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.

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.

Perspective of healthcare providers on assessing the quality and accessibility of health services for chronic diseases in Jordan during Covid-19: a mixed method study.

BACKGROUND: Hospital services in all parts of the world were severely affected by the crisis caused by the Coronavirus pandemic. This was particularly concerning for patients who suffer from chronic diseases. AIM: This study aimed to: assess the level of quality and accessibility of chronic disease services from the perspectives of healthcare providers, assess the association between healthcare providers' socio-demographic factors and their perspectives on accessibility and quality level, and explore the providers' perspectives on the barriers and facilitators of quality and accessibility to chronic disease health services during the COVID -19 pandemic. METHOD: Design: An explanatory mixed method design was employed in this study using a questionnaire and focus group discussion approach. The questionnaire consisted of three sections including, demographic, accessibility, and quality. SAMPLE: A convenience sampling approach was used to collect the quantitative from 412 healthcare providers working at public, private, and teaching hospitals. A purposive sample of 12 healthcare providers were interviewed to collect the qualitative data. ANALYSIS: The quantitative data were analyzed using SPSS Statistics Version 25. The qualitative data was analyzed using the thematic analysis approach. RESULTS: This study found that the quality and accessibility of chronic disease services in northern Jordan were affected during COVID-19. Quantitative: The majority of the participants reported moderate level of accessibility and quality. Qualitative: Four main and six subthemes were identified: 1) Accessibility barriers including transportation and fear of infection; 2) Accessibility facilitators including availability of Personal Protective Equipment (PPE) and Covid-19 vaccination; 3) Quality barriers including staff shortage; 4) Quality facilitators including safety protocol. CONCLUSION: The quality and accessibility of chronic disease services were affected due to the healthcare system restating to address the Covid-19 pandemic. Different barriers and facilitators for chronic disease healthcare services accessibility and quality were identified. The findings of this study lay the ground for healthcare decision and policymakers to develop strategies and formulate polices to ensure these patients receive the needed healthcare services, and hence improve their health outcomes.

The effectiveness of COPA-based training program on the infection-control competencies of newly hired healthcare professionals.

Competency-based education that relies on nurses' and healthcare professionals' needs assessment is crucial to tackling healthcare crises such as COVID-19. Strengthening the capacities of human resources by implementing customized infection control training programs is therefore mandatory. This study aims to measure the effectiveness and satisfaction of the Competency Outcomes and Performance Assessment (COPA)-based training program. The study implemented a single group pretest-posttest experimental design. A single-stage cluster sampling technique was used. All field hospitals in Jordan were listed, and one hospital was randomly selected. A total of 87 personnel from different disciplines agreed to participate after reading the letter of information and signing the informed consent. A panel of experts representing different disciplines and hospital units initially met and agreed upon a list of competencies required for the training program, and the program was accordingly developed. The study measured the healthcare professionals' competencies in infection control and prevention before and after the administration of the competency-based training program. The results revealed significant differences between participants' pretest and posttest scores in all infection control domains and the total scores. For example, the increase in participants' total competency scores after the training was statistically significant (P < 0.007). The mean total satisfaction score was 61.18 + 7.00 reflecting that the participants were highly satisfied with the provided training. In conclusion, it is imperative to provide healthcare professionals with adequate clinical training to ensure that healthcare services are going to be delivered in the highest possible quality and minimize the possible adverse events.

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.

Validation and measurement invariance of the Arabic Health Literacy Questionnaire.

Health literacy plays a key role in empowering individuals and enabling them to make health-related decisions. Despite the advances in health literacy research, there are gaps in the literature that require further inquiry, and establishing comprehensive and valid measurements is one of them. Thus, this research was conducted to examine the psychometric properties of the Arabic Health Literacy Questionnaire (HLQ), including the reliability, validity, and measurement invariances of the nine HLQ scales. A cross-sectional design was used in this study. A sample of university students (N = 1011) was recruited, the mean of age was 21.1 years old (SD = 2.28). The Arabic HLQ and a demographics questionnaire were completed by the participants. Confirmatory factor analyses (CFA) and measurement invariances were performed for each HLQ scale. The values of Cronbach's α and composite reliability were above .70 for all HLQ scales. The CFA analyses showed that all HLQ scales meet the criteria that were set a priori: RMSEA ≤.07, CFI ≥.95, and Chisq/df < 5. In addition, all standardized factor loadings were above .50. Regarding the measurement invariance, the results supported the equal form measurement invariance for all HLQ scales. The equality of factor loadings measurement invariance across gender was also supported for all HLQ scales. Measurement invariance of factor loadings and equality of indicator intercepts was partially supported. These results show that the internal consistency, convergence, and factor structure of the HLQ are all supported. The Arabic HLQ is a reliable, valid tool to measure health literacy among Arabic-speaking populations.

