Factors Predicting Dependence on Waterpipe Smoking Among Waterpipe Exclusive Smokers.

ABSTRACT: The current study targeted a sample of waterpipe (WP) exclusive smokers to identify the levels and predictors of dependence on this smoking pattern and to examine the relationship between WP smoking (WPS) dependence and depressive symptoms. A cross-sectional research design was employed with a community sample of 270 subjects who are currently WP exclusive smokers. Assessment of WPS dependence and depressive symptoms was performed using self-report measures. About 62.6% of the subjects were WPS dependent. The unique significant predictors of WPS dependence were age, depression levels, age of starting WPS, duration of WPS, income, smoking WP daily, the belief of being attracted to WPS, and the desire to stop WPS. These predictors explained 35% of the variance in WPS dependence. WPS dependence was associated with increased depressive symptoms. Although few studies have been conducted, the WPS dependence prevalence appears to be alarmingly high among WP exclusive smokers. Factors associated with WPS dependence provide useful information that can be used to tailor WP prevention interventions.

The Impact of Leadership Styles of Nurse Managers on Nurses' Motivation and Turnover Intention Among Jordanian Nurses.

Aim: The purpose of this study is to examine the relationship between leadership styles of nurse managers, nurses' motivation, and turnover intentions among Jordanian nurses. Design: A descriptive correlational cross-sectional study using a self-administered questionnaire was conducted. Methods: A convenience sampling technique was utilized to select the required .sample A sample of 170 registered nurses working at private hospitals in Jordan was surveyed. Moreover, a questionnaire of Path-Goal Leadership, Multidimensional Work Motivation Scale, and Turnover Intention Scale was used to assess leadership styles of nurse managers, nurses' motivation and turnover intention among the participants. Descriptive and inferential tests were used to ask the research questions. Results: The participants perceived the supportive leadership style as the highest (M = 24.4, SD = 4.66). The mean work motivation among participants was 87.12, and the mean turnover intention was 22.01. Nurses' motivation has a positive correlation with all leadership styles. Years of experience predict the nurses' work motivation. Among the leadership styles; two of them significantly predict nurses' work motivation (supportive style) p < 0.001, and (achievement-oriented style) p < 0.001. Finally, the highest correlation coefficient was noticed between work motivation and achievement-oriented style (r = 0.46, p < 0.001) by moderate positive correlation, and the lowest correlation coefficient was between work motivation and directive style (r = 0.29, p < 0.001), whereas the results revealed that turnover intention was not significantly correlated with any of the leadership styles. Conclusion: The results present a unique theoretical underpinning that highlights the factors that affect nurses' turnover intention. So, these findings could be used as guide for policy makers to establish organizational policies toward satisfying nurses' motivation and quality of life to enhance their retention. Besides, enriching the factors that may enhance nurses' motivation and reduce their turnover intention.

The Relationship Between Mindfulness and Conflict Resolution Styles Among Nurse Managers: A Cross-Sectional Study.

Introduction: Mindfulness might help nurse managers in dealing with conflicts. However, the relationship between mindfulness and conflict resolution styles were still not clearly understood. Objective: To identify the relationship between mindfulness and conflict resolution and to predict the conflict resolution styles of nurse managers through mindfulness. Methods: A descriptive correlational cross-sectional design was employed. A convenience sample of 197 nurse managers was recruited from five public and two university hospitals. Data about nurse managers' mindfulness and conflict management styles were collected through self-reported scales. The data was collected between January and March 2020. Results: Mindfulness was significantly associated with integrating (r = 0.31, p < .001) and obliging (r = 0.14, p = .045) conflict resolution styles. Mindfulness was able to uniquely predict using the integrating conflict resolution style (χ² = 4.65, p = .031). Conclusions: Mindfulness is uniquely related to integrating conflict resolution among nurse managers. The findings encourage stakeholders in health care organizations to develop training programs to improve managers' conflict resolution skills and to invest in managers' mindfulness.

