Assessing Professional Competencies Among Undergraduate Nurses: An Exploratory Study.

AIM: The study aimed to identify nursing students' professional competencies and examine which factors of the clinical learning environment affect these competencies. BACKGROUND: Professional competencies are vital for the quality and safety of nursing practice. The learning environment is important for the development of professional competencies. METHOD: Data were collected from 178 nursing students using the Clinical Learning Environment and Supervision Scale and the Nursing Professional Competencies Scale-Short Form. RESULTS: The highest competency was achieved in value-based nursing care; the lowest competency was achieved in development, leadership, and organization of nursing. Factors such as positive pedagogical atmosphere, nursing care on the ward, and good supervisory relationship affected learning and, in turn, improved professional competencies. CONCLUSION: The results establish a link between the clinical environment and reported professional competencies, leading to a call for more focused coverage of these factors in the academic curricula.

Spiritual Wellbeing and Quality of Life among Hemodialysis Patients in Jordan: A Cross-Sectional Correlational Study.

Purpose: Nursing research studies investigating the relationship between spiritual wellbeing and health-related quality of life are lacking among Arab hemodialysis patients in Jordan or any other Arab country. The purpose of this study was to explore the associations between spiritual wellbeing, its religious and existential wellbeing dimensions, and health-related quality of life among Jordanian Muslim hemodialysis patients. Design: A cross sectional, quantitative correlational study. Methods: A convenience sample of 150 Jordanian hemodialysis patients completed a structured, self-administered questionnaire. Descriptive, bivariate, and multivariate regression models were used. Findings: The Jordanian hemodialysis patients had a moderate level of spiritual wellbeing and religious wellbeing, a low level of existential wellbeing, and a poor health-related quality of life. The findings revealed a significant moderate positive correlation between the spiritual wellbeing and its dimensions, and health-related quality of life. The existential wellbeing was the strongest predictor, with a large, positive, and significant effect after controlling for other spiritual, demographic and medical-related variables. Conclusion: Overall, the study suggests Jordanian hemodialysis patients use their religious and spiritual beliefs and practices as a coping mechanism, especially as sources of satisfaction, peace, comfort, strength and support, to help improve their health-related quality of life.

Self-care among persons with heart failure: Examining the impact of mindfulness and impulsivity using conditional process analysis.

BACKGROUND: According to the literature, self-care in persons with heart failure is inadequate. Such inadequate levels of self-care necessitate a thorough investigation of the potential predictors. PURPOSE: To: (a) determine the level of self-care among persons with heart failure in Jordan; (b) determine the relationship between mindfulness, impulsivity, and self-care among persons with heart failure; (c) investigate the potential moderation effect of impulsivity on the relationship between mindfulness and self-care. METHODS: A cross-sectional study was conducted. A convenience sample of 100 persons with heart failure in an outpatient clinic at King Abdullah University Hospital was recruited. The following tools were used to collect the data via phone survey: Self-Care of Heart Failure Index, Barratt Impulsiveness Scale, and the Mindful Attention Awareness Scale. RESULTS: The sample consisted of 78 male and 22 female persons with heart failure. The effect of mindfulness was statistically significant only on self-care symptom perception, and not significant on other aspects of self-care. Impulsivity moderated only the effect of mindfulness on self-care symptom perception. Correlation analysis showed a significant relationship between mindfulness and impulsivity (r = -.532, p < .01). CONCLUSION: Mindfulness is likely to improve at least one aspect of self-care (self-care symptom perception) and reduce impulsivity among heart failure persons.

Efficient multimodal deep-learning-based COVID-19 diagnostic system for noisy and corrupted images.

INTRODUCTION: In humanity's ongoing fight against its common enemy of COVID-19, researchers have been relentless in finding efficient technologies to support mitigation, diagnosis, management, contact tracing, and ultimately vaccination. OBJECTIVES: Engineers and computer scientists have deployed the potent properties of deep learning models (DLMs) in COVID-19 detection and diagnosis. However, publicly available datasets are often adulterated during collation, transmission, or storage. Meanwhile, inadequate, and corrupted data are known to impact the learnability and efficiency of DLMs. METHODS: This study focuses on enhancing previous efforts via two multimodal diagnostic systems to extract required features for COVID-19 detection using adulterated chest X-ray images. Our proposed DLM consists of a hierarchy of convolutional and pooling layers that are combined to support efficient COVID-19 detection using chest X-ray images. Additionally, a batch normalization layer is used to curtail overfitting that usually arises from the convolution and pooling (CP) layers. RESULTS: In addition to matching the performance of standard techniques reported in the literature, our proposed diagnostic systems attain an average accuracy of 98% in the detection of normal, COVID-19, and viral pneumonia cases using corrupted and noisy images. CONCLUSIONS: Such robustness is crucial for real-world applications where data is usually unavailable, corrupted, or adulterated.

