac illnesses, and left ventricular failure. It has the potential to help doctors with interpretation, diagnosis, risk assessment, and illness management. Aside from that, AI-enhanced ECGs have been demonstrated to boost the identification of heart failure and other cardiovascular disorders, particularly in emergency department settings, allowing for quicker and more precise treatment options. The use of AI in cardiology, however, has several limitations and obstacles, despite its potential. The effective implementation of AI-powered ECG analysis is limited by issues such as systematic bias. Biases based on age, gender, and race result from unbalanced datasets. A model's performance is impacted when diverse demographics are inadequately represented. Potentially disregarded age-related ECG variations may result from skewed age data in training sets. ECG patterns are affected by physiological differences between the sexes; a dataset that is inclined toward one sex may compromise the accuracy of the others. Genetic variations influence ECG readings, so racial diversity in datasets is significant. Furthermore, issues such as inadequate generalization, regulatory barriers, and interpretability concerns contribute to deployment difficulties. The lack of robustness in models when applied to disparate populations frequently hinders their practical applicability. The exhaustive validation required by regulatory requirements causes a delay in deployment. Difficult models that are not interpretable erode the confidence of clinicians. Diverse dataset curation, bias mitigation strategies, continuous validation across populations, and collaborative efforts for regulatory approval are essential for the successful deployment of AI ECG in clinical settings and must be undertaken to address these issues. To guarantee a safe and successful deployment in clinical practice, the use of AI in cardiology must be done with a thorough understanding of the algorithms and their limits. In summary, AI-enhanced electrocardiography has enormous potential to improve the management of cardiovascular illness by delivering precise and timely diagnostic insights, aiding clinicians, and enhancing patient outcomes. Further study and development are required to fully realize AI's promise for improving cardiology practices and patient care as technology continues to advance.

Workplace resilience and compassionate care among Jordanian private sector nurses.

BACKGROUND: Compassionate care is a hallmark of the nursing profession. Yet, nursing is beset by perennial problems, not the least of which is nursing shortage and increased workload. As such, resilience becomes a critical ingredient that nurses must possess to overcome such challenges. However, there needs to be more evidence of the relationship between compassionate care and resilience within the Jordanian nursing context. AIM: To explore the relationship between workplace resilience and compassionate care among Jordanian nurses working in the private sector. METHODS: The study utilized a descriptive cross-sectional correlational design. Convenience sampling with inclusion-exclusion criteria was used to select participants from three private hospitals in Jordan. The Compassionate Care Questionnaire was used to measure levels of compassionate care, and the Resilience at Work Scale was used to measure workplace resilience. Ethical approval was obtained before data collection. RESULTS: A total of 161 nurses participated in the study. Participants had high levels of compassionate care and workplace resilience. Male nurses and nurses with lower workloads had significantly higher levels of compassionate care. Likewise, older nurses, nurses with postgraduate degrees, and nurses with experience of less than 5 years in the current area had significantly higher levels of workplace resilience. Compassionate care had a mordantly solid and significant positive relationship with workplace resilience and all its seven dimensions (living authentically, finding one's calling, maintaining perspective, managing stress, interacting cooperatively, staying healthy, and building networks. CONCLUSION: Developing workplace resilience can support nurses in implementing compassionate care. Nurse Managers and hospital administrators must consider the effects of compassionate care and workplace resilience on nurses and patients. Future research can include a longitudinal exploration of compassionate care and workplace resilience and an investigation of the levels of these variables outside a hospital setting.

The mediating role of learning motivation in the relationship among perceived stress and emotional regulation among Saudi nursing students in clinical practice.

