Moderating role of relationships between workloads, job burnout, turnover intention, and healthcare quality among nurses.

BACKGROUND: In Jordan, nurses consider a primary providers of direct patient care, and play a multifaceted role in ensuring healthcare quality. The study aimed to examines the moderating effect of job satisfaction in the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. METHODS: A cross-sectional research approach was adopted among 311 from Registered Nurses (RN) across Jordanian hospitals. Job satisfaction, workload scale and job burnout scale were shared between March and April 2023. RESULTS: The overall findings indicate that workload, job burnout, and turnover intention are negatively and significantly related to healthcare quality, and that job satisfaction moderates the relationship between workload and healthcare quality, job burnout and healthcare quality, and turnover intention and healthcare quality. These findings have broad implications for healthcare organizations, emphasizing the pivotal role of job satisfaction in mitigating the negative effects of workload, burnout, and turnover intentions among nurses. CONSULSION: Strategies to enhance job satisfaction, such as reducing work-related stress and fostering supportive work environments, should be prioritized by healthcare policymakers and institutions to ensure the delivery of high-quality patient care.

Knowledge and practice of informal caregivers on pressure injury prevention and treatment among patients receiving palliative care.

BACKGROUND: Pressure injuries (PIs) are prevalent in palliative care. Lack of knowledge and skills among informal caregivers on PI prevention and management contributes significantly to the occurance or deterioration of PIs. AIM: The aims of this study were to: (1) determine the level of knowledge and practices of informal caregivers on PI prevention and treatment; (2) explore the socio-demographic characteristics of informal caregivers that influence PI prevention and treatment among patients who need palliative care. METHODS: The quantitative cross-sectional descriptive design was used to collect data from 146 informal caregivers, and a valid and reliable questionnaire was used. RESULTS: A total of 146 informal caregivers of patients with PI completed the study. Most participants had a relatively low level of PI prevention, treatment knowledge and practice. Participants who were older than 28 years, working for the government and married had significantly better knowledge and practice of PI prevention and treatment than other participants. CONCLUSION: Information for informal caregivers in different settings about PI prevention and treatment is needed. Informal caregivers need to acquire more professional practices and knowledge to improve the quality of patient care.

Using primary healthcare facilities and patients' expectations about triage system: Patients' perspective from multisite Jordanian hospitals.

BACKGROUND: Using primary healthcare facilities can decrease the tension and workload in emergency departments (EDs). This study aim to examine the patient's use of primary healthcare facilities before EDs visits and their expectations about the triage. METHODS: A cross-sectional design was utilized in at various EDs in different hospitals. A convenience sample of 726 patients were enrolled and completed a self-administrated questionnaire. RESULTS: The mean age of the participants was 38.1 (SD = 12.9). Most participants (68.2 %) did not have primary care physicians and did not want to know how long other patients waited (61.4 %). There are significant relationships between participants' desired to know how long other patients have been waiting and their age (X2 = 4.02, P < .05), education level (X2 = 13.5, P < .001), and current job (X2 = 9.90, p < .05). Also, periodic updates from EDs staff about the delays were significantly related to participants' age (X2 = 3.29), current job (X2 = 28.4), marital status (X2 = 8.93), and residency place (X2 = 9.94). CONCLUSION: Educating patients about the triage system and the importance of using primary healthcare facilities is recommended to reduce ED waiting times and overload.

Expectations of emergency patients regarding triage system knowledge upon arrival: an interpretive study.

BACKGROUND: One of the most important aspects of healthcare knowledge is having a thorough understanding of the triage system which is used in emergency departments. This study aims to assess the level of awareness of Jordanian patients who visit the ED about the triage procedure. METHODS: A descriptive, cross-sectional design was utilized in the emergency department at the biggest public hospital in Jordan. A convenience sample of a self-administrated questionnaire utilizing a Discounted Cash Flow Interview (DCF) survey was filled out. RESULTS: A total of 726 participants were recruited with a response rate of 90.8%. The mean age of the participants was M = 38.1 (SD = 12.9), and the age of the participants varied from 18 to 89 years. More than half of the participants were male (n = 383, 52.8%) and married (n = 425, 58.5%). A significant relationship between the overall perception of knowing what a teaching hospital is and patients' educational level (X2 = 11.9, P < 0.003), current job (X2 = 25.2, P < 0.001), nationality (X2 = 7.20, P < 0.007), and family income (X2 = 15.9, P < 0.001). CONCLUSION: More investigation is required to determine the causes of the low knowledge of the triage system. The study suggests increasing staffing levels, giving nursing staff ongoing education and training, and integrating technology and automation to reduce the load of patient care.

