The hidden curriculum of gatekeeping: Dismissal experiences of health service psychology trainees.

Health service psychology (HSP) programs, encompassing clinical, counseling, and school psychology, play a pivotal role in shaping the U.S. health care workforce. Practicum and internship sites are critical gatekeepers within this training. However, there is limited empirical evidence available regarding the prevalence of clinical dismissal and its consequences for affected trainees. To bridge these gaps in our understanding of clinical dismissal during HSP training, Study 1 conducted an analysis of a quantitative survey involving training directors (N = 123) from HSP academic programs. The results revealed that 28% of programs reported at least one trainee having been dismissed from a practicum or internship site within the past seven years, with an overrepresentation of racial minority and international trainees. In addition, PsyD programs (56%) exhibited a significantly higher likelihood of having dismissed trainees compared to PhD programs (23%) over the same period. In Study 2, qualitative interview data were collected from ten trainees who had experienced dismissal during their HSP training. Using the Consensual Qualitative Research method, we identified six distinct domains, each comprising unique categories and subcategories: Antecedents to dismissal, reasons for dismissal, process of dismissal, chain reactions, trainee impact, and recommendations. Taken together, this mixed-method study highlights that clinical dismissal is not an uncommon occurrence in HSP training and raises significant concerns about the current implementation process. We illuminate structural issues and offer recommendations to improve the process of clinical dismissal within the HSP field. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The use of laser photobiomodulation as pre-anesthetic tissue management technique in reducing injection pain in children.

BACKGROUND: One of the main goals for pediatric dentists is to offer a painless anesthesia experience. Laser photobiomodulation is among the suggested strategies to decrease injection pain. So, this study aimed to assess the impact of laser photobiomodulation on local anesthesia (LA) injection pain in children and its effect on the efficacy of LA during pulpotomy and SSC procedures. METHODS: The research was carried out as a randomized controlled clinical trial with two parallel group design. It involved 64 cooperative healthy children, age range from 5 to 7 years, each having at least one maxillary molar indicated for pulpotomy. Children were randomly allocated to one of the two groups based on the pre-anesthetic tissue management technique used: test group received laser photobiomodulation, while control group received topical anesthetic gel. Pain during injection, pulpotomy, and SSC procedures was assessed using physiological measures (Heart Rate (HR)), subjective evaluation (modified Face-Pain-Scale (FPS), and objective analysis (Sound-Eye-Motor scale (SEM)). RESULTS: A total of 64 children with mean age 6.23 ± 0.78 participated in this research. The mean HR scores were significantly lower in the laser PBM group during buccal and palatal infiltration injections. The SEM mean scores were significantly lower in the laser PBM group during both injections. For the FPS scale, the number of children who recorded satisfaction during injection was significantly higher in laser PBM group. There was no statistically significant difference in mean HR as well as in SEM and FPS scores between the two groups during pulpotomy and SSC procedures. Comparisons between the two study groups were performed using independent samples t- and Mann-Whitney U tests. Significance was set at p value < 0.05. CONCLUSION: Laser photobiomodulation is a promising non-pharmacological pre-anesthetic tissue management technique in children that offered less painful injection compared to topical anesthetic gel without compromising the effectiveness of LA. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05861154. Registered on 16/5/2023.

The relationship between diabetes-related knowledge and kidney disease knowledge, attitudes, and practices: a cross-sectional study.