Psychometric properties of the Arabic version of the Existence Scale.

The Existence Scale (ES) is a theory-based measure assessing personal fulfillment and finding meaning in life. This study aims to translate the ES into Arabic language and test its psychometric properties in Jordan populations. A methodological design was performed on a convenience sample of 551 participants by three samples of nurses, schoolteachers, and undergraduate students. Data collection was carried out between February and May 2019. Translation and back translation, face validity (Important Score>1.5), content validity ratio (CVR>0.62) and index (CVI/Ave>0.80), construct, convergent, and discriminant validity were obtained. Furthermore, Cronbach's alpha, composite reliability, and average variance extracted were investigated in this study. The results showed that five items were deleted based on content validity ratio and four items were deleted based on their low factor loading. The exploratory factor analysis showed four subscales for the translated ES (37 items), explaining 61.57% of the variance collectively. The confirmatory factor analysis supported the four subscales with acceptable goodness of fit indices. The result of the total Cronbach's alpha for the ES was 0.93, and for subscales it ranged from 0.88 to 0.93. Composite reliability and average variance extracted results for the translated ES were supportive of the reliability. These results confirm that the translated Arabic version of the ES (37 items) in Jordan populations is acceptable regarding validity and reliability.

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.

Knowledge of Jordanian nurses and attitudes toward patients with suicidal attempt.

Nurses' attitudes toward attempted suicide may affect the quality of care provided to those patients. There is a significant relationship between suicide literacy level and stigmatizing attitudes toward suicide. This study aimed to examine nurses' knowledge and attitudes toward patients with suicidal attempts. A cross-sectional correlational design was used to guide this study, and data were collected using an online survey. The Stigma of Suicide Scale-short form (SOSS-SF) was used to measure stigmatizing attitudes toward suicide, while the Literacy of Suicide Scale (LOSS) was used to measure suicide literacy level. The sample consisted of 343 Jordanian nurses, and their mean age was approximately 31 years old. Only 58 (16.9%) nurses reported having suicide training. Nurses had low stigmatizing attitudes toward suicidal patients. Nurses showed low suicide literacy levels. Only 46% of nurses had scores equal to or higher than the passing score of the LOSS. Linear multiple regression was used to predict nurses' level of stigma toward suicidal patients. Among the four predictors entered in this analysis, only LOSS showed a significant and negative effect. This study highlighted the importance of suicide training and education for nurses because it may improve their attitudes, self-confidence, and professional practices when providing care for patients.

A study of the relationship between nurses' experience, structural empowerment, and attitudes toward computer use.

OBJECTIVE: This study examined the relationship between structural empowerment and nurses' experience and attitudes toward computer use. METHODS: This study was conducted using a cross-sectional quantitative design. A total of 184 registered nurses from four hospitals in Jordan participated in the current study. Data were collected using a demographics questionnaire, the Conditions for Work Effectiveness Questionnaire-II (CWEQ-II), and the Pretest for Attitudes toward Computers in Healthcare (PATCH). RESULTS: The median of experience in years among nurses was 5.0, ranging from one to 26 years. The mean score for the attitudes toward computer use was 61.90 ± 11.38. Almost half of the participants, 45.11%, were in the category of "feel comfortable using user-friendly computers." The participants' mean average of the total structural empowerment was 12.40 ± 2.43, and the values for its four subscales were: opportunity 3.57 ± 0.87, resources 2.83 ± 0.85, information 3.06 ± 0.79, and support 2.95 ± 0.86. The frequencies analysis revealed that most participants had a moderate level of empowerment (n = 127, 69.02%). The bivariate correlation between nurses' experience and attitudes toward computer use was significant (r = -0.17, P < 0.05). The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak (r = 0.20, P < 0.01). CONCLUSION: The results indicated that more experienced nurses are more reluctant toward computer use. However, creating an empowering work environment can facilitate nurses' attitudes toward computer use.

Reliability and validation of the Arabic version of the Conditions for Workplace Effectiveness Questionnaire-II.

