Pain and anxiety in patients with breast cancer treated with morphine versus tramal with virtual reality.

The treatment of pain and anxiety in cancer patients includes both pharmaceutical and non-pharmacological approaches. The researchers of this study aimed to compare the effectiveness of morphine versus Tramal with virtual reality therapy (VR) in reducing pain and anxiety in female patients with breast cancer. The sample was composed of 80 women with breast cancer who where treated at a specialized cancer center in Jordan. A quasi-experimental design was used in the study intervention. When used with VR, the tramal analgesics did not differe significactly from the effect of morphine in reducing the pain and anxiety. However, both groups had a significant drop in the level of pain and anxiety. When combined with VR, the use of weak opioids such as Tramal will have nearly the same effect as strong opioids such as Morphine in reducing pain and anxiety in breast cancer patients.

Health satisfaction and family impact of parents of children with cancer: a descriptive cross-sectional study.

BACKGROUND: The impact on parents of coping with a child who has cancer can be both severe and multifarious. Considerable distress persists throughout the treatment phase, persisting even after completion of treatment with heightened anxiety and stress associated with thoughts of recurrence or relapse. AIM: The purpose was to investigate the links between parents' satisfaction with the health care offered to their child with cancer and the impact on families of caring for such a child (including their health-related quality of life) in a Middle Eastern country. STUDY DESIGN: A descriptive, correlational, cross-sectional design was adopted. Arabic versions of parent-completed, validated instruments were completed by 113 parents whose child had cancer. RESULTS: Family relationship was found to be the best functioning domain, and daily activities were seen to be the poorest. In general, parents expressed satisfaction with their child's health care, but inadequate attention had been paid to their emotional needs. Cases in which children were reported to exhibit more emotional and behavioural problems correlated with greater negative impact on the family and disrupted family functioning. DISCUSSION: Parental quality of life was more severely affected than family quality of life. This results from mothers taking up most of the caregiver burden, and the impact on mothers was significantly greater than that on fathers. Children were protected from stress and anxiety by their mother. This burden on mothers resulted in deficits in emotional, social and physical functioning. PRACTICE AND POLICY IMPLICATIONS: Nurses and other health professionals should redress the balance between family-centred care strategies and child-centred approaches. Effort is needed to provide psychological support to parents by ensuring adequate preparation of staff, especially nurses, to recognise need and provide support in a therapeutic environment. Support may be needed for years after the diagnosis. This is a health professional role that may currently be neglected, and for which training is essential.

Prolonged Grief Disorder and Its Relationship With Perceived Social Support and Depression Among University Students.

The purpose of the current study was to examine the association between prolonged grief disorder, perceived social support, and severity of depression among Saudi Arabian university students after the death of a significant individual. A cross-sectional design was used to examine descriptive characteristics, correlational relationships, and statistical mean differences between male and female participants on prolonged grief disorder (PGD) scores in a convenience sample of Saudi Arabian college students. The Prolonged Grief Disorder-13 tool, Multidimensional Scale of Perceived Social Support, and the revised Beck Depression Inventory® were completed by 226 Saudi Arabian undergraduate students. Students reported moderate perceived social support from family, friends, and significant others. Only 13 (5.8%) individuals reported perceived support from academic staff. Students with the highest PGD scores were the least well-supported and most depressed. The need for academic staff and social workers to provide more social support to grieving students is discussed. [Journal of Psychosocial Nursing and Mental Health Services, 57(2), 44-51.].

Health-related quality of life and its association with self-esteem and fatigue among children diagnosed with cancer.

AIMS AND OBJECTIVES: To identify the links between self-esteem, fatigue and health-related quality of life for children and young people during and following treatment for cancer. BACKGROUND: Measures to minimise adverse outcomes for survivors of childhood cancer have been developed, but the crucial periods of returning to school and transition to adult life and adult services are not addressed so well. Screening of quality of life, fatigue and self-esteem in childhood cancer patients during and after treatment is important for optimising the nursing response and improving outcomes for children. DESIGN: A cross-sectional, descriptive, correlational, comparative survey was designed. METHODS: Validated measures of the attributes being studied were used. This study was conducted in private rooms on the ward and in the outpatient clinic of a major oncology hospital in Jordan in 2015. Seventy children aged 5-16 years were included. Ethical approval was secured. RESULTS: The age range of the children was 5-16 years (Mean 10·17, SD 3·4 years). Thirty were girls and 40 were boys. The total quality of life scores ranged from 21-100 (M = 65·5; SD = 17·6). The total scores of fatigue range from 12·5-100 (M = 65·79; SD = 22·20). Children with a high level of fatigue experienced lower quality of life. CONCLUSION: Continuing education centres at hospitals may find the results of this study helpful to provide professional updates and training events to enhance nurses' understanding of psychosocial distress responses and ability to intervene effectively within the multiprofessional effort. RELEVANCE TO CLINICAL PRACTICE: The outcomes of this study may enhance the development of guidelines for routine assessment by nurses and others of these factors among children with cancer. The nursing role in ensuring holistic care and attention to the problems of most concern to patients could be strengthened.

