Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study.

BACKGROUND: Anxiety affects the patient's perception of postoperative pain and causes a significant increase in the consumption of analgesia postoperatively. OBJECTIVE: This study assesses the relationship between preoperative anxiety, postoperative pain and postoperative pethidine consumption. METHODS: A prospective cohort design was used. Data were collected from 100 patients who were undergoing a laparoscopic cholecystectomy at St Joseph Hospital, Jerusalem. Pain-controlled analgesia with pethidine was utilised to manage pain throughout the postoperative period. The visual analogue scale scores and pethidine consumption of all patients were recorded. FINDINGS: Participants' mean level of pain was higher in the preoperative period (mean visual analogue scale = 1.3) compared with their mean level of pain in the postoperative period (mean visual analogue scale = 0.5). There is a statistically significant difference between the participants' level of anxiety and postoperative pain level (p < 0.001). Gender, weight, level of education and smoking were predictors of developing preoperative anxiety. Also, gender, smoking and medication were statistically significant predictors of developing postoperative pain. Furthermore, gender, medical history and medication were statistically significant predictors of pethidine consumption postoperatively. CONCLUSIONS: The preoperative anxiety reduction intervention should be promoted and implemented as routine care for all surgical patients.

The burden in family caregivers of people living with dementia: prevalence and predictors.

BACKGROUND: Providing care for people with dementia incorporates a level of burden which can affect quality of life for both the caregiver and the recipient of care. This study measures the level of burden experienced by Jordanian caregivers for people with dementia and explore related predictors. METHODS: Through a cross-sectional survey, participants were invited through convenience sampling to participate in a structured interview. RESULTS: A total of 406 participants completed the survey. According to Zarit Burden Interview, the mean burden score of the sample was 26.2 (SD = 16.2). This score falls under the mild to moderate burden level. Older age of the patient, severe dementia, lower number of caregivers, if the caregiving negatively affected family relations, and if the caregiving negatively affected jobs, were significant predictors of burden. CONCLUSION: Caregivers in the current study reported no burden to a minimum burden. This result does not mean that these caregivers have no or minimal stress or that they do not have psychological needs; on the contrary, these results call for more attention to providing extra psychological and emotional support to caregivers of patients with dementia in order to decrease the burden level and maintain their efforts in caregiving. Future studies are required to discern the shape and context of unmet caregiver needs, assessment, and support.

Perceptions of spirituality and predictors of competence in spiritual care among nursing students in five middle eastern countries: A cross-sectional survey.

BACKGROUND: Spiritual Care is integral to holistic nursing; however, it often remains underprovided due to a lack of education. OBJECTIVE: This study examined perceptions of spirituality and predictors of competence in spiritual care among nursing students in Middle Eastern countries. DESIGN: A cross-sectional survey was used. PARTICIPANT/SETTING: Nursing students (n = 785) from five universities in Middle Eastern countries were included. METHODS: Participants completed the Spiritual Care-Giving Scale-Arabic and Spiritual Care Competency Scale. Multiple linear regression analysis was used to identify the predictors of perceived competence in spiritual care. RESULTS: Nursing students showed positive attitudes towards spirituality, with a mean score of 5.1 (SD = 0.60) on the Spiritual Care-Giving Scale-Arabic. However, their perceived competence in providing spiritual care was low to moderate with a mean score of 79.0 (SD = 32.0) on the Spiritual Care Competency Scale. The bivariate analysis indicated significant relationships between students' spiritual care competence and gender, previous exposure to spirituality education, willingness to undergo spirituality training, and total spirituality score. Finally, significant predictors of higher competence included regular admission status, prior spiritual education, willingness to undergo spiritual care training, and higher personal spirituality scores. CONCLUSION: Nursing students in the Middle East have positive attitudes towards spirituality, but low to moderate competence in providing spiritual care. The influence of personal spirituality on competence underscores the importance of fostering a supportive environment for students to reflect on their beliefs. Comprehensive curriculum revisions and training programs, along with the recognition of the impact of personal spirituality, are essential to prepare future nurses for holistic people's care.

Prevalence, Predictors, and the Role of Social Support in Posttraumatic Stress Disorder Among Cancer Patients in Oman.