BACKGROUND: Nursing students often face high levels of stress due to demanding responsibilities during clinical placement. Emotional regulation, the ability to manage and regulate one's emotions effectively, is crucial for nursing students in dealing with stress and maintaining their overall well-being. Additionally, learning motivation plays a vital role in students' engagement and academic success. The current investigation aimed at studying the link that exists among stress, learning motivation, and emotional regulation among Saudi undergraduate nursing students. The study also aimed at investigating the sequential mediating effects that motivation might perform in this association. METHODS: A quantitative cross-sectional methodology was used in the present research, which recruited 367 Saudi undergraduate nursing students. RESULTS: The results of the ANOVA showed that the level of perceived stress was linearly and negatively correlated with emotional regulation and motivation. Upon conducting structural equation modeling, significant direct and indirect effect pathways were identified between perceived stress, emotional regulation, and motivation, while only indirect pathways were identified between perceived stress and emotional regulation. CONCLUSIONS: This study provides evidence of the mediating role of learning motivation in the relationship between perceived stress and emotional regulation among Saudi nursing students. The results highlight the negative impact of stress on emotional regulation and learning motivation and emphasize the importance of addressing motivational factors in interventions aimed at enhancing emotional regulation among nursing students.

Bridging the generational gap between nurses and nurse managers: a qualitative study from Qatar.

BACKGROUND: The nursing workforce comprises multiple generations, each with unique values, beliefs, and expectations that can influence communication, work ethic, and professional relationships. In Qatar, the generational gap between nurses and nurse managers poses challenges to effective communication and teamwork, impacting job satisfaction and patient outcomes. AIM: This study investigates the generational gap between nurses and nurse managers in Qatar, aiming to identify strategies to enhance collaboration and create a positive work environment. METHODS: A qualitative research design was used, involving semi-structured interviews with 20 participants, including frontline nurses and senior nurse managers. Participants were purposively sampled to represent different generations. Data were collected through face-to-face and virtual interviews, then transcribed and thematically analyzed. FINDINGS: Four key themes emerged: Optimizing the Work Environment: Older generations preferred transformational and situational leadership, while younger nurses valued respect, teamwork, accountability, and professionalism. Strengthening Work Atmosphere through Communication and values: Older nurses favored face-to-face communication, while younger nurses preferred digital tools. Cultivating Respect and Empathy: Younger nurses emphasized fairness in assignments and promotions, while older nurses focused on empathy and understanding. Dynamic Enhancement of Healthcare Systems: Younger nurses were more adaptable to technology and professional development, while older nurses prioritized clinical care and patient outcomes. CONCLUSION: The study reveals significant generational differences in leadership preferences, communication styles, and adaptability to technology. Addressing these gaps through effective leadership, ongoing education, and open communication can improve job satisfaction and patient care.

Current Landscape and Future Directions of Deprescribing and Polypharmacy Practices in Jordan.

This review explores the current landscape and future directions of deprescribing and polypharmacy practices in Jordan. The prevalence of polypharmacy, defined as the concurrent use of multiple medications by an individual, has been increasing in recent years due to various factors, such as population aging and the greater availability of medications. However, polypharmacy can lead to adverse drug events, suboptimal medication adherence, increased healthcare costs, and reduced quality of life. Deprescribing, on the other hand, involves the discontinuation or reduction of unnecessary or potentially harmful medications to improve patient outcomes. The findings presented in this review highlight the current state of deprescribing and polypharmacy practices in Jordan, including factors influencing their prevalence. Additionally, it discusses the challenges healthcare professionals face in implementing deprescribing strategies and identifies potential solutions for enhancing these practices in Jordanian healthcare settings. Moreover, this paper provides insights into future directions for deprescribing and polypharmacy practices in Jordan. Overall, this review offers valuable insights into the current landscape of deprescribing and polypharmacy practices in Jordan while also providing recommendations for future directions to optimize medication management strategies that can ultimately benefit patient outcomes within a sound healthcare system framework.

Bridging the gap: How investing in advanced practice nurses could transform emergency care in Africa.

