Disordered eating in Jordanian adolescents.

BACKGROUND: Disordered eating attitudes and behaviours are linked to poor physical and psychological outcomes. AIM: To examine the individual, psychological, and socio-cultural factors associated with disordered eating attitudes among Jordanian adolescents. METHODS: A stratified sampling method was used to select school students aged 15 to 18 years from three governates in Jordan in 2013/2014. Participants filled out questionnaires on socio-demographic variables, the Eating Attitudes Test (EAT-26; to discriminate adolescents with disordered eating); the Body Shape Questionnaire (BSQ; used to measure psychological factors associated with disordered eating); Body Mass Index was calculated and obesity evaluated according to international cut off points (to categorize normal weight, overweight, and obese adolescents, and these categories were used as individual factors associated with disordered eating). RESULTS: A total of 963 (460 boys and 503 girls) participated in the study. Disordered eating (EAT score ≥ 20) was present in 389 (40.4%); body shape dissatisfaction (BSQ scores ≥110) was present in 161 (16.8%). Overweight and obesity were found in 332 (34.5%) participants. Unhealthy weight loss behaviours (such as self-induced vomiting, substance abuse, and smoking) were very common. Multivariate logistic regression analysis demonstrated that female sex, urban residence, distorted perceptions of weight, BMI (excess weight), body dissatisfaction, and socio-cultural variables (parents, peers and mass media) were significantly associated with disordered eating. CONCLUSION: Jordanian urban adolescents seem to embrace Western norms to fit in with the demands of Western culture. Socio-cultural factors, particularly mass media, play a significant role in changing adolescents' norms. Prevention and intervention programs are needed to control these disorders.

Assessment of Headache Among High School Students in Jordan.

Headache is considered one of the most common complaints affecting all ages: children, adolescents, and adults. A school-based, cross-sectional study was conducted to assess primary headache among high school students aged 16-18 in Grades 11-12, over a period of 3 weeks (May 2017). A questionnaire was designed, in accordance with the International Headache Society's criteria. The Pearson's χ2 test was computed to show the differences between the variables. Nearly two thirds of the students reported having headache (19.0% tension-type headache, 8.8% migraine, and 39.0% unknown type). Nearly a quarter sought help for headache, and the most frequently used analgesic was acetaminophen (82.2%) followed by aspirin (5.1%). The current study revealed that the prevalence of headache and migraine was initially high and increased with age. Moreover, headache is one of the major public health problems among high school students. An education program conducted by school nurses and other health-care providers regarding headache and migraine is needed.

Palestinian community perceptions of do-not-resuscitation order for terminally Ill patients: A qualitative study.

AIM AND OBJECTIVES: To illustrate the Palestinian community's views, opinions and stances about the concept of do-not-resuscitate for terminally ill patients. BACKGROUND: Do-not-resuscitate orders are practised in many countries worldwide, but there is no consensus on their practice in the Middle East. Do-not-resuscitate orders may be applied for terminally ill paediatric patients. Some studies have been conducted describing people's experiences with these do-not-resuscitate orders. However, few studies have considered community perspectives on do-not-resuscitate orders for terminally ill patients in Palestine. DESIGN: A descriptive-qualitative design was adopted. METHODS: A purposive sample of 24 participants was interviewed, with consideration of demographical characteristics such as age, gender, education and place of residency. The participants were recruited over a period of 6 months. Individual semistructured interviews were utilised. These interviews were transcribed and analysed using thematic analysis. FINDINGS: Significantly, the majority of the participants did not know the meaning of do-not-resuscitate and thought that removal of life-sustaining devices and do-not-resuscitate were the same concept. Most of the interviewees adopted stances against do-not-resuscitate orders. Several factors were suggested to influence the decision of accepting or rejecting the do-not-resuscitate order. The majority of the participants mentioned religion as a major factor in forming their viewpoints. The participants expressed different views regarding issuing a law regarding do-not-resuscitate orders. CONCLUSION: Our findings provide a unique understanding that there is a general misunderstanding among our participants regarding the do-not-resuscitate order. Further research with policymakers and stakeholders is still required.

