The Association Between Coping Strategies and Psychological and Emotional Distress Among Health Care Providers Caring for Autistic Children in Jordan.

BACKGROUND: Health care providers (HCPs) caring for autistic children report more perceived psychological and emotional distress related to their job. However, not much is known about what can be done to mitigate such distress, especially in countries with limited mental health resources, such as Jordan. OBJECTIVE: This study aimed to examine the association between coping strategies (problem-focused, emotion-focused, and avoidant) and perceived emotional and psychological distress among HCPs of autistic children in Jordan. METHODS: In this cross-sectional study, a convenience sample of 180 HCPs working with autistic children in Jordan were recruited through autism centers and social media using an online self-administered questionnaire. RESULTS: The multiple linear regression analysis revealed that 31% of the variability in perceived emotional distress was explained by its significant association with problem-focused coping, emotion-focused coping, and avoidant coping. Likewise, 39% of the variability in perceived psychological distress was explained by its significant association with gender, having an immediate family, area of specialty, problem-focused coping, emotion-focused coping, and avoidant coping. CONCLUSIONS: The study shows that problem-focused coping significantly decreases perceived emotional distress, whereas emotion-focused and avoidant coping significantly increase perceived emotional distress. Avoidant coping significantly increases perceived psychological distress. Understanding the association between coping strategies and perceived emotional and psychological distress among HCPs can assist mental health nurses in identifying at-risk providers and providing timely emotional and psychological support.

Academic procrastination, loneliness, and academic anxiety as predictors of suicidality among university students.

Suicide is a major public health concern, and university students are at higher risk of suicide than any other age group. The purpose of this study was to examine the prediction power of loneliness, academic anxiety, and academic procrastination on suicidality among university students. A cross-sectional, correlational design was used to recruit 403 university students using the electronic survey format in Jordan. Data were collected regarding loneliness, academic anxiety, academic procrastination, and suicidality. A two-step multiple hierarchical regression analysis was performed. Only 17.1% (n = 69) of students were at risk of suicide, low to moderate level of loneliness, moderate level and moderate to high level of academic procrastination of academic anxiety. The model that included the sociodemographic and the psychological factors was significant (F18,390 = 12.3, p < 0.001) where the total variance in suicidality was 37.3% (R2 = 0.373). Being a working student, being on psychotropic medication, romantic and family relationships domains of loneliness, and academic anxiety were found to be predictors of suicidality (p < 0.05). Suicide is a significant problem among university students. Mental health professionals and policymakers need to enhance the use and access to mental health services and seek psychological counselling to combat the increasingly observed phenomenon of suicide among young people.

Levels and predictors of empathy, self-awareness, and perceived stress among nursing students: a cross sectional study.

BACKGROUND: High levels of empathy and self-awareness and low level of stress among nursing students are the core elements of improving patients' care and outcomes. The purpose of this study is to assess the levels, relationships, and predictors of empathy, self-awareness, and perceived stress in a sample of undergraduate Jordanian nursing students. METHODS: A descriptive cross-sectional design was employed to collect data from 330 students using a web-based survey. RESULTS: The total mean scores of empathy, self-awareness, and perceived stress were 75.75, 40.17, and 55.65, respectively. Students who are studying in public universities, with higher GPA, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of empathy. Students with lower income level, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of self-awareness. Female students, those who sleeping 6 h and less, did not get a balanced diet or perform exercise, studying in public universities, lower GPA, have intention to leave nursing, and did not satisfy with nursing; reported higher level of perceived stress. CONCLUSIONS: Nursing students reported adequate empathy level, low self-awareness level, and moderate perceived stress level. Students who are satisfied and have no intention to leave nursing reported higher level of empathy, self-awareness, and perceived stress. It is necessary to conduct interventional programs that enhance students' well-being especially empathy and self-awareness, and reduce the level of their stress.

Status and predictors of medical students' knowledge and attitude towards palliative care in Jordan: a cross-sectional study.