AIM: This paper aims to highlight the vital importance of investing in advanced practice nursing (APN) for enhancing emergency care throughout Africa. BACKGROUND: APN's role is increasingly recognized as pivotal in optimizing healthcare, particularly in emergency settings in Africa. It offers improved patient care quality and strengthens the healthcare workforce. SOURCES OF EVIDENCE: Evidence is drawn from successful implementations of APN in various healthcare environments. This includes the development of APN-specific curricula and training, mentorship initiatives, clinical supervision, and defining advanced nursing roles within healthcare organizations. Investing in APNs in emergency care in Africa can lead to improved quality and access to care, cost-effectiveness, enhanced patient outcomes and satisfaction, and opportunities for professional development and career advancement in the healthcare workforce. DISCUSSION: Despite facing barriers in implementation, APN in emergency care presents innovative solutions. Investing in APN can help healthcare entities and policymakers surmount these challenges, providing specialized patient care and improving health outcomes. The discussion emphasizes the benefits such as enhanced access to care, reduced healthcare costs, and improved patient outcomes, alongside bolstering the healthcare workforce. CONCLUSION: The necessity and benefits of investing in APN for emergency care in Africa are clear. It is crucial for improving healthcare delivery and outcomes. IMPLICATIONS FOR NURSING PRACTICE: APN investment leads to a more competent and efficient nursing workforce, capable of addressing complex emergencies and improving patient care. IMPLICATIONS FOR NURSING POLICY AND HEALTH/SOCIAL POLICY: The paper advocates for policies that support APN development and integration into the healthcare system, emphasizing the need for research to assess APN's long-term impact and establish best practices for its implementation in emergency care across Africa.

Liver ultrasound evaluation of acutely increased liver function tests of COVID-19 hospitalized patients.

Background: The incidence of hepatic abnormalities has been notably higher following the coronavirus disease 2019 (COVID-19) infection, attributed to the virus's entry into cells via angiotensin-converting enzyme 2 (ACE2) surface expression. The gastrointestinal tract's significant ACE2 expression, alongside a lesser degree in the biliary epithelium, has been implicated in gastrointestinal symptoms and liver injury. Purpose: The aim of this study was to determine whether specific ultrasonographic findings in the liver correlate with acute increases in liver function tests (LFTs) among hospitalized patients. Methods: A retrospective analysis was conducted on hospitalized COVID-19 patients at Hazem Mebaireek General Hospital in Qatar, from March 1, 2020, to June 30, 2020. The study focused on patients who experienced acute increases in LFTs, excluding those with chronic liver disease. Ultrasound imaging and patient records were reviewed to gather data. Results: Out of 223 ultrasound studies of COVID-19 patients, 158 met the inclusion criteria. The majority were male, with a mean age of 47.76 ± 13.76 years. Ultrasound results showed 43.7% normal liver parenchyma, while 56.3% exhibited nonspecific abnormalities such as diffuse liver hyperechogenicity (39.2%), enlargement with diffuse hyperechogenicity (12.7%), and other findings (4.4%). The biliary tree was predominantly normal (96.2%), with 3.8% showing abnormalities, including intrahepatic (2.5%) and extrahepatic (1.3%) dilatation. Gallbladder evaluations were normal in 60.1% of cases, with 39.9% showing abnormalities like stones (6.3%), stones with sludge (13.3%), polyps (6.3%), wall thickening (1.9%), and other conditions (12%). A significant correlation was found between abnormal liver parenchyma findings and elevated levels of bilirubin (total and direct) and alkaline phosphatase, with p-values < 0.05. Only aspartate aminotransferase levels showed a significant correlation with biliary tree abnormalities. Conclusion: The most common ultrasonographic finding associated with acute increases in LFTs among hospitalized COVID-19 patients was diffuse liver hyperechogenicity, with or without enlargement. These findings suggest a nonspecific yet significant association with liver function anomalies in the context of COVID-19.

Angiotensin-converting enzyme 2 (ACE2) polymorphisms and susceptibility of severe SARS-CoV-2 in a subset of Pakistani population.