BACKGROUND: Diabetes mellitus (DM) is one of the main noncommunicable diseases encountered in primary health care clinics. DM is considered one of the most common causes of chronic kidney disease (CKD). In this study, we aimed to assess the knowledge, attitudes, and practices (KAP) of patients with DM on the early detection and prevention of CKD, determine its relationship with other variables, and examine the relationship between KAP scores for the prevention and early detection of CKD and the Michigan Diabetic Knowledge Test. METHODS: We collected data from 2 Nablus primary healthcare centers using a questionnaire that contains three sections: sociodemographic section, questions related to DM, and CKD screening index, which is formed of three scales. We used the Michigan Diabetic Knowledge Test (MDKT) to assess the knowledge of diabetic patients. RESULTS: The study was carried out among 386 diabetic patients with a mean age of 57.62 ± 12.4 years (ranging from 28 to 90). The median (interquartile range) was 11 (8-14) for the knowledge scale, 56 (52-59) for the attitude scale, and 30 (26-33) for the practice scale. In the multiple linear regression, only patients under 55 years old (p = 0.012), with normal BMI (p = 0.030), high educational level (p < 0.001), high monthly income (p = 0.020), and MDKT test score (p = 0.007) were significantly associated with higher knowledge score. Furthermore, patients who were over or equal to 55 years old (p = 0.007), had a high monthly income (p = 0.016), used a single oral diabetic drug (p = 0.003), had a total number of medications less than 4 (p = 0.010), and had a high knowledge and MDKT test were significantly associated with a higher attitude score. Finally, a patient with normal BMI (p = 0.002), city residency (p = 0.034), high educational level (p = 0.003), less frequent tobacco use (p < 0.001), last HbA1c (p = 0.023) and greater knowledge, attitude, and MDKT score were significantly associated with better practices toward CKD prevention and early detection. CONCLUSION: Regarding KAP analysis, higher practice scores for the prevention and early detection of CKD were significantly associated with patients with normal BMI, being city residents, high educational level, less tobacco use, last HbA1c below 7, and higher knowledge, attitude, and MDKT score.

Patient Denial of Myocardial Infarction in the Prehospital Phase: Prevalence and Correlates.

BACKGROUND: Limited knowledge exists regarding patients' denial of myocardial infarction (MI) before hospitalization for an MI. OBJECTIVE: The aim of this study was to determine the prevalence and correlates of denial of MI in the prehospital phase of a confirmed MI. METHODS: This secondary analysis included 166 hospitalized patients (mean [SD] age, 54.1 [10.5] years) who developed MI outside a healthcare facility and had high congruence between their experienced and expected symptoms. Measurements included the Denial subscale of the Brief COPE Inventory, the modified Response to Symptoms Questionnaire, and a Likert scale measuring perceived risk for MI. Patients who arrived at a hospital at least 1 hour after the onset of their symptoms were considered to have prolonged prehospital delay. RESULTS: Despite their high symptom congruence, 77% of patients denied the possibility of having an MI before hospitalization. The lower denial group was characterized by cardiac history, whereas the higher denial group was distinguished by nonsmoking, a lower perceived risk of MI, less anxiety at symptom onset, and more concerns about seeking medical help. Compared with the lower denial group, patients in the higher denial group were more likely to underestimate the seriousness of their symptoms and delay seeking medical help. The higher denial group responded to symptoms in a more passive manner (eg, waiting), whereas the lower denial group showed a more problem-solving approach (eg, contacting emergency services). CONCLUSIONS: Denial of MI is highly prevalent in the prehospital phase and is negatively linked with cognitive, emotional, and behavioral responses to MI symptoms.

Parent and child adjustment dual trajectories at the beginning of the COVID-19 syndemic.

Children and their families have been significantly impacted by the unfolding of the COVID-19 syndemic. We sought to identify (1) groups of families with distinct profiles of joint trajectories of parental anxiety and child emotional distress and (2) protective and risk factors associated with these dual-trajectory profiles. A sample of 488 parents (65% White; 77% mothers) with 3- to 8-year-old children (MAge  = 5.04, SDAge  = 1.59) was followed from late March to early July in 2020. Survey data on parent (i.e., anxiety symptoms) and child (i.e., emotional distress) adjustment were collected at three time points. Using multivariate growth mixture modeling, we identified one group with low parental anxiety and child emotional distress (42.7%) and three other distinct groups with varying risk levels among parents and/or children. We also identified protective (e.g., positive parenting) and risk (e.g., child negative affect, negative parenting, perceived stress with racism) factors in predicting parent and child adjustment. It can be concluded that, overall, our sample (mostly middle- and high-socioeconomic status families) demonstrated family resilience amid COVID-19, consistent with prior disaster coping literature. At the same time, our findings also indicated the need to identify at-risk families and modifiable factors for post-disaster public health interventions.

