Knowledge of Coronary Heart Disease Risk Factors among a Community Sample in Oman: Pilot study.

OBJECTIVES: The aim of this study was to assess the knowledge of Omani adults regarding conventional coronary heart disease (CHD) risk factors and to identify demographic variables associated with these knowledge levels. METHODS: This descriptive cross-sectional pilot study was carried out among a convenience sample of 130 adults attending a health awareness fair held in a local shopping mall in Muscat, Oman, in November 2012. A modified version of the Heart Disease Facts Questionnaire in both English and Arabic was used to assess knowledge of CHD risk factors. Scores were calculated by summing the correct answers for each item (range: 0-21). Inadequate knowledge was indicated by a mean score of <70%. Descriptive and multivariate logistic regression analyses were performed to establish the participants' knowledge levels and identify associated demographic variables. RESULTS: A total of 114 subjects participated in the study (response rate: 87.7%). Of these, 69 participants (60.5%) had inadequate mean CHD knowledge scores. Knowledge of CHD risk factors was significantly associated with body mass index (odds ratio [OR] = 0.739; P = 0.023), marital status (OR = 0.057; P = 0.036) and education level (OR = 9.243; P = 0.006). CONCLUSION: Low knowledge levels of CHD risk factors were observed among the studied community sample in Oman; this is likely to limit the participants' ability to engage in preventative practices. These findings support the need for education programmes to enhance awareness of risk factors and prevention of CHD in Oman.

Evidence-Based Practice: Knowledge, attitudes, practice and perceived barriers among nurses in Oman.

OBJECTIVES: The aim of this study was to describe nurses' practices, attitudes, knowledge/skills and perceived barriers in relation to evidence-based practice (EBP) in Oman. METHODS: This descriptive cross-sectional study was conducted between February and November 2012. A self-reported 24-item questionnaire was used to measure EBP practices, attitudes and knowledge/skills among a convenience sample of 600 nurses working in four governmental hospitals in Muscat, Oman. Responses were scored on a one to seven rating scale. Barriers to EBP were measured on a five-point Likert scale using two subscales. Descriptive statistics and general linear regression were used to analyse the data. RESULTS: A total of 414 nurses were included in the study. The greatest barriers to developing EBP among nurses were insufficient time for research (3.51 ± 0.97) and insufficient resources to change practices (3.64 ± 0.99). Nurses with more years of experience reported increased use of EBP (P <0.01), more positive attitudes towards EBP (P <0.001) and fewer barriers to research (P <0.01). Significant positive correlations were found between years of experience and practice (r = 0.16) and attitudes (r = 0.20). Nurses with a baccalaureate degree reported fewer barriers to research than those qualified at a diploma level (P <0.001). Nurses who perceived more barriers to research reported less use of EBP (P <0.001), less positive attitudes towards EBP (P <0.001) and limited EBP knowledge/skills (P <0.001). CONCLUSION: These findings provide a basis for enhancing nursing practices, knowledge and skills. Continuing education for nurses and minimising barriers is crucial to increasing the use of EBP in Oman.

Perceived learning needs of Yemeni patients after coronary artery bypass graft surgery.

AIMS AND OBJECTIVES: To explore the information needs of Yemeni patients who have undergone coronary artery bypass graft surgery before hospital discharges and to examine the differences in the patients' learning needs according to age, gender, level of education and working condition. BACKGROUND: Postcoronary artery bypass graft (CABG) patients need more information before their discharge from the hospital. This need of information must be assessed and provided for them before their discharge from hospital to help them with adequate care and recovery at home. Design. A descriptive, correlational design. METHODS: Data were collected from 120 CABG patients before their discharge from Al- Thawra Hospital, Sana'a, Yemen, by using modified Cardiac Patients Learning Needs Inventory (CPLNI) instrument. The Statistical Package for the Social Sciences was used to analyse the collected data. RESULTS: The information about chest and leg wound care, medication information, other pertinent information and complications were indicated to be the most valued by CABG patients prior to discharge. There was a statistically significant difference between patients' total learning needs according to their socio-demographic characteristics. Male patients needed more information than female patients (p=0.004). Younger (p=0.021) and middle-aged (p=0.032) patients needed more information than older ones. Highly educated (p=0.000) and school-level (p=0.002) patients needed more information than those in the uneducated group. Working patients needed more information than non-working ones (p=0.000). CONCLUSION: This study suggests that CABG patients have high information needs within 24-48 hours before hospital discharge. In addition, the results of this study showed that there are statistically significant differences in patients' learning needs according to their demographic characteristics. RELEVANCE TO CLINICAL PRACTICE: Assessment of CABG patients' information needs before their discharge from hospital helps in developing effective educational programme that will help these patients in their recovery at home.

Perception of risk of coronary heart disease among Jordanians.

