Medication adherence among patients with cardiovascular diseases: a cross-sectional study.

Background: Medication adherence has been recognised as one of the greatest areas to improve health outcomes and reduce health expenditure. Poor medication adherence has multifactorial causes that need to be understood. Aim: To determine the levels of medication adherence and examine the factors associated with medication adherence among patients with cardiovascular diseases (CVDs) in Jordan. Methods: A cross-sectional, descriptive correlational design was used to conduct this study. A convenience sample was used to recruit 250 patients with CVDs from outpatient clinics of Jordanian hospitals. Data were collected using the Multidimensional Scale of Perceived Social Support and Morisky Medication Adherence Scale, in addition to sociodemographic and clinical-related factors during the period from June to September 2019. Results: It was found that the total mean score of medication adherence was 2.84 (standard deviation = 1.9), which reflected low adherence. A significant positive correlation was found between medication adherence and marital status and the number of diseases. However, smoking was negatively correlated with medication adherence. Smoking was the predictor of medication adherence. Conclusions: Medication adherence among patients with CVDs needs to be improved. Thus, healthcare professionals should develop strategies and interventions based on identifying factors to enhance medication adherence among those patients.

Evaluation of compassion fatigue and compassion satisfaction among emergency nurses in Jordan: A cross-sectional study.

BACKGROUND: Nurses working in emergency departments are overworked and exposed to frequent stressors over time, leading to compassion fatigue, burnout, and secondary traumatic stress. AIMS: This study aimed to assess the levels of compassion fatigue and compassion satisfaction, and examine the relationship of these two variables with specific demographic, health-related, and work-related factors among emergency nurses in Jordan. METHODS: This is a cross-sectional study. The Professional Quality of Life Scale Version 5 was used to collect data. RESULTS: A convenience sampling method was used to recruit 203 registered nurses from emergency departments in Jordan. The mean compassion fatigue and satisfaction scores were moderate. There was a significant but negligible correlation between compassion satisfaction and educational levels (r = 0.15, p < 0.05) and between secondary traumatic stress and comorbid diseases (r = -0.16, p < 0.05). CONCLUSIONS: Although the levels of compassion fatigue and satisfaction were moderate, both may negatively affect nurses' care and patient outcomes. Conversely, compassion satisfaction should be improved in order to overcome the negative effects of compassion fatigue.

Postpartum depression among first-time Jordanian mothers: levels and associated factors.

Postpartum depression among first-time mothers is a sensitive issue and few studies were conducted related to this topic in developing countries including Jordan. Thus, this study purposed to assess postpartum depression levels and associated factors among Jordanian first-time mothers. A cross-sectional design was adopted, and 193 postpartum first-time mothers living in Amman governorate were recruited. A questionnaire consisting of two parts was used to record data, sociodemographic and maternal health, and Patient Health Questionnaire (PHQ-9). Findings showed that 34.1% of the women experienced postpartum depression. The employment, gravida, antenatal health problems, breastfeeding problems, newborn health problems, and availability of assistance during the postpartum period significantly correlated with postpartum depression. Thus, the understanding of postpartum depression and related factors would provide important empirical evidence for healthcare professionals and policy-makers when planning to develop strategies and measures to minimize postpartum depression among first-time mothers.

Effect of Educational Program on Knowledge, Skills, and Personal Preparedness for Disasters Among Emergency Nurses: A Quasi-Experimental Study.

Continuous nursing education has a significant correlation with increasing knowledge, improving skills, and personal preparedness for disasters among nurses which leads to a decrease in mortality rate and enhances the quality of care. However, there is limited literature evaluating the effect of educational programs on the knowledge, skills, and personal preparedness for disaster preparedness among emergency nurses at Arab countries including, Jordan. This study evaluated the effect of an educational program on knowledge, skills, and personal preparedness for disasters among emergency nurses. A quasi-experimental study and one-group pretest-posttest design was used. A convenience sample was adopted to recruit registered nurses who are working in emergency rooms in the private and government health sectors in Jordan (N = 50). This study was conducted between May and June 2021. The intervention included an educational program consisting of 5 topics about disasters. The participants attended this program for 8 h over 1 week via Zoom application. There were significant differences between the pre-post educational intervention for knowledge (t = 4.79, P ≤ .001), skills (t = 6.66, P ≤ .001), and personal preparedness (t = 9.56, P ≤ .001) for disasters. These findings suggested the importance of implementing continuous education and training programs for emergency nurses about disasters due to increasing frequency of disasters worldwide.

Knowledge of Critical Care Nurses about End-of-Life Care towards Terminal Illnesses: Levels and Correlating Factors.

