Pain and anxiety in patients with breast cancer treated with morphine versus tramal with virtual reality.

The treatment of pain and anxiety in cancer patients includes both pharmaceutical and non-pharmacological approaches. The researchers of this study aimed to compare the effectiveness of morphine versus Tramal with virtual reality therapy (VR) in reducing pain and anxiety in female patients with breast cancer. The sample was composed of 80 women with breast cancer who where treated at a specialized cancer center in Jordan. A quasi-experimental design was used in the study intervention. When used with VR, the tramal analgesics did not differe significactly from the effect of morphine in reducing the pain and anxiety. However, both groups had a significant drop in the level of pain and anxiety. When combined with VR, the use of weak opioids such as Tramal will have nearly the same effect as strong opioids such as Morphine in reducing pain and anxiety in breast cancer patients.

Missed Nursing Care in Medical and Surgical Wards in Jordan: A Cross-Sectional Study.

Missed nursing care is a multifaceted patient safety issue receiving increased attention among healthcare scholars worldwide. There is limited research on missed nursing care in the Jordanian healthcare context. The current study sought to examine the perceptions of Jordanian nurses toward the amount and types of missed nursing care in medical and surgical wards. We also examined the differences in missed care items between public, private, and university hospitals in Jordan. This was a cross-sectional study using the MISSCARE Survey tool. Data collection spanned 4 months between March and July 2021. The final study sample consisted of 672 registered nurses employed in five public, three private, and two university hospitals in Jordan. Data were analyzed using descriptive statistics, Analysis of variance, and Pearson correlation coefficent test. Of the 672 registered nurses who participated, the majority were females (n = 421; 62.6%). Most participants held a bachelor's degree in nursing (n = 577; 85.9%). The three most common missed nursing activities in the participating hospitals were: ambulation, oral care, and emotional support. Nurses working in public hospitals reported the highest missed nursing care. The age and number of patients under care significantly correlated with missed nursing care. The findings could help nursing managers develop plans to reduce missed nursing care in their healthcare institutions.

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.

Hypertension and mobile application for self-care, self-efficacy and related knowledge.

Managing hypertension is not only concerned with lowering blood pressure (BP) by using antihypertensive medications but also aims at minimizing its consequences through adopting self-care. The aim of this study was to assess the effectiveness of mobile application on self-care, BP control, self-efficacy and hypertension-related knowledge among adult patients with hypertension. A randomized design, two groups, pretest-posttest, between subjects with a 1:1 allocation ratio was used. The sample was selected from cardiology clinics has completed the study. Using a block randomization method, 57 of the participants were assigned to the intervention group receiving the educational application intervention, and 59 of them were assigned to the control group receiving usual care. The study's findings showed that participants in the intervention group reported statistically significant higher self-care and knowledge scores than the participants in the control group after 8 weeks of receiving the study intervention. Additionally, compared with the control group participants, more participants in the intervention group demonstrated BP control. The educational application is effective in improving knowledge, self-care and BP control. The positive results indicate the value of integrating mobile applications in the care of patients with hypertension.

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.

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.

Nursing knowledge and perceptions of COVID-19 pandemic in Jordanian intensive care units.

OBJECTIVES: The goal of this study was to find out the level of knowledge and perception among the nurses in intensive care units (ICUs). METHODS: The study was set up in a cross-sectional design. During the COVID-19 pandemic, nurses completed a self-reporting questionnaire to assess their knowledge and perception of the pandemic. 182 ICU nurses were asked for information. We used statistical analyses that were both descriptive and inferential. RESULTS: There was a statistically significant link between nurses' knowledge and their years of experience (r = 0.15, p = .03), their experience with COVID-19 infection (r = 0.83, p = .01), and having a first-degree relative who had COVID-19 (r = 0.17, p = .02). Also, nurses knew a fair amount about COVID-19. There was a statistically significant link between how nurses felt and how they were trained to care for COVID-19 patients (r = 0.15, p = .034), nurses who had COVID-19 infection (r = 0.30, p = .001), and having a first-degree relative who had COVID-19 infection (r = 0.18, p = .014). CONCLUSION: The Jordanian nurses' understanding of COVID-19 disease is categorized as average because the majority of their responses ranged between 56 % and 86 %. The nurses' knowledge was related to their length of experience in the field, and their perceptions were related to how they had been trained to care for COVID-19 patients.

Skin and mucous membranes colonisation with Staphylococcus aureus or MRSA as a risk factor for surgical site infections in elective Caesarean Section.

