Acceptance of Remote Education During COVID-19 Outbreak in Undergraduate Nursing Students.

ABSTRACT: This study aimed to examine the acceptance and predictors of remote education through Internet-based learning among undergraduate nursing students in Jordan. An online survey was used with a sample of 344 students to assess satisfaction with remote education. Responses indicated that undergraduate nursing students were unsatisfied with remote education for several reasons. Many students (n = 188, 55 percent) strongly agreed that problems and obstacles were encountered when they studied subjects electronically. The acceptance of remote education was predicted by educational level (p = .01), device used (p = .001), and Internet reliability p = .001).

Illness perception in patients with coronary artery disease: A systematic review.

The aim of this study was to conduct a systematic review that investigates the differences in illness perception with age and gender in patients diagnosed with coronary artery disease. Previous studies show some discrepancies regarding the influence of age and gender on the specific dimensions of coronary artery disease patients' illness perception. A systematic review using a narrative synthesis process included preliminary synthesis, exploration of relationships and assessment of the robustness of the synthesis and findings was conducted. Search terms were used to identify research studies published between 1996 and December 2014 across four key databases: CINAHL, Medline, PsycINFO and Web of Science. A total of 14 studies met the inclusion criteria of the review. The review found that men had a stronger perception that their own behaviour had caused their illness than women. In addition, older patients had lower perceptions of the consequences and chronicity of their illness. This analysis concludes that some dimensions of illness perception vary according to age and gender of patients with coronary artery disease. These differences should be taken into consideration, particularly when providing health education and cardiac rehabilitation.

Relationships between Inflammatory Biomarkers and Fatigue among Patients with Moderate and Severe COVID-19.

Background: Patients with moderate or severe COVID-19 infection suffer from varying levels of fatigue; however, there is a lack of understanding regarding the effect of inflammation on fatigue; and whether these relationships differ according to the severity of the infection. Aim: To assess the relationships between selected inflammatory biomarkers and fatigue levels among hospitalized Jordanian patients with moderate or severe COVID-19 infection. Methods: A quantitative cross-sectional design was used. A total of 352 participants were recruited for the study. Data regarding fatigue type and level were collected using the Chalder fatigue scale. Laboratory test results regarding several selected inflammatory biomarkers (e.g., ESR, CRP, IL-6, D-dimer, and others) were collected from patient records. The severity of the COVID-19 infection was determined using the criteria of the Ministry of Health in Jordan based on the results of O2% (oxygen saturation). Results: The mean scores of the total fatigue level significantly differed between the two levels of the severity of COVID-19 infection (moderate and severe levels) (t = -3.0, p < 0.05). Similar findings were observed with physiological fatigue (t = -3.50, p < 0.05), and no significant difference was observed in psychological fatigue. Out of the selected inflammatory markers, only neutrophil and lymphocyte count had a significant influence on total fatigue level. Conclusion: The level and type of fatigue was affected by the severity of the disease. However, the disease process itself represented by the levels of the inflammatory markers showed little influence on fatigue. The implications such as continuous screening of fatigue, and monitoring of the levels of the inflammatory markers are important to assist in diagnosing and managing COVID-19 patients. Furthermore, the relationship between the inflammatory process and fatigue is complex and requires further exploration.

Role of inflammation in determining the severity of COVID-19 infection in patients with diabetes: A comparative study.

There is a need to consider the geographical origins when studying the association between COVID-19 and the comorbid conditions. To examine the role of inflammation in determining the severity of COVID-19 among hospitalized patients with diabetes and compare these roles with those who does not have diabetes. A cross sectional comparative design was used with a convenience sample of 352 patients. Samples were collected from hospitalized patients with COVID-19 who were divided into 2 groups (diabetes and non-diabetes). Data regarding results of selected inflammatory markers and sociodemographic were collected. The severity of COVID-19 differed significantly between the diabetes and non-diabetes groups (Chi square = 25.58 P < .05). There was significant difference in the mean scores of neutrophil counts, monocyte count, Basophil count, erythrocyte sedimentation rate, partial thromboplastin time, C-creative protein, platelets, white blood cells, and mean cellular hemoglobin center between those with and those without diabetes. The diabetes were shown more increased in the predictors and severity of the COVID-19 disease. However, neutrophil to lymphocyte ratio, neutrophil count, and age were the significant predictors of the severity level of COVID-19 among patients with diabetes. In conclusion, our study addressed the influence of having diabetes among hospitalized patients with moderate and severe COVID-19 infection. The results showed that severity of COVID-19 infection was affected by diabetes where those with diabetes had more tendency to suffer from the severe form of the disease rather that the moderate level.

