Adolescents and type 1 diabetes: A grounded theory on adolescents' experiences of adaptation to type 1 diabetes.

PURPOSE: Type 1 diabetes influences adolescents' health status and therapeutic management. Adaptation for adolescents with type 1 diabetes is considered a significant issue for this cohort group and is based on many factors, including availability of resources, and family and community support. Thus, this study aimed to explore Palestinian adolescents' experiences of adaptation to type 1 diabetes in the West Bank. DESIGN AND METHODS: A qualitative grounded theory approach was adopted. The purposive sample consisted of fourteen adolescents aged from 12 to 18 years and diagnosed with type 1 diabetes. The data were collected using semi-structured and face-to-face individual interviews during the period from March to June 2023. A constant comparative method was used to analyze data. FINDINGS: The core category had emerged with categories and subcategories. There were three categories and ten subcategories including difficulties in the management of type 1 diabetes, for example, "insulin injections, dietary management, and control of HbA1c levels", burdens of type1 diabetes, for example, "burden regarding follow-up treatment, the burden of interaction and communication, emotional burden, and economic burden", and fears and worries of unexpected future life, for example, "worries about disease complications, worries regarding social relationships, and worries about marriage and parenthood". CONCLUSION: Adolescents diagnosed with type 1 diabetes suffer from difficult experiences influencing their adaptation to this disease. PRACTICE IMPLICATIONS: Counseling programs concerning self-care management for those adolescents need to be developed in addition to support programs. Health education programs are needed to develop their adaptation and coping skills to these experiences.

The association between psychological reactions, resilience, and work engagement among Palestinian critical care nurses in West Bank.

AIM: This study aimed to assess the association between psychological reactions (e.g., stress, anxiety, and depression), resilience, and work engagement among Palestinian critical care nurses in the West Bank and examine the correlation of psychological reactions and resilience with work engagement. BACKGROUND: Work engagement is associated with psychological reactions and resilience, particularly among critical care nurses. There is a lack of studies on work engagement and these factors in Palestine. METHODS: A cross-sectional, descriptive correlational design was adopted. A convenience sample consisting of 273 critical care nurses from private and governmental hospitals was recruited to participate. Depression, Anxiety, Stress Scale-21 (DASS-21), Connor-Davidson Resilience Scale-25 (CDRS-25), Utrecht Work Engagement Scale-9 (UWES-9), and demographic data were used to collect data during the period from March 20 to May 20, 2023. RESULTS: Findings demonstrated that 53.9% of the nurses reported mild-to-moderate levels of depression, 49.8% reported moderate-to-severe levels of anxiety, and 49.1% reported moderate-to-severe levels of stress. Additionally, 57.5% and 52.7% of them had low resilience and work engagement, respectively. Moreover, work engagement negatively correlated with depression (r = -0.796, P < 0.01), anxiety (r = -0.654, P < 0.01), and stress (r = -0.796, P < 0.01), while positively correlated with resilience (r = 0.42, P < 0.01) and gender (r = 0.121, P < 0.05). Depression, anxiety, stress, resilience, and gender were the main predictors of work engagement. DISCUSSION: The majority of the nurses suffered from depression, anxiety, and stress. Additionally, more than half of the participants had low resilience and work engagement. Moreover, increased depression, anxiety, and stress were correlated with decreased work engagement, while high resilience and gender as being female positively correlated with high work engagement. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: Policymakers and hospital administrators should develop interventions to improve critical care nurses' resilience and minimize psychological reactions, which have a significant influence on work engagement. Future studies should be conducted to examine the effectiveness of these interventions.

The Relationship Between Quality of Life and Depressive Symptoms Among Jordanian Community-Dwelling Older Adults.