BACKGROUND: Cancer, regardless of type, presents a formidable life challenge affecting patients' psychological well-being. Many perceive cancer diagnosis and treatment as traumatic. OBJECTIVES: This study aimed to estimate posttraumatic stress disorder (PTSD) prevalence in Omani adult cancer patients, identify predictors, and probe its correlation with social support. METHODS: This cross-sectional study enrolled 343 adult cancer patients undergoing treatment from 3 hospitals in the Middle East country of Oman. Posttraumatic stress disorder was assessed via the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, and perceived social support was measured using the Multidimensional Scale of Perceived Social Support. RESULTS: The prevalence of PTSD among Omani adult cancer patients was 27.4%. Enhanced social support correlated with lower PTSD risk (odds ratio [OR], 0.95; 95% confidence interval [CI], 0.93-0.97; P < .001). Predictors included shorter time since diagnosis (OR, 0.98; 95% CI, 0.97-0.99; P = .017), no psychiatric referral (OR, 0.46; 95% CI, 0.23-0.96; P = .04), and insufficient social support (OR, 0.96; 95% CI, 0.94-0.98; P < .001). CONCLUSIONS: Social support significantly mitigates PTSD risk. Routine assessment and psychiatric referrals, especially for recent diagnoses, can enhance patients' lives. Reevaluating the PTSD diagnostic cutoff score (33) merits consideration for improved clinical use. IMPLICATIONS FOR PRACTICE: Early PTSD assessment, particularly for low-social support new-diagnosed patients, is crucial for timely intervention. Psychiatric referrals can guide specialized treatments. Stressing social support's role can guide healthcare providers, including oncology nurses, in supporting patients effectively.

Assessment of Cognitive Impairment and Related Factors Among Elderly People in Jordan.

Background: With an increase in elderly people, it is essential to address the issue of cognitive impairment and support healthy aging. This study aimed to assess cognitive impairment and factors associated with it among older adults. Materials and Methods: A cross-sectional study was carried out in different catchment areas within the Jerash governorate in the north of Jordan. The Elderly Cognitive Assessment Questionnaire (ECAQ) and a household face-to-face interview were used to collect data from 220 older adult participants aged 60 years and more. Descriptive statistics were conducted to describe the study variables. Correlation tests were applied to find associations between them. Logistic regression analysis was applied, with a minimum significance level (p < 0.05). Results: About 9.10% of the older adults had cognitive impairment. Cognitive impairment was correlated with age, self-perceived health, hypertension, stroke, and mental illness. The primary predictors of cognitive impairment were age [odds ratio (OR) =1.07 (1.01-1.14), p = 0.001] and stroke [OR = 10.92 (1.44-82.85), p = 0.001]. Conclusions: While many factors were correlated with cognitive impairment, the strongest predictors of cognitive impairment were age and stroke.

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.

Prevalence and Triggering Factors of Headache among Jordanian Adolescents in Al-Mafraq Region.

Aims: This study evaluates the epidemiology of headache and migraine among adolescents aged 12 to 15. Methods: A school-based cross-sectional study was conducted to collect and analyze data from students in grades 7-10 over the course of one month, using a simple random sampling method. The overall number of participants in this study was 692, with an average age of 13.9 years (SD = 1.3). Descriptive measures and Fisher's exact test were computed. Multivariate regression was calculated to assess the predictors of headache and migraine. Findings. Approximately one-half of the students reported having headaches: tension-type headaches (10.3%), migraines (4.8%), and other headache types (31.5%). Moreover, girl students in the age group of 14-15 reported more headaches and migraines. Conclusion: The prevalence of headache and migraine in Jordan is high and increasing as students grow older. Health education programs led by school nurses and other healthcare practitioners are urgently needed.

The influence of the pulmonary recruitment maneuver on post-laparoscopic shoulder pain in patients having a laparoscopic cholecystectomy: a randomized controlled trial.

BACKGROUND: Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy. METHODS: Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H2O. The control group included patients whose residual CO2 gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO2 gas removal. RESULTS: When Ramsay's Sedation Score's results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics. CONCLUSION: Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain.

Nurses' knowledge of chemotherapy-induced neutropenia and its management: a cross-sectional survey.

BACKGROUND: Chemotherapy-induced neutropenia (CIN) is a serious and potentially life-threatening condition that is associated with high morbidity, mortality, and healthcare costs. OBJECTIVE: This study aims to assess nurses' level of knowledge of CIN and its association with socio-demographic factors. METHODS: A cross-sectional survey design was used. RESULTS: Participants had a mean age of 34.1 years (SD = 7.1 years) and were predominantly female (78%) and with a bachelor's degree in nursing (95.6%). The nurses had a moderate level of knowledge about neutropenia and its management (mean total score 16.3 out of 30, SD = 3.7). Those who had a post-graduate degree (P = .048), had received an oncology educational course (P = .011), had attended a course on neutropenia (P = .007), who were working in an oncology unit (P = .002), and had more oncology experience (P = 001) were more likely to have a higher level of knowledge of CIN and its management compared to their other counterparts. CONCLUSION: Based on the findings of a moderate level of knowledge of CIN among nurses, the findings call for the need for further education and training. As a long-term plan, this might be accomplished by encouraging nurses to pursue post-graduate education or oncology-specialized certification and supporting them with scholarship grants. However, deliberate plans for short courses, training and workshops on oncology or CIN are other choices with a more immediate impact on nurses' knowledge and clinical practice. Finally, integrating oncology nursing education within nursing curricula is urgently needed.

