Death Anxiety and Associated Factors Among Oncology Nurses and Physicians.

Background: Providing care for dying patients is a stress-inducing, complicated, as well as essential responsibility for health care providers. Furthermore, end-of-life care is associated with intense personal emotions such as grief, anxiety, depression, frustration, and guilt. Moreover, caring for terminally ill patients is a challenging task that confronts physicians and nurses with the psychological concerns of dealing with death, which is accompanied by a high level of physical and psychological discomfort.Objective: This study was aimed to measure the level of death anxiety among oncology nurses and physicians and to determine the associated factors that influence their level of death anxiety.Method: A cross-sectional descriptive design was used to guide this study, a non-probability convenience sampling method was used to recruit 200 oncology nurses and physicians from one specialized cancer center in Jordan. Data were collected using an electronic self-reported questionnaire include demographic data sheet and Collett-Lester fear of death scale, as well as all participants were invited via email for voluntary participation in this study.Result: The results revealed that the oncology nurses and physicians exhibited a moderate levels of death anxiety (CLDFODS = 91.07), furthermore, the result showed that female nurses and physicians exhibited a higher level of anxiety than male. Further, there were statistically significant differences in nurses' and physicians' level of death anxiety according to years of experience, receiving previous education on death and dying, and religious beliefs. On the other hand, there is no statistically significant differences in nurses' and physicians' level of death anxiety based on present or previous experience with loss of someone close to them.Conclusion: Jordanian oncology Nurses and physicians exhibited a moderate levels of death anxiety and fear of death, therefore, they have to address the inevitability of mortality since they are caring for dying patients frequently. They have to understand and acknowledge their thoughts regarding death and dying, as well as their death anxiety level before interacting with dying patients.

The effect of spiritual well-being on symptom experience in patients with cancer.

PURPOSE: To explore the effect of spiritual well-being on the symptom experience of patients with cancer. METHODS: This is a cross-sectional survey that enrolled 459 patients with cancer from three large hospitals in Jordan in 2018. Participants completed questionnaires related to demographic data, spiritual well-being, and symptom experience. Additional information was obtained from the medical record review. We then conducted multiple regression to evaluate if spiritual well-being predicts the patients' reported symptom distress. RESULTS: Patients reported thirty-six symptoms. Of which 15 have a prevalence of more than 30%. Fatigue was the most prevalent symptom (n = 282, 61.4%), followed by pain (n = 243, 52.9%) and anxiety (n = 230, 50.1%). Spiritual well-being predicted 7.1% of the total variance in patients' symptom distress (F, 19.650; p < 0.0001). Additional predictors were gender, education level, having a problem covering the treatment cost, family cancer history, and whether taking a complementary treatment or not. CONCLUSIONS: Patients with cancer experience multiple symptoms related to the disease and its treatment. Improving patients' spiritual well-being through an increased sense of meaning and peace can improve cancer symptom experience by decreasing symptom distress. In general, hospitals in Jordan focus on direct symptom management and do not look after patients' spiritual needs. Raising awareness about the importance of patients' spiritual well-being and providing appropriate spiritual assessment and interventions to patients with spiritual distress can improve patients' symptom experience.

Nurses' Perceptions of Spirituality and Spiritual Care Giving: A Comparison Study Among All Health Care Sectors in Jordan.

AIMS: This study aimed to describe nurses' perceptions of spirituality and spiritual care in Jordan, and to investigate the relationship between their perceptions and their demographic variables. METHODS: The study used a cross-sectional descriptive design and recruited a convenience sample of 408 Jordanian registered nurses to complete the spiritual care giving scale. RESULTS: The findings of the study demonstrated that most of the participating nurses had a high level of spirituality and spiritual care perception. Significant differences were found between male and female nurses' perceptions of spirituality and spiritual care (P < 0.05); previous attendance of courses on spiritual care also made a significant difference to perceptions (P < 0.05). CONCLUSIONS: The research findings suggest that, Jordanian nurses' gender made a difference in their perceptions of spirituality and spiritual care. They had satisfactory levels of perception of spirituality and spiritual care. Moreover, spiritual care courses appeared to have a positive impact on their perception of spirituality and spiritual care. Enhancing nursing care by integrating standardized spiritual care into the current nursing care, training, and education should also be emphasized.

