The experiences of young women living post-stroke in Jordan: a descriptive phenomenological study.

BACKGROUND: The incidence of stroke in younger adults is rising, particularly among women living with stroke who face multiple physical, psychological, and social challenges that negatively affect their quality of life. Consequently, women's roles in life would be negatively affected at home, work, and in society. This study aimed to explore the lived experience of women suffering from a stroke in Jordan. METHODOLOGY: This paper uses semi-structured interviews to present a descriptive phenomenological study of eight young women suffering from a stroke. The Colaizzi (1978) method was used to analyze interview transcripts. MAIN RESULTS: Three main emerging themes that describe the lived experiences of women with a stroke: 1) Experiencing stroke as a woman; 2) Stroke and the intimate relationship with the spouse; 3) Challenges of women's journey while receiving health care. CONCLUSION: After their stroke, Jordanian women have experienced profound, interrelated, and multifaceted difficulties in all aspects of their life and relationships inside and outside the family. Whilst healthcare providers recognize these stressful symptoms; however, there is a lack of attention and care to meet these needs.

Exploring the healthcare needs and experiences of pregnant women with congenital heart disease: A qualitative study.

PROBLEM: Little is known regarding the healthcare needs and experiences of pregnant women with congenital heart disease (CHD) during pregnancy. BACKGROUND: Congenital heart diseases are the most common birth anomalies, and they embrace a wide range of defects ranging from mild to complex and life-threatening defects. Pregnancy carries many physiological and psychological changes that affect pregnant woman with CHD and need special attention and consideration. AIM: To explore the healthcare needs and experiences of Jordanian women with CHD during pregnancy. METHODS: A descriptive phenomenological design was used. Utilising purposive sampling, 15 participants were recruited. Data was collected using individualised semi-structured interviews. Interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi's method. FINDINGS: Three themes were identified: a) A broad spectrum of health needs during pregnancy, b) not being cared for, c) and the healthcare journey: Challenges and recommendations. Findings revealed that pregnancy in women with CHD is associated with many challenges and needs, and the lived healthcare experiences are mostly negative. DISCUSSION: This study addresses the healthcare needs and experiences of pregnant women with CHD during pregnancy. Our findings shed light on healthcare needs explored hidden aspects of the experiences of this vulnerable population and gave them the chance to make their voices heard. CONCLUSION: The study concluded that pregnant women with CHD experience hardship associated with negative challenges and personal suffering. The findings highlight the importance of the basic values and the need for a holistic approach and effective teamwork to minimise suffering among pregnant women with CHD.

Effect of High-Fidelity Simulation on Self-Satisfaction and Self-Confidence Among Nursing Students.

Introduction: Newly graduating nurses should be able to enter clinical practice as safe, accurate, competent, and compassionate professionals in health care settings that necessitate them to be learners who can easily get familiar with a broad diversity of clinical practice settings. Purposes: The purpose of this study was to evaluate the effect of high-fidelity simulation experiences on self-satisfaction and self-confidence among the pediatric nursing students. Methods: A quasi-experimental design, post-test, was carried out through the recruitment of a convenience sample of 150 nursing students from Arab American University. The students were randomly assigned to the study (n = 75) or control (n = 75) groups. Data were collected using learner satisfaction and self-confidence scales. Results: The results of the post-test revealed that there was a significant difference between both groups in self-satisfaction (t (148) = 11.14, P < .001) and self-confidence (t (148) = 13.04, P < .001). The mean score of self-satisfaction for the study group (22.45 ± 2.27) was higher than control group (16.80 ± 3.76). Also, the study group' mean self-confidence score (35.72 ± 3.49) was higher than the control group (27.28 ± 4.39). Conclusion: High-fidelity simulation was confirmed to be an helpful tool to keep an effective and safe learning method for pediatric nursing students, thus increasing their satisfaction and confidence.

Palliative care needs of Jordanian women's experience of living with stroke: a descriptive phenomenological study.

