The validation of the Arabic version of the resilience scale 14 (RS-14).

BACKGROUND/OBJECTIVES: Nurses in Lebanon are facing multiple crises and the severity of the situation calls for an empirical examination of their resilience status. Evidence indicates that resilience can buffer the negative effect of workplace stressors on nurses and is associated with favorable patient outcomes. The objective of this study was to test the psychometric properties of the Arabic Resilience Scale-14 that was utilized to measure resilience among Lebanese nurses, METHODS: Data was collected from nurses working in health care centers using a cross-sectional survey design. We estimated the confirmatory factor analysis using the Diagonally Weighted least Squares. Fit indices for the confirmatory factor analysis model included Model chi-square, root-mean squared error of approximation and Standardized Root Mean Square Residual. Statistical significance was set at p < 0.05. RESULTS: 1,488 nurses were included in the analysis. The squared multiple correlations values ranged from 0.60 to 0.97 thus supporting the construct validity of the originally hypothesized five factor model (self-reliance, purpose, equanimity, perseverance, and authenticity). CONCLUSIONS: The Arabic version of the Resilience Scale 14 tool is considered a valid tool for measuring resilience in any situation involving Arabic speaking nurses.

Attitudes of midwives and obstetricians towards midwives practiced roles in hospitals: A national study in Jordan.

AIMS: The aims of this study were to identify midwives' and obstetricians' attitudes towards midwives practised roles in hospitals and to identify the differences in their attitudes towards midwives practiced roles. MATERIALS AND METHODS: A descriptive, cross-sectional, study design was used. A convenience sample of 303 midwives and 143 obstetricians were recruited. Participants were from 12 Ministry of Health (MOH) and Royal Medical Services (RMS) hospitals distributed across seven governorates. Two reliable and valid self-administered questionnaires were used to collect data including socio-demographic data-related characteristics of participants and obstetricians' and midwives' attitudes towards midwives' practiced role in hospitals. RESULTS: There were significant differences between obstetricians in the three subscales of attitudes: midwives women relationship attitude subscale, midwives trust and mutual respect subscale and work environment attitudes subscale. A significant difference by the institution was reported: obstetricians and midwives who worked in MOH reported more positive attitudes than those who worked in RMS. CONCLUSION: The results show that obstetricians recognise that midwives are qualified and competent professionals but still lack the competencies/skills to make them independent practitioners. The findings also confirm the need to improve midwives' practices by moving from being able to perform a specific task to possess all three attributes of "competencies," where they can intervene, manage and make decisions with confidence in each situation. IMPLICATION FOR PRACTICE: Based on the current study findings, parallel cooperation between educational/academic policymakers from both midwives and obstetricians may re-evaluate and upgrade the midwifery curriculum to meet the ICM competencies and health sector needs as a step to graduate competent midwives where their responsibility is recognised and organised.

Factors Associated with Cervical Cancer Screening Uptake: Implications for the Health of Women in Jordan.

Purpose: The existing factors that influence cervical cancer screening uptake worldwide do not necessarily reflect the situation in Jordan. Therefore, the aim of this study was to determine the factors associated with cervical cancer screening uptake among Jordanian women. Methods: In this cross-sectional study, 500 married Jordanian women aged 21 to 65 years were recruited from eight nongovernmental organisations and community settings in Amman. Data were collected with a self-administered questionnaire regarding sociodemographic and reproductive data, a health utilisation data form, and scales on the perceived benefits of screening, perceived barriers to screening, perceived susceptibility to cervical cancer, and perceptions regarding the severity of cervical cancer. Descriptive statistics, multivariate logistic regressions, and independent t-tests were used in the data analysis. Results: Among the 500 age-eligible women, only 156 (31.2%) had been screened for cervical cancer. Healthcare provider encouragement, years of marriage (odds ratio (OR) = 5.24, confidence interval (CI) = 95%, p = 0.00), and use of the private healthcare sector (OR = 2.20, CI = 95%, p = 0.012) were significant predictors of cervical cancer screening. Conclusion: Cervical cancer screening uptake among Jordanian women is significantly low; determining factors for the decision to undergo screening include encouragement from the healthcare provider, the number of years of marriage, and use of the private healthcare sector. To improve uptake, structured screening programmes need to be implemented in collaboration with national partners and institutions to decrease the incidence of cervical cancer in Jordan.