The factor structure of the internet addiction tool with university students in Jordan.

Internet addiction is a growing phenomenon affecting people in varying ways around the globe. This study examined the factor structure and internal reliability of the Internet Addiction Test (IAT) with a heterogeneous sample of university students in Jordan. The study used a cross-sectional design, and all the questionnaires were completed in classrooms. A sample of 587 students from seven universities in Jordan was obtained. The exploratory and confirmatory factor analyses of the 20-item IAT revealed that a four-factor solution offered the most parsimonious explanation of the data. The IAT reliably assesses distinct domains of Internet addiction. These domains are Excessive Use, Loss/Suffer, Attached To, and Impaired Social Relations. Thus, it is recommended to use the obtained four factors when assessing Internet addiction among a similar population.

Psychosocial correlates of Internet addiction among Jordanian university students.

Internet addiction is a significant international mental health problem among university students. The purpose of the current study was to investigate the correlation of Internet addiction with university students' characteristics in Jordan using a descriptive, correlational, cross-sectional design. The Internet Addiction Test, Beck Depression Inventory, and Multidimensional Scale of Perceived Social Support were administered to a random sample of 587 undergraduate university students. The findings demonstrated that university year level, student age, depression, and family support were significant correlates of Internet addiction. The current study should raise awareness in nurses and other health care providers that Internet addiction is a potential mental health problem for this student population. The findings from the current study will help develop appropriate interventions for these students and inform future research.

The MM-CGI Cerebral Palsy: modification and pretesting of an instrument to measure anticipatory grief in parents whose child has cerebral palsy.

AIMS AND OBJECTIVES: To establish the potential of a modified version of the MM-CGI Childhood Cancer to assess anticipatory grief in parents of children with cerebral palsy, to amend the existing scale for use with the specific patient group, to test the psychometric properties of the modified version (MM-CGI Cerebral Palsy) and to review the clinical potential of the new scale. BACKGROUND: Parents of children with cerebral palsy may experience reactions similar to parents of children with other enduring or life-limiting conditions, and anticipatory grief may be one such psychological reaction. While the burden of caring is sometimes balanced by positive perceptions of the child, which enhance coping ability, for many parents the outcome is damage to their physical and mental health and impaired family functioning. DESIGN: A cross-sectional, descriptive, correlational design. METHODS: The MM-CGI Cerebral Palsy was administered in structured interviews with 204 parents. Standardised measures of caregivers' depression, stress and perceived social support were also administered. Mothers and fathers were recruited from healthcare centres and schools for special education. Cronbach's alpha was used to assess internal consistency, and Pearson's product-moment correlation was used to assess construct validity. RESULTS: The subscales were each found to measure a single dimension of anticipatory grief, and significant correlations were established with existing instruments. The instrument demonstrated excellent internal consistency reliability and good construct validity. CONCLUSIONS: The MM-CGI Cerebral Palsy could be useful for diagnosing anticipatory grief among parents of children with cerebral palsy. This preliminary work moves the programme on to testing in intervention studies. RELEVANCE TO CLINICAL PRACTICE: In the absence of an existing measure for the assessment of anticipatory grief, specifically in parents of children with cerebral palsy, the MM-CGI Cerebral Palsy could prove to be an effective assessment tool for clinicians and researchers.

Quality of life, anxiety and depression among patients with chronic obstructive pulmonary disease and their spouses.

Chronic obstructive pulmonary disease (COPD) could have a negative impact on quality of life (QoL) and is associated with anxiety and depression in both patients and informal caregivers. The aim of this study was to examine the relationships between anxiety, depression and QoL of both Jordanian patients with COPD and their spouses. The selected design used in this study was a cross-sectional, descriptive, correlational design. A total of 67 patients and spouses were interviewed in 2011, using self-administered questionnaires. Descriptive statistical analysis was applied. Bivariate correlation analysis was undertaken to examine the relationship between variables. The results showed that patients and spouses with high levels of anxiety and depression reported a poor QoL. Patients had a lower QoL than their spouses. A better understanding of patient and spouse psychological wellbeing and QoL will provide nurses with the information needed in terms of developing strategies for reducing patients' and spouses' anxiety and depression and thus improve their QoL. The health-service agencies and government should improve policy by improving family-centred services for both patients and spouses.