The association of mindfulness with professional quality of life and negative emotional states among critical care nurses during COVID-19 pandemic.

BACKGROUND: The recent coronavirus disease 2019 (COVID-19) pandemic has imposed severe psychological pressure on nurses. Mindfulness has been shown to be effective in improving professional quality of life (ProQOL) and reducing psychological distress in a wide range of populations and contexts. However, its role in supporting critical care nurses during the outbreak of COVID-19 has yet to be established. PURPOSE: This study explores the relationship of mindfulness with negative emotional states and ProQOL among nurses working in critical care units during COVID-19 pandemic. METHODS: A cross-sectional descriptive correlational design was used. A sample of 156 critical care nurses completed self-reported measures of mindfulness, ProQOL, and negative emotional states. Multiple regressions were used to address the study purpose. RESULTS: Overall, the participants had severe anxiety, moderate depression, moderate stress, moderate burnout, moderate secondary traumatic stress, and moderate compassion satisfaction. Mindfulness was significantly and negatively associated with stress (r = - 0.230, p = .004), depression (r = - 0.190, p = .018), burnout (r = - 0.218, p = .007), and secondary traumatic stress (r = - 0.168, p = .037). Mindfulness explained 3% of the variance in depression (B = -0.19, p = .018), 3.9% of variance in stress, (B = -0.201, p = .012), 4.2% of variance in BO (B = -0.206, p = .009), and 2.2% of the variance in secondary traumatic stress (B = -0.168, t = -2.104, p = .037), controlling for demographics. CONCLUSIONS: The current study provides preliminary evidence that mindfulness can be helpful in reducing critical care nurses' psychological distress and promoting their ProQOL, and is worthy of further investigation in this population.

Triage Knowledge and Practice and Associated Factors Among Emergency Department Nurses.

Objective: The study aims at assessing the triage knowledge and practices and their associated factors among emergency department nurses employed in King Fahad Medical City (KFMC), Saudi Arabia. Method: The study employed a cross-sectional, descriptive, and correlational design. Data collection was carried out from February 11, 2021, until April 27, 2021. The study included all emergency department nurses who were working in the KFMC during the data collection period and excluded those who were on leave at the time of data collection. A self-reported questionnaire with adequate validity and reliability was used. Statistical analysis was performed using the IBM SPSS Version 25 employing descriptive statistics, independent t-test, one-way ANOVA, and Pearson correlation test. Results: A total of 147 emergency department nurses completed the study. Participants demonstrated generally high levels of triage knowledge and triage practice. However, knowledge deficit and incorrect practice related to some aspects were noted. There were no significant differences in triage knowledge and practice according to participants' demographics including gender, job title, qualification, emergency nursing training, and previous training in triage (P > 0.05). Most participants (n = 141, 95.9%) had access to their triage systems and the majority (n = 79, 53.7%) utilize triage systems on a daily basis. Half said that only professional nurses performed the triage role (n = 69, 46.9%). There was a significant positive relationship between triage knowledge and practice (r = 0.486, P < 0.01). Conclusion: The respondents had a high level of triage knowledge and practice. However, they have some areas of knowledge deficit and some deficiencies in the conversion of their knowledge into practice. The study recommends the development of further training and education in emergency nursing to address knowledge deficits and incorrect triage practices.

Empowerment Predicting Nurses' Work Motivation and Occupational Mental Health.