Perspectives of Registered Nurses on refugee healthcare in Lebanon and Jordan (PROfILE): A multi-site cross-sectional study protocol.

AIM: This is a study protocol to investigate nurses' perspectives on refugee health care in two countries. The aims are to: (a) explore self-reported work environment factors, including work stressors, self-rated leadership, staffing and resources adequacy, and teamwork among Jordanian and Lebanese nurses caring for refugees; (b) investigate the relationship between nurse related outcomes (physical health; emotional exhaustion) and their psychosocial work environment; and (c) assess the association between nurses' perceived work environment factors and implicit rationing of care and quality of patient care. BACKGROUND: Globally, the care of refugees is achieving increased attention. Over 6.3 million people are internally displaced and 4.8 million recorded Syrian expatriates are residing in and receiving healthcare services in the neighbouring host countries. DESIGN: This is a cross-sectional, comparative study using a survey design. METHOD: The study setting involves both private and public hospitals and primary healthcare centres that provide care to refugees on regular basis in Lebanon and Jordan. The estimated sample size includes 3,000 Registered Nurses from Lebanon and 2,500 nurses and midwives from Jordan. DISCUSSION: Workplace factors affecting quality of nursing care and psychosocial status of nurses caring for refugees will be identified. Potential findings will help leaders design interventions to support nurses who are serving refugees for safer care and better patient outcomes. Findings will assist in more efficient resource allocation and management. IMPACT: New knowledge on the impact of providing health care for refugees will be generated based on the structure of nursing care (e.g., work environment), on the nursing process (e.g., implicit rationing of care), and nurse outcomes (health) in two hosting communities. Moreover, factors enabling resilience in patients, providers, and systems will be identified and be of potential use in addressing the growing global problem of caring for displaced persons.

Students' Perceptions of Characteristics of Victims and Perpetrators of Bullying in Public Schools in Jordan.

BACKGROUND: School bullying is the most common school violence among adolescents and has become a global concern. Little is known about the characteristics associated with bullies and victims among Jordanian students. OBJECTIVES: The aim of the study was to examine student perceptions of school bullying-specifically, the characteristics of perpetrators and victims and how to stop bullying-and assess differences in perceptions between boys and girls. METHODS: Cross-sectional study, using self-reported questionnaires, was employed to collect data from eighth-grade students (N = 913; 51% male) from a mixed rural and suburban area in northern of Jordan during the 2013-2014 school year. Descriptive statistics were used to summarize item responses. Chi-squared tests were performed to compare responses between the male and female students. RESULTS: Most of the students described a bully as one who is a coward underneath (78.9%), lacks respect for other people (70%), wants to show power (67.5%), wants to impress others (60.8%), and wants to feel superior (59.6%). Students perceived victims of bullying as having low self-esteem (68.2%), talking or sounding different than others (50.9%), shy (35%), and having no friends (27.1%). Students suggested that, to stop bullying, the victim should stand up for himself (75.4%), should become psychologically stronger (75.1%), and should involve adults (teachers, family, or others; 45.9%). There was a significant gender difference, in which boys and girls were describing victims and bullies differently. DISCUSSION: A significant percentage of students relate bullying and victimization characteristics to psychosocial characteristics and less to physical characteristics. The results offer valuable information necessary to design and implement school bullying prevention and intervention programs.

Perception of Jordanian mothers to nursing support during their children hospitalisation.

AIMS AND OBJECTIVES: To describe Jordanian mothers' perceptions of nursing support provided during hospitalisation of their children and identify socio-demographic characteristic of mothers and children associated with mothers' perceptions of nursing support. BACKGROUND: Nursing support is crucial to mothers to ease and relieve pain and stress experience during hospitalisation of their children. DESIGN: A cross-sectional design. METHOD: A total of 235 mothers who stayed with their children during their hospitalisations for medical or surgical health problems were recruited for the purpose of the study. Mothers of children of one month to two years old from two governmental hospitals in Amman-Jordan were interviewed over a period of two months. Data were collected using Nursing Parent Support Tool and demographic data questionnaire. RESULTS: This study showed that the perception of Jordanian mothers to nursing support was moderate (M = 3·23, SD = 0·95). Stepwise multiple regression analysis showed that mothers' satisfaction to nursing support and mothers' education explained (0·332) of the variance in the mother's perception of nursing support. CONCLUSION: Satisfaction with nursing care and level of education are important factors in Jordanian mothers' perception of nursing support. Nurses need to understand the importance of these factors when providing support and holistic care. RELEVANCE TO CLINICAL PRACTICE: To enhance high level of satisfaction of nursing care, paediatric nurses in the practice settings should establish parent support groups and provide educational materials that are beneficial for educated and uneducated parents.

