The impact of cognitive fusion on stress among nurses: Exploring gender as a moderator controlling for depressive symptoms.

AIM: To investigate the influence of cognitive fusion on stress among nurses, with a focus on exploring gender as a moderator among Jordanian nurses controlling for depressive symptoms. BACKGROUND: Stress is a significant concern among healthcare workers, particularly nurses, given the escalating work demands and organizational constraints. METHODS: Data were collected from 206 nurses using a cross-sectional design. Participants completed surveys that included measures for cognitive fusion, stress, and depressive symptoms. Statistical analysis included bivariate correlations, independent sample t-tests, and moderation analysis using Hayes PROCESS. The results were reported using The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. RESULTS: The findings revealed a moderate correlation among stress, cognitive fusion, and depressive symptoms. The regression model explained 42% of the variance in stress, with significant contributions from cognitive fusion, gender, depressive symptoms, and the interaction between cognitive fusion and gender. Gender moderated the relationship between cognitive fusion and stress, indicating differential effects for males and females. CONCLUSION: This study underscores the importance of cognitive fusion in understanding and managing stress among nurses. The moderating effect of gender highlights the need for tailored interventions. Reducing stress among nurses may benefit their mental health and potentially enhance patient care and treatment outcomes. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: The study highlights crucial implications for nursing policy. Addressing cognitive fusion is vital to reducing nurse stress, directly impacting patient care quality and healthcare outcomes. Policymakers should prioritize gender-aware strategies within nursing policies, fostering a less stressful and more supportive work environment. By doing so, healthcare institutions can enhance the well-being of nurses and ultimately improve patient care, aligning with broader healthcare policy objectives of patient safety and quality improvement.

Identifying Health Literacy Strengths and Needs Among Jordanian Acute Myocardial Infarction Patients.

Acute myocardial infarction is a significant health issue, particularly in Jordan where ischemic heart disease is the leading cause of death. Effective management of acute myocardial infarction is essential to mitigate its consequences. Although health literacy is crucial for the successful management of acute myocardial infarction, research about the strengths and needs of health literacy among acute myocardial infarction patients is still limited. This study was conducted to identify the health literacy strengths and needs of Jordanian acute myocardial infarction patients using cluster analysis. A cross-sectional design was used to conduct this study in a sample of acute myocardial infarction patients in Jordan (N = 114). A demographics questionnaire and the Health Literacy Questionnaire were used to collect the data. Data analysis was performed using hierarchical cluster analysis using Ward's method. Seven distinct clusters of acute myocardial infarction patients were identified, each characterized by unique health literacy profiles and sociodemographic characteristics. Cluster 7 had the highest health literacy scores across all nine Health Literacy Questionnaire scales. Sociodemographic factors such as age, education level, and gender influenced health literacy levels, with female, younger, more educated patients exhibiting higher health literacy. Through identifying the specific strengths and needs, this research provides a foundation for developing targeted health literacy interventions for acute myocardial infarction patients. Improving health literacy among acute myocardial infarction patients can enhance their ability to manage their health and potentially reduce the complications associated with acute myocardial infarction.

The association between undergraduate nursing students' health literacy and bullying and cyberbullying victimization.

BACKGROUND: Bullying and cyberbullying victimization are common among undergraduate nursing students. However, evidence regarding health literacy association with bullying and cyberbullying victimization is lacking. PURPOSE: To investigate the association between health literacy and bullying and cyberbullying victimization in undergraduate nursing students. METHODS: A cross-sectional design was used with a sample of undergraduate nursing students (N = 397). The students completed three data collection scales (Forms of Peer Victimization Scale, Florence Cyberbullying-Cybervictimization Scales, and Health Literacy Questionnaire) and a demographics questionnaire. Data analysis was performed using cluster analysis and independent samples t-test. RESULTS: The mean age of students was 20.93 (SD = 2.16). Cluster analysis revealed that there were two clusters; undergraduate nursing students in cluster 1 had lower scores on health literacy and higher scores on bullying and cyberbullying victimization. The t-test results showed that undergraduate nursing students with a history of bullying victimization had lower scores on health literacy scales than those who reported no exposure to bullying victimization (p < .05). The largest mean difference was found in the "social support for health" scale. CONCLUSION: The findings of this study provide evidence that health literacy is a key determinant of mitigating bullying and cyberbullying victimization in undergraduate nursing students.