BACKGROUND: Palliative care focuses on the ability of medical students to use their expanded experiences and knowledge; however, basic medical education does not provide adequate knowledge and skills regarding palliative and end-of-life care. This study designed to examine knowledge related to palliative care and attitudes toward dying people among medical students in Jordan. METHODS: Cross-sectional, descriptive design was used in this study. A total of 404 medical students were recruited using convenience sampling techniques from six medical programs. Data was collected using a self-administered questionnaire in relation to knowledge and attitudes regarding palliative care and dying persons using Palliative Care Assessment Knowledge (PCAK) and Frommelt Attitudes toward Care of the Dying Scale Form B (FATCOD-B). RESULTS: Medical students have a moderate level of knowledge related to palliative care in (PCAK) part1 subscale about; pain managing (n = 156, 38.6 %), managing other palliative care symptoms (n = 164, 40.6 %), and in witnesses' family counseling and breaking bad news discussion (n = 178, 44.1 %). However, medical students have inadequate knowledge concerning the palliative care in part-2of the scale. Furthermore, students have positive attitudes towards caring for dying patients with mean score of 108.76 (SD = 8.05). The highest ranked attitude subscales were; Fairs/Malaise (M = 29.03, SD = 4.28), Communication (M = 21.39, SD = 2.51) and Relationship (M = 18.31, SD = 1.55). There was a significant difference in attitudes in relation to gender (t = -5.14, p < 0.001) with higher female mean score (M = 109.97) than males (M = 105.47). Also significant difference found among those who are exposed to Palliative Care and those who are not (t = -6.33, p < 0.001) with higher mean score of those exposed to palliative acre courses (M=298) than those who did not (M=106). CONCLUSION: Improving knowledge and attitudes of medical students regarding palliative and end of life care should be highlighted to medical educators and medical schools need to incorporate palliative and end-of-life care into medical curricula across all levels.

Social cognitive elements of mental illness stigma among healthcare professionals currently working in general hospitals: A cross-sectional study from Jordan.

AIM: To assess the social cognitive elements of the stigma of mental illness (knowledge, attitudes and behaviours) among healthcare professionals (HCPs) in Jordan. DESIGN: A cross-sectional descriptive design. METHODS: A total of 206 HCPs were conveniently recruited from general hospitals in Jordan. The mental attitude, knowledge and intended behaviours scales were used to measure stigma elements. RESULTS: Participants reported a moderate level of knowledge, a moderate negative attitude and a moderate or not greater interest to deal with people with mental health illnesses. The bivariate correlation revealed a negative significant correlation between HCPs' knowledge and attitude, indicating that HCPs with more knowledge significantly have more positive attitude (lower average score) towards those suffering from the illness. A more significant correlation was found between HCPs' knowledge and behaviour. The HCPs who had more knowledge were holding more interest and willingness towards dealing with persons with mental illness. PATIENT OR PUBLIC CONTRIBUTION: Negative attitudes among HCPs demand awareness programmes pertaining to the stigma of mental illness to afford higher standards of practice for patients with mental problems.

The efficacy of using psychotherapy treatments for obsessive-compulsive disorder on minimizing suicidal thoughts and behaviours: A scoping review.

BACKGROUND: Suicidal thoughts and behaviours (STBs) are significant public health challenges that affect a variety of individuals and communities. Despite numerous efforts to discover and refine psychotherapy treatments to minimize STBs, the efficacy of STB treatments remains unclear. OBJECTIVE: Conduct a scoping review to assess the efficacy of using psychotherapy treatments to minimize STBs among individuals with obsessive-compulsive disorder (OCD). METHOD: A scoping review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines (PRISMA-ScR) to screen 163 studies published between 2010 and 2021. RESULTS: A total of seven articles that fulfil the eligibility criteria reported that psychotherapy treatments for obsessive-compulsive disorder were found to be effective and applicable approaches to minimize the severity of the OCD symptoms and STBs, despite variance in studies' target samples, types of interventions, periods and indicators. CONCLUSION: The current review has provided evidence showing the significant effects of psychotherapy treatments on various health-related aspects of life for individuals diagnosed with obsessive-compulsive disorder, and it is recommended to use them for enhancing treatment outcomes and minimizing STBs. IMPLICATION FOR PRACTICE: This scoping review verifies the formalization and incorporation of psychotherapy treatments for OCD to minimize STBs into standard practice and highlights the importance of mental health professionals being part of the implementation of these treatments.

