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.

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.

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.

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.

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.

The influence of family violence and child marriage on unmet need for family planning in Jordan.

BACKGROUND: Risk for unmet need for contraception is associated with men's perpetration of intimate partner violence (IPV) against women and may be influenced by violence perpetrated by other family members (family violence, FV). Women who married as minors may be most vulnerable to the potential compounding effect of IPV and FV on unmet need. AIM: Using nationally representative data from the 2012 Jordan Population and Family Health Survey we examined unmet need by exposure to IPV and FV by women's age at marriage (<18, 18+ years). DESIGN: Logistic regression was used to test whether IPV and FV were independently associated with unmet need, by age at marriage. Interaction terms (IPV×FV) were tested in both models. Stratification by FV was employed to clarify the interpretation of significant interactions. RESULTS: IPV increased the odds of unmet need by 87% [adjusted odds ratio (AOR) 1.87; 95% confidence interval (95% CI) 1.13-3.10] and 76% (AOR 1.76; 95% CI 1.30-2.38) among women who married prior to and after the age of 18 years, respectively. Women married as minors who experienced IPV and FV had a four-fold higher likelihood of having an unmet need (AOR 6.75; 95% CI 1.95-23.29) compared to those experiencing only IPV (AOR 1.49; 95% CI 0.84-2.38). No interaction between IPV and FV was detected for women married at or above majority. CONCLUSIONS: Laws that prohibit child marriage should be strengthened and health sector screening for violence experience could help identify women at risk of unmet need and improve women's reproductive agency.

The influence of a health education programme on healthy lifestyles and practices among university students.

This study aimed at exploring the lifestyles of university students, the relationship between specific demographical variables and health practices and the role of training in improving these practices. An experimental and a comparison group were selected using the convenient sampling method. Two 5-day training programmes on healthy lifestyles were conducted. Self-reported behaviours of both groups were assessed before and after the programme. The results reflected slightly positive health practices related to the three behavioural categories with the type of diet being the highest and physical activity being the lowest. No significant differences were reflected in relation to the selected variables. A positive influence of training on improving health behaviours of university students related to the three behavioural categories was observed. Results suggest a similar course to be included as a university elective and students' involvement in available extra curricular activities be encouraged.

Intimate partner violence and interference with women's efforts to avoid pregnancy in Jordan.

This study examines the association between intimate partner violence (IPV) and women's experience of interference with their attempts to avoid pregnancy among 353 women surveyed at reproductive health clinics throughout Jordan. Approximately 20 percent of respondents indicated that their husbands or someone else had interfered. Among those others than husbands who were identified, mothers-in-law were the most frequently mentioned, followed by the respondents' mothers and sisters-in-law. Multivariate logistic regression was used to control for potential confounders in determining whether each of the three measures of intimate partner violence (physical violence, sexual violence, and controlling behaviors) was significantly associated with having an increased risk of experiencing interference, as were several sociodemographic variables: nonconsanguineous marriage, residence with in-laws, and rural residence. Physicians, nurses, and family planning counselors must be made aware of the challenges that women may face from their families when they attempt to regulate their fertility.

Jordanian women's experiences with the use of traditional family planning.

The United Nations Population Fund (UNFPA) and the Hashemite Kingdom of Jordan Ministry of Health (MOH) have identified the importance of strengthening national capacity through the integration of reproductive health (RH) services into the primary health care system. It is reported that a high percentage of Jordanian women use traditional family planning (TFP) methods, frequently using them incorrectly. Our purpose in this qualitative descriptive study was to explore the issues and challenges related to the use of TFP among Jordanian women. Six focus groups with women of childbearing age (18-44 years of age; n = 51) were held in the northern, central, and southern regions of Jordan. Study participants used traditional methods such as withdrawal, periodic abstinence, and breastfeeding. Often TFP methods were used incorrectly, resulting in a high failure rate with unplanned pregnancies occurring within short inter pregnancy intervals. Women preferred using TFP because of side effects experienced while using modern family planning (MFP) methods, misconceptions, and lack of correct information about MFP methods. Husbands often declined to use condoms but supported the use of TFP methods. Women indicated that they have unmet needs for family planning and that they would consider using MFP methods if accurate information was available at health centers. They emphasized the importance of competent and knowledgeable health care providers (HCPs) who contribute to decision making regarding use of family planning.