Arab nursing students' perception of the emotional experience of patient care: A phenomenological study.

BACKGROUND: A shared emotional response helps with understanding what other people are feeling and/or thinking; and it is a vital skill in clinical settings. Collectivist communities place more emphasis on the emotional components of their feelings in comparison to the cognitive aspects of their emotions. PURPOSE: This study aimed to explore the emotions experienced by students at their first clinical placement. METHODS: A hermeneutic phenomenological approach was used among nine baccalaureate students. RESULTS: Three major themes emerged from the data: overwhelming emotions; unbalanced perception of professional identity; and adjustment and adaptation. CONCLUSIONS AND DISCUSSION: It is evident that nursing students from collectivist communities encounter challenges in dealing with their emotions and managing their patients' emotions; however, they were capable of empathizing with their patients using the two components of their empathy; affective (emotion) and cognitive (cognition), with prominence given to the affective part. As countries become increasingly multi-cultural, which in turn influences the characteristics of people entering pre-registration nursing programs, nursing leaders are invited to address both dimensions of empathy as part of the nursing curriculum. Attention should also be given in clinical settings to appropriate channeling of clinical empathy to cultivate a professional identity.

A 5-Year-Old Palestinian Bedouin Girl with Repeated Self-Induced Injuries to the Digits, a Diagnosis of Congenital Insensitivity to Pain, and Anhidrosis.

BACKGROUND Congenital insensitivity to pain with anhidrosis (CIPA), also referred to as hereditary sensory and autonomic neuropathy type IV, is a rare autosomal recessive disease caused by mutations in the NTRK1 gene. The inability to feel pain and temperature often leads to repeated severe and unintentional self-inflicted injuries; these can result in severe complications, as patients heal slowly from skin and bone injuries. This case report describes a 5-year-old Palestinian girl with self-inflicted injury to the digits, a dislocated distal inter-phalangeal joint of the left big toe, and a diagnosis of CIPA. CASE REPORT A 5-year-old girl, a daughter of related Palestinian Bedouin parents, presented with a chronic unhealed wound over the planter surface of the left foot. Painless repetitive minor traumata over the same area badly affected wound healing and this led to wound dehiscence and dislocation of the distal inter-phalangeal joint of the left big toe. Surgical fixation of the dislocated joint along with intravenous antibiotics and close follow-up resulted in eventual improvement and near complete wound healing despite the obviously slow healing process. The girl also displayed evidence of unintentional self-inflicted injury, which within the overall clinical context warranted a clinical suspicion of CIPA. This was confirmed by genetic testing for the presence of a homozygous frameshift mutation in the NTRK1 gene (c.1842_1843insT; p.Pro615Serfs*12). CONCLUSIONS This case report shows that a physician should have a low threshold of suspicion to investigate for CIPA when managing children with multiple unintentional self-inflicted injuries, anhidrosis, and pain insensitivity, mainly through genetic testing to detect mutations in the NTRK1 gene.

Shared governance: a children's hospital journey to clinical nursing excellence.

BACKGROUND: Shared governance is examined through a framework for developing independent decision making in professional nursing practice and improving patient care outcomes. AIMS: This study is designed to obtain a baseline measurement of the degree of shared governance in a selected children's hospital in Saudi Arabia. METHODS: The study was guided by the Donabedian model. The Professional Nursing Governance Index was used. A total of 400 questionnaires were distributed to nurses working at the hospital, with a response rate of 77% (n = 307). Descriptive and inferential statistics were used for analysis. RESULTS: The results corresponded with those from nurses and managers in most subscales of the Index of Professional Nursing Governance (information, goals, resources, participation and practice). However, nurses working in the operating theatre and surgical unit have a perceived higher level of shared governance than those in critical care units and medical wards. CONCLUSIONS: The results could encourage shareholders and leaders in the nursing field to develop the perception of shared governance by adopting a shared governance model, which in turn might improve the quality of nursing care.

Effectiveness of antibiotics versus ibuprofen in relieving symptoms of nosocomial urinary tract infection: A comparative study.

BACKGROUND AND PURPOSE: Antibiotic therapy has been the mainstay of treatment in the management of hospitalized patients with nosocomial urinary tract infection (UTI); however, its use is associated with an increase in resistance and high cost. Ibuprofen showed effectiveness in relieving symptoms of UTI, but its superiority is questionable. The goal of this study was to compare the effectiveness of antibiotics against ibuprofen in relieving symptoms of UTI and to identify factors that affect symptom relief. METHODS: This study was conducted in three public hospitals in Jordan. Patients with nosocomial UTI were assigned to either antibiotics or ibuprofen. Symptoms of UTI were assessed at the time of initiation of treatment and 5 days later. CONCLUSIONS: Antibiotics were more effective in relieving symptoms of UTI than Ibuprofen. Comorbidity and length of hospitalization affected symptom relief during the treatment of UTI. IMPLICATION FOR PRACTICE: Nurse practitioners in the clinical settings can take an active role in helping patients with UTI to achieve relief of symptoms by supporting the use of antibiotics over ibuprofen in symptom resolution.

Compliance of Middle Eastern hospitals with the central line associated bloodstream infection prevention guidelines.

