Syrian refugee women's experiences of barriers to mental health services for postpartum depression.

OBJECTIVE: To describe Syrian refugee women's experiences of the barriers to access mental health services for postpartum depression (PPD). DESIGN: A descriptive qualitative study was conducted. METHODS: Fifteen purposefully selected Syrian refugee women who scored ≥10 on the Edinburgh Postnatal Depression Scale participated in the semi-structured telephone interviews. Transcripts were coded verbatim and analysed thematically according to the dimensions of Levesque's model of patient-centred access to healthcare. Data were collected between August 2022 and February 2023. RESULTS: Five themes with 14 subthemes were identified: (1) approachability covered lack of knowledge and misconceptions related to PPD and its treatment, lack of awareness of available psychosocial services and perceived need of mental health treatment; (2) acceptability comprised being a refugee, stigma of mental illness, cultural preferences of healthcare provider and language barrier; (3) availability and accommodation encompassed transportation barrier and location of the centre, no support for childcare and lack of time; (4) affordability included financial difficulties and health insurance coverage; (5) appropriateness comprised no screening for PPD and intermittent services with limited focus on mental health. CONCLUSIONS: The findings of this study reveal that Syrian refugee women experienced multi-faceted complex barriers to access mental health services for PPD. It is important for health professionals, including nurses, and policymakers to address the cultural mental health needs of this population and establish strategies to protect their legal and health rights. IMPACT: Our study has important practice and policy implications for establishing strategies designed specifically for refugee mothers to mitigate their perceived barriers to PPD treatment and ultimately improve their mental health. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research was used. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution. Participants were Syrian refugee women with PPD symptoms and contributed only to the interviews and member checking.

Perceived Stress and Resilience Among Psychiatric Nurses Working in Inpatients Units.

The aim of this study is to assess the levels, relationships, and predictors of resilience and perceived stress among psychiatric nurses working in inpatient units. A descriptive, cross-sectional, predictive design was employed to collect data from 140 psychiatric nurses through a self-reported questionnaire. The questionnaire consisted of sociodemographic and work-related variables, Connor-Davidson Resilience Scale (CD-RISC-25), and perceived stress scale (PSS-10). The total mean score of the perceived stress was 22.73 (SD = 3.54) indicating a moderate level. The total mean score of the resilience was 49.49 (SD = 15.31) indicating a low level. Resilience correlated positively with educational level and job satisfaction; and negatively with intention to leave psychiatric settings. Significant differences were found in resilience with educational level, intention to leave psychiatric settings, and job satisfaction. Three independent variables predicted resilience: educational level, ward/unit, and job satisfaction; and only one variable (intention to leave psychiatric settings) predicted the perceived stress.

The Association Between Proneness to Smartphone Addiction and Social Anxiety Among School Students and the Mediating Role of Social Support: A Call to Advance Jordanian Adolescents' Mental Health.

BACKGROUND: Social anxiety is an emerging public health issue associated with significant impairment of social functioning during adolescence. Among many determinants of social anxiety, proneness to smartphone addiction may significantly contribute to the development of social anxiety. To cope with the consequential development of social anxiety, adolescent school students may rely on various forms of social support. Particularly in the Middle East, including Jordan, the relationship between proneness to smartphone addiction and adolescent social anxiety is understudied. AIM: To examine the mediating role of social support in the relationship between proneness to smartphone addiction and social anxiety in a sample of adolescent school students. METHODS: In this cross-sectional study, 432 adolescents were recruited via a random cluster sample from public schools across three provinces in Jordan. The data were collected face-to-face using the Social Anxiety Scale for Adolescents, the Smartphone Addiction Proneness Scale, and the Multidimensional Scale of Perceived Social Support. RESULTS: Significantly higher levels of social anxiety were associated with females of lower economic status who reported more gaming hours and higher levels of proneness to smartphone addiction. Familial social support significantly mediated the relationship between proneness to smartphone addiction and social anxiety, controlling for the other covariates in the social anxiety model. CONCLUSIONS: Familial social support reduced the impact of proneness to smartphone addiction on social anxiety. Nurses may supplement treatment for reducing social anxiety in adolescents suffering from proneness to smartphone addiction by fostering sources of familial social support.