Identifying Symptom Clusters in Cancer Patients Receiving Chemotherapy using Symptom Occurrence and Distress Dimensions.

The current study explored symptom clusters in a heterogenous sample that includes all age groups, and all types of cancer being treated with chemotherapy. A cross-sectional survey design was used. The sample comprise 393 cancer patients with a mean age of 52.1 years (SD 13.9). The most prevalent symptoms were tiredness (78.9%), lack of energy (71.8%), and irritability (66.9%) and the most distressing symptom was lack of appetite. Four clusters of the symptom experience: chemotherapy-related, psychological, fatigue and pain, and gastrointestinal symptoms, regardless of the dimension used, were identified. The content and number of symptoms within each cluster using the distress dimension were slightly different from the occurrence dimension. The findings call for an early comprehensive assessment and treatment of symptoms for patients undergoing chemotherapy. Also, healthcare providers especially nurses need to thoroughly assess and manage these symptoms to ease patients' experience, enhance their compliance and improve their quality of life.

Undergraduate nursing students' knowledge of and attitudes toward people with alzheimer's disease.

As the population ages, the number of people living with Alzheimer's disease is expected to grow; consequently, nursing students are expected to care for more people with Alzheimer's disease in their future careers. Exploring nursing students' level of knowledge and attitudes is essential here to fill any knowledge gap and enhance attitudes. For this reason, the current study aimed to measure the knowledge of and attitudes toward people living with Alzheimer's disease among undergraduate Jordanian nursing students. A descriptive cross-sectional design was utilized. Data were collected through an online questionnaire consisting of the Alzheimer's Disease Knowledge Scale (ADKS) and Dementia Attitudes Scale (DAS). A third part contained questions about previous formal education about Alzheimer's disease, reading Alzheimer's research, and the need for formal education about Alzheimer's disease. The study targeted all undergraduate Jordanian nursing students. A total of 275 students agreed to participate and completed the questionnaire. Jordanian nursing students had low knowledge regarding people living with Alzheimer's disease, with a mean ADKS score of 18.3 out of 30; however, their attitudes were positive, with a mean DAS score of 91 out of 140. There was no statistical difference in attitude or knowledge between different academic levels. The majority of students (90.5%) expressed their desire to have a formal education regarding Alzheimer's disease. Knowledge regarding people with Alzheimer's disease could be improved through training and education. Positive attitudes reported by students could augment the learning process.

Public information needs and attitudes regarding cancer and cancer patients in Oman: a cross-sectional survey.

BACKGROUND: Exploring public information needs and attitudes towards cancer patients might be the first step in developing an intervention that encourages public engagement in early detection and cancer prevention programmes. AIM: To explore Omani public information needs and attitudes towards cancer in Oman. METHODS: A cross-sectional survey design was used. FINDINGS: Of the 569 participants, 369 (64.9%) were female; the mean age was 30.9 (SD=9.5) years. Of the participants, 94.4% wanted to be informed if they were found to have cancer in the future. The mean total attitudes score was 40.2 (SD=4.7) out of a maximum 48. Further, being employed, preferring to be informed about cancer diagnosis and having positive attitudes towards cancer and cancer patients predicted higher information needs. CONCLUSIONS: The current paternalistic approach seems to be no longer appropriate for cancer patients in Oman, and more active patient involvement in decision-making is needed.

Knowledge, attitudes, and practices toward epilepsy among schoolchildren in Jordan.

The purpose of this study was to assess knowledge, attitudes, and practice toward epilepsy among Jordanian schoolchildren. A cross-sectional design was used, utilizing a self-administered questionnaire to assess students' knowledge, attitudes, and practices in eight schools in a single province in Jordan. The results showed students' age ranged from 12 to 18 years (mean = 15.19, SD = 1.8). Students demonstrated inadequate knowledge and negative attitudes toward people with epilepsy. None of the participating students had received first aid or seizure management training in or out of school. The conclusion state that students demonstrated poor knowledge and negative attitudes toward people with epilepsy. They had no form of education or training regarding epilepsy management or first aid, indicating a need to launch education sessions as part of the school curriculum and to introduce straightforward activities in the school health education program.