The Relationship Between Patients' Overall ICU Experiences, Psychological Distress, and Sleep Quality Among Jordanian Burn Patients: A Cross-Sectional Study.

Objectives This study aimed to assess patients' experiences, psychological distress, and sleep quality among Jordanian burn patients. Method A cross-sectional, correlational design was used. A sample of 150 patients admitted to the burn-specific intensive care unit completed the study. Demographical data, Intensive Care Experience Questionnaire, and sleep ICU questionnaire were used for data collection. Descriptive and inferential statistics were used for analysis. Results Participants were found to have poor sleep quality and severe psychological distress. Sleep quality was negatively associated with awareness of ICU experience (r = -.190, P = .020) and psychological distress (r = -.190, P = .020) and positively associated with the recall of experience in ICU. Female participants had significantly greater ICU experience frightening and recall. Participants who experienced burn complications had significantly higher psychological distress. Discussion There is a need to offer an encouraging environment to burn patients to improve the psychological health and sleep quality in critical care units.

How Does Perceived Social Support, Mindfulness, and Coping Strategies Influencing Death Anxiety Among Patients With Tuberculosis.

Objective: This study aimed to assess the relationship between coping strategies, social support, mindfulness, and death anxiety among TB survivors. Methods: A descriptive, cross-sectional design was used. A convenience sample of 120 adult patients diagnosed with TB were enrolled from public hospital. Results: The patients had moderate death anxiety (M = 45.3, SD = 6.88). However, TB patients reported high perceived coping strategies, great social support, and dispositional mindfulness. The death anxiety was negatively associated with mindfulness (r = -0.211; p < .05) and with perceived social support (r = -0.368, p < .05). Attention awareness to living activity, perceived social support, type of TB, and duration of treatment were predicted the participants' death anxiety. Conclusions: The presence of death anxiety among TB patients is a significant and tangible issue that can significantly impact their overall well-being. Addressing this concern is pivotal for their mental resilience, treatment adherence, and overall recovery.

The experience of patients with hematological malignancy in their terminal stage: a phenomenological study from Jordan's perspective.

BACKGROUND: Patients diagnosed with hematological malignancies residing in low-middle-income countries undergo significant physical and psychological stressors. Despite this, only 16% of them receive proper care during the terminal stages. It is therefore crucial to gain insight into the unique experiences of this population. AIM: To have a better understanding of the needs and experiences of adult patients with advanced hematological malignancy by exploring their perspectives. METHODS: A qualitative interpretive design was employed to collect and analyze data using a phenomenological approach. The study involved in-depth interviews with ten participants aged between 49 and 65 years, utilizing a semi-structured approach. RESULTS: Two primary themes emerged from the participants' experiences of reaching the terminal stage of illness: "Pain, Suffering, and Distress" and "Spiritual Coping." The first theme encompassed physical and emotional pain, suffering, and distress, while the second theme was centered on the participants' spiritual coping mechanisms. These coping mechanisms included seeking comfort in religious practices, relying on spiritual support from family and friends, and finding solace in their beliefs and faith. CONCLUSION: Patients with hematological malignancies in the terminal stages of their disease experience severe pain, considerable physical and psychosocial suffering, and spiritual distress. While they require support to cope with their daily struggles, their experiences often go unnoticed, leading to disappointment and loss of dignity. Patients mainly rely on their spirituality to cope with their situations. Healthcare providers must acknowledge these patients' needs and provide more holistic and effective care.

Mindfulness, Social Support, and Psychological Distress Among Jordanian Burn Patients.