BACKGROUND: Stroke is a prevalent neurological disease that can have a profound impact on women's physical, psychosocial, and spiritual well-being. In many cases, women living with stroke may have marginalized palliative care needs that are often not adequately addressed by healthcare providers. Unfortunately, the experience of women with stroke and their specific palliative care needs have been largely overlooked in research conducted in Jordan. AIM: The purpose of this study is to examine the specific palliative care needs of women who have experienced a stroke and are currently living in Jordan. By conducting this research, we aim to identify the various physical, emotional, social, and spiritual needs of women with stroke and gain a better understanding of how these needs can be addressed through palliative care interventions. METHODS: This research utilized a phenomenological descriptive study approach to explore the experiences of twelve women recruited from the outpatient clinic of rehabilitation centers. The data was collected through semi-structured interviews. The analysis was conducted using the method of Colaizzi (1978), which involves identifying significant statements, extracting meanings, and formulating an exhaustive description of the phenomenon under study. RESULTS: The study findings uncovered three primary themes that reflect the palliative care needs of women who are currently living with stroke in Jordan, including (1) Spiritual practices, beliefs, and needs; (2) Coping with distressing symptoms; and (3) Managing the delivery of unfavorable news. DISCUSSION: This study provides valuable insights into the experiences of Jordanian women living with stroke, highlighting the far-reaching consequences of this condition on various aspects of their lives. The findings reveal that stroke has a significant impact on women's physical, emotional, social, and spiritual well-being, with many facing unmet palliative care needs. By illuminating these challenges, our study underscores the importance of taking a holistic approach to stroke care that addresses the multifaceted needs of women living with stroke. Healthcare providers must consider these findings and integrate palliative care interventions into treatment plans to improve the quality of life of women living with stroke in Jordan. CONCLUSION: This study provides valuable insights into the palliative care needs of women who have experienced a stroke. Our findings highlight the importance of addressing women's physical, psychosocial, and spiritual needs as part of a comprehensive approach to stroke care. We recommend integrating palliative care interventions into rehabilitation programs to improve the quality of life of women living with stroke in Jordan. By doing so, we can address the pain and complications that can arise from stroke, while also providing holistic support to address the emotional and spiritual impact of the illness. This approach has the potential to improve outcomes for women living with stroke and enhance their overall well-being.

Effect of progressive muscle relaxation exercise on anxiety among nursing students prior to critical care clinical training.

Introduction: Intensive care units are considered stressful and emotionally risky situations by both professionals and patients and their families. The purpose was to assess the effect of progressive muscle relaxation exercise on anxiety among nursing students in intensive care units prior to clinical training. Method: A randomized, controlled study design was used. The study composed of 80 nursing students from Arab American University. For 2 weeks, the experimental group's 40 participants were taught progressive muscle relaxation exercises to help with anxiety control, whereas the control group's 40 participants received no training. Results: The results revealed that the experimental group was capable of reducing the anxiety (p < 0.05). Also, the experimental group had les anxiety (1.15 ± SD = 0.43) compared with the control group (2.83 ± SD = 0.40). Conclusion: The current study's findings confirmed the effect of progressive muscle relaxation exercise (PMRE) on anxiety reduction in intensive care units during clinical training among nursing students.

Do nurses participate in end-of-life decision making?

BACKGROUND: To explore how Jordanian nurses participate in the end-of-life (EoL) decision-making process. METHODS: Interviews with 10 patients and family caregivers, and focus group discussions with seven healthcare professionals (HCPs), were conducted. Interviews were audio-recorded, transcribed and analysed following inductive thematic analysis. FINDINGS: The participants agreed that nurses are not fully engaged and did not have a direct role in the EoL decision-making process. However, the participants highlighted that 'nurses bridge the gaps in the decision-making process', where nurses act as mediators to facilitate the decision-making process. Lastly, nurses were viewed as 'nurturers and supporters during the journey of the patient's illness'; they were always available to answer their questions, offer help and advise when necessary during palliative referral and throughout the illness. CONCLUSIONS: Although nurses did not directly participate in EoL decisions, they have several vital contributions that need to be rearranged into structured decisional coaching.

Jordanian nursing students' engagement and satisfaction with e-learning during COVID-19 pandemic.