Exploring Mental Health and Psychosocial Well-Being in Recovered Jordanian Individuals With COVID-19: A Phenomenological Study.

BACKGROUND: COVID-19-related healthcare services focus primarily on medical and physical treatments. Related treatments for psychosocial and mental health needs have not been a priority for healthcare professionals. Understanding the process by which individuals who have recovered from COVID-19 adapt psychologically will allow better planning for mental healthcare and healthcare outcomes. PURPOSE: The purpose of this study was to explore how recovered individuals with COVID-19 adapted to related psychological and social stressors during the infection period. METHODS: A descriptive phenomenological approach was used to investigate a purposive sample of 13 individuals in Jordan who had recovered from COVID-19. Data were collected using semistructured interviews. RESULTS: Perceptions related to being diagnosed with COVID-19 were distinguished into four major themes: conscious awareness (acceptance, victimization, and normalizing), uncertainty (apprehension and poor communication), sources of psychosocial support (caring family, healthcare professionals' support, and self-grieving), and resilience (optimism, positive thinking, and spirituality). CONCLUSIONS: The findings of this study indicate the need to integrate psychosocial and mental healthcare services into healthcare plans provided to individuals with COVID-19 and similar pandemic infections.

The effect of a contact-based intervention on attitudes and intended behaviors of nursing students toward people with mental illness: A quasi-experimental study.

Background and Aim: Although nursing students are professionally and ethically trained and educated to respect patients with a variety of medical and mental problems, they continue to exhibit negative attitudes and behaviors toward mental disease and patients with mental illness. The accumulated evidence indicates that contact-based intervention (CBI) is helpful in enhancing nursing students' attitudes and behaviors toward patients with mental illness. Although evidence found to support the CBI, culture and settings might play a significant role to decide its effectiveness. This would call for testing further the effectiveness of CBI across cultures and healthcare settings. The purpose of this study was to assess the effect of a CBI on the attitudes and intended behaviors of nursing students in Jordan toward people with mental illness. Methods: A quasi-experimental, pre-post, design was used. Data were collected from 81 nursing students from two nursing schools implementing the CBI using self-reported questionnaires to measure students' attitudes and intended behaviors toward people with mental illness. Data were collected during the first semester of the academic year 2019/2020. The paired-samples and independent-samples t tests were used to test the study's hypotheses. Results: At baseline, the results indicated that there were no statistically significant differences between the experimental and control groups in terms of their attitudes and intended behaviors toward people with mental illness. At posttest, statistically significant improvements in the attitudes and intended behaviors of nursing students found in the experimental group and between control and experimental groups toward people with mental illness compared with baseline pretest measures (p < 0.001). Conclusion: The CBI did improve the attitudes and intended behaviors of Jordanian nursing students toward people with mental illness. Significant implications for nurses were discussed.

Healthcare providers' intention to leave their jobs during COVID-19 pandemic: A cross-sectional study.

Background and Aims: During the coronavirus pandemic (COVID-19), healthcare providers confronted risks of disease transmission to themselves and their family members, resulting in physical and psychological burdens. This might affect their decisions to leave their jobs temporarily or permanently, fearing infection and protecting their families. This study examined the factors related to the intention to leave a job among healthcare providers during the COVID-19 pandemic in Jordan. Methods: A cross-sectional correlational design was used to collect data using a convenience sample of 557 healthcare providers working in different sectors across Jordan. Data were collected using a self-administered questionnaire about the intention to leave jobs during the pandemic. Results: The sample included 368 females (63.8%) and 209 males (36.6%) participants. The mean age of participants was 30.8 years (SD = 6.65). Differences found in intention to leave job during COVID-19 in relation to age (t = 2.60, p < 0.05), gender (X 2 = 4.25, p < 0.001), and marital status (X 2 = 18.2, p < 0.001). Participants with a high risk of exposure to COVID-19 and who experienced higher workloads had higher scores of intention to leave their job during COVID-19, while being married had lower scores. Conclusions: Policy-makers need to pay attention to young and single healthcare providers during the COVID-19 pandemic to prevent them leave their job. Crucial guidelines for managing workload during the COVID-19 pandemic are needed. Policy-makers during pandemics have to protect healthcare providers who feel they are at high risk of infection.