INTRODUCTION: The preparedness of nurses in relation to providing palliative care is not always adequate, indeed, it is sometimes unsatisfactory; this may be caused by lack of knowledge and limited experience in end-of-life care (EOLC). Thus, this study purposed to assess the levels of registered nurses' knowledge about EOLC, examine the relationships between EOLC knowledge and some demographic variables, and explore predictors of EOLC knowledge. METHODS: A cross-sectional design survey was conducted with Jordanian registered nurses in critical care units (N = 175) in different heath sectors in Jordan. The End-of Life Professional Caregiver Survey (EPCS) was used. RESULTS: Findings showed that nurses had moderate/quite a lot of knowledge (M (SD) = 2.58 (.48)) about EOLC. The cultural and ethical values was the highest subscale of knowledge about EOLC (M (SD) = 2.74 (.52)), while effective care delivery subscale was the lowest one ((M (SD) = 2.33 (.66). Knowledge about EOLC was correlated with age (r = .145, P < .05), work experience (r = .173, P < .05), and training course in palliative or EOLC (r = .217, P < .01). The main predictor of EPCS was training courses in palliative or EOLC (B = .190, P < .05). CONCLUSION: The nurses need to enhance their knowledge about EOLC and correlating factors should be taken into consideration when developing any intervention program. Nurses need palliative care training courses; also more attention is required in palliative care education particularly in clinical skills in effective care delivery.

Nurses' Self-Efficacy, Confidence and Interaction With Patients With COVID-19: A Cross-Sectional Study.

OBJECTIVE: The aim was to evaluate nurses' self-efficacy, confidence, and nurse-patient interaction during caring of patients with coronavirus disease 2019 (COVID-19). METHODS: A cross-sectional design with online survey was used with a Self-efficacy scale, Self-confidence scale, and Caring nurse-patient interaction scale: 23-item Version-Nurse (CNPI-23 N). RESULTS: A sample of 120 nurses participated in the current study. The results showed that the participants had a moderate level of self-efficacy, self-confidence and interaction (M = 28.84 (SD = 7.7), M = 47.41 (SD = 9.0), and M = 93.59 (SD = 16.3), respectively). Positive relationships were found between nurse' self-efficacy, self-confidence, and nurse-patient interaction (r = 0.81; P < 0.0001 and 0.79; P < 0.0001, respectively). Significant differences were found in self-efficacy according to years of experience, academic qualifications and position (F = 2.10; P = 0.003; F = 3.60; P = 0.002, and F = 2.60; P =0.007, respectively). Furthermore, the results indicated that there was a significant difference in self-confidence and nurse-patient interaction also. CONCLUSION: Nurse educators and administrators should develop and implement further strategies, such as continuing education and training, compensatory payment, organizational support, and availability of protective measures to increase their self-efficacy, self-confidence, and interaction with COVID-19 patients.

Professional Values Development Among Jordanian Baccalaureate Nursing Students.

AIM: The aims of the study were to identify professional values among third- and fourth-year baccalaureate nursing students at private and public universities in Jordan and to investigate the demographic variables correlating with professional values. BACKGROUND: Educational curricula reinforce professional values among nursing students. METHOD: A cross-sectional design was used; the questionnaire included a demographic variable survey and the Nurses Professional Values Scale-3. RESULTS: The mean score for the overall value scale was moderate (3.5, SD = 0.4, range 1-5). The caring subscale was the highest (3.9); the professionalism and the activism subscales had the same mean (3.3). Male students, studying in private universities and employed in health care, scored higher (p = .002, .001, and .01, respectively). Study track and age were insignificantly correlated. CONCLUSION: The development of professional values is associated positively with practice and employment status; clinical experience improved students' sense of professionalism.

Pain management in the older adult: The relationship between nurses' knowledge, attitudes and nurses' practice in Ireland and Jordan.

BACKGROUND: Research studies regarding nurses' knowledge attitudes and practice in the older adult are limited. Furthermore, none of these studies attempted to investigate the relationship between knowledge attitudes and practice. Furthermore, little studies compared nurses' knowledge, attitudes and practice between Eastern and Western countries. AIM: To describe the factors associated with nurses' acute pain management practice in the context of caring for older adult patients. METHOD: A quantitative, correlational, comparative and cross-sectional survey approach. DATA COLLECTION: Data were collected using survey questionnaire. SAMPLE: A sample of 267 registered nurses from Ireland and Jordan (one private hospital in each country). RESULTS: A multiple linear regression analysis revealed that nurses' general knowledge and attitude towards pain management was associated with their pain management practice, with a regression coefficient of 0.14 (p = 0.002). However, knowledge of pain in the elderly failed to reach a statistically significant relationship with pain management practice. In regards to country and gender, Irish nurses had an average score that was 2.61 points higher than Jordanian nurses (p < 0.001), female nurses had an average score that was 0.67 points higher than male nurses (p = 0.025). The overall regression model was significant (p < 0.001) with an R2 value of 43.2%, indicating that 43.2% of the variation in scores was explained by knowledge, attitude and practice. CONCLUSION: More research studies combining the three concepts (knowledge, attitude and practice) are recommended in the area of pain management.