INTRODUCTION: Empowering nurses is essential for improving work outcomes, and understanding the role of structural and psychological empowerment in supporting nurses' work motivation and occupational mental health are essential to stimulate nurses' productivity and preserve their mental health. OBJECTIVES: To evaluate nurses' perspectives about the levels of structural and psychological empowerment in their working areas. Additionally, to evaluate nurses' motivation and occupational mental health, and to predict the nurses' motivation and occupational mental health through structural and psychological empowerment. METHODS: A descriptive correlational design and quota sampling were used. Two hundred registered nurses were recruited from two hospitals in Jordan. Data were collected using four valid and reliable self-report questionnaires. RESULTS: Nurses who participated in this study were young and have an average total experience in nursing of fewer than 10 years. Nurses in this study reported a moderate level of structure empowerment and a low level of psychological empowerment. Significant positive relationships were documented between both structural, psychological empowerment, and nurses' work motivation (r = 0.85), (r = 0.83) respectively. A significant negative relationship found between both structural, psychological empowerment, and nurses' occupational mental health (r = -0.31), (r = -0.29) respectively. CONCLUSIONS: The levels of nurses' work motivation and occupational mental health can be predicted through the levels of structural and psychological empowerment. The higher workplace empowerment was associated with increased work motivation, as well as reduced the feeling of occupational stress among nurses. Thus, administrators should invest in fostering structural and psychological empowerment in the work environment.

Professional Self-Concept and Self-Confidence for Nurses Dealing with COVID-19 Patients.

PURPOSE: To identify the impact of dealing with COVID-19 patients in clinical areas on nurses' professional self-concept and self-confidence. BACKGROUND: Professional self-concept is considered a critical factor in the recruitment/retention process in nursing, nursing shortage, career satisfaction, and academic achievements. Professional self-confidence is also a crucial determinant in staff satisfaction, reducing turnover, and increasing work engagement. DESIGN: Descriptive, comparative study. METHODS: The study was conducted between February to May 2021 by utilizing a convenience sampling technique. A total of 170 nurses from two facilities were recruited from two COVID-19- and non-COVID-19-designated facilities. The level of professional self-concept and self-confidence was assessed by utilizing the Nurses' Self-Concept Instrument and Self-Confidence Scale. RESULTS: The professional self-concept level among the group exposed to COVID-19 patients was lower than the comparison group, while the professional self-confidence level among the exposed group to COVID-19 patients was similar to the comparison group. On the other hand, the satisfied staff and those who received professional training in dealing with COVID-19 patients reported a higher level of professional self-concept. CONCLUSIONS: Dealing with COVID-19 patients has an impact on professional self-concept; the exposure group was lower than those who did not deal with COVID-19 patients, while the professional self-confidence level among the exposed group was similar to the comparison group. Getting professional training in dealing with COVID-19 patients and being satisfied at work were significant factors in improving professional self-concept. Policymakers should create strategies that target the improvement of professional training in dealing with COVID-19 patients.

Nurse-nurse collaboration and performance among nurses in intensive care units.

BACKGROUND: An essential element for offering high-quality care in the intensive care units (ICUs) is the intraprofessional collaboration among nurses, which facilitates the exchange of knowledge and information and hence improves performance. More research is needed to understand the relationship between the nurse-nurse collaboration and job performance in the ICUs due to the multidimensionality of both concepts, the complexity of the ICU environment, and the lack of studies. AIM: To examine the relationship between nurse-nurse collaboration and self-perceived nurse performance among Jordanian nurses in ICUs. DESIGN: Descriptive, correlational cross-sectional design was used. METHODS: Data were collected through an online survey including the demographic questionnaire, the nurse-nurse collaboration scale, and six-dimensions scale for nursing performance. RESULTS: In total, 155 critical care nurses participated (response rate = 46.97%). Self-perceived job performance was significantly associated with gender (t = -3.189, P = .002), age (r = -0.301, P < .01), workplace (F = 28.20, P = .001), the type of ICU (F = 17.70, P = .001), and the number of assigned patients (r = 0.407, P < .01). Among all nurse-nurse collaboration subscales, only the conflict management subscale was an independent significant predictor of self-perceived nursing performance (t = 3.06, B = 3.066, P = .003). CONCLUSIONS: Effective conflict management is associated with better nurse performance, which could ultimately improve patient care in ICUs. RELEVANCE TO CLINICAL PRACTICE: Conflict resolution is an important dimension of optimal nurse-nurse collaboration and has an important effect on nursing performance. Nurses and nurse managers in ICUs need to attend workshops and training programs in conflict management.