Psychological Predictors of Fibromyalgia Among High School Students.

The purpose of the current study was to examine prediction power of psychological factors (i.e., alexithymia and psychological distress) on fibromyalgia among high school students. A cross-sectional, correlational design was used. Data related to alexithymia, psychological distress, and fibromyalgia were collected from 483 high school students from the northern part of Jordan using stratified cluster random sampling. Results showed that psychological distress is a significant predictor of fibromyalgia (odds ratio = 1.1, p < 0.001). Significant differences were found between males and females in relation to alexithymia (t = -4.87, p < 0.001), psychological distress (t = -6.0, p < 0.001), and fibromyalgia (χ2 = 4.14, p = 0.04, phi = 0.07). Age was only significantly correlated with alexithymia (r = 0.06, p < 0.05). Given the relationship among psychological distress, alexithymia, and fibromyalgia, mental health professionals should carefully observe psychological disturbances among high school students. [Journal of Psychosocial Nursing and Mental Health Services, 60(8), 19-25.].

The Association of Persistent Symptoms of Depression and Anxiety with Recurrent Acute Coronary Syndrome Events: A Prospective Observational Study.

The purpose of this study was to examine the role of persistent symptoms of depression and anxiety in a second acute coronary syndrome (ACS) event. Data presented in this study were from an RCT study. A follow-up for 24 months after baseline to detect a second ACS event among 1162 patients from five hospitals. Hierarchal Cox regression analyses were used. The results showed that persistent depression only (HR 2.27; 95% CI: 1.35-3.81; p = 0.002), and comorbid persistent depression and anxiety (HR 2.03; 95% CI: 1.03-3.98; p = 0.040) were the significant predictors of a second ACS event. Secondary education level compared to primary educational level (HR 0.63; 95% CI: 0.43-0.93; p = 0.020) and college or more education level compared to primary educational level (HR 0.47; 95% CI: 0.27-0.84; p = 0.011) were the only demographic variables that were significant predictors of a second event. The study reveals that attention must be paid by healthcare providers to assess and manage persistent depression; particularly when it is co-morbid with anxiety.

Testing Efficacy of Relapse Prevention Intervention among Patients Diagnosed with Schizophrenia in Jordan.

Relapse prevention is an essential component in sustaining positive treatment outcomes.The purpose of this study was to test the efficacy of a relapse prevention intervention on the ability of patients and their primary caregivers to self-detect and manage early warning signs of relapse, and its impact on relapse rate among patients diagnosed with schizophrenia.Quasi-experimental design; one group posttest only, repeated measure time-series design was employed. A total of 40 patients and their primary caregivers represented the sample in this study.The statistical analysis revealed that the effect of relapse prevention intervention on patients and their primary caregivers' ability to self-detect severity and manage early warning signs of relapse has sustainable and positive effect on patients and their primary caregivers from T1 to T3 (patients, M = 9.0-9.3; caregivers, M = 9.7-9.9). Also, positive effect of intervention detected on abilities of patients and primary caregivers to manage EWS from T1 to T3 (patients, M = 35-36.0; caregivers, M = 39.7-38.1). The analysis also showed a low relapse rate (14.9%).The study showed that relapse prevention interventions is effective and applicable approach that psychiatric nurses can use to ensure sustainable positive outcomes of psychiatric healthcare among patients with schizophrenia.

Using Relapse Prevention Interventions to Maintain Remission and Minimize Relapse Rates for Individuals With Schizophrenia: A Scoping Review.

