Jordanian nursing students' experience of harassment in clinical care settings.

INTRODUCTION: Nursing students experienced various types of bullying and abuse in their practice areas. This study aims to assess the incidence, nature, and types of bullying and harassment experienced by Jordanian nursing students in clinical areas. METHODOLOGY: A cross-sectional, descriptive design was used, utilizing a self-report questionnaire. A convenient sampling technique was used to approach nursing students who are in their 3rd or 4th year in governmental and private universities. RESULTS: Of 162 (70%) students who reported harassment, more than 80% of them were females and single. Almost 40% of them reported that males were the gender of the perpetrator. Almost 26.5% of them reported that patient's relatives or friends were the sources of harassment. Psychological/verbal harassment was the most reported type of harassment (79%). Findings showed that there was a statistically significant difference in psychological/verbal harassment based on gender and type of the university. Also, there were significant negative correlations between psychological/verbal harassment, professional achievement, and personal life. CONCLUSION: Harassment in the clinical area is affecting the professional and personal lives of students, who lack the knowledge of policy to report this harassment.

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

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

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

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

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

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

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

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

Risk of Posttraumatic Stress Disorder and Its Relationship With Perceived Social Support Among Family Caregivers of Individuals With Schizophrenia or Bipolar Disorder.

A cross-sectional descriptive correlation study was performed to investigate the risk of posttraumatic stress disorder (PTSD) among 300 family caregivers of individuals with schizophrenia or bipolar disorder and examine the relationship between perceived social support and risk of PTSD. The Arabic version of the PTSD Checklist for DSM-5 (APCL-5) was used to investigate risk of PTSD; the Arabic version of the Multidimensional Scale of Perceived Social Support was used to measure perceived social support. Mean score of the APCL-5 was 46.1, indicating risk of PTSD among family caregivers. A negative moderate correlation was found between risk of PTSD and perceived social support. The caring process is demanding and highly stressful, putting family caregivers at risk for PTSD. Social support is crucial in decreasing this risk. [Journal of Psychosocial Nursing and Mental Health Services, 57(8), 37-43.].

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.

Gender Differences in Anxiety and Complications Early After Acute Myocardial Infarction.

BACKGROUND: Anxiety is the earliest psychological response to acute myocardial infarction. When anxiety persists or becomes severe, it has negative consequences including increased risk for in-hospital complications. Therefore, it is necessary to determine which groups of people are at risk for high anxiety after acute myocardial infarction. OBJECTIVE: The aim of this study was to determine whether there is a difference in anxiety levels and rate of complications based on gender early after acute myocardial infarction. METHODS: A comparative design was used. Patients with acute myocardial infarction were interviewed within 72 hours (mean [SD], 40 [18] hours) of admission to the hospital and completed a sociodemographic and clinical questionnaire and the Anxiety Subscale of Hospital Anxiety and Depression Scale. In addition, clinical data were abstracted from the participants' medical record after discharge. RESULTS: A total of 250 patients, with a confirmed diagnosis of acute myocardial infarction, participated in this study: 163 men and 87 women. Female patients were more anxious (15.5 [3.6] vs 8.1 [2.9], P < .01) and had more complications (1.1 [1.9] vs 0.6 [0.08], P < .05) than male patients did. CONCLUSIONS: Anxiety is a global problem after acute myocardial infarction. Exploration of reasons why women of different cultures are at a higher risk for anxiety after acute myocardial infarction is necessary. It is of high clinical importance to determine strategies for managing anxiety in patients with or suspected to have acute myocardial infarction, especially women.

Post Traumatic Stress Disorder in Parents of Children With Cancer in Jordan.

AIM: To investigate levels of post traumatic stress disorder (PTSD) of those parenting children with cancer and make a comparison between mothers and fathers. BACKGROUND: Parenting a child with cancer is traumatic. Maternal and paternal roles and responsibilities change after the cancer diagnosis of their child, adding more stress to the lives of all concerned. The gender of the parent may have an effect on their PTSD. However, there is a lack of studies in Arabic countries on the differences between parents in their PTSD levels. METHODS: A sample of 416 biological parents (comprising 207 mothers and 209 fathers) of children with cancer in Jordan completed a demographic checklist and the PTSD Checklist Civilian (PCLC). RESULTS: There was a significant difference in PTSD levels between mothers and fathers, with mothers having significantly higher PTSD levels than fathers. The mean PTSD levels for mothers was (M=59.68, SD=4.86) compared to (M=52.76, SD=5.81) for fathers. The magnitude of the differences in the means was very large (eta squared=0.29). Additionally, results indicated that there was a significant negative correlation between parental PTSD levels with their age and the time since their child was diagnosed with cancer (r=-0.68, r=-0.62 respectively and p<0.001). An increase in parental PTSD levels was associated with a decrease in parental age and short time duration since the cancer diagnosis of the child. CONCLUSION: The study concluded that parenting children with cancer is traumatic and mothers were at higher risk of PTSD than fathers. Risk of PTSD was found to decrease with time. IMPLICATIONS FOR NURSING EBP: Investigating differences in PTSD between mothers and fathers in Jordan may be helpful when designing interventions to reduce the risk of PTSD. An individual parental support program is important, taking into consideration that mothers are at higher risk of PTSD, and both parents need thorough attention and care.

