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.

Post-traumatic stress disorders among Syrian refugees residing in non-camp settings in Jordan.

OBJECTIVES: To measure the prevalence and severity of post-traumatic stress disorders (PTSD) among Syrian refugees and explore its association with various factors. METHODS: A cross-sectional study was carried out among a convenience snowball sample of Syrian refugees residing in non-camp settings in Jordan in 2019. A 4-part self-administered structured questionnaire was used to collect data. Part one included socio-demographic data, part 2 included an Arabic version of Harvard Trauma Questionnaire (HTQ) (part I: trauma event and part IV: trauma symptoms), part 3 was related to participants' physical symptoms, and part 4 to participants' satisfaction with the healthcare they received. RESULTS: Study participants (n=279; mean age 32 years (SD=10.45), 52% were males) reported high prevalence of traumatic symptoms (86.2%); of these, 68.5% were considered symptomatic for PTSD (HTQ-16 sub-scale or the entire symptom scale HTQ-45 mean item score of >2.5), regardless of the type of trauma. Those who were middle-aged, a female, unemployed, sexually abused or raped, had a family member who died in the conflict, witnessed catastrophic events like burning, or razing of residential areas, and have received the body of a family member while being prohibited from expressing grief and doing funeral rites, were more likely to be considered as a case of PTSD. CONCLUSION: Majority of the refugees residing in non-camp settings in Jordan suffer from PTSD. Refugees have low satisfaction with the healthcare services provided.

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)

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.

Post-stroke Anxiety Among Patients in Jordan: A Multihospital Study.

This study aimed to assess the prevalence, correlates, and significant associated factors of anxiety among patients with stroke. A cross-sectional, correlation design was utilized. The Hospital Anxiety and Depression scale was used to detect and assess the severity of anxiety and depression among mentally well patients at general hospital settings. Among the 226 patients with stroke, 45.6% had clinically significant levels of anxiety to be considered as a definite case. Having a short duration since the stroke onset, being a definite case of depression, being unable to perform self-care activities, having an insufficient monthly income, and having visual problems due to stroke were the significantly associated factors. The high prevalence of anxiety among patients with stroke highlights the need for interventions of early detection and management to enhance recovery. Patients who have any of the significant traits predicted post-stroke anxiety required special attention.

Periprocedural anxiety associated with cardiac catheterisation and the monitored physiological measures.

OBJECTIVES: To describe, compare and examine self-reported anxiety levels and associated physiological responses of blood pressure, heart rate and respiratory rate of patients undergoing cardiac catheterisation (CATH). METHODS: Repeated measure design was used to assess a sample of 100 patients who had undergone cardiac catheterisation (CATH) in a major specialised heart institute in Jordan. RESULTS: Patients' anxiety levels differed significantly across the three time periods (baseline, prior to and post CATH). The mean anxiety levels prior to CATH scored with State Anxiety Inventory (M = 52.14, SD = 6.0) was significantly higher than that at baseline (M = 48.35, SD = 5.6) and post CATH (M = 36.27, SD = 9.7). CONCLUSION: Most patients experienced anxiety when scheduled for a CATH. The highest level of anxiety was within two hours prior to the procedure and the lowest was post procedure.

The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorder.

BACKGROUND: The United Nations has declared the Syrian crisis as the worst humanitarian crisis of the twenty-first century. Pharmacists play a vital role in humanitarian aid and in delivering health advices for refugees. Many Syrian refugees are in need of psychosocial assessments. OBJECTIVE: Objective of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD), assessed by pharmacists among Syrian civilian refugees residing in Amman, Jordan. METHODS: A cross-sectional study involving Syrian civilian refugees living in Amman, Jordan, was conducted using the published and validated Arabic version of the Harvard Trauma Questionnaire (HTQ). Pharmacists recruited civilian Syrian refugees and completed the HTQ. The questionnaire included 45 questions, with the first 16 questions (HTQ-16) intended to assess the trauma symptoms felt by refugees. Assessments were done by the pharmacists and refugees were categorized to suffer PTSD if their mean item score for the HTQ-16 scale was > 2.5. RESULTS: Study participants (n=186; mean age 31.5 years; 51.3% males) had a HTQ-16 mean score of 2.35 (SD=0.53), with a range of 1.19 - 3.63. Over a third of participants (38.7%) were categorized as having PTSD. Males reported significantly worse PTSD symptoms (mean=2.42, SD=0.50) compared to females (mean=2.26, SD=0.57). Correlation between the mean item score for the HTQ-16 and characteristics of the study participants showed higher mean item score correlated with being a male, older in age, a smoker, and if trauma was experienced. CONCLUSIONS: Many Syrian civilian refugees living in Jordan suffer from PTSD. Male participants were found to be more affected by the severity of the disorder. Pharmacists are suitably situated to identify civilian Syrian refugees suffering from PTSD in dire need of help, paving the way for much needed healthcare resources to be delivered to this particular group of refugees.