Exploring Elementary Schoolteachers' Perceptions of Attention Deficit Hyperactivity Disorder (ADHD) in Northern Jordan.

The purpose of this study was to ascertain elementary schoolteachers' perceptions of attention deficit hyperactivity disorder (ADHD) in northern Jordan. This study utilized a descriptive cross-sectional research design using a self-reporting questionnaire to gather data from elementary schoolteachers in northern Jordan from February to June 2019. The results indicate that elementary schoolteachers in northern Jordan have negative perceptions regarding ADHD and its causes, treatment, and diagnosis. The lack of professional pre-service training and education about children's behavioral problems overall, but especially regarding ADHD knowledge and management of children with ADHD was found to be deficient among our sample of elementary schoolteachers. The pronounced lack of research on teacher management of ADHD in children in Jordan may have contributed to these findings. Structured educational and training programs addressing children with ADHD should be implemented to enhance teachers' knowledge about ADHD and to improve their role in helping the affected children and their families.

The impact of online synchronous versus asynchronous classes on nursing students' knowledge and ability to make legal and ethical decisions.

BACKGROUND: Educating nursing students on laws and ethics is essential since the nursing profession requires providing services that have many legal and ethical implications. OBJECTIVES: The goal of this study was to measure the effectiveness of two teaching strategies (providing online synchronous classes versus asynchronous classes) on nursing students' knowledge of legal and ethical issues and their ability to make legal and ethical decisions. DESIGN: This study used a randomized control trial (RCT) design. SAMPLE AND SETTING: A total of 127 students from two governmental universities in Jordan participated in and completed the current study. The students were randomly assigned either to the experimental group which received the synchronous classes (n = 60, 47.2%) or the control group which received asynchronous classes (n = 67, 52.8%). METHOD: The two study groups were given a pre-test to measure their knowledge and ability to make legal and ethical decisions. After the pre-test, an online synchronous educational class about legal and ethical issues in nursing was carried out by the same educator twice a week and lasted for approximately 1.5 h each. At the same time, the students in the control group were provided with the same material but as asynchronous classes and were encouraged to watch the classes during the lecture. After completing the educational classes, both groups were asked to complete the post-test questionnaire. RESULTS: The results indicated significant outcomes in terms of increasing the knowledge and the ability to make an ethical decision of students who attended the educational classes. However, the synchronous and asynchronous classes did not result in significant differences in students' learning outcomes. CONCLUSION: Educating nursing students about legal and ethical issues in the nursing profession is important to prepare them to make legal and ethical decisions. In addition, using different teaching strategies is quite important in educating nursing students.

Self-Reported Obsession Toward COVID-19 Preventive Measures Among Undergraduate Medical Students During the Early Phase of Pandemic in Jordan.

Background: Coronavirus disease 2019 (COVID-19) pandemic and its associated precautionary measures have substantial impacts not only on the medical, economic, and social context but also on psychological health. This study aimed to assess the obsession toward COVID-19 preventive measures among undergraduate medical students during the early phase of the pandemic in Jordan. Methods: Online questionnaires were distributed between March 16, 2020 and March 19, 2020. Socio-demographic characteristics were collected, and self-reported obsession toward COVID-19 preventive measures was assessed using a single question.COVID-19 knowledge, risk perception, and precautionary measures were evaluated using scales. Using the chi-square test, Student t-test, and one-way ANOVA, we assessed the differences in the obsession of students with socio-demographic characteristics and scores of the scales. Results: A total of 1,404 participants (60% were female participants) completed the survey with a participation rate of 15.6%. Obsession with preventive measures was reported by 6.8%. Obsession was significantly more common among women (9.2%) than men (3.3%) and students who attended COVID-19 lectures (9.5%) than those who did not attend such lectures (5.8%) (p < 0.001 and p = 0.015, respectively). Obsessed participants reported significantly higher levels of COVID-19 knowledge (p = 0.012) and precautionary measures (p < 0.001). COVID-19 risk perception had a mild effect size difference but with no statistical significance (p = 0.075). There were no significant differences in the academic levels of participants (p = 0.791) and universities (p = 0.807) between students who were obsessed and those who were not. Conclusions: Obsession is one of the significant but unspoken psychological effects of COVID-19 precautionary measures among undergraduate medical students. Medical schools should be equipped with means to handle pandemic psychological effects.

