Professional Quality of Life, Job Satisfaction, and Intention to Leave among Psychiatric Nurses: A Cross-Sectional Study.

Psychiatric nurses are challenged with high levels of stress, which, in turn, lower their professional quality of life (ProQoL) and job satisfaction and increase their intention to leave jobs in psychiatric settings. An adequate level of ProQoL improves patient care provision. The purpose of this study is to assess the levels, relationships, and predictors of the professional quality of life of Jordanian psychiatric nurses and their job satisfaction and intention to leave their job. A descriptive cross-sectional design was used to collect data using the Professional Quality of Life Scale-5 from a convenience sample. Data were collected from 144 psychiatric nurses working in the largest psychiatric hospitals run by Ministry of Health, military, and university-affiliated hospitals. The results showed that the mean scores for compassion satisfaction (CS), burnout (BO), and secondary traumatic stress (STS) were 35.21, 27.0, and 26.36, respectively. The mean scores for intention to leave and job satisfaction were 2.33 and 3.7, respectively. The income level, educational level, intention to leave, and job satisfaction significantly differed in the CS dimension. Nurses' age, intention to leave, and job satisfaction significantly differed in BO. Nurses' age, years of experience, frequent C-shifts worked, and work affiliation were different in STS. Burnout, STS, and educational level predicted CS. CS, STS, job satisfaction, and level of education predicted BO. BO, CS, and frequently working night C-shifts predicted STS. Due to the presence of nurses reporting low levels of ProQoL, job satisfaction, and intension to leave, more studies are needed to assess the factors that affect ProQoL among psychiatric nurses and to evaluate interventional programs that improve the quality of life of psychiatric nurses. This is important in retaining nurses and increasing their job satisfaction. There is a need for interventions that enhance ProQoL. Also, longitudinal studies that measure ProQoL overtime are recommended. This study was not registered.

Nurses' Knowledge and Practice of Appropriate Techniques of Body Mechanics and Non-specific Back Pain.

Background Nursing is a compassionate profession that carries occupational hazards, including work-related injuries. Back pain is a common concern due to the physically demanding tasks performed by nurses. Utilizing proper techniques of body mechanics is vital to prevent work-related back pain and enhance overall well-being. Aim To assess the knowledge and practice of the nurses working in Jordanian hospitals about the appropriate techniques of body mechanics and their relation to non-specific back pain. Methods A cross-sectional design with a convenience sample of 280 participants was randomly selected from hospitals. The tool included the use of a paper questionnaire or scanning the barcode at nursing stations; a reliable, adopted tool was used in this study. Results Out of 280 participants, six (2.1%) had poor knowledge, 96 (34.3%) had average knowledge, and 178 (63.6%) had good knowledge, with a mean score of 3.72±0.58. For practice, seven (2.5%) had poor, 225 (80.4%) had average, and 48 (17.1%) had good practice, with a mean score of 3.30±0.49. Both knowledge and practice scores were negatively correlated with non-specific back pain (rpb = -.393 and rpb = -.306, p < .001), respectively. Furthermore, sociodemographic characteristics did not significantly affect body mechanics knowledge and practice scores (p > 0.05) for all variables. Conclusion Nurses working in Jordanian hospitals had good knowledge of body mechanics but average practice. Higher knowledge and practice levels were correlated with less experience of non-specific back pain. Additionally, there was no significant difference in sociodemographic data between nurses with knowledge and practice scores.

The Relationship Between Self-Efficacy and Functional Capacity Among Discharged Heart Failure Patients in Jordan.