Perceived breathlessness and psychological distress among patients with chronic obstructive pulmonary disease and their spouses.

The purpose of this study was to describe the impact of breathlessness on Jordanian patients with chronic obstructive pulmonary disease (COPD) and their spouses' perception of the patients' breathlessness. A cross-sectional, descriptive, correlational design was used with a sample of 67 Jordanian patients with COPD related breathlessness and their spouses. The Dyspnoea 12 Scale (D-12) and Hospital Anxiety and Depression Scale (HADS) were administered to both patients and spouses. There was a significant positive correlation between total patients' D-12 scores and total HADS scores. Spouses who perceived the patients to have more severe breathlessness affect (D-12 affect subscale) were more likely to experience a higher level of psychological distress (HADS total). Both patients and spouses reported clinically significant levels of anxiety and depression. There was no statistical difference in total D-12 and HADS scores between COPD patients and their spouses. The finding of this study indicates the importance of healthcare providers in supporting both patients with breathlessness and their spouses and the need to develop family-centred services.

Quality of life and anticipatory grieving among parents living with a child with cerebral palsy.

The purpose of this study was to describe the quality of life and anticipatory grieving among Jordanian parents living with a child with cerebral palsy. A cross-sectional, descriptive, correlational design was used with 204 Jordanian parents. Both mothers and fathers were recruited from health-care centres that provided comprehensive care for children with cerebral palsy in Jordan and from schools for special education. Structured interviews were conducted using the Marwit and Meuser Caregiver Grief Inventory Cerebral Palsy and Quality of Life Index. The majority of the parents reported that providing care for a child with cerebral palsy is requiring more emotional energy and determination than ever expected. There was a significant negative correlation between total anticipatory grief score and total quality of life score and all subscales. This indicates that parents with high level of intensity of anticipatory grief had lower quality of life. No statistically significant differences were found in anticipatory grief and quality of life responses between mothers and fathers. The outcomes of this study have important implications for encouraging family-centred care and inform policy to improve the lives of children with cerebral palsy and their parents.

Psychological distress and perceived support among Jordanian parents living with a child with cerebral palsy: a cross-sectional study.

BACKGROUND: Cerebral palsy, with a prevalence in Europe of 2-2.5 per 1000 live births, is the most common severe physical disability affecting children. While many parents have positive perceptions of their disabled children, caring for a child with disability can be exhausting and stressful, and social support is an important coping resource. There is little evidence about how having a child with cerebral palsy affects Jordanian parents. AIM: The purpose of this study was to provide insight into the psychological distress and perceived support among Jordanian parents living with a child with cerebral palsy. METHOD: In 2010, a cross-sectional, descriptive, correlational design was used with a nonprobability sample of 204 Jordanian parents. Both mothers and fathers, interviewed individually rather than in pairs, were recruited from health care centres that provided comprehensive care for children with cerebral palsy in Jordan and from designated schools for special education. The Gross Motor Function Classification System, the Perceived Stress Scale (PSS), the Beck Depression Inventory, the Strengths and Difficulties Questionnaire and the Multidimensional Scale of Perceived Social Support (MSPSS) were administered to parents. Descriptive statistical analysis was applied. Bivariate correlation analysis was undertaken to examine the relationship between variables. RESULTS: More than 60% of parents often felt nervous and stressed. The mean score on the PSS was 27.0 (SD=9.33), and the mean score on the MSPSS was 58.9 (SD=15.1). Severe disability in the child was associated with high mental distress in the parent and linked to low support from friends. There was a significant negative correlation between parental stress, depression and social support. Parents with the most psychological distress were the least well supported. CONCLUSION: This study has implications for health professionals in terms of developing strategies for reducing parental stress. There are implications for policy to provide support for parents and to develop family-centred services. The findings will inform an intervention study to investigate multi-professional support.

The psychosocial impact of child labour in Jordan: a national study.