Healthcare Professionals' Insights Regarding the Applicability of the STEADI Falls Prevention Program Among Neurology Patients: A Qualitative Study.

Aim: Falls are common among hospitalized patients especially those with neurological health conditions. This highlights the need to implement evidence-based, comprehensive fall prevention programs. However, certain barriers hinder successful implementation of fall prevention programs in hospitals. The aim of this study was to explore the insights of healthcare professionals regarding the implementation of an interdisciplinary falls prevention program among patients with neurological health conditions. Methods: A qualitative, descriptive design was used to conduct this study. Healthcare providers at two neurology units from two hospitals were invited to attend interdisciplinary workshops on fall prevention using the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program. Reflective journals were used to collect the data. A total of 23 healthcare providers returned their completed journals and thematic analysis was performed to extract the main themes. Findings: Thematic analysis revealed a total of four main themes: (1) The STEADI program provides an interdisciplinary approach to identifying fall risks, (2) The STEADI program improves patient safety and facilitates recovery, (3) The STEADI program fails to accommodate all neurology patients, and (4) Time and space constraints hinder success. Conclusion: Responses to the reflective journals revealed that the participants were able to identify the advantages of using the STEADI program for both healthcare professionals and patients with neurological conditions. The comprehensive and evidence-based approach, coupled with its interdisciplinary nature, was highly appraised by the participants.

The Effect of the Stopping Elderly Accidents, Deaths, and Injuries Program on Falls Prevention in Neurosurgical Patients.

ABSTRACT: BACKGROUND: Despite the negative consequences of falls among neurosurgery patients in acute care settings, there is a lack of high-quality evidence for successful fall prevention programs. This study was conducted to evaluate the effectiveness of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program on falling prevention compared with routine falling protocol in neurosurgical patients in Jordan. METHODS: A prospective quasi-experimental design was used in this study. The sample comprised 70 neurosurgical patients from a major university-affiliated hospital in Jordan. The study sample was assigned into a control group (35 patients) and an intervention group (35 patients). A demographics questionnaire, and different fall risk screening tools and tests were used in this study as recommended by the STEADI program. RESULTS: Multivariate analysis of variance results showed a significant effect ( P = .001) of the STEADI program on the linear combination of outcome measures. Independent samples t tests further confirmed the program's effectiveness, with statistically significant mean differences in most outcome measures between the intervention and control groups post intervention. After implementing the study intervention, participants in the intervention group had a statistically significant lower risk for falls. CONCLUSION: The findings indicate potential effectiveness in improving neurosurgery patients' outcomes and reducing the risk of falls. Implementing the study recommendations can enhance patient safety and promote evidence-based fall prevention interventions in neurosurgery patients.

Testing a modified motivational interviewing counseling program.

BACKGROUND: Motivational Interviewing is a well-established person-centered counseling approach toward positive behavioral change. However, several limitations have been reported using motivational interviewing applications. PURPOSE: This study explored the potential of an innovative intervention (namely, modified motivational interviewing) to address the limitations associated with the original form of Motivational Interviewing. METHODS: The research used a phenomenological qualitative design to include three focus groups with a total sample size of 24 university nursing students to examine their experiences with the Modified Motivational Interviewing. The focus groups were transcribed verbatim and then coded to extract the themes. RESULTS: The following ten themes emerged from the data analysis: increasing discrepancy; ambivalence; ready, willing, and able; change as a natural process; the role of the modified motivational interviewing facilitator; spontaneous generalization; peer support facilitates change; help-seeking behavior; practical applications of the modified motivational interviewing; and problems encountered during the implementation of modified motivational interviewing. CONCLUSIONS: The proposed intervention can potentially be a cost-effective replacement for the original format of motivational interviewing intervention. Further research is needed to support the modified motivational interviewing.