Dimensions of sleep characteristics and predictors of sleep quality among heart failure patients: A STROBE compliant cross-sectional study in Jordan.

Awareness of poor sleep quality and sleep disturbances, as some of the factors that affect negatively quality of life for patients with the different classes of heart failure (HF) would enable health care providers to offer more comprehensive care. The purposes of this study were to describe sleep quality and predictors of disturbances in sleep in heart failure patients in Jordan. An explanatory cross- sectional design was employed to examine sleep quality, dimensions of sleep characteristics, types of disturbances in sleep within the different classes of HF in Jordan. Data were collected from 2 cardiac clinics and 2 medical clinics at 3 hospitals in Jordan. The most common types of disturbances in sleep in all classes of HF were waking up for urination, waking in the middle of the night or early morning, waking up due to cough and snoring, and difficulty to fall asleep within the 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Regression analysis revealed that significant correlations were found between sleep quality and gender, disease duration, number of medications currently taken and ejection fraction (P < .05). Our findings indicated that sleep quality and disturbances in sleep were worsening with the increase of the New York heart association functional classification sheet class. Moreover, sleep quality had a significant association with gender, disease duration, ejection fraction, and the number of medications currently taken.

Sleep quality among different classes of heart failure patients in Jordan: A STROBE compliant cross-sectional study.

Many researchers emphasize the importance of studying sleep quality among patients with heart failure (HF). Because of the importance of this topic, many studies have been conducted to address the different aspects of sleep-in various populations of patients with HF. The purposes of our study were: to assess the types of disturbances in sleep within the different classes of HF, and to assess whether there were differences in the levels of sleep quality and types of disturbances in sleep within the different classes in non-hospitalized Jordan patients with HF. Data were gathered from 2 cardiac clinics and 2 medical clinics at 3 Jordan hospitals. A minimum sample of 200 people was recruited to participate in this study based on these criteria and factors. The prevalence of low sleep quality and types of disturbances in sleep were increased with the increase in New York Heart Association class. Nearly 3 quarters of the study sample had poor sleep quality 73.5% (n = 147). Using a score of 5 as a cut point, 147 patients with HF in our study sample had poor sleep quality. The most common types in all classes were waking up for urination, waking in the middle of the night or early morning, waking up due to coughing and snoring, and difficulty falling asleep within 30 minutes. However, waking up due to feeling cold or hot were rarely reported in all classes of patients with HF. Poor sleep quality negatively affects the quality of life in patients with HF by decreasing physical cognitive and psychosocial performance in those patients. This is the first study in literature study sleep quality in the different New York Heart Association functional classes.

Undergraduate health profession students attitudes toward illicit substance users in Jordan.

BACKGROUND: The use of illicit substances is a critical international issue that must be addressed by healthcare systems worldwide. Today, the problem of illicit substance use is increasingly becoming a burden on healthcare systems in both developed and developing countries. The aims of this study were: (1) to describe the attitudes of health major undergraduate students (the study participants) toward illicit substance users; (2) to describe the discriminatory behaviors among the study participants toward illicit substance users; and (3) to examine the relationship between the attitudes and the actual discriminatory behaviors of the study participants. METHOD: A cross-sectional descriptive design was used to investigate the attitudes and behaviors of health professional undergraduate students enrolled at university in Jordan. RESULTS: Students who were younger and identified as female were generally more positive toward illicit substance users versus those students who were older and identified as male. CONCLUSION: The findings of this study supported the literature that students who were younger and identified as female were generally more positive toward illicit substance users versus those students who were older and identified as male. It is therefore important to determine whether the type of courses in health majors available for undergraduate students affects their attitudes toward illicit substance users.

