The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers.

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

Obstacles of Online Learning Facing Nursing Students after the COVID-19 Pandemic.

Background: After the COVID-19 pandemic, the online style of instruction started to replace the traditional style in Jordan. Aims: This study aims to (1) assess the nursing students' perceived obstacles to online learning in Jordan; (2) explore significant relationships between participants' characteristics and their perceived obstacles; and (3) assess for significant differences in the perceived obstacles based on participants' characteristics. Methods: A cross-sectional, descriptive design was utilized in this study. A convenient sample of 325 nursing students responded to a self-reported questionnaire utilizing Google Forms. Both descriptive and inferential statistics were used to analyze the dataset using the SPSS software. Results: The mean scores of the obstacles to online learning were 2.94 (SD = 0.95) for the academic obstacles subscale, 2.90 (SD = 0.83) for the technological obstacles subscale, and 3.25 (SD = 1.00) for the administrative obstacles subscale. Significant associations were found between participants' characteristics and perceived obstacles to online learning. For instance, the type of university was significantly associated with academic (r = -0.32, p < 0.01), technological (r = -0.21, p < 0.01), and administrative obstacles (r = -0.32, p < 0.01). Furthermore, significant differences were found in the perceived obstacles based on the participants' demographic and studentship-related characteristics. Conclusions: According to their perceptions of online learning, nursing students in Jordan face three types of obstacles: academic, technical, and administrative. Decision-makers should intervene to enhance the online learning experience by overcoming the reported obstacles.

Breakfast Skipping and Associated Factors Among Jordanian University Students.

Background: Although breakfast skipping among university students is a significant concern, its prevalence and the contributing factors among university students have received little attention in the literature. This study aims to determine the prevalence of skipping breakfast among Jordanian university students and examine the associated factors and variations in rates of skipping breakfast by day of the week. Materials and Methods: A cross-sectional study was conducted among undergraduate students between March and May 2022 through a self-questionnaire. A convenience sample of 891 students was chosen at four Jordanian public universities. The data were analyzed using descriptive and inferential statistics. Results: The prevalence of skipping breakfast among university students was 66%. The reasons for skipping breakfast were having no time due to oversleeping and having no feeling of hunger (59% for both), followed by having no energy to prepare the breakfast and making no difference (49% and 48%), and not being able to afford to eat or buy breakfast (19%). There is a strong correlation between eating fast food and skipping breakfast. With whom the student eats breakfast is significantly associated with breakfast skipping, revealing that the highest percentages of skipping occur with friends. About 63% of students skipped breakfast through university days compared with 37% on the weekend, while 37% of them had breakfast through university days compared with 67% on the weekend. Conclusions: A high percentage of university students in Jordan skip breakfast. More attention should be paid to correlating factors and developing interventions to help students adhere to the breakfast.

Knowledge and Compliance With Standard Precautions Among Nurses.

Introduction: The spread of microorganisms is caused by direct or indirect contact, respiratory droplets, and airborne transmission. Knowledge and compliance with standard precautions are crucial in preventing infection in the hospital. Objectives: To assess the level of knowledge and compliance with standard precautions among registered nurses who work in military hospitals and the factors affecting compliance with standard precautions. Methods: A descriptive cross-sectional study was conducted. Four hundred and eight registered nurses at three Jordanian Royal Medical Services hospitals completed an online self-report questionnaire using a convenience sampling technique. The statistical package for social sciences (SPSS) version 25 was used to analyze the data. Results: The level of knowledge of standard precautions among nurses was excellent, with an overall mean score of 15.59 ± 2.22 out of 20; around half (54%) of them had an excellent level. Nurses' compliance with standard precautions was intermediate, with an overall mean score of 59.65 ± 14.57 out of 80. Forty-seven percent of nurses had a high degree of compliance. Compliance with standard precautions was correlated positively with age, working experience in years, total knowledge score, training in standard precautions, and availability of personal protective equipment, and negatively with exposure to sharp injuries. Conclusion: Nurses play a key role in preventing and managing hospital infections through their responsibility for a large proportion of patient treatment and care. Therefore, efforts should be made to improve nurses' perceptions of the basic elements of standard precautions. Even so, results showed that compliance with standard precautions was intermediate. This highlights the need to take the necessary measures to raise the level of compliance. Even so, results showed that compliance with standard precautions was intermediate. This highlights the need to take the necessary measures to raise the level of compliance.