A brief mindfulness-based intervention, sleep quality, sleep duration, and fatigue among nurses: A randomized controlled trial.

AIMS: The purpose of the current study was to investigate the effectiveness of a mindfulness-based intervention in improving sleep duration, sleep quality, and fatigue among Jordanian nurses. DESIGN AND METHODS: A randomized controlled trial was used to conduct this study. Data from 123 nurses (60 nurses in the interventional group and 63 nurses in the control group) were collected and analyzed. The primary outcome measures were compared between the intervention and control groups using repeated measure MANOVA to assess changes in sleep duration, sleep quality, and fatigue over time. RESULTS: The results showed that there was a statistically significant multivariate effect of the intervention on the linear combination of the dependent variables (sleep duration, sleep quality, and fatigue) (V = 0.23, F (3, 119) = 12.02, p < .001) with Partial η2 of 0.23. Follow-up analysis showed that the intervention group had lower sleep disturbances (Mean difference = -6.53, CI = -7.79 to -5.26) and less fatigue (Mean difference = -13.36, CI = -17.24 to -9.47) than the control group. CONCLUSIONS: The current study showed that the mindfulness-based intervention effectively addresses sleep quality and fatigue in nurses, which in turn is expected to positively impact the health care system. CLINICAL RELEVANCE: Mindfulness-based interventions effectively address sleep quality and fatigue associated with nurses' job performance and outcomes. Implementing brief mindfulness-based interventions is crucial as they can be self-implemented and fit into nurses' busy schedules.

Validation and cross-cultural adaptation of the six-dimension scale of nursing performance- arabic version.

BACKGROUND: Nursing performance is a key indicator of patients' care quality and safety. Most healthcare research tools are available in the English language; however, nurses around the world can employ these tools if rigorously adapted and cross-culturally validated. AIMS AND OBJECTIVES: This study aims to provide a cross-cultural adaptation and validation of the six-dimension scale of nursing performance to be used among Arabic-speaking nurses. DESIGN: The study employed a descriptive, correlational design with a cross-sectional approach. METHODS: A five-step cross-cultural adaptation process was adopted. The scale was administered to 216 Jordanian nurses between January 2022 to April 2022. SPSS and AMOS were used for descriptive and correlation analyses and testing the six-dimension model through structural equation modeling (SEM). RESULTS: The current study produced a valid, reliable, culturally adapted Arabic language version of the six-dimension scale of nursing performance. The internal consistency of the tool was supported by a Cronbach Alpha's value of 0.99. The model's goodness of fit indices were: CFI = 0.96, RMSEA = 0.048, and CMIN/df = 1.49. The exploratory factor analysis (EFA) of the scale identified three factors with eigenvalues greater than 1.00., explaining 75.22% of the variance. A subsequent EFA, specifying six factors, yielded 79.79% explained variance. All item factor loadings exceeded 0.30, confirming the scale's robust factor structure. CONCLUSIONS: This study proved that following a robust cross-cultural adaptation process results in a reliable and valid measure of nursing performance to be used among Arabic-speaking nurses. The study supports the dimensionality of nursing performance as evidenced by the SEM results. Therefore, the findings have the potential to considerably enhance studying nursing performance in healthcare fields in Arabic-speaking nurses. RELEVANCE TO CLINICAL PRACTICE: The validation and cross-cultural adaptation of the Arabic version of the Six-Dimension Scale of Nursing Performance have direct implications for improving the quality of nursing services, enhancing patient safety, promoting cultural competence, and supporting the professional growth of Arabic-speaking nurses.

The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness among nurses: A randomized controlled trial.