Nursing and PharmD Undergraduate Students' Attitude Toward the "Do Not Resuscitate" Order for Children with Terminally Ill Diseases.

BACKGROUND: Nurses and Doctor of Pharmacy (pharmD) must communicate and properly documented the do not resuscitate orders for terminally ill children and their relatives. They also have to offer excellent care including more family support, assisting the child with terminally ill disease in passing on peacefully, and preventing unnecessary cardiopulmonary resuscitation. This research was aimed to survey attitudes of nursing and pharmD undergraduate students about the "do not resuscitate" order for children with terminally ill diseases. METHODS: A cross-sectional correlational design was used to study the correlation between attitude toward DNR and demographic variables. More than 400 nursing and pharmD students from Jordan University of Science and Technology were recruited in this study. All the participating students were e-mailed information regarding the study, including the web survey link. RESULTS: The results showed that there was a significant difference in perception toward do not resuscitate order between nursing and pharmD students (p ≤ 0.05). The pharmD students had more positive attitude toward do not resuscitate than the nursing students. Approximately, 60% of the nursing and pharmD students would disclose the need for the do not resuscitate order for children with terminally ill diseases Demographic variables were not associated with the perception toward do not resuscitate orders (p ≥ 0.05). CONCLUSION: This study showed that Jordanian nursing and pharmD students are willing to learn more about different aspects of do not resuscitate orders for terminally ill children. Analyzing their responses to many items showed their misconception about do not resuscitate orders for terminally ill children.

Guidelines for the orthopedic surgeon in the era of COVID-19.

Amid the current pandemic of coronavirus disease 2019 (COVID-19), orthopaedic surgery was one of the fewer specialties that remained active managing emergent and urgent orthopaedic and trauma cases. On the other hand, with the continued spread of this pandemic and its associated socioeconomic confinement and unpredictability of the pandemic curve; many health care facilities were forced into halting all elective and non-urgent activities including orthopaedic specialties. This in part was to help in reallocation of required resources and focusing on the proper management of COVID-19 patients, and to prevent the transmission of infection among health care workers and patients. In this article we analyzed developments and recommendations of international reports about the current outbreak and its impact on the practice of orthopaedic surgery. Our aim was to provide comprehensive and easy guidelines for the management of urgent and emergent cases in hot zones and for the process of returning to usual orthopaedic work flow in a balanced strategy to assure safe practice and providing quality care without the risk of exhausting institutional resources or the risk of COVID- 19 transmission among health care workers or patients.

Do Illness Perception Predict Perceived Learning Needs Among Patients Treated With Percutaneous Coronary Intervention.

BACKGROUND: The number of coronary heart disease (CHD) patients treated with percutaneous coronary intervention (PCI) has increased. The illness perception (IP) of PCI recipients needs to be evaluated. Yet, little is known whether patients' IP predicts perceived learning needs among patients treated with PCI. OBJECTIVE: The aim of this study was to assess patients' IP and to examine its influence on perceived learning needs post PCI. METHODS: A cross-sectional design was used. A convenience sample of 208 patients who had undergone first-time PCI participated in the study. Data were collected before patients were discharged from the hospital using the Brief Illness Perception Questionnaire and the Percutaneous Coronary Intervention Learning Need Scale. RESULTS: Patients were highly concerned about their illness and perceived high consequences and symptoms related to CHD. They perceived low levels of personal and treatment control over their illness. Patients reported high learning needs. Multiple linear regression showed that low perception of personal control (P < .037), treatment control (P < .041), and high perception of disease symptoms (P < .018) significantly predicted high perceived learning needs. CONCLUSION: Hence, the patients' IP influences perceived learning needs, which may be included in routine clinical assessments. Tailored health education programs are needed for patients treated with PCI; such a program should target patients who perceived low levels of personal and treatment control over illness and have a high perception of symptoms.

Development and psychometric testing of the Physical Examination Attitudes and Practices Scale.