OBJECTIVE: The current study aimed to examine the relationship between depressive symptoms and quality of life among Jordanian community-dwelling older adults. METHODS: A cross-sectional, descriptive correlational design was used. A convenience sample (N = 602) was selected to recruit the participants in the Amman governorate during the period from August to November 2021. RESULTS: Findings demonstrated that the mean (SD) age of older adults was 67.5 (7.0) years and 51.5% of participants were females. Also, 54.1% of the participants experienced moderate to severe depressive symptoms with a total mean (SD) score was 8.57 on a scale of 0 to 15, while the mean (SD) for the quality of life scale was 12.12 (3.85) on a scale of 4 to 20. Significant differences existed in quality of life and depressive symptoms based on marital status (p < .001), educational level (p < .001), working status (p < .01), income (p < .001), and chronic disease (p < .01). Quality of life and its domains were negatively associated with depressive symptoms (B= - 0.596, p < .001). Also, marital status, working, educational level, income, and chronic disease were associated with depressive symptoms. CONCLUSION: Strategies to improve quality of life should be promoted to minimize depressive symptoms among older adults and consider significant demographic factors.

Self-awareness, empathy, and patient-centered care among critical care nurses in Jordan.

Self-awareness, empathy, and patient-centered care are essential components for nurses for improving nurse-patient relationship and providing high-quality care for the patients. There is limited research regarding these components among critical care nurses in Arab countries, including Jordan. Thus, this study purposed to evaluate the self-awareness, empathy, and patient-centered care among critical care nurses in Jordan. A cross-sectional, descriptive correlational design was applied. Data were collected from 140 registered nurses from six hospitals in different health sectors. Findings showed that the mean scores for self-awareness, empathy and patient-centered care were as follows: 1.92 (SD = 0.27), 4.87 (SD = 0.88), and 3.71 (SD = 0.80), respectively. These results indicate that nurses had a high level of self-awareness and empathy and a low level of patient-centered care. There was no relationship between self-awareness and socio-demographic variables, perceived stress, and social support. Also, there was a positive relationship between empathy and social support (r = 0.310, p < 0.001). Patient-centered care had a positive relationship with social support (r = 0.202, p < 0.05) and perceived stress (r = 0.175, p < 0.05), also, male nurses had higher patient-centered care than female encounters. Social support was a predictor of empathy, while social support and perceived stress were the main predictors for patient-centered care. The results of the study reflect the need for educational programs to promote self-awareness and empathy to enhance patient-centered care and achieve high-quality patient care. Additionally, correlating factors with PCC (social support and perceived stress) should be taken into consideration upon implementing any interventional programs.

Postpartum depression among first-time Jordanian mothers: levels and associated factors.

Postpartum depression among first-time mothers is a sensitive issue and few studies were conducted related to this topic in developing countries including Jordan. Thus, this study purposed to assess postpartum depression levels and associated factors among Jordanian first-time mothers. A cross-sectional design was adopted, and 193 postpartum first-time mothers living in Amman governorate were recruited. A questionnaire consisting of two parts was used to record data, sociodemographic and maternal health, and Patient Health Questionnaire (PHQ-9). Findings showed that 34.1% of the women experienced postpartum depression. The employment, gravida, antenatal health problems, breastfeeding problems, newborn health problems, and availability of assistance during the postpartum period significantly correlated with postpartum depression. Thus, the understanding of postpartum depression and related factors would provide important empirical evidence for healthcare professionals and policy-makers when planning to develop strategies and measures to minimize postpartum depression among first-time mothers.

Effect of incredible years autism spectrum and language delays (IY-ASD) program on stress and behavioral management skills among parents of children with autism spectrum disorder in Palestine.

PURPOSE: This study purposed to evaluate the effect of the Incredible Years Autism Spectrum and Language Delays (IY-ASD) program in reducing parents' stress and improving aggressive and disruptive behaviors in the parents among parents of children with autism spectrum disorder in Palestine. DESIGN AND METHODS: A one-group pre-posttest design was used. Thirty-four parents who enrolled in the Palestinian Child Institute in Nablus were recruited. RESULTS: Findings revealed a significant difference between parents' total stress pre and post-IY-ASD (t = 1.2, p < 0.01 and parents' behavioral management skills toward their children with autism spectrum disorder. The study demonstrated that the IY-ASD program for 16 sessions reduced stress among parents of children with autism spectrum disorder in Palestine and improved aggressive and disruptive behaviors in the parents. CONCLUSION: The IY-ASD program can be successfully implemented for parents of this cohort group. PRACTICE IMPLICATIONS: Healthcare providers can adopt such a program for enhancing parenting roles with their children experiencing autism spectrum disorder.

