The impact of applying unfolding case-study learning on critical care nursing students' knowledge, critical thinking, and self-efficacy; a quasi-experimental study.

BACKGROUND: The unfolding case-study learning approach is a growing modernized learning strategy implemented in different health disciplines. However, there is a lack of existing research that examines the effects of unfolding case studies in advanced nursing courses. AIM: To examine the impact of applying an unfolding case-study learning approach on critical care nursing students' knowledge, critical thinking, and self-efficacy. METHODS: This posttest-only, quasi-experimental study was conducted at XXX University in Palestine. A single-stage cluster sampling was used to assign nursing students enrolled in the critical care nursing course into experiment and conventional groups. The intervention group (n= 91) underwent unfolding case-study learning for selected cardiovascular topics, whereas the conventional group (n= 78) was taught using the traditional teaching methods. The posttest assessment was conducted using Knowledge Acquisition tests, Yoon`s Critical Thinking Disposition Instrument (YCTD), and the Self-Efficacy for Learning and Performance instruments. The Social Constructivist Theoretical Framework was integrated into the study. RESULTS: Homogeneity was achieved between both groups concerning Age, Gender, and GPA. The experiment group scored significantly higher than the conventional group regarding the posttest knowledge acquisition tests (7.12 vs. 5.49, respectively, t=-12.7, P<0.001, CI: -1.89 to -1.38), critical thinking (4.32 vs. 3.63 respectively, t=17.390, p<0.001, CI: -77 to -61) and self-efficacy (6.12 vs. 4.4 respectively, t=-30.897, p<0.001, CI: -1.82 to -1.60). Multivariate analysis revealed that 69 % of the variations of posttest scores were influenced by critical thinking scores (Adjusted R Squared=0.690, F=3.47, P=0002, η2=0.969). Similarly, self-efficacy has been shown to contribute by 74 % to the variations of scores after conducting the study program (Adjusted R Squared=0.743, F=4.21, P=0001, η2=0.974). However, the variations of both critical thinking and self-efficacy scores were not significantly influenced by the contribution of knowledge acquisition (p=0.772 and 0.857, respectively) and students' GPA (p=0.305 and 0.956, respectively). CONCLUSIONS: Irrespective of knowledge level and GPA, the unfolding case-study learning approach can enhance the critical thinking and self-efficacy of students enrolling in advanced nursing courses.

The Impact of Work Environment on Structural Empowerment among Nurses in Governmental Hospitals.

BACKGROUND: The work environment is considered an important factor for the success of any healthcare organization that keeps upstanding and can compete with others to achieve the organization and employee's goals. This study aims to examine the effect of the workplace environment on the structural empowerment of registered nurses in governmental hospitals. METHODS: A cross-sectional, descriptive survey study. The sample consisted of 405 nurses from three Jordanian governmental hospitals. Data were collected using an online self-reported questionnaire that was distributed to the participants. The questionnaire included sections on demographic characteristics, the structural empowerment scale, and the work environment scale. Data collection took place between 1 January 2023 and 15 February 2023. RESULTS: The participants demonstrated various levels in their perceptions of the working environment. They demonstrated a moderate perception level toward stress and work pressure, role clarity, peer cohesive subscale, and for working environment scale while they reported a low perception level on ethical, autonomy, work practices, managerial support, commitment, and social responsibility subscales. However, the nurses' work environment overall score was found to be at a moderate level (3.15 out of 5 ± 0.61). Furthermore, their structural empowerment level was found to be at a moderate level (19.40 out of 30 ± 3.68). CONCLUSIONS: Highly empowered nurses' work environments display higher structural empowerment. Applying structural empowerment in work environments is very important to improve nurses' performance, ensure the highest level of patient care quality, and achieve organizational goals.

Perceived Relationship Between Horizontal Violence and Patient Safety Culture Among Nurses.

Objective: Despite the value of undertaking patient safety culture, its association with horizontal violence in nursing workplace is still understudied. This study aimed to investigate the association between the perceived patient safety culture and its relationship with horizontal violence among nurses working in Jordan. Methods: A cross-sectional correlational design was used. Nurses working in major governmental hospitals in Jordan were conveniently recruited to complete an online self-administered questionnaire, which included the following tools: Hospital Survey on Patient Safety Culture and Negative Behaviours in Healthcare (NBHC) Survey. The survey was designed to measure attitudes and perceptions on patient safety culture at multiple levels of a healthcare organization with ten dimensions. The Negative Behaviours in Healthcare (NBHC) survey was developed as an adaptation of the Lateral Violence in Nursing Survey (LVNS) with 25 items and two open-ended questions. Results: A total of 330 nurses responded to the questionnaire. Nurses moderately perceived patient safety culture (HSOPS mean = 3.5, SD = 1.1). Low incidence of horizontal violence was claimed (mean = 2.1, SD = 1.1). However, it was associated with moderate negative correlation with patient safety culture (r = -0.53, p < 0.001). Regression model revealed that patient safety culture explained an additional 53% of the variance of horizontal violence after controlling the effects of age and length of clinical experience (R-square change: 0.560, SE: 19.7, P: 0.001, CI: 1.21-1.57). Conclusion: Despite its low incidence, patient safety culture was found influential to the horizontal violence based on the perspectives of nurses in Jordan. Patient safety culture can be incorporated with other factors that contribute to the development of horizontal violence in nursing workplace.