Predictors of Chemotherapy Safe-Handling Precautions and Knowledge Among a Sample of Jordanian Oncology Nurses: A Model-Building Approach.

BACKGROUND: There are adverse side effects associated with handling chemotherapy; however, using safe-handling precautions can minimize or prevent these potential effects. Despite availability of international guidelines for chemotherapy handling, adherence to precautions is below expectations. This study examined knowledge of safe-handling precautions among a sample of oncology nurses in Jordon. METHODS: A cross-sectional study was employed that included a convenience sample of 153 oncology nurses. Oncology nurses from two hospitals completed the Chemotherapy Handling Questionnaire. Descriptive analysis, Spearman rank correlation coefficients, and regression analyses were performed to determine the predictors of precaution use when handling hazardous drugs among participants. FINDINGS: We observed that age, number of patients for whom the worker administered chemotherapy per day, the number of patients receiving chemotherapy per day in the participant's work unit, nurses' knowledge about safe-handling precautions, perceived risk, perceived barriers, self-efficacy, organization influence/workplace safety climate, conflict of interest, and interpersonal influences were predictors of use of safe-handling precautions (adjusted R2 = .66, p < .001). CONCLUSION/APPLICATION FOR PRACTICE: Several predictors for using safe-handling precautions were identified. Clinically, chemotherapy handling procedures should be evaluated frequently to identify barriers to safe practices and to improve worker safety.

Correlation between quality of life of cardiac patients and caregiver burden.

BACKGROUND: Caregivers experience high strain related to care giving. There is increasing interest in examining the caregiver burden of cardiac patients and studying the characteristics of caregivers. PURPOSE: To explore the correlation between quality of life cardiac patients and caregiver's burden. METHODS: A cross-sectional design using a convenience sample of caregivers and patients with cardiac conditions. Sociodemographic sheet, Dutch Objective Burden Inventory (DOBI), and Quality of Life (QLI-Cardiac 4). Linear regression was used to explore the predictors. RESULTS: 200 caregivers and 200 patients with cardiac diseases completed the study. The overall mean scores of both DOBI and QLI-4 indicated moderate results 1.51(SD 0.4), 19.8 (SD 4.7) respectively. Predictors of caregiver burden were young, less educated caregivers and high QoL of cardiac patients. CONCLUSION: Caregivers should receive more support and training from healthcare providers to develop their coping and resilience skills in a way that decreases their care burden and improves their quality of care and self-confidence.

Quality of life, care needs, and information needs among patients diagnosed with cancer during their treatment phase.

Proper assessment of patients' needs might enhance patients' outcomes, ability to cope with new challenges, identify required resources, prioritize service needs, determine patients with higher need levels, and improve patients' quality of life. A cross-sectional descriptive design was used. Total of 113 patients from different settings completed the study surveys including demographic sheet, Short-form cancer needs questionnaire (CNQ-SF), Functional Assessment of Cancer Therapy-General (FACT-G), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-INFO 25). Regression analysis indicated that care needs and information needs were predictors of QOL (R2 = 0.688, adjusted R2 = 0.61, F (1.17, p < 0.001)). A significant correlation exists between QOL, care needs and information needs. Daily nursing practices should include assessing patients; care needs, information needs, and QOL through using valid and reliable scales.

Using Mixed-Methods Research to Study Coping Strategies among Colorectal Cancer Patients.

OBJECTIVE: The objective was to identify and understand the coping strategies of colorectal cancer (CRC) patients. METHODS: A mixed-methods approach including quantitative and qualitative methods was used to collect data from Jordanian patients. In the quantitative phase, we aimed to determine the coping strategies employed in a representative sample (n = 200) of Jordanian adult patients with CRC using the Jalowiec Coping Scale. In the qualitative phase, we aimed to understand these coping strategies through an in-depth and detailed exploration. A sample of ten participants was chosen purposefully based on their coping score in the quantitative phase, and interviews were conducted. Quantitative data were analyzed using SPSS software version 23. Qualitative data were analyzed using directed content analysis. RESULTS: Results from the quantitative phase indicated that evasive coping strategies were used predominantly, followed by confrontive coping strategies and optimistic coping strategies. In contrast, fatalistic and emotive coping strategies had the lowest scores. In addition, the results indicated that the total scores for the effectiveness of coping strategies ranged from 42 to 143, with a mean of 93.45 (standard deviation 13.67); higher scores reflected greater effectiveness. Content analysis in the qualitative phase identified three themes, and subcategories emerged, including perceived collaborative support, increased awareness of treatment, and internal power. CONCLUSIONS: CRC patients used different coping strategies to face the new challenge. Oncology nurses can play a pivotal role in enhancing these coping strategies through implementing multidisciplinary programs.

