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.

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.

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.

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.

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.

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.].

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.

Nursing students' perceived stress and coping behaviors in clinical training in Saudi Arabia.

BACKGROUND: Clinical training has been recognized as a stressful experience for nursing students. AIMS: The aims of this study were to identify levels and types of stressors among nursing students during their clinical training and their coping behaviors. METHODS: Data were collected using a purposive sampling method from 100 nursing students using a self-reported questionnaire composed of Perceived Stress Scale and Coping Behavior Inventory. RESULTS: Results showed that "assignments and workload" as well as "teachers and nursing staff" were the highest sources of stress in clinical training. The most common coping behaviors used were "problem-solving" and "staying optimistic". There was a significant difference in perceived stress among students in regard to the way of choosing nursing. There were significant differences in coping behaviors in regard to the presence of relatives in nursing, living status and mothers' educational level. The predictors of perceived stress were self-choosing for nursing and the presence of relatives in nursing, while the predictors for coping behaviors were stress from peers and daily life as well as mothers' educational level. CONCLUSIONS: Nursing teachers and staff are encouraged to develop strategies that decrease level of stress and promote adaptive coping behaviors among nursing students during their clinical training.

Effect of intimate partner violence on health of women of Palestinian origin.

BACKGROUND: Intimate partner violence is a problem in women who are refugees but the relationship of this violence to physical health has not been studied well. AIM: To identify significant associations between physical health problems and partner violence by type in refugee women. METHODS: For this cross-sectional study, data were collected from a convenience sample of 238 women attending healthcare centres of the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) in three Jordanian cities (Amman, Irbid and Zarqa). RESULTS: Victims of violence reported different health problems. However, rates of health problems were higher among victims of psychological partner violence and more health problems had significant associations with psychological violence when compared to physical and sexual partner violence. Furthermore, women's self-rated health status was only significantly associated with psychological partner violence but not with the other types of partner violence. CONCLUSION: Vulnerability to partner violence is related to life stressors women may encounter. Physical health is a fundamental target for psychological partner violence; evidenced by the resultant wide range of health problems in victims. This association occurs although psychological violence is not associated with health trauma/injury that physical and sexual partner violence usually generate. This conclusion highlights one aspect of the associated harm of psychological partner violence in victims' lives. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Empowerment of women socially, economically and psychologically, in collaboration with related community parties, should be an adopted international health policy by the governments. Screening policy for partner violence should be integrated with health and nursing services. Nurses are in a position to facilitate the implementation of health policy. Their role include helping women identify resources of help, develop required skills necessary for dealing with violence and identify their social support network. LIMITATIONS: Social desirability and use of convenience sampling are major limitations of the study.

Prevalence of intimate partner violence among women visiting health care centers in Palestine refugee camps in Jordan.

This study was conducted to investigate the prevalence of intimate partner violence (IPV) among a sample of women visiting health care centers in Palestine refugee camps in Jordan. We found that different types of IPV, including physical, emotional, sexual, economic, and control behaviors by the partners were experienced by the participants. This study was among a number of studies that investigated this phenomenon in residents of Palestinian camps. It adds to existing studies in this field, however, as it focuses on the prevalence of the top five types of IPV in these women. Co-occurrence of IPV, that is, experiencing two or more types of partner violence at the same time, was noticed in these women. Experiencing control by one's partner and the presence of different attitudes between men and women toward the use of violence were factors contributing to the occurrence of this phenomenon in these women. National efforts aiming at breaking the cycle of violence should be fostered through media and public awareness campaigns. Changing people's attitudes concerning men's use and women's acceptance of violence should be the aim of these efforts.

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

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

Predictors of antenatal depression among Jordanian pregnant women in their third trimester.

Antenatal depression has not been well studied worldwide. The objective of this study was to identify the prevalence and predictors of antenatal depression among Jordanian pregnant women in their third trimester. A correlational design was used with a convenience sample of 218 Jordanian pregnant women. Data were collected using valid and reliable measures and were analyzed with regression. Fifty-seven percent of the women displayed symptoms of depression. Thirty-seven percent (34% adjusted) of the variability in depression levels was predicted by knowing scores on life satisfaction, perceived stress, family and nonfamily stressful relationships, education, and parity. For that, antenatal depression needs early detection and treatment.

Mental health status of women in Jordan: a comparative study between attendees of governmental and UN relief and works agency's health care centers.

This study aimed at investigating differences in mental health problems between attendees of governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan. Further, predictors of mental health problems based on women's demographic profile were investigated. A convenience sample of 620 women attending governmental and United Nations Relief and Works Agency for Palestine Refugees health care centers in Jordan was recruited for this purpose. Independent samples t-tests were used to identify differences in mental health, and multiple linear regression was implemented to identify significant predictors of women's mental health problems. Results indicated an absence of significant differences in mental health problems between attendees of the two types of health care centers. Further, among the demographic indicators that were tested, income, spousal violence, and general health were the predictors of at least three different mental health problems in women. This study highlights opportunities for health professionals to decrease women's propensity for mental health problems by addressing these factors when treating women attending primary care centers in different Jordanian towns, villages, and refugee camps.

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.

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.

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.

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.

Patterns of coping with partner violence: experiences of refugee women in Jordan.

OBJECTIVE: The relationship between intimate partner violence (IPV) and women's use of negative and positive coping strategies was investigated. DESIGN AND SAMPLE: For this cross-sectional study, a convenience sample of 300 refugee women was recruited from health care centers in three cities in Jordan. Logistic regression adjusted to women's demographic characteristics was used. RESULTS: The study's results revealed that, compared to non victims, victimized women showed a lower tendency to receive psychological support from the family (adjusted OR = 0.53, 95% CI = 0.29-0.96), to smoke (adjusted OR = 0.28, 95% CI = 0.09-0.82), to use tranquilizers (adjusted OR = 0.014, 95% CI = 0.00-0.86), to think of suicide (adjusted OR = 0.04, 95% CI = 0.009-0.15), and to attempt suicidal actions (adjusted OR = 0.02, 95% CI = 0.002-0.19). CONCLUSIONS: The study indicated that women's lack of use of negative coping strategies (smoking, use of tranquilizers, suicidal thoughts, and suicidal actions) was promising. However, the lack of use of positive coping strategies (disclosure of abuse, psychological support from friends, and help from family/friends) was somewhat concerning. The role of health care professionals may be helpful in this context. Counseling and support to IPV victims via effective listening, nonjudgmental discussions, and provision of information can be offered by health professionals as part of the treatment in health care centers.

Psychological outcomes of intimate partner violence experienced by Jordanian working women.

This study aimed at investigating psychological health problems experienced by working women as a result of their experiences of intimate partner violence (IPV). One hundred one working women participated in the study. Results indicated that nearly half of the participants reported partner violence. Compared with nonabused women, abused women showed significantly higher levels of depressive symptoms (t (78) = -3.4, p = .001) and stress (t (93) = -4.8, p < .0001), while self-esteem did not differ significantly between the two groups. Acknowledgment of this problem and early recognition of the victims may result in improving the health of working women in Jordan.