Low birth weight in Jordan: a hospital-based study.

Background: Low birth weight (LBW) is one of the leading causes of neonatal and infant morbidity and mortality.Objective: To determine the prevalence and possible risk factors associated with LBW in four regional hospitals in Jordan.Methods: This retrospective study analyzed the medical records of all singleton live births for the period 2011-2015.Results: A total of 22,789 singleton live births were included for this study. Of these, 4133 (18%) had a LBW. Rates of LBW increased over the 5 years study period. Factors associated with LBW were preterm birth, pregnancy complications or comorbidities, older maternal age (≥35 years), first-born infants, and having a female baby.Conclusion: Midwives' assessment and health education messages to mothers included awareness of risk factors associated with LBW of neonates in Jordan. Effective public health interventions need to highlight the importance of a healthy diet and valuing female off-spring.

Postnatal women's perspectives on the feasibility of introducing postpartum home visits: a Jordanian study.

In Jordan, there is a deficiency in postnatal care provided to women and their newborns. This study investigated the feasibility of initiating postnatal home visits in Jordan. Thirty Jordanian mothers who had recently given birth were recruited from two governmental hospitals in the northern region of Jordan to participate in a qualitative study through face-to-face, voice-recorded interviews. The findings revealed that initiating postnatal home visits as part of postnatal care was well-received by the participants. Mothers' views and perceptions regarding postpartum home visits play an integral role in finding areas to improve postnatal services.

Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines: A Middle Eastern Survey.

This study was a self-reported cross-sectional survey that investigated nurses' and hospitals' compliance with ventilator-associated pneumonia prevention guidelines and the barriers and factors that affect their level of compliance. A questionnaire was completed by 471 intensive care unit nurses from 16 medical centers in 3 Middle Eastern countries: Jordan, Egypt, and Saudi Arabia. The results show that both nurses and hospitals have insufficient compliance. Previous education, experience, and academic degree were all found to affect nurses' compliance.

Postpartum evaluation of vitamin D among a sample of Jordanian women.

The aims of this study were to explore the vitamin D status among a sample of Jordanian postpartum women and identify factors associated with vitamin D deficiency. A total of 171 postpartum women agreed to participate. Participants completed a questionnaire on factors related to vitamin D deficiency and provided a blood sample to assess their plasma vitamin D (25(OH)D) levels using DIA source Immuno-Assays S.A. ANALYSIS: The majority of women (76%, n = 130) had vitamin D deficiency and 24% (n = 41) of participants had vitamin D insufficiency. Factors associated with vitamin D deficiency were younger age (< 30 years), low education level, unemployment, multiparity, lactation, dress style, limited sunlight exposure, high BMI, dark skin colour and lack of multivitamin use. Vitamin D supplementation must be considered during pregnancy and lactation to prevent hypovitaminosis in both mother and baby.

Prevalence of Hypovitaminosis D Among Jordanian Healthy Infants: A Descriptive Cross Sectional Study.

UNLABELLED: To determine vitamin D deficiency and associated risk factors of hypovitaminosis D among Jordanian healthy infants. DESIGN AND METHODS: A total of 171 infants receiving a routine health check at a Maternal and Child Health Care Center were recruited. Plasma vitamin D 25-OHD level was assessed using a standard analysis of a blood sample. Other data collected included age, gender, birth order, season of birth, and mode of feeding. RESULTS: Prevalence of vitamin D deficiency (≤15 ng/mL) was 77% (132 out of 171 infants). Infants at risk of vitamin D deficiency were those between 1 to 6 months of age, male, third born or later, born in winter, and exclusively breastfed. The multivariate model showed birth order to be the largest contributor of vitamin D deficiency (R(2)=0.196), followed by breastfed infants (R(2)=0.071), infants born in winter (R(2)=0.037), male gender (R(2)=0.028), and infants aged between 1 and 6 months (R(2)=0.027). CONCLUSION: Hypovitaminosis D appears to be more common among healthy infants in Jordan. Hypovitaminosis D was found to be common among third or later exclusively breastfeed male infants aged 1 to 6 months who were born during winter. PRACTICE IMPLICATION: Maternal and child health nurses have a critical role to play in educating mothers about the importance of preventing hypovitaminosis D through adequate sun exposure and ensuring adequate supplementation. A higher dose of vitamin D supplementation for high-risk infants beyond the age of 1 year from developing countries should be administered.

Development and Validation of Women's Satisfaction With Hospital-Based Intrapartum Care Scale in Jordan.

BACKGROUND: Measuring satisfaction with care during labor is an important way to improve maternity services for women. This study was undertaken to develop an instrument to measure women's satisfaction with intrapartum hospital-based care. METHOD: A multidimensional instrument was initially developed, using three core aspects identified from the literature. An expert panel was convened to further modify the instrument. Finally, a total of 300 low-risk women who gave birth in the past 2 months were asked to complete the instrument to assess validity and reliability. FINDINGS: The 14-item instrument was found to have content and construct validity as well as a high level of reliability (α = .88). CONCLUSIONS: This new instrument is a valid and reliable measure of satisfaction with intrapartum care in a Jordanian setting. The instrument can provide valuable information on the quality of services and on future planning for maternity services.