Comparison of two self-report scales to assess anxiety and depressive symptoms in hemodialysis patients.

INTRODUCTION: Psychiatric illness is prevalent among hemodialysis (HD) patients. This study compared the assessment of anxiety and depressive symptoms among HD patients using two self-administered scales; hospital anxiety and depression scale (HADS) and brief symptom inventory (BSI). METHODS: A cross-sectional study was conducted among a convenience sample of HD patients (n = 352) from different dialysis centers in Jordan. Patients were interviewed in dialysis units, and demographics, clinical status, disease, and dialysis history data were collected. Symptoms of anxiety (HADS-A ≥ 8 and BSI-A ≥ 0.82) and depression (HADS-D ≥ 8 and BSI-D ≥ 0.82) were also measured. RESULTS: The mean age of participants was 52.2 ± 15.6 years. The majority had been receiving HD three times daily and for >2 years. A significant moderate-strong correlation was observed between HADS-A and BSI-A (r = 0.753, p < 0.0001) as well as HADS-D and BSI-D (r = 0.588, p < 0.0001). Anxiety prevalence was 43.7 % using HADS-A ≥ 8 and 80.7 % using BSI-A ≥ 0.82, while depression prevalence was 53.1 % using HADS-D ≥ 8 and 51.7 % using BSI-D ≥ 0.82. When HADS was used as a standard, the operating characteristics reveal that a higher cut-off for BSI-A is recommended (≥1.58) for better anxiety screening. DISCUSSION: Specific and suitable cut-off points need to be further explored and validated for HADS and BSI scales among patients undergoing dialysis.

Using participatory culture-specific consultation to support the mental health needs of summer camp staff.

Nearly 30% of all U.S. youth attend summer camp each year, making it one of the broadest reaching out-of-school-time interventions in the country. Camp provides a space for seasonal employees, who are often emerging adults, to explore work values and identity, engage in mentoring and support opportunities, and stay connected to a community larger than themselves. However, research on camp experiences also suggests camp settings and expectations around emotional and physical care can cause counselors to experience burnout, compassion fatigue, and reduced job satisfaction. Using participatory culture-specific consultation, the current study addressed a gap in the literature about systemic interventions to manage camp counselor mental health by designing, implementing, and evaluating a mental health consultation model at one of the largest YMCA summer camps in the country. Results suggest the intervention effectively addressed certain administrator and staff needs; results also suggest the model could be refined to more effectively respond to the particular contextual challenges of summer camps. Implications and recommendations for other summer camps are discussed.

Influence of active versus passive parental presence on the behavior of preschoolers with different intelligence levels in the dental operatory: a randomized controlled clinical trial.

BACKGROUND: Dental fear and anxiety still pose the most common factors proposed for the child's negative behavior in the dental operatory. Intelligence has an impact on the children's communication, feelings, and responsiveness to dental situations. The benefits of parental presence on reinforcing the child's behavior during dental treatment are still debatable. This study aimed to assess the effect of parental active versus parental passive presence techniques on the overall behavior of preschool children with different intelligence levels. METHODS: This randomized controlled trial was conducted from December 2017 to August 2019. It recruited 150 healthy children, 3-6-year-old, with no history of previous dental pain/treatment, and intelligence quotient level of 70- ≤ 110 stratified into 3 equal groups (high, average, low). In the first visit, each IQ group was randomly divided into test (PAP) and control (PPP) groups. In the second visit, dental fear was assessed before preventive intervention, the test groups were then managed using parental active presence technique, while the control groups were managed using parental passive presence technique. The overall behavior was assessed at the end of the visit. Data was analyzed using Chi-square test and logistic regression analysis. RESULTS: The parental active presence technique had significant effect on children with high and low intelligence quotients. There were significantly higher odds of positive behavior in high than low intelligence quotient children, (OR 4.08, 95% CI 1.43, 11.67, P = 0.01). The parental active presence technique had significantly higher odds of positive behavior than the parental passive presence technique, (OR 4.08, 95% CI 1.71, 9.76, P = 0.002). CONCLUSIONS: The parental active presence technique had positively influenced the children's overall behavior irrespective of their intelligence levels. This trial was retrospectively registered, trial identifier number: NCT04580316, 8/11/2020.