Parenting from a Jordanian perspective: findings from a qualitative study.

PURPOSE: The main purpose of this qualitative descriptive study was to explore Jordanian parents understanding of parenting. METHODS: A convenient sample of 110 Jordanian parents recruited from four health centers participated in the study. A semi-structured one-on-one interview with open-ended questions was used to collect the data. RESULTS: Three thematic areas reflecting parent understands of parenting were identified; parenting as embraced by Islam, transferring of cultural values and traditions, and parenting as a challenge. CONCLUSIONS: Parenting behavior and its effectiveness are reflected by the strong interplay of Islamic teachings, socio-cultural values and traditions in addition to the challenges and difficulties of being a parent. CLINICAL RELEVANCE: As the ultimate goal of parenting is to promote the wellbeing and the development of children, it is crucial that health care providers involved in the design and delivery of family and children's services have a thorough understanding of how parents perceive parenting and how their understanding can be integrated in programs to enhance parental roles.

Quality of life of Jordanian menopausal working and retired women and its associated factors: a cross-sectional study.

Objective: Life expectancy of Jordanian women has increased, indicating that the number of women entering menopause age, during the prime of their working life, will also increase. Therefore, assessments of the quality of life (QoL) of working and retired women and factors associated with overall wellbeing, are essential for the provision of quality services and care. Method: A cross-sectional study was conducted with 200 Jordanian women between the ages of 45 to 60 years old. The Utian QOL tool was used to assess the quality of life among menopausal women. Multiple regressions were used to determine predictors for QoL for the whole sample and for each group of working and retired women. Results: The study shows that the total QoL for women was 77.5 ±14.4, with a significant difference (p=.023) in total QoL and the occupational domain (p=.003) between working and retired women. Employed women with fewer chronic diseases and using frequent preventive measures had a higher QoL compared to others. Conclusion: Working itself might be an important indicator for better a quality of life among menopausal women. Better working conditions and more attention from the health care providers for the menopausal changes and the preventive measures could enhance women's perceived QoL in addition to increasing their productivity.

Quality of Life and Health Status of Jordanian Women Users of Various Contraceptive Methods and Associated Factors: Implications for Contraceptive Policies.

AIM: The study aimed at investigating the differences in health status of women users and non-users of contraceptive methods and assess differences in contraception quality of life (CQoL) according to method used. METHODS: Across sectional study with 372 women between the ages of 18 and 49 years old were recruited. Participants completed the health status and the CQoL questionnaire, which was validated using factor analysis combining three factor loading measures with a good Cronbach's alpha reliability coefficient. RESULTS: Results showed that there were no significant differences in health status between users and non-users. There was a significant difference in QoL according to the method used at the p <0.05 level for the three conditions F (2193) = 6.0 and p = 0.003. Post hoc analysis indicated that the total CQoL was significantly higher in IUD users (M = 55.7, SD = 9.6) than users of natural methods (M = 50, SD = 9.0, p < 0.01). In addition, the total CQoL was significantly higher among women from the southern region (M = 56.7, SD = 9.0) than from the northern and mid-regions (M = 49.5, SD = 0.07 and M = 52, SD = 10, respectively, p < 0.01). CONCLUSION: The physiological changes of women's QoL was affected by the use of the IUD method with significantly lower QoL scores than those who used oral contraceptives and non-hormonal methods. In addition, there was no significant difference in health status between users and non-users of contraceptive methods. IMPLICATIONS: The study has implications for contraceptive counselling on quality of life of women users of IUD and women from the south region and provides opportunities for the advancement of the reproductive health services in Jordan.

Women's career progression to management positions in Jordan's health sector.