The Decisional Balance Toward Health Behaviors Among Patients With Hypertension.

The decisional balance is related to the transtheoretical model, and involves weighting the pros and cons of performing a behavior. The study aimed to assess hypertensive patients' decisional balances about smoking, weight control, and physical exercise. A cross-section descriptive correlation design was used, and 110 patients were recruited using convenience sampling in outpatient clinics. The decisional balance was measured using "Decisional Balance Scales," which assess an individual's decisional balance related to smoking, weight control, and physical exercise behaviors. The results predicted that Jordanian hypertensive patients with higher physical exercise decisional balance and higher weight decisional balance had lower smoking decisional behaviors. Nurses can foster health promotion and behavioral change by employing interventions that improve decisional balances. Improving the decisional balance of one behavior would have a positive impact on other behaviors. Thus, designing multidimensional interventions might be effective for modifying different types of health behaviors, and fostering health promotion practices.

Factors that influence the quality of pain management in patients with skin traction.

BACKGROUND: Pain management is a systematic multidimensional process with differing approaches. Investigating the factors that affect the quality of pain management may provide nurses with ideas, suggestions, and trends that target improvements in the pain management experience among orthopaedic patients. AIMS: To assess the elements of the quality of pain management and identify factors that significantly predict higher quality pain management in patients with skin traction. METHODS: A descriptive correlational design was used to recruit a convenience sample of 116 patients. The revised American Pain Society Patient Outcome Questionnaire was used to explore the quality of pain management. RESULTS: Patients suffered from severe pain for more than 64% of the time during the first 24 h after the skin traction was applied. The uncontrolled pain negatively affected patients' abilities to carry out activities in bed, fall asleep, and stay asleep. The quality of pain management indicators using a scale of one to 10 were: "pain severity" = 5.93, "pain interference" = 5.01, "side effects of medications" = 1.5", and "satisfaction about care" = 6.2". CONCLUSIONS: The quality of pain management for fracture patients on skin traction was not optimum in this study. The uncontrolled pain negatively affected patients' physical status and general wellbeing.

Readiness for Behavior Change in Patients Living With Ischemic Heart Disease.

BACKGROUND: Readiness for behavioral change may be evaluated by assessing the patient's stage of change, as described in the transtheoretical model. Identifying readiness to change in patients with ischemic heart disease may enhance the effectiveness of interventions that target risk reduction and lifestyle modification. PURPOSE: This study was designed to assess the readiness of patients with ischemic heart disease to change health behaviors as well as to identify the factors that significantly predict this change. METHODS: A descriptive correlation design approach was adopted, and a convenience sample of 122 patients with ischemic heart disease was recruited from an outpatient cardiac clinic. Readiness for behavioral change was evaluated by assessing the stages of change of the participants, as described in the transtheoretical model. Data on readiness to change were collected using the "readiness for lifestyle change inventory." RESULTS: A total of 62.2% and 43.4% of the participants were in the precontemplation phase of change for "cease smoking" and "be physically active," respectively; about 33% of the patients were in the maintenance phase for "control weight"; 36.1% were in the maintenance phase for "reduce consumption of high-fat foods"; and 51.6% and 57.4% were in the maintenance phase for "eat fruits and vegetables" and "practice relaxation," respectively. Participants who were overweight or obese showed higher readiness to practice physical activity, and those with high cholesterol levels showed a higher readiness to reduce the amount of fat in their diet. Higher income was found to predict higher readiness to eat fruits and vegetables. CONCLUSIONS: Patients are not adequately ready to change their health-related behaviors. Higher cardiovascular risk predicts higher readiness to change health behaviors.

Risk profile of myocardial infarction in young versus older adults.

