Health-Related Quality of Life Among Patients With Stroke: A Cross-Sectional Study.

PURPOSE: To assess levels and predictive factors of health-related quality of life (HRQOL) among stroke patients. METHODS: The study employed a cross-sectional predictive correlational design. Levels of HRQOL were assessed using the Stroke-Specific Quality of Life (SS-QOL) scale, and the Hospital Anxiety and Depression Scale was employed to assess psychological aspects among 209 Saudi stroke patients. The analysis included demographic and medical variables to comprehensively explore influencing factors. RESULTS: A two-step hierarchical multiple regression analysis was performed. The overall SS-QOL summary score (49 items) showed a mean score of 94.4 (SD = 8.1), indicating poor functioning. Nine predictor variables were found to significantly predict HRQOL levels, including age (ß = -0.212, p ≤ .001), female (ß = -5.33, p ≤ .001), unmarried (ß = 2.48, p ≤ .001), low gross monthly income (GMI) (ß = -9.02, p ≤ .001), medium GMI (ß = -8.36, p ≤ .001), having a medical history of hypertension (ß = 2.7, p ≤ .01), time since stroke (ß = 3.26 p ≤ .001), and being a probable case of anxiety (ß = -4.29, p ≤ .001) and/or depression (ß = -2.75, p ≤ .001). These variables collectively explained ~76% of the variance in HRQOL scores (adjusted R2 = .762, F (16,192) = 42.6, p ≤ .001). CONCLUSIONS: Stroke patients exhibited poor HRQOL levels influenced by various factors. Clinicians should consider these predictors and intervene early to enhance HRQOL among patients at risk, emphasizing the importance of optimizing patient outcomes.

Machine-learning Algorithms for Ischemic Heart Disease Prediction: A Systematic Review.

PURPOSE: This review aims to summarize and evaluate the most accurate machinelearning algorithm used to predict ischemic heart disease. METHODS: This systematic review was performed following PRISMA guidelines. A comprehensive search was carried out using multiple databases such as Science Direct, PubMed\ MEDLINE, CINAHL, and IEEE explore. RESULTS: Thirteen articles published between 2017 to 2021 were eligible for inclusion. Three themes were extracted: the commonly used algorithm to predict ischemic heart disease, the accuracy of algorithms to predict ischemic heart disease, and the clinical outcomes to improve the quality of care. All methods have utilized supervised and unsupervised machine-learning. CONCLUSION: Applying machine-learning is expected to assist clinicians in interpreting patients' data and implementing optimal algorithms for their datasets. Furthermore, machine-learning can build evidence-based that supports health care providers to manage individual situations who need invasive procedures such as catheterizations.

Prevalence of depression and its associated factors among stroke survivors in Saudi Arabia.

AIM: The purpose of this study was to investigate the prevalence of poststroke depression (PSD) in Saudi Arabia and its association with socio-demographic and clinical factors. DESIGN: A predictive correlational cross-sectional study. METHODS: The study adopted a non-probability convenience sampling method to recruit 211 stroke survivors between April and October 2021 from the neurology outpatient departments of two main governmental hospitals in Saudi Arabia. PSD was measured using a self-assessment reliable and valid scale (The Hospital Anxiety and Depression Scale [HADS]). RESULTS: More than two-thirds (70.6%) of the study sample (Mean age = 53 years, SD = 8.5, 51.2% were males) experienced some degree of depression (Score ≥8); of these, approximately half (48.8%) were in severe depression. The final prediction model was statistically significant (χ2 [15] = 31.39, p Ë‚ .01). PSD is a statistically significant health issue and requires immediate attention by healthcare providers to improve the health outcomes of stroke survivors.

Medications adherence and associated factors among patients with stroke in the Kingdom of Saudi Arabia

Background: Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods: Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients’ adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients’ adherence to their selfcare activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient’s details and medications was done via the patient’s hospital file. Results: The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients’ adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. (AU)

The Effect of Transurethral Resection of the Prostate on Erectile and Ejaculatory Functions in Patients with Benign Prostatic Hyperplasia.