OBJECTIVE: This study aimed to examine the psychometric properties of the Conditions for Workplace Effectiveness Questionnaire-II-Arabic Version (CWEQ-II-AV), which measures structural empowerment among nurses. To enhance the usability and credibility of the CWEQ-II among researchers within Arabic-speaking countries, a valid and reliable Arabic version of the measure is necessary. METHODS: A cross-sectional research design was used. From December 2018 to June 2019, 275 nurses working in 4 hospitals participated in the study. Reliability was assessed by examining internal consistency and split-half reliability. A confirmatory factor analysis was performed to evaluate the factor structure of the CWEQ-II-AV. RESULTS: The psychometric properties of the CWEQ-II-AV were excellent regarding the six-factor model (opportunity, information, resources, support, formal power, and informal power). The results showed the following fit indices meet the criteria set a priori: comparative fit index (CFI) = 0.96, root mean square of error approximation (RMSEA) = 0.06, and χ 2/df = 2.08. Cronbach's α coefficient was 0.95 for the total questionnaire and ranged between 0.83 and 0.89 for the individual subscales. The split-half reliability was 0.91 for the total questionnaire and ranged from 0.83 to 0.87 for individual subscales. CONCLUSION: This study provides evidence that CWEQ-II-AV is both a reliable and valid measure of structural empowerment among Arab nurses.

Effectiveness of an educational program on improving healthcare providers' knowledge of acute stroke: A randomized block design study.

BACKGROUND: Stroke is a time-sensitive neurological disease and a life-threatening medical condition. Providing timely management for stroke patients is a crucial issue in healthcare settings. The primary objective of this study is to evaluate the effectiveness of an evidence-based educational program on healthcare providers' (HCPs) overall knowledge of stroke. METHODS: A randomized block design with post-test only was used. A total of 189 HCPs (physicians, registered nurses, and paramedics) involved with treating stroke patients in the emergency were recruited. Participants were randomly assigned to either the intervention or waiting list control group. A one-session, stroke educational program was offered to the HCPs followed by a post-test designed to assess knowledge about stroke. RESULTS: A significant main effect on the profession type was found, with physicians having higher mean scores of stroke knowledge compared with nurses and paramedics (F [2, 183]=48.55, P<0.001). The implemented educational program had a positive effect on increasing the level of stroke knowledge among HCPs (F [1, 183]=43.31, P<0.001). The utilization of any evidence-based assessment tools for patients with suspected stroke was denied by 36% of the total sample. CONCLUSIONS: The implemented intervention can increase HCP's knowledge regarding stroke. Stroke education should be considered as one of the essential requirements for professional development for all HCPs in the emergency.

Prevalence of medical errors and barriers to report among nurses and nursing students in Jordan: A cross-sectional study.

BACKGROUND: Medical errors (MEs) are serious but preventable threats to patient safety. Annually, 421 million hospitalizations take place worldwide, from those an estimation of around 43 million MEs occur. Low-middle income countries account for two-thirds of these MEs. AIM: To examine the prevalence and contributing factors predicting MEs and its reporting among Jordanian nurses and nursing students. METHODS: The study used a cross-sectional descriptive design. A total of 178 nursing students and 123 bedside nurses participated in this study. Study data were collected through a five-section newly developed survey. RESULTS: MEs are highly prevalent in Jordanian hospitals. More than 70% of nurses and nursing students have no previous training in preventing and reporting MEs. The most prevalent type of MEs were related to changing positions for bedridden patients followed by medication errors, iatrogenic infections, and falls. Staff shortage was the main cause of MEs from participants' perspectives. CONCLUSION: A central concern of these results is the need for providing effective programs on identifying and preventing MEs in health-care settings and integrate these programs into graduate nursing curriculums. Strategies should be implemented to establish electronic systems that are accessible, confidential, and a time-saver to enhance reporting MEs.

COVID-19 Help-Seeking Behaviors: Application of the Theory of Planned Behavior.