Self-esteem, stress, and depressive symptoms among Jordanian pregnant women: social support as a mediating factor.

This study purposed to assess the mediating role of social support between stress, depressive symptoms, and self-esteem among Jordanian pregnant women. Across-sectional study recruited a total of 538 pregnant Jordanian women using a cluster stratified random sampling technique, during the period from September 2019 to February 2020. The study used the following measures: The Perceived Stress Scale (PSS), Beck's Depression Inventory (BDI), Rosenberg Self-Esteem Scale, and Multidimensional Social Support Scale (MSPSS). Descriptive statistics and inferential statistics were used to test the mediating effect of social support in terms of the association between depression and self-esteem. The results were considered significant if p ≤ .05. The findings showed that 75.6% of participants had moderate-to-high stress levels. High levels of stress, depressive symptoms, and low self-esteem were highly correlated with low social support (p < .05). Depressive symptoms predict the self-esteem (F(2, 537) = 158.631 p < .05). Social support significantly mediates the relationship between the depressive symptoms and self-esteem with p = .01. Thus, during the antenatal care, administration of screening tools to identify pregnant women with low social support levels and at risk of developing psychological difficulties would allow primary healthcare to promote for positive health outcomes for the mothers and the babies.

The Relationship Between Nursing Informatics Competency and Clinical Decision-Making Among Nurses in West Bank, Palestine.

This study aimed to examine the relationship between nursing informatics competencies and clinical decision-making by taking into account nurses' individual characteristics and job-related characteristics. A cross-sectional design was used. The cluster random sampling method was adopted to select 14 governmental hospitals in West Bank, Palestine, in which all nurses in these hospitals were invited to participate in this study. Results found that the total mean (SD) score for the nursing informatics competency scale was 2.6 (0.88), which indicates that the nurses had lower nursing informatics competency, and the informatics skills subscale had the lowest mean score (mean [SD], 2.4 [1.00]). Concerning clinical decision-making, the total mean (SD) score was 2.59 (0.38), which indicates that the nurses had lower clinical decision-making. Regarding clinical decision-making subscales, searching for information and unbiased assimilation of new information had the highest mean score (mean [SD], 2.64 [0.39]); on the contrary, the canvassing of objectives and values subscale had the lowest mean score (mean [SD], 2.53 [0.38]). Nursing informatics competency had a positive relationship with clinical decision-making. Thus, it is necessary to enhance nurses' informatics competency, especially informatics skills and clinical decision-making, by developing training programs about this technology directed to nurses.

Association between work-related psychological empowerment and quality of nursing care among critical care nurses.

AIM: This study aimed to examine the association between work-related psychological empowerment and quality of nursing care in Jordanian critical care nurses. BACKGROUND: Nurses' work-related empowerment is the essential element to enhance nurses' quality of care. There are few studies about this area among critical care nurses. METHODS: A cross-sectional design was used, and data were collected from critical care registered nurses (N = 480) from different health sectors. RESULTS: The mean scores of work-related psychological empowerment and quality of nursing care were 5.22 (SD = 0.92) and 3.75 (SD = 0.62), respectively. The nurses had agreement level of psychological empowerment and very good level of quality of nursing care. There was a positive relationship between quality of nursing care and psychological empowerment. CONCLUSION: The need to enhance work psychological empowerment is necessary to improve quality of nursing care. IMPLICATION FOR NURSING MANAGEMENT: The results reflect the need for policy-makers and nursing managers to develop and implement strategies to promote psychological empowerment to provide high quality of nursing care among critical care nurses.

Perceptions of patient safety culture among emergency room nurses in Jordanian accredited hospitals.