BACKGROUND: Self-efficacy is an important factor associated with healthy lifestyle changes in heart failure treatment. Functional capacity testing of heart failure patients (HFPs) can stratify prognosis. Reduced functional capacities in HFPs are linked to a poor heart failure prognosis. Limited research has examined the potential relationship between self-efficacy and functional capacity. AIM: The aims of this study were to assess self-efficacy level and functional capacity among HFPs after hospitalization, and examine whether there is a relationship between them. METHODS: A descriptive correlational design was used. A convenience sample of 220 HFPs was recruited from 2 hospitals in Jordan. The Arabic version of Cardiac Self-Efficacy Questionnaire was used to assess self-efficacy, the 6-Minute Walking Test (6-MWT) was used to assess functional capacity, and the Borg rating of perceived exertion scale (Borg Scale) was used to assess exertion during 6-MWT. RESULT: The sample included 46.8% male (n = 103) and 53.2% female (n = 117). The mean age was 52.66 ± 8.91 years. Most of the HFPs were categorized based on New York Heart Association classification as class I, 35.9% (n = 79), and class II, 41.4% (n = 91). The mean ejection fraction was 41.46 ± 9.44. The global self-efficacy was moderate (32.98 ± 9.92), and the mean score for the 6-MWT was 494.35 ± 143.37. The Borg Scale mean was 10.94 ± 3.34. In addition, there was a positive relationship between self-efficacy and 6-MWT (r = 0.63, n = 220, P = .01). CONCLUSION: This study provides baseline data for further research on treatment of HFPs, and the development of evidence-based tailored health interventions to maintain and improve self-efficacy and functional capacity among these service users. Moreover, replicated researches can test the study results considering different methodologies, such as using objective functional capacity tool and longer follow-up periods.

Levels and predictors of empathy, self-awareness, and perceived stress among nursing students: a cross sectional study.

BACKGROUND: High levels of empathy and self-awareness and low level of stress among nursing students are the core elements of improving patients' care and outcomes. The purpose of this study is to assess the levels, relationships, and predictors of empathy, self-awareness, and perceived stress in a sample of undergraduate Jordanian nursing students. METHODS: A descriptive cross-sectional design was employed to collect data from 330 students using a web-based survey. RESULTS: The total mean scores of empathy, self-awareness, and perceived stress were 75.75, 40.17, and 55.65, respectively. Students who are studying in public universities, with higher GPA, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of empathy. Students with lower income level, who have no intention to leave nursing, and who are satisfied with nursing; reported higher level of self-awareness. Female students, those who sleeping 6 h and less, did not get a balanced diet or perform exercise, studying in public universities, lower GPA, have intention to leave nursing, and did not satisfy with nursing; reported higher level of perceived stress. CONCLUSIONS: Nursing students reported adequate empathy level, low self-awareness level, and moderate perceived stress level. Students who are satisfied and have no intention to leave nursing reported higher level of empathy, self-awareness, and perceived stress. It is necessary to conduct interventional programs that enhance students' well-being especially empathy and self-awareness, and reduce the level of their stress.

The Effect of Benson's Relaxation Technique on Fatigue and Quality of Life of Patients Diagnosed With Heart Failure.

Patients with heart failure (HF) reported poor quality of life (QOL) due to different reasons among which fatigue is the most important. Improving QOL is a crucial objective for patients with HF and their primary health care providers. Managing fatigue with medication is not enough. Benson's relaxation technique (BRT) is a complementary therapy used to manage fatigue among different populations with limited studies checking its effect among patients diagnosed with HF. The purpose of this quasi-experimental study was to check the effect of BRT on fatigue and QOL among 140 (68 intervention and 72 control) patients diagnosed with HF. Intervention group performed BRT for 20 minutes twice a day for 2 months. Control group received regular care from their health care providers. At baseline, there were no differences between intervention and control groups regarding fatigue, physical component summary, and mental component summary. At follow-up, intervention group had higher scores in physical and mental component summaries than control group (45.48 ± 10.52 vs 37.97 ± 14.78) and (46.22 ± 8.39 vs 41.01 ± 10.36), respectively. Also, intervention group had lower levels of fatigue than control group (2.54 ± 0.87 vs 6.33 ± 0.61). In conclusion, the use of BRT as a complementary therapy for patients with HF might decrease fatigue level and improve QOL.

Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE.

