A Quantitative Examination of Illness Models Among People With Opioid Use Disorder Receiving Methadone Treatment.

BACKGROUND: Few studies have examined illness models among people with addiction. We investigated illness models and their associations with demographics and treatment beliefs among patients receiving methadone treatment for opioid use disorder. METHODS: From January 2019 to February 2020, patients receiving methadone treatment at outpatient opioid treatment programs provided demographics and rated using 1 to 7 Likert-type scales agreement with addiction illness models (brain disease model, chronic medical condition model [CMCM], and no explanation [NEM]) and treatment beliefs. Pairwise comparisons and multivariate regressions were used to examine associations between illness models, demographics, and treatment beliefs. Statistical significance was set at P < 0.05. RESULTS: A total of 450 patients participated in the study. Forty percent self-identified as female, 13% as Hispanic, and 78% as White; mean age was 38.5 years. Brain disease model was the most frequently endorsed illness model (46.2%), followed by CMCM (41.7%) and NEM (21.9%). In multivariate analyses, agreement with brain disease model was significantly positively associated with beliefs that methadone treatment would be effective, counseling is important, and methadone is lifesaving, whereas agreement with CMCM was significantly positively associated with beliefs that methadone treatment would be effective, counseling is important, 12-step is the best treatment, taking methadone daily is important, and methadone is lifesaving. In multivariate analyses, agreement with NEM was negatively significantly associated with beliefs that methadone would be effective, counseling is important, taking methadone daily is important, and methadone is lifesaving. DISCUSSION: Many patients in methadone treatment endorsed medicalized addiction models. Agreement with addiction illness models appear to be related to treatment beliefs.

Investigating the prevalence of body dysmorphic disorder among Jordanian adults with dermatologic and cosmetic concerns: a case-control study.

Body Dysmorphic Disorder (BDD) is an underexplored psychiatric condition in Middle Eastern countries, particularly in patients with dermatologic concerns, where alterations in appearance may elevate the risk of BDD. We studied patients at Jordan University Hospital's general dermatology and cosmetic clinics from July to September 2022, comparing them to healthy controls. Patients with dermatologic conditions were evaluated per the International Classification of Diseases (ICD-10) criteria by trained dermatologists. All participants completed the Dysmorphic Concerns Questionnaire (DCQ), Perceived Stress Scale, Patient Health Questionnaire-2, General Anxiety Disorder Assessment tool-2. We assessed BDD prevalence using four DCQ cutoffs: 9, 11, 14, and 17, reporting effect sizes as odds ratios (OR). Our study involved 1500 participants, with an average age of 29.3 (± 14.8) years and a female-to-male ratio of 3.15-to-1. At the 9, 11, 14, and 17 DCQ cutoffs, BDD prevalence was 78.2%, 54.2%, 26.5%, and 11.7%, respectively. Patients with dermatologic concerns were more likely to exhibit clinical BDD symptoms than controls at the 11-cutoff (OR: 1.26; 95% CI 1.01-1.58; p < 0.05). Conversely, those with cosmetic concerns were more prone to clinical BDD than controls at cutoffs 9 (OR: 2.26; 95% CI 1.28-3.97; p < 0.05) and 11 (OR: 1.50; 95% CI 1.03-2.20; p < 0.05). Our logistic regression revealed consistent associations between higher DCQ scores and elevated anxiety, depression, perceived skin disease-related stigma, and reduced quality of life (p < 0.05). In conclusion, patients with dermatologic issues and those seeking cosmetic procedures are at significant risk of developing BDD, necessitating proactive screening and referrals for specialized care by dermatologists due to the associated psychological distress and unproductive consultations. Providing specialized training for healthcare professionals to establish an integrated care approach to address the needs of patients with BDD should be the focus of future research projects.

Exploring Vaccination Challenges among Syrian Refugees in Jordan: Insights from Camps and Communities, and Perceived Parental Barriers to Childhood Vaccination Uptake.