INTRODUCTION: The aim of this study was to investigate the effect of TURP on erectile function (EF) and ejaculatory function (EJF). METHODS: A total of 91 patients who underwent TURP were retrospectively assessed. Patients were divided into two groups based on International Index of Erectile Function (IIEF-5): group A included 41 patients with normal EF, and group B included 50 patients with erectile dysfunction (ED). All patients were evaluated for EF and EJF at baseline, 1, 3, and 6 months after TURP by using IIEF-5, Ejaculatory Domain-Male Sexual-Health Inventory (Ej-MSHQ). RESULTS: In group A, there were no significant statistical differences in mean IIEF-5 at baseline and after TURP 22.88 ± 0.81 versus 22.63 ± 2.63 (p = 0.065). However, in group B, there was significant improvement in IIEF-5 after TURP all over the follow-up time points in comparison to the baseline (p = <0.001). The loss of EJF was significant among patients in group A. There was significant improvement of IPSS and Qmax in group A after surgery compared to group B. CONCLUSION: The results confirmed that TURP has no significant negative influence on EF, and patients with preexisting ED were improved after TURP. On the contrary, the loss of EJF was significant.

The Association of Persistent Symptoms of Depression and Anxiety with Recurrent Acute Coronary Syndrome Events: A Prospective Observational Study.

The purpose of this study was to examine the role of persistent symptoms of depression and anxiety in a second acute coronary syndrome (ACS) event. Data presented in this study were from an RCT study. A follow-up for 24 months after baseline to detect a second ACS event among 1162 patients from five hospitals. Hierarchal Cox regression analyses were used. The results showed that persistent depression only (HR 2.27; 95% CI: 1.35-3.81; p = 0.002), and comorbid persistent depression and anxiety (HR 2.03; 95% CI: 1.03-3.98; p = 0.040) were the significant predictors of a second ACS event. Secondary education level compared to primary educational level (HR 0.63; 95% CI: 0.43-0.93; p = 0.020) and college or more education level compared to primary educational level (HR 0.47; 95% CI: 0.27-0.84; p = 0.011) were the only demographic variables that were significant predictors of a second event. The study reveals that attention must be paid by healthcare providers to assess and manage persistent depression; particularly when it is co-morbid with anxiety.

Medications adherence and associated factors among patients with stroke in the Kingdom of Saudi Arabia.

Background: Stroke is one of the most significant neurological problems around the world, and is considered a leading cause of death. Due to polypharmacy and multimorbidity, stroke patients are susceptible to have lower levels of adherence to their medications and self-care activities. Methods: Patients who have suffered a stroke and had recently been admitted to public hospital were approached for recruitment. Patients' adherence to their medications was examined using a validated questionnaire during an interview between the principal investigator and the patients, where patients' adherence to their self-care activities was assessed using a developed, validated and previously published questionnaire as well. Reasons for lack of adherence was explored from the patients. Verification of patient's details and medications was done via the patient's hospital file. Results: The mean age of the participants (n=173) was 53.21 (SD= 8.61) years. Assessing patients' adherence to medications showed that more than half of them stated that they sometimes/often forgot to take their medication/s, while 41.0% sometimes/often stopped their medication/s from time to time. The mean adherence to medications score (out of 28) was 18.39 (SD=2.1), with 83.8% having a low adherence level. It is found that patients who did not take their medications were due to forgetfulness (46.8%) and complications from taking the medications (20.2%). Better adherence was associated with higher educational level, higher number of medical conditions, and higher frequency of glucose monitoring. Adherence to self-care activities showed that majority of patients performed correct self-care activities three times a week. Conclusion: Post-stroke patients in Saudi Arabia have indicated low levels of medication adherence, while reporting good adherence to their self-care activities. Better adherence was associated with certain patient characteristics such as higher educational level. These findings can help in focusing the efforts to improve adherence and health outcomes for stroke patients in the future.

Clinical Trial on Mindfulness with Family Caregivers for Patients with Cancer.

To examine the effectiveness of a brief mindfulness-based interventions (MBIs) and educational interventions (EI) on self-efficacy and burden among family caregivers (FCs) of patients with cancer in Jordan. A quasi-experimental design was conducted. Two interventions were performed: the brief MBIs and the EIs were applied. A sampling of 138 FCs completed the study interventions. The FCs in the mindfulness group demonstrated a significant improvement in measures of self-efficacy and reduction in burden scores. Furthermore, in the EI group, only self-efficacy was significantly higher in the post-test. Burden reduction was significantly higher in the EI group than the mindfulness group. Appropriate supportive interventions should be directed to improve self-efficacy and reduce burden to assist FCs to carry out their crucial role in providing care for their patients.