AIMS: The purposes of this study were to (1) assess compliance with the CLABSI prevention guidelines, (2) assess the predictors of compliance, and (3) investigate the effect of compliance on the rate of CLABSI and related mortality. BACKGROUND: Implementation of the Central Line Associated Bloodstream Infection (CLABSI) prevention guidelines from the Centers for Disease Control and Prevention (CDC) helps to reduce the rate of CLABSI and related mortality, although the extent to which hospitals implement these guidelines is questionable. METHODS: A prospective design was used in this study. Observations were conducted over three months in the intensive care units of 58 hospitals in three Middle Eastern countries. An observational checklist, based on the CDC guidelines, was used to assess compliance. The rate of CLABSI and related mortality were obtained from patients' records. RESULTS: The degree of compliance, rate of CLABSI and mortality were highly variable. The multiple regression model showed that the hospitals' characteristics explained 82.0% of the variance of compliance (R2Adj= 0.820, F=29.82, p<0.05). The number of beds in the intensive care unit and patient-nurse ratio were significant predictors of compliance. A lower number of beds and a lower patient-to-nurse ratio were related to higher compliance. Moreover, higher compliance with CLABSI prevention guidelines was associated with lower rate of CLABSI and related mortality. CONCLUSIONS: Improvement in the patients' outcome can be achieved through compliance with the CLABSI prevention guidelines. lowering patient-nurse ratio and the number of beds in the ICUs would help to improve compliance.

Cardiopulmonary resuscitation training for undergraduates from nonmedical majors: Effectiveness of the three tiers model.

BACKGROUND: Integrating cardiopulmonary resuscitation (CPR) in undergraduate education would help to increase the rate of bystander CPR. However, few qualified trainers are available for this purpose. Training student nurses to become CPR trainers on campus could reduce this shortage. PURPOSE: The purposes of this study were to assess CPR skills of students from nonmedical majors and to examine the effectiveness of the three tiers model for CPR training. SETTINGS: One public university in Jordan. PARTICIPANTS: Student nurses and undergraduates from nonmedical majors. METHOD: Five student nurses attended CPR training courses based on the American Heart Association CPR guidelines. The trainees provided the same CPR training to a sample of 197 undergraduates from nonmedical majors. The participants were asked to imagine a real-life scenario of out-of-hospital cardiopulmonary arrest and to perform CPR on a manikin. Assessment of skills was made before and after training, using a structured observational checklist. RESULTS: In the pretest, participants showed poor CPR skills with a pass rate of only 4%. In the posttest, participants demonstrated significant improvement: t(196) = 26.78, P = 0.00. CONCLUSION: The three tiers model for CPR training would be an effective strategy to compensate for the shortage in the number of certified CPR trainers.

Clinical Burdens of ß-Thalassemia Major in Affected Children.

BACKGROUND: ß-thalassemia major (BTM) is an inherited blood disorder leading to severe anemia. A better understanding of BTM complications can be considered an important factor in developing effective health care provision. METHOD: A descriptive exploratory design was used to identify the clinical burden of BTM from affected children's perspective. A convenience sample of 45 patients with BTM, accompanied by a family member, was recruited from a governmental hospital during April-May 2015. RESULTS: The most reported clinical burden was facial deformity 86.9%, followed by systematic infection (48.8%), growth delay (44.4%), and liver problems (39.9%). Patient age was significantly associated with clinical burdens such as bone pain and facial deformity. The number of blood transfusions received was associated with growth delay and bone pain. CONCLUSION: This study highlights the clinical burdens of thalassemia on affected children, in terms of physical appearance, growth delay and other burdens.

Factors Associated with Colorectal Cancer Among Jordanians: a Case- Control Study

Objective: In recent years, the incidence of colorectal cancer (CRC) in Jordan has been on the rise. We aimed to determine associations with lifestyle factors, demographic and clinical variables. Methods: This case-control study included 102 patients diagnosed with CRC and 198 age and gender matched healthy subjects as controls. Cases were purposefully sampled; however, the control group were selected by simple random sampling of a cross-section of the population in Northern Jordan. Participating cases and controls completed an anonymous questionnaire inquiring about their demographic characteristics, lifestyle factors, and clinical variables. Data about the medical history and diagnosis of participating cases were obtained from the cases themselves and confirmed by reviewing their medical records. Results: In the cross tabulation analysis, the Chi square test showed that diabetes and hypertension were significantly associated with CRC (P <0.05). Additionally, regression modeling revealed that age ≥ 45 years (OR=10.93), positive family history for CRC (OR=5.53), physical inactivity (OR=7.4), cigarette smoking (OR=3.71), and having other types of cancer (OR=13.61) were all associated with increased risk of CRC. Conclusions: Physical inactivity and cigarette smoking are among the top modifiable risk factors for CRC among Jordanians. Moreover, diabetes and hypertension were found to be statistically significant risk factors in univariate, but not multivariate analysis. More effective strategies for elevating awareness and prevention are required at both national and international levels. Improving screening strategies is needed for early detection of CRC in Jordan.

The Effectiveness of Cognitive Behavioral Therapy versus Psychoeducation in the Management of Depression among Patients Undergoing Haemodialysis.

The aim of this randomized controlled trial was to compare the effectiveness of psychoeducation versus cognitive behavioral therapy (CBT) in the management of depression among renal dialysis patients. A sample of 130 dialysis patients participated in the study and they were assigned at random to one of two therapies: psychoeducation (N = 65) or CBT (N = 65). Hamilton depression rating scale was completed by the participants in both groups prior to the therapies and after completion. Both therapies were effective in the management of depression, although psychoeducation was superior. Psychoeducation is recommended over CBT in the management of depression among renal dialysis patients.

Compliance of Nurses and Hospitals With Ventilator-Associated Pneumonia Prevention Guidelines: A Middle Eastern Survey.

This study was a self-reported cross-sectional survey that investigated nurses' and hospitals' compliance with ventilator-associated pneumonia prevention guidelines and the barriers and factors that affect their level of compliance. A questionnaire was completed by 471 intensive care unit nurses from 16 medical centers in 3 Middle Eastern countries: Jordan, Egypt, and Saudi Arabia. The results show that both nurses and hospitals have insufficient compliance. Previous education, experience, and academic degree were all found to affect nurses' compliance.

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.