BACKGROUND: Nursing education was affected by the COVID-19 pandemic as most institutions shifted to e-learning. The aim of the current study was to examine students' engagement and satisfaction levels with e-learning during the COVID-19 pandemic. METHODS: A descriptive correlation design was used to guide this study. A voluntary response sampling method was used to recruit undergraduate nursing programs in Jordan. Data were collected using an electronic link to a self-reported questionnaire. RESULTS: A total of 1,562 undergraduate nursing students responded to the questionnaire. The study showed that most students have high engagement in the emotional, skills, and performance subscales and low engagement in the participation subscale. Further, they were moderately satisfied with e-learning during the COVID-19 pandemic. CONCLUSIONS: Students identified several issues regarding their e-learning, which must be considered to improve their engagement and satisfaction. Further, the study revealed several shortcomings in preparing students to attend e-learning classes.

Exploring the lived experiences of women with congenital heart disease during pregnancy: A phenomenological study.

OBJECTIVE: Congenital heart diseases (CHDs) are the most common birth anomalies, and they embraced a wide range of defects ranging from mild defects to complex and life-threatening defects. Medical advancement improved children's survival, and more females are reaching childbearing age. The purpose of this study was to explore and describe the lived experience of Jordanian pregnant women with CHD during pregnancy. METHOD: This study used a descriptive phenomenological design. Purposive sampling was used in recruiting 15 women from Jordan with CHD who had given birth to at least one live newborn. The study was conducted from October 2019 to April 2020. Data was collected from a public cardiac centre using face-to-face semi-structured interviews. Interviews were recorded and transcribed verbatim. Analysis was done using Colaizzi's method. FINDINGS: Three themes were identified: Being a woman with CHD, being pregnant with CHD, and being a CHD patient and healthcare-seeking behaviour. The findings revealed that pregnancy experiences of women with CHD are usually associated with many difficulties, negative emotions, and challenges. CONCLUSION AND IMPLICATIONS FOR PRACTICE: The findings indicated the need for increased awareness and the importance of social support amongst both Jordanian women with CHD and healthcare providers. Also, the study provides new information to healthcare providers and policymakers to better understand the lived experiences of pregnant with CHD from their perspectives as it was associated with many difficulties, negative emotions, and challenges.

Decision Making Near End of Life: A Qualitative Exploration of the Lived Experiences of Jordanian Healthcare Providers.

BACKGROUND: Discussions related to a patient's prognosis and interventions near end of life are challenging and stressful for healthcare providers. Many reported experiencing emotional distress and discomfort during the decision-making process. OBJECTIVES: The aim of this study was to describe the lived experience of nurses and physicians who participate in decision making near the end of a patient's life. METHODS: A descriptive, phenomenological approach was used with a purposive sample of 7 nurses and 6 physicians from 2 palliative and end-of-life care institutions in Jordan. Data derived from focus group discussions conducted online via the ZOOM video communication application, and analysis followed Colaizzi's qualitative methodology. RESULTS: Three major themes emerged from the healthcare providers' experiences. Initially, the participants described how they "strive toward optimal decision-making near end of life," "the overwhelming experience of decision making near end of life," and finally, their struggle in sharing details about the end of life when patients ask and whether to tell or not to tell them as "the time for hard talk." CONCLUSIONS: The healthcare providers' experiences revealed several issues of decision making near a patient's end of life, such as a lack of appropriate training and administrative support, emotional distress, fear of legal liability, and the burden of a hard talk with patients. These findings necessitate institutional support of setting appropriate policies and guidelines, staff counseling, and healthcare provider support. IMPLICATIONS FOR PRACTICE: Institutions providing palliative and end-of-life care can use this study's findings to support their staff by setting appropriate practice guidelines and providing staff training and counseling.

Death and Dying Through the Lens of Jordanian Muslim Patients and Caregivers.

The current phenomenological-qualitative study explored the meaning of death and dying from a Jordanian-Muslim perspective. Data were collected through face-to-face interviews with eight patients and five family caregivers, then analyzed following the Braun and Clarke steps. The analysis revealed two main themes; confronting death and preparing for a good death. The experience of terminal illness compelled the patients and their family caregivers to think of imminent death and want to prepare for it. On the other hand, Muslim terminally-ill patients accepted death and surrendered to God's decree; however, they feared the unknown of the dying experience. Furthermore, the patients were concerned about being a burden to their families during the last days of their lives. Additionally, Muslim patients and caregivers identified five components of a 'good death' from the Arab-Muslims' perspectives, including having a good closure, dying with dignity, coming to peace, not dying alone, and having a religious engagement.