Knowledge and Attitudes of Jordanian University Students Toward Epilepsy: A Cross-Sectional Comparison Study.

People with epilepsy face stigma which arguably causes more suffering than the disease itself. The purpose of this study is to compare the knowledge and attitudes of nursing with nonnursing Jordanian university students toward epilepsy. A cross-sectional comparative, quantitative study was conducted. A newly structured questionnaire was developed to collect related data. The results revealed that there were 145(30.5%) nursing students and 331 (69.5%) nonnursing students with mean age of the participants was 22.9 years ( SD = 4.7) and 60% of them were men. Although the majority of the Jordanian university students were aware of epilepsy, their knowledge varied according to their major subject of study. Nursing students possessed a good knowledge of, and more positive attitudes toward, epilepsy compared with other nonnursing students. Therefore, universities are required to improve the knowledge of their students about epilepsy by integrating education about health and first aid course into their curriculum.

Prevalence of attention deficit hyperactivity disorder among school-aged children in Jordan.

The purpose of this study was to determine the prevalence of attention deficit hyperactivity disorder (ADHD) symptoms among school children in Jordan and the probable associated risk factors. This was a crosssectional descriptive study and simple random sampling was used to select 480 students, aged 6-12 years, from government primary schools in Mafraq City, Jordan. Data were collected using the modified Arabic version of the Attention Deficit Disorder Evaluation Scale (ADDES) school version and parental questionnaire. Prevalence rates within the inattentive, hyperactive-impulsive and combined subtypes were 10.83, 9.58 and 20.21%, respectively. Increased family size and being male were both associated with increased prevalence of ADHD symptoms. The study revealed that ADHD is common among Jordanian school children. The government should establish education programmes to increase awareness of ADHD.

Adherence to Antipsychotic Drug Measured by an Arabic Version of Morisky Scale.

A cross-sectional study (n = 108) was conducted to assess medication adherence levels among people with mental illness in Jordan using the Arabic version of Morisky Medication Adherence Scale. The findings showed a significant negative correlation between patients' level of adherence, frequency of admissions, and relapses per year and a negative correlation between adherence level and frequency of follow up appointments per month. Nonadherence to antipsychotic medication in Jordan is very high and the reasons for this need to be further explored as nonadherence negatively effects the global burden of disease associated with mental illness, particularly in developing countries.

Epidemiology of Nonfatal Injuries Among Schoolchildren.

Nonfatal injuries are considered as one of the major public health hazards affecting schoolchildren, and the majority of these injuries occur at school or in the home. A cross-sectional study was conducted over a period of 3 months, March-May 2015. The participants were 4,355 Jordanian schoolchildren in Grades 7-12. The Pearson χ(2) test was computed, and the odds ratio was used to determine the magnitude of various risk factors for nonfatal injuries among schoolchildren. The overall incidence of nonfatal injury was 33.9%. The group most likely to sustain nonfatal injuries was boys, aged 12-15, in Grade 7, whose parents had a low level of education or a high family income. Injury prevention in schools and at homes is a cornerstone for protection or reducing the incidence of injuries. School nurses have a duty to follow up and examine the accident reports and evaluate whether safety policies are applied and are effective in different school settings. Furthermore, health and education authorities should develop a national program for preventing injuries.

Patient- and family caregiver-related barriers to effective cancer pain control.

Cancer is a worldwide health problem. In Jordan, cancer is the second leading cause of death. Approximately 2,000 people die from cancer every year, 70% of them experiencing varying high levels of pain as a result of ineffective pain relief. The purpose of this study was to identify the attitudinal barriers to effective cancer pain relief in patients and their family caregivers in Jordan. A cross-sectional questionnaire survey was used. A convenience sample of 300 cancer patients and 246 family caregivers were recruited from four different Jordanian hospitals between August 2009 and May 2010. Patients completed the Arabic version of the Barriers Questionnaire II (ABQ-II), the Arabic Brief Pain Inventory (A-BPI), and a demographic questionnaire. Family caregivers completed the ABQ-II and a demographic questionnaire. The A-BPI results identified that more than 70% of cancer patients in localized stage and more than 90% of patients with advanced cancer experienced substantial pain. Four major barriers to pain control were highlighted: fears related to addiction, side effects, communication concerns, and fatalistic beliefs. This study provides baseline information about the barriers to effective cancer pain control in Jordan.