Jordanian nurses' attitudes toward using electronic health records during COVID-19 pandemic.

Electronic health records (EHRs) have proven their effectiveness during the coronavirus disease (COVID-19) pandemic. However, successful implementation of EHRs requires assessing nurses' attitudes as they are considered the first line in providing direct care for patients. This study assessed Jordanian nurses' attitudes and examined factors that affect nurses' attitudes toward using EHRs. A cross-sectional, correlational design was used. A convenient sample of 130 nurses was recruited from three major public hospitals in Jordan. All Participants completed the Nurses' attitudes Towards Computerization (NATC) Questionnaire. The overall nurses' attitude was positive; the mean was 61.85 (SD = 10.97). Findings revealed no significant relationship between nurses' attitudes toward using EHRs and nurses' age, gender, education level, previous computer skills experience, years of work experience, and years of dealing with EHRs. However, the work unit was found to have a significant correlation with nurses' attitudes toward using EHRs. Therefore, nurse administrators should arrange for the conduct of educational workshops and continuous training programs considering the needs of the nurses.

The Lived Experience of Jordanian Persons With a Stoma: A Qualitative Study.

Individuals may live with an intestinal stoma either temporarily or for the rest of their lives. The purpose of this study was to understand the lived experience of Jordanian persons living with a stoma. Qualitative design was employed via semistructured interviews with 22 Muslim participants who had an intestinal stoma. Thematic analysis of the transcripts resulted in 3 main themes. The first core theme was stoma burden, which represented difficulties and challenges resulting from the creation of a stoma. This theme was divided into 4 subthemes: physical, self-care, social, and psychological burdens. The second theme was the adaptation to a stoma, whereas the third theme was suggestions for healthcare providers to decrease stoma burden. Conclusively, these themes conveyed that the presence of supportive family members and qualified healthcare providers can decrease the burden of a stoma. Generally, persons with a stoma (ostomates) experienced stoma-related physical, social, psychological, and financial burdens. Therefore, ostomates were in need of training, psychosocial therapy, and more follow-ups to prevent and treat stoma complications and adapt to living easily with the stoma.

Weaning practices of Jordanian mothers: A qualitative study.

Weaning is an essential process to meet the nutritional demand of the growing infant. The aim of this study was to explore the weaning practices used by Jordanian mothers to wean their infants from breastfeeding. A qualitative exploratory approach was used in this study. Six focus group discussions were conducted in three maternal child health centres in Zarqa city, Jordan, with 35 participants, who were selected purposefully. Interviews were audiotaped and transcribed verbatim. Transcripts were analysed using the process of thematic analysis. Five major themes emerged; these included 'Reasons for weaning', 'Confusion and challenges experienced with weaning', 'Lack of instructions', 'Methods of weaning' and 'Psychological impact on mothers'. The study showed that weaning infants yielded a set of obstacles while shifting to solid foods. Guilt, fear of complications and lack of self-confidence were emotions that emerged during the weaning process. All mothers complained of a lack of health education regarding weaning of infants. Health education by healthcare providers about weaning practices utilising official weaning guidelines is a highly appreciated and validated approach to help mothers facing challenges associated with weaning. Choosing the appropriate time of weaning, food choices, determining the amount and consistency of food, and dealing with discomfort associated with weaning are issues that must be discussed with mothers by health professionals.

Nurses' experiences of psychosocial care needs of children with thalassaemia and their families in Jordan: A phenomenological study.

AIM: To explore the experiences of Jordanian nurses regarding the psychosocial care needs of children with thalassaemia and their families. DESIGN: A descriptive phenomenological approach was employed. METHODS: A purposive sampling strategy was used to select 10 nurses who had experience in caring for children with thalassaemia. Unstructured, face-to-face interviews were conducted. Coliazzi's data analysis process was applied. RESULTS: The analysis revealed three major themes: (1) valuing psychosocial support; (2) caring for paediatric patients needs certain competencies in nurses and (3) barriers to providing psychosocial care. Nurses expressed the importance of providing psychosocial care. A lack of specialists in psychosocial care as well as a lack of screening tools, and entertainment facilities for children was identified to be impeding effective psychosocial care. Implementing training programmes for nurses concerning providing psychosocial care and making the appropriate changes in nursing curricula at the educational level are recommended.

Experiences of first-line nurse managers during COVID-19: A Jordanian qualitative study.

