Mindfulness-based intervention as a symptom management strategy in patients with end-stage renal disease: A controlled clinical trial.

AIM: The study's purpose was to examine the effect of mindfulness-based intervention (MBI) on physical and psychological symptoms in patients with end-stage renal disease (ESRD) in Jordan. METHODS: A repeated-measure randomized control study was conducted in a haemodialysis unit in Jordan between April 2023 and July 2023. Participants (N = 61) were selected using convenience sampling and then randomly assigned into experimental and control groups. The experimental group performed 30-min MBI, three times a week for 8 weeks during haemodialysis sessions. The Depression, Anxiety and Stress Scale-21 and the Patient Health Questionnaire-15 were used to measure the outcomes at baseline, after 5 weeks of the intervention and at the end of the intervention. RESULTS: Mixed-model repeated-measure ANOVAs revealed that the experimental group showed significantly lower levels of stress, depression and physical symptoms than the control group over time. Within-subject repeated-measure ANOVAs revealed that, in the experimental group, physical symptoms improve significantly over the three points of time. However, significant reductions in psychological symptoms occurred 5 weeks after initiating the intervention, but there was no further significant improvement at the end of the intervention. CONCLUSION: The study supports the integration of MBI as a symptom management strategy into nursing care plans of patients with ESRD. TRIAL REGISTRATION: Clinical trial.gov; registration ID: NCT06064708.

The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness among nurses: A randomized controlled trial.

BACKGROUND: Nurses experience various health-related issues due to the nature of their work. AIM: This study aimed to examine the effect of a mindfulness-based intervention on stress overload, depression and mindfulness among nurses. A secondary objective was to examine the role of the setting (i.e., in and out of the hospital as a natural setting) on mindfulness-based intervention effectiveness. METHODS: A randomized controlled trial with three groups' pretest-posttest design was used in this study. A total of 195 nurses were recruited-65 intervention-inside hospital, 60 intervention-outside hospital, and 63 control. The mindfulness-based intervention was delivered by a certified mindfulness practitioner over 4 weeks in Jordan. Data were collected using a demographics questionnaire, the Stress Overload Scale Short, the Center for Epidemiologic Studies Depression Scale-Revised, and the Five Facet Mindfulness Questionnaire. RESULTS: Multivariate analysis showed a statistically significant effect of the intervention on the linear combination of the dependent variables V = 0.44, F[6, 368] = 17.56, p < .001. Follow-up analyses showed that a mindfulness-based intervention significantly decreased stress overload, depression, and increased mindfulness levels among nurses in intervention groups compared with the control group. In addition, conducting a mindfulness-based intervention outside the hospital has a better effect on mindfulness levels than the inside hospital. LINKING EVIDENCE TO ACTION: The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness should be considered when planning for nurses' well-being and the quality of care provided. Nurse managers are encouraged to use the study's findings to promote nurses' well-being.

Knowledge toward COVID-19 in children among undergraduate students at the beginning of COVID-19 era.

AIMS: To describe the level of knowledge of undergraduate students in Jordan toward COVID-19 in children in respect of the clinical signs of the disease, modes of transmission, protection measures against the disease and satisfaction with governmental measures. DESIGN: A cross-section was utilized in this study. METHODS: An online survey questionnaire was utilized in this research study. All undergraduate students in Jordan were able to take part. The size of the sample was 799. Knowledge toward COVID-19 among children was used to assess the participants' knowledge about COVID-19. RESULTS: The findings indicate that the students had a good understanding of the clinical signs, mode of transmission and protection measures and were satisfied with governmental measures. According to the students' responses, the resource they used the most was social media followed by news channels. Our study also found that medical specialty students had more knowledge toward COVID-19 than non-medical.

Differential effects of guided imagery and progressive muscle relaxation on physical and emotional symptoms in nursing students taking initial clinical training: A randomized clinical trial.