Development and psychometric evaluation of the Chronic Kidney Disease Screening Index.

OBJECTIVE: Public understanding of chronic kidney disease (CKD) is important to ensure informed participation in CKD prevention programs. This study aimed to develop and to test the psychometric profile of the CKD Screening Index that measures patient's knowledge, attitudes, and practices regarding CKD prevention and early detection. METHODS: A cross-sectional design was implemented and a total of 740 Jordanian patients recognized at risk for CKD were recruited by convenience sampling from out-patient departments. Development and psychometric validation of the CKD Screening Index were conducted in four phases: (1) item generation, (2) pilot study, (3) preliminary psychometric validation study to examine factor structure, and (4) final psychometric validation with 740 participants. RESULTS: On factor analysis, 24 items categorical knowledge items loaded into one factor and yielded a Guttman Split-Half Coefficient of 0.80. In a separate factor analysis, 15 items were loaded on two attitude factors (Cronbach alpha coefficient = 0.69), and nine items loaded on two practice factors (Cronbach alpha coefficient = 0.68). The CKD Screening Index associated significantly and negatively with depressed and anxious patients compared to their counterparts. PRACTICE IMPLICATIONS: This promising CKD Screening Index can be used for an early identification of patients at risk for CKD, thus, allowing the development of interventions to raise these patients' awareness. Future studies are needed on other populations with different cultural background to support reliability and validity of this new instrument.

The Effectiveness of Immersive Virtual Reality as A Complementary Approach and a New Direction in Cancer Related Fatigue Management.

Background: Recent advancements in the field of medical technology have illuminated that the implementation of virtual reality interventions can be highly effective in managing cancer-related fatigue. Moreover, this innovative intervention has demonstrated a substantial improvement in patients' overall well-being and daily functioning. Thus, it represents a promising alternative to traditional pharmacological treatments by effectively addressing symptoms and enhancing quality of life. Therefore, the integration of this approach signifies a significant advancement in patient care. Nevertheless, despite the ongoing efforts to diversify non-pharmacological treatments, pharmacological interventions are still the predominant method for managing cancer-related fatigue. Aim: This systematic review aimed to evaluate the effectiveness of immersive virtual reality in cancer-related fatigue management, and to explore the main side effects of immersive virtual reality. Methods: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Several online databases were used to find eligible studies in peer-reviewed journals relevant to the study keywords. Specifically, the included studies were systematic reviews and clinical trials that used immersive virtual reality-based intervention among adult patients with cancer and suffering from cancer-related fatigue. As well as were published in the English language from 2014 to 2024. As well as, three researchers independently contributed to study selections, data extraction, and study evaluations from different aspects: including quality assessment, risk of bias, and study synthesis. Results: After an extensive and comprehensive search, a total of ten published studies were included in this review study; 6 articles were quantitative clinical trial studies, and the other 4 were systematic review and meta-analysis studies. The quality of 6 included clinical trials was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for quantitative studies, the overall result showed that 33.3% of studies rated with moderate quality, no study was rated with low quality, and (66.7%) studies rated as high-quality studies. As well, the quality assessment of all review studies showed that all included systematic reviews and meta-analyses with a low risk of bias and high to moderate power of evidence. The result of this extensive and comprehensive review showed that immersive virtual reality has a significant effect in reducing cancer-related fatigue, however, still, there is a significant variation in the employment of immersive Virtual Reality protocols for cancer symptom management worldwide. Conclusion: Immersive virtual reality is an effective non-pharmacological intervention in reducing and controlling cancer-related fatigue among patients with various types of cancer, as well as being an affordable, cost-effective approach. Nevertheless, there remains a notable gap in the existing literature concerning virtual reality protocols, associated side effects, and the underlying mechanisms by which immersive virtual reality alleviates fatigue. Therefore, further research studies are warranted to address these gaps and advance our understanding in these areas.