Prevalence and Correlates of Depression, Anxiety, and Suicidality Among High School Students: A National Study.

The current study aimed to estimate the prevalence of depression, anxiety, and suicidality and their correlated factors among high school students in Jordan. A descriptive cross-sectional correlational research design was used. Data were collected using self-reported questionnaires completed by students attending high schools in Jordan. Data show that anxiety and depression are prevalent among adolescents and are associated with higher risk of suicide and disease prevalence. Twenty-seven percent of the variance in suicidality is explained by anxiety and depression. This finding indicates that the most significant predictor of suicidality is anxiety and depression among high school students. Results show that mental health issues are a genuine general health issue among high school students. Health care professionals should routinely screen for mental health problems among young people. Mental health and well-being advancement programs should be coordinated and directed by all parties involved in youth mental health. [Journal of Psychosocial Nursing and Mental Health Services, 59(8), 43-51.].

Psychometric evaluation of the Arabic version of the higher education inventory scale for nursing students.

BACKGROUND: Studies in the literature have relied on a single instrument to assess stress levels and sources among nursing students in Jordan and in other Arab countries. Thus, there is a need to develop Arabic versions of psychometrically validated instruments for evaluating a wider range of aspects related to stress and stressors. The Higher Education Stress Inventory (HESI) is an instrument used to assess various aspects of stress and stressors related to higher education in different educational settings and among different student populations. To date, no exploratory or confirmatory factor analyses have been conducted to study the factor structure of the Arabic version of the HESI. Therefore, the current study aimed to evaluate the psychometric properties of the Arabic version of the HESI (Arabic-HESI) among nursing students in Jordan. METHODS: The structure of the instrument was tested using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and maximum likelihood estimation among a sample of 355 nursing students at five Jordanian universities. RESULTS: The Arabic-HESI proved to have excellent content validity index (CVI = 0.92). The instrument showed good internal consistency reliability (Cronbach's α = 0.75), as well as for the two emerged factors "challenges" and "dissatisfaction" (Cronbach's α were 0.75, 0.72 respectively). The results support the two-factor model for the Arabic-HESI, as the instrument was found to have robust structure and acceptable goodness-of-fit indices. CONCLUSION: The Arabic-HESI is a reliable and valid instrument for assessing stress levels and stressors among nursing students in Jordan. Using the shortened version of the HESI to assess stress among nursing students is recommended. Identifying new features of stress and stressors among nursing students in Jordan will enable universities and nursing faculties to better support their students.

Statin eligibility based on the ACC/AHA guidelines among Middle Eastern patients with diabetes mellitus presenting with acute myocardial infarction.

BACKGROUND: Statin eligibility based on the American College of Cardiology/American Heart Association cholesterol guidelines among patients with diabetes admitted with first time acute myocardial infarction has not been evaluated in the Middle East. PURPOSE: To assess statin eligibility for diabetic patients admitted with first time myocardial infarction in Jordan according to ACC/AHA guidelines. METHODS: Consecutive patients admitted with a first acute myocardial infarction who were not taking statins, and had their serum lipoproteins measured upon hospital admission were enrolled in the study. Statin eligibility among patients with diabetes admitted with first time myocardial infarction was determined based on the ACC/AHA guidelines. RESULTS: Of 774 patients enrolled, 292 (37.30%) had diabetes. Compared with non-diabetic patients, those with diabetes were females, older, more hypertension, more hypercholesterolemia, more triglycerides, more diastolic blood pressure, less smokers and less low density lipoprotein. Among patients with diabetes, 242 diabetic patients (82.9%) were statin eligible, including 20 (6.90%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 222 (76%) for being aged 40-75 years with LDL-C 70-189 mg/dL. No patient had a calculated atherosclerotic cardiovascular risk score ≥7.5%. On the other hand, 393 non-diabetic patients (81.3%) were statin eligible, including 41 (8.50%) for having high serum levels of low density lipoprotein cholesterol (LDL-C) >190 mg/dL, and 351 (72.80%) for being aged 40-75 years with LDL-C 70-189 mg/dL. CONCLUSIONS: Based on the ACC/AHA guidelines, the majority of patients with diabetes admitted with first acute myocardial infarction would have been eligible for statin treatment if they have LDL-c >190 mg/dl or aged 40-75 years old and they have their LDL 70-189 mg/gl. More efforts should be taken for patients who are female, older than 50 years, hypertensive, elevated diastolic blood pressure have hypercholesterolemia, and elevated triglycerides because of their significant association with diabetes.