The purpose of this study was to identify the psychosocial impact of child labour in Jordan, distinguishing between the impact on working school children, nonworking school children and working and nonschooled children. More than 351 million children across the world work. Emotional, behavioral and psychiatric problems in working children are a considerable public health problem in developing countries. A descriptive, comparative, cross-sectional design was used in this study. All data were collected in 2010. A total of 4008 children aged six to 16 years were interviewed. Of these, 2093 (52.2%) were nonworking school children, 896 (22.4%) working school children, and 1019 (25.4%) working and nonschooled children. Working school children reported psychosocial problems more often than working and nonschooled children. Child labour has a negative impact on children's psychosocial health and development. These findings indicate that psychoeducational support and problem-solving programs help children to cope better with the consequences of their work and study. More effort is needed to reduce children's involvement in labour. Understanding the impact of work on child mental and social health is essential to inform policy and future research as well as to improve the lives of children.

Informing mothers of neonatal death and the need for family-centered bereavement care: A phenomenological qualitative study.

PURPOSE: To understand the lived experience of mothers surrounding the time of being informed of neonatal deaths in intensive care units. DESIGN: A phenomenological qualitative approach was employed. METHODS: Twelve mothers (age 24-41 years) were identified from the neonatal mortality records of two large neonatal intensive care units with high neonate turnover rates in Amman, Jordan. Data were collected using semistructured interviews with the participants. Interpretive phenomenology was used to generate themes regarding the essence of the mother's experience. RESULTS: Critical analyses of mothers' accounts revealed three major themes: (a) Minimize the hurt, which described how mothers intuited overprotection by their families while the news was conveyed indirectly to them; (b) The striking reality of death, which captured mothers' distressing experiences while realizing the loss of their neonates; and (c) Farwell my baby, which accentuated mothers' needs and experiences while neonates' bodies were honored and prepared for burial per the cultural norms in Jordan. PRACTICE IMPLICATIONS: Our findings highlighted the complex dynamics of familial interactions and cultural influences on mothers' bereavement experiences at the time of neonatal death. The grieving mothers expressed unfulfilled needs of receiving professional bereavement support at the time of neonatal death. Strategies are needed to optimize the supportive role of specialized nurses in providing family-centered bereavement care to mothers and their families who experience neonatal death.

Anticipatory grieving among parents living with a child with cancer.

AIM: This paper is a report of a comparative study of anticipatory grief of parents of children newly diagnosed with cancer and those whose children were diagnosed 6-12 months earlier. BACKGROUND: Public perceptions of cancer as a fatal illness persist despite improved prognosis for children. Parents may experience feelings of despair, hopelessness, and worthlessness - the most common psychological expressions of anticipatory grief. With a focus on developing more effective therapeutic intervention, healthcare professionals have developed greater interest in the concept of anticipatory grief. METHOD: One hundred and forty parents, divided between 'newly diagnosed' and '6-12 months after diagnosis' groups, were recruited in 2006 from two hospitals representative of the healthcare sector in Jordan. Structured interviews were conducted to assess anticipatory grief, using the Marwit and Meuser Caregiver Inventory: Childhood Cancer. Analysis was performed using t-tests. RESULTS: Fewer than half of the parents in both groups reported being at peace with themselves and their situation in life. Parents of newly diagnosed children reported more severe anticipatory grief responses than those in the second group. No statistically significant differences were found in responses between mothers and fathers. CONCLUSION: Healthcare professionals should encourage parents to discuss negative feelings related to their child's illness and potential outcome. Hospital policies need to include the provision and promotion of support group services for parents, and nurses should encourage parents to exploit such services.

Maternal Bereavement: Mothers' Lived Experience of Losing a Newborn Infant in Jordan.

The death of a newborn infant is one of the most devastating situations a mother could experience. The aim of this study was to understand bereavement and its associated meanings as lived and experienced by the mothers who lost their newborn infants in the intensive care units of hospitals in Jordan. Data were generated using semistructured face-to-face interviews with 12 mothers who had the experience. A qualitative phenomenological approach was used for data analysis. Three main themes emerged from the analysis: (1) longing and grieving, as natural emotional responses to the loss; (2) adaptive work of coping, as the mothers internalized meanings to cope with their loss; and (3) moving forward but with a scar, as the mothers moved on with their lives while they carried the unforgettable memories of the newborns' death experience. Bereavement support services should be considered vitally important as soon as the news of a newborn's death is delivered to the mother. Palliative care nurses and other health care providers should give careful attention to the meanings that the mothers attached to the loss and support each bereaved mother's spiritual values and effective coping mechanisms.

Stress and coping strategies among Saudi nursing students during clinical education.