Background: The initial clinical training has been reported by nursing students as the most challenging component of the nursing programs. Although progressive muscle relaxation and guided imagery have been reported to improve emotional and physical health, the use of such approaches among nursing students rarely exist. Purpose: The purpose of this study was to examine the deferential effects of progressive muscle relaxation [PMR] and guided imagery [GI] on physical and emotional symptoms in nursing students taking their initial clinical training. Methods: Using a three-group, randomized, single blinded study conducted in a large Jordanian university, 156 nursing students were randomly allocated into one of three study groups (PMR group, GI group, and control group). The physical symptoms and emotional symptoms of depression, anxiety, and stress were assessed at baseline and end of the intervention. The study protocol was registered in ClinicalTrail.gov, identifier: xxxxxx. Results: Using one-way MANOVA and post-hoc comparisons, the results showed that PMR and GI significantly reduced more physical symptoms than control condition although PMR was more effective than GI in this regard. GI significantly decreased more emotional symptoms such as anxiety, depression, and stress than PMR and control condition. PMR decreased anxiety, depression, and stress but the results were not statistically significant. Conclusion: The findings of this study support the ABC relaxation theory claiming that PMR im-proves better physical symptoms while GI improves better emotional symptoms. However, further studies using students from multiple settings are needed.

Effects of mindfulness meditation on trait mindfulness, perceived stress, emotion regulation, and quality of life in hemodialysis patients: A randomized controlled trial.

Objective: This study aimed to examine the effects of mindfulness meditation on trait mindfulness, perceived stress, emotion regulation, and quality of life in end-stage renal disease patients undergoing hemodialysis. Methods: An experimental study with repeated measures design was conducted among a sample of 74 end-stage renal disease patients undergoing hemodialysis between January and May 2021 in the dialysis center at Jahra hospital, Kuwait. The patients were randomly assigned to the experimental (n = 37) and control groups (n = 37). The experimental group participated in 30-min mindfulness meditation sessions (three sessions a week for five weeks) held during their hemodialysis sessions; the participants in the control group were instructed to sit with their eyes closed and relaxed for 30 min three times a week for five weeks during hemodialysis sessions. The dependent variables of both groups were measured at baseline (T0), middle of intervention (T1), and end of intervention (T2) using the Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS), Emotion Regulation Questionnaire (ERQ), and Kidney Disease Quality of Life (KDQOL-36) questionnaire. The study was registered in the ClinicalTrial.gov (Identifier: NCT05176730). Results: The repeated measures ANOVA (within-subject) results for the experimental group showed that mindfulness meditation had significantly decreased perceived stress by the end of the intervention. Also, mindfulness meditation improved mindfulness, emotion regulation, and kidney disease-related quality of life in the experimental group, and this improvement occurred significantly at both T1 and T2. The repeated measures ANOVA (within and between-subject) results showed that the experimental group, as compared to the control group, had lower perceived stress, higher trait mindfulness, higher emotional regulation, and higher kidney disease-related quality of life over time. Conclusions: The positive findings of this study offer health policy-makers and hospital administrators a promising tool to use with patients undergoing hemodialysis as a way to manage stress and improve quality of life. However, this study should be replicated in multiple settings with follow-up assessments.

The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery.

Objectives: This study aimed to evaluate the effectiveness of slow deep breathing relaxation exercise (SDBRE) in reducing patients' pain levels during chest tube removal (CTR) post coronary artery bypass grafting (CABG) surgery. Methods: In 2019, fifty post-CABG patients were conveniently selected from a cardiac intensive care unit in Jordan's major referral heart institute. The patients were randomly assigned to either an intervention group or a control group. A total of 25 patients were assigned into the experimental group who received slow deep breathing relaxation Exercise (SDBRE) alongside the conventional care before CTR. The remaining 25 patients constituted the control group (50%) that had CTR following conventional care. The Visual Analogue Scale (VAS) was used to measure the participants' pain levels during three phases: before CTR (Time 1), 5-min post CTR (Time 2), and 15-min post CTR (Time 2) to compare the intervention effect between the two groups. Results: The data analysis findings for the control and intervention group of patients showed that there was a statistically significant decline in their pain level across time for both groups (H = 32.71, P < 0.01; H = 47.23, P < 0.01) respectively. The intervention group had significantly lower pain levels than the control group at Time 2 (3.50 [1.20, 5.30] vs. 7.90 [7.00, 9.00], P < 0.01) and Time 3 (0.00 [0.00, 1.30] vs. 3.60 [2.40, 4.10] P < 0.01). Conclusions: Using SDBRE during CTR is an effective technique for reducing pain which can minimize the need for analgesics and their associated adverse effects.

Self-care among persons with heart failure: Examining the impact of mindfulness and impulsivity using conditional process analysis.