Maintaining remission and improving quality of life for individuals with schizophrenia can encourage them to return to work, participate in volunteer opportunities, and establish healthy intimate relationships. The purpose of the current review was to explore the impacts of using relapse prevention interventions on maintaining remission and minimizing relapse rate for individuals with schizophrenia. A scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to screen 134 studies published between 2010 and 2020. A total of 14 articles met eligibility criteria. Included studies showed that intervention strategies tailored to meet the needs of individuals with schizophrenia must be developed and applied in different psychiatric settings to maintain remission and minimize relapse rate. [Journal of Psychosocial Nursing and Mental Health Services, 60(7), 47-54.].

Nursing students' attitudes towards death and caring for dying patients.

AIM: To examine the attitudes of undergraduate Jordanian nursing students towards death and caring for dying patients. DESIGN: A cross-sectional correlational design. METHODS: The Frommelt Attitude Toward Care of the Dying and Death Attitude Profile-Revised scales were used in this study with a convenience sample of 555 students from nursing schools in Jordan. RESULTS: Nursing students had positive attitudes towards death (M = 153.7, SD = 21.5) and a positive attitude towards caring for dying patients (M = 98.1, SD = 9.2). Fear of death, escape acceptance and death avoidance were significant negative predictors, while neutral acceptance, higher academic level and female gender were significant positive predictors of caring for dying patients (F = 4.5). CONCLUSION: Nursing students had positive attitudes towards caring for dying patients that was influenced by university type, academic level and gender. Nursing education must further focus on death, dying and end-of-life care across the core courses of nursing curricula, theory and practicum.

Impact of plastic surgery medical training on medical students' knowledge, attitudes, preferences, and perceived benefits: Comparative study.

INTRODUCTION: Misconceptions surrounding the discipline of plastic surgery are widespread among not only the public, but medical students and professionals, as well. The purpose of this study was to explore how the inclusion of plastic surgery rotation into the medical curriculum affects medical students' knowledge, attitudes and preferences regarding plastic surgery specialization and referral.   Design and Methods: A descriptive-correlational design was utilized to collect data from 200 medical students in the final two years of education from two separate six-year medical programs in Jordan. Data was collected using self-reported questionnaires regarding knowledge of surgical procedures allocation, attitude towards plastic surgery, preference of specialization, and benefits of plastic surgery to physicians and patients. RESULTS: Analysis showed that medical students of plastic surgery integrate rotation (program A) had a higher average score of correct procedure-allocation (M = 12.57, SD = 3.14), compared to non-integrated plastic survey rotation program (program B) (M = 8.29, SD = 3.05) 8.29. About 83% of students in program A had their knowledge on plastic surgery from direct exposure to a plastic surgeon, compared to 43% of program B, and 24% of students in program A reported that their perception of plastic surgery influenced by media compared to 62% of those in program B. CONCLUSIONS: medical students who have been exposed to plastic surgery education are more confident about procedures of plastic surgery specialty and had more reliable sources of knowledge about plastic surgery than those who were not exposed to plastic surgery rotation.

Predictors of Depression and Anxiety Among Senior High School Students During COVID-19 Pandemic: The Context of Home Quarantine and Online Education.

This study aimed to examine the prevalence and predictors of depression and anxiety among senior high school students in Jordan during the COVID-19 pandemic. The study used an anonymous online survey that targeted senior high school students in Jordan. Almost two thirds of students reported depressive symptoms and anxiety. Father's level of education, mothers' level of education, perceived difficulties in online education, gender, and age were significant predictors of depression, while father's level of education, difficulties in online education, gender, and age were significant predictors of anxiety (p < .05). Among those identified as having depression, 30.7% were male and 50.7% were female. The prevalence of anxiety among students was high, and the prevalence of anxiety in females (46.9%) is greater than males (27.6%). School health nurses and mental health counselors at schools need to emphasize the mental health and psychosocial support needs for senior high school students.

Resiliency process and socialization among Palestinian children exposed to traumatic experience: Grounded theory approach.