AIM: The aim of this study is to assess the perceptions of patient safety culture among emergency room nurses in Jordan. BACKGROUND: Patient safety culture is considered an international priority for health care institutions. There is a lack of studies on patient safety culture among emergency room nurses in international and Arab countries including Jordan. METHODS: A cross-sectional design was used to perform among emergency room nurses (N = 424) who are working in two health sectors (government and private) in Jordan. RESULTS: Results showed that the total perception mean of patient safety culture was 70.6% (M = 3.87, SD = 0.64), which indicates that the perceptions of patient safety culture among emergency room nurses need potential for improvement. Three areas in patient safety culture were reported as strong, including teamwork within units (77.4%; M = 3.87, SD = 0.64), feedback and communication about the error (76.6%; M = 3.83, SD = 0.65) and organisational learning-continuous improvement (75.4%; M = 3.77, SD = 0.63). The lowest scores were for areas of frequency of events reported (63.6%; M = 3.18, SD = 0.99) and handoffs and transitions (64.4%; M = 3.22, SD = 0.78). Patient safety culture was correlated with income, educational level and principal of patient safety. CONCLUSION: Regular assessment for emergency rooms is required to provide essential information to hospital managers on the areas that need improvement to promote patient safety culture.

Evaluation of psychological reactions among teenage married girls in Palestinian refugee camps in Jordan.

INTRODUCTION: Girls married at an early age are more likely to be victims of violence from their husbands or their in-laws. This may lead them to experience mental problems such as post-traumatic stress, depression, and/or anxiety. There are a lack of data related to the psychological reactions among teenage married girls living at the Palestinians refugee camps. AIM: This study aimed to evaluate depression, anxiety, and stress symptoms among teenage married girls in Palestinian refugee camps in Jordan. It also aimed to identify factors correlating with the study selected psychological reactions. METHODS: A cross-sectional, descriptive correlational design was used. The participants were recruited using non-probability sampling methods. The mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS). RESULTS: A total of 205 participants were included in the study. Their mean age was 16.90 (SD ± 0.96) years. Of the participants, 39.6%, 35.6%, and 9.8% experienced moderate to extremely severe levels of depression, anxiety, and stress symptoms, respectively. There were significant relationships between all the mental health symptoms and participant age, parent's educational level, and exposure to previous trauma. CONCLUSION: A high proportion of females living in Palestinian refugee camps married in their teenage years experienced moderate to severe mental health symptoms, particularly anxiety and depression. These results inform the need for psychological support to girls who are affected by teenage marriage.

Evaluation of Fatigue among Older Population in Jordan.

Objective: Fatigue among older adults has not received empirical attention in the Arabic region. Thus, this study aimed to assess the levels of fatigue and its related psychosocial factors and examine the predictors of fatigue in older Jordanians aged 60 years and more.Methods: This study used a cross-sectional design and our sample was 250 older adults receiving health services at comprehensive healthcare centers in Amman Governorate, the capital of Jordan. The study used the following scales: Fatigue scale, Rosenberg Self-Esteem Scale, Perceived Stress Scale, Multidimensional Social Support Scale, and sociodemographic and lifestyle behaviors datasheet.Results: The results showed that approximately 57% of the participants experienced severe fatigue. Nearly 90% of the older adults reported having moderate to high levels of stress, around 97% experienced moderate and high levels of social support, and almost 68% had normal self-esteem. The significant predictors of the total fatigue scores were, consuming soft drinks, practicing exercise, perceived levels of stress, and social support levels.Conclusions: Awareness of the magnitude and the factors predicting fatigue among elderlies in Jordan should inform the practice and encourage clinicians to implement individualized care plans that include fatigue reduction strategies, to elderlies visiting healthcare centers.

Factors Associating Vaccination Delay among Jordanian Children under Two Years of Age.