OBJECTIVES: To identify language-related communication barriers that expatriate (non-Arabic) healthcare practitioners in the UAE encounter in their daily practice. DESIGN: Qualitative study utilising semi-structured in-depth interviews. The interviews were conducted in English language. SETTING: Different healthcare facilities across the UAE. These facilities were accessed for data collection over a period of 3 months from January 2023 to March 2023. PARTICIPANTS: 14 purposively selected healthcare practitioners. INTERVENTION: No specific intervention was implemented; this study primarily aimed at gaining insights through interviews. PRIMARY AND SECONDARY OUTCOMES: To understand the implications of language barriers on service quality, patient safety, and healthcare providers' well-being. RESULTS: Three main themes emerged from our analysis of participants' narratives: Feeling left alone, Trying to come closer to their patients and Feeling guilty, scared and dissatisfied. CONCLUSIONS: Based on the perspectives and experiences of participating healthcare professionals, language barriers have notably influenced the delivery of healthcare services, patient safety and the well-being of both patients and practitioners in the UAE. There is a pressing need, as highlighted by these professionals, for the inclusion of professional interpreters and the provision of training to healthcare providers to enhance effective collaboration with these interpreters.

Nurses' knowledge, attitudes and practices towards palliative care provided to patients diagnosed with cancer.

AIM AND OBJECTIVES: This study aimed to explore the levels of knowledge, attitudes, and practices toward palliative care (PC) among nurses working with patients diagnosed with cancer in Jordan. BACKGROUND: PC is a growing specialty in healthcare and nursing in Jordan with an increased need to expand its scope, develop policies to govern it, and increase the awareness of its importance especially for patients diagnosed with cancer. DESIGN: Cross sectional design was used in the current study. METHODS: Using an online self-report questionnaire data was collected from 228 nurses working at four hospitals in Amman. The four hospitals were from three different healthcare sectors: one public, one educational, and two private hospitals. A convenience sampling method was employed. RESULTS: Results showed a low level of PC knowledge (M = 8.8), a moderate level of attitudes (M = 80.9) toward dying patients, and a moderate level of PC practices (M = 52.7). Differences in PC knowledge, attitudes, and practices were found in regard to nurses' gender, level of education, PC training, years of experience, and working sector. Significant correlations were found between PC practices with both PC knowledge and attitudes toward dying patients. No significant relationship between PC knowledge and attitudes toward dying patients. CONCLUSION: Low level of PC knowledge and moderate level of attitudes toward dying patients. Differences in PC knowledge, attitudes, and practices were found in regard to some participants' demographics.

Psychometric Properties of the Posttraumatic Stress Disorder Checklist among the Lebanese Population Exposed to the Beirut Explosion: A Cross-Sectional Study during the COVID-19 Pandemic.

Objective: This study was aimed at testing the psychometric properties of the posttraumatic stress disorder (PTSD) checklist for the Diagnostic Statistical Manual version 5 (DSM-5) (PCL-5) among the Lebanese population and at identifying the prevalence of PTSD. Design: A cross-sectional survey of PCL-5 among 950 Lebanese, using the online survey platform by Google Form, was conducted. Snowball recruitment was used to identify participants for the survey. Results: Face, content, construct, discriminant, and convergent validity had been accomplished through the survey. The reliability using Cronbach's alpha, composite, and average variance extracted was identified as superior. We also found that more than half of the participants (55.6%) scored 33 or above which is the cut-off score for a likely diagnosis of PTSD. Conclusion: The current study provides further support for the validity and reliability of the Arabic version of PCL-5 among non-Western populations. This supports using the checklist in the screening of probable PTSD.

The Impact of an Educational Programme on Jordanian Intensive Care Nurses' Knowledge, Attitudes, and Practice Regarding Delirium and their Levels of Self-Efficacy: A Quasi-Experimental Design.

Background: Delirium is a common problem among patients in Intensive Care Units (ICUs); however, it remains underdiagnosed. We aimed to determine the impact of a nursing education program on Jordanian nurses' knowledge, practice, attitudes, self-efficacy, and ability to detect delirium among ICU patients. Materials and Methods: We conducted a nonequivalent, quasi-experimental design from January 2019 to January 2020. A total of 175 nurses who work in an ICU were included at the baseline and divided into two groups: (1) intervention (86 nurses), who received education for 6 hours each day across two different days and (2) a control group (89 nurses), who maintained their usual routine of care. Data were collected by means of a booklet of questionnaires about the nurses' knowledge and practice, attitudes, and self-efficacy. Results: Data from 160 nurses were included in the analysis. The education program intervention (n = 81) significantly increased nurses' knowledge and practice, positive attitudes, and self-efficacy compared with the control group (n = 79, p < 0.001). In addition, nurses who received the educational intervention were able to detect more cases of delirium (28%, from a total of 51 patients) than the controls, who detected three (6.50%) out of a total of 31 patients (p = 0.003). Conclusions: The ICU nurses who received the delirium-focused educational program increased their knowledge and practice, positive attitudes, and their self-efficacy; in addition, their ability to detect delirium was increased. The implementation of such a program is recommended for the health policymakers and stakeholders.

