Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation.

AIM: To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs. BACKGROUND: Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care. METHODS: A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach. RESULTS: The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity. CONCLUSIONS: The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.

Perceived barriers to effective use of telehealth in managing the care of patients with cardiovascular diseases: a qualitative study exploring healthcare professionals' views in Jordan.

BACKGROUND: The use of telehealth in the management of care and care delivery has been increasing significantly during the COVID-19 pandemic. Telehealth is an emerging technology used to manage care for patients with cardiovascular diseases (CVDs) in Jordan. However, implementing this approach in Jordan faces many challenges that need to be explored to identify practical solutions. PURPOSE: To explore the perceived challenges and barriers to using telehealth in managing acute and chronic CVDs among healthcare professionals. METHODS: A qualitative, exploratory study was conducted by interviewing 24 health professionals at two hospitals in different clinical areas in Jordan. RESULTS: Several barriers were reported by participants that affected the utilization of telehealth services. The barriers were categorized into the following four themes: Drawbacks related to patients, Health providers' concerns, Procedural faults, and telehealth To complement the service only. CONCLUSIONS: The study suggests that telehealth can be instrumental in supporting care management for patients with CVD. It means that understanding the advantages and barriers to implementing telehealth by the healthcare providers in Jordan can improve many aspects of the healthcare services for patients with CVD within the healthcare settings in Jordan.

Electrolyte Imbalance Among Patients With and With No ST-Elevation Myocardial Infarction: A Cohort Study.

Electrolytes imbalances are highly prevalent and have shown a high impact on mortality in patients with acute myocardial infarction. These electrolytes imbalance have prognostic value in predicting mortality in patients with acute myocardial infarction. The purpose of this study was to assess the prognostic value of electrolyte imbalances in predicting 1-month mortality among patients with myocardial infarction with and with no ST-elevation. This cohort study was conducted in a referral hospital in the West Bank, Palestine. All patients with confirmed medical diagnosis of acute myocardial infarction and admitted to the medical coronary care unit in the hospital were eligible participants. A convenience sample of 186 participants was obtained. These participants were followed up for 1 month to assess their survival (alive or dead). Demographic and clinical data were recorded by reviewing their health records. The derived data were analyzed using SPSS version 19. About 36% of all patients were found to be hyponatremic, 15% of them have hypokalemia, and 9% of patients had hypocalcemia. There was a significant difference between STEMI and non-STEMI in sodium (t = 4.7, P < .001). A multivariate logistic regression analysis was performed to predict 1-month mortality for patients with myocardial infarction with and with no ST-elevation. The predictors that were found to be significant are sodium (odds ratio [OR] = 0.789, P = .010), calcium (OR = 0.221, P = .014), diastolic blood pressure (OR = 0.933, P = .047), and blood urea nitrogen (OR = 0.821, P = .005). Electrolyte imbalance was highly prevalent among patients with acute myocardial infarction. Hyponatremia and hypocalcemia were present and associated significantly with predicting 1-month mortality. Health care providers should take into consideration the electrolytes of patients with acute myocardial infarction from the first moment of admission and correct them early to maximize the clinical outcomes and survival for patients.

The experience of family carers of children with incurable cancer: a qualitative study from the occupied Palestinian territory.