The purpose of this study was to determine if skin and mucous membrane colonisation with Staphylococcus aureus (S. aureus) and methicillin-resistant Staphylococcus aureus (MRSA) increases the incidence of surgical site infection (SSI) post-elective Caesarean Sections. A prospective study was conducted at a major centre in Jordan, involving 127 patients who underwent elective Caesarean Section surgeries during 2019. Participants were screened for skin and mucous membranes colonisation for S. aureus preoperatively and were followed for 90 days for any signs of SSI. The screening sites were on three parts of the patients' bodies; nose, throat, and groyne. The total SSI incidence was 18.9%. Among participants with SSI; 66.7% had a superficial infection and 33.3% had deep tissue infection. Skin and mucous membrane colonisation was positive in 42 participants (33.1%) in one of the three screening sites. Participants with positive skin and mucous membrane colonisation were found to have SSI incidence 2.43 times more than the non-colonised participants (Fisher's Exact test = 3.832, p = .05, CI: 0.098-6.02). Participants with S. aureus skin and mucous membranes colonisation were significantly 2.94 times with more SSI incidence than those who were not colonised (Fisher's Exact test = 5.485, p = .02, CI: 1.164-7.439). Skin and mucous membrane colonisation was found to increase the incidence of SSI. More attention should be performed to screen for skin and mucous membranes colonisation and subsequent selective skin decolonisation to decrease SSI incidence.IMPACT STATEMENTWhat is already known on this subject? Surgical site infection (SSI) is a challenge that increases the costs of health care. Surgical site infection is associated with high costs mainly due to the increase in the length of hospital stay. Skin screening for S. aureus or MRSA colonisation was found to be important for selective skin decolonisation using appropriate antiseptic preparation and preoperative antibiotic prophylaxis.What do the results of this study add? The incidence of SSI in the colonised group was found to be 2.43 times higher than in the non-colonised group.What are the implications of these findings for clinical practice and/or further research? Screening for colonisation and subsequent selective skin decolonisation should be a part of SSI prevention policies.

Cancer-related fatigue: Systematic reviews and meta-analyses of mind-body intervention.

OBJECTIVES: This study aimed to evaluate the methodological quality of systematic reviews and meta-analyses of mind-body interventions (MBIs) for the management of cancer-related fatigue. METHODS: A comprehensive search on multiple databases was conducted to identify relevant systematic reviews and meta-analyses published from January 2008 to December 2019. Two authors independently selected reviews, extracted data, and evaluated the methodological quality of included reviews using Assessing the Methodological Quality of Systematic Reviews (AMSTAR). RESULTS: Sixteen reviews published between 2010 and 2018 were eligible for inclusion. The methodological quality of the 16 included systematic reviews was moderate (score 4-7) to high (score ≥ 8) on the 11-point AMSTAR scale. The most common methodological weaknesses were the lack of a list of excluded studies (n = 15, 93.8%) and a priori protocol (n = 2,87.5%). Furthermore, most of the systematic reviews did not search the gray literature for eligible studies (n = 13, 81.3%). SIGNIFICANCE OF THE STUDY: This study has revealed the need for high methodological quality systematic reviews on the MBIs for the management of cancer-related fatigue. Thus, further research should focus on methodologically strong systematic reviews by providing a priori design, not limiting the publication type, and providing an excluded primary studies list. Additionally, the researchers should conduct systematic reviews according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

Predictors of job satisfaction of registered nurses providing care for older adults.

BACKGROUND: The population worldwide is ageing. This has required the nursing profession to respond to the growing demands of providing nursing care to this population. PURPOSE: To identify predictors of job satisfaction among registered nurses providing care for older adults. METHODS: A cross-sectional correlational design was used with a convenience sample of nurses. The Quality Work Competence Questionnaire, Job Satisfaction Scale and Nurses' Occupational Stress Scale were used to measure study variables. Descriptive statistics and multiple regressions were used to analyse the data. RESULTS: The study included 500 nurses; and 68% dissatisfied with their job. Nurses were mostly dissatisfied with the physical conditions in which they work (55.2%) and the rate of payment (50.2%). Physical strain demonstrated the highest positive correlation with nurses' satisfaction (r = .36). More years of experience, skills and employee development, high nurses' competence, and more physical strain predicted high job satisfaction. CONCLUSION: Job dissatisfaction among nurses providing care for older adults is high and is influenced by nurses' experience, professional development, competency and physical strain. IMPLICATIONS: Health care organisations should apply strategies that enhance the development of the professional competency of their nursing staff.