Needs of Migrant Arab Muslim Childbearing Women in the United Kingdom.

Introduction: This study aims to examine the challenges faced by migrant Arab Muslim women in accessing maternity services and to suggest ways to improve the childbirth experience for them. Methodology: An interpretive ontological-phenomenological perspective guided by the philosophical tenets of Heidegger was used to examine the childbirth experiences of Arab Muslim women. Results: The sample size was 24 in-depth semistructured audiotaped interviews with eight women in the United Kingdom. The "Vulnerable Woman" was the main theme of our findings, which was discussed in five subthemes: language exclusion, discrimination and prejudice, bureaucracy and "stiff upper lip," conflicting ideology, and the conventional as strange. Conclusions: Maternity care should be culturally competent and emphasize the importance of recognizing differences as well as creating trusting relationships. At the same time, midwives should be aware of the dangers of labeling women because of their cultural and religious beliefs.

Correlates and Predictors of Stigmatization of Patients With Mental Illness Among Nursing Students.

The purpose of the current study was to explore knowledge of, attitudes about, and perception of stigma among nursing students in relation to mental illness, and to identify the predictors of stigma toward patients with mental illness based on nursing students' characteristics, knowledge, and attitude. A cross-sectional survey was conducted on 169 participants from a university in Jordan. The regression model predicted a relatively moderate proportion of variance in stigma perception. Significant predictors in the model were family income, father's educational level, and experience with mental health patients. Findings of the current study showed that undergraduate nursing students who had experience with patients with mental illness hold relatively positive perceptions toward mental health patients. Enhancing the content of nursing curriculum regarding issues related to patients with mental illness could help students develop better assessment skills, have more positive attitudes, and gain more accurate knowledge about mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 57(1), 43-51.].

Effect of 2 Enteral Feeding Schedules on Intra-abdominal Pressure in Patients Receiving Mechanical Ventilation: A Randomized Controlled Trial.

BACKGROUND: Elevated intra-abdominal pressure is associated with morbidity in critically ill patients. Enteral feeding is important for these patients but may cause complications. OBJECTIVE: To compare the effects of 2 intermittent feeding schedules on intra-abdominal pressure in patients receiving mechanical ventilation. METHODS: A single-blinded, prospective, parallel-group, randomized controlled trial was conducted in an intensive care unit in a teaching hospital in Egypt. Fifty adult patients requiring more than 48 hours of mechanical ventilation were enrolled. Patients were randomly sorted into 2 study groups. The intervention group received intermittent enteral feedings 5 times daily at 4-hour intervals. The control group received intermittent enteral feedings 10 times daily at 2-hour intervals. Both groups fasted for 8 hours overnight. Intra-abdominal pressure was measured 7 times: at admission and before and after the first 3 feedings on the third day of the intensive care unit stay. RESULTS: One-way repeated-measures analysis of variance showed that mean intra-abdominal pressure was higher in the control group before the first feeding (t = 2.27, P = .03) but was higher in the intervention group after the second feeding (t = 2.51, P = .02) and after the third feeding (t = 2.41, P = .02). Vomiting and diarrhea were not significantly different between the groups. More constipation and abdominal distension occurred in the intervention group than in the control group. CONCLUSION: Intra-abdominal pressure was not significantly affected by feeding interval. However, reducing the time interval between intermittent enteral feedings may minimize the risk for constipation and abdominal distension.

Nurses and internet health-related information: review on access and utility.

PURPOSE: To review literature on the nurses' use and access to Internet Health Related Information (HRI). There is relatively little evidence in published literature on barriers, attitudes and how nurses utilize online health-related information. METHODS: Literature search was carried-out on Cumulative Indexes to Nursing and Allied Health Literature (CINAHL), MEDLINE, Google Scholar, Springer and Sage publications. The search timeframe has focused on the outburst of Internet usage between the years 2000 and 2014. RESULTS: Quality of available websites and databases containing health-related information vary widely in their accuracy, validity and reliability that require nurses to continuously evaluate their relevance. CONCLUSION: Emphasis on the necessity for training in the use of information technology is important to the nurses' continuous professional development. Literature showed a strong evidence of the increased access to the Internet by nurses to retrieve information related to clinical practice, which in turns enhance the quality of care and communication among nurses.