Pressure ulcer incidence in acute care settings: a multicentre prospective study.

OBJECTIVE: Pressure ulcers (PUs) are one of the most commonly occurring complications in hospitalised patients. Knowing the size of the problem and its risk factors will help in preventing it. The aim of this study is to measure the incidence of PUs in acute care settings in Jordan and to explore associated risk factors. METHOD: A prospective incidence study for hospitalised patients in Jordan according to the European Pressure Ulcer Advisory Panel methodology. All patients admitted into four Jordanian hospitals over a period of six months were included. RESULTS: The cumulative incidence rate was 0.48%. Using multivariate analysis, a low albumin level, elevated white blood cells, incontinence and having more chronic illnesses were significantly associated with acquiring PUs. CONCLUSION: Incidence of PUs in Jordan is lower when compared with other parts of the world; this could be related to the relatively younger Jordanian population compared with other populations. DECLARATION OF INTEREST: The author has no conflicts of interest to declare.

Student nurses' knowledge about the management of chemotherapy-induced neutropenia: Multi-national survey.

BACKGROUND: Chemotherapy-induced neutropenia is a serious global health concern. It is essential that student nurses who are the future of healthcare are equipped with the right knowledge to care for the unique needs of patients with neutropenia. OBJECTIVE: The study assesses student nurses' knowledge of neutropenia management and examines the difference in their knowledge with regard to their demographics. DESIGN: A descriptive cross-sectional survey design was used. SETTINGS: Participants for this survey were recruited from four nursing schools from three countries: Jordan, Oman, and Saudi Arabia. PARTICIPANTS: The study sample comprised 230 student nurses representing all three countries. METHODS: Online data collection was implemented. A message including the link to the study questionnaire was sent to students through their university portal. Demographic data and the neutropenia knowledge questionnaire were collected. RESULTS: The student nurses showed poor knowledge of neutropenia and its management (mean = 10.1 out of 30). The bridging students (M = 12.6, SD = 9.8) had significantly higher mean total knowledge scores than the regular students (M = 9.8, SD = 5.5) (t = 2.9, df = 38.9, p = 0.006). However, students who had received previous education about neutropenia management (M = 11.6, SD = 5.0) had significantly higher mean knowledge scores than those who had not (M = 9.5, SD = 5.6) (t = -2.73, df = 134.8, p = 0.007). CONCLUSIONS: The study findings underscore the overarching necessity to improve students' knowledge of neutropenia and its management. However, addressing this concern is multifaceted and requires deliberate effort from various agencies. Developing innovative strategies to increase the coverage of oncology nursing in the curriculum, improving faculty expertise, enhancing staff nurses' knowledge and skills, provision of funding, and adoption of oncology-related competencies in the nursing program need to be explored as key solutions.

Nurses' knowledge and attitude toward people with Alzheimer's disease: An exploratory study.

BACKGROUND: Alzheimer's disease (AD) constitutes a significant health problem that affects mainly older people and causes a significant decline in cognitive abilities, thus affecting the quality of life and independence. AIM: The current study aimed at exploring knowledge and attitude toward people with AD among Jordanian nurses. METHOD: A cross-sectional survey utilizing a self-administered questionnaire was conducted in three Jordanian hospitals. Nurses' attitude was measured using the Dementia Attitude Scale (DAS). Knowledge was measured using the Alzheimer's Disease Knowledge Scale (ADKS). RESULTS: A total of 207 nurses agreed to participate and completed the questionnaire. Most nurses demonstrated poor knowledge of AD with an ADKS score of 17.8 out of 30. In contrast, nurses had a positive attitude toward people with AD, with a total DAS mean score of 83.8 out of 140. CONCLUSION: Nurses lacked knowledge regarding AD, which could be attributed to insufficient education during university studies or after employment. Attitude toward people with Alzheimer's was positive in general; this implies that nurses have the potential to learn more about AD to enhance the care provided for people with the condition.

Symptom Clusters Predictive of Quality of Life Among Jordanian Women with Breast Cancer.

OBJECTIVES: This study was conducted to explore symptom clusters among women with breast cancer in Jordan. DATA SOURCES: A cross-sectional survey of 516 women with breast cancer who were recruited from three hospitals. CONCLUSION: This study demonstrated that women with breast cancer experienced several symptoms at the same time. These symptoms tend to cluster in five main groups, and patients experiencing the psychological, nausea and vomiting, and pain clusters are expected to have a lower mean score of quality of life. IMPLICATIONS FOR NURSING PRACTICE: Nurses need to assess and manage symptoms as clusters to improve the quality of life of women with breast cancer. Symptoms clusters should guide symptoms management practice and be given a priority equal to the active treatment of cancer. Symptoms management and cancer treatment should be started simultaneously.