Psychological Reactions of Lebanese Nurses to Workplace Violence in Critical Care Units.

Introduction: Workplace violence (WPV) is a growing concern that constitutes a major threat to occupational health and safety, thereby comprising a priority issue for policymakers. Given the increasing prevalence of chronic diseases and comorbidities among the Lebanese population, nurses working in critical care settings encounter intense workloads and high-risk interactions, potentially increasing the risk of WPV. Objectives: This study aimed to investigate the traumatic and psychological reactions of Lebanese critical nurses who have been exposed to WPV, and the risk factors for depression and anxiety. Methods: The study utilized a cross-sectional descriptive correlational design; 112 critical care nurses from diverse departments took part in this study during the period of June to July 2021. Results: A positive, significant correlation between WPV exposure and self-reported anxiety was observed, p = .03 with high levels of WPV, especially among patients and their families. Although verbal abuse was found to be more prevalent among critical care nurses in Lebanon compared to physical and sexual violence, the severity of the situation and its impact on the nurses' mental health and well-being cannot be ignored. Conclusions: WPV for critical care nurses is a serious issue that needs to be considered. Policy-makers should develop the politics of regulating the nursing profession, especially for critical care nurses in Lebanon.

Burnout, quality of life and perceived patient adverse events among paediatric nurses during the COVID-19 pandemic.

PURPOSE: This cross-sectional, descriptive, correlational study aimed to measure burnout, quality of life (QOL) and perceptions of patient-related adverse events among paediatric nurses amid the COVID-19 pandemic and assess the relationships between these scores and participants' demographic and work-related characteristics. BACKGROUND: The mental health of most nurses may severely suffer due to the significant adversities that they struggle with while they care for their patients amid the COVID-19 pandemic. Mental distress negatively affects nurses' relationships and work performance, which may adversely influence the quality of care and patient safety. METHODS: A convenient sample of 225 Jordanian paediatric nurses completed a test batter comprising the Copenhagen Burnout Inventory, the Brief Version of the World Health Organisation's Quality of Life questionnaire and the nurse-perceived patient adverse events' questionnaire. This study was prepared and is reported according to the STROBE checklist. RESULTS: Paediatric nurses reported high levels of burnout, low QOL and high occurrence of hospital-acquired infections. Participants' age and hospital/unit capacity were significantly associated with burnout and QOL. CONCLUSION: Personal traits, perceived salary insufficiency and hospital/unit capacity represent factors that aggravate burnout, lower quality of life and worsen perceived patient safety among paediatric nurses. RELEVANCE TO CLINICAL PRACTICE: Policymakers should promote nurses' mental integrity and patient safety by addressing issues of workload and financial sufficiency and by provide interventions aimed to increase nurses' resilience. PATIENT OR PUBLIC CONTRIBUTION: Patients or public were not involved in setting the research question, the outcome measures, the design or implementation of the study. However, paediatric nurses responded to the research questionnaires.

Relationship of stigmatization and social support with depression and anxiety among cognitively intact older adults.

Aims and objectives: This study aimed to assess depression and anxiety symptoms among older adult residents of long-term care facilities (LTCFs) in Jordan and to examine the relationships between stigmatization and social support with depression and anxiety. Methods: Data was collected between December 2019 and March 2020 using a cross-sectional design. A total of 90 LTCF residents responded to measures of cognition, anxiety, depression, stigmatization, and social support. Descriptive statistics and multiple regression analyses were used in this study. Results: The average scores of depression and anxiety were high among the participants, with 81.1% of the participants found to be at risk of developing clinical depression. Stigmatization was positively correlated with depression and anxiety, whereas social support was negatively correlated with depression. Stigmatization was a significant predictor of both anxiety and depression scores (ß = .19, p = .03; ß = .32, p = .001, respectively). Conclusions: Older adults residing in LTCFs in Jordan suffer from many psychological distress symptoms, which place them at risk of serious mental problems. Reducing stigmatization would improve the psychological well-being of LTCF residents. Relevance to clinical practice: Caregivers working at LTCFs should be aware that with the longer stay, older adult residents are expected to complain of psychological distress symptoms. Thus, frequent assessment of the residents is highly recommended. In addition, caregivers should provide the residents with appropriate social support to mitigate the negative impact of a lengthy stay.

Nurses' burnout and quality of life: A systematic review and critical analysis of measures used.