PURPOSE: This study aims to identify and explore experiences, perspectives, barriers and enablers to women's career progression to management positions in the health-care sector and to assess women's and men's perceptions of the policies and practices of the health-care system concerning gender equality and nondiscrimination between women and men. DESIGN/METHODOLOGY/APPROACH: A cross-sectional survey was conducted among health-care professionals in ten selected hospitals, including physicians, registered nurses/midwives and pharmacists with or without managerial positions. FINDINGS: This study included a total of 2,082 female and 1,100 male health-care professionals. Overall, 70% of women and men reported that opportunities for advancement are based on knowledge and skills in their institution. However, 58.9% of women (p < 0.001) reported that women are more likely to face barriers to career advancement than men do in their workplace. Lack of women in general/line management and discrimination against women by supervisors at the point of promotion were the main barriers to women's career progression, as they were reported by two-thirds of women. The main barrier, as perceived by men (62.3%) was that women have family and domestic responsibilities. PRACTICAL IMPLICATIONS: To overcome barriers in women's career progression, there is a need to establish a career planning and capacity-building program for women in the health sector. ORIGINALITY/VALUE: Jordanian female health-care professionals face different barriers that affect their career progression, including inequity and discrimination in the workplace, negative views about women's abilities, lack of qualifications and training, hostile cultural beliefs and family responsibilities.

COVID-19 Fear and Anxiety among Patients with Chronic Heart Failure: A Cross Sectional Study.

Although the current management of COVID-19 is mainly focused on efficacious vaccine and infection control, the most common psychological reactions (such as fear and anxiety) associated with the COVID-19 pandemic have not been investigated and even neglected in patients with heart failure who are at greater risk for morbidity and mortality. We assessed COVID-19 related fear and anxiety among patients with heart failure and determined their associated factors. A cross sectional survey was conducted among 300 consecutive patients with heart failure during the period of March 2021−June 2021. Almost 50.7% of patients had fear of COVID-19 and 36.3% had coronavirus anxiety. Age > 55 was significantly associated with increased odds of fear (OR = 2.6) and anxiety (OR = 4.3). Patients with angina were more likely to have fear (OR = 3.0) and anxiety (OR = 2.2) and patients with chronic lung disease were more likely to have fear (OR = 3.0) and anxiety (OR = 3.3). Increased age, having angina, and having chronic lung disease were associated with increased odds of fear of COVID-19 and coronavirus anxiety. Psychological support needs to be integrated in patient care with special attention to physiological risk factors that are associated with COVID-19 comorbidities.

Quality of life of working and non-working Jordanian mothers caring for chronically ill child and its associated factors.

BACKGROUND: Balancing work-life and routines of daily life gets complex when a child is chronically ill. AIM: This study aimed to examine the QOL of working and non-working mothers caring for children with a chronic illness in Jordan and determine predictors of QOL of working mothers. DESIGN: Descriptive comparative cross-sectional design. METHOD: Data from 164 mothers who cared for a child with a chronic disease were collected. The World Health Organization Quality of Life - BREF (WHOQOL-BREF) was used to collect the data on physical, psychological, social relationships, and environment domains. RESULTS: The quality of life of working mothers was significantly lower than those of non-working mothers on all domains of WHOQOL-BREF. Mother's working status, monthly income, evaluation of their own health explained 41% of the variance. Social, family and employer support may help them overcome the challenges of caring for a child with a chronic illness and maintain good QOL.

Stress urinary incontinence among Jordanian women living in rural areas: Prevalence, associated factors and self-management behaviours.