Professional Quality of Life, Job Satisfaction, and Intention to Leave among Psychiatric Nurses: A Cross-Sectional Study.

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered.

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.

Breakfast Skipping and Associated Factors Among Jordanian University Students.

Background: Although breakfast skipping among university students is a significant concern, its prevalence and the contributing factors among university students have received little attention in the literature. This study aims to determine the prevalence of skipping breakfast among Jordanian university students and examine the associated factors and variations in rates of skipping breakfast by day of the week. Materials and Methods: A cross-sectional study was conducted among undergraduate students between March and May 2022 through a self-questionnaire. A convenience sample of 891 students was chosen at four Jordanian public universities. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of skipping breakfast among university students was 66%. The reasons for skipping breakfast were having no time due to oversleeping and having no feeling of hunger (59% for both), followed by having no energy to prepare the breakfast and making no difference (49% and 48%), and not being able to afford to eat or buy breakfast (19%). There is a strong correlation between eating fast food and skipping breakfast. With whom the student eats breakfast is significantly associated with breakfast skipping, revealing that the highest percentages of skipping occur with friends. About 63% of students skipped breakfast through university days compared with 37% on the weekend, while 37% of them had breakfast through university days compared with 67% on the weekend. Conclusions: A high percentage of university students in Jordan skip breakfast. More attention should be paid to correlating factors and developing interventions to help students adhere to the breakfast.

Self-Transcendence as a Mediator of the Relationship Between Reminiscence Functions and Death Anxiety: Implications for Psychiatric Nurses.

BACKGROUND: Jordan's population of older adults is growing due to improved health care and lifestyle, but the country has limited mental health care resources, causing challenges for the health care system. Reminiscence is a point of nursing intervention and a way for psychiatric nurses to help people improve their mental health by expanding their personal boundaries (self-transcendence). AIMS: The study aimed to examine the mediating effects of self-transcendence on the relationship between reminiscence functions and death anxiety in a sample of Jordanian older adults. Psychiatric nurses can refine reminiscence therapy by targeting aspects of self-transcendence to reduce death anxiety. METHODS: An online cross-sectional survey was employed to collect the data. A total of 319 older adults participated in the study. The sample was recruited using convenience and snowball sampling strategies through social media and personal contacts. RESULTS: The reminiscence function of "Bitterness Revival," gender, the presence of a life-threatening disease, a history of psychiatric disorder, and the work sector were statistically significant predictors of death anxiety. This model accounts for 24% of the death anxiety score (F = 7.789, p < .001). Reminiscence functions 1, 2, and 5 predicted self-transcendence. This model explained 25% of the variance in the self-transcendence score (F = 6.548, p < .001). Self-transcendence exerts a positive, partial mediating effect between "Bitterness Revival" and death anxiety, controlling for other covariates in the death anxiety model (p = .016). CONCLUSIONS: The study is informative for understanding the role of self-transcendence in buffering death anxiety, notwithstanding "Bitterness Revival" reminiscences. This knowledge reveals practical implications for psychiatric nurses about the importance of developing reminiscence interventions to promote self-transcendence and ease death anxiety.

Pregnant Women's experiences with intimate partner violence one year after the COVID-19 pandemic in Jordan.

AIM: To assess the prevalence and compare the levels of intimate partner violence (IPV) before and during the pandemic and to identify the factors that associated with physical IPV among Jordanian pregnant women. DESIGN: A cross-sectional, correlational design. Women were asked to report their experience with IPV twice: during and before the pandemic. METHODS: A convenience sampling technique was used to select pregnant women from National Woman's Health Care Center from 15 April to 1 September 2021. The Domestic Violence Questionnaire Screening Tool (DVQST) was used to assess the levels of IPV. RESULTS: The women (n = 232) who participated in the study experienced considerable levels of IPV before (69% control IPV, 59.90% psychological, 46.10% physical, 43.10% sexual) and during (75.90% control IPV, 64.20% psychological, 46.10% physical, 40.90% sexual) the pandemic. There were statistically significant (p ≤ 0.05) higher mean DVQST scores for control IPV and psychological IPV during the pandemic (control IPV mean = 9.78, psychological mean = 7.03) versus before the pandemic (control IPV mean = 8.95, psychological mean = 6.62). Woman's educational level, marriage duration, woman's employment status, and level of mutual understanding were inversely associated with physical IPV during the pandemic. PATIENT OR PUBLIC CONTRIBUTION: IPV is a global public health problem and a major violation of human rights. The levels of control IPV and psychological IPV increased during the COVID-19 pandemic, while the levels of physical and sexual IPV stayed the same. Antenatal screening for IPV is crucial to save women and their offspring from suffering this type of violence.