Health professionals' perceptions regarding family witnessed resuscitation in adult critical care settings.

AIMS AND OBJECTIVES: To deepen our understanding of the perceptions of health professionals regarding family witnessed resuscitation in Jordanian adult critical care settings. BACKGROUND: The issue of family witnessed resuscitation has developed dramatically in the last three decades. The traditional practice of excluding family members during cardiopulmonary resuscitation had been questioned. Family witnessed resuscitation has been described as good practice by many researchers and health organisations. However, family witnessed resuscitation has been perceived by some practitioners to be unhealthy and harmful to the life-saving process. The literature showed that there are no policies or guidelines to allow or to prevent family witnessed resuscitation in Jordan. DESIGN: An exploratory qualitative design was adopted. METHODS: A purposive sample of 31 health professionals from several disciplines was recruited over a period of six months. Individual semi-structured interviews were used. These interviews were transcribed and analysed using thematic analysis. FINDINGS: It was found that most healthcare professionals were against family witnessed resuscitation. They raised several concerns related to being verbally and physically attacked if they allowed family witnessed resuscitation. Almost all of the respondents expressed their fears of patients' family members' interfering in their work. Most of the participants in this study stated that family witnessed resuscitation is traumatic for family members. This was viewed as a barrier to allowing family witnessed resuscitation in Jordanian critical care settings. CONCLUSION: The study provides a unique understanding of Jordanian health professionals' perceptions regarding family witnessed resuscitation. They raised some views that contest some arguments in the broader literature. Further research with patients, family members, health professionals and policy makers is still required. RELEVANCE TO CLINICAL PRACTICE: This is the first study about family witnessed resuscitation in Jordan. Considering multi-disciplinary healthcare professionals' views would be helpful when starting to implement this practice in Jordanian hospitals.

Self-medication among school students.

Self-medication, usually with over-the-counter (OTC) medication, is reported as a community health problem that affects many people worldwide. Most self-medication practice usually begins with the onset of adolescence. A school-based cross-sectional study was conducted in Mafraq Governorate, Jordan, using a simple random sampling method to select 6 public schools from a total of 34 schools. The total sample consisted of 422 school students from Grades 7 through 12. Measures of central tendency and χ(2) were used to compare the difference between the categorical variables. The prevalence of self-medication among the participants was 87.0%. Nearly 75% of self-medication was used for pain relief. The prevalence of self-medication among school students is very high and increases with age. School nurses and other local health-care workers must coordinate with school principals to disseminate health education campaigns about safe use of medication to provide awareness and education to school students, parents, and families.

Electronic versus paper records: documentation of pressure ulcer data.

BACKGROUND: The documentation of patient data on health records is a vital component of the care process. Accurate and complete recording of this data is a necessary practice. The adoption of electronic health records to improve the quality of nursing documentation is on the rise. OBJECTIVES: This study compares the accuracy and completeness of pressure ulcer data documentation between electronic and paper records. DESIGN: A descriptive, comparative design with a retrospective review of patient records. Settings and sample: Two hospitals were chosen purposefully, one using electronic recording of patient data and the other using paper records. METHODS: In the first phase, all hospitalised patients aged 18 years and over were inspected for pressure ulcers. In the second phase, the files of patients with pressure ulcers were audited. RESULTS: Of the 52 patients with ulcers found in the hospital that used an electronic system, 43 of their records documented the pressure ulcers (83%). Of the 55 patients with pressure ulcers in the hospital using paper records, 39 files had corresponding documentation of the presence of a pressure ulcer (71%). CONCLUSION: In terms of accuracy and completeness, more comprehensive documentation practice was found on the electronic health records compared with paper records. However, both types of systems have shortcomings in the practice of pressure ulcer data documentation.

Depression in Nonhospitalized Jordanian Patients With Coronary Artery Disease.