PURPOSE: This study examines the association between selected socio-demographic factors (gender, birth order, parents' educational levels, and parents' employment status) and reasons for vaccination delay among Jordanian children under two years of age. DESIGN & METHODS: A cross-sectional, prospective study was conducted in the three comprehensive public health centres in Amman Governorate in Jordan from January-June, 2019. The electronic vaccination record was designed to collect socio- demographic information and reasons for vaccination delay in children. This data was collected from the medical records of those children. RESULTS: The findings revealed that 150 (8.3%) children under two years of age were registered as vaccination-delayed cases. The factors associated with vaccination delay were age (Chi-square test [χ2] [6150] = 15.02, p-value [p] < 0.01), birth order (χ2 [6150] = 15.02, p < 0.01), mother's educational level (χ2 [2150] = 9.27, p < 0.05), and father's and mother's employment (χ2 [2150] = 7.89, p < 0.05; χ2 [2150] = 10.54, p < 0.01, respectively). CONCLUSION: Timeliness of vaccination should be promoted to prevent illness outbreaks and provide specific protection for children, taking into consideration the significance of age and birth order. PRACTICE IMPLICATIONS: Interventions and strategies need to implementation to reduce vaccination delay and improve timeliness.

Assessment of Temper Tantrums Behaviour Among Preschool Children in Jordan.

PURPOSE: A good understanding of children's emotions, activities, and needs should be promoted. This study assessed temper tantrum behaviour, including frequency, severity, duration, common behaviours, reasons, locations, contexts, and parent's strategies, among Jordanian children aged 24-48 months. DESIGN AND METHODS: A cross-sectional design was used to conduct this study. A non-probability convenience sample was adopted to recruit 213 parents of children aged between 24 months to 48 months. All parents completed the Parents' Experience of Temper Tantrums in Children's questionnaire. RESULTS: Findings showed that about half of the children experienced weekly tantrums, however, half of the parents reported that mild tantrums were exhibited by their youngsters, with an average duration of minutes. The most frequently reported tantrum behaviour was 'screaming or shouting'. "Seeking attention" was the most frequent reason and most tantrums occurred when visiting someone else's home. Unfamiliar situations were the most commonly associated with tantrum episodes. The main strategies used by parents to lessen their child's tantrums were first, stating a consequence (e.g., timeout), and secondly, ignoring the behaviour. CONCLUSIONS: The results draw attention to significant aspects of tantrums, such as the duration, where children managed to maintain a tantrum episode for more than seven minutes on average. Tantrum behaviours, reasons, locations, context, and parents' strategies to control tantrums were significant in developing proper interv entions. PRACTICE IMPLICATIONS: The findings of this study are of practical use in equipping parents and caregivers with the appropriate strategies to enable them to halt tantrums among children.

Evaluation of Social Phobia among Syrian Refugees' Youth in Jordan.

Social phobia is one of the most common anxiety disorders in youth yet still under-recognized and undertreated. This study purposed to evaluate the level of social phobia and examine correlating selected socio-demographic factors (age, gender, marital status, working status, and educational level) among Syrian refugees' youth in Jordan. A cross-sectional, descriptive correlation design was selected to carry out this study. The convenience sample composed of 290 youth aged 15-25 years were recruited from Amman and Mafraq cities. The data was collected using a questionnaire which consists of socio-demographic data and social phobia scale. The findings found that the participants had a high level of social phobia. There was a correlation between social phobia and age (r = 0.64; p < 0.001), educational level (r = - 0.23; p < 0.001), and gender (r = -0.14; p < 0.05). The youth being males, elder youth (>19-25 years), and having low educational level had a higher level of social phobia. Age was the main significant predictor of social phobia. The current findings confirm the necessity of developing social and psychological strategies and interventions to minimize this problem among youth affected by social phobia.

Depressive Symptoms among Older Jordanian Patients with Cancer Undergoing Treatment.

OBJECTIVES: To date, predictive and risk factors for depression among older patients with cancer have not been adequately studied in the Middle Eastern countries including Jordan. Therefore, this study aimed to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer aged 60 years and over who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms. METHODS: A cross-sectional design was conducted on a convenience sample consisting of 150 patients with cancer from one of the biggest governmental hospitals in Jordan. RESULTS: The findings revealed that almost 34% and 27% of the patients experienced anxiety and depression and had a moderate level of hope. Correlating factors with depression were age, duration of treatment, hope, anxiety, educational level, and health insurance. However, low duration of treatment, high anxiety, and low hope were the significant predictors of high depression. CONCLUSION: Understanding the risk factors correlated with depression could help develop early interventions to enhance the psychological consequences for patients with cancer at risk for depression. CLINICAL IMPLICATIONS: Health-care providers need to develop psychological care for older patients with cancer and interventions directed at minimizing depression. Also, nurses should focus on providing holistic care including physical, social, psychological, and spiritual dimensions. Depression care should be an important part of the comprehensive treatment care plan for older patients undergoing cancer treatment.