BACKGROUND: According to the literature, self-care in persons with heart failure is inadequate. Such inadequate levels of self-care necessitate a thorough investigation of the potential predictors. PURPOSE: To: (a) determine the level of self-care among persons with heart failure in Jordan; (b) determine the relationship between mindfulness, impulsivity, and self-care among persons with heart failure; (c) investigate the potential moderation effect of impulsivity on the relationship between mindfulness and self-care. METHODS: A cross-sectional study was conducted. A convenience sample of 100 persons with heart failure in an outpatient clinic at King Abdullah University Hospital was recruited. The following tools were used to collect the data via phone survey: Self-Care of Heart Failure Index, Barratt Impulsiveness Scale, and the Mindful Attention Awareness Scale. RESULTS: The sample consisted of 78 male and 22 female persons with heart failure. The effect of mindfulness was statistically significant only on self-care symptom perception, and not significant on other aspects of self-care. Impulsivity moderated only the effect of mindfulness on self-care symptom perception. Correlation analysis showed a significant relationship between mindfulness and impulsivity (r = -.532, p < .01). CONCLUSION: Mindfulness is likely to improve at least one aspect of self-care (self-care symptom perception) and reduce impulsivity among heart failure persons.

The Benefits of Mindfulness Meditation on Trait Mindfulness, Perceived Stress, Cortisol, and C-Reactive Protein in Nursing Students: A Randomized Controlled Trial.

PURPOSE: Mindfulness meditation was used to reduce stress and its responses such as cortisol and C-reactive protein (CRP) among healthy and ill individuals in various cultures, but its effect has not yet been studied among nursing students, experiencing tremendous stress. The objective of this study was to examine the effects of mindfulness meditation on trait mindfulness, perceived stress, serum cortisol, and serum C-reactive proteins (CRP) in nursing students. PATIENTS AND METHODS: Using a two-arm, randomized, parallel study (conducted in a large university in Jordan, 108 nursing students were randomly assigned to experimental group receiving five 30-minute weekly sessions of mindfulness meditation and control group sitting quiet during the experimental sessions. Trait mindfulness, perceived stress, serum cortisol, and CRP were measured at baseline and end of the intervention. RESULTS: Using one-way MANOVA and post-hoc comparisons, the results showed that mindfulness meditation was significantly effective in decreasing serum cortisol levels and perceived stress. The mindfulness meditation also decreased CRP and increased trait mindfulness although the results did not reach statistically significant levels. CONCLUSION: These findings underscore the need for serious consideration of mindfulness meditation in nursing colleges to improve stress and raise immunity in this vulnerable population. TRIAL REGISTRATION: Mindfulness Meditation for Nursing Students: clinicaltrials.gov, identifier: NCT05099224.

Mediating role of resilience on the relationship between stress and quality of life among Jordanian registered nurses during COVID-19 pandemic.

Rationale: Registered nurses are struggling on the front line to manage patients with COVID-19 and other illnesses, placing them at increased risks for severe perceived stress. Although perceived stress has often been considered a significant risk factor for impaired quality of life among registered nurses, having resilience has been generally shown to be associated with better quality of life. Purpose: This study aimed to investigate the mediating effects of resilience on the relationship between perceived stress and quality of life in Jordanian clinical registered nurses during the COVID-19 pandemic. Methods: The study used a cross-sectional correlational design with an online survey and adhered to the STROBE guideline for cross-sectional studies. A total of 550 registered nurses working in 6 hospitals were conveniently selected. Data were collected via a demographic questionnaire, the Perceived Stress Scale (PSS), the Connor-Davidson Resilience Scale (CD-RISC), and the WHOQOL scale. Descriptive, Pearson correlation, t-test, one-way ANOVA, and hierarchical linear regression analyses were used to analyze the data. Results: The results indicated that resilience was negatively correlated with perceived stress and quality of life. Further, resilience was found to play a partial mediating role in the relationship between perceived stress and quality of life. Therefore, the results partially supported our study hypotheses. Conclusion: Health policy makers and administrators in Jordan should be aware of the importance of assessing and improving nurses' resilience to decrease devastating effects of stress on quality of life.

Nutritional status and its determinants among community-dwelling older adults in Jordan.