BACKGROUND: Patients with coronary artery disease (CAD) are likely to experience depression, which contributes to the burden of disease and is a risk factor for mortality. Patients in outpatient clinics in Jordan are not routinely screened for depression. Significant relationships among patient characteristics must be determined to ascertain the predictors of depression. PURPOSE: The aims of this research were to assess the level of depression symptoms in nonhospitalized patients with CAD; to examine the relationships between depression and relevant sociodemographic, self-reported health history, and patient health perception variables; and to identify possible predictors of depression in Jordan. METHODS: This cross-sectional study recruited a convenience sample (N = 174) of nonhospitalized outpatients who had been diagnosed with CAD. Self-reported demographic, health history, and health perception information (independent variables) were provided by the participants. The depression scores (dependent variable) for the participants were assessed using the Cardiac Depression Scale. Data were analyzed using descriptive statistics, the chi-square test, Pearson's correlations, and multiple linear regressions. RESULTS: Half of the participants reported mild to moderate depression, with 37% reporting severe depression. Predictors of depression included gender (being female), having a concomitant chronic disease, prior surgery, irregular exercise, impaired sexual activity, and self-perceived poor psychological health. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: To improve patient outcomes, clinical personnel should screen patients with CAD for depression and offer a combined pharmaceutical and therapeutic treatment intervention. An easy-to-administer instrument to detect depression may be included in the standard patient checkup routine used in clinics. Several patient characteristics were found to significantly affect depression and health outcomes.

Awareness and Knowledge of Ovarian Cancer Symptoms and Risk Factors: A Survey of Jordanian Women.

Ovarian cancer accounts for 3% of all female cancers and has a high mortality rate among gynecological malignancies. Early diagnosis carries a high survival rate of 93%. So, this study was carried out to assess the knowledge and awareness of Jordanian women about ovarian cancer symptoms and risk factors. A cross-sectional survey design was used; 896 women completed the survey. The mean of total symptoms recognized was low at level of 3.2 ( SD = 2.7) out of 10. The three highest known symptoms among women were as follows: extreme fatigue (43.2%), back pain (42.4%), and persistent pain in pelvic area (40.7%). The most commonly known risk factor was smoking (68.4%), followed by having ovarian cyst(s) (59.7%). Hence, with the absence of an effective screening program, a national awareness campaign is urgently needed to improve the public's understanding of symptoms and risk factors and increasing women's confidence in symptom recognition.

The relationship between physical activity and diet, and overweight and obesity, in young people.

BACKGROUND: Childhood obesity has a worldwide association with serious health problems and complications that increase the risk of illness and death. AIM: To identify and assess the factors contributing to overweight and obesity among school students in north Jordan. METHOD: A descriptive cross-sectional study involving 1,554 students was conducted between October 2014 and February 2015. RESULTS: More than two thirds (70%) of participants were normal weight (5th percentile-<85th percentile), while 12% were overweight and 13% were obese. The prevalence of obesity was high (20%) among those eating snacks three times per day. The prevalence of overweight was high (12%) among those who followed no regular physical activity programme. CONCLUSION: Collaboration is required between policymakers, healthcare professionals, business and community leaders, schools and local organisations to create suitable environments that support healthy lifestyles for children and young people.

A descriptive study of adherence to lifestyle modificationfactors among hypertensive patients.

BACKGROUND/AIM: Healthy life style recommendations (e.g., physical activity, healthy diet, and decreased cholesterol levels) play an important role in controlling blood pressure (BP). This study aimed to assess lifestyle modification factors among patients diagnosed with hypertension. MATERIALS AND METHODS: A descriptive-survey design was used. Data were collected using four questionnaires; one was the Beliefs about Medication questionnaire (BMQ) and the rest were developed to collect data about demographic and clinical characteristics and lifestyle modification factors. RESULTS: In total 312 questionnaires were completed. The results revealed that our participants did not follow the healthy lifestyle recommendations; for example, the mean blood sugar (BS) level, body mass index (BMI), and cholesterol levels were 155 mg/dL (standard deviation (SD) = 71.9), 29 kg/m2 (SD = 5.4), and 197 mg/dL (SD = 86.6), respectively. A significant correlation was shown between age and BP (P = 0.000). Increase in diastolic BP (DBP) correlated with a significant increase in cholesterol level (P = 0.002) and BMI (P = 0.006). CONCLUSION: Our study showed that somewhat hypertensive patients in Jordan did not follow a healthy lifestyle. Therefore, urgent action by addressing behavioral risk factors has a positive impact on preventing and controlling hypertension.