Psychometric Properties of the Coping Behavior Inventory Among Students of Arabic Universities.

PURPOSE: To examine the psychometric properties of the Coping Behavior Inventory (CBI) among Arab students in Jordanian universities. METHODS: A stratified random sampling technique was used to select the universities and classes from each university. The total sample size was 587 students recruited from seven universities during the academic year 2015. The structure of the CBI was analyzed by exploratory factor analysis (EFA) using Statistical Package for Social Science and confirmatory factor analysis (CFA) using AMOS software. EFA for the original CBI showed poor factors structure with low reliabilities. RESULTS: EFA and CFA revealed the modified 15-item and 3-factor scale (Problem Solving, Avoidance, Stay Optimistic), with high goodness of fit indices and strong items loading. CONCLUSION: The use of the modified version of CBI with students at the university level is recommended.

The implementation of mindfulness-based interventions and educational interventions to support family caregivers of patients with cancer: A systematic review.

PURPOSE: This review aims to determine the effectiveness of mindfulness-based interventions (MBIs) and educational interventions (EIs) as supportive care for family caregivers (FCs) of patients with cancer. DESIGN AND METHODS: Review was conducted following PRISMA guidelines. The search protocol was performed using EBSCO, Google Scholar, and Science Direct for the studies published between 2007 and 2017. FINDINGS: Little evidence is available on the usefulness of MBIs among FCs of patients with cancer. However, the available evidence supports that MBIs have the potential to enhance overall well-being and reduce the burden for FCs. EIs have shown positive outcomes on some aspects of well-being and reducing the burden. PRACTICE IMPLICATIONS: The findings provide preliminary support for effectiveness of MBIs and EIs as a supportive care for FCs.

Predictors of burden and quality of sleep among family caregivers of patients with cancer.

PURPOSES: This study aimed to (1) assess the levels of burden and quality of sleep among family caregivers (FCs) of patients with cancer and (2) examine the predictors of burden among FCs of patients with cancer in Jordan. METHODS: A convenience sample of 111 FCs of patients with cancer has completed the Caregiver Burden Inventory and Pittsburgh Sleep Quality Index to assess the levels of burden and quality of sleep. RESULTS: The mean and (standard deviation) of burden for FCs was 37.9 (16.3) indicating high level of burden. The mean and (standard deviation) of quality of sleep for FCs was 9.1 (4.3) reflecting poor quality of sleep. The multiple linear regression analysis was performed to identify the significant predictors of burden. The study model was able to explain 36% of variance in burden. Burden was significantly predicted by poor quality of sleep for FCs, stage of cancer for patients, side effects of treatment, presence of chronic illnesses among FCs, and the level of education for FCs. CONCLUSIONS: Supportive care for FCs, considering all predictors of burden, needs to be considered in order to reduce their burden, which will consequently maintain their caregiving role.

Examining the Relationship Between Nursing Informatics Competency and the Quality of Information Processing.

The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months. The analysis showed that nine predictors explained 22% of the variance in the quality of information processing, whereas the statistically significant predictors were nursing informatics competency, clinical specialty, and years of nursing experience. There is a need for policies that advocate for every nurse to be educated in nursing informatics and the quality of information processing.

Maturity Level of the Stigma Concept Associated with Cancer Diagnosis in the Nursing Literature

Objective: This study aimed to evaluate the maturity level of stigma as a concept in nursing and its relationship to care provided for patients with cancer. Methods: The four principles of Morse and his colleagues were used to evaluate the maturity level of the stigma concept: epistemological, logical, pragmaticl, and linguistic. Analysis was conducted with the literature published between 2006 and 2016. Results: The findings of this study suggest that the concept of stigma in nursing is immature, defined inconsistently, and measured with different instruments. How stigma is defined can influence nurses in their assessment of patients with cancer and identification of their needs. Conclusion: Although extensive studies have been conducted in the field of mental illness, it is only recently that the effect of stigma on treatment of cancer patients has attracted attention. Thus, substantial work yet needs to be done to understand the breadth and scope of stigma impacting on individuals with cancer.