Quality of life among patients with supraventricular tachycardia post radiofrequency cardiac ablation in Jordan.

BACKGROUND: Supraventricular tachycardia (SVT) is a common arrhythmia with associated symptoms such as palpitation, dizziness, and fatigue. It significantly affects patients' quality of life (QoL). Radiofrequency cardiac ablation (RFCA) is a highly effective treatment to eliminate arrhythmia and improve patients' QoL. The purpose of this study was to assess the level of QoL among patients with SVT and examine the difference in QoL before and after RFCA. METHODS: One group pre-posttest design with a convenience sample of 112 patients was used. QoL was assessed by 36-Item Short Form (SF-36). Data were collected at admission through face-to-face interviews and 1-month post-discharge through phone interviews. RESULTS: There was a significant difference between QoL before (33.7±17.0) and 1 month after (62.5±18.5) the RFCA. Post-RFCA patients diagnosed with atrioventricular nodal reentrant tachycardia had higher QoL than other types of SVT. Moreover, there were significant negative relationships between QoL and the number and duration of episodes pre- and post-RFCA. There were no significant differences in QoL based on: age, sex, working status, marital status, smoking, coronary artery disease, diabetes mellitus, and hypertension. CONCLUSIONS: After RFCA, the QoL of patients with ST improved for both physical and mental component subscales.

COVID-19 vaccine hesitancy among women planning for pregnancy, pregnant or breastfeeding mothers in Jordan: A cross-sectional study.

BACKGROUND: Women planning to become pregnant, who are pregnant, and who are breastfeeding are more hesitant to take COVID-19 vaccines compared to other women globally. AIM: This study investigates COVID-19 vaccine hesitancy among women, who are planning for pregnancy, currently pregnant, and breastfeeding women in Jordan. METHODS: An online cross-sectional study was conducted in the biggest three cities in Jordan, including 874 women. RESULTS: Women who were planning for pregnancy, pregnant, or breastfeeding reported statistically significant lower levels of perception of the seriousness of COVID-19 (7.12 ± 0.72, 7.53 ± 1.80, 7.2439 ± 7296, respectively), significant lower levels of perceived benefits of the vaccine (8.92 ± 2.15, 8.73 ± 1.93, 9.09 ± 2.10, respectively), significant lower levels of motivation and causes of action (7.15 ± 1.71, 6.7524 ± 1.40, 7.27 ± 1.68, respectively), and significantly higher levels of COVID-19 vaccination hesitancy (31.32 ± 6.40, 30.11 ± 4.49, 30.27 ± 6.29, respectively) than other women. Married women, those whoe were previously infected with COVID-19, and those who had chronic diseases reported statistically significant lower levels of perception of COVID-19 seriousness, perceived benefits of COVID-19 vaccine, motivation to take COVID-19 vaccine, and causes of action, and significantly higher levels of hesitancy to take COVID-19 vaccine than unmarried women, those who have not been infected with COVID-19, and those who were medically healthy (p<0.001). There were statistically significant positive correlations between perception, perceived benefits, motivation, and cause of action with years of education; and statistically significant negative correlations between perception, perceived benefits, motivation, and cause of action with age (p<0.001). CONCLUSIONS: Women who were planning for pregnancy, pregnant, or breastfeeding in Jordan showed miderate scores in COVID-19 vaccine hesitancy despite the current international recommendations for its safety for women and their foetuses or neonates.

Health professionals and family members during cardiopulmonary resuscitation: A qualitative study on the experience of witnessing resuscitation in Jordanian critical care units.