BACKGROUND: Nurses' burnout might affect their quality of life, productivity and nursing care services. AIM: The aim of this systematic review was to systemically review the relationship between nurses' burnout and quality of life and to introduce practical recommendations to reduce nurses' BO and improve their QOL. METHODS: In April 2021, MeSH terms (("Nurses"[Mesh]) AND "Burnout, Professional"[Mesh]) AND "Quality of Life"[Majr] were used to search five electronic databases: CINAHL, PubMed, Medline, Psychology and Behavioral Sciences Collection and Google Scholar. RESULTS: The search produced 21 studies exploring nurses' burnout and their quality of life within the last ten years (2009-2021). Most of these studies found significant relationships between the burnout dimension(s) and quality of life dimension(s) among the nurses. CONCLUSION: Nurses have moderate to high levels of burnout and were negatively associated with poor quality of life. Interventional programs are needed to decrease nurses' burnout and improve their quality of life.

Knowledge of Jordanian nurses and attitudes toward patients with suicidal attempt.

Nurses' attitudes toward attempted suicide may affect the quality of care provided to those patients. There is a significant relationship between suicide literacy level and stigmatizing attitudes toward suicide. This study aimed to examine nurses' knowledge and attitudes toward patients with suicidal attempts. A cross-sectional correlational design was used to guide this study, and data were collected using an online survey. The Stigma of Suicide Scale-short form (SOSS-SF) was used to measure stigmatizing attitudes toward suicide, while the Literacy of Suicide Scale (LOSS) was used to measure suicide literacy level. The sample consisted of 343 Jordanian nurses, and their mean age was approximately 31 years old. Only 58 (16.9%) nurses reported having suicide training. Nurses had low stigmatizing attitudes toward suicidal patients. Nurses showed low suicide literacy levels. Only 46% of nurses had scores equal to or higher than the passing score of the LOSS. Linear multiple regression was used to predict nurses' level of stigma toward suicidal patients. Among the four predictors entered in this analysis, only LOSS showed a significant and negative effect. This study highlighted the importance of suicide training and education for nurses because it may improve their attitudes, self-confidence, and professional practices when providing care for patients.

Paediatric nurses' burnout, quality of life and perceived patient adverse events during the COVID-19 pandemic: Testing an integrated model using structural equation modelling.

PURPOSE: A model was hypothesised by integrating two theoretical models: the compassion satisfaction-compassion fatigue and empowerment models. This study aimed to assess the extent to which this integrated model can explain the relationships between paediatric nurses' burnout quality of life, perceived patient safety and work-related variables during the COVID-19 pandemic. BACKGROUND: Nurses' burnout is negatively associated with quality of life (QOL) and positively with patient safety. Several theoretical models were introduced to explain burnout determinants and outcomes such as Golembiewski, Munzenrider and Stevenson model, Leiter and Maslach's process model, and Lee and Ashforth's model. However, few models described burnout in relation to QOL or patient safety. METHODS: A sample of 225 paediatric nurses responded to questionnaires about burnout, QOL, adverse events and work-related variables. Compassion satisfaction - compassion fatigue and empowerment models were integrated into a single model and tested using structural equation modelling analysis. This study was prepared and is reported according to the STROBE checklist. RESULTS: The final model explained 65% of the variance of burnout and 37% of the variance of QOL. The work-related variables (co-workers' support, job satisfaction, satisfaction with the monthly salary, participation in continuous education and exposure to violence) are predicting paediatric nurses' burnout and quality of life. CONCLUSION: The Compassion satisfaction - compassion fatigue -Empowerment integrated model allows for assessing the different paths in the relationship between work-related variables and burnout. RELEVANCE TO CLINICAL PRACTICE: These results might be essential for nursing managers to develop strategies that improve nurses' work environment and minimise their burnout during COVID-19 pandemic. These strategies should focus on enhancing co-workers' support, job satisfaction and participation in continuous education. Furthermore, paediatric nurses should be protected from any violence.

Public knowledge, attitude, practices, and level of anxiety toward the COVID-19 pandemic among people living in Oman.

The purpose was to examine knowledge, attitudes and preventive practices, as well as anxiety and stress of people living in a Gulf country with a diverse population toward the coronavirus disease 2019 (COVID-19) pandemic. A descriptive cross-sectional, exploratory design was used to meet the aims of this study. The target population was all individuals aged 18 years and older and who can read and write Arabic, English, or Hindi. The results showed that most individuals demonstrated a high level of knowledge regarding COVID-19. Most individuals believed that COVID-19 is not fatal and that countries can control the COVID-19 virus. Despite the lower levels of anxiety and stress among this population, many individuals reported high levels of stress and anxiety. Higher levels of anxiety, higher levels of knowledge, and being married were associated with more preventive practices. This study showed that the level of knowledge is positively associated with compliance with preventive measures. Providing the public with accurate and consistent information regarding COVID-19 may enhance their compliance with preventive measures. Using different risk communication strategies will ensure collaboration from the public and encourage them to be active members when facing contagious diseases.