Physical Intimate Partner Violence and Maternal Outcomes in a Hospital-Based Sample of Pregnant Women in Jordan.

AIM: The purpose of this study was to examine the effect of physical intimate partner violence on maternal pregnancy/ birth outcomes. METHODS: A cross-sectional, descriptive, comparative design was used. Consecutively, 223 birthing women were chosen. Data was collected in 2014 using the Arabic World Health Organization's Domestic Violence Questionnaire. RESULTS: Results showed that women who had experienced physical violence during pregnancy had a significantly higher risk of pregnancyinduced hypertension, cesarean section, more pain killer use during birth, and excessive use of postnatal medication. CONCLUSION: Jordanian health policy makers should find a strategy to eliminate intimate partner violence and reduce its negative impact on women. The inclusion of intimate partner violence screening and identification for every pregnant woman is vital. Sufferers should receive a betterfocused care in order for early detection and treatment of complications that are related to intimate partner violence.

Patients Hospitalized for Psychiatric Problems and Their Knowledge, Attitudes, and Practices Toward COVID-19.

The current study aimed to assess knowledge, attitudes, and practices (KAP) toward coronavirus disease 2019 (COVID-19) of persons hospitalized for psychiatric problems and the correlation between knowledge and demographics. A correlational, cross-sectional study was used to collect data through structured interviews from a convenience sample of 200 patients with psychiatric disorders seeking treatment at a psychiatric hospital using the Knowledge, Attitudes, and Practices questionnaire. Participants had poor knowledge (51.5%), moderate attitudes (75%), and low to moderate practices (61%) toward COVID-19. Knowledge was different across most demographic and illness-related variables. Global assessment of functioning and educational level predicted knowledge and accounted for 37.5% of the variance. Due to disability and poor self-care, persons hospitalized for psychiatric problems are more vulnerable to infectious diseases than the general population. Mental health nurses need to raise KAP toward COVID-19. Current results are informative to health care policymakers and mental health authorities in helping identify target populations for prevention and education about COVID-19. [Journal of Psychosocial Nursing and Mental Health Services, 60(8), 37-45.].

Confirmatory factor analysis of the Arabic version of the reminiscence functions scale with strict measurement invariance across gender.

PURPOSE: Recognizing reminiscence functions can help psychiatric nurses promote patients' mental health. This study aimed to confirm the six-factor, 39-item structure of the Arabic version of the Reminiscence Functions Scale (RFS) in a sample of Jordanian adults (N = 470) and examine the invariance of structure across gender. DESIGN AND METHOD: Post hoc model adjustment was conducted sequentially using modification indices (MI) to improve model fit. Measurement invariance across gender was examined using this adjusted Arabic RFS score (ARFS). FINDINGS: After post hoc adjustment using MI, the fit indices for the adjusted (32-item) ARFS improved, indicating a good fit for the data. The adjusted ARFS factor structure indicated strict measurement invariance across gender. CONCLUSIONS: CFA supports a 32-item, six-factor model. PRACTICE IMPLICATIONS: Psychiatric nurses can use the adjusted ARFS to measure subjects' reminiscence functions and predict the psychological and emotional distress associated with these functions.

Abuse by the male intimate partner: Psychometric testing of the modified worksite harassment tool in working women.