AIM: To develop and test a scale that assesses the attitudes and practices of registered nurses toward physical examination (PE) in of (delete) the clinical settings. METHODS: A cross-sectional methodological design with a convenience sample of 277 registered nurses was used. A Likert-type scale was constructed using 55 Likert-type items that were extracted from the relevant literature. Exploratory factor analyses were conducted using varimax rotation. Factor loading, eigenvalues, and screeplots were used to determine the best fit model. RESULTS: The final version of the scale consisted of four factors. The determinant score was (0.001) and the total variance explained was 56.26%. All of those four factors had eigenvalue more than 1. The final version of the scale (the 20-item scale) was tested for reliability and was internally consistent (Cronbach's α = 0.833). The scale was supported for its validity. CONCLUSION: The final version of the scale can be used to determine nurses' perspective and use of PE, and assist in bridging the gap between what is taught and what is practices regarding PE.

Diabetes self-care management practices among insulin-taking patients.

BACKGROUND: Diabetes self-care management (DSCM) is complex because various factors and relationships influence its processes. AIMS: This study aimed to identify the level of DSCM, compare the levels of self care between patients with type 1 and patients with type 2 diabetes, and identify significant predictors of self-care among Jordanian patients with type 1 and type 2 diabetes who were taking insulin. METHODS: A descriptive cross-sectional design was employed using a convenience sample of 310 Jordanian patients. The Arabic translated version of the 40-item Diabetes Self-Management Scale was used to collect data. RESULTS: The type of diabetes (t(310) = 4.81; p < .001) and the type of medications (insulin, or insulin and tablets) (t(310) = 4.75; p < .001) significantly affected the level of self-care. Age (t(296) = - 3.41; p = 0.001), gender (t(296) = -4.78; p < 0.001) training in self-care (t(296) = 4.30; p < .001), educational level (t(296) = 2.81, P = .005) and using traditional treatment (herbal therapy) (t(296) = -4.64, p < .001) significantly predicted self-care and explained around 58% of the variance in self-care. CONCLUSIONS: Various factors were found to influence self-care. Further research is needed to explore the complex nature of DSCM.

Prevalence of depression and its associated factors in patients post-coronary artery bypass graft surgery.

This research aimed to determine the depression level and its correlation experienced by post-coronary artery bypass graft patients after being discharged from cardiac intensive care units. A cross-sectional design was employed for assessing variables. The Self-rating Depression Scale, as proposed by Zung, was used by the researchers on a convenience sample of Jordanian patients (N = 143) who were approached soon after their discharge from the targeted units. The results suggested that the level of depression among Jordanian patients was relatively high (M = 62.7, SD = 5.6). Moreover, depression was significantly higher among female, unmarried and unemployed patients. Patients who received their information about coronary artery bypass graft surgery from nurses had a lower level of depression. Age, length of stay in the cardiac intensive care unit and hospital type significantly predicted the level of depression. The research concluded that the post-coronary artery bypass graft patients who experienced an early onset depression required more attention to highlight the importance of supportive interventions.

Beliefs and Practices of Patients with Diabetes toward the Use of Herbal Therapy.

This study aimed to assess the prevalence of using herbal therapy and the beliefs toward the use of this type of therapy among patients with diabetes. It also aimed to identify the significant predictors of these beliefs and the factors that increase the likelihood of using herbal therapy. A descriptive cross-sectional design was used. A convenience sample comprised 310 patients with diabetes. Sixty-seven (21.6%) of the participants used herbal therapy. The mean beliefs score was 3.72 and ranged from (0-12). Linear regression showed that beliefs were significantly predicted by self-care, attending workshops, education level, and number of complications. The logistic regression showed that the lower the self-care and the higher the beliefs, the more likelihood the patient uses herbal therapy. Informing patient through individualized diabetes education influences the patient's beliefs and promotes self-care. This education program should target mainly those patients with low self-care, high number of complications, lower educational level and having more complications.

Psychometric properties and characteristics of the Diabetes Self Management Scale.