Burn is associated with psychological distress, anxiety, and depression. Social support and mindfulness are considered a strength source for postburn survivors to resume their daily living activities. There is a lack of literature that supported the direct impact of mindfulness on social support and psychological distress among burn survivors. The aim of this study is to examine the impact of mindfulness and social support in enhancing the psychological well-being of burn survivors in Jordan. A cross-sectional descriptive design and convenience sampling technique were utilized to meet the study goal. A self-reported questionnaire was completed by a sample of 212 burn survivors. The questionnaire consists of 3 tools to measure psychological distress, social support, and mindfulness. A significant correlation was found between social support and psychological distress among the Jordanian burn survivors. Mindfulness revealed a distinctive variance in psychological distress among the study participants. In addition, some sociodemographic and clinical data have a relationship with psychological distress. Several factors among burn survivors have influenced their psychological and social support status. Also, mindfulness is important for enhancing psychological well-being and affecting the social support among burn patients.

Consequences of Psychological Aspects: From Jordanian Heart Failure Patients' Beliefs.

Introduction: Psychological aspects are common in patients with heart failure (HF). Psychological aspects have negative consequences in patients with HF. Objective: This study was conducted to gain a deeper understanding of the consequences of psychological aspects in Jordanian patients with HF. Methods: This study is a qualitative study conducted with the participation of 24 patients with HF. Data were collected using semi-structured interviews. Results: The main theme of the findings can be expressed as "Consequences of psychological aspects of HF." The following four sub-themes emerged from the data: social isolation, disturbance of feelings, being non-compliant, and growing burden on the health care system. Conclusion: The findings revealed the need for informing healthcare providers about the negative consequences of psychological aspects and develop clinical guidelines to evaluate psychological aspects to support these patients.

Amiodarone-Induced Myxedema Coma in Elderly Patients: A Systematic Review of Case Reports.

This systematic review aimed to explore whether elderly patients administered amiodarone were susceptible to developing myxedema coma. Utilizing the Cochrane guidelines, a comprehensive review of databases such as Medline (PubMed), Science Direct, CINAHL Cochrane, and Google Scholar was undertaken to examine case reports on amiodarone-induced myxedema coma. Following stringent criteria for inclusion, 12 pertinent case reports were identified. These findings suggested a high probability of myxedema coma development in patients who had been administered amiodarone. Specifically, patients who received an oral dosage of 100-200 mg of amiodarone were reported to have developed bradycardia and hypothermia alongside elevated thyroid-stimulating hormone (TSH) levels. Upon diagnosis, the majority of patients were treated with a regimen of levothyroxine and hydrocortisone medication. Despite the myriad potential causes of myxedema coma complicating the diagnosis, it was found that through a combination of clinical symptoms and serum TSH measurements, a confirmed diagnosis could be reached. Furthermore, it was observed that amiodarone-induced myxedema coma responded favorably to treatment with levothyroxine and glucocorticoids.

Constipation Severity and Quality of Life among Patients with Cancer Who Received Prophylactic Laxatives: Quasi-Experimental Study.

BACKGROUND: Prophylactic laxatives were associated with decreasing the incidence of Opioid-induced constipation among patients with cancer. This study aims to evaluate the effectiveness of early prophylactic laxatives therapy on the severity of constipation and quality of life among patients with cancer receiving opioids. METHODS: Using a quasi-experimental design with 64 patients assigned to control group and 66 patients assigned to intervention group. The final sample was composed from 112 patients (57 in control group and 55 in intervention group), who were selected from an oncology clinic. Patients in the intervention group have received prophylactical laxatives The intervention included an oral colonic stimulant laxative (i.e., Bisacodyl, Dose= 3 tab/ day and/or Senna 6.8 mg twice daily) and an oral colonic osmotic laxative (i.e., Lactulose, Dose = 15 ml three times per day). Patients in the control group continue to receive their routine care without laxatives. RESULTS: Patients in the intervention group have reported a significant reduction in the severity of constipation symptoms at eight weeks post the intervention (p < 0.001). Furthermore, the patients in the intervention group have revealed a significant improvement in their quality of life (QoL) (p< 0.001). CONCLUSIONS: Patients with cancer need to use the first line of laxatives as prophylactic alongside with opioids to minimize the severity of Opioid-induced constipation symptoms and to enhance the QoL.

Healthcare providers' intention to leave their jobs during COVID-19 pandemic: A cross-sectional study.