The Syrian refugee crisis in Jordan: a cross sectional pharmacist-led study assessing post-traumatic stress disorder

Background: The United Nations has declared the Syrian crisis as the worst humanitarian crisis of the twenty-first century. Pharmacists play a vital role in humanitarian aid and in delivering health advices for refugees. Many Syrian refugees are in need of psychosocial assessments. Objective: Objective of this study was to investigate the prevalence of post-traumatic stress disorder (PTSD), assessed by pharmacists among Syrian civilian refugees residing in Amman, Jordan. Methods: A cross-sectional study involving Syrian civilian refugees living in Amman, Jordan, was conducted using the published and validated Arabic version of the Harvard Trauma Questionnaire (HTQ). Pharmacists recruited civilian Syrian refugees and completed the HTQ. The questionnaire included 45 questions, with the first 16 questions (HTQ-16) intended to assess the trauma symptoms felt by refugees. Assessments were done by the pharmacists and refugees were categorized to suffer PTSD if their mean item score for the HTQ-16 scale was > 2.5. Results: Study participants (n=186; mean age 31.5 years; 51.3% males) had a HTQ-16 mean score of 2.35 (SD=0.53), with a range of 1.19 - 3.63. Over a third of participants (38.7%) were categorized as having PTSD. Males reported significantly worse PTSD symptoms (mean=2.42, SD=0.50) compared to females (mean=2.26, SD=0.57). Correlation between the mean item score for the HTQ-16 and characteristics of the study participants showed higher mean item score correlated with being a male, older in age, a smoker, and if trauma was experienced. Conclusions: Many Syrian civilian refugees living in Jordan suffer from PTSD. Male participants were found to be more affected by the severity of the disorder. Pharmacists are suitably situated to identify civilian Syrian refugees suffering from PTSD in dire need of help, paving the way for much needed healthcare resources to be delivered to this particular group of refugees

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Identifying treatment related problems and associated factors among hospitalized post-stroke patients through medication management review: A multi-center study.

BACKGROUND: Stroke is a major cause of disability and one of the leading causes of death among the elderly. Treatment related problems can lead to undesirable consequences. The Medication Management Review (MMR) service is aimed at identifying, resolving and preventing TRPs, subsiding the undesirable outcomes associated with TRPs. OBJECTIVES: To explore the types, frequencies and severity of TRPs amongst post-stroke patients recruited through hospitals via conducting the MMR service by clinical pharmacists in Jordan. Associations between patient factors and the identified TRPs were explored. METHODS: This cross-sectional descriptive study was conducted over three months in 2017 in different geographical areas throughout Jordan. Randomly recruited patients were interviewed at the hospitals to collect their demographic data and clinical characteristics. Types/frequencies/severity of TRPs for each stroke patient were identified by a clinical pharmacist. Associations between the identified TRPs and patient's factors were explored through multiple regression analysis.Key findings:Out of 198 stroke patients (mean age: 56.6 ±â€¯14.2) who completed the study, 110 (55.6%) were males. Many of the patients (82 (41.6%)) were smokers and 61 (69.2%) had hypertension and/or diabetes. The mean number of TRPs per patient was 2.5 ±â€¯1.1. The most common TRP categories involved efficacy issues (198 (40.6%)), inappropriate drug adherence (136 (27.9%)) and inappropriate patient knowledge (114 (23.4%)). More than 70.0% (342/487) of the identified TRPs were of major severity. Higher number of TRPs was found to be associated with being a male, having a lower educational level, being a current smoker, having a higher number of drugs and a poorer quality of life. CONCLUSION: Lack of drug efficacy, inappropriate drug adherence and patient knowledge were the major TRPs identified via delivering the MMR service to post-stroke patients. The identified TRPs highlights the importance of the MMR service, and supports planning future strategies aimed at decreasing the incidence of strokes.

Pain among non-verbal critically Ill mechanically ventilated patients: Prevalence, correlates and predictors.