Relationship between anxiety, post-traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross-sectional study.

WHAT IS KNOWN ON THE SUBJECT?: Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood. FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals. While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees. WHAT DOES THE PAPER ADD TO EXISTING KNOWLEDGE?: The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact. Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post-traumatic stress disorder correlated with a higher FM impact. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees. Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM. Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions. ABSTRACT: INTRODUCTION: Fibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees. AIM: To assess the impact of FM and its associated factors in female refugees. METHODS: A cross-sectional study was conducted. The impact of FM, anxiety, post-traumatic stress (PTSD) and insomnia was investigated. RESULTS: 288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact. CONCLUSION: Mental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD. IMPLICATIONS FOR PRACTICE: Mental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions.

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.

Public knowledge, attitudes, and practice about COVID-19 pandemic.

COVID-19 is a newly discovered global pandemic that affected almost all countries, including Jordan. Knowledge, attitude and practices are fundamental to suppress the spread of the virus. This study aimed to examine knowledge, attitude and practices about COVID-19 in Jordan. A cross-sectional design was used to recruit a convenience sample of public from Jordan. An online instrument used to assess knowledge, attitude and practices about COVID-19, and was developed by the research team. The data were collected online through social media networks in Jordan. The data were collected during May 2020. 2470 participants participated and completed the study questionnaire. Results indicated good knowledge, practice, and attitude, about COVID-19 among the public in Jordan. Linear regression showed that female, aged 40 years or more, married, with Bachelor degree or higher, employed, and participants believe that Jordan will control COVID-19 had higher knowledge compared to their counterparts. Besides, linear regression showed that female, living in Amman city, with high knowledge about COVID-19, and believing that Jordan will control COVID-19 had higher practice compared to their counterparts. Knowledge, attitude and practices levels regarding COVID-19 among Jordanian population during the pandemic were high. However, health authorities and government have to implement and maintain educational programs to enhance the Jordanian population's awareness regarding COVID-19 and to prevent its spread specially among male, aged less than 40 years, unmarried, with less than Bachelor degree, unemployed, and for participants believe that Jordan will not control COVID-19.

Distance education during the COVID-19 outbreak: A cross-sectional study among medical students in North of Jordan.

INTRODUCTION: In the spot of the new emerging COVID-19 pandemic and its major impact worldwide on day-to-day activities many rules had to be changed in order to fight this pandemic. Lockdown started in Jordan and around the globe affecting several aspects of life including economy, education, entertainment, and government policies. Regarding education, the priority was to ensure the safety and progress of the educational process. Thus, new methods of teaching had to be applied using the online learning at Jordan University of Science and Technology (JUST), Faculty of Medicine. This study was done to assess (1) Class Experience (2) Students and Lecturers' Interaction (3) Online Learning Advantages & Disadvantages (4) Students' Preference. METHODS: A cross sectional study was conducted Convenience sampling technique was used to collect the data from the participants using a survey composed of 18 questions on Google Forms platform. A link was sent to the undergraduate medical students at the Jordan University of Science & Technology via their e-learning accounts (n = 3700). The form was available from May 22nd, 2020 to May 30th, 2020 for 8 days long. Data analysis was done using SPSS V 23. RESULTS: 2212 out of 3700 students responded, (55.8%) of them were in the basic years and (44.2%) of them were in the clinical years. (55.8%) of students started to take online lectures after 3 weeks. (45.7%) used the hybrid teaching method (asynchronous and synchronous), (31.4%) used live classes, and 22.8% recorded classes. Zoom was the most used platform. (48.7%) and (57%) of clinical students and basic students express their interaction as bad, while the others had good and excellent interaction. Maintaining social distance was the most advantage of online teaching, while poor technical setup and no direct contact were the most disadvantage, furthermore inability to have real clinical access was a significant problem for clinical students (p < .001). With reference to students' preferences 75% of students were not pleased with their experience and 42% of students prefer to integrate online learning with traditional learning. CONCLUSION: Most medical students at JUST preferred the traditional face-to-face teaching method over the solo online teaching methods with recommendations to convert to a more integrated educational system. Also, a well-established infrastructure should be done in involving online teaching.