BACKGROUND: The interaction between healthcare professionals (HCPs) and family members during cardiopulmonary resuscitation (CPR) in critical care units (CCUs) has received significant attention. In the Arabic region, family members are typically excluded from participating in critical care treatments, despite the cultural and religious significance of their presence. This highlights a lack of policies and research addressing the cultural factors related to family involvement in CPR within this context. OBJECTIVES: The purpose of this study was to explore the nature of the relationship between HCPs and family member relations during CPR in Jordanian CCUs. METHODS: This study employed a qualitative research design. Data were collected through semi-structured interviews with 45 participants, including 31 HCPs and 14 family members of patients who had undergone CPR in Jordan. Data was managed, organized, and thematically analyzed using NVivo. RESULTS: The study revealed three main themes: Family-Witnessed Resuscitation (FWR) through the eyes of HCPs, FWR through the eyes of family members, and the relationship between HCPs and family members during CPR. The last theme has three subthemes: "Looking out for the Patient," "Looking out for Ourselves," and "Looking out for Each Other." These themes highlighted the complex and dynamic relationships between HCPs and family members during CPR in Jordan. Participants emphasized the importance of clear communication, mutual respect, and a collaborative approach to decision-making during CPR. CONCLUSION: The resultant study model uniquely explains the relationship between Jordanian health professionals and family members during CPR, with important implications for clinical practice and healthcare policies regarding family involvement during resuscitation in Jordan. Further research is needed to explore the cultural and societal factors influencing family involvement in resuscitation in Jordan and other Arab countries.

Factors affecting the levels of anxiety and depression among patients with end-stage renal disease undergoing hemodialysis.

BACK GROUND: Hemodialysis (HD) is a lifesaving procedure required for many patients with end stage renal disease (ESRD) who are not able to undergo a kidney transplant. However, HD could cause anxiety and depression for those patients. This study aimed to assess the levels of anxiety and depressive symptoms and find out the predictors affecting them. MATERIALS AND METHODS: A cross-sectional, descriptive correlational design was adopted on a sample of 230 patients who received HD. Patients answered the Hospital Anxiety and Depression Scale along with demographic and clinical variables. RESULTS: The study found that patients with ESRD undergoing HD had a high level of anxiety (mean = 10.59 SD = 2.78) and depression (mean = 10.86 SD = 2.49). There were significant differences in anxiety and depressive symptoms in regard to comorbidity, vascular access type, fatigue, fear, and financial status. Predictors of anxiety and depressive symptoms were: creatinine level, fatigue level, HD duration, number of dialysis sessions, blood urea nitrogen level, and age. CONCLUSIONS: Anxiety and depression are under-diagnosed in patients with ESRD undergoing HD in Jordan. Screening and referral to psychological health specialists are needed.

The effect of COVID-19 vaccine tele-educational program on vaccine hesitancy and receiving the vaccine among women planning for pregnancy, pregnant or breast-feeding mothers.

BACKGROUND: COVID-19 hesitancy among women planning to become pregnant, who are pregnant, and who are breast-feeding is still a global phenomenon. Unfortunately, there is a lack of national educational programs that provide those groups of people with the information they need about the vaccine. OBJECTIVE: This study investigated the effect of the COVID-19 vaccine tele-educational program on vaccine hesitancy and receiving the vaccine among women planning for pregnancy, pregnant and breast-feeding mothers. METHODS: This study implemented a quasi-experimental pre-post design and was conducted in Jordan. It was a two-time study and had two groups of women; 220 women participated in the control group, and 205 women participated in the intervention group (those received the tele-educational program). All participating women answered the demographic characteristics sheet and the Arabic version of Hesitancy About COVID-19 Vaccination Questionnaire twice. RESULTS: Results showed that after conducting the program the interventional group reported significantly higher vaccination rate and lower mean score of hesitancy than the control group (M = 24.67, SD = 5.11; M = 27.45, SD = 4.92; respectively) t (423) = -4.116, p-value < 0.001. Moreover, before the program, women in the intervention group reported significantly higher levels of hesitancy compared to those in the same group after the program (M = 28.35, SD = 4.91; M = 24.66, SD = 5.11; respectively) t (204) = 17.83, p-value < 0.001. CONCLUSIONS: The study concluded that awareness of pregnant women after being given the tele-education program about COVID-19 vaccination decreased their hesitancy and improved their willingness to participate in the COVID-19 vaccination. Therefore, health workers should focus on providing scientific-based information about the vaccine to reduce the doubts of pregnant women about participating in the COVID-19.