The authors' purpose was to examine psychometric qualities of the modified worksite harassment tool in working women. Internal consistency was used for reliability and principal components analysis and correlation for construct validity. Two items were dropped due to poor psychometric qualities. Cronbach's alpha was 0.78. Two factors (subscales) emerged from dimensionality testing. The abuse scores found using the tool, as well as by the two factors, were significantly correlated with women's depressive symptoms, stress, and diagnosis with chronic illnesses. Incorporating the modified worksite harassment tool with routine assessment of women in health care facilities within the work settings was recommended.

Depression, anxiety and stress among undergraduate students during COVID-19 outbreak and "home-quarantine".

AIM: Many people including students affected physically and psychologically by coronavirus disease (COVID-19) outbreak and "home-quarantine." This study aimed at assessing the prevalence and predictors of depression, anxiety and stress among university students in Jordan during "home-quarantine" due to the outbreak of COVID-19. DESIGN: This is a cross-sectional descriptive study. METHODS: Data were collected from a convenience sample of 1,380 Jordanian university students. A web-based survey was used to collect data from the participants using the DASS-21. RESULTS: The prevalence of depression, anxiety and stress in different levels was 78.7%, 67.9% and 58.7%, respectively, which are higher during "home-quarantine." The mean scores of depression, anxiety and stress were at moderate levels. Strong correlations were found between depression, stress and anxiety, with demographic, health-related, lifestyle variables. Several variables also predicted depression, stress and anxiety.

Nursing students' knowledge about behavioral and biopsychosocial domains of dementia: A cross-sectional survey study.

PURPOSE: The purpose of this study was to investigate nursing students' knowledge about behavioral and biopsychosocial domains of dementia and the factors associated with nurses' knowledge. METHODS: A cross-sectional, predictive study was conducted using a web-based survey. A convenience sample of 356 nursing students from a large public university completed an anonymous online survey comprising 25 Likert-scale items. Univariate analyses (two-sample t tests and one-way ANOVA) were used for model selection at the cutoff level of 0.20 in producing a multivariate linear regression model. Multiple linear regression analysis was conducted to predict a given student's score using the demographic variables selected. The regression model was used to infer pairwise demographic group comparisons while controlling for other demographic variables. FINDINGS: The mean score of students' knowledge about dementia was 24.53 ± 7.81 out of 48 (52%). Students scored the lowest scores on knowledge about communication with and behaviors of people with dementia and the risk factors and health promotion areas in dementia care. Students' gender, current grade point average (GPA), family history with dementia, and education level had statistically significant effects on the mean total dementia knowledge score and respective subscales (p < 0.05). The model predicting the total dementia knowledge score explained the most variation among all five models conducted (29%). CONCLUSIONS: The findings indicate that nursing curricula should introduce educational programs related to all aspects of dementia knowledge earlier on. IMPLICATIONS FOR NURSING PRACTICE: The survey findings suggest raising standards of dementia knowledge and implementing educational strategies in clinical settings that adequately prepare nurses to interact with or care for people with dementia.

Religiosity and stigma toward patients with mental illness among undergraduate university students.

There is a dearth of research that investigates the relationship between religiosity and stigma of mental illnesses by the context of Jordanian culture. So, this study aimed to describe the relationship between religiosity and stigma against mental illnesses as described by undergraduate university students in Jordan. This study design was descriptive correlations study among 338 University Students, undergraduate students in Jordan. The findings indicate there is a significant correlation (r = - 0.154, p < 0.05) between stigma toward patient with mental illnesses and religiosity. The higher religiosity score is associated with more negativity toward stigma of patient with mental illnesses. Also, the findings indicated there was a significant difference between medical and non-medical student's specialty area and stigma toward patients with mental illnesses (t = 111.14, p = 0.01). Non-medical students reported more stigma for patients with mental illnesses. Stigma against patient with mental illnesses should be addressed at different levels. Cultural competency curriculum should be established for medical and non-medical students to assure more acceptance attitudes and avoidance of stigma against patients with mental illnesses.

Physical violence in college women: Psychometric evaluation of the safe dates-physical violence victimization scale.