AIM: The aim of this study is to explore the experiences of Jordanian first-line nurse managers during COVID-19. BACKGROUND: Nurses are exposed to life-threatening occupational risks during COVID-19. Exploring the first-line nurse managers' experiences will help in designing health policies to better deal with such emerging crises. METHODS: A descriptive phenomenological study was conducted. A purposive sample was used to recruit 16 first-line nurse managers from Jordanian hospitals. Semistructured interviews were conducted. Phenomenological data analysis method was used to analyse the data. RESULTS: Four major themes emerged: (a) unprecedented pressure (first-line nurse managers revealed their suffering with the unprecedented demanding situations during COVID-19 pandemic); (b) strengthening system and resilience (nurse managers employed several strategies to strengthen the health system and enhance resilience); (c) building a supportive team (the presence of a robust supportive system is vital to deal with the pandemic); and (d) maturity during the crisis (exposure to a new experience developed nurse managers management skills and self-awareness). CONCLUSIONS: The unprecedented pressure associated with COVID-19 drained first-line nurse managers physically and psychosocially. Providing adequately trained staff and medical equipment is important to better deal with crises. IMPLICATIONS FOR NURSING MANAGEMENT: Strengthening emergency training and improving emergency response plans of hospitals are essential.

The transactional model of stress and coping as guidance for understanding adolescent patients' experience with thalassemia: Case report.

PURPOSE: This case report investigated the transactional model of stress and coping as guidance for nursing care of an adolescent patient with thalassemia. SOURCES USED: A case study of a 15-year-old female patient with ß-thalassemia major. Data were collected using patient medical records, an interview with the patient and physical examination. RESULTS: Four issues related to coping were isolated: Worsening physical symptoms; psychosocial consequences, coping process, and building supportive networks. These issues and the patient's adaption are explored via the transactional model. CONCLUSIONS: Having thalassemia was cognitively appraised by the patient as a stressful and taxing situation with detrimental consequences, such as changes in physical appearance, stigmatization, and depression. Nurses should evaluate each patient's physical and psychosocial needs, utilizing appropriate theoretical models for designing a suitable care plan. As the case study demonstrates, the transactional model was an effective guide for nurses in planning care of an adolescent patient with thalassemia.

Beliefs and Adherence Associated With Oral and Infusion Chelation Therapies in Jordanian Children and Adolescents With Thalassemia Major: A Comparative Study.

The researcher assessed the beliefs and adherence associated with both oral deferasirox and deferoxamine infusion chelation therapies among Jordanian children with thalassemia major, and compared the adherence levels between the recipients of each. In this descriptive cross-sectional study, 120 participants were recruited from 3 major thalassemia treatment clinics in Jordan using convenience sampling. Data were collected through questionnaires on demographic- and disease-related information, the beliefs about medicines, and a medication adherence report scale. Most participants showed a high adherence to deferoxamine infusion and oral deferasirox (87.20% and 89.08%, respectively), and believed in the necessity of deferoxamine for maintaining health (89.34%). However, 41.32% of the participants had strong concerns about deferoxamine use. While most participants believed in the need for oral deferasirox (89.84%), about 40.7% had strong concerns about its use. An independent samples t test showed no statistically significant difference in the adherence between the oral deferasirox and infusion deferoxamine recipients (t=1.048, DF=118, P=0.075). Jordanian children with thalassemia have positive beliefs and adherence to both oral and infusion chelation therapies. Health care providers should pay attention to patients' beliefs and discuss the major concerns pertaining to iron chelation therapy with them to enhance the continuity of adherence therapy.

Challenges of having a child with thalassaemia major: a phenomenological study.

Thalassaemia major is a chronic inherited illness that requires everlasting treatment with blood transfusions and chelating drug therapies. Primary caregivers, especially mothers, encounter many challenges when dealing with their affected child. This study aimed to explore challenges facing Jordanian mothers when having a child with thalassaemia major. A descriptive phenomenological approach was used. Mothers were selected purposefully from two major thalassaemia treatment clinics in Jordan. Semi-structured, face-to-face interviews were conducted and supported by a pre-prepared interview agenda. Colaizzi's process of descriptive phenomenology was used for analysing interviewees' transcripts. A total of 23 Jordanian mothers joined the study. A number of formulated meanings, categories and clusters of themes were instrumental in the emergence of three main themes: 'unprecedented psychosocial distress', 'additional financial burden' and 'deficiency of knowledge and its sources'. The study revealed that rearing a child with thalassaemia entails suffering from different forms of challenges. Psychological distress, social isolation, worries, and fear of the disease and its future consequences were reported. Mothers showed that the added financial burden resulting from frequent hospitalisation and unpaid leave was a challenge. Deficiency in knowledge, including lack of knowledge about the disease and lack of sources of knowledge, was another challenge. Health education is a highly acknowledged and valued approach to lowering distress and challenges associated with rearing a thalassaemic child.