PURPOSE: The purpose of this study was to determine the stress level and coping strategies among undergraduate Saudi female nursing students during their clinical education. DESIGN AND METHODS: In this study, a descriptive correlational cross-sectional design was used. The Demographic Information Questionnaire, Perceived Stress Scale, and Coping Behavior Inventory were completed by 121 female Saudi undergraduate nursing students. FINDINGS: The findings showed that stress from taking care of the patient subscale (M = 12.0, SD = 5.0) was ranked the highest mean among all perceived stress subscale scores. The most commonly used coping strategies among nursing students in clinical practice was a problem-solving strategy (M = 15.8, SD = 4.3). PRACTICE IMPLICATIONS: Facilitating the use of effective coping strategies in nursing students will promote quality of care for their patients.

Psychometric Properties of the Coping Behavior Inventory Among Students of Arabic Universities.

PURPOSE: To examine the psychometric properties of the Coping Behavior Inventory (CBI) among Arab students in Jordanian universities. METHODS: A stratified random sampling technique was used to select the universities and classes from each university. The total sample size was 587 students recruited from seven universities during the academic year 2015. The structure of the CBI was analyzed by exploratory factor analysis (EFA) using Statistical Package for Social Science and confirmatory factor analysis (CFA) using AMOS software. EFA for the original CBI showed poor factors structure with low reliabilities. RESULTS: EFA and CFA revealed the modified 15-item and 3-factor scale (Problem Solving, Avoidance, Stay Optimistic), with high goodness of fit indices and strong items loading. CONCLUSION: The use of the modified version of CBI with students at the university level is recommended.

Depression and perceived social support among Saudi patients with multiple sclerosis.

PURPOSE: To examine the association between depression level and perceived social support among patients with multiple sclerosis (MS) in Saudi Arabia. DESIGN AND METHODS: A cross-sectional, descriptive, correlational design was used with 140 patients. A self-reporting questionnaires were used. FINDINGS: The age range of the participants was 18-59 years (mean 34.3 years, SD 7.69). The mean score for reported depression was 27.5 which is considered as moderate level of depression. The mean score of the Multidimensional Scale of Perceived Social Support (MSPSS) was 45.3 (SD = 16.2). Patients with MS who received higher level of social support exhibits lower level of depression. PRACTICE IMPLICATIONS: Aside from addressing physiological needs, healthcare providers must ensure that patients with MS receive positive social support to decrease level of depression.

Testing of the Hospital Anxiety and Depression Scale in Patients With Chronic Obstructive Pulmonary Disease.

PURPOSE: The aim of this study was to develop the Arabic version of the Hospital Anxiety and Depression Scale (A-HADS) and test its psychometric proprieties for the assessment of anxiety and depression in patients with chronic obstructive pulmonary disease (COPD). METHOD: The A-HADS and Quality of Life Index Pulmonary version were completed by 67 Jordanian patients with COPD. RESULTS: Cronbach's alpha coefficient has been found to be 0.75 for the A-HADS anxiety subscale and 0.82 for the A-HADS depression subscale. A-HADS scores correlated significantly with the Quality of Life Index Pulmonary version and demonstrated construct validity. IMPLICATIONS: This preliminary validation study supports the A-HADS as a reliable and valid instrument for the assessment of anxiety and depression in Arabic speaking patients with COPD.

The Psychometric Properties of an Arabic version of the PedsQL Multidimensional Fatigue Scale Tested for Children with Cancer.

Fatigue is considered to be one of the most reported symptoms experienced by children with cancer. A major aim of this study was to develop an Arabic version of the Pediatric Quality of Life (PedsQL) Multidimensional Fatigue Scale (child report) and to test its psychometric proprieties for the assessment of fatigue in Arabic children with cancer. The PedsQL Multidimensional Fatigue Scale (Arabic version) and the PedsQL TM 4.0 Generic Core scale (existing Arabic version) were completed by 70 Jordanian children with cancer. Cronbach's alpha coefficients were found to be 0.90 for the total PedsQL Multidimensional Fatigue Scale (Arabic version), 0.94 for the general fatigue subscale, 0.67 for the sleep/rest fatigue subscale, and 0.87 for the cognitive fatigue subscale. The PedsQL Multidimensional Fatigue Scale scores correlated significantly with the PedsQL TM 4.0 Generic Core scale and demonstrated good construct validity. The results demonstrate excellent reliability and good validity of the PedsQL Multidimensional Fatigue Scale (Arabic version) for children with cancer. This is the first validated scale that assesses fatigue in Arabic children with cancer. The English scale has been used with several pediatric clinical populations, so this Arabic version may be equally useful beyond the field of cancer.