The association of mindfulness with professional quality of life and negative emotional states among critical care nurses during COVID-19 pandemic.

BACKGROUND: The recent coronavirus disease 2019 (COVID-19) pandemic has imposed severe psychological pressure on nurses. Mindfulness has been shown to be effective in improving professional quality of life (ProQOL) and reducing psychological distress in a wide range of populations and contexts. However, its role in supporting critical care nurses during the outbreak of COVID-19 has yet to be established. PURPOSE: This study explores the relationship of mindfulness with negative emotional states and ProQOL among nurses working in critical care units during COVID-19 pandemic. METHODS: A cross-sectional descriptive correlational design was used. A sample of 156 critical care nurses completed self-reported measures of mindfulness, ProQOL, and negative emotional states. Multiple regressions were used to address the study purpose. RESULTS: Overall, the participants had severe anxiety, moderate depression, moderate stress, moderate burnout, moderate secondary traumatic stress, and moderate compassion satisfaction. Mindfulness was significantly and negatively associated with stress (r = - 0.230, p = .004), depression (r = - 0.190, p = .018), burnout (r = - 0.218, p = .007), and secondary traumatic stress (r = - 0.168, p = .037). Mindfulness explained 3% of the variance in depression (B = -0.19, p = .018), 3.9% of variance in stress, (B = -0.201, p = .012), 4.2% of variance in BO (B = -0.206, p = .009), and 2.2% of the variance in secondary traumatic stress (B = -0.168, t = -2.104, p = .037), controlling for demographics. CONCLUSIONS: The current study provides preliminary evidence that mindfulness can be helpful in reducing critical care nurses' psychological distress and promoting their ProQOL, and is worthy of further investigation in this population.

Patients Hospitalized for Psychiatric Problems and Their Knowledge, Attitudes, and Practices Toward COVID-19.

The current study aimed to assess knowledge, attitudes, and practices (KAP) toward coronavirus disease 2019 (COVID-19) of persons hospitalized for psychiatric problems and the correlation between knowledge and demographics. A correlational, cross-sectional study was used to collect data through structured interviews from a convenience sample of 200 patients with psychiatric disorders seeking treatment at a psychiatric hospital using the Knowledge, Attitudes, and Practices questionnaire. Participants had poor knowledge (51.5%), moderate attitudes (75%), and low to moderate practices (61%) toward COVID-19. Knowledge was different across most demographic and illness-related variables. Global assessment of functioning and educational level predicted knowledge and accounted for 37.5% of the variance. Due to disability and poor self-care, persons hospitalized for psychiatric problems are more vulnerable to infectious diseases than the general population. Mental health nurses need to raise KAP toward COVID-19. Current results are informative to health care policymakers and mental health authorities in helping identify target populations for prevention and education about COVID-19. [Journal of Psychosocial Nursing and Mental Health Services, 60(8), 37-45.].

Determinants of husbands' violence against women in Jordan.

BACKGROUND: Intimate partner violence (IPV) is the most common form of abuse against women. It comes in the form of physical, sexual, emotional, and controlling behaviors abuse, and affects women's physical and psychological well-being. Perceived social support decreases IPV risk. PURPOSE: This study explores the determinants of IPV in J society. METHOD: One hundred and eighty-seven women exposed to IPV were recruited from J Women Unions to take part in this cross-sectional prospective quantitative design, administering the Arabic version of the Multidimensional Scale of Perceived Social Support (AVMSPSS) to 187, who also answered the demographic characteristics data sheet. RESULTS: Almost 83% of participants perceived that they received lower to moderate PSS. Based on multiple regression, determinants of IPV were PSS, followed by participant education, husband education, participant age, and financial income (p < .001). The number of children and parental level of education showed no statistical significance. CONCLUSION: The findings highlight the importance of social support systems among IPV women. Alongside socioeconomic development continuing to increase education among both men and women, there is a need to increase societal awareness and foster social support systems to prevent violence against women and offer resources to affected women, targeted at the most at-risk age groups.

The Effect of Benson Relaxation Technique on Depression, Anxiety, and Stress of Jordanian Patients Diagnosed with Multiple Sclerosis: A Cross-Sectional Study.