Effect of High-Fidelity Simulation on Clinical Judgment Among Nursing Students.

INTRODUCTION: Nursing education needs to be improved in order to bridge the gap between education and clinical practice. However, clinical placements for nursing students are limited and student nurses often take merely an observer role, especially in critical situations. High-fidelity simulation (HFS) is a teaching method that can bridge the gap between education and clinical practice. The purpose of this study was to evaluate the influence of using HFS as a teaching method on clinical judgment among pediatric nursing students at the Arab American University utilizing a bacterial meningitis case scenario. METHODS: A quasi-experimental study with a convenience sample of one hundred and fifty baccalaureate nursing students enrolled in a pediatric health nursing course. Nursing students were randomly assigned to high-fidelity simulation experience or traditional methods. The clinical judgment was assessed using Lasater Clinical Judgment Rubric Tool. RESULTS: Results revealed that the high-fidelity simulation experience has improved pediatric nursing students' clinical judgment. The mean clinical judgment differed significantly at post-test in the intervention group after the simulation (t (148) = 7.20, P < .001). CONCLUSION: The HFS can be an effective tool to provide a safe and effective learning environment for pediatric nursing students, consequently improving their clinical judgment.

Nursing Faculty Experience With Online Distance Education During COVID-19 Crisis: A Qualitative Study.

BACKGROUND: COVID-19 pandemic influenced education and forced universities to shift from face-to-face teaching to remote online teaching. This sudden shift in educational pedagogy provoked several challenges to educators. PURPOSE: The purpose of this study is to explore the first experience of nursing faculty members with online distant education (ODE) within the context of COVID-19 national curfew. METHODS: A qualitative descriptive design guided by a phenomenological approach was used utilizing purposive sampling for exploring the experiences of fifteen nursing faculty members by two focus group discussions through Zoom. RESULTS: Qualitative analysis, using Colaizzi's method revealed four major themes including: (1) resolving immediate reaction toward abrupt compulsory online teaching; fulfilling teaching responsibilities; managing the challenges of ODE, (2) struggling with available resources and capabilities; (3) ODE defeated geographic and time boundaries, and interrupted personal time management: yet a new learning experience; insufficiency of ODE; and (4) achieving clinical competencies and learning outcomes. CONCLUSIONS: This study provides evidence on the importance of preparing and training faculty to embrace and sustain the mastery of ODE to ensure the success of ODE. It also emphasizes the institutional and infrastructure readiness to enhance the transition from traditional teaching and learning to ODE.

Involvement of Jordanian Patients and Their Families in Decision Making Near End of Life, Challenges and Recommendations.

This study aims to explore the challenges in involving patients and their families in decision making near end of life and to provide recommendations to overcome these challenges. A qualitative descriptive phenomenological approach was used with a purposive sample of 8 patients, 7 family caregivers, 7 nurses, and 6 physicians from 2 institutions that provide palliative and end-of-life care services in Jordan. Data were collected using interviews with patients and family caregivers and focus group discussions with nurses and physicians. Colaizzi's method was used to analyze the data. The thematic analysis revealed 5 themes representing the participants' experiences of challenges with decision making near end of life. The identified challenges are (1) struggle with lack of information; (2) improper communication; (3) patient's or family's decision: the cultural taboo; (4) health care providers prefer staying in their comfort zone; and (5) the paradox of surviving and letting go. In addition, the participants endorsed several recommendations to raise public awareness of palliative and end-of-life care, amplify the patients' voice, and raise the bar of communication sensitivity. Decision making near the end of life is a challenge. However, the current study highlighted several areas for improvement that can improve the process and optimize patients' and their families' involvement.

Experiences of nursing students under the unprecedented abrupt online learning format forced by the national curfew due to COVID-19: A qualitative research study.