Functional health literacy and caregiving burden among family caregivers of patients with end-stage renal disease.

Family caregivers of patients with end-stage renal disease (ESRD) experience significant caregiver-related burden, yet the contribution of their functional health literacy (FHL) to caregiving burden has not been elucidated. We investigated the magnitude of FHL and caregiving burden and their association in a descriptive, correlational cross-sectional study of family caregivers of Jordanian patients with ESRD (N = 88). The short versions of the FHL for Adults and the Zarit Burden Interview were used for assessment of caregivers. Demographic and clinical information of patients and their family caregivers were self-reported. Of family caregivers, 41% had limited FHL and 38% experienced high caregiver burden. FHL and history of comorbidity in family caregivers predicted caregiving burden independent of demographic and clinical factors. Consideration of FHL in support interventions for family caregivers may minimize some of the high perceived caregiving burden, but clinical trials of such interventions are needed to confirm this conclusion.

Validation of the modified NUTRIC score on critically ill Jordanian patients: A retrospective study.

BACKGROUND: Nutritional status has been proven to be associated with poor outcomes in mechanically ventilated patients in intensive care units (ICU). Nutritional assessment has been assessed using different tools. Few data are available on the validity of the modified Nutrition Risk Assessment Tool for Critically Ill (mNUTRIC) score in ICU patients receiving mechanical ventilation (MV). AIM: This study aimed to assess prognostic performance of the mNUTRIC score for discriminative abilities for 30-day mortality and prolonged MV. METHODS: This was a multi-centre retrospective study that included 737 mechanically ventilated patients using secondary data analysis. Data were collected on variables required to calculate mNUTRIC score. Patients with a mNUTRIC score ≥5 were considered at nutritional risk. Predictive performance of the mNUTRIC was assessed for discriminative abilities for Acute Physiology and Chronic Health Evaluation II at baseline, mortality in 42 days of follow-up and outcomes related to MV. RESULTS: A total of 737 patients on MV met the inclusion criteria. The majority (57.1%) of patients were male. The mean age of the participants was 62.1±18 years. Of all patients, 482 (58%) were at high nutritional risk (mNUTRIC score ≥5). Median ventilator days were 3 (±7.2) days and 72 (±174) hours. The overall mortality rate was 78.8% (n=652), and weaning failure was 79.8% (n=660). CONCLUSIONS: This study showed new evidence on the validity of the mNUTRIC as a tool for assessing nutritional risk in an ICU population in Jordan. The mNUTRIC score obtained from the current retrospective data suggests that the use of the tool can truly identify and diagnose critically ill patients with malnutrition.

A Survey on Sexual Counseling for Patients With Cardiac Disease Among Nurses in Jordan.

BACKGROUND: Recovery among patients with cardiac disease also requires attention to their sexual health. However, cultural, religious, and social factors may make Arab Muslim patients reluctant to disclose their sexual concerns and nurses hesitant to discuss patients' sexuality matters. OBJECTIVE: The aim of this study was to explore sexual counseling (SC) among nurses in Jordan in terms of responsibility, confidence, and practice. METHOD: This was a descriptive, correlational study. Staff nurses were recruited from 10 hospitals in Jordan. Nurses completed the cardiac version of the Survey of Sexuality-Related Nursing Practice and reported their demographics. RESULTS: The sample consisted of 379 nurses (female, 59%; mean age, 28.1 years). A significant proportion of nurses viewed assessment/discussion of patients' sexuality matters as not within their responsibilities (39%), did not feel confident to address sexuality matters (50%), and rated themselves as not at all/not very knowledgeable about sexuality (60%). Few nurses were routinely integrating SC in clinical practice (9%). Sexual counseling was associated with nurses' gender (male, higher confidence and practice) and previous training on sexuality in nursing practice. CONCLUSIONS: Nurses in Jordan, especially female nurses, are neither prepared nor competent to provide SC. Nurses need focused education on sexuality to optimize patients' sexual health.

Displaced Syrian children's reported physical and mental wellbeing.