Experiences of Academic Women in Jordan on Their Return to Work After Childbirth.

OBJECTIVE: To describe the experiences of women living in Jordan returning to work at their academic positions after giving birth to their first newborns. DESIGN: Qualitative descriptive phenomenological design. SETTING: Various schools within a governmental university in Jordan. This study describes the challenges women in academia experience in the context of Jordan's Arabic patriarchal communities. PARTICIPANTS: A purposive sample of 15 women returning to their academic positions. METHODS: Unstructured, face-to-face, in-depth interviews of women returning to their academic positions within 3 months after giving birth to their first newborns. The recorded interviews were analyzed using Braun and Clarke's thematic analysis process. RESULTS: Three major themes emerged: Living in Chaos, The Urgent Need for Transitional Time, and Calling for Help andSupport. Participants described their return to work as a period marked by a sense of chaos and instability, in which they felt a loss of control over their lives. They expressed a pressing need for a transitional period before resuming full-time academic roles, highlighting the importance of a gradual return. Finally, participants shared their struggles with the extra demands added to their daily routine. As working mothers, participants experienced extreme distress while attempting to fulfill their daily responsibilities. They emphasized the lack of adequate support in this challenging period. CONCLUSION: Women returning to their academic work after giving birth to their first newborns need to be prepared physically and emotionally for the changes and responsibilities of their new life. A longer period of maternity leave or a transitional period may help women working in academia to manage the demands of multiple maternal roles alongside their professional commitments. These findings highlight the absence of formal policies needed to support women in academia in their return to work after maternity leave.

In the shadows of OCD: Jordanian patients' experiences during the COVID-19 quarantine.

WHAT IS KNOWN ON THE SUBJECT?: The COVID-19 pandemic has brought new sources of stress and challenges for people dealing with obsessive compulsive disorder (OCD). WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: The study uncovered the unique experiences of Jordanian patients with OCD during the COVID-19 pandemic, revealing three main themes: Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance, estranging family attachments and shifting OCD landscapes. Family dynamics played a significant role, with some families unintentionally exacerbating OCD symptoms through excessive accommodation, while others openly expressed irritation, both contributing to worsened symptoms. The research unveiled a notable deficiency in the availability of professional mental health support for individuals with OCD throughout the pandemic. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Accessible and culturally appropriate e-mental health interventions can bridge the gap in mental health support, especially during crises like the pandemic. It is crucial to involve family members in the treatment process to address family dynamics that may either support or hinder recovery among patients with OCD. ABSTRACT: INTRODUCTION: Pandemics, like COVID-19, can significantly harm the mental well-being and overall quality of life for individuals and their families. Those with pre-existing mental conditions, especially obsessive compulsive disorder (OCD), are more vulnerable to negative psychosocial effects since the fear of being infected or transmitting infection to others are some of the main characteristics of the illness. There is a need for a nuanced understanding of the personal, social and cultural experiences of people with OCD within their specific psychosocial context. AIM: To explore how Jordanian patients with OCD experienced their illness during COVID-19. METHOD: A descriptive phenomenological design using semi-structured interviews with a purposive sample of 12 patients diagnosed with OCD and experiencing different types of OCD symptoms. Data were analysed thematically, and reported based on the critical appraisal skills programme (CASP) checklist for qualitative studies. RESULTS: Three main themes emerged: (1) Navigating Constraints: The Dual Pathways of Social Engagement and Avoidance (seeking solace through social interaction and embracing quarantine as an opportunity for social avoidance); (2) Estranging family attachments (enforcing proximity and struggling with intimacy); and (3) Shifting OCD landscapes (transforming existing obsessions and escaping to new compulsions). The interviews documented a complete lack of references to receiving professional mental health support throughout the pandemic. DISCUSSION: This study aligns with previous research indicating a surge in OCD severity during the pandemic, fuelled by distressing news and heightened hygiene measures. Notably, it underscores the strain on familial relationships, with some cases showing protective effects but many demonstrating worsening symptoms due to excessive family accommodation. The absence of professional mental health support during the pandemic raises questions about the quality and accessibility of mental health services in Jordan. IMPLICATIONS FOR PRACTICE: The findings underscore the need for continued mental health support and intervention, particularly during times of heightened stress and isolation. Integrating e-mental health resources and cultural adaptation can play a vital role in providing accessible and effective support for individuals with OCD, including those in the Jordanian Arab culture. As we navigate future challenges, it is crucial to prioritize the well-being of individuals with OCD and ensure they have access to appropriate and tailored mental health services.