Depression, anxiety, and stress (DAS) are common symptoms of multiple sclerosis (MS) patients and are highly correlated with poor quality of life. Managing DAS among such patients can improve their quality of life (QoL), empowering them with improved autonomy, self-care, independency, and ability to perform daily activities. This study is aimed at examining the effectiveness of the Benson Relaxation Technique (BRT) on reducing DAS among patients diagnosed with MS in Jordan. This quasiexperimental study of 105 Jordanian patients diagnosed with multiple sclerosis tested an intervention group (60 patients) who received BRT and a control group (45 patients) who received normal treatment. Data were collected from January 2021 to April 2021, using the Arabic version of the Depression Anxiety Stress Scale (DASS21). The intervention group was instructed to perform the BRT two times a day for 10 minutes at home for eight weeks at two specific times, with 7-8-hour intervals between each episode. STROBE guidelines were followed in reporting the review. At the baseline comparison, there was no statistical difference between the interventional and control groups with regard to DAS. The levels of DAS between the two groups after three months of the last sessions of the intervention (postintervention) were compared. The results showed that the intervention group had significantly lower levels of DAS compared to the control group. The levels of the DAS were significantly lower for the intervention group postintervention. Adding relaxation techniques to the therapeutic routine is a cost-effective complementary treatment to decrease DAS among MS patients and improve their QoL. Relevance to Practice. This study provides a baseline of data that could facilitate further investigations in the future to improve the quality of services delivered to such patients and thus their QoL and satisfaction.

Effect of Aggression Management Training on Perceived Stress Levels of Nurses Working in Mental Health Care Settings in Jordan.

The current study investigated the effect of an aggression management training course on reducing perceived stress levels of nurses working in mental health care settings in Jordan. This quasi-experimental pre/post study included 83 nurses (44 male, 39 female; mean age = 33 years) who completed a sociodemographic characteristics questionnaire and the Arabic Version of the Perceived Stress Scale 10-Items Questionnaire. Participants attended 32 hours of an aggression management training course and then answered the questionnaires for a second time. Female nurses reported significantly higher stress levels than male nurses before and after the training course. Paired-samples t test showed a significant decrease in the mean total score of perceived stress of all nurses after attending the training course. The results of this study highlight the need to design and implement aggression management courses, as such training can improve nurses' mental health and perceived stress levels. [Journal of Psychosocial Nursing and Mental Health Services, 58(10), 32-38.].

Correlation of selected stress associated factors with vitamin D deficiency in Jordanian men and women.

Background: To identify stress associated factors for vitamin D deficiency (VDD) in healthy Jordanian people based on serum 25(OH)D levels. Design: Prospective cohort study. Methods: Three hundred and seventy-one Jordanian men and women aged 17-52 years, who were identified as VD deficient 25(OH)D <30 ng/mL, were eligible to participate in the study. Serum vitamin 25(OH) D was measured using chemiluminescent immunoassay. Cortisol, parathyroid hormone, calcium, phosphate, fasting lipid profile, and blood glucose were also analyzed. Questionnaires were used to collect lifestyles parameters. Anthropometric parameters including: body mass index (BMI), waist (W) and hip (H) circumferences, W/H ratio (WHR) were also calculated. Results: The vast majority (91%) of the participants had vitamin D deficiency (25- (OH) D <30 ng/mL). Positive correlations were observed between vitamin D deficiency and the following anthropometric parameters in all study sample; gender (P=0.010), height (P=0.22), height/hip ratio (P=0.015) and waist/hip ratio (P=0.013). Lifestyle parameters that indicated very weak positive correlations with VDD were number of family members (P=0.011) and insufficient exposure to sunlight (P=0.023). The following clinical parameters showed weak or very weak correlations with VDD; serum cortisol (r=0.318), low density lipoprotein (r=0.246) and total cholesterol (r=0.133). Skin color and water pipe tobacco smoking were added to the multivariable stepwise regression analyses as they have been weakly correlated with VDD. These predictors together explained only 12.2% of the variance in serum cortisol levels in the VDD study sample. Conclusion: A weak positive association between VDD and elevated serum cortisol was observed in this study. Subcutaneous changes may be involved in that association but further studies are needed to clarify a potential role for adrenocorticotropic hormone (ACTH).