BACKGROUND: Treatments for childhood cancers have raised the survival rate, however different forms of malignancy continue to cause untimely deaths, and cancer remains a leading cause of death among children. Global research on paediatric cancer is limited for several reasons. Most research has focused on specific methodologies, including questionnaires with heterogeneous samples. In addition, many studies have covered a broad range of cancer diagnoses, and a wide range of children's ages and periods between diagnosis and treatment. These methods are unable to capture the essence of experiences and cultural differences. This study aimed to explore the experience of family carers of children with incurable cancer in occupied Palestinian territory. METHODS: The study was conducted in the Paediatric Cancer Department of Beit Jala Hospital, which is the first public cancer department for children in the West Bank. The family carers of children aged 1-18 years with any type of incurable cancer in this hospital were considered eligible for participation, and the individual most involved in the care of the child was selected. To recruit participants, head nurses of medical and surgical paediatric floors provided assistance in approaching the carers of eligible children. The main objectives of the study were then discussed with the family carers. Semi-structured interviews were conducted with participants, and an interpretative phenomenological analysis approach was used to analyse the collected information. Ethical approval was obtained from the Beit Jala Hospital ethical review board and written informed consent was obtained from all participants. FINDINGS: 14 interviews were conducted. Participants were nine mothers, four grandmothers, and one father. Family carers discussed their caring experiences, including their experiences in administering special treatments, their suffering due to treating irritable children, and the information given to them about their children's illness. Family carers reported that they changed the focus of their care from an initial emphasis on normalising their children's lives to relieving their physical and psychological discomfort. This change of focus accompanied changes in carers' understanding of their child's disease over time. As carers became more realistic regarding the future of their children, they attempted to make their lives as comfortable as possible. Finally, carers discussed the support system around them; they found several resources to support them in the care of their children, including the experiences of other parents of children with similar diseases, the hospital environment, and their religious beliefs. Nevertheless, they stated that they needed more support during this difficult time of their lives. INTERPRETATION: There is a need to support parents of children with incurable cancer in the occupied Palestinian territory. Suggestions to improve the quality of care provided for these parents include the education and recruitment of health care professionals, including social workers and psychologists, to provide emotional and spiritual support. FUNDING: None.

The impact of online teaching on stress and burnout of academics during the transition to remote teaching from home.

BACKGROUND: The higher education institutions worldwide have been transformed unexpectedly to online teaching. This sudden movement from blended learning or traditional face-to-face teaching has severely disrupted university activities and posed many challenges for teaching staff, who were asked to develop online versions of their courses overnight. This study explores the effect of the current changes in education style and working from home on the stress and burnout levels of teaching staff. METHODS: This study utilized a cross-sectional design, whereby 278 participants (faculty and course instructors) from 17 campuses of one of the largest colleges in United Arab Emirates completed a web-based survey. Numerous instruments were utilized to obtain the following data: participants demographics; their perceived stress during online teaching; their perception of the impact of teaching from home on their family's daily life, physical health, mental health and ability to cope with stress; burnout level; and their satisfaction with online teaching. RESULTS: Around 60% of participants reported moderate stress level during online teaching (moderate stress = 5 to 8) under COVID-19 (M 6.21 ± 2.26). An independent sample t-test and ANOVA tests revealed that participants with 7-10 years of online teaching experience reported more stress than participants who have 4-6 years online teaching experience (M 7.29, ±1.11 Vs. 5.30, ±2.69; P = 0.04). Moreover, multiple regression analysis showed that higher stress levels and lower satisfaction with the online teaching experience were associated with more significant personal and working burnout. Married participants with school-age children were at greater risk of personal burnout. CONCLUSION: The transition to remote education imposed mental burdens and stress on faculty members. Supportive professional development strategies to enrich faculty with online teaching skills are urgently required.

Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study.

INTRODUCTION: Telemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched. PURPOSE: To explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems. METHOD: A qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014). RESULTS: The analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services. CONCLUSION: The current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.

The effectiveness of an interactive digital-based educational program in improving breastfeeding knowledge, attitudes and self-efficacy among primiparous women in Egypt.