The novel coronavirus disease (COVID-19) is highly contagious. More than 247 million cases have been confirmed by the end of October 2021. Seeking help earlier may slow the spread of COVID-19 because it may help in early detection of infected cases, and it facilitate tracing those who were with close contact with infected cases. The purpose of this study is to identify participants' intentions toward COVID-19 seeking help and the factors affecting their decision. This is a cross-sectional study. An online survey using Google Forms was used for data collection. Hierarchical multiple regression analysis was used to explain intentions to seek help for COVID-19. The concepts included in the Theory of Planned Behavior and COVID-19 knowledge were used as predictors. The sample included 780 participants, with an average age of 28.60±9.86 years old. Most of the sample were female (67.4%) and having a bachelor's degree (72.7%). Participants showed high level of knowledge regarding COVID-19, 73% of the sample had a total knowledge score equal to or higher than 85%. Also, participants had high positive attitudes and high intentions to seek help for COVID-19. The four predictors: Attitudes towards COVID-19, subjective norm, perceived behavioral control, and COVID-19 knowledge significantly explained intentions to seek help. Participants had high intentions to seek help for COVID-19, which was related to having positive attitudes toward seeking help, high social approval, high perceived controllability, and high COVID-19 knowledge levels. Regular awareness campaigns during early stages of pandemics should be performed to improve attitudes and knowledge level, which may improve prevention measures, and promote help seeking behaviors. Consequently, this may facilitate early detection of cases, and slow the spread of pandemics.

Parenting a Child With Autism Spectrum Disorder: Perspective of Jordanian Mothers.

INTRODUCTION: Parenting a child diagnosed with autism spectrum disorder (ASD) is challenging for mothers because of concerns related to behavior, difficulties in accessing specialized care, and lack of community acceptance, yet their stories in Jordanian context are still unknown. Common challenges in Jordan include financial burdens, lack of public awareness, and lack of specialized knowledge even among health care providers, which may lead to delays in obtaining the diagnosis and interventions for ASD. METHOD: A phenomenological descriptive approach was used to explore and understand the mothers' everyday lived experiences of raising a child with ASD. Semistructured interviews were conducted with 14 mothers to identify their challenges so that nurses can identify gaps in services, empower families, and facilitate optimum care to these Jordanian families. FINDINGS: The main themes that emerged were (1) mothers' journeys with the diagnosis, in which mothers recognized the abnormalities of their children, reported delays in getting the diagnosis and initiation of treatment, and described a wide range of reactions to the diagnosis from grief and guilt to a blessing from God; (2) the burden of care, by which mothers reported physical and emotional exhaustion, financial burdens, and concerns about the quality of available services; and (3) the consequences and the hurdle of having a child with ASD, which affected the family relationships and social life. DISCUSSION: Jordanian mothers caring for children with ASD face several challenges, including physical, psychological, financial, and social challenges, in addition to limited specialized services. Identifying their unique challenges and needs are essential to support them, provide appropriate services and resources, and develop policies and guidelines for culturally competent quality services.

The association between mindfulness and health promotion in undergraduate nursing students: A serial multiple mediator analysis.

AIM: This study was conducted to examine the association between mindfulness and health promotion among undergraduate nursing students and explore the mediation effect of certain factors (perceived stress, depressive symptoms, self-care agency, and impulsivity) on this relationship. DESIGN: Cross-sectional quantitative design. METHODS: A total of 195 undergraduate nursing students from a public university in Jordan participated in this study. A demographic questionnaire was used in addition to using well-established, validated tools to measure health promotion, mindfulness, perceived stress, depressive symptoms, impulsivity, and self-care agency. Data were collected between March and November 2018. Data were analysed using PROCESS macros. RESULTS: The direct association between mindfulness and health promotion was positive but not statistically significant. Simple mediation analysis showed that perceived stress is the only statistically significant mediator (effect = 0.03; 95% CI: LL = 0.008, UL = 0.057). The serial multiple mediator analyses revealed that three combinations of the mediators made the mindfulness effect on health promotion statistically significant; perceived stress and self-care agency (effect = -0.01, 95% CI: LL = -0.022, UL = -0.01); depressive symptoms and self-care agency (effect = 0.016, 95% CI: LL = 0.006, UL = 0.03); and perceived stress with depressive symptoms and self-care agency (effect = 0.006, 95% CI: LL = 0.002, UL = 0.013). CONCLUSIONS: The results of this study add to the literature evidence concerning the mediation role of perceived stress, depressive symptoms, and self-care agency on the relationship between mindfulness and health promotion among nursing students. IMPACT: This study examined the complex relationship between mindfulness and health promotion. There is a mediation effect of nursing students' perceived stress, depressive symptoms, and self-care agency on the relationship between mindfulness and health promotion. Researchers interested in designing mindfulness-based interventions to optimize health promotion of nursing students could benefit from the findings of this study.