The relationships between paediatric nurses' social support, job satisfaction and patient adverse events.

AIMS: To explore the relationships of family, co-worker and manager support with paediatric nurses' satisfaction and their perception of adverse events. Furthermore, this study aimed to assess the job satisfaction, social support and the perceived patient adverse events. DESIGN: This study used a cross-sectional correlational design. METHODS: A convenient sample of 225 paediatric nurses was selected from nine hospitals in Jordan. Both the Pearson correlations and multiple regression tests were used in the analysis. The study was prepared and is reported according to the STROBE checklist. RESULTS: Significant and positive correlations were found between paediatric nurses' job satisfaction and the social support they receive. Significant negative correlations were also found between adverse events and both family and manager support. The multiple regression results showed that manager support is a significant negative predictor of both pressure ulcers and patient falls, and family support significantly predicted paediatric nurses' job satisfaction.

Social Support, Self-Efficacy, and Psychological Wellbeing of Adults with Type 2 Diabetes.

Social support improves self-efficacy, which in turns enhances self-management that lead to better psychological outcomes of persons with type 2 diabetes (T2D). The purpose of this study was to examine the relationship between social support and psychological outcomes of adults with T2D. A cross-sectional design was used to recruit a sample of 339 participants from a diabetes clinic. The participants responded to a series of questionnaires on demographics, social support dimensions, and self-management; self-efficacy; and psychological outcomes. The function and quality of social support were positively associated with self-efficacy. Self-efficacy was significantly associated with both self-management and psychological outcomes. In addition, self-efficacy demonstrated successful mediation role in the relationship between social support and psychological outcomes of T2D, however, self-management failed to mediate this relationship. The quality and functionality of social support are distinctive variables that should be recognized to promote social support interventions to reduce or prevent T2D-related psychological outcomes.

COVID-19 Help-Seeking Behaviors: Application of the Theory of Planned Behavior.

The novel coronavirus disease (COVID-19) is highly contagious. More than 247 million cases have been confirmed by the end of October 2021. Seeking help earlier may slow the spread of COVID-19 because it may help in early detection of infected cases, and it facilitate tracing those who were with close contact with infected cases. The purpose of this study is to identify participants' intentions toward COVID-19 seeking help and the factors affecting their decision. This is a cross-sectional study. An online survey using Google Forms was used for data collection. Hierarchical multiple regression analysis was used to explain intentions to seek help for COVID-19. The concepts included in the Theory of Planned Behavior and COVID-19 knowledge were used as predictors. The sample included 780 participants, with an average age of 28.60±9.86 years old. Most of the sample were female (67.4%) and having a bachelor's degree (72.7%). Participants showed high level of knowledge regarding COVID-19, 73% of the sample had a total knowledge score equal to or higher than 85%. Also, participants had high positive attitudes and high intentions to seek help for COVID-19. The four predictors: Attitudes towards COVID-19, subjective norm, perceived behavioral control, and COVID-19 knowledge significantly explained intentions to seek help. Participants had high intentions to seek help for COVID-19, which was related to having positive attitudes toward seeking help, high social approval, high perceived controllability, and high COVID-19 knowledge levels. Regular awareness campaigns during early stages of pandemics should be performed to improve attitudes and knowledge level, which may improve prevention measures, and promote help seeking behaviors. Consequently, this may facilitate early detection of cases, and slow the spread of pandemics.

Assessing knowledge and ageist attitudes and behaviors toward older adults among undergraduate nursing students.

Caring for older adults is viewed as a low prestigious profession and a less attractive career option for nursing students. Knowledge deficit is a major perceived barrier to reliving ageist attitudes and behaviors among nursing students. In the Middle East, there is limited evidence regarding ageism among nursing students. This study aimed to examine the association of nursing students' demographics and knowledge of aging with ageist attitudes and behaviors. A cross-sectional design was used to recruit a convenience sample of 290 undergraduate nursing students in Jordan. The majority of nursing students reported poor knowledge, held ageist attitudes, and expressed ageist behaviors. A significant difference was found between senior and junior nursing students in the level of knowledge about aging. Also, significant correlations were found among students' knowledge about aging and ageist attitudes and behaviors. Targeting knowledge deficit and ageist attitudes and behaviors among nursing students is crucial for optimal geriatric care.