A new approach in exploring satisfaction with nursing care by nurses themselves.

AIMS AND OBJECTIVES: To examine the level of satisfaction with nursing care from nurses' perspectives, as patients and/or as caregivers for hospitalised relatives. BACKGROUND: Many studies that have examined patients' satisfaction with nursing care in Jordan and worldwide found high ratings of satisfaction with nursing care among patients. These ratings may be inflated because patients, as the recipients of care, are often unequipped to judge specific aspects of care, unless the patient is also a nurse. METHODS: A descriptive cross-sectional design was used. Data were collected using the Patients Satisfaction with Nursing Care Quality Questionnaire. The total sample size was 231 registered nurses from eight hospitals in Jordan. All participating nurses had either experienced hospitalisation for a minimum of 24 hr for themselves or as caregivers for one of their close relatives, currently or within the last year. RESULTS: The average age of participants was 31.7 (SD = 0.40) years. Most of the participants were female with <10 years of work experience. The average score for the level of satisfaction was 2.96 of 5, which reflects a moderate level of satisfaction with nursing care. None of the 19 items of the satisfaction scale exceeded the moderate level. The highest mean score of satisfaction level was 3.20 (SD = 1.17) for the skills and competence of nurses, while the lowest mean score was 2.68 (1.22) for the coordination of care after discharge. CONCLUSION: Nurses as patients and/or caregivers evaluated the nursing care during their hospitalisation differently in comparison with public patients. The findings indicated that nurses perceived only moderate levels of satisfaction when undergoing experiences of hospitalisation. RELEVANCE TO CLINICAL PRACTICE: The findings from this study may help nurses to become more alert for meeting the patients' needs as desired under the best practice.

Post-Stroke Depression in Jordan: Prevalence Correlates and Predictors.

BACKGROUND: Post-stroke depression is among the most frequent neuropsychiatric complications of stroke, and it is associated with poor prognosis and outcomes. This study aimed to assess the prevalence of depression; its correlates, and predictors among patients with stroke in Jordan. METHODS: A cross-sectional, descriptive correlation design was used among 198 patients with stroke admitted to 9 hospitals all over Jordan. Depression was assessed using the validated hospital depression subscale (HDS) of the Hospital Anxiety and Depression scale. RESULTS: Study patients (mean age 56.62 years [SD = 14.2], 53% were males) experienced high prevalence of depression (76%); of these, 51.6% were categorized as higher depression category (a case of depression; HDS = 11-21). Factors that correspondingly predicted higher depression categories were low level of education (odds ratio [OR] = 3.347, 95% confidence interval [CI] = 2.920-23.949, P < .001), having a preparatory level of education (OR = 8.363, 95% CI = 1.24-9.034, P = .017), having comorbid chronic diseases (OR = .401, 95% CI = .190-.847), being a smoker (OR = 2.488, 95% CI = 1.105-5.604, P = .028), patients who reported inability to perform daily activities by themselves (OR = 3.688, 95% CI = 1.746-7.790, P = .001), and patients with comorbid dysphasia (OR = 12.884, 95% CI = 4.846-34.25, P < .001). CONCLUSIONS: Post-stroke depression is a significant health problem among Jordanian patients with stroke and warrants serious attention. Clinicians need to consider these important predictors when assessing and managing depression among patients at risk.

Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review.

BACKGROUND: Communication with patients has always been a major concern in nursing care. Invasive mechanically ventilated (IMV) patients suffer from a communication barrier due to the presence of the endotracheal tube (ETT), which makes them unable to communicate through speech. AIM: The purpose of this review is to examine available evidence regarding existing knowledge, skills, perceptions and barriers to IMV patient communication in order to guide the development of strategies that enhance effective communication with these patients. METHODS: A review of the published literature was conducted between January 2010 and December 2016. RESULTS: The literature support clear and concise communication in all areas of care, especially when patients suddenly become speechless. Invasive mechanically ventilated patients want to be heard, have control over their treatment and contribute to decisions concerning their health. CONCLUSION: There is a need for the establishment of an effective nurse -patient communication strategy, which may include determining the mode of communication used by the patient, waiting and giving time to allow a patient to participate in the communication, confirming the message that was communicated with a patient himself/ herself, and the use of assistive and augmented communication to support comprehension when needed.