BACKGROUND: In developing countries, the number of adults who develop myocardial infarction (MI) at a young age is high. The popularity of waterpipe smoking (WPS) has increased among the same age group. It is unknown if WPS contributes to the incidence of early-onset MI. OBJECTIVE: To study the association of WPS with early-onset MI, which is defined as first MI occurring in individuals 18 ≥ age ≤ 45 years compared to those older than 45 years. METHODS: This was a cross-sectional study. The association of WPS with first-time MI was compared between younger and older adults (N = 225). RESULTS: Twenty-five percent of all participants developed an acute MI before the age of 46 years. Both cigarette and WPS were more common among younger first-time MI patients than older first-time MI patients. CONCLUSIONS: WPS is one risk factor that distinguishes the risk profile of young adults with early-onset MI.

Effectiveness of nurse-led video interventions on anxiety in patients having percutaneous coronary intervention.

AIM: Managing anxiety is essential to control anxiety-related complications. This study aimed to evaluate the effectiveness of a nurse-led video-based educational intervention on anxiety levels among patients undergoing a percutaneous coronary intervention. METHODS: A pre-test, post-test quasi-experimental design was used. Between June 2015 and July 2016, 99 participants were allocated to comparison versus intervention groups, and a video-based educational intervention about the percutaneous coronary intervention was provided to the intervention group. The State Anxiety Inventory was used to measure anxiety levels at baseline, 2 hours before, and 4 to 6 hours after a percutaneous coronary intervention. RESULTS: After providing the video-based intervention, at 2 hours before the procedure, results showed a statistically significant difference in anxiety mean scores (33.08 versus 60.88) between the intervention and comparison groups, respectively (P < 0.001). At 4 to 6 hours after the procedure, the anxiety mean score for the intervention group (M = 24.1) was statistically significantly lower than that of the comparison group (M = 44.17; P < 0.001). CONCLUSIONS: A pre-procedure nurse-led educational intervention provided by video had a significant effect on reducing anxiety levels among patients undergoing percutaneous coronary intervention. Patients in the intervention group experienced a steady and consistent trend of anxiety reduction pre-cutaneous and post-percutaneous coronary intervention.

Investigating cardiovascular patients' preferences and expectations regarding the use of social media in health education.

BACKGROUND: To reach more people in the community, health educators have considered employing social media alongside traditional health education methods. AIMS: To understand the preferences and expectations of patients with cardiovascular diseases (CVDs) regarding the use of social media in health education. To assess the association between patients' socio-demographics with their preferences and expectations about the use of social media in health education. METHODS: This is a cross-sectional descriptive study, which included 135 subjects with an established diagnosis of CVDs. The subjects were met at three cardiac outpatient clinics and recruited through a convenience sampling technique. They were recruited if they were adults, oriented and diagnosed with the CVDs for at least six months. RESULTS: Most subjects (50.3%) were interested in receiving health education through social media, and 74.8% of them felt that using social media in health education would improve the process and lead to better outcomes. Preference for social media was significantly related to younger age, higher education, lower income, watching health education programmes on television, positive family history of CVDs, and currently has a job. Furthermore, higher positive expectations regarding using social media in health education were significantly related to higher education, watching health education programmes on television, being single, and currently has a job. CONCLUSIONS: Subjects with CVDs are enthusiastic about health education through social media, believing that it will be good for educating them and providing them with the up-to-date information they need to live with their diseases. Findings of this study may positively contribute to the international efforts of improving health education through employing social media to improve accessibility to health education materials, and consequently decrease the burden of CVDs.

Knowledge, attitudes, beliefs and patterns of waterpipe use among Jordanian adults who exclusively smoke waterpipes.