BACKGROUND: Nurses experience various health-related issues due to the nature of their work. AIM: This study aimed to examine the effect of a mindfulness-based intervention on stress overload, depression and mindfulness among nurses. A secondary objective was to examine the role of the setting (i.e., in and out of the hospital as a natural setting) on mindfulness-based intervention effectiveness. METHODS: A randomized controlled trial with three groups' pretest-posttest design was used in this study. A total of 195 nurses were recruited-65 intervention-inside hospital, 60 intervention-outside hospital, and 63 control. The mindfulness-based intervention was delivered by a certified mindfulness practitioner over 4 weeks in Jordan. Data were collected using a demographics questionnaire, the Stress Overload Scale Short, the Center for Epidemiologic Studies Depression Scale-Revised, and the Five Facet Mindfulness Questionnaire. RESULTS: Multivariate analysis showed a statistically significant effect of the intervention on the linear combination of the dependent variables V = 0.44, F[6, 368] = 17.56, p < .001. Follow-up analyses showed that a mindfulness-based intervention significantly decreased stress overload, depression, and increased mindfulness levels among nurses in intervention groups compared with the control group. In addition, conducting a mindfulness-based intervention outside the hospital has a better effect on mindfulness levels than the inside hospital. LINKING EVIDENCE TO ACTION: The effect of a mindfulness-based intervention on stress overload, depression, and mindfulness should be considered when planning for nurses' well-being and the quality of care provided. Nurse managers are encouraged to use the study's findings to promote nurses' well-being.

The Effect of a Mindfulness-Based Intervention on Family-Work and Work-Family Conflicts Among Nurses: A Randomized Controlled Trial.

Purpose: Nurses' working environment poses various challenges that lead to conflict between work- and family-related roles. Work-family and family-work conflicts (WFCs and FWCs) negatively affect nurses' well-being and patient outcomes. Thus, the current study examined the effectiveness of a mindfulness-based intervention on WFC and FWC among nurses. Method: A randomized controlled trial, pre-post-test design was used in the current study. A total of 123 nurses were recruited and randomly assigned to the intervention (n = 60) and control (n = 63) groups. Findings: Multivariate analysis showed that there was a statistically significant effect of the intervention on the linear combination of the dependent variables V = 0.1, F (2, 120) = 6.61, p < .01. The analyses showed that the mean difference of the WFCs and FWCs scores was significant with the intervention group showing lower mean scores than the control group. In addition, both groups showed higher work-family conflict mean scores compared to the FWC. Discussion: The findings of this study showed that the mindfulness-based intervention significantly improved nurses' WFCs and FWCs. The results should be considered when planning for nurses' well-being and the quality of care being provided to promote holistic nursing care.

Psychometric properties and measurement invariance of the Arabic Self-Care Inventory.

BACKGROUND: Self-care is a fundamental aspect of health and well-being for healthy individuals and those with chronic illnesses. However, the available self-care measurement instruments have limited support regarding their psychometric properties. Research about the validation of comprehensive, theory-based self-care tools in the Arabic language and culture is also limited. In addition, many self-care measurement tools are available only for people with chronic illnesses. OBJECTIVE: To examine the psychometric properties of the Arabic version of the Self-care Inventory (SCI) in the general adult population in Jordan. METHODS: This study was conducted using a cross-sectional design. Data collection was performed using a demographics questionnaire, and Arabic versions of the SCI, Self-care Self-Efficacy, and the Center for Epidemiologic Studies Depression Scale-revised. SPSS and AMOS were used to analyze the data. Data analysis was conducted by performing confirmatory factor analysis, measurement invariance, internal consistency, and bivariate correlations. RESULTS: The results revealed that the SCI comprises three scales: self-care maintenance, self-care monitoring, and self-care management. The goodness of mode fit indices showed that the models of these scales fit the data well by meeting the following set a priori criteria: (RMSEA < .07, CFI > .95, and X2/df < 5). The factor loadings of the individual items of the SCI provided further evidence about the factor structure of the three scales. Regarding measurement invariance, the results indicated that partial invariance across participants' sex is assumed. The values of both Cronbach's α and composite reliability showed that the internal consistency of the SCI is supported. Cronbach's α of the self-care maintenance, self-care monitoring, and self-care management were .82, .86, and .83, respectively. CONCLUSION: The psychometric properties of the Arabic version of the SCI demonstrate its validity and reliability as a robust assessment tool for measuring self-care in the general adult population.