Malnutrition is the main cause of two-thirds of deaths among Egyptian under five children, which could be due to reduced rates of breastfeeding, as it is one of the contributing factors. Breastfeeding is the optimal solution for health promotion to mothers and their infants. It has various benefits not only for the mother and infant but also for society. Breastfeeding educational programs are essential for the enhancement of knowledge and self-efficacy of new mothers, and to ensure a longer duration of breastfeeding. Therefore, this study aims to evaluate the effects of an interactive digital-based educational program about breastfeeding on the knowledge, attitudes, and self-efficacy of primiparous women in Egypt. A quasi-experimental study design was adopted. The study was held in Itay El-baroud maternal and child health center, whereby 120 pregnant women were purposively selected. Then, they were randomly assigned to either a study group (60) or control group (60). The derived data were statistically analysed using SPSS version 20, Pearson correlation coefficient, chi-square test and independent sample t test were utilized. Four tools were utilized for data collection. A statistically significant mean difference was found concerning total breastfeeding knowledge scores after one month and three months. The total attitude and self-efficacy scores showed highly statistically significant differences after one month and three months from the start of the program. Moreover, breastfeeding self-efficacy was found to be positively correlated with knowledge and attitude. In conclusion, the interactive digital-based educational program about breastfeeding was suggested to be effective in enhancing the knowledge, attitude and self-efficacy of the primiparous women, in combination with other health education activities. Therefore, it is recommended that web-based educational sites are created for first-time mothers.

Assessing sense of coherence as an element of primary-focused health services in schools for children and adolescents with complex health care needs.

AIM: This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools. BACKGROUND: The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development. METHODS: This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes. RESULTS: A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems. CONCLUSION: Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population. IMPLICATIONS FOR NURSING MANAGEMENT: Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.

Perceptions of nurses about reporting medication administration errors in Jordanian hospitals: A qualitative study.

INTRODUCTION: Reporting Medication Errors (MEs) is a critical issue that confronts healthcare providers and institutions all over the world, yet this issue has only recently been examined in developing countries. PURPOSE: To explore the perceptions of Jordanian nurses around reporting MEs and to identify potential barriers to reportage in their context. METHODOLOGY: A qualitative descriptive approach was followed; whereby24 Jordanian nurses were interviewed. RESULTS: Two main themes emerged. The first revolved around nurses' perceptions of ME reporting, and the second theme pertained to the daily barriers that prevented them from reporting MEs. CONCLUSION: This study identified many individual behaviors and system defects that exacerbate the lack of ME reporting in Jordan. The results point to an opportunity for Jordanian hospital managers to acknowledge these problems and thereby facilitate their resolution and increase the quality of healthcare in their organizations.

Challenges facing oncology nurses in Jordan: A qualitative study.

BACKGROUND: The literature shows that oncology nurses have more stressors than nurses in other units. They face many challenges both within and outside the work environment that affect them negatively. Most of the reviewed studies concerning these challenges were conducted in developed countries. AIM: The purpose of this study was to explore the challenges experienced by oncology nurses in Jordan during their daily practice. METHOD: A qualitative descriptive approach was adopted. Semistructured individual face-to-face interviews were conducted with 24 nurses. Participants were selected from oncology departments in one of the biggest governmental hospitals in Jordan. RESULTS: Two main themes were drawn from the data analysis. The first discussed the personal challenges that oncology nurses encountered. These included emotional attachment to patients and difficulties in separating work and personal life. The second related to organizational challenges in the work environment, which included the nurses' lack of authority to inform patients about their diseases, nursing staff and supply shortages, and a lack of orientation programs. All of these factors affected the psychological status of the nurses. CONCLUSIONS: The results of this study indicated that the working environment for oncology nurses is highly stressful and demanding and these nurses face many challenges in their work. The understanding and consideration of these challenges by stakeholders, managers, and organizational leaders would lead to improvements in the nurses' psychological state, thereby enhancing the quality of care in these units and helping with staff retention.

Coping among adolescents with long-term health conditions: a mixed-methods study.