Science is digging for the varied presentation of COVID-19 patients exposed to the same risk factors, and medical conditions may be influenced by the presence of polymorphic genetic variants. This study investigated the link between ACE2 gene polymorphisms and the severity of SARS-CoV-2. This cross-sectional study recruited COVID-19 PCR-positive patients by consecutive sampling from Ziauddin Hospital from April to September 2020. DNA was extracted from whole blood, followed by gene amplification and Sanger's sequencing. Most of the patients, 77: 53.8%, were serious. Males were higher (80; 55.9%) with age more than 50 years (106: 74.1%). We found 22 ACE2 SNPs. rs2285666 SNP was most prevalent with 49.2% CC, 45.2% TT, 4.8% CT heterozygosity, and 0.8% AA genotypes. Variants with multiple genotypes were also insignificantly associated with the severity of COVID-19 in the analysis of the dominant model. Only rs2285666 had a significant statistical link with gender (p-value 0.034, OR; 1.438, CI; 1.028-2.011) while rs768883316 with age groups (p-value 0.026, OR; 1.953, CI; 1.085-3.514). Haplotypes ATC of three polymorphisms (rs560997634, rs201159862, and rs751170930) commonly found in 120 (69.77%) and TTTGTAGTTAGTA haplotype consisting of 13 polymorphisms (rs756737634, rs146991645, rs1601703288, rs1927830489, rs1927831624, rs764947941, rs752242172, rs73195521, rs781378335, rs756597390, rs780478736, rs148006212, rs768583671) in 112 (90.32%) had statistically significant association with the severity having p = value 0.029 and 0.001 respectively. Males of old age and diabetics are found to have more severe COVID-19 infection in the current study. We also found that common ACE2 polymorphism rs2285666 influences the susceptibility of acquiring the severe SARS-CoV-2 infection.

Implications of the medication regimen complexity index score on hospital readmissions in elderly patients with heart failure: a retrospective cohort study.

BACKGROUND: The likelihood of elderly patients with heart failure (HF) being readmitted to the hospital is higher if they have a higher medication regimen complexity index (MRCI) compared to those with a lower MRCI. The objective of this study was to investigate whether there is a correlation between the MRCI score and the frequency of hospital readmissions (30-day, 90-day, and 1-year) among elderly patients with HF. METHODS: In this single-center retrospective cohort study, MRCI scores were calculated using a well-established tool. Patients were categorized into high (≥ 15) or low (< 15) MRCI score groups. The primary outcome examined the association between MRCI scores and 30-day hospital readmission rates. Secondary outcomes included the relationships between MRCI scores and 90-day readmission, one-year readmission, and mortality rates. Multivariate logistic regression was employed to assess the 30- and 90-day readmission rates, while Kaplan-Meier analysis was utilized to plot mortality. RESULTS: A total of 150 patients were included. The mean MRCI score for all patients was 33.43. 90% of patients had a high score. There was no link between a high MCRI score and a high 30-day readmission rate (OR 1.02; 95% CI 0.99-1.05; p < 0.13). A high MCRI score was associated with an initial significant increase in the 90-day readmission rate (odd ratio, 1.03; 95% CI, 1.00-1.07; p < 0.022), but not after adjusting for independent factors (odd ratio, 0.99; 95% CI, 0.95-1.03; p < 0.487). There was no significant difference between high and low MRCI scores in their one-year readmission rate. CONCLUSION: The study's results indicate that there is no correlation between a higher MRCI score and the rates of hospital readmission or mortality among elderly patients with HF. Therefore, it can be concluded that the medication regimen complexity index does not appear to be a significant predictor of hospital readmission or mortality in this population.

Palliative care needs of Jordanian women's experience of living with stroke: a descriptive phenomenological study.