Relationships between Inflammatory Biomarkers and Fatigue among Patients with Moderate and Severe COVID-19.

Background: Patients with moderate or severe COVID-19 infection suffer from varying levels of fatigue; however, there is a lack of understanding regarding the effect of inflammation on fatigue; and whether these relationships differ according to the severity of the infection. Aim: To assess the relationships between selected inflammatory biomarkers and fatigue levels among hospitalized Jordanian patients with moderate or severe COVID-19 infection. Methods: A quantitative cross-sectional design was used. A total of 352 participants were recruited for the study. Data regarding fatigue type and level were collected using the Chalder fatigue scale. Laboratory test results regarding several selected inflammatory biomarkers (e.g., ESR, CRP, IL-6, D-dimer, and others) were collected from patient records. The severity of the COVID-19 infection was determined using the criteria of the Ministry of Health in Jordan based on the results of O2% (oxygen saturation). Results: The mean scores of the total fatigue level significantly differed between the two levels of the severity of COVID-19 infection (moderate and severe levels) (t = -3.0, p < 0.05). Similar findings were observed with physiological fatigue (t = -3.50, p < 0.05), and no significant difference was observed in psychological fatigue. Out of the selected inflammatory markers, only neutrophil and lymphocyte count had a significant influence on total fatigue level. Conclusion: The level and type of fatigue was affected by the severity of the disease. However, the disease process itself represented by the levels of the inflammatory markers showed little influence on fatigue. The implications such as continuous screening of fatigue, and monitoring of the levels of the inflammatory markers are important to assist in diagnosing and managing COVID-19 patients. Furthermore, the relationship between the inflammatory process and fatigue is complex and requires further exploration.

Psychometric properties of the Arabic version of Barratt Impulsiveness Scale 11: The development of short form.

Impulsivity is an important mental health-related variable that has been associated with various human behaviors. The Barratt Impulsiveness Scale is the most frequently used measure to examine impulsivity. However, its psychometric and factor structure was not examined in Arabic speaking population. The goal of the current study was to examine the psychometric properties and factor structure of the Barratt Impulsiveness Scale in Arabic speaking population. The current study used a cross-sectional design. Two independent samples were recruited: college students (N = 250) and persons with heart failure (N = 165). Exploratory factor analysis, then a series of confirmatory factor analyses were used to assess one- and three-factor models of the Barratt Impulsiveness Scale (30 items; i.e., BIS-11) and Barratt Impulsiveness Scale (15 items; i.e., BIS-15). Because our analysis did not support the factor structure of the previous versions of the Barratt Impulsiveness Scale, we used confirmatory factor analysis to evaluate the model structure of the single-factor measure. To assess the measurement invariance, the newly developed measure was examined across different genders and populations. Due to poor psychometrics of BIS-11 and BIS-15, a short form (BIS-SF) was developed; and validity, reliability, and measurement invariance were supported. The current analysis showed that BIS-11 and BIS-15 have poor psychometrics. Thus, there was a need to improve the measure by reducing the number of items and re-evaluating the psychometrics of the new measure. The BIS-SF is a reliable, valid tool to assess impulsivity in our samples. Other studies need to support the current study findings in populations with other chronic illnesses.

The Effect of Risk Propensity on Family-Work and Work-Family Conflicts in Jordanian Nurses: Does Gender Matter?

INTRODUCTION: Work and family duties may be in conflict, which can cause a problem faced by nurses and lead to significant physical and mental health risks. This study examined whether gender moderated the relationship between risk propensity with work-family and family-work conflicts in Jordanian nurses. METHOD: A cross-sectional study was conducted to collect data from 206 nurses currently employed in two major referral hospitals. Data analysis was performed using the Macros process and correlations. RESULTS: The bivariate correlations showed that family-work conflict was significantly correlated with depression, stress, and risk propensity. Work-family conflict was only correlated with depression and stress. Macros process results showed that gender moderated the relationship between risk propensity and family-work conflict. These results showed that the risk propensity significantly affected family-work conflict in male but not female nurses. DISCUSSION: The results showed that gender moderated the relationship between risk propensity and family-work conflict but not between risk propensity and work-family conflict.