BACKGROUND: Adolescents with long-term health conditions may be at risk of developing psychological comorbidities and adopting ineffective coping mechanisms if they are not adequately supported at home or school. AIM: To understand the strategies adolescents use when dealing with challenging health situations, and gain an in-depth understanding of the characteristics of their preferred care environment if they have unexpected health crises. DESIGN: The study used a concurrent mixed-methods design, with data gathered between January and May 2019. Descriptive and non-parametric tests were used to analyse quantitative and qualitative data. RESULTS: 'Problem-focused disengagement' was the most-often used coping strategy. The second and third most common strategies were 'problem-focused engagement' and 'emotion-focused engagement'. Finally, girls tended to adopt more negative coping strategies than boys. The analysis revealed that most adolescents preferred home over school as the care environment because these caring agents were close and available, knew how to care for them and had the resources to provide or access care, and listened and understood them. CONCLUSION: Adolescents adopted disengagement and negative coping strategies early in their attempts to cope with stressful events before adopting more positive strategies. This is alarming, especially as school health services are not sufficiently supportive of adolescents at times of stress and illness. Adolescents often perceive school providers as unavailable and lacking knowledge about their health needs.

Palestinian managers' views and practices regarding the prevention of home injuries: An explorative qualitative study.

BACKGROUND: Unintentional injuries are an important global public health problem. Potentially, some senior managers have a major role to play in the prevention of home injuries. AIMS: To explore senior managers' perceptions and practices regarding the prevention of home injuries among children and the potential factors that might influence such practice in Ramallah District of Palestine. METHOD: Qualitative interviews were undertaken using a purposive sampling strategy of 18 senior-level managers. Thematic analysis was undertaken. RESULTS: The study revealed that half of the interviewed managers' thought that injury prevention was a priority, and the majority of their institutions had worked on increasing parental awareness regarding injury prevention. Nevertheless, their practice in providing financial and psychological support to the parents was reported less. The participants stated that many factors had interchangeably influenced the practice in injury prevention, including factors related to staff, parents, and environment. CONCLUSION: This study highlights the importance of managers' role in injury prevention and draws attention to the numerous obstacles that they face. Attempts to prevent injuries should use a combination of interventions at many levels including: parents, health staff, as well as the wilder governmental, physical.

Exploring the psychological status of Jordanian nurses working with cancer patients.

AIM: This study aims to explore the psychological status of nurses working with cancer patients in Jordan. BACKGROUND: Literature shows that nurses face many stressors in their job, in particular oncology nurses. Some of them have psychiatric illness such as anxiety and depression. Most of the reviewed studies were conducted in developed countries, and none in the Middle East. METHOD: A qualitative descriptive approach was adopted, whereby interviews were conducted with 24 nurses that were selected from the oncology departments of one governmental hospital. RESULTS: Participants identified coping with death and dying in nursing care and some cultural issues (that they encountered) as the main factors that influence their psychological well-being, which in turn may have contributed to a reduced quality of care for patients. CONCLUSION: Findings indicated that the working environment within oncology is highly stressful, which might negatively affect the nurses' job satisfaction and the quality of care that they provided. IMPLICATIONS FOR NURSING MANAGEMENT: Findings of this study could help health care managers to understand the impact of psychological stressors on nurses' performance, and the importance of improving the psychological status of oncology nurses.

Effectiveness of Basic Life Support Training for Middle School Students.

Bystander cardiopulmonary resuscitation improves survival after out-of-hospital cardiac arrest. This study aimed to assess the effectiveness of a basic life support (BLS) educational course given to 110 middle school children, using a pretest posttest design. In the pretest, students were asked to demonstrate BLS on a manikin to simulate a real-life scenario. After the pretest, a BLS training course of two sessions was provided, followed by posttest on the same manikin. Students were assessed using an observational sheet based on the American Heart Association's BLS guidelines. In the pretest, students showed significant weakness in the majority of guidelines. In the posttest, they demonstrated significant improvement in their BLS skills. BLS training in the middle school was effective, considering the lack of previous skills. It is recommended that BLS education be compulsory in the school setting.

Palestinian community perceptions of do-not-resuscitation order for terminally Ill patients: A qualitative study.

