Factors Influencing University Students' Acceptance to Undertake the COVID-19 Vaccine in Jordan.

Vaccines are effective measures that can mitigate the high burden of diseases. However, vaccine refusal poses serious challenges for achieving coverage for population immunity. With the availability of coronavirus disease-2019 (COVID-19) vaccines, limited information is available about the university students' acceptability and attitudes toward COVID-19 vaccines. This article reports study findings regarding factors that influence university students' decision of acceptability to the COVID-19 vaccine in Jordan. Results highlight the continued need for clear and consistent information about the vaccine by health care decision-makers and university administrations.

Postoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction.

BACKGROUND: Unrelieved postoperative pain contributes to soaring medical costs and poor quality of life. Whilst much has been written about postoperative pain prevalence in the literature, few empirical studies have explored pain care in Middle Eastern countries. AIMS: This study aimed to determine pain prevalence, its characteristics, beliefs and satisfaction among postoperative patients in Jordan. DESIGN: This is a descriptive survey design. SETTINGS: This study was conducted in a 200-bed Jordanian public hospital located in the southern province of Jordan. PARTICIPANTS: A convenient sample of 143 surgical patients was selected. METHODS: Data were collected by the American Pain Society Patient Outcomes questionnaire, Brief Pain Inventory scale and beliefs towards pain scale. Data were analyzed using SPSS version 21. RESULTS: Pain prevalence following surgery during the first 24 hours was 87%. The overall Mean of satisfaction of all participants was moderate (66.6%). The analysis found that the greatest interference of pain was with activity (Mean ± SD = 6.27 ± 3.30). The belief "people get addicted to pain medicine easily" was the most common misunderstanding (Mean ± SD = 3.48 ± 1.71). Male participants had worse average pain experience but were more satisfied with pain management than females (ps = .012, .017, respectively). Participants aged 30 or more had better pain management experience and satisfaction than those aged under 30 (p = .021). CONCLUSIONS: The study revealed high pain prevalence among surgical patients that remains undertreated. If patients' postoperative environment is to be a "Pain Free Zone", nurses' training programs and the application of various screening tools in the postoperative context taking into account the role of gender and culture are urgently needed.

Using Opioids With Surgical Patients: Nurses' Attitudes and Experiences.

Opioids such as morphine are effective analgesics and have been recognized worldwide for many years; yet, they are underutilized. The study explores the attitudes and experiences relating to opioids, in general, and morphine, in particular, among Jordanian surgical nurses. The Opioids Attitudes Scale was used. A total of 123 questionnaires were distributed, and 120 were returned, achieving a response rate of 96%. Focus group discussions (n = 4) were conducted with surgical nurses (n = 34). The majority of nurses believe that the addiction is the most serious side effects of opioids. Qualitative analysis revealed 2 major themes. The first theme was referred to as "not being in the same boat," highlighting a lack of teamwork, and comprised 2 subthemes: blame culture and physicians versus nurses. The second "morphine as the last on the list" was also made up of 2 subthemes: the lack of confidence and the fear of legal persecution. Nurses showed negative attitudes and misconceptions about opioids and morphine use within a fragmented surgical unit culture. Therefore, serious efforts must be made to create and sustain an effective unit culture reform and communications path from patient to nurse and doctor.

Nurses' Knowledge, Attitudes, and Barriers Toward Pain Management Among Postoperative Patients in Jordan.

PURPOSE: The purpose of this study was to measure nurses' knowledge, attitudes, and barriers regarding pain management (PM) of postoperative patients in Jordan. DESIGN: A descriptive survey research design was used. METHODS: This descriptive study adopted a modified version of the "Knowledge and Attitudes Survey Regarding Pain" tool, administered to 120 nurses working in surgical wards. FINDINGS: Nurses had inadequate knowledge of PM, with a mean knowledge score of 63.9%. Knowledge of PM and attitudes toward PM were associated positively with the age of the participant (P = .001), years of experience in the surgical area (P = .026), and academic degree of participants (P = .026). CONCLUSIONS: Surgical nurses in this study had low knowledge levels and poor attitudes regarding PM in postoperative patients. Unless identified barriers to PM are seriously addressed, this vital aspect of holistic care will continue to be marginalized.

Disordered eating in Jordanian adolescents.