Perceived Stress in Family Caregivers of Individuals With Mental Illness.

The current study aimed to measure the stress levels of family caregivers of individuals with mental illness and compare their stress levels according to the diagnosis and other sociodemographic characteristics. The sample comprised 310 family caregivers of individuals with mental illness in Jordan. Family caregivers completed a demographic checklist and the Arabic version of the Perceived Stress Scale 10-Item (PSS-10) questionnaire. A significant difference was found in PSS-10 levels among family caregivers according to gender, diagnosis of their family member, and time since diagnosis. Female caregivers reported significantly higher stress levels than male caregivers. Family members of individuals with schizophrenia reported the highest stress levels (p < 0.001). Results also indicated that there was a significant negative correlation between PSS-10 levels of family caregivers and time since diagnosis. Investigating stress levels in family members of individuals with mental illness may be helpful when designing interventions to reduce such stress. [Journal of Psychosocial Nursing and Mental Health Services, 55(6), 30-35.].

Conflict management style of Jordanian nurse managers and its relationship to staff nurses' intent to stay.

AIM: To explore the relationship between conflict management styles used by nurse managers and intent to stay of staff nurses. BACKGROUND: Nursing shortages require managers to focus on the retention of staff nurses. Understanding the relationship between conflict management styles of nurse managers and intent to stay of staff nurses is one strategy to retain nurses in the workforce. METHODS: A cross-sectional descriptive quantitative study was carried out in Jordan. The Rahim organization conflict inventory II (ROCI II) was completed by 42 nurse managers and the intent to stay scale was completed by 320 staff nurses from four hospitals in Jordan. The anova analysis was carried out. RESULTS: An integrative style was the first choice for nurse managers and the last choice was a dominating style. The overall level of intent to stay for nurses was moderate. Nurses tend to keep their current job for 2-3 years. There was a negative relationship between the dominating style as a conflict management style and the intent to stay for nurses. CONCLUSION: The findings of the present study support the claim that leadership practices affect the staff nurses' intent to stay and the quality of care. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can improve the intent to stay for staff nurses if they use the appropriate conflict management styles.

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

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

Perceived Stress and Resilience Among Psychiatric Nurses Working in Inpatients Units.

The aim of this study is to assess the levels, relationships, and predictors of resilience and perceived stress among psychiatric nurses working in inpatient units. A descriptive, cross-sectional, predictive design was employed to collect data from 140 psychiatric nurses through a self-reported questionnaire. The questionnaire consisted of sociodemographic and work-related variables, Connor-Davidson Resilience Scale (CD-RISC-25), and perceived stress scale (PSS-10). The total mean score of the perceived stress was 22.73 (SD = 3.54) indicating a moderate level. The total mean score of the resilience was 49.49 (SD = 15.31) indicating a low level. Resilience correlated positively with educational level and job satisfaction; and negatively with intention to leave psychiatric settings. Significant differences were found in resilience with educational level, intention to leave psychiatric settings, and job satisfaction. Three independent variables predicted resilience: educational level, ward/unit, and job satisfaction; and only one variable (intention to leave psychiatric settings) predicted the perceived stress.

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

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

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

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

Examining the influence of anxiety and depression on medication adherence among patients diagnosed with acute myocardial infarction.

BACKGROUND: Effective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools. METHODS: Employing a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details. RESULTS: The study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence. CONCLUSION: The study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study.

BACKGROUND: Anxiety affects the patient's perception of postoperative pain and causes a significant increase in the consumption of analgesia postoperatively. OBJECTIVE: This study assesses the relationship between preoperative anxiety, postoperative pain and postoperative pethidine consumption. METHODS: A prospective cohort design was used. Data were collected from 100 patients who were undergoing a laparoscopic cholecystectomy at St Joseph Hospital, Jerusalem. Pain-controlled analgesia with pethidine was utilised to manage pain throughout the postoperative period. The visual analogue scale scores and pethidine consumption of all patients were recorded. FINDINGS: Participants' mean level of pain was higher in the preoperative period (mean visual analogue scale = 1.3) compared with their mean level of pain in the postoperative period (mean visual analogue scale = 0.5). There is a statistically significant difference between the participants' level of anxiety and postoperative pain level (p < 0.001). Gender, weight, level of education and smoking were predictors of developing preoperative anxiety. Also, gender, smoking and medication were statistically significant predictors of developing postoperative pain. Furthermore, gender, medical history and medication were statistically significant predictors of pethidine consumption postoperatively. CONCLUSIONS: The preoperative anxiety reduction intervention should be promoted and implemented as routine care for all surgical patients.

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

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

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

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

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

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