PURPOSE: The conflict in Palestine is known to be one of the longest ongoing conflicts in the world affecting children with harmful psychological consequences. The purpose of this study was to explore the process of resilience among Palestinian children exposed to psychological trauma due to detention experiences. METHOD: A qualitative approach utilizing grounded theory design was used. Data collected by a semi-structured interview format from 18 Palestinian children aged 12-18 years were exposed to detention. RESULTS: The study revealed four main categories with focus and initial coding subcategories. Major categories were: revering and honoring the prisoners, normalizing the abnormal situations (positive adaptation), awareness and political socialization during childhood, and developing identity and belonging to the homeland. The results indicated that Palestinian children exposed to political detention had their own positive perception of the trauma and had a high level of posttraumatic maturation. PRACTICE IMPLICATION: The study concluded that early childhood political awareness, family and community support, sociocultural perception of prisoner children, and sense of belonging improved the ability of detained children to normalize abnormal situations and successfully cope with psychological trauma. So, the study has significant implications for nursing practice in the field of childhood trauma and intervention, it can help nurses working with traumatized children to assess and intervene according to the child's perception about the trauma and ability to cope.

The moderation effect of locus of control on the relationship between job demand and job satisfaction among nurses.

BACKGROUND: Job demand and job satisfaction in nursing profession have been identified as significant indicators of quality of nursing care. Job demand is the most influential job stressor and has been connected to negative consequences on nurses' ability to function. PURPOSE: The purpose of this study was to examine the moderating effect of work locus of control on the relationship between job demand and job satisfaction among nurses working at public hospitals. METHODS: A quantitative, cross-sectional, correlational design was utilized to randomly recruit 427 registered nurses working at two major public hospitals. Data were collected using a self-administered questionnaire regarding job demand, job satisfaction and work locus of control. RESULTS: Work locus of control had a significant moderating effect on the relationship between job demand and satisfaction. External locus of control had a negative effect on the job demand and job satisfaction relationship, whereas internal locus of control positively buffered this correlation. CONCLUSION: This study adds a novel contribution to the body of knowledge that buffering effect of job demand among nurses is much dependent on appropriately enhancing internal locus of control, consequently improving job satisfaction.

Prevalence, Barriers, and Interventions Related to Medication Adherence Among Patients With Major Depressive Disorder: A Scoping Review.

The current scoping review aimed to identify the prevalence, contributing factors, methods of measurement, and interventions related to medication adherence among patients with major depressive disorder (MDD). A total of 37 articles met inclusion criteria. The prevalence of medication adherence among patients with MDD ranged from 10.6% to 85.4%. Approximately 67% of studies used self-report data collection. Illness-related factors (e.g., onset of illness, duration of illness, symptoms, illness severity), medication-related factors (e.g., adverse reactions, duration of treatment, cost of treatment), and patient-related factors (e.g., beliefs, attitudes, knowledge, self-stigma) were the most reported factors associated with medication adherence. In addition, multi-faceted interventions were recommended over single-element interventions to enhance medication adherence. There is a need to integrate appropriate and effective assessment measures of medication adherence that lead to better health care outcomes, lower risk factors, and improved interventions related to medication adherence. [Journal of Psychosocial Nursing and Mental Health Services, 59(1), 39-51.].

Sexual Satisfaction Among Infertile Couples: Demographics and Psychosocial Health Factors.

The purpose of the current study was to explore sexual satisfaction among infertile couples in Jordan and its associations with psychosocial and sociodemographic factors. Using a descriptive correlational design, 248 infertile couples from outpatient clinics were recruited and filled out a questionnaire on sexual satisfaction, in addition to perceived social support, depressive symptoms, psychological stress, coping skills, optimism, life satisfaction, and sociodemographics. Sexual satisfaction was significantly and positively correlated with perceived social support, optimism, life satisfaction, and coping. Stronger association was observed between sexual satisfaction and optimism. No difference was found in sexual satisfaction in relation to participants' gender, age, working status, or education. This study highlights the importance of building mental health nurses' competence to provide education and counseling on sexuality to improve the quality of life of infertile couples and optimize their sexual wellness. The most recent guidelines for psychosocial care for infertile couples are discussed. [Journal of Psychosocial Nursing and Mental Health Services, 58(9), 40-47.].