Validity of Arabic Version of Beliefs About Medication Questionnaire.

To assess the validity and reliability of the Arabic version of the Beliefs About Medication Questionnaire, a cross-sectional design was used and the data were collected from 605 patients with chronic diseases. The study was conducted between July 2013 and December 2013. The results showed that the Cronbach's alpha coefficient (.71) was satisfactory. There was a significant strong positive correlation between test-retest for the same group subsample, with a correlation coefficient range of .45 to .78. There were no statistically significant differences between retest subgroups and remaining samples in the questionnaire subscales. The percentage of missing value was around 0.03, which confirmed the feasibility of the Arabic version of the questionnaire. These findings suggested that having a culturally acceptable, valid and reliable instrument to identify patients' beliefs toward medication in Jordan will play an important role in tailoring appropriate intervention to enhance patient compliance with their prescribed medication.

Workplace violence toward emergency department staff in Jordanian hospitals: a cross-sectional study.

BACKGROUND: Workplace violence against emergency department staff (EDS) is considered one of the most common and widespread phenomena of violence in the hospital setting. PURPOSE: The purpose of this research is to determine the incidence of workplace violence and the predictors of violent behavior against EDS working at hospitals in Jordan. METHODS: A cross-sectional study was used to investigate the workplace violence experiences of a convenience sample of 355 EDS working at 8 government-run and 4 privately run Jordanian hospitals. Data were collected using a self-administered questionnaire that was developed for this study. RESULTS: Nearly three quarters (72%) of participants reported being exposed to violent acts. Patients and their relatives were identified as the main perpetrators of this violence. The contributing factors to workplace violence identified by the participants included overcrowding, lack of resources, staff shortages, and the absence of effective antiviolence policies. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Policies and legislation related to workplace violence should be instituted and developed. Furthermore, EDS should be trained to deal with violent incidents and to understand violence management policies.

The relationship between social support and adherence to healthy lifestyle among patients with coronary artery disease in the north of Jordan.

Numerous studies have shown that social support improves health behaviors in patients with coronary artery disease (CAD). The purpose of this study was to examine the relationship between adherence to a healthy lifestyle, and social support and selected sociodemographics among patients with CAD. Cross-sectional descriptive design was used. A convenient sample of 153 patients with CAD was recruited from the cardiac clinic in an educational hospital in the north of Jordan. One hundred and thirty-three patients completed the interview. Social support was the most significant predictor-t(124) = 9.51, p < .001-which explained 60% of variance in adherence to a healthy lifestyle. Providing patients with adequate social support improves adherence to a healthy lifestyle. More attention should be given to the elderly and patients with low income to enhance adherence to a healthy lifestyle. The applications of this study in practice provide a guide for nursing clinical assessment of social support for patients facing CAD.

Exploring the competency of the Jordanian intensive care nurses towards endotracheal tube and oral care practices for mechanically ventilated patients: an observational study.

Oral care is an important feature of nursing; it is known that oropharynx is considered the main reservoir of bacterial colonization, so the removal of oral infection is a major duty of all health care providers, particularly nurses. We performed this study to explore endotracheal tube and oral care practices for mechanically ventilated patients of Jordanian intensive care nurses, and to study Jordanian intensive care nurses' practices during, prior to, and post endotracheal tube and oral care for mechanically ventilated patients. Endotracheal tube and oral care of Jordanian intensive care nurses for mechanically ventilated patients was compared with recommendations for endotracheal tube and oral care of American Association of Critical Care Nurses and guidelines of Centers for Disease Control and Prevention. Non- participant structured observational design was conducted using a 24 -item structured observational schedule. The findings show that nurses different in their oral care practices; did not follow American Association of Critical Care Nurses recommendations; and therefore delivered lower-quality oral care than predictable. Important inconsistencies were observed in the nurses' hyperoxygenation, respiratory assessment techniques and infection control practices.