Health literacy of university employees: The role of sociodemographic characteristics and nutritional status.

BACKGROUND: Health literacy plays a key role in promoting overall health and preventing diseases among individuals and communities. However, the literature regarding health literacy among university employees is still evolving and not thoroughly understood. OBJECTIVE: This study was conducted to examine the association between health literacy and sociodemographic characteristics and nutritional status of university employees in Jordan. METHODS: This study was conducted using a cross-sectional design. A total of 163 university employees participated by completing a demographics questionnaire and the Health Literacy Questionnaire. The Health Literacy Questionnaire is considered a comprehensive tool to assess health literacy, and it encompasses nine distinct scales. The body mass index was calculated by obtaining the participants' height and weight. RESULTS: The results of multivariate analysis of variance showed that three factors had a statistically significant effect on the linear composite of the Health Literacy Questionnaire scales. These factors were the university employees' age, highest level of education, and body mass index. Follow-up analyses revealed that university employees' sociodemographic characteristics and nutritional status affect different domains of health literacy. Compared to overweight employees, those with normal body mass index had higher mean average scores on six (out of nine) scales of the Health Literacy Questionnaire. CONCLUSION: These results highlight the need for addressing the nutritional status and sociodemographic characteristics as a source of disparity in university employees' health literacy. Such factors should be addressed in designing tailored health promotion interventions for university employees.

Work family conflict, family work conflicts and work-related quality of life: The effect of rotating versus fixed shifts.

AIMS AND OBJECTIVE: This study examined the difference between rotating and fixed shift schedules on work-family conflict, family-work conflict and work-related quality of life. BACKGROUND: There is a lack of evidence regarding the effect of rotating shifts on work-family conflict, family-work conflict and work-related quality of life among nurses. DESIGN: A cross-sectional design was used to conduct this study. METHODS: Data were collected from 216 nurses using the Work and Family Conflict Scale and Work-Related Quality of Life. Bivariate correlations and independent samples t-tests were performed. The results of the current study were reported using the STROBE checklist. RESULTS: Bivariate correlations showed that work-related family quality of life is negatively associated with work-family and family-work conflicts. The mean differences between the two groups (rotating and fixed shifts) were significant for all three variables: work-family conflicts, family-work conflicts and work-related quality of life. CONCLUSIONS: Rotating shifts are associated with an increased risk of experiencing work-family and family-work conflicts and decreasing their quality of working life, which may adversely affect the quality of care provided. RELEVANCE TO THE CLINICAL PRACTICE: The effect of shift types on nurses and how rotating shifts have more severe consequences on nurses should be considered. Nurse managers are encouraged to use the findings of this study to mitigate the risk of any work-family or family-work conflicts and improve nurses' work-related quality of life. PATIENT OR PUBLIC CONTRIBUTION: The chief nursing officers at the data collection settings facilitated direct contact with potential participants and data collection.

Health Literacy and Smoking Habits Among a Sample of Jordanian University Students.

Limited health literacy is a significant predictor of engaging in unhealthy behaviors. However, the literature regarding the association between health literacy and smoking in university students is very limited. Thus, this study was conducted to examine the association between university students' health literacy and smoking habits. A cross-sectional design was used. A sample of university students (N = 327) was recruited to conduct this study. Data collection was performed using a demographics questionnaire and the health literacy questionnaire. AMOS was used to conduct data analysis using structural equation modeling analysis with maximum likelihood estimation. Different versions of the structural model were compared and evaluated based on specific fit indices criteria. The results showed that 30% of the participants were current smokers. Smoking cigarettes was the most common type of smoking in this study, and 23.1% of the participants were current users of two or more types of smoking (e.g., cigarettes and hookah). The structural model with three latent variables (health literacy, smoking status and type, and smoking frequency and duration) was the one that best fit the data; the model fit indices were X2 = 305.84, df = 102, p < .001; RMSEA = .068; CFI = .95; CMIN/df = 2.51; TLI = .929; and AIC = 355.75. A single standard deviation increase of health literacy causes .38 decrease in smoking status and type and .13 decrease of smoking frequency and duration. The results showed that health literacy is negatively associated with smoking in a sample of Jordanian university students.