Effect of simulation modules on Jordanian nursing student knowledge and confidence in performing critical care skills: A randomized controlled trial.

BACKGROUND: Simulation is known to have a significant effect as a teaching strategy in nursing education. However, no studies have been conducted to examine the effect of simulation on nursing students' knowledge and confidence in performing critical care skills in Jordan. PURPOSE: This study aimed to test the effect of simulation on university nursing students' knowledge and confidence in performing critical care skills for patients with cardiac, respiratory and neurological health problems. METHOD: A randomized controlled (pre-test-post-test) design was implemented. The experimental group (n = 38) attended 9 simulation scenarios, theoretical lectures and clinical training in hospital about cardiac, respiratory and neurological health problems, while the control group (n = 38) attended only the theoretical lectures and clinical training in hospital. Knowledge and confidence were measured using knowledge exam and self-confidence scale respectively. RESULTS: A paired t-test indicated that mean knowledge and confidence regarding implementing critical care skills were significantly higher P < 0.001 in the post-test than that in the pre-test, in both the experimental and the control group. However, independent t test revealed that the students in the experimental group scored significantly higher P < 0.001 than control group in both knowledge and confidence regarding performing critical care skills. CONCLUSION: Theoretical and clinical training is valuable teaching strategies that help enhance knowledge and confidence in applying critical care skills. However, adding simulation has a more significant effect than theoretical and clinical training in improving nursing students' knowledge and confidence in performing critical care nursing skills. Author strongly recommended considering simulation as alternative effective educational approach for clinical training especially during COVID-pandemic.

Do Illness Perception Predict Perceived Learning Needs Among Patients Treated With Percutaneous Coronary Intervention.

BACKGROUND: The number of coronary heart disease (CHD) patients treated with percutaneous coronary intervention (PCI) has increased. The illness perception (IP) of PCI recipients needs to be evaluated. Yet, little is known whether patients' IP predicts perceived learning needs among patients treated with PCI. OBJECTIVE: The aim of this study was to assess patients' IP and to examine its influence on perceived learning needs post PCI. METHODS: A cross-sectional design was used. A convenience sample of 208 patients who had undergone first-time PCI participated in the study. Data were collected before patients were discharged from the hospital using the Brief Illness Perception Questionnaire and the Percutaneous Coronary Intervention Learning Need Scale. RESULTS: Patients were highly concerned about their illness and perceived high consequences and symptoms related to CHD. They perceived low levels of personal and treatment control over their illness. Patients reported high learning needs. Multiple linear regression showed that low perception of personal control (P < .037), treatment control (P < .041), and high perception of disease symptoms (P < .018) significantly predicted high perceived learning needs. CONCLUSION: Hence, the patients' IP influences perceived learning needs, which may be included in routine clinical assessments. Tailored health education programs are needed for patients treated with PCI; such a program should target patients who perceived low levels of personal and treatment control over illness and have a high perception of symptoms.

The Most and the Least Performed Self-Care Behaviors Among Patients With Heart Failure in Jordan.

Assessing self-care is important aspects among patients with heart failure. However, few studies were conducted to assess self-care among patients with heart failure in Jordan. Therefore, this study aimed to assess the most and the least performed maintenance self-care behaviors and to examine the relationship between maintenance self-care behaviors and selected sociodemographics. A cross-sectional design utilizing a convenience sample of 226 patients with heart failure was used. The maintenance self-care mean was 53.89 and considered below the clinical target level (≥70). Asking for low salt item and performing physical exercises were the most performed self-care behaviors, while "trying to avoid getting sick" and "checking ankles for swelling" were the least performed self-care behaviors. Limited self-care behaviors indicated the need to implement cardiac education that may improve self-care behaviors. Cardiac education should target mainly patients with low income, low educational level, elderly, living alone, unemployed, and who are using traditional treatment.