The Effectiveness of P6 and Auricular Acupressure as a Complimentary Therapy in Chemotherapy-Induced Nausea and Vomiting Among Patients With Cancer: Systematic Review.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is one of the most prevalent and distressing side effects of chemotherapy among patients with cancer worldwide. Despite continuing advances in antiemetic medicines, nausea and vomiting associated with cancer chemotherapy remain a substantial therapeutic concern for many patients. However, P6 and Auricular acupressure (AA) have been recognized as potential therapy for managing chemotherapy-induced nausea and vomiting. AIM: This study aimed to evaluate the effectiveness of P6 and Auricular acupressure (AA) in reducing chemotherapy-induced nausea and vomiting among patients with cancer. And to explore a prominent and effective evidence-based protocol for implementing acupressure to treat chemotherapy-induced nausea and vomiting. METHOD: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Several databases were used to search for eligible studies using specific keywords. Only systematic reviews and clinical trials on acupressure for managing CINV among adults with cancer were included. This review covered articles published in English from 2015 to 2022. RESULTS: A total of 14 published studies were included in this review study; 10 articles were trial studies, and the other 4 were systematic review and meta-analysis studies. The quality of 10 included clinical trials were assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for quantitative studies, the overall result showed that 40% of study rated with moderate quality, no study was rated with low quality, and (60%) studies rated as high-quality study. As well as the quality assessment of all review studies showed that the majority of included systematic reviews and meta-analysis with a low risk of bias and high to moderate power of evidence. In all included studies the acupressure was utilized as a primary complementary intervention for chemotherapy induced nausea and vomiting. The result of this extensive and comprehensive review the P6 and auricular acupressure is an effective complementary therapy in reducing and controlling chemotherapy-induced nausea and vomiting among participants with various types of cancer and receiving various types of chemotherapy. CONCLUSION: The successful and effective application of acupressure in managing CINV for certain types of cancer had been supported in previous literature as a safe, affordable, and non-invasive alternative to pharmaceutical medications. However, standardization guidelines regarding the use of acupressure independently or in combination with other pharmacological therapies to address CINV in various cancers require immediate attention.

After the doctorate: a qualitative study investigating nursing research career development in Jordan.

There is a dearth of research exploring the development of postdoctoral nursing research careers in non-Western contexts. This paper reports on a qualitative study of Jordanian graduates of UK PhD programs. Interviews were held with 16 graduates who worked in the nursing faculty of seven different universities in Jordan. Participants reported that their doctoral degree had equipped them with confidence and enthusiasm for developing a research career. Mentorship, leadership, and peer support were identified as essential to supporting ongoing research activity. Access to these sources of support was variable and participants also described a range of institutional and organizational structures that directly or indirectly discouraged them from developing research productivity. This research suggests that support for postdoctoral novice researchers is an important area for further attention - for Jordanian universities, for UK PhD supervisors (and their associated academic departments), and for the wider nursing community.

Gender as a Moderator of Spirituality and Spiritual Care in ICU Nurses During COVID-19 Pandemic.