Background and Aims: During the coronavirus pandemic (COVID-19), healthcare providers confronted risks of disease transmission to themselves and their family members, resulting in physical and psychological burdens. This might affect their decisions to leave their jobs temporarily or permanently, fearing infection and protecting their families. This study examined the factors related to the intention to leave a job among healthcare providers during the COVID-19 pandemic in Jordan. Methods: A cross-sectional correlational design was used to collect data using a convenience sample of 557 healthcare providers working in different sectors across Jordan. Data were collected using a self-administered questionnaire about the intention to leave jobs during the pandemic. Results: The sample included 368 females (63.8%) and 209 males (36.6%) participants. The mean age of participants was 30.8 years (SD = 6.65). Differences found in intention to leave job during COVID-19 in relation to age (t = 2.60, p < 0.05), gender (X 2 = 4.25, p < 0.001), and marital status (X 2 = 18.2, p < 0.001). Participants with a high risk of exposure to COVID-19 and who experienced higher workloads had higher scores of intention to leave their job during COVID-19, while being married had lower scores. Conclusions: Policy-makers need to pay attention to young and single healthcare providers during the COVID-19 pandemic to prevent them leave their job. Crucial guidelines for managing workload during the COVID-19 pandemic are needed. Policy-makers during pandemics have to protect healthcare providers who feel they are at high risk of infection.

Systematic Review and Meta-Synthesis about Patients with Hematological Malignancy and Palliative Care.

OBJECTIVE: The current study aims to review, appraise, and synthesize the available studies and recommend the significant clinical implications for healthcare professionals to understand the existing findings of palliative care experience among patients with hematology malignancy. METHODS: After excluding the registered or ongoing systematic reviews in the PROSPERO database regarding the lived experience of palliative care among patients with HM, our systematic review and meta-analysis protocol was registered in PROSPERO [CRD42021270311]. A search for published articles in English between January 2000 and December 2020 was conducted among different electronic databases using PRISMA guidelines 2020. Meta-synthesis was accomplished using the JBI meta-aggregation method to synthesize the findings. The implemented approach involved all qualitative research and mixed-method studies that included a qualitative part. RESULTS: This review contained eight studies which led to 25 codes and seven categories. Finally, three synthesized themes were developed: (1) Approaching the end of life among patients with Hematology Malignancy, (2) submission and surrender of patients with Hematology Malignancy during their terminal stage, and (3) Entrance to the palliative care world. Therefore, realizing the importance of palliative care services to patients with Hematology Malignancy by providing evidence-based education and timely referral is crucial. CONCLUSION: There was a substantial increase in the HMs rate with late referral to palliative care services. The results of this review may draw attention to some issues reported by patients with Hematology Malignancy. Scaling up palliative care services for those patients is essential to minimize end-of-life suffering and the long-term impact of inadequate palliative care for patients with Hematology Malignancy.

Characteristics, Mortality Rates, and Treatments Received in Last Few Days of Life for Patients Dying in Intensive Care Units: A Multicenter Study.

BACKGROUND: Information is presently lacking about the end-of-life care in intensive care unit (ICU). We explored the characteristics, mortality rates, and treatments received in the last few days of life for patients who died in ICU. METHODS: This was a retrospective multicenter cohort study. We included patients who died from different medical illnesses between January 2014 and January 2017 in 8 medical ICUs across 3 major health-care systems in Jordan. Of 11 029 patients who were admitted for the study in ICUs, data from 3885 health records were retrieved and analyzed. Pediatric patients aged younger than 18 years and patients admitted to an ICU for less than 4 hours were excluded. RESULTS: The mean ICU mortality rate was 34.6% (29%-38%), with a slight decline from 2014 through 2016. Most of the patients who died were male (56.6%), transferred from the emergency department (46.8%), and had multiple comorbidities (74%). Cardiopulmonary resuscitation, invasive mechanical ventilation, pharmacological hemodynamic support, and artificial hydration were pursued until death for most patients (91.5%, 80.1%, 78.8%, and 94.1%, respectively). CONCLUSIONS: Aggressive treatment modalities were usually pursued for critically ill patients at the end of their lives. There is a need to explore further the current end-of-life care needs and practices in ICUs in Jordan and to tailor end-of-life care and management suitably to meet the needs of Islamic and Arabic cultures.