PURPOSE: To investigate pain levels and factors that are predictive of pain for mechanically ventilated patients during rest and during routine nursing procedures. MATERIAL AND METHODS: Pain levels were assessed using Behavioral Pain Scale (BPS) and physiological measures among 247 mechanically ventilated patients. RESULTS: At rest, 33.2% of patients suffered pain, with a BPS > 3; of these, 10% presented significant pain levels (BPS ≥ 5). Variables that correspondingly predicted resting pain were age (ß = -0.010, p < 0.001), sedation score (ß = -0.153, p < 0.01), and method of ventilation (ß = -0.281, p = 0.021). During the procedures, 90% of patients suffered pain, with a median BPS of 6 (IQR: 4-8), and 83% of patients experienced significant pain levels. Age (ß = -0.022, p = 0.001), sedation score (ß = -0.355, p < 0.001), receiving sedation and/or analgesia in last hour (ß = 0.483, p = 0. 01), resting pain levels (ß = -0.742, p < 0.001) and the type of painful procedure (ß = -0.906, p < 0.001) were significant predictors of procedural pain. CONCLUSIONS: Many mechanically ventilated patients suffer resting and procedural pain. Many variables were found to play a role. Clinicians need to consider these variables and intervene to decrease pain among patients at risk.

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.

Educational Video Intervention Effects on Periprocedural Anxiety Levels Among Cardiac Catheterization Patients: A Randomized Clinical Trial.

PURPOSE: To explore the effectiveness of an educational video intervention in lowering periprocedural anxiety among Jordanian patients hospitalized for cardiac catheterization (CATH). There are many potential reasons of anxiety related to CATH including involvement of the heart and the actual test procedure. METHODS: A randomized controlled trial took place in a specialized heart institute in Jordan. The sample size was 186 patients who had undergone CATH procedure. Patients anxiety levels were measured by physiological parameters of anxiety (blood pressure, heart rate, and respiratory rate) and by the Spielberger State Anxiety Inventory (SAI). RESULTS: After video education, there was a significant difference in periprocedural perceived anxiety between the groups: preprocedural anxiety levels (M = 39.03, SD = 5.70) for the experimental group versus (M = 49.34, SD = 6.00) for the control, p < .001, and postprocedural perceived anxiety for the experimental group (M = 29.18, SD = 5.42) versus (M = 41.73, SD = 5.41) for the control. CONCLUSION: Providing an educational video intervention about CATH may effectively decrease periprocedural anxiety levels.

Pain Assessment and Management in Critically ill Intubated Patients in Jordan: A Prospective Study.

OBJECTIVES: The purpose of this study was to describe: (1) pain indicators used by nurses and physicians to assess pain, (2) pain management interventions (pharmacological and non-pharmacological) used by nurses, and (3) indicators used by nurses to verify pain intervention effectiveness. METHODOLOGY: A total of 301 medical records of currently admitted patients from six different ICUs in Jordan were reviewed using a data collection instrument developed by Gélinas et al. (2004) Pain-related indicators were classified into non-observable (patient's self-reports of pain) and observable (physiological and behavioral) categories. RESULTS: Only 105 (35%) of a total 301 reviewed medical records contained pain assessment data. From these medical records, 15 pain episodes were collected altogether. Observable indicators documented 98% of the 115 pain episodes. Patients' self-reports of pain were documented only 1.7% of the time. In 78% and 46% of the 115 pain episodes, pharmacological and nonpharmacological interventions for pain management were documented, respectively. Only 37% of the pain episodes were reassessed with self- report (1%) and observable indicators (36%) to determine the effectiveness of the interventions. CONCLUSION: Pain documentation for assessment, management, and reassessment was lacking and needs improvement.

Pain among mechanically ventilated patients in critical care units.

BACKGROUND: Pain is a common experience among mechanically ventilated patients. Pain among mechanically ventilated patients is aggravated by factors such as stage of illness, invasive procedures, and surgical interventions. The aim to this study was to investigate pain levels and predictors among mechanically ventilated patients during rest and routine nursing interventions. MATERIALS AND METHODS: A cross-sectional descriptive correlational design was used, with a total sample of 301 mechanically ventilated patients. Patients' pain levels were assessed using Behavioral Pain Scale during rest and routine nursing interventions. RESULTS: The mean pain score levels during rest (mean = 3.69, standard deviation [SD] = 0.81) were lower than mean pain score levels during routine nursing interventions (mean = 7.1, SD = 2.5). During rest, pain scores were significantly correlated with age (r = -0.12, P = 0.046), and heart rate (r = 0.24, P < 0.001). During nursing interventions, pain scores were significantly correlated with age (r = -0.25, P < 0.001), heart rate (r = 0.36, P < 0.001), and diastolic blood pressure (BP) (r = 0.21, P < 0.001). The age and past surgical history were found to be significant (age: ß = -0.009, P = 0.002; past surgical history: ß = -1.376, P < 0.001). CONCLUSION: Mechanically ventilated patients experience pain during rest as well as during routine nursing interventions. Pain levels were associated with age, heart rate, and diastolic BP. The age and past surgical history should be considered as important predictive factors.