AIMS AND OBJECTIVES: The purpose of this study was to assess perceptions of risk of coronary heart disease among Jordanians and its association with demographic variables and health behaviours. BACKGROUND: Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life-saving interventions in the presence of coronary heart disease symptoms. DESIGN: A descriptive study. METHODS: Using descriptive statistics and regression analysis, a convenience sample of 300 adults was used. RESULTS: Older Jordanians had higher perception of risk of coronary heart disease (ß = 0·237, p < 0·001). Jordanian women (ß = -0·121, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm than Jordanian men. Also, adult Jordanians who reported not having family member with coronary heart disease (ß = 0·129, p < 0·05) perceived coronary heart disease more as unobservable, unknown, new and delayed in manifestation of harm. Adults with higher level of education indicated higher perception of risk of coronary heart disease. There were no significant associations between perception of risk of coronary heart disease and health behaviours among adult Jordanians. CONCLUSIONS: Our data indicate the need for heart disease education programmes for all adults, including programmes targeted for younger adults, women and persons with low levels of education. It is important to emphasise that adopting healthy lifestyle behaviours can influence their risk for developing long-term disease. RELEVANCE TO CLINICAL PRACTICE: Perception of risk of heart disease can greatly influence the decisions taken by adults in regard to their health care. Lack of accurate risk perception may prevent adults from considering the need for early preventive behaviours or seeking early life-saving interventions in the presence of coronary heart disease symptoms.

Risk factors for deep sternal wound infections after cardiac surgery in Jordan.

AIM: The purpose of this study was to assess rates of and risk factors for deep sternal wound infection after coronary artery bypass grafting surgery. BACKGROUND: Deep sternal wound infection is one of the most devastating complications of cardiac surgery, resulting in multiple operative and non-operative procedures and increased hospital costs. DESIGN: A retrospective design using an existing coronary artery surgery database of adults (n=206) who had undergone coronary artery bypass grafting surgeries between January 2004-January 2006 at a university affiliated hospital, northern Jordan was used. METHOD: Multiple logistic regression analyses were used to asses rates of and risk factors for deep sternal wound infection. RESULTS: Deep sternal wound infection incidence rate was 22% of the total sample. Risk factors of deep sternal wound infection include: (1) diabetes (OR=0·317, p=0·048), (2) Obesity (OR=0·275, p=0·011), (3) duration of surgery (OR=4·22, p=0·032) and (4) use of intraaortic balloon pump (OR=0·033, p=0·001). CONCLUSION: The proposed model provides a preliminary indication of risk factors placing coronary artery bypass grafting patients at risk of DSWI. Further investigations and testing of the model are needed. RELEVANCE TO CLINICAL PRACTICE: Determining patients who are at risk of developing deep sternal wound infection after cardiac surgeries is the first step towards its prevention.

The Perception of Risk of Heart Disease Scale: development and psychometric analysis.

Perception of risk of getting heart disease is an important predictor of individuals' engagement in a healthy lifestyle. This study describes the development and testing of the Perception of Risk of Heart Disease Scale (PRHDS). The 20-item instrument was tested in successive steps with 295 individuals for internal consistency, test-retest reliability, and construct validity. The three subscales of dread risk, risk, and unknown risk had internal consistency values ranging from .68 to .80. The total scale alpha was .80. Evidence of the instrument's stability over time was supported by subscale test-retest reliabilities ranging from .61 to .76. Construct validity was documented with a positive correlation between PRHDS and the Health Promotion Lifestyle Profile II (r = .20 to .39). Further psychometric testing of the PRHDS in a larger sample with a heterogeneous cultural background is recommended.

Determinants of self-reported physical activity among Jordanian adults.

PURPOSE: To assess health-promoting behaviors among adult Jordanians and examine relationships among individual characteristics (age, gender, income, and education), perceptual factors (perceived self-efficacy, perceived benefits, and perceived barriers), competing demands, and self-reported physical activity. DESIGN: A cross-sectional, correlational design with self-administered questionnaires was conducted in three major cities in Jordan. METHODS: Descriptive statistics and path analysis were used to examine the direct and indirect effects of independent variables on adults' physical activity. FINDINGS: Men scored higher than did women on physical activity, and women scored higher than did men on health responsibility. Total variance in self-reported physical activity accounted for by independent variables was 30%. Self-efficacy had the strongest direct effects, followed by perceived benefits, perceived barriers, and competing demands on physical activity. Age had the strongest indirect effect on physical activity participation via perceptual factors. CONCLUSIONS: Counseling these adults for physical activity should include application of behavior change strategies suitable to age and focused on increasing self-efficacy, decreasing barriers, increasing perception of benefits, and decreasing sedentary activities.

Correlates of exercise participation in adolescents.

OBJECTIVE: The purpose of this analysis was to determine correlates of exercise participation among adolescents. DESIGN: A secondary analysis was conducted of data from a cross-sectional survey of 300 adolescents seen at an urban clinic. Using descriptive statistics and path analysis, we examined the direct and indirect effects of independent variables on exercise participation. RESULTS: Independent variables accounted for 15% of variance in exercise participation. In gender-stratified models, independent variables explained 18% of the variance for females. Older females were associated with lower exercise participation scores (beta=-.273, p<.001). Adolescent females who reported a strong relationship with parent(s) reported higher exercise participation scores (beta=.146, p<.05). Females with higher perception of environmental opportunities for exercise were associated with higher exercise participation (beta=.180, p<.05). Depressive symptoms had the strongest indirect effect (beta=-.10) on exercise participation via behavior-specific cognitions/affect factors among females. CONCLUSION: The results support that interventions to increase exercise should focus on older female adolescents. Providing information about environmental opportunities for exercise, enhancing relationship with parents, and intervening with adolescents at risk for depression might improve exercise rates in female adolescents.