BACKGROUND: The elderly population of Jordan is growing, due to the low mortality rate, high total fertility rate, and the high rate of forced migration from neighboring countries to Jordan in recent years. However, the prevalence of chronic illnesses associated with other comorbidities among the elderly population in Jordan is high. Maintaining a good nutritional status is essential for maintaining general health and well-being among older people. AIM: The aim of this study is to identify the nutritional status of community-dwelling older adults in Jordan and determine its possible associated factors. METHODOLOGY: A cross-sectional, descriptive design was utilized. Proportional multistage nonprobability sampling was employed to obtain a convenient sample of 225 Jordanian community-dwelling older adults. The participants were asked to complete a set of questionnaires related to nutritional status, which included a demographic information sheet, and the Mini Nutritional Assessment (MNA). RESULTS: Among the sample, only 60 participants (26.7%) showed normal nutritional status. Most of the participants (n = 156; 68.3%) were found to be at risk of malnutrition, and nine participants (4%) were found to suffer from malnutrition. Advanced age (r = -0.631; p = 0.001), body mass index (BMI) (r = 0.546; p = 0.001), being single (mean (M) = 20.43, SD = 3.55), being male (M = 21.10, SD = 3.73), being unemployed (M = 21.71, SD = 3.51), being dependent in activities of daily living (ADLs) (M = 21.35; SD = 3.62), eating only two meals per day (M = 19.60; SD = 3.39), having suffered from illness or anxiety in the preceding 3 months (M = 21.11; SD = 2.39), having a mid-arm circumference of less than 31 cm (M = 19.51; SD = 3.47), low consumption of fruit and vegetables (M = 20.79; SD = 2.53), and polypharmacy (M = 20.62, SD = 4.09) were found to predict susceptibility to malnutrition among the participating older adults. Amongst the variables, age was identified as the most significant predictor of nutritional status and explained approximately 40% of the variance in nutritional status. CONCLUSION: Malnutrition in older adults is a multifaceted phenomenon that needs to be integrated into the comprehensive assessment of older adults. It is essential that health-care professionals, particularly nurses, are fully aware of the associated risks of malnutrition among the elderly population. The high prevalence of the risk factors for malnutrition warrants conducting a controlled national-based assessment, using probability sampling, of the nutritional status among older adults in Jordan. Specifically, there is a real need to assess nutritional status among older adults who are at high risk of malnutrition, including senior, unmarried, male, unemployed, ADL dependent, and/or poly-medicated older adults.

Testing the Effectiveness of Cognitive Behavioral Therapy in Relieving Nurses' Ageism Toward Older Adults: A Randomized Controlled Trial.

BACKGROUND: Although cognitive-behavioral therapy (CBT) techniques are well known for targeting psychological distresses, to date, no study has investigated their effectiveness in relieving death anxiety and ageism among nurses. METHODS: A parallel randomized controlled trial was conducted according to the CONSORT guidelines during October 2019 at the university hospital. A total of 110 nurses were selected through proportional stratified sampling and randomly assigned to the experimental and control groups. The intervention consisted of six two-hour training sessions delivered over five modules with the integration of different CBT exercises. The effect of CBT was assessed by measuring the differences in the students' responses to a series of validated questionnaires of study variables pre-test (before the training sessions) and post-test (after the training sessions). Clinical registration was completed at ClinicalTrial.gov (ID: NCT04319393). RESULTS: Overall, using CBT techniques led to significant improvements in the study outcomes. At postintervention, the nurses who had received CBT training had significantly better self-esteem and interpersonal relationships, a greater sense of symbolic immortality, and less death anxiety and ageism than the nurses in the control group. CONCLUSIONS: CBT is an effective evidence-based psychological intervention for relieving nurses' ageism towards older adults. The psychological well-being of nurses caring for older adults is crucial, and new techniques should be adopted to relieve nurses' accumulated stress and decrease their death anxiety. Future studies which investigate the effectiveness of CBT on other forms of discrimination, such as racism and sexism in healthcare settings, are recommended.

Transgender Individuals and Osteoporosis Prevention.

BACKGROUND: Risk behaviors and hormone use place transgender individuals (TIs) in jeopardy for osteoporosis. PURPOSE: The purpose of this study was to expand the science about the knowledge, health beliefs, and osteoporosis (OP) preventing behaviors of TIs. METHODS: This was a mixed-methods pilot study of a convenience sample of 31 TIs 30 years and older. Participants completed an online Osteoporosis Bone Health Survey. Fifteen participants were randomly selected for an interview to describe their perceptions of bone health. RESULTS: Transgender individuals performed poorly on the knowledge measure. There were no significant findings for osteoporosis health beliefs. Participants' daily dietary dairy calcium intake was 800 mg and daily walking activity was 17 minutes. Perceptions of bone health revealed two essential elements, knowing and doing. CONCLUSION: Determining TIs' bone health perception is important because of their unique healthcare issues. Healthcare providers need to be aware of TIs' bone health needs to help enhance TIs' OP knowledge, health beliefs, and preventing behaviors.