Objectives: To assess the prevalence of stress urinary incontinence (SUI) among Jordanian women aged 35-65 years living in in rural areas and its associated risk factors. Patients and methods: A cross-sectional study utilising a convenience sample of 1000 non-pregnant women who were recruited from healthcare centres and community settings. Participants completed a structured questionnaire that included demographic and gynaecological data, and questions about SUI. Descriptive analysis and logistic regression were used to analyse the data. Results: Overall, 551 women (55.1%) reported having SUI with a duration of 37.9-47.6 months. The mean age of the women was 45.38 years and 29.6% were post-menopausal. Moreover, 40.6% were overweight, 38.9% obese, and 16.9% were smokers. Married women comprised 81.8%; with 37.1% having four to six children and 92.8% had a normal delivery, whereas 28% had a history of caesarean section. Coughing was the major precipitating factor for SUI (87.7%). In addition, 64.8% of women with SUI did not avoid activities that precipitated SUI such as housekeeping and lifting, and 78.6% did not seek any medical care. The major significant correlates for SUI were: high body mass index (odds ratio [OR] 2.506, 95% confidence interval [CI] 1.744-3.600, P < 0.001), being aged >50 years (OR 1.716, 95% CI 1.183-2.489, P = 0.004), a history of gynaecological/pelvic surgery (OR 1.631, 95% CI 1.206-2.205, P = 0.001), and vaginal delivery (OR 1.052, 95% CI 1.004-1.101, P = 0.033). Conclusion: SUI prevalence among Jordanian women is high with symptoms reported in more than a half of study participants. Older age, obesity, a history of gynaecological surgery, and history of vaginal delivery were the major correlates of SUI. Public awareness is needed to identify the condition for early diagnosis and treatment of SUI. Abbreviations: BMI: high body mass index; OR: odds ratio; (M)(S)(U)UI: (mixed) (stress) (urge) urinary incontinence.

Prevalence of violence during pregnancy: findings from a Jordanian survey.

BACKGROUND: Violence during pregnancy is a significant health and social problem. In the last few years several factors have contributed to the emergence of family violence as a high priority social and health issue in Jordan, and the acknowledgement that abuse during pregnancy is a harmful act to the mother and the fetus. The purposes of this study were to investigate the prevalence of physical, emotional, verbal, and sexual violence on pregnant women, and to describe the relationships between violence and selected study variables. METHODS: A descriptive study was conducted using a self-administered questionnaire. A convenience sample of 316 pregnant women was recruited from five Maternal and Child Health Centers, located in Irbid City in the North of Jordan. RESULTS: The prevalence of physical, emotional, verbal and sexual violence by husbands during pregnancy was 10.4%, 23.4%, 23.7%, and 5.7%, respectively. Prevalence of physical, emotional and verbal violence by a family member other than the husband was 1.9%, 11.1% and 13.9%, respectively, and most perpetrators were the mother in-law. Data also showed that there was a significant association between prevalence of violence and unplanned pregnancy, the pregnant women's perception of their husband's violent attributes and the women's low self-esteem. Pre- and post-natal visits should include assessment for family violence and intervention when violence or abuse is identified. The findings support continued public awareness of family violence to bring about social and political changes that increase reporting and reduce incidence of violence in Jordan.

Why do Jordanian women stay in an abusive relationship: implications for health and social well-being.

PURPOSE: The purpose of this study was to explore why Jordanian women stay with an abusive husband. DESIGN: The study used a qualitative approach to collect data from 28 abused women who were recruited through their community during the summer and fall of 2007. METHODS: Data were collected using an open-ended question through one-on-one in-depth interviews. FINDINGS: Results from analysis of the qualitative data revealed that abused Jordanian women identified five main reasons for staying with an abusive husband: the inherited social background, financial dependency, lack of family support, sacrificing self for the sake of the children, and the adverse social consequences of divorce. CONCLUSIONS: The results indicate that Jordanian women are strongly bound by traditions and cultural rules and lack all means of empowerment. Results of the study have implications for healthcare providers, social workers, policy makers, and educators to enhance the health and social well-being of Arab Muslim women in Jordan. The findings may also apply to Arab families immigrating to the United States, Canada, and Europe who tend to bring their cultural beliefs, values, and norms, and may help healthcare professionals dealing with violence against women in these countries. CLINICAL RELEVANCE: Healthcare professionals worldwide need to play an instrumental role in providing culture-specific and evidence-based care to empower women staying in abusive relationships, taking into consideration the influence of Arab Muslim culture.

Violence against women: unveiling the suffering of women with a low income in Jordan.

The descriptive qualitative study documents experiences of Jordanian women abused by their husbands. Thirteen married women living with an abusive husband were recruited from a major primary healthcare center. The women described forms, intensity, and consequences of their husband's acts. Despite their anguish, women justified, normalized, and tolerated abuse; this acceptance reflected their cultural values and norms. Implications for nursing practice include (a) identifying abused women, (b) empowering them with knowledge to change their sociocultural perceptions of marital relationships, (c) designing interventions that address their needs, and (d) educating health care providers to take a role in addressing spousal abuse.