Accuracy of Body Weight Estimation Among Palestinian Refugee Adolescents Living in Jordan: A Cross-Sectional Study.

PURPOSE: We aimed to examine the prevalence of obesity among adolescents living in a refugee camp in Jordan and analyze the factors influencing their weight perceptions. DESIGN: Cross-sectional survey. METHODS: We examined the body weight perception, and the influence of psychological, cultural, and social factors, among Palestinian refugee adolescents living in Jordan using a cross-sectional survey. Univariate, bivariate, and multiple logistic regression analyses were used to investigate the relationships between body weight status, weight perception, satisfaction with weight, screen time, and depression status of these adolescents. RESULTS: A total of 620 adolescents participated in the study, of which 24% were either overweight or obese. Overweight or obese adolescents were more likely to underestimate their weight (p < .001), while those with depressive symptoms (Patient Health Questionnaire for Adolescents score > 14), were more likely to overestimate their body weight (p = .021). Having symptoms indicative of depression (adjusted odds ratio [AOR] = 1.70; 95% confidence interval [CI] = 1.16-2.50) and having a body mass index in the overweight/obese range (AOR = 4.16; 95% CI = 2.73-6.35) were predictors of discordant weight perception. CONCLUSIONS: This study showed that excess body weight is a significant issue among Palestinian refugee adolescents living in a refugee camp in Jordan. Underlying depression is an important factor in excess weight and distorted weight perceptions especially among this vulnerable group. CLINICAL RELEVANCE: The study highlights the importance of addressing discordant body weight perception and depression in weight management in nursing interventions for vulnerable adolescent groups.

Prevalence of Depression and Its Influence on the Quality of Life of Jordanians Living in Residential Care Facilities.

BACKGROUND: As a third-world country experiencing a rise in the elderly population and changes to traditional family structures, improving psychological health is critical to improving quality of life (QoL) in the older adults living in residential care facilities in Jordan. PURPOSE: This study aimed to (a) estimate the prevalence of depression among nursing home (NH) residents in Jordan; (b) measure perceived QoL in these NH residents in the dimensions of mobility, self-care, usual activity, pain and discomfort, and anxiety/depression; and (c) assess the influence of depression on each of these QoL dimensions. METHODS: This cross-sectional study recruited a convenience sample of 155 participants living in a residential care facility in Jordan. The instruments used included a sociodemographic and clinical questionnaire, the Mini-Mental State Examination, a Geriatric Depression Scale (GDS), and the EuroQol, which is a five-dimension, five-level questionnaire. The data were presented as means, standard deviations, and percentages as well as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). RESULTS: A high prevalence of depression was found in the study population, with 72.3% having a score between 6 and 9 on the GDS, which is suggestive of depression. Moreover, 18.1% scored ≥ 10 on the GDS, which is indicative of a nearly continual state of depression. With regard to the QoL dimensions, 84.5% of the participants reported experiencing pain, 81.9% reported anxiety/depression, 80.6% reported problems performing usual activities, 75.5% reported problems with self-care, and 63.2% reported mobility difficulties. Pain, anxiety, and depression were found to be significantly associated with level of depression (AOR = 2.78 and 95% CI [1.18, 6.57], AOR = 5.81 and 95% CI [2.14, 15.78], and AOR = 4.75 and 95% CI [1.87, 12.07], respectively). CONCLUSIONS: Depression is common among NH residents in Jordan and is associated significantly with poor QoL. This study yielded empirical data that may be used to develop strategies to enhance or promote the mental health status and QoL of NH residents in Jordan.

Coping strategies as moderating factors to compassion fatigue among critical care nurses.