AIM AND OBJECTIVES: To illustrate the Palestinian community's views, opinions and stances about the concept of do-not-resuscitate for terminally ill patients. BACKGROUND: Do-not-resuscitate orders are practised in many countries worldwide, but there is no consensus on their practice in the Middle East. Do-not-resuscitate orders may be applied for terminally ill paediatric patients. Some studies have been conducted describing people's experiences with these do-not-resuscitate orders. However, few studies have considered community perspectives on do-not-resuscitate orders for terminally ill patients in Palestine. DESIGN: A descriptive-qualitative design was adopted. METHODS: A purposive sample of 24 participants was interviewed, with consideration of demographical characteristics such as age, gender, education and place of residency. The participants were recruited over a period of 6 months. Individual semistructured interviews were utilised. These interviews were transcribed and analysed using thematic analysis. FINDINGS: Significantly, the majority of the participants did not know the meaning of do-not-resuscitate and thought that removal of life-sustaining devices and do-not-resuscitate were the same concept. Most of the interviewees adopted stances against do-not-resuscitate orders. Several factors were suggested to influence the decision of accepting or rejecting the do-not-resuscitate order. The majority of the participants mentioned religion as a major factor in forming their viewpoints. The participants expressed different views regarding issuing a law regarding do-not-resuscitate orders. CONCLUSION: Our findings provide a unique understanding that there is a general misunderstanding among our participants regarding the do-not-resuscitate order. Further research with policymakers and stakeholders is still required.

Current practices for assessing clinical judgment in nursing students and new graduates: A scoping review.

OBJECTIVE: To map current assessment practices for learning outcomes related to nurses' clinical judgment from undergraduate education to entry to practice. DESIGN: Scoping review using the Joanna Briggs Institute guidelines and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). DATA SOURCES: Electronic databases-Cumulative Index of Nursing and Allied Health Literature (CINAHL Complete; EBSCOhost), EMBASE (Ovid), MEDLINE (Ovid), PsycINFO (Ovid), and Web of Science (Social Sciences Citation Index, Citation Index Expanded)-using a combination of descriptors and keywords related to nursing students, newly graduated nurses, clinical judgment and related terms (e.g., critical thinking, clinical reasoning, clinical decision-making, and problem-solving), and assessment. METHODS: Two reviewers independently extracted study characteristics and, for each outcome relevant to clinical judgment, the concept, definition and framework, assessment tool, and the number and schedule of assessments. Data were synthesized narratively and using descriptive statistics. RESULTS: Most of the 52 reviewed studies examined the outcome of a discrete educational intervention (76.9 %) in academic settings (78.8 %). Only six studies (11.5 %) involved newly graduated nurses. Clinical judgment (34.6 %), critical thinking (26.9 %), and clinical reasoning (9.6 %) were the three most frequent concepts. Three assessment tools were used in more than one study: the Lasater Clinical Judgment Rubric (n = 22, 42.3 %), the California Critical Thinking Skills Test (n = 9, 17.3 %), and the Health Science Reasoning Test (n = 2, 3.8 %). Eleven studies (21.2 %) used assessment tools designed for the study. CONCLUSION: In addition to a disparate understanding of underlying concepts, there are minimal published studies on the assessment of nursing students and nurses' clinical judgment, especially for longitudinal assessment from education to clinical practice. Although there is some existing research on this topic, further studies are necessary to establish valid and reliable clinical competency assessment methods that effectively integrate clinical judgment in clinical situations at relevant time points.

Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE.

OBJECTIVES: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice. DESIGN: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language. SETTING: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023. PARTICIPANTS: 14 purposively selected healthcare practitioners. INTERVENTION: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews. PRIMARY AND SECONDARY OUTCOMES: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being. RESULTS: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied. CONCLUSIONS: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

Challenges to online education during the time of COVID-19: A focus group study.