BACKGROUND: Disordered eating attitudes and behaviours are linked to poor physical and psychological outcomes. AIM: To examine the individual, psychological, and socio-cultural factors associated with disordered eating attitudes among Jordanian adolescents. METHODS: A stratified sampling method was used to select school students aged 15 to 18 years from three governates in Jordan in 2013/2014. Participants filled out questionnaires on socio-demographic variables, the Eating Attitudes Test (EAT-26; to discriminate adolescents with disordered eating); the Body Shape Questionnaire (BSQ; used to measure psychological factors associated with disordered eating); Body Mass Index was calculated and obesity evaluated according to international cut off points (to categorize normal weight, overweight, and obese adolescents, and these categories were used as individual factors associated with disordered eating). RESULTS: A total of 963 (460 boys and 503 girls) participated in the study. Disordered eating (EAT score ≥ 20) was present in 389 (40.4%); body shape dissatisfaction (BSQ scores ≥110) was present in 161 (16.8%). Overweight and obesity were found in 332 (34.5%) participants. Unhealthy weight loss behaviours (such as self-induced vomiting, substance abuse, and smoking) were very common. Multivariate logistic regression analysis demonstrated that female sex, urban residence, distorted perceptions of weight, BMI (excess weight), body dissatisfaction, and socio-cultural variables (parents, peers and mass media) were significantly associated with disordered eating. CONCLUSION: Jordanian urban adolescents seem to embrace Western norms to fit in with the demands of Western culture. Socio-cultural factors, particularly mass media, play a significant role in changing adolescents' norms. Prevention and intervention programs are needed to control these disorders.

Impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes: Randomized controlled trial.

AIMS: The primary aim of this study was to evaluate the impact of pharmaceutical care interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes patients in Jordan. METHODS: A randomized controlled clinical trial was conducted on 106 patients with uncontrolled type 2 diabetes seeking care in the diabetes clinics at Jordan University Hospital. Patients were randomly allocated into control and intervention group. The intervention group patients received pharmaceutical care interventions developed by the clinical pharmacist in collaboration with the physician while the control group patients received usual care without clinical pharmacist's input. Fasting blood glucose and HbA1c were measured at the baseline, at three months, and six months intervals for both intervention and control groups. RESULTS: After the six months follow-up, mean of HbA1c and FBS of the patients in the intervention group decreased significantly compared to the control group patients (P<0.05). Also, the results indicated that mean scores of patients' knowledge about medications, knowledge about diabetes and adherence to medications and diabetes self-care activities of the patients in the intervention group increased significantly compared to the control group (P<0.05). CONCLUSIONS: This study demonstrated an improvement in HbA1c, FBS, and lipid profile, in addition to self-reported medication adherence, diabetes knowledge, and diabetes self-care activities in patients with type 2 diabetes who received pharmaceutical care interventions. The results suggest the benefits of integrating clinical pharmacist services in multidisciplinary healthcare team and diabetes management in Jordan.

Predictors of non-adherence to follow-up visits and deferasirox chelation therapy among jordanian adolescents with Thalassemia major.

Poor adherence to treatment can have negative effects on outcomes and heath care cost. However, little is known about the factors that impact adherence to deferasirox chelation therapy. The aims of this study were to identify rates and predictors of non-adherence to medical regimen among thalassemia major adolescents on deferasirox oral chelation therapy by using subjective (self-reporting) and objective (serum ferritin and follow-up visits) measures. Convenient samples of 164 adolescents, aged 12-19 years were recruited from three National Thalassemia Centers in Jordan. Patients were interviewed using a four-section questionnaire and the medical records were checked. Results indicated that rate of adherence according to self-report was (73%); while to follow-up medical appointments and serum ferritin level rates was 57% and 47%, respectively. One-third of participant adolescents (n = 52) were psychologically impaired. Multivariate analysis showed that factors affecting adolescent non-adherence to deferasirox chelation therapy is different from that affecting adherence to follow-up visits. In general, adolescents more than 16 years old, presence of sibling with thalassemia, lack of parental monitoring, lower family income, decrease frequency of blood transfusion, and psychological impairment were found significant predictors of non-adherence among adolescents. Disease knowledge was not associated with adherence status of the adolescents. Clinician should be aware of high prevalence of low adherence to chelation therapy during adolescent years. Nurses need to regularly assess, monitor, and promote adherence behavior that might impact patients' outcomes.

Diabetes awareness and diabetes risk reduction behaviors among attendance of primary healthcare centers.