PURPOSE: This study measured levels of compassion fatigue, burnout and satisfaction among critical care and emergency nurses. It investigated coping strategies as moderating factors and as predictors to levels of compassion fatigue. METHODS: Using a cross-sectional design, this study was conducted on 228 (84.4%) out of 270 from four Jordanian hospitals. Nurses worked in different types of critical care units and emergency departments. Nurses completed a demographic questionnaire on the professional quality of life and coping strategies indicator scales. RESULTS: Nurses had low to average compassion satisfaction, burnout and secondary stress syndrome. Problem-solving and avoidance ranged between very low and average levels. Nurses reported having very low to average levels on seeking social support scale. Female nurses had better compassion satisfaction compared with their male colleagues, and the type of unit had a significant impact on the secondary stress syndrome, problem-solving, and seeking social support. Nurses from the surgical cardiovascular ICU scored the highest mean scores on the secondary stress syndrome. Better coping strategies were associated with higher compassion satisfaction and lower levels of secondary stress syndrome. Problem-solving significantly predicted compassion satisfaction, avoidance significantly predicted secondary traumatic syndrome. CONCLUSIONS: Coping strategies are moderating factors that could improve compassion satisfaction among critical care nurses. Managers could use findings to create healthier and supportive work environments. We recommend focusing on activities that promote better coping strategies, including improving the social support system. We also recommend replicating this study using a qualitative approach to identify further causes of compassion fatigue.

Health Related Quality of Life Among Patients With Multiple Sclerosis: The Role of Psychosocial Adjustment to Illness.

BACKGROUND: Multiple Sclerosis (MS) is associated with poor quality of life (QOL). Individuals suffering from MS must make multiple adjustments as their condition changes. To date, little is known about the role of psychosocial adjustment in improving QOL of patients with MS. PURPOSE: The purpose of this study is to identify the relationship between psychosocial adjustment and HRQOL controlling for demographic variables among patients with MS. METHODS: This study used a descriptive-correlational design. A sample of 160 patients from two hospitals participated in the study. Self-reported data were collected using the demographic survey, Multiple Sclerosis Quality of Life (MSQoL-54) tool and Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR). RESULTS: Participants reported poor QOL and difficulty with psychosocial adjustment. The QOL and psychosocial adjustment were correlated with various demographic variables. After controlling for demographic variables, psychosocial adjustment explained a large variance in the mental health composite of QOL (r square change = 44%) and the physical health composite of QOL = (r square change = 38%). CONCLUSION: Psychosocial care could play a vital role in improving quality of life among MS patients.

Medication Administration Errors: Perceptions of Jordanian Nurses.

BACKGROUND: Medication administration errors (MAEs) have short- and long-term implications on patients' health as well as on hospitals' accreditation and financial status. PURPOSE: The purpose was to explore Jordanian nurses' perceptions about MAEs. METHODS: A cross-sectional design was used with a convenience sample of 470 nurses. RESULTS: The most common types of MAEs were wrong time (32.6%) and wrong patient (30.5%). In addition, night shifts accounted for 42.9% of MAEs; the factor that contributed the most to MAEs was workload. CONCLUSION: Developing effective quality assurance programs in relation to medications and medication administration in all Jordanian health care settings is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of medication rights as well as medication calculation. A distraction-free zone should be created and reinforced in all medication rooms.

Teaching module for improving oncology nurses' knowledge and self-confidence about central line catheters caring, complications, and application: A pretest-posttest quasi-experimental design.

The aim of the present study was to assess the effectiveness of implementing an educational module based on the Centers for Disease Control and Prevention guidelines on the nurses' knowledge and self-confidence regarding central line catheters (CVCs) caring, complications, and application. A pretest-posttest quasi-experimental design was used. A sample of 100 oncology nurses from oncology units participated in two groups, experimental group (N = 50) and control group (N = 50). The participants completed knowledge test and self-confidence scale before and after the educational program. The results showed that there was a significant difference between the experimental and control groups regarding knowledge related to CVC guidelines and management after the interventional sessions (t = -7.85, P = .001). The mean and standard deviation for experimental group were 15.95 (5.45) and 7.35 (2.73) for the control group. Furthermore, the results showed significant difference (t = -22.20, P = .001) between the experimental group (M = 61.50, SD = 14.20) and the control group (M = 35.50, SD = 7.20) regarding self-confidence in managing CVCs. It is concluded that using educational program strengthens nurses' skills, improves safety, and increases opportunity to learn, and thus, it will increase the self-confidence.

Predictors of uncertainty among postdischarge coronary artery bypass graft patients in Jordan.

Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs. A total of 161 participants completed the study questionnaires. Participants showed a moderate level of uncertainty, less cardiac symptom distress, and high learning needs. Uncertainty was significantly correlated with learning needs while less correlated with symptom distress. Hierarchal multiple regression revealed that gender, employment status, education level, and learning needs are factors associated with uncertainty among CABG patients. It was concluded that symptom distress does not necessarily induce uncertainty. Intensive care professionals should undertake individual's characteristics to anticipate uncertainty.