BACKGROUND: The unprecedented abrupt shift to remote online learning (OL) within the context of the national lockdown due to the 2019 coronavirus disease (COVID-19) highlights the importance of addressing students' preparedness in managing their first experiences with OL. PURPOSE: To investigate the experiences of undergraduate nursing students during their first uses of OL to increase the understanding of their encountered opportunities and challenges. DESIGN: A descriptive qualitative design guided by a phenomenological approach was used. METHODS: The study used a purposive sampling technique to recruit 18 undergraduate nursing students from two universities. Data were collected using two focus group discussions, and the discussions with participants were audio/video recorded through the online platform Zoom due to the national imposed curfew. Content analysis employed Colaizzi's steps to derive the themes/categories. RESULTS: The study revealed four themes: experience of helplessness, burdens, and burnout; the need for social and technical support to manage OL; the propensity to consider OL as a positive opportunity; and the deficiency of OL in fulfilling the educational outcomes of clinical courses. CONCLUSIONS: Abrupt remote OL was a challenge to clinical encounters. This format was very stressful; however, it was also useful. The current study highlighted the need for further research on the effectiveness of remote OL platforms in regard to the achievement of the intended learning outcomes of clinical courses.

Nurse students' attitudes toward the nursing profession after witnessing workplace violence.

Background Workplace violence is one of the most compelling problems facing health care sectors all over the world. The detrimental impact of workplace violence extends to affect nurse students who receive their training in clinical areas. Objective The study aimed to investigate the impact of witnessing workplace violence during clinical training on the attitudes of Jordanian nursing students toward the nursing profession. Methods Cross-sectional design was used in this study. Data were collected through electronic survey questionnaires from 131 nursing students from three nursing schools in Jordan. Attitude Scale for Nursing Profession was used to assess the participants' attitude toward nursing profession. Results The results showed that about 34% of student participants witnessed workplace violence during their clinical training. Nursing student participants who did not witness workplace violence showed significantly more positive attitude toward nursing profession than who did witness. Conclusion Witnessing workplace violence had a significant negative impact on how nursing students view nursing job.

Developing an Understanding of Adolescents' Knowledge, Attitudes, and Practices Toward COVID-19.

Adolescents are more likely to engage in risky health practices related to COVID-19. Their compliance with infection control measures is a key factor to mitigate the spread of the disease. The purpose of this study was to explore the knowledge, attitudes, and practices toward COVID-19 and their correlates among Jordanian adolescents. An online cross-sectional survey was utilized. A total of 1,054 Jordanian adolescents aged 12-18 completed and returned the survey. Overall, Jordanian adolescents showed a good base of knowledge regarding COVID-19 (regardless of their demographic characteristics) and tended to hold positive attitudes toward the country's curfew and other protective measures. The majority of adolescents reported that television and social media were their main source of information on COVID-19, while few reported receiving such information from their schools. The majority reported practicing effective health protective behaviors to prevent the spread of COVID-19, which was significantly predicted by their knowledge and attitudes toward these measures. However, there was a relatively small, yet clinically significant, percentage of adolescents who showed poor knowledge on COVID-19, had negative attitudes toward protective measures, and reported being engaged in risky practices related to infection spread. Tailored efforts are needed to improve the levels of knowledge, attitudes, and practices among adolescents. Raising awareness and promoting positive attitudes are vital to change adolescents' health practices. Policy makers should ensure that school nurses are available in all schools and working to their full scope. School nurses are the eyes and ears of public health and primary care. They are essential members on pandemic preparedness, reopening and reentry planning teams, and can lead health care in schools and practice in a holistic culturally competent proactive manner to address the needs of students.

The effectiveness of age-appropriate pre-operative information session on the anxiety level of school-age children undergoing elective surgery in Jordan.

BACKGROUND: Undergoing surgery is an anxious experience for children. Applying anxiety reduction age-appropriate programs by nurses would be beneficial in reducing anxiety to children. AIM: To test the effectiveness of age-appropriate preoperative information session in reducing anxiety levels of school-age children undergoing elective surgery in Jordan. DESIGN: The study used a quasi-experimental design. METHODS: One hundred and twenty-six children were recruited from an educational hospital in Amman from January to June 2012 and were randomly assigned to intervention and control groups. The anxiety levels of children were assessed using the State Anxiety Scale for children, and children's levels of cooperation after surgery were assessed using Children Emotional Manifestation Scale. The heart rate and blood pressure of children were also measured 1 hour before going to operation room. RESULTS: The study results revealed that children in the intervention group reported lower anxiety levels and more cooperation than children in the control group. Also, they displayed lower heart rate and blood pressure than children in the control group. CONCLUSION: The application of age-appropriate preoperative intervention for children could be beneficial in decreasing anxiety levels and increasing their cooperation post surgery.