Predictors of health-related quality of life among industrial workers: A descriptive correlational study.

Assessment and evaluation of the health-related quality of life of industrial workers is an important research focus. This descriptive correlational study identifies the predictors of health-related quality of life using a random sampling of industrial workers (n = 640) from construction factories in Amman Governorate in Jordan using demographic characteristics, a health and work-related factors questionnaire, and the World Health Organization Quality of Life-Brief scale. Results showed that industrial workers had good physical health but a poor working environment. There was a statistically significant relationship between educational level, conflict between work and individual life and work and social life, working hours, and workload, and all domains of health-related quality of life. Overall, educational level was the main predictor for all domains of health-related quality of life. Such results confirm the need to develop appropriate interventions and strategies to improve workers' health-related quality of life. Furthermore, developing an integrated approach among policymakers, employers, and work organizations to enhance industrial workers' occupational health programs could be effective.

Effect of creative art therapy (CATs) on depressive symptoms and quality of life among Jordanian community-dwelling older people: an experimental study.

BACKGROUND: There are a lack of studies examining the effect of creative art therapy on older people. This study aimed to evaluate the effect of creative art therapy on reducing depressive symptoms and improving the quality of life among Jordanian older people. METHODS: A one-group time-series design (pretest, posttest, and follow-up) was adopted between June 2021 and April 2022 on 102 community-dwelling older people who suffered from depressive symptoms and low quality of life in Amman Governorate. FINDINGS: Significant differences were found among older people in pre-, post-, and follow-up therapy for depressive symptoms and quality of life. Post hoc tests showed a statistically significant reduction in symptoms and an improvement in quality of life from pre to post-intervention, which was sustained at follow-up. CONCLUSION: Results suggested that using creative art therapies as a therapeutic intervention for older persons was effective in minimizing depressive symptoms and improving quality of life.

Challenges and Strategies in Implementing Hospital Accreditation Standards Among Healthcare Professionals in Healthcare Systems in Yemen: A Phenomenological Study.

INTRODUCTION: The implementation of hospital accreditation standards in healthcare systems in Yemen that ensure safe and high-quality healthcare services is hampered by specific challenges. Therefore, this study was purposed to explore the challenges and strategies for applying hospital accreditation standards among healthcare professionals in Yemen. METHODS: A qualitative, phenomenological design was adopted to conduct this study. Semi-structured interviews were used to collect data during the period from January 1, 2022, to February 28, 2022. RESULTS: Based on the content analysis, the study outcomes and lack of (i) funding, (ii) competent human resources, (iii) optimal infrastructure, and (iv) equipment and supplies deter the implementation of hospital accreditation standards. Also, this study highlighted the cultural and social barriers limiting the effectiveness of hospital accreditation standards, the need for increased investment in healthcare infrastructure and human resources, and cultural sensitivity training for healthcare professionals to enhance the implementation of and compliance with hospital accreditation standards. CONCLUSIONS:  Policymakers should engage global corporations and development partners for technical assistance and capacity building that support the local application of hospital accreditation standards.

A Relationship between Management Commitment, Psychological Empowerment, and Job Performance among Employees in Higher Educational Institutions in Palestine: Multi-Wave Survey.

This study aimed to assess the relationship between management commitment, psychological empowerment, and job performance among Palestinian academic employees in higher education institutions. A multi-wave survey was utilized and 665 academics were recruited from several public and private universities in West Bank, in which the stratified sampling method was adopted to select universities. Findings demonstrated that participants reported moderate levels of management commitment and job performance and agreeable levels of psychological empowerment. Management commitment and psychological empowerment positively correlated with job performance (p < 0.01). However, management commitment had a direct influence on job performance and management commitment had a relationship with psychological empowerment (p < 0.01). Thus, strategies should be carried out to enhance management commitment and psychological empowerment to improve job performance among academic staff.