Annual Period Prevalence and Risk Factors of Dementia Among Older Jordanian Hospitalized Patients.

BACKGROUND: The number of people living with dementia is forecasted to increase rapidly, particularly in developing and underdeveloped countries. No epidemiological studies of dementia have been reported in Jordan; therefore, the number of people living with dementia and the risk factors are unknown. OBJECTIVE: Measure the annual period prevalence of dementia, along with its risk factors in Jordanian hospitalized patients over the age of 50 years. METHODS: The prevalence of dementia was measured using a prospective survey design for over one year. Risk factors were explored using a case-control match design. RESULTS: The total number of participants in the overall survey was 31,411, and the number of participants included as cases with dementia was 406, the number of matched controls free of dementia was 416. The general annual period prevalence of dementia for people older than 50 years was 1.29%, comprising 406 patients. Multivariate analysis revealed that older age, male gender, family history of dementia, and illiteracy were significant risk factors for dementia. CONCLUSION: The prevalence of dementia in Jordan is lower than the global prevalence due to the relatively younger Jordanian population. Results from this study can provide baseline information for policymakers for significant health planning to meet the needs of such a group of patients.

A Rare Case with New Insights: Pure Sensory Guillain Barre Syndrome with Axonal Features.

The pure sensory variant of Guillain-Barré syndrome "GBS" is controversial. Scarce case reports in the literature have described pure sensory presentations secondary to acute demyelination of peripheral sensory nerves. Pure sensory GBS secondary to axonal damage is rarer and even more controversial owing to a significant overlap with sensory neuronopathy. A 31-year-old lady with history of a recent primary varicella zoster virus (VZV) infection presented with acute onset of sensory symptoms and signs involving her four limbs and the trunk, without weakness. Examination was remarkable for severe impairment in all sensory modalities in her limbs and trunk, pseudo-athetoid limb movements, sensory ataxia, positive Romberg's sign, and areflexia, with no motor involvement. CSF analysis showed elevated protein without pleocytosis known as albuminocytological dissociation. MRI of the spine with contrast showed multiple root enhancement. Nerve conduction studies "NCS" demonstrated absent sensory action potentials, with normal motor nerves responses. Initial electromyography was normal. After differential diagnoses were appropriately excluded, the patient was diagnosed with pure sensory axonal GBS and treated with IVIG for five days. Gradual clinical improvement was seen over the following months, with improvement in six-month GBS disability score down to two. Follow-up NCS showed findings similar to the initial study but follow-up EMG studies revealed denervation potentials in multiple levels, suggesting a subclinical axonal motor involvement and excluding sensory neuronopathy. To our best knowledge, this case represents the first case of pure sensory GBS with onset after a documented primary VZV infection. The findings in this case illustrate the difficulties in diagnosing pure sensory GBS and the significance of an early treatment. It also demonstrates the potential value of follow-up EMGs in excluding sensory neuronopathy as an important differential diagnosis for this condition.

Barriers to the Provision of Spiritual Care by Nurses for Hospitalized Patients in Jordan.

BACKGROUND AND PURPOSE: Spiritual care is an essential part of holistic patient care but is provided infrequently in practice. There is a paucity of research investigating the barriers to the provision of spiritual care among Jordanian nurses. The main purpose of this cross-sectional, correlational study was to identify these barriers and to explore the associations with nurses' personal and professional characteristics. A secondary purpose was to examine the psychometric properties of a newlydeveloped spiritual care barriers instrument. METHODS: We surveyed a convenience sample of Jordanian nurses (N = 282). Participants completed both the Spiritual Well-Being Scale (SWBS) and the Spiritual Care Barriers Scale (SCBS). We conducted an exploratory factor analysis to examine the internal structure of the SCBS, and internal consistency was assessed by Cronbach's alpha. RESULTS: The most common perceived barriers were lack of private places (82.3%), absence of an imam (79.8%), insufficient time (78.8%), inadequate skills and competencies (73.7%), lack ofreligious and spiritual facilities and resources in the hospital (71.3%), and insufficient knowledge (71.3%). Nurses' personal spiritual and existential well-being were negatively associated with spiritual care barriers. Head nurses and supervisors reported lower mean scores on perceived barriers than did associate nurses. The SCBS exhibited acceptable evidence of internal consistency and validity. IMPLICATIONS FOR PRACTICE: The findings help Jordanian nurse decision makers in practice and education to overcome barriers to the provision of spiritual care to better meet the spiritual needs of Muslim patients.