Cultural validation of pediatric pain assessment tools: Jordanian perspective.

The purpose of this study was to examine the cultural validity, reliability, and preference of three pain assessment tools among 95 Jordanian children. Pain intensity was assessed using the Poker Chip, the Faces, and the Word Description Scales. The test-retest reliability and the convergent validity were supported for the three scales. Jordanian children preferred the Poker Chip Tool to the Faces Scale and the Word Descriptive Scale. Gender differences in relation to scale preference were evident: female children preferred the Poker Chip Tool and male children preferred the Faces Scale; such differences were contributes of the socialization process within the Arab culture. The three scales are valid, reliable, and can be used with confidence to assess pain among Jordanian children. Findings also showed that children have a subculture of their own regardless of their cultural orientation. Findings have implication to nurses in Jordan as well as to transcultural nursing.

Adversities of being infertile: the experience of Jordanian women.

OBJECTIVE: To describe and interpret the experiences of and adversities faced by infertile Jordanian women as described from their own perspectives. DESIGN: A qualitative descriptive design. SETTING: The women were interviewed at a nonprofit women's organization in the north of Jordan. The organization focuses on empowerment and health issues. PATIENT(S): This study included a purposive sample of 25 infertile Jordanian women who were unsuccessfully trying to conceive for a minimum of 1 year, and who were receiving treatment for infertility. INTERVENTION(S): Face-to-face, in-depth, semistructured interviews were conducted, audiotaped, and transcribed using thematic analysis. MAIN OUTCOME MEASURE(S): Outcomes were measured using thematic analysis of the interview transcripts. RESULT(S): Four key adversity themes emerged from the data: the adversity of incomplete being, the social adversity of being infertile, the adversity of another wife, and the adversity of changes in the marital relationship. CONCLUSION(S): Jordanian women are seriously affected by infertility and experience personal, social, and marital adversities, which affect their well-being. These adversities need to be conceptualized within a framework that can be used to empower and counsel infertile women in all aspects of life.

Attitudes toward and justification for wife abuse among Syrian medical and nursing students.

PURPOSE: To explore the perceptions of and attitudes toward violence and beliefs of contextual justification of wife abuse among Syrian medical and nursing students. DESIGN: A descriptive, cross-sectional design was used. The Perceptions of and Attitudes toward Wife Abuse Questionnaire was used to collect data from a convenience sample of 621 medical and nursing students from three public universities in Syria. RESULTS: Only 18.4% of the students had positive attitudes toward interpersonal violence reflecting low tolerance to wife beating and use of physical force for problem solving and child discipline, and 16.1% did not justify wife beating. Medical, older, female students, from urban areas, with more educated parents, and those who did not experience violence or witness violence between their parents had significantly more positive attitudes toward wife abuse and significantly less justification of wife beating (p < .05). CONCLUSION AND IMPLICATIONS: Education about violence against women of future medical and nursing students is the responsibility of medical and nursing educators and health policy makers, who have to acknowledge the influence of the sociocultural factors in shaping student's attitudes toward wife abuse and develop strategies to enhance these attitudes at the early stages of professional preparation.

Health hazards and risks for abuse among child labor in Jordan.

The phenomenon of child labor has become the main concern of developing countries. The literature related to child labor discusses the causes and socioeconomic factors contributing to child labor but few studies examined risks for physical, emotional, and sexual abuse among child labor. Therefore, the purpose of this qualitative study was to identify the characteristics of working children as well as identify health risks and risks for abuse associated with child labor. A convenience sample of 41 children working in the industrial city of Irbid were interviewed by using a semistructured interview guide. Findings revealed that children who were engaged in child labor were poor and dropped out of school to assist their families financially. The findings also showed that children were exposed to health hazards such as inhaling chemicals and physical injuries. Physical, verbal, and sexual abuse also were present among these children. The findings from this study concluded that child labor creates an unhealthy environment for socially disadvantaged children. Health professionals, including pediatric and community health care providers, have an instrumental role that needs to be focused on protecting children, enforcing policies, and implementing strategies to help socially and economically disadvantaged children.