BACKGROUND: Stroke is a prevalent neurological disease that can have a profound impact on women's physical, psychosocial, and spiritual well-being. In many cases, women living with stroke may have marginalized palliative care needs that are often not adequately addressed by healthcare providers. Unfortunately, the experience of women with stroke and their specific palliative care needs have been largely overlooked in research conducted in Jordan. AIM: The purpose of this study is to examine the specific palliative care needs of women who have experienced a stroke and are currently living in Jordan. By conducting this research, we aim to identify the various physical, emotional, social, and spiritual needs of women with stroke and gain a better understanding of how these needs can be addressed through palliative care interventions. METHODS: This research utilized a phenomenological descriptive study approach to explore the experiences of twelve women recruited from the outpatient clinic of rehabilitation centers. The data was collected through semi-structured interviews. The analysis was conducted using the method of Colaizzi (1978), which involves identifying significant statements, extracting meanings, and formulating an exhaustive description of the phenomenon under study. RESULTS: The study findings uncovered three primary themes that reflect the palliative care needs of women who are currently living with stroke in Jordan, including (1) Spiritual practices, beliefs, and needs; (2) Coping with distressing symptoms; and (3) Managing the delivery of unfavorable news. DISCUSSION: This study provides valuable insights into the experiences of Jordanian women living with stroke, highlighting the far-reaching consequences of this condition on various aspects of their lives. The findings reveal that stroke has a significant impact on women's physical, emotional, social, and spiritual well-being, with many facing unmet palliative care needs. By illuminating these challenges, our study underscores the importance of taking a holistic approach to stroke care that addresses the multifaceted needs of women living with stroke. Healthcare providers must consider these findings and integrate palliative care interventions into treatment plans to improve the quality of life of women living with stroke in Jordan. CONCLUSION: This study provides valuable insights into the palliative care needs of women who have experienced a stroke. Our findings highlight the importance of addressing women's physical, psychosocial, and spiritual needs as part of a comprehensive approach to stroke care. We recommend integrating palliative care interventions into rehabilitation programs to improve the quality of life of women living with stroke in Jordan. By doing so, we can address the pain and complications that can arise from stroke, while also providing holistic support to address the emotional and spiritual impact of the illness. This approach has the potential to improve outcomes for women living with stroke and enhance their overall well-being.

Satisfaction and self-confidence among nursing students with simulation learning during COVID-19.

AIM: This survey aimed to investigate nursing students' satisfaction and self-confidence in simulation in education during the COVID-19 pandemic. Along with comparing these levels based on selected students' characteristics. DESIGN: A cross-sectional survey. METHODS: The survey was conducted at the faculty of nursing of a private university in Jordan. Students' satisfaction and self-confidence levels in simulation learning were measured using the National League for Nursing (NLN) Student Satisfaction and Self-confidence in Learning Scales. RESULTS: A total of 138 undergraduate nursing students participated in the survey. Students' satisfaction levels and self-confidence in simulation learning were lower (just above the scale's midpoint) than scores reported in similar surveys. The lowest student ratings were reported as "the variety of learning activities that can be done using simulation" and "the self-confidence to develop the needed skills and knowledge to be used in real clinical settings". The results also indicated that as students' progress in the bachelor's degree program, they develop higher levels of self-confidence in simulation-based learning. CONCLUSIONS: Nursing students' experience of simulation learning was observed to be negatively affected by the COVID-19 pandemic. High-fidelity simulation, in particular, among other simulation modalities, can be more beneficial in similar situations. Education stakeholders are invited to invest in the resources of high-fidelity simulation to maximize its benefits and help in the recovery phase after the pandemic.

The association of patient safety culture with intent to leave among Jordanian nurses: a cross-sectional study.

BACKGROUND: The existence of patient safety culture is crucial for healthcare providers' retention, particularly for nurses. Patient safety culture is getting more attention from healthcare organizations worldwide, and Jordan is no exception. Nurses' satisfaction and retention are paramount to providing safe, high-quality patient care. PURPOSE: To investigate the relationship between patient safety culture and intent to leave among Jordanian nurses. METHODS: A descriptive cross-sectional design was used. A sample of 220 nurses was selected through convenience sampling from one governmental and one private hospital in Amman. The patient safety culture survey and anticipated turnover scale were used to collect data. Descriptive statistics and Pearson r correlation were used to answer the research questions. RESULTS: The findings showed that nurses had 49.2% positive scores for patient safety. Teamwork (65.3%) and handoff and exchange of information (62% each) had the highest scores, while staffing and workplace (38.1%) and response to error (26.6%) had the lowest. Moreover, nurses had strong intentions to leave their jobs (M = 3.98). A moderately significant but not highly negative relationship existed between patient safety culture and intent to leave (r = -0.32, p = 0.015). CONCLUSIONS: There are opportunities to improve patient safety culture, satisfaction, and nurse retention in Jordanian hospitals by implementing several recommendations, such as ensuring better staffing patterns and increasing staff motivation by utilizing various available methods.

The relationship between emotional intelligence and organizational commitment among nurses working in governmental hospitals in Jordan.