PURPOSE: To identify and understand the multifaceted barriers faced by Syrian refugees when seeking vaccination services for their children. METHODS: A survey questionnaire was administered through structured interviews to a sample of Syrian refugees residing inside the Al-Zaatari camp and in various urban areas across Jordanian communities. This process utilized a multi-stage sampling approach, beginning with a random selection from clusters or strata, and then employing convenience sampling within each to select participants. The survey covered demographics, barriers to vaccination, and vaccine hesitancy. RESULTS: A total of 332 participants completed the survey with a mean age of 32.7 ± 10 years ranging from 18 to 67. More than half of the sample (59%) had an education of 11th grade or less. Sociodemographic disparities regarding barrier perception were evident among participants. Middle-aged adults (older than 32), males, and those with a monthly income less than USD 200 had scored significantly higher on barrier perceptions across all categories (p < 0.05). In-camp residents were less likely to face vaccination barriers compared to those living outside the camps (p < 0.001). Psychological antecedents of vaccine assessments showed that younger individuals had significantly higher scores in complacency, calculation, and constraints (p < 0.05). Participants with lower income had lower constraints and calculation scores (p < 0.05). In-camp residents had significantly higher scores in complacency, constraints, and calculation constructs compared outside camps counterparts (p < 0.05). Participants with no formal education had higher scores in complacency and constraints, and those with less than a 12th-grade education and higher education degrees scored significantly higher on the collective responsibility construct (p < 0.05). CONCLUSIONS: Efforts to promote vaccination among refugees should consider the specific challenges faced by this population, including financial barriers, healthcare access inequalities, and the impact of living arrangements. Public health strategies should address not only individual and psychological factors but also the physical and logistical challenges in obtaining vaccines.

Factors affecting cervical screening using the health belief model during the last decade: A systematic review and meta-analysis.

AIMS: To examine the utility of the health belief model (HBM) and other socioeconomic factors in shaping cervical screening behaviors. Also, to provide recommendations on improving screening uptake. METHODOLOGY: A systematic literature search was conducted using the PubMed/MEDLINE, Cochrane/CENTRAL, and Web of Science databases for articles reporting on the factors associated with cervical screening using the HBM within the period from January of 2002 to January of 2023. Effect sizes for the various HBM constructs were pre-determined using the log odds ratio (logOR) and expressed with their confidence intervals. All reporting was in line with the PRISMA guidelines. RESULTS: A total of 21 studies were included in the final analysis comprised of 15,365 participants. Our pooled analysis demonstrated that perceived susceptibility (OR: 1.40, 95% CI, 1.03-1.89), perceived benefits (OR: 1.30; 95% CI, 1.13-1.50), and self-efficacy (OR: 1.11; 95% CI, 1.05-1.17) were significantly associated with both the uptake of and intention to adopt preventive measures against cervical cancer. Conversely, women with higher perceptions of barriers were less likely to adopt any measure for cervical cancer screening or prevention (OR: 0.72; 95% CI, 0.57-0.91). In terms of sociodemographic effectors, older age (OR: 1.09; 95% CI, 1.01-1.19), graduate/post-graduate education (OR: 2.80; 95% CI, 1.46-5.37), higher knowledge of cervical cancer (OR: 2.21; 95% CI, 1.27-3.84), and being married (OR: 3.89; 95% CI, 1.38-10.92) were all associated with altering preventive behaviors and intentions toward cervical cancer. CONCLUSION: This review delineates the most important and effective cognitive components that should be targeted within interventions aiming to promote cervical cancer prevention.

Perceived attitudes and barriers towards medical research: a survey of Jordanian interns, residents, and other postgraduates.

PURPOSE: We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output. METHODS: Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish. RESULTS: A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341-8.307), age (OR, 1.087; 95% CI, 1.019-1.159), academic standing (OR, 1.730; 95% CI, 1.103-2.715), and confidence (OR, 1.086; 95% CI, 1.009-1.169) were positive predictors of publication in peer reviewed journals. CONCLUSION: The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.

An investigation of knowledge and attitudes towards antidepressants: a cross-sectional survey of Jordan's six medical schools.