The impact of health literacy on college students' psychological disturbances and quality of life: a structural equation modeling analysis.

BACKGROUND: The literature regarding the effect of health literacy on college students' psychological health and quality of life is scarce. The purpose of conducting this cross-sectional study was to examine the effect of health literacy on certain psychological disturbances (perceived stress, depressive symptoms, and impulsivity) and quality of life of college students. METHODS: A cross-sectional quantitative design was utilized in this study. A total of 310 four-year college students participated in this study. The students completed a demographics questionnaire as well as already established and validated measures of health literacy, perceived stress, depressive symptoms, impulsivity, and quality of life. Structural equation modeling was performed to analyze the data to explore the effect of health literacy on the psychological disturbances and quality of life. RESULTS: The results showed that health literacy has a negative effect on three psychological disturbances commonly experienced by college students; perceived stress, depressive symptoms, and impulsivity. In addition, the effect of health literacy on the quality of life was positive. CONCLUSION: The proposed conceptual model was supported. College students' counseling staff could use the findings to better address students' needs pertinent to psychological health and quality of life. Future research is warranted to develop a more comprehensive model that explains the role of health literacy in determining college students' psychological health and quality of life.

Validation of the Arabic version of the center for epidemiologic studies depression-revised: A comparison of the CESD-R and CESDR-12.

BACKGROUND: The Center for Epidemiologic Studies Depression-Revised (CESD-R) is a widely used tool to screen for depression in the general population. An Arabic version of the CESD-R has not yet been translated and validated. Thus, this article reports the findings of two studies that were conducted to examine the psychometric properties of the Arabic version of the CESD-R. METHODS: Both studies were conducted using cross-sectional designs among college students from two large universities in Jordan. A total of 988 students were recruited from University A and 251 from University B. Data were collected using self-report measures of depression, perceived stress, and quality of life. Exploratory factor analysis was performed followed by a series of confirmatory factor analyses to compare different versions of the Arabic CESD-R. Measurement invariance was performed across both samples and gender of participants. RESULTS: The analyses revealed that the goodness-of-fit indices for the 20-item version of the Arabic CESD-R are not supported. Alternatively, a shorter version (CESDR-12) was created and the results supported its reliability, validity, and measurement invariance. This version, compared to a 10-item version, is supported theoretically as the items are more reflective of the DSM-V criteria for diagnosing depression. LIMITATIONS: The specificity and sensitivity of the CESDR-12 were not evaluated in this article. CONCLUSION: The Arabic CESDR-12 is a reliable, valid tool to screen for depression. Considering the prevalence and potential consequences of depression among college students, this tool could be used to identify those at risk and provide timely counseling and interventions.

Health literacy: exploring disparities among college students.

BACKGROUND: Health literacy is a multidimensional concept that is considered a primary public health concern. This concept is often neglected in research, and the evidence regarding health literacy in college students is limited. The aim of this study was two-fold: to determine the needs and limitations of health literacy among college students and to explore the relationships among the nine dimensions of health literacy and sociodemographic factors, including age, gender, nationality, year of study, field of study, smoking status, history of chronic diseases, use of on-campus gym, and the intention to exercise on-campus. METHODS: This study was conducted using a cross-sectional approach. A total of 520 college students participated in this study. The average age was 21.03 years (SD = 2.29), with 47.5% males and 52.5% females. Data were collected using a demographics questionnaire and the Health Literacy Questionnaire (HLQ). In addition to descriptive statistics, multivariate analysis of variance (MANOVA) and follow-up analyses were performed to explore any statistically significant mean differences among levels of health literacy and sociodemographic factors. RESULTS: The levels of health literacy on the nine HLQ scales were lower than the levels reported in the literature. Multivariate analysis showed a significant effect of age, gender, smoking status, year of study, and field of study on the level of health literacy. Follow-up analyses revealed that female students, students from the health-related faculties, and those who do not smoke have higher levels of health literacy compared to their counterparts. A detailed comparison between the levels of the HLQ scales was made based on students' demographic characteristics. The field of study had the most prominent effect on the level of college students' health literacy; mean differences were statistically significant (p < .001), and effect sizes were large (ranging from .66 to 1.35 for the nine scales of the HLQ). CONCLUSION: College students' health literacy is influenced by demographic characteristics. Such variations could amplify some of the existing health disparities. The implications of the findings on health, health promotion, and interprofessional education are discussed.