OBJECTIVE: Assessing diabetes self care management is essential for nursing care for diabetes. There is a need to have valid and reliable scales that assess the actual performance of diabetes self management. The purpose of this study was to revise and conduct psychometric testing and analysis of the Diabetes Self Management Scale (DSMS). METHODS: A cross-sectional methodological design was used. A convenience sample was used and 78 adults with diabetes and taking insulin from five sites in the Midwest area of the U.S participated in the study. Reliability analysis was done using Ferketich techniques to make decisions about whether any given item should be retained or deleted. RESULTS: A descriptive analysis for the 60 items of the scale was conducted; several items had low variability compared to the other items on the scale. The correlation matrices showed that a total of 20 items had poor item characteristics. These 20 items were deleted resulting in developing 40- item version of the scale. The 40 - item scale had high level of internal consistency (Cronbach's α = 0.947). The validity testing of the 40 - item scale was guided by the Research Model for Diabetes Self Care Management; results were congruent with the model and showed strong correlation with self efficacy, moderate correlation with self care agency, and weak correlation with diabetes knowledge. CONCLUSION: The items and the scale (DSMS) have undergone careful psychometric testing. The 40-item DSMS is a reliable and valid instrument to measure diabetes self care management among people with diabetes.

The influence of treatment modality on illness perception and secondary prevention outcomes among patients with acute myocardial infarction.

OBJECTIVES: This study aims to determine if patients with acute myocardial infarction differ in illness perception and secondary prevention outcomes depending on the treatment they received. METHODS: A repeated measures design was used to compare patients with acute myocardial infarction receiving three different treatment modalities: ST-elevation myocardial infarction treated by primary percutaneous coronary intervention, ST-elevation myocardial infarction treated by thrombolytic therapy, and non ST-elevation myocardial infarction treated by medication. A convenient sampling technique was used to recruit 206 patients with acute myocardial infarction who agreed to participate in the current study. Patients' illness perception, physical activity, and demographical and clinical data were collected during hospital admission and again at 6 months. RESULTS: A total of 186 patients completed the study. Results showed that the primary percutaneous coronary intervention group perceived their illness as acute rather than chronic (P = 0.034) and has lower personal control (P = 0.032), higher treatment control (P = 0.025), and higher perception of illness coherence (P = 0.022) compared with patients receiving thrombolytic therapy and treated after non-ST segment infarction. Moreover, they report low control of their blood pressure (P = 0.013) and less physical activity (P = 0.001). CONCLUSION: The results of this study revealed that patients' treated with primary percutaneous coronary intervention had negative illness perception and limited behavioral changes 6 months after hospitalization in comparison with other treatment modalities such as percutaneous coronary intervention and thrombolytic treatment. Further research is recommended to confirm this association with longer follow-up study and among different cultures.

Prevalence of Depression and its Associated Factors among Jordanian Diabetic Foot Patients

Background: Diabetes mellitus is widespread metabolic disorders with long-term complications, which include significant psychosocial dysfunctions such as depression and physiological dysfunctions such as diabetic foot (DF). Related to diabetic studies in general, the prevalence of depression is high and causes deterioration in health related outcomes and quality of life, whereas the studies about depression and diabetic foot in specific are meager and insufficient. Purposes: The purposes of this study were to assess the prevalence of depression, to identify factors associated with depression, and to identify the rate of unscreened depression among diabetic foot patients. Methods: The design of this study is cross-sectional. A convenience sampling of 216 diabetic foot patients was recruited from diabetic clinics of government hospitals in Jordan during the period from January 2016 to March 2016. Data was collected using a structured self-report questionnaire which consisted of 2 sections including socio-demographic questions with one self-reported question, and Patient Health Questionnaire-9 (PHQ-9) scale to assess depression. Results: The current study showed that 179 diabetic foot patients (82.9%) had depression according to PHQ-9 scale with different levels of depression, namely, mild, moderate, moderately severe, and severe that consist 25%, 25.5%, 18.5%, and 13.9% of the total sample respectively. Multiple linear regression showed that the availability of social support by the family and being a nurse as main healthcare provider were associated with low depression scores among DF patients, also high glycated hemoglobin was associated with high depression scores (F=8.923, p=0.001). Conclusion: Prevalence of depression among Jordanian diabetic foot patients and the rate of unscreened depression were high, which indicates an urgent need for thorough assessment of depression level that may help in early detection, treatment, and prevention of depression among diabetic foot patients. Several factors viewed to be associated with depression level that should take into consideration in the diabetic foot care plans.