OBJECTIVE: Depression is Jordan's most ravaging mental illness. Despite the growth of antidepressant use, only a handful of studies examine the factors affecting antidepressant knowledge among healthcare workers or medical students. Therefore, we aimed to explore the knowledge and attitudes towards antidepressants across Jordan's six medical schools. METHODS: Using a cross-sectional design, we investigated the knowledge and attitudes towards antidepressants through the Drug Attitude Inventory and a literature-validated knowledge domain. Clinical students from Jordan's six medical schools were recruited. Differences in knowledge and attitudes scores were examined by year of study, medical school among other factors. A multivariate linear regression model was utilized to assess predictors of knowledge. RESULTS: We included a total of 1,234 participants representing Jordan's six major schools of medicine. About 14.9% of participants had a personal history of antidepressant use while 20.5% reported family history of psychiatric disease. The majority of students demonstrated favorable attitudes towards antidepressants (74.1%). Students demonstrated an average understanding of antidepressants' mechanism of action, side effects, but not indications in special populations. Senior medical students, higher GPA, higher family income, personal history of antidepressants, and family history of psychiatric illnesses were associated with significantly higher knowledge scores (all p-values < 0.001). In addition to attitudes scores, the aforementioned were positive predictors of knowledge scores in the multivariate model. CONCLUSION: Medical students' knowledge towards antidepressants leaves room for significant improvement. Yet, it is evident that significant differences for both attitudes and knowledge exist across medical schools which may indicate a gap in either training or teaching methodology.

Factors influencing gender preference towards surgeons among Jordanian adults: an investigation of healthcare bias.

Studies investigating gender bias against female surgeons yielded conflicting results ranging from neutrality to a clear preference towards male surgeons. Yet, such bias remains understudied within Middle Eastern nations. We aimed to assess preferences of surgeons' gender among Jordanians and explore reasons for possible gender bias across different surgical specialties. A total of 1708 respondents were examined using a cross-sectional, self-administered questionnaire to evaluate the gender preferences of surgeons, characteristics associated with preferred surgeon's gender, and surgeon's preference in certain specialties. Nearly 52.0% of participants had no gender preference for surgeons. Among those with a preference, 75.7% preferred male surgeons while 24.3% preferred female surgeons. Reputation, knowledge, and experience were the most important factors when choosing a surgeon. Male surgeons were viewed as more trustworthy, knowledgeable, experienced, and communicative. Female surgeons were dominantly perceived as more compassionate, cooperative, and prone to listen. Male respondents were 5 times more likely to choose a surgeon of similar gender (OR 5.687; CI 3.791-8.531). Male surgeons were favored for cardiovascular and orthopedic surgeries. Similarly, female surgeons were favored in gynecological and obstetric surgeries, plastic surgeries, and breast surgeries. Female gender (OR 6.193; CI 4.077-9.408), living outside Amman (OR 1.517; CI 1.066-2.160), and being married (OR 2.504; CI 1.601-3.917) were all significant positive predictors of preferring female surgeons. Our findings highlight differences in gender preference and perception of surgeons among Jordanian adults.

Investigating the impact of COVID-19 on patients with cancer from areas of conflict within the MENA region treated at King Hussein Cancer Center.

Background: There is a paucity of evidence regarding the impact of COVID-19 on cancer care among refugees or patients from areas of conflict. Cancer care for these populations remains fragmented due to resource scarcity and limited infrastructure. Aims: To explore the effect of COVID-19 on cancer care among patients from areas of conflict treated at King Hussein Cancer Center (KHCC). Methodology: We performed a retrospective chart review of all patients from areas of conflict, treated at KHCC from 2018 to 2021. Patients' demographics and clinical characteristics are presented in the form of descriptive statistics. Interrupted Time Series (ITS) analysis was utilized to investigate the impact of COVID-19 on the number of admissions throughout the study's period. Results: A total of 3317 patients from areas of conflict were included in the study. Among these, 1546 were males (46.6%) while 1771 (53.4%) were female. Libyans (34.6%), Palestinians (24.8%), Iraqis (24.5%), Syrians (15.3%), and Sudanese patients (0.9%) constituted our study sample. ITS analysis demonstrated that the start of the COVID-19 lockdown significantly decreased admissions by 44.0% (p = 0.020), while the end of the COVID-19 restriction significantly improved admissions by 43.0% (p = 0.023). Among those with available SEER stages, more than a quarter of patients had distant metastasis (n = 935, 28.2%) irrespective of age and biological sex. Advanced presentations during 2020 had approximately a 16% and 6% increase compared to 2018 and 2019, respectively. Breast cancer (21.4%), hematolymphoid cancers (18.1%), and cancers of the digestive system (16.5%) were the most common cancers among our cohort. Conclusion: Restrictions associated with COVID-19 had a significant effect on the number of admissions of patients from areas of conflict. In the long term, this effect may impact the survival outcomes of affected patients.