Jordanian adolescents' health behaviour and school climate.

AIM: This study was conducted to assess the occurrence of physical activity, nutritional habits, tooth brushing and seat belt use behaviour among adolescent school students in Jordan, and to examine the effect of psychosocial aspects of school on these behaviours. METHOD: A cross-sectional descriptive correlational design was used to draw a sample of in-school adolescents aged between 11 and 15 years. The final sample included 1166 adolescents from five public and two private schools. Study participants filled in a translated version of the health behaviour in school aged children questionnaire. Descriptive statistics, correlational (point biserial), and bivariate analyses (chi-square tests) were used to analyse the data. RESULTS: Among the study sample 34.5% of the adolescents practised exercise outside school hours once a week or less frequently, and only 53.1% of them brushed their teeth more than once a day. Regarding seat belt use, 44.7% of the adolescents used them rarely or never. Concerning carbonated sugary drinks and sweets consumption, about 64% and 83.3% of the adolescents, respectively, consumed them once a day or more often. The percentages of adolescents who never drank low fat or whole fat milk were 43.1% and 38.2%, respectively. CONCLUSIONS: The study concluded that school adolescents do engage in unhealthy behaviour. Psychosocial aspect of schools were associated with students' physical activity, nutritional habits, tooth brushing and seat belt use behaviours.

Jordanian nurses' perception and interventions related to promoting smoking cessation.

AIMS AND OBJECTIVES: To determine nurses' perceptions related to smoking cessation, health promotion and interventions provided to hospitalised patients. BACKGROUND: Smoking is a major health problem in Jordan. The cost for treating smoking-related health conditions is a significant strain on the healthcare system. Nurses are in an ideal position to encourage smoking cessation. Little is known about Jordanian nurses' perceptions related to smoking cessation issues. METHODS: A qualitative design was used to collect data from 22 Jordanian nurses using focus groups. Purposive sampling was used to select the study participants. Content analysis was conducted, to determine themes related to the research questions. RESULTS: Nurses indicated that smoking cessation counselling is important. However, they did not feel that their counselling was very effective. Nurses indicated that the presence of a well-defined hospital policy regarding smoking was a facilitator to smoking cessation and antismoking clinics would also help to decrease smoking. Challenges to nurses' interventions included lack of hospital policy, lack of time and nurses who smoke could not be role models or provide effective counselling. Regarding decreasing smoking in Jordan, nurses had suggestions that included scare techniques and increasing taxes on cigarettes as well as enforcing policies that prevent cigarette sales to children under 16. CONCLUSIONS: Nurses are well aware of the hazards of smoking and indicate a belief that encouraging smoking cessation is an appropriate activity. Changes in smoking rules and the enforcement of rules, as well as increased public health efforts related to smoking cessation, are necessary to decrease smoking prevalence in Jordan. RELEVANCE TO CLINICAL PRACTICE: Training in smoking cessation counselling and increased awareness of the resources may increase nurses' ability to have an impact on decreasing the smoking prevalence in Jordan.

Nurses' Experiences of Grief Following Patient Death: A Qualitative Approach.

PURPOSE: To explore the lived experiences of nurses' feelings, emotions, grief reactions, and coping mechanisms following their patients' death. BACKGROUND: On a daily basis, nurses are experiencing patients' death, which exposes them to grief. Nurses' grief has not been sufficiently addressed in practice settings, although it has been a well-known threat to health and work performance. DESIGN: A qualitative design guided by a phenomenological approach was adopted. METHOD: Data were collected from a purposive sample of 21 Jordanian nurses by conducting three focus groups and analyzed using Colaizzi's framework. FINDINGS: Four themes were generated in which participants reported feelings of grief following their patients' death. Their grief emotions were reported as sadness, crying, anger, shock, denial, faith, fear, guilt, fear of the family's reaction, and powerlessness. CONCLUSIONS: The study provided evidence that nurses respond emotionally to patients' death and experience grief. Nurses are burdened by recurrent patients' deaths and try to cope and overcome their grief. This study emphasizes the importance of developing strategies to help nurses positively cope with their grief from a holistic perspective. This will reflect positively on the nurses' performance.