BACKGROUND: Widespread waterpipe smoking (WPS) is reported worldwide. Although remarkable numbers of waterpipe smokers do not smoke cigarettes, very few studies have explored the phenomenon of WPS in people who smoke water pipes exclusively. The aim of this study was to assess levels of knowledge, attitudes, beliefs and patterns of WPS among Jordanian waterpipe-only smokers. METHODS: A cross-sectional descriptive design was used; with 247 participants who were recruited through convenience sampling from 23 cafés offering waterpipes. An interview and self-reported questionnaire was used to collect data. RESULTS: The average age for starting WPS was 19.4 ± 5.6 years, of whom 71% started as teenagers. Participants like WPS because they like its flavor and social environment (46.3% and 29.5% respectively). The majority of participants reported that they smoked a waterpipe for the first time with their friends (66.8%), they usually smoke in the company of others (63.2%), and believe that quitting cigarettes smoking is harder than quitting WPS (61.6%). More than half (56.7%) of participants have extremely poor knowledge about the health effects of WPS. Participants who had smoked cigarettes in the past, were more knowledgeable than those who had never smoked cigarettes. The majority of participants, and specifically women, have high positive feelings and emotions (attitude) toward WPS, and 88.3% of them reported that it is a socially acceptable behavior. CONCLUSIONS: Waterpipe smoking participants started WPS at an early age, and are attracted to the social environment that accompanies WPS. Participants have high positive attitude about WPS however they lack knowledge about harmful health effects of WPS.

Self-reported adherence to therapeutic regimens among patients with hypertension.

OBJECTIVES: To assess Jordanian hypertensive patients' adherence rate to hypertension therapeutic regimen (HTR) and to identify the strongest predictors of adherence rate among such patients. DESIGN AND SAMPLE: A descriptive comparison design and convenience sampling were used. The sample comprised 192 participants who came to their regular appointments in a public healthcare center. MEASUREMENT: The Hill-Bone Compliance to High Blood Pressure Therapy Scale and the Hypertension Knowledge-Level Scale were used to assess adherence to HTR and knowledge of hypertension, respectively. RESULTS: The mean total score for adherence to HTR was 87.3, and 82.8% of participants reported good adherence overall. Adherence scores were significantly higher among women, less educated, unemployed participants, those with comorbidities, those with a negative family history of hypertension, and those who visited their physicians regularly. To identify the most significant predictors of adherence to HTR, multiple linear regression analysis was performed. Results indicated that good adherence to HTR was predicted by greater knowledge about hypertension and regularly visiting a physician. CONCLUSIONS: Adherence to taking antihypertensive medications was good overall among the study participants; these participants, however, were less interested in adherence to reduced sodium intake and keeping up with medical appointments. Hypertensive patients appear to follow instructions related to pharmacological management and are less likely to comply with other elements of HTR.

Perceived learning needs according to patients who have undergone major coronary interventions and their nurses.

AIMS AND OBJECTIVES: The aim of this study was to identify the differences in perceived learning needs between cardiac patients who have undergone major coronary interventions and their nurses. BACKGROUND: The decrease in length of stay after cardiac interventions has signalled an urgent need to provide effective in-hospital health education. Therefore, the content of health education should bridge the gap between nurses' and patients' views of what information is important for ensuring patients' optimum recovery. DESIGN: A descriptive comparative design was employed. METHODS: Patients were invited to participate if they had undergone angioplasty or bypass surgery and were ready for discharge within 24-48 hours. A convenience sample of 365 cardiac patients and 166 cardiac nurses participated in this study. Baseline data on patients' and nurses' sociodemographics, clinical history and experience were collected through personal interviews. Then, participants completed the Patient Learning Needs Scale to identify their perceptions of the learning needs after cardiac interventions. RESULTS: The top-priority learning needs according to both patients and cardiac nurses was information on wound care and medication. In contrast, the lowest-priority learning need was physical activity. Nurses perceived information about physical activity as most needed to patients, whereas patients perceived information about medications, postintervention complications and postintervention concerns as mostly needed. CONCLUSION: The disparity between perceptions of patient and nurses on the essential content to be learned highlights the importance of considering both of these parties when establishing health education programmes. In addition, nurses should focus more on information related to the recovery period and immediate needs after discharge. RELEVANCE TO CLINICAL PRACTICE: Information about wound care, medication and potential complications should be the core of predischarge education programmes. In addition, nurses should focus on improve patients' awareness of secondary prevention and lifestyle modification, as patients pay less attention to these vital topics.