BACKGROUND: Surviving a warzone inflicts harmful consequences on the physical health and the psychosocial wellbeing of children. This study aimed at exploring the physical and psychosocial perceived state of health of displaced Syrian refugee children in Jordan. METHODS: A cross-sectional explorative design was applied. Structured questionnaires were used to collect data through face-to-face interviews with 250 Syrian refugee children. Descriptive and inferential statistics were used. RESULTS: Children had fair levels of physical health; their health concerns were minor. Psychosocially, 25% (n = 63) suffered from loneliness and 24% (n = 59) reported feeling depressed. The majority of children (>60%) had low rates of somatic pain. Age had a negative correlation with hyperactivity (r = -.14, p = .034); gender differences were found in anger expression and anger trait (p < .05). CONCLUSIONS: The results in this study highlight a number of physical and psychosocial health concerns among refugee children. The health needs of displaced Syrian children need to be addressed using comprehensive assessment and care. Our findings documented the physical and psychosocial health needs of the displaced Syrian children in Jordan and addressed areas of focus to guide health promotion interventions and community health efforts for them.

Evaluating the Psychometric Properties of the Arabic Version of the Diabetes Distress Scale.

The current study evaluated the psychometric properties of the Arabic version of the Diabetes Distress Scale (DDS-A) among Arab patients with diabetes mellitus (DM) using a descriptive cross-sectional design. Participants' DDS-A total scores significantly correlated with depressive symptoms (r = 0.288, p = 0.000) as well as two subscales, emotional burden (r = 0.276, p = 0.000) and regimen distress (r = 0.265, p = 0.000). Participants' DDS-A scores had significant negative correlations with income, DM self-management, and knowledge (r = -0.184, p = 0.008; r = -0.310, p = 0.000; r = -0.174, p = 0.003, respectively) and a positive correlation with HbA1c level (r = 0.153, p = 0.018). Factor analysis revealed a four-factor solution that retained all items and explained a variance of 65.59%. Cronbach's alpha was 0.822 for the total scale and 0.778 to 0.881 for the subscales, indicating a high internal consistency. The DDS-A was found to be a psychometrically sound measure to evaluate DM-related distress among Arab patients. [Journal of Psychosocial Nursing and Mental Health Services, 55(9), 43-51.].

The association of co-morbid symptoms of depression and anxiety with all-cause mortality and cardiac rehospitalization in patients with heart failure.

BACKGROUND: Patients with heart failure (HF) experience multiple psychologic symptoms. Depression and anxiety are independently associated with survival. Whether co-morbid symptoms of anxiety and depression are associated with outcomes in patients with HF is unknown. OBJECTIVE: To determine whether co-morbid symptoms of depression and anxiety are associated with all-cause mortality or rehospitalization for cardiac causes in patients with HF. METHOD: A total of 1260 patients with HF participated in this study. Cox regression analysis was used to determine whether co-morbid symptoms of depression and anxiety independently predicted all-cause mortality and cardiac rehospitalization. Anxiety and depression were treated first as continuous-level variables, then as categorical variables using standard published cut points. Patients were then divided into 4 groups based on the presence of anxiety and depression symptoms. RESULTS: When entered as a continuous variable, the interaction between anxiety and depression (hazard ratio = 1.02; 95% CI: 1.01-1.03; p = 0.002) was a significant predictor of all-cause mortality in patients with HF. When entered as a categorical variable, co-morbid symptoms of depression and anxiety (vs no symptoms or symptoms of anxiety or depression alone) independently predicted all-cause mortality (hazard ratio = 2.59; 95% CI: 1.49-4.49; p = 0.001). None of the psychologic variables was a predictor of cardiac rehospitalization in patients with HF whether using the continuous or categorical level of measurement. CONCLUSION: To improve mortality outcomes in patients with HF, attention must be paid by health care providers to the assessment and management of co-morbid symptoms of depression and anxiety.

The contribution of symptom incongruence to prehospital delay for acute myocardial infarction symptoms among Jordanian patients.