Researchers examined psychometric characteristics of the Safe Dates-Physical Violence Victimization scale in 97 Jordanian college women. Reliability coefficient and Principal Components Analysis were used. Construct validity was examined using independent samples t-test. Cronbach's alpha of 0.80 was yielded. Two dimensions (injury-causing tactics and threatening tactics) were identified. Using construct validity analysis, researchers indicated significant differences in the mean depression, anxiety, stress, and childhood victimization scores among women reporting physical violence, compared to their counterparts. College women possess psychological stressors due to academic and social responsibilities. Such stressors influence their decision to leave the partner which adversely impacts their psychological health.

Couvade Syndrome Among Jordanian Expectant Fathers.

Studies of different cultures have reported that expectant fathers experience physiological and psychological changes during their partner's pregnancy. These symptoms are classed as Couvade Syndrome (sympathetic pregnancy) symptoms. The main aim of this study was to determine the prevalence of Couvade Syndrome among Jordanian expectant fathers. A descriptive quantitative research design that utilized the Men's Health During Partners' Pregnancy (MHDPP) questionnaire was employed to collect data from three Maternal and Child Health Care Centers in public hospitals. A total of 449 participants completed the questionnaire. Descriptive statistics were used to describe the characteristics of the sample and the main variables. Chi-square tests were conducted to find the relationship between the pregnancy trimester and the specific Couvade Syndrome symptom. Jordanian expectant fathers experienced high rates of Couvade Syndrome (59.1%). The prevalence of Couvade Syndrome among the participants is considered to be the highest reported rate when compared to the results of previous studies. This rate may be due to the tendency among men in Jordan to have a strong desire for children soon after marriage and to have a strong commitment to family life. With a better understanding of the expectant father's response to pregnancy, health-care providers would be better able to provide them with the necessary support and education. This could contribute to the health and well-being of expectant fathers and their families.

Effects of Intimate Partner Physical Violence on Newborns' Birth Outcomes Among Jordanian Birthing Women.

Intimate partner physical violence against women (VAW) during pregnancy is a common experience all over the world. In Jordan, the number is double the reported international average. Data on effect of violence on birth outcomes are important for planning, implementing, and evaluating maternal health programs. The research question was, "Does intimate partner physical VAW during pregnancy increase the risk of negative birth outcomes for newborns among birthing women in Jordan?" Natural experiment design was used for this study. A consecutive sampling technique was used for selecting the victims of physical violence ( n = 79) and a simple random sampling for selecting non-victims ( n = 79). Intimate partner physical violence was measured by using the Arabic version of World Health Organization's (WHO) domestic violence questionnaire, which has an accepted interrater validity. Analysis of covariance (ANCOVA) and chi-square were used to detect the differences in birth outcomes between the victims and non-victims of physical violence. The results showed that there is a significant difference in newborn's birth weight between the victims of violence and non-victims with a small effect size. However, there were no significant differences between the two groups in preterm birth and assisted newborn ventilation. The non-significant effect of violence on the incidence of preterm birth contradicts the published literature. Intimate partner violence (IPV) is rooted in Jordanian culture and widely accepted among married Jordanian women. Midwives, doctors, educators, and policy makers should work together to eradicate violence and detect victims of it, to improve birth outcomes and decrease newborn morbidity and mortality rates.

Disclosure of Spousal Violence: Viewpoints From the Jordanian Society.

The objectives of this study were to identify reasons behind not disclosing spousal violence and examine relationships between these reasons and women's demographic profile including the experience of spousal violence. Jordanian women ( N = 709) aged 16 to 66 years ( M = 32.6, SD = 8.7) attending health care centers were recruited. Results indicated that women's intentions to maintain the family unit and use of patience with abuser represented the top two reasons for not disclosing violence. Non-significant relationships were, generally, identified between not disclosing spousal violence and women's demographic profile. Women's justification of spousal violence and witnessing parental violence were the proposed reasons for women's lack of disclosure of violence. Implications for this study include health professionals' use of evidence-based knowledge and skills to deal with victims of violence. Researchers' roles include creating physical and emotional environment that urges disclosure of violence. Furthermore, they can contribute with health professionals in the implementation of health education programs directing victims and perpetrators in the places where they can be located. Proper collaboration between health professionals, researchers, and policy makers may significantly limit suffering of victims of violence.