INTRODUCTION: Nurses' emotions and feelings in response to their environment and their ability to manage their emotions can significantly affect several aspects of their job. In Jordan, studies are still investigating whether emotional intelligence is significantly related to organizational commitment. AIM: To investigate whether a significant relationship exists between emotional intelligence and organizational commitment among Jordanian nurses working in governmental hospitals in Jordan. METHODS: The study used a descriptive cross-sectional correlational design. A convenience sampling method was used to recruit participants working in governmental hospitals. A total of 200 nurses participated in the study. A participant information sheet developed by the researcher was used to obtain the participants' socio-demographic characteristics, the Emotional Intelligence Scale (EIS) developed by Schutte and colleagues, and the Organizational Commitment Scale developed by Meyer and Allen were utilized for data collection. RESULTS: Participants had high levels of emotional intelligence (M, SD = 122.3, 14.0) and moderate levels of organizational commitment (M, SD = 81.6, 15.7). Emotional intelligence had a significant, positive relationship with organizational commitment (r = 0.53, p < 0.01). Male nurses, widowed nurses, and nurses with higher postgraduate qualifications demonstrated significantly higher levels of emotional intelligence and organizational commitment than female nurses, single nurses, and nurses with undergraduate degrees (p < 0.05). CONCLUSION: Participants in the current study were highly emotionally intelligent and moderately committed to their organizations. Policies supporting the implementation of interventions to improve organizational commitment and maintain a high level of emotional intelligence should be developed and promoted by nurse managers and hospital administrators, as well as decision-makers should magnet the nurses with postgraduate degrees at clinical sites.

Harnessing Artificial Intelligence: Strategies for Mental Health Nurses in Optimizing Psychiatric Patient Care.

This narrative review explores the transformative impact of Artificial Intelligence (AI) on mental health nursing, particularly in enhancing psychiatric patient care. AI technologies present new strategies for early detection, risk assessment, and improving treatment adherence in mental health. They also facilitate remote patient monitoring, bridge geographical gaps, and support clinical decision-making. The evolution of virtual mental health assistants and AI-enhanced therapeutic interventions are also discussed. These technological advancements reshape the nurse-patient interactions while ensuring personalized, efficient, and high-quality care. The review also addresses AI's ethical and responsible use in mental health nursing, emphasizing patient privacy, data security, and the balance between human interaction and AI tools. As AI applications in mental health care continue to evolve, this review encourages continued innovation while advocating for responsible implementation, thereby optimally leveraging the potential of AI in mental health nursing.

Leadership Practices as Perceived by Emergency Nurses During the COVID-19 Pandemic: The Role of Structural and Psychological Empowerment.

INTRODUCTION: To our knowledge, no studies have explored leadership practices in relation to structural and psychological empowerment among nurses during COVID-19. Therefore, the purpose of this study was to examine those relationships in Jordanian nurses working in emergency departments during the COVID-19 pandemic. METHODS: A descriptive, correlational cross-sectional design was used in this study. The participants were emergency nurses working at 3 large hospitals in Jordan. The participants were surveyed via an online questionnaire between September 2021 and January 2022. A total of 3 valid scales were included in the questionnaire to assess the nurses' clinical leadership practices in relation to perceived structural and psychological empowerment. RESULTS: A total of 193 emergency nurses were surveyed, of which 116 participants (60.1%) were male, and their average age was 29.64 (SD 4.74) years. Nurses had a moderate level of clinical leadership practices 12.50 (SD 1.65), moderate level of perceived structural empowerment 3.67 (SD 0.44), and a high-moderate level of perceived psychological empowerment 5.96 (SD 0.65). Clinical leadership practices were shown to have a significant positive relationship with structural (r = 0.65; P < .01) and psychological (r = 0.74; P < .01) empowerment. Predictors of clinical leadership practices of the Jordanian emergency nurses during COVID-19 were ranked in order of significance; structural and psychological empowerments were the highest significant predictors. However, patient to nurse ratio (>6 patients/nurse) was the lowest significant predictor. DISCUSSION: Although structural and psychological empowerments play a pivotal role in predicting the leadership practices of the emergency nurses in Jordan, the nurses should enhance their leadership style for better management and effective communication during critical situations such as pandemics.