Qualitative investigators have suggested that symptom incongruence, or a mismatch between symptoms that patients expect and those they experience in acute myocardial infarction (AMI), increases the time to hospitalization by affecting emotional, cognitive, and behavioral factors. No quantitative studies have been conducted that verify these relationships. We aimed to (a) examine the relationships among symptom incongruence, prehospital delay, anxiety level at onset of symptoms, perceived seriousness and importance of symptoms, source to which symptoms were attributed, and patients' first response at symptom onset and (b) test the independent association of symptom incongruence to prehospital delay. Jordanian patients with AMI (n = 299) were interviewed using validated questionnaires, and medical records were reviewed to collect information on patients' prehospital delay time, symptom incongruence, and response to AMI symptoms. Patients had low mean (7.5 ± 3.6) symptom incongruence scores (range 0-21 out of 24) and relatively short median prehospital delay (1.3 hours). Symptom incongruence was positively correlated with and independently predicted prehospital delay. Greater anxiety and greater perceived seriousness and importance of symptoms were associated with less incongruence and shorter prehospital delay. Patients who attributed their symptoms to a cardiac etiology had significantly shorter prehospital delay and less symptom incongruence than their counterparts. Patients who contacted the emergency medical service directly after symptom onset had shorter prehospital delay than their counterparts who did not, but did not differ on the level of symptom incongruence. Symptom incongruence may increase prehospital delay by complicating patients' efforts to label and respond to AMI symptoms.

Development and psychometric evaluation of the Chronic Kidney Disease Screening Index.

OBJECTIVE: Public understanding of chronic kidney disease (CKD) is important to ensure informed participation in CKD prevention programs. This study aimed to develop and to test the psychometric profile of the CKD Screening Index that measures patient's knowledge, attitudes, and practices regarding CKD prevention and early detection. METHODS: A cross-sectional design was implemented and a total of 740 Jordanian patients recognized at risk for CKD were recruited by convenience sampling from out-patient departments. Development and psychometric validation of the CKD Screening Index were conducted in four phases: (1) item generation, (2) pilot study, (3) preliminary psychometric validation study to examine factor structure, and (4) final psychometric validation with 740 participants. RESULTS: On factor analysis, 24 items categorical knowledge items loaded into one factor and yielded a Guttman Split-Half Coefficient of 0.80. In a separate factor analysis, 15 items were loaded on two attitude factors (Cronbach alpha coefficient = 0.69), and nine items loaded on two practice factors (Cronbach alpha coefficient = 0.68). The CKD Screening Index associated significantly and negatively with depressed and anxious patients compared to their counterparts. PRACTICE IMPLICATIONS: This promising CKD Screening Index can be used for an early identification of patients at risk for CKD, thus, allowing the development of interventions to raise these patients' awareness. Future studies are needed on other populations with different cultural background to support reliability and validity of this new instrument.

Perceived social support is a partial mediator of the relationship between depressive symptoms and quality of life in patients receiving hemodialysis.

BACKGROUND: The meaning of social support is well documented, but less is known about mediating characteristics that examine which patients with end stage renal disease (ESRD) and depressive symptoms are most likely to benefit. AIMS: The aim of this study was to examine whether perceived social support mediated depressive symptoms on the outcome of quality of life (QoL). DESIGN: A correlational, cross-sectional study was conducted with a convenience sampling of 190 patients with ESRD. RESULTS: There was partial mediation effect of social support on depressive symptoms in the prediction of QoL. CONCLUSION: Effective management of depressive symptoms will improve QoL mostly when social support is promoted in patients with ESRD receiving hemodialysis.

Do local and landscape context affect the attractiveness of flower gardens to bees?