Evaluating the experience of Jordanian women with maternity care services.

Evaluation of women's experiences about the care they receive during childbirth is important to assess the quality of maternity services. We explored the experiences of Jordanian women to examine whether they were satisfied with their childbirth experiences. Semistructured interviews were conducted with 460 women after giving birth. A content analysis was conducted on the qualitative data. Four themes were identified that represented the women's poor experiences of care during childbirth, including seeing childbirth as a dehumanized experience, feeling that childbirth was processed technologically, a lack of human support, and being in an inappropriate childbirth environment. The findings of this study may help policymakers to provide quality care to women during childbirth.

Undergraduate nursing students' stress sources and coping behaviours during their initial period of clinical training: a Jordanian perspective.

Baccalaureate nursing students often experience high levels of stress during training that may result in psychological or emotional impairment during their professional life ultimately affecting the quality of patient care they provide. Clinical instructors provide the needed support and guidance for students to relieve stress and promote a positive clinical experience. The aim of this study was to identify the level and types of stress perceived by baccalaureate nursing students in Jordan in their initial period of clinical practice and to identify the coping strategies that students used to relieve their stress. This descriptive cross-sectional study was conducted with 181 nursing students' representative of second year undergraduate students from two universities in Jordan. Proportions and t-tests were used to analyze the data. The results showed that the source of stress for these students came mainly from assignment work and the clinical environment. The most common coping strategy used by students was problem-solving behaviour followed by staying optimistic and transference attention from the stressful situation to other things while avoidance was the least frequent used.

A review of midwifery education curriculum documents in Jordan.

BACKGROUND: There is worldwide recognition that midwives are specialists in normal pregnancy, labour and birth and the postnatal period and that they should be educated to be primary providers of maternity care. In Jordan midwives currently have limited opportunities to fulfil this role. Since the mid-1980s, two public community colleges have offered three-year diploma midwifery education programmes in two major cities in Jordan. In 2002 the first and only four-year bachelor of midwifery education programme was established in one public university. AIM: A review to describe the design and content of midwifery education programmes in Jordan and address the question: Does the design of midwifery education programmes in Jordan encourage confidence that graduates will be competent to practise to the full capacity of the internationally defined role and scope of practice of the midwife and undertake the role of primary maternity care providers for women with low-risk pregnancies? DESIGN: A review of Jordanian midwifery education curriculum documents was undertaken using information and documents provided by midwifery programme coordinators. PARTICIPANTS: Programme coordinators in all institutions in Jordan providing midwifery education programmes. FINDINGS: The curriculum documents reflected a medical model, with an emphasis on illness and intervention rather than preparation for the internationally defined full role and scope of practice of the midwife. IMPLICATIONS FOR PRACTICE: This study provides a profile of midwifery education curriculum documents in Jordan with recommendations for changes that would position midwives as potential primary maternity care providers for women in Jordan who have uncomplicated pregnancies.

Barriers to developing midwifery as a primary health-care strategy: a Jordanian study.

AIM: To identify the current barriers to developing midwifery as a primary health-care strategy in Jordan and to explore the strategies to overcome these barriers. DESIGN: An exploratory design using an action research approach was undertaken. Workshop discussion groups and reflection were used to collect the data. A thematic approach was taken for the analysis. PARTICIPANTS: Data were collected from a convenience sample of 64 midwives and educators who attended workshops. FINDINGS: The professional identity and image for midwifery has been confused within a medically dominated health system and has not been seen as a primary health strategy. Midwives are not able to practice to the full role and scope of the midwife. IMPLICATIONS FOR PRACTICE: Key issues identified need to be addressed before midwifery can be part of a primary health-care strategy in Jordan.

Childbirth practices in Jordanian public hospitals: consistency with evidence-based maternity care?

BACKGROUND: In 1996, the World Health Organization stated that 'childbirth is a natural process and in normal birth, there should be a valid reason to interfere with this natural process' and encouraged practices that are evidence-based. The practices encouraged included avoiding unnecessary augmentation of labour, facilitating upright position for birth and restricting the use of routine episiotomy. Many countries have been slow to fully implement evidence-based practice in maternity care. The aim of this study was to examine maternity hospital practices in Jordan and assess their consistency with evidence-based maternity care. METHODS: An explorative research design with non-participant observation was used. Data were collected from low-risk women during labour and birth using a questionnaire for maternal characteristics and an observational checklist. A proportional stratified sample was selected to recruit from three major public hospitals in Jordan. Data were analysed using descriptive statistics. RESULTS: A total of 460 women were observed during labour and birth. The majority were multiparous (80%). A range of interventions were observed in women having a normal labour including augmentation (95%), continuous external fetal monitoring (77%), lithotomy position for birth (100%), and more than one third (37%) had an episiotomy with varying degrees of laceration (58%). CONCLUSIONS: Childbirth practices were largely not in accordance with the World Health Organization evidence-based practices for normal birth. High levels of interventions were observed, many of which may not have been necessary in this low-risk population. Further work needs to occur to explore the reasons why evidence-based practice is not implemented in these hospitals.