Perceived barriers towards the importance and application of medical research: a source of gender disparity among medical undergraduates.

BACKGROUND: Little is known about gender disparity among medical undergraduates in the developing world. Therefore, this study aims to explore the attitudes and perceived barriers among Jordanian medical students, particularly women. METHODS: An online, self-administered questionnaire, developed after an extensive literature review, was disseminated across all six Jordanian medical schools targeting more than 5000 medical students. Student t-test and ANOVA were used to document mean differences among different groups. Linear and logistic regression models were used to find predictors of publication and number of publications. RESULTS: A total of 636 students participated in the survey with a women to men ratio of 1.1. Women medical students report significantly higher knowledge (t(634) = 2.47, p = 0.013), personal (t(634) = 3.31, p = 0.001), and total barriers scores than men (t(634) = 3.02, p = 0.003). Moreover, compared to men, women were less likely to find same-sex mentorship (t(634) = 3.18, p = 0.001) or receive credited authorship (t(634) = 2.12, p = 0.011). Overall, women medical students were more likely to perceive that their gender (t(634) = 3.58, p < 0.001) and people's perception of their gender (t(634) = 4.25, p < 0.001) are barriers to their career advancement. Binary logistic regression demonstrated that gender is a significant predictor of being able to publish (OR: 1.645; 95%CI: 1.002-2.731), while linear regression demonstrated that gender is a predictor of number of publications (ß: 0.113; 95%CI: 0.063-0.288). CONCLUSION: A significant gender disparity exists in terms of both attitudes and overall barriers among Jordanian medical undergraduates which calls for immediate policy changes as to produce successful clinicians and researchers.

Knowledge, Attitudes, and Perceptions of Jordanians Toward Adopting and Using Telemedicine: National Cross-sectional Study.

BACKGROUND: Due to the upsurge of COVID-19, nations are increasingly adopting telemedicine programs in anticipation of similar crises. Similar to all nations worldwide, Jordan is implementing efforts to adopt such technologies, yet it is far from complete. OBJECTIVE: This study aims to assess the knowledge, attitudes, and perceptions of Jordanians toward telemedicine, to identify key factors predisposing individuals to its use or acting as barriers to its implementation. METHODS: We implemented a cross-sectional design using an online, self-administered questionnaire executed in Google Forms and distributed through social media. Differences in knowledge and attitude scores were examined using independent sample t tests and ANOVA. A multivariate linear regression model was computed to assess predictors of awareness toward telemedicine. RESULTS: A total of 1201 participants fully completed the questionnaire. Participants were characterized by a mean age of 36.3 (SD 14.4) years and a male-to-female ratio of nearly 1:1. About 50% (619/1201, 51.5%) of our studied population were aware of telemedicine, while nearly 25% (299/1201, 24.9%) declared they had observed it in action. Approximatively 68% (814/1201, 67.8%) of respondents were willing to use telemedicine. The majority of the sample portrayed favorable and positive views toward telemedicine. Higher educational degrees, living in urban districts, and having a higher perception of electronic usage ability were associated with higher knowledge and better attitudes toward telemedicine (all P<.05). The multivariate linear regression analysis demonstrated that perceived ability to use electronics was associated with positive attitudes (ß=0.394; 95% CI 0.224 to 0.563), while living in Southern Jordan predicted poor attitudes toward telemedicine (ß=-2.896; 95% CI -4.873 to -0.919). CONCLUSIONS: Jordanians portray favorable perceptions of telemedicine. Nonetheless, concerns with regards to privacy, medical errors, and capacity for accurate diagnoses are prevalent. Furthermore, Jordanians believe that integrating telemedicine within the health care system is not applicable due to limited resources.