Planting floral resources is a common strategy for increasing the abundance and diversity of beneficial flower-visiting insects in human-modified systems. However, the context of the local area and surrounding landscape may affect the attractiveness of these floral resource provisioning plots. We compared the relative effects of local floral resources and surrounding urban land-use on the abundance of bees on flowering plants in common gardens in eastern Tennessee, USA. We planted four types of common garden plots at each of five different landscapes representing a variety of surrounding land use: 1) Urban Garden, 2) Forage Grassland, 3) Mixed Agriculture, 4) Forest, and 5) Organic Farm. Each common garden plot type had a fixed plant community representing one of three plant families (Asteraceae, Fabaceae, Lamiaceae) or a mix of all three, and all four common gardens were replicated at all the sites. We concurrently sampled bees in the garden plots and in a 50 m radius (local area) around the garden plots. We found that the size of the floral display (i.e. the visual display size of flowers) and diversity of flowers in the local area did not affect bee abundance or species richness in the garden plots. Although there was a significant positive association between developed land use in a 2 km radius and bee abundance in the gardens, the effect was small, and there was no relationship between land use and bee abundance or species richness in the local area. There were significant differences in the composition of the bee community between the local area and garden plots, but the largest determinants of bee community composition and species richness in the gardens were floral display size and variation in the garden plant species in bloom. This finding is promising for anyone wishing to promote pollinator populations by providing more floral resources.

Slowing the progression of chronic kidney disease: comparison between predialysis and dialysis in Jordanian patients.

BACKGROUND: The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) has increased worldwide; however, data regarding the prevalence of CKD in Jordan are limited. Therefore, the present study investigated the associated risk factors of both CKD and ESRD in Jordanian patients. METHODS: A convenience sample of 161 patients with CKD (n = 92) and ESRD (n = 69) was recruited through randomly selected hospitals from the governmental, private and educational sectors in Jordan. A sociodemographic data and behavioral variables (exercise frequency per week, body mass index, and smoking status) were collected and compared between the two groups to obtain the needed information. RESULTS: ESRD in amounted to relatively 68% in males and 52% in the unmarried patients (p = 0.01). In addition, patients with poor physical activity were more likely to be on the postdialysis phase. Patients with ESRD were characterized with low BMI when compared with patients CKD (t = 3.1, p = 0.004). CONCLUSION: National CKD and ESRD risk assessment is important in considering primary prevention for CKD progression. At the front line in health care, the nurse can play a vital role in assessing patient's risk for renal disease progression.

Predictors of dietary and fluid non-adherence in Jordanian patients with end-stage renal disease receiving haemodialysis: a cross-sectional study.

AIMS AND OBJECTIVES: The purpose of this study is to provide insight into the relationship between dietary and fluid non-adherence, depressive symptoms, quality of life, perceived barriers and benefits of exercise, and perceived social support among Jordanian patients with end-stage renal disease receiving haemodialysis using Pender's health promotion model. BACKGROUND: Non-adherence to dietary and fluid restrictions is a leading cause of treatment failure and poor outcomes in end-stage renal disease. Yet, factors that interfere with the patients' ability to follow their dietary restrictions are unknown. DESIGN: A descriptive, correlational, cross-sectional design was used. METHODS: Jordanian patients (n = 190) with end-stage renal disease receiving haemodialysis from three main Jordanian cities were included. The dialysis diet and fluid nonadherence questionnaire, Beck Depression Inventory-II, Quality Of Life Index, Dialysis Patient-Perceived Exercise Benefits and Barriers Scale, and the Multidimensional Perceived Social Support were employed to measure the key variables. RESULTS: Patients were more likely men with mean age of 48·2 ± 14·9. Only 27% of the patients showed full commitment to diet guidelines and 23% to fluid guidelines during the last 14 days. Depression (M = 18·8 ± 11·4) had significant negative association with quality of life (importance and satisfaction) (r = -0·60, r = -0·32, p = 0·001, respectively). Multiple hierarchal regressions revealed a predictive model of only two variables: age (B = -0·22, p = 0·05) and residual renal function (B = -0·23, p = 0·012) for dietary non-adherence. CONCLUSIONS: Non-adherence to diet and fluid guidelines association with individual characteristics, health perception and psychosocial variables should be investigated in a longitudinal design. Relationship of non-adherence with culture-related factors should deeply be assessed among Jordanian patients with end-stage renal disease receiving haemodialysis. RELEVANCE TO CLINICAL PRACTICE: Identification of the factors that may worsen dietary and fluid non-adherence may lead to improved therapeutic interventions within the mainstream of medical practice for Jordanian patients with end-stage renal disease receiving haemodialysis.