AIMS: The aims of this study were to assess level of awareness about diabetes and the level of adoption of diabetes risk behaviors among adult attending primary healthcare centers. METHODS: A cross-sectional descriptive study was conducted using a self-administrated questionnaire. In addition to demographic information, the questionnaire contained questions on diabetes awareness related to diabetes definition, symptoms, risk factors, complications and management of diabetes as well as questions on diabetes risk reduction behaviors and sources of information on diabetes. The data was analyzed with independent t-test, Pearson's correlation coefficient, and ANOVA test. RESULTS: A total of 541 participants aged ≥ 18 years were recruited. The mean score of diabetes awareness was 27.5/40 [SD=5.7]. The participants performed best in symptoms section with a mean score of 6.3/8 [SD=1.6], and worst in the risk factors section with a mean score of 3.6/6 (SD=1.4). With respect to diabetes risk reduction behaviors the results showed that the highest mean score was for fat reduction 2.0/4 [SD=0.8]; and the lowest mean score was for weight control or losing 1.7/4 [SD=0.8]. CONCLUSIONS: The current study demonstrated that substantial numbers of adult Jordanian lack the sufficient awareness about diabetes to prevent and cope with the increasing prevalence of diabetes in Jordan. Also, it demonstrated that adoption of diabetes risk reduction behaviors was suboptimal. Raising public awareness of diabetes and diabetes risk reduction behaviors through population-based programs and mass media should be planned and implemented.

Knowledge and attitudes regarding pain management among Jordanian nursing students.

BACKGROUND: The presence of pain is one of the main reasons why people seek health care, however pain is often undertreated. Inadequate treatment has been linked to health care professionals' failure to assess pain and to intervene appropriately. It may also result from the limited attention given to pain management in nursing curricula. OBJECTIVES: The objectives of this study were to explore the current knowledge and attitudes regarding pain management among baccalaureate nursing students and the factors that might influence such knowledge and attitudes, and nursing students perceived barriers to adequate pain management during clinical practice. METHODS: The descriptive design included a sample of 240 baccalaureate nursing students in three nursing schools in three governmental universities in Jordan. The Knowledge and Attitudes Survey Regarding Pain scale was used to measure knowledge and attitudes regarding pain management. Data were analyzed by descriptive statistics and independent sample t test. Data were collected over a period of three months from April 2012 to June 2012. RESULTS: Of the 340 distributed questionnaires; 240 completed questionnaires were returned. The data showed that nursing students were found to have inadequate knowledge and attitudes related to pain and its management. The mean correct score for the entire scale was 34.1%. (SD=9.9). Findings revealed that there were significant differences found in the students' scores related to pain management training and frequency of using pain assessment tools (p<0.05).The most frequently identified barriers were lack of knowledge and training regarding pain management followed by not using pain assessment tools by nurses who are working in the clinical areas. CONCLUSION: The study findings demonstrated that nursing students have insufficient knowledge and attitudes regarding pain and its management and could benefit from additional education and training on that issue.

Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus.

OBJECTIVE: The objective was to evaluate the relationships between diabetes management self-efficacy and diabetes self-management behaviors and glycemic control. METHODS: A cross-sectional design was used. A convenience sample of 223 subjects with type 2 diabetes, ≥25 years old, who sought care at the National Diabetes Center in Amman, Jordan, was enrolled. A structured interview and medical records provided the data. The instruments included a sociodemographic and clinical questionnaire, a diabetes management self-efficacy scale, and a diabetes self-management behaviors scale. Glycosylated hemoglobin was used as an index for glycemic control. The analyses are presented as proportions, means (±S.D.), odds ratios, and 95% confidence intervals obtained from logistic regressions. RESULTS: Diet self-efficacy and diet self-management behaviors predicted better glycemic control, whereas insulin use was a statistically significant predictor for poor glycemic control. In addition, subjects with higher self-efficacy reported better self-management behaviors in diet, exercise, blood sugar testing, and taking medication. The findings showed that more than half of the subjects did not have their diabetes under control and that only 42% had attended diabetes education programs. CONCLUSIONS: The majority of subjects did not have their diabetes controlled; their self-efficacy was low, and they had suboptimal self-management behaviors. Therefore, strategies to enhance and promote self-efficacy and self-management behaviors for patients are essential components of diabetes education programs. Furthermore, behavioral counseling and skill-building interventions are critical for the patients to become confident and be able to manage their diabetes.