Virtual Reality Technology for Pain and Anxiety Management among Patients with Cancer: A Systematic Review.

BACKGROUND: Pain and anxiety have negative effects on the treatment of patients with cancer. Virtual reality technology is a form of distraction which is still unclear in its methodological quality in reducing pain and anxiety. AIMS: To summarize and evaluate the methodological quality of primary studies on the virtual reality (VR) technology for the management of pain and anxiety among patients with cancer, and to analyze the effectiveness of VR in the reviewed studies. DESIGN: This review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. SETTING: Multiple databases from their inception through November 2018. METHODS: A comprehensive search was performed to identify studies that evaluated the effectiveness of VR in managing pain and anxiety among patients with cancer. The methodological quality of included studies was appraised using the modified Downs and Black checklist. RESULTS: Thirteen studies published between 1999 and 2018 were eligible for inclusion. These included studies were classified as being of good or fair quality. The consensus across the included studies was that compared with standard care, VR plus standard care were more effective in reducing pain and anxiety especially in children and adolescent patients who were undergoing painful procedures, and in adult and elderly patients who were undergoing anti-cancer treatments and during their hospitalization. CONCLUSION: Although more high- methodological quality studies are needed to determine whether VR technology is effective in controlling symptoms in patients with cancer, the results of this review suggested that VR intervention may be beneficial for the management of pain and anxiety in patients with cancer. Therefore, clinicians may consider VR technology as an adjunctive intervention for pain and anxiety management.

Relationship Between Control Over Nursing Practice and Job Satisfaction and Quality of Patient Care.

BACKGROUND: Control over nursing practice (CONP) in the work setting is associated with several positive consequences such as increased job satisfaction, support of teamwork, decreased patient mortality, and improved quality of care. PURPOSE: The purpose of this study was to examine the level of perceived CONP among Jordanian registered nurses (RNs) and determine its relationship with their job satisfaction and quality of patient care. METHOD: A descriptive, cross-sectional correlational design was used. A convenience sample of 230 RNs was recruited from 4 hospitals. RESULT: The RNs had a moderate level of perceived CONP. This control was positively correlated with their work satisfaction and perception of the quality of patient care that they delivered. CONCLUSION: Nurse managers should be encouraged to take into consideration nurses' perceived CONP to improve working conditions for nurses.

Virtual reality as a distraction technique for pain and anxiety among patients with breast cancer: A randomized control trial.

OBJECTIVE: The goal of this study was to assess the effectiveness of immersive virtual reality (VR) distraction technology in reducing pain and anxiety among female patients with breast cancer. METHOD: A randomized control trial design was used with a sample of 80 female patients with breast cancer at a specialized cancer center in Jordan. Participants were randomly assigned into intervention and comparison groups.ResultThe study findings showed that one session of the immersive VR plus morphine made a significant reduction in pain and anxiety self-reported scores, compared with morphine alone, in breast cancer patients.Significance of resultsImmersive VR is an effective distraction intervention for managing pain and anxiety among breast cancer patients. Using immersive VR as an adjuvant intervention is more effective than morphine alone in relieving pain and anxiety; furthermore, VR is a safe intervention more than pharmacological treatment.

Predictors of quality of care provided for older adults.

BACKGROUND: The work conditions in which the nurses provide care for older adults affect the quality of care. STUDY AIM: (a) To describe the quality of care for older adults as perceived by the nurse; (b) to examine the relationship between occupational stress, work climate, employee development and quality of care for older people; and (c) to determine the predictors of quality of care provided for older adults. METHODS: A descriptive correlational design was used in this study. A multi-strategic sampling technique was used to recruit a sample of 500 nurses providing care for older adults in hospitals and health care centres. RESULTS: Almost 80% of the participating nurses reported that their workplace was insufficiently staffed. Quality of care was significantly associated with occupational stress, nurses' competence and employee development. Significant predictors of quality of care were occupational stress, work climate and employee development. CONCLUSION: Enhancing nurses' work climate, decreasing occupational stress and increasing chances for employee development would improve the quality of care provided for older adults. IMPLICATIONS FOR NURSING MANAGEMENT: Health institutions have the opportunity to implement work environment improvements that increase support for advancing staff knowledge and skills by providing additional support for continuing education regarding the care of older adults.

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.].

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.

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.

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.

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.