Effect of a modified motivational interviewing intervention on university students' psychological, cognitive, and nutritional health: A randomized controlled trial.

BACKGROUND: Motivational interviewing is a set of interviewing techniques that are employed to promote behavioral change. However, motivational interviewing is a costly intervention that requires training, and its effectiveness relies greatly on the skills and training of specialists. To overcome these limitations, this study developed and implemented a modified version of motivational interviewing. AIM: This study was conducted to investigate the effect of a modified motivational interviewing (MMI) intervention on university students' psychological, cognitive, and nutritional health indicators. METHODS: This randomized controlled trial study was conducted using an experimental, repeated-measures, two-group design. The authors developed a modified version of motivational interviewing, and its effect was investigated among university students. The final sample size in this study was 94 university students (intervention = 48 and control = 46). Psychological, cognitive, and nutritional health indicators were measured at baseline and 1 month postrandomization and 3 months postrandomization. Repeated-measures multivariate analysis of variance was used to analyze the data. RESULTS: The results of the multivariate analysis revealed a significant effect of the MMI intervention on the linear combination of the dependent variables: Pillai's trace = 0.28, F (9, 84) = 3.59, p = .001. The univariate analysis showed that the effect of the MMI intervention was significant on four dependent variables (namely, uncontrolled eating, emotional eating, perceived stress, and mindfulness). CONCLUSION: The MMI intervention improved university students' perceived stress, uncontrolled eating, emotional eating, and mindfulness. Further research should be conducted to validate the results reported in this article.

Examining the underlying processes of different dimensions of self-care behavior among persons with heart failure.

PURPOSE: This study was conducted to compare how potential predictors differentially contribute to the different dimensions of self-care in persons with heart failure. METHODS: A cross-sectional design was used in this study. Purposive sampling was used to recruit a sample (N = 252) in this study. The data were collected from three major referral hospitals in Jordan. Data analysis was performed using multiple linear regression. RESULTS: The results showed that around 89% of our sample had insufficiency in at least one dimension of self-care. The initial regression models showed that different combinations of predictors were significantly associated with different dimensions of self-care. These models were also different in terms of the variance explained and the coefficients of the significant predictors. After the follow-up analysis of the best fit models for these dimensions, these differences were maintained. CONCLUSION: Despite the similarities in the proposed variables predicting different self-care dimensions, their differences may suggest variations in the underlying processes controlling different self-care dimensions. The current study showed that seven out of the nine proposed variables predicted different dimensions of self-care either in the initial or best-fit models.

Factors influencing mindfulness among Jordanian nurses: A cross-sectional study.

AIM: The current study aimed to examine if work-related factors, psychological variables and selected demographics predict mindfulness among Jordanian nurses. BACKGROUND: Mindfulness has been associated with various work-related variables. Studies examining mindfulness antecedents in nurses are scarce. METHODS: A cross-sectional study was conducted to collect data from 173 nurses currently employed in three major referral hospitals. A demographic questionnaire and instruments to collect data about nursing mindfulness, depression, stress, work-family conflict, and family-work conflict were used. RESULTS: The bivariate analysis showed that all study variables combinations were significant except for the correlation between income and mindfulness. The best fit model showed that only four variables significantly contributed to the model: depression, stress, family-work conflict, and educational level. These variables explained 57% of the variance in mindfulness in our sample. CONCLUSIONS: Depression, stress, family-work conflict and educational levels contributed to mindfulness levels in Jordanian nurses. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should be aware of the factors that may affect their employees' mindfulness levels and target these factors through the application of evidence-based interventions to improve nurses' levels of mindfulness, which in turn will mitigate the negative impact of lower levels of mindfulness.