Assessing Public's Knowledge About Hypertension in a Community-Dwelling Sample.

BACKGROUND: Hypertension is one of the major risk factors for cardiovascular diseases that affect a high proportion of people worldwide. Understanding people's levels of knowledge about hypertension might contribute effectively to nurses' efforts to prevent, treat, and control the disease. OBJECTIVES: The objectives of this study were to identify the levels of knowledge about hypertension disease among Jordanian adults and to identify differences in knowledge about hypertension on the basis of sociodemographic and clinical variables. METHODS: A convenience sample was used in this descriptive comparison design as was the Hypertension Knowledge-Level Scale, which measures 6 dimensions of knowledge about hypertension (definition, treatment, drug compliance, lifestyle, diet, and complications). RESULTS: There were 284 participants, and the mean total knowledge about hypertension was 73.65. The participants had higher levels of knowledge about lifestyle and complications; lower scores were recorded for definition of hypertension as well as the relationship between diet and hypertension. Participants with higher education levels, who watched health programs, exercised regularly, visited their physicians regularly, and had other chronic diseases, had greater knowledge about hypertension. CONCLUSIONS: Although the total level of knowledge about hypertension is good among the participants, more efforts are needed to improve all dimensions of hypertension-related knowledge. Sociodemographic and clinical variables have significant relationships with levels of knowledge about hypertension. This necessitates the importance of considering these variables when designing and providing health educational programs.

Knowledge of stroke and cerebrovascular risk factors among Jordanian adults.

This study aimed to identify the level of knowledge of stroke and cerebrovascular risk factors among Jordanian adults. It also aimed to measure the prevalence of cerebrovascular risk factors and to compare the stroke-related knowledge among participants based on their sociodemographical data. Two hundred twenty-four participants were included in this cross-sectional descriptive study. Data on prevalence and knowledge of stroke and cerebrovascular risk factors were collected through self-report questionnaires. Widespread prevalence of cerebrovascular risk factors was noted. The most common risk factors were inactivity (74%), overweight and obesity (59%), and smoking (34%). Moreover, only 30% of the study participants were able to enumerate three or more risk factors. The most commonly recognized risk factors were smoking (76%), hyperlipidemia (60%), and obesity (53%). Participants lacked basic knowledge about stroke; the average score for stroke knowledge was 8.8 of 20, with 49% of the participants achieving lower than the average score. Therefore, community awareness of stroke and cerebrovascular risk factors should be increased through national health education campaigns. In addition, health promotion programs should be adopted. They need to focus on utilizing available resources to reduce the high prevalence of major cerebrovascular risk factors in the Jordanian community. This will in turn reduce people's risk of experiencing strokes and other cerebrovascular diseases.

Predischarge education improves adherence to a healthy lifestyle among Jordanian patients with acute coronary syndrome.

Risk factor reduction and modification of patient lifestyle have become the focus of secondary prevention and cardiac rehabilitation programs. Considering the scarcity of resources in developing countries, nurses can potentially provide great benefit to acute coronary syndrome patients by utilizing hospital time to teach the patients how to lower their risk for recurrence and adopt healthier lifestyles after discharge. The purpose of this study was to identify the effectiveness of a predischarge education on acute coronary syndrome patients' lifestyles. Quasi-experimental pretest-post-test design was used. The patients assigned to the experimental group were offered predischarge education that stimulates lifestyle modification and adoption of a healthier lifestyle. The experimental group scored significantly higher than the control group in three lifestyle components - health responsibilities, nutrition, and interpersonal relations. In conclusion, predischarge education helps motivate acute coronary syndrome patients to adhere to a healthy lifestyle postdischarge. Therefore, nurses must be educated and prepared to be qualified health educators, and health education should continue as one of the most important daily nursing practices, thus it is invested in the preparation of acute coronary patients' discharge plan.