AIM: To explore the experience of online education during coronavirus disease 2019 (COVID-19) from the perspectives of nurse educators, postgraduate students, and undergraduate students in two universities in the Occupied Palestinian Territory (OPT). This article only highlights the challenges faced by nurse educators and students. METHOD: A qualitative design using a focus group strategy was employed. The data were collected from two universities in the OPT from September 2020 to October 2020. The maximum variation sampling strategy was used. FINDINGS: Seven focus groups were conducted with nurse educators (n = 2), postgraduate students (n = 1), and undergraduate students (n = 4). The findings revealed that nurse educators and students faced several challenges when they were abruptly turned to online learning. These challenges included challenges concerning clinical courses, lack of resources, lack of interaction, evaluation, and their home environment. CONCLUSIONS: This study is the first to demonstrate the challenges involved in nursing education in OPT during the COVID-19 pandemic. IMPACT: The findings of this study can be used to improve the online learning experience during COVID-19. As a recent change to nursing education, it is vital to understand the nature of the problems related to this sudden change.

The Associations Between Patients' Characteristics and the Quality of Life Among Acute Coronary Syndrome Patients in Jordan: A Cross-Sectional Study.

Introduction: Acute coronary syndrome (ACS) is one of the most significant leading causes of death and disability in the world. The quality of life (QoL) score is used to evaluate the impact of ACS treatments on the patients' physical, emotional, and social functioning. It is considered a significant indicator of the progress of the patients' health status and is useful in predicting patients' needs for continuing, modifying, or changing their treatment plans. Objective: To identify the associations between patients' characteristics and the QoL among ACS patients in Jordan. Methods: A descriptive cross-sectional study was conducted using a convenience sample of 372 participants with ACS from six referral hospitals in Jordan. Results: Jordanian patients with higher educational level and exercise had significant and positive association with QoL (ß = 0.257, p < .001), (ß = 0.191, p < .001), respectively. Also, patients who reported having dyslipidaemia and having unstable angina (UA) had lower score of QoL (ß = -0.165, p < .001), (ß = -0.149, p < .001), respectively. Finally, gender and working status did not significantly appear to have an association with the total QoL. Conclusions: This study sheds light on the importance of increasing the level of patients' awareness about their illness by educating them about it and encouraging them to engage in physical activity programs.

Comparison of blended versus traditional classrooms among undergraduate nursing students: A quasi-experimental study.

BACKGROUND: Blended learning is a relatively new educational approach that has been introduced into higher education in Palestine. While it has many advantages, there is no empirical evidence, nor any case studies from Palestine to support the use of blended learning over traditional classroom. OBJECTIVES: To compare students' learning outcomes, learning perceptions of their educational environment, and satisfaction of blended learning versus traditional classroom. DESIGN: A quasi-experimental study. SETTING: A public university in Palestine. PARTICIPANTS: 102 Bachelor of Science in nursing students enrolled on the maternal health course. METHODS: Students freely chose to register for the blended teaching section (49 students) or traditional classroom (53 students), then the teaching method for each section was assigned. Student demographics, course component grades, perceptions of the educational environment, measured by the Arabic version of Dundee Ready Education Environment Measurement (DREEM) inventory, and degree of satisfaction were collected in this study. Descriptive statistics and the Independent Sample t-test were used to analyze the data. RESULTS: The sample included 49 students in the blended teaching section and 53 students in the traditional section. Overall DREEM scores, Student Perceptions of Learning, and Student Perceptions of Teachers were significantly higher for students taught with the blended method compared to traditional classroom settings. The total DREEM scores were between 101 and 151 for both sections, indicating that all students, regardless of teaching method, had more positive than negative perceptions of their educational environment. Moreover, there was no significant difference in scores and total course GPA (Grade Point Average), both with and without assignment grades, or between blended and traditional learning in first, second and final exams. However, students taught with the blended format scored significantly higher in assignments than students taught the traditional classroom. CONCLUSIONS: Blended learning can be a useful educational approach in nursing education and Palestinian universities may consider using it for nursing courses.