Background: Earlier research has found that female healthcare providers often report greater spirituality and spiritual care than males. This would evoke attention toward factors contributing to such differences, particularly gender. Aim: To examine the moderating effects of gender on the relationships between demographic characteristics of ICU nurses and their perceived spirituality and spiritual care. Methods: A cross-sectional correlational design was used to recruit a national sample of 865 nurses working in ICUs in Jordan and providing care to patients diagnosed with COVID-19. Data were collected using a self-report bilingual version of Spirituality and Spiritual Care Rating Scale (SSC) and analysed using the SPSS software package. Results: Social status, monthly income, and receiving previous courses or lecture training on spirituality and spiritual care were predictors of higher SSCRS scores. Working with COVID-19 patients was a positive predictor (B = 0.074, p = 0.023), suggesting that working with COVID-19 patients is more likely to have a higher level of SSC. Gender was a negative predictor (B = -0.066, p = 0.046), suggesting that female participants are likelier to have a lower SSC score. Conclusion: Working with patients during the COVID-19 pandemic positively impacted nurses' perception of SCC, but female nurses had lower score than male nurses indicating the need for more emphasis on training female nurses and exploring further the areas in which they need more training and to be able to provide an effective SSC. A sustainable up-to-date training and in-service education programs responding to nurses' needs and emerged emergencies crisis need to be integrated into nursing quality of care policy development.

The buffering role of social support on the severity of physical symptoms among patients living with cancer.

BACKGROUND: The role of perceived social support (the individual's perception that family, friends and others are available as psychological, social and material support) and its moderating effect on the psychological and physical factors among patients suffering medical problems is still debated. AIM: To explore the effect of perceived social support on the relationship between psychological and health-related factors on the severity of physical symptoms among patients with cancer. METHODS: A descriptive-correlational, cross-sectional design was used to recruit 459 patients with cancer from three major hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS: Social support was significantly correlated to the severity of physical symptoms (p>.05) among patients with cancer, while psychological distress, sadness, disturbed body image and anxiety were not (p<.05). The multiple hierarchal regression model showed that social support has no significant moderation effect on the relationship between psychological and health-related factors and the severity of physical symptoms controlling for sociodemographic factors among patients with cancer. CONCLUSION: Patients with cancer suffering physical and psychological disturbances do not benefit from social support as a way of controlling the severity of their symptoms. Palliative nurses need to tailor a social support intervention to their patients with cancer, in order to use both professional and family resources.

The experience of family support among patients newly diagnosed with cancer in Jordan.

PURPOSE: To describe the experiences of family support from the perspectives of patients newly diagnosed with cancer. METHODS: Descriptive qualitative phenomenological design was undertaken, including in-depth individual interviews with 13 newly diagnosed cancer patients from two hospitals in Jordan. RESULTS: Three themes emerged: 'being there,' 'family reunion and connectedness,' and 'gratified with family support.' Being there includes the compassion of family together, support by encouragement, and using religious rituals and traditional remedies. A cancer diagnosis brings family reunions and connectedness and strengthens relationships between spouses. The patients expressed gratitude that their families were compassionate, active listeners, and willing to help, which helped them make decisions related to cancer treatment and overcome their fears. CONCLUSIONS: Findings show the strength and priority of family support in Jordanian Arabic culture during an initial cancer diagnosis. In cultures where family members take the burden of care, religion and cultural practices play a vital role in directing patient care. Understanding the experiences of family support from the patients' view could help nurses provide comprehensive and culturally sensitive care and requires adopting a family-centered approach in preparing care plans for patients.

Looking back at the doctorate: a qualitative study of Jordanian graduates from PhD programs in the UK.

Many countries develop their nursing capacity by sending nurses overseas to gain their doctorates. There is a lack of research on their subsequent experience and career development. Focusing on the Jordanian and UK contexts, this qualitative study explored the doctoral and postdoctoral experience. Interviews were held with 16 PhD nursing graduates in Jordan. The participants had studied in 12 different universities in the UK and now worked as faculty members in seven Jordanian universities. The data were analyzed thematically. The participants reported that the most difficult task (but also the most significant achievement) was the transition to autonomous scholarship. They also described a profound personal transformation as a result of living in another country. However, very few of them could cite examples of how they were using their skills now to influence their current practice within their faculty roles. This suggests a possible under-use of the skills, new perspectives, and enthusiasm that new doctoral graduates bring back home with them. Future research should focus on identifying ways to support and develop doctoral nursing graduates to maximize their potential on their return home.