The relationship between social networking sites usage and psychological distress among undergraduate students during COVID-19 lockdown.

During the outbreak of the COVID-19 pandemic, interpersonal interactions are restricted to social networks. Undergraduate students are isolated in their homes and dorms. Loneliness is closely related to psychological distress. Fear of contracting the disease will worsen psychological distress. The purpose of this study was to assess the severity of depression, anxiety, and stress symptoms among undergraduate students and their relationships with social networking sites usage during the COVID-19 lockdown. An online survey was used to recruit 456 participants for this cross-sectional descriptive study. Self-reported questionnaires were used to collect data on students' demographics, depression, anxiety, stress, and social networking usage. The results revealed that the majority of students had symptoms of depression (74.1%), anxiety (59.6%), and stress (61.2%). Female students had higher depression and anxiety symptoms than males. Senior-level students' psychological distress symptoms were significantly different from those of junior level. The largest percentage of students (91.9%) used social networking sites for entertainment. The academic usage of social networking sites was negatively (p < .05) correlated with depression and stress scores, while entertainment usage was positively correlated with anxiety. Age was not found to be significantly correlated with psychological distress. Academic and entertainment use of social networking sites were successfully associated with psychological distress symptoms after controlling for demographics. During this unprecedented time of undergraduate students' course of study, they were experiencing higher than average distress symptoms. These symptoms could be mitigated by continuing the regular academic activities and delivering the most accurate up-to-date information on the COVID-19 through social networking sites.

Nursing Empowerment: How Job Performance Is Affected by a Structurally Empowered Work Environment.

OBJECTIVE: The purpose of this study is to investigate the level of structural empowerment and explore its relationship with job performance among nurses. BACKGROUND: Empowered nurses display more authority and an awareness of the accomplishment of their contribution to organizational goals. METHODS: A cross-sectional study was conducted with a convenience sample of nurses in 4 hospitals in Jordan. Data were collected using a self-administered questionnaire. RESULTS: A total of 195 nurses responded to the questionnaires, including 88 males (45.1%) and 107 females (54.9%). Overall, participants perceived their work environment to be moderately empowering. There is a significant positive correlation between structural empowerment and job performance. CONCLUSIONS: Highly empowered nurses display higher performance than less empowered nurses. Nurse managers must create an empowering work environment that supports nurses' job performance positively through structural empowerment. Applying structural empowerment in the work setting is crucial for ensuring the highest quality of patient care, improving nurses' performance, and reaching the organizational goals.

Development and psychometric evaluation of Nurses and Midwives' Perceptions of their Roles in Primary Healthcare.

OBJECTIVE: This study aimed to develop Nurses and Midwives' Perceptions of their Roles in Primary Healthcare (NMPR-PHC) and evaluate its psychometric properties. METHODS: A cross-sectional survey was performed to recruit a convenient sample of 150 registered nurses and midwives from various primary healthcare settings in Jordan. Reliability was evaluated by examining the internal consistency and split-half reliability of the item. A exploratory factor analysis was performed to assess the factor structure of the NMPR-PHC. RESULTS: The final version of NMPR-PHC contained 18 items. Exploratory factor analysis revealed six factors (care coordination and interprofessional collaboration, workplace facilitators of the primary healthcare, management of care, research, workplace constraints of primary healthcare, and advanced education) for the questionnaire which explained 66.49% of the total variance. The Cronbach's α of the total scale was 0.834, the subscales Cronbach's α were ranging between 0.662 and 0.770, and the split-half reliability of the total scale was 0.734. CONCLUSION: The overall performance of the questionnaire showed promising sound psychometric properties. The NMPR-PHC can be recommended for use as a tool for the assessment of nurses and midwives' perceptions of their roles in primary healthcare.

The relationship between occupational stress, psychological distress symptoms, and social support among Jordanian healthcare professionals.

Occupational stress is a major problem for healthcare providers, with some professionals experiencing higher numbers of stressful situations than others. Although it is difficult to eliminate stress in professionals' daily lives, providing social support can lower psychological distress symptoms. This study aims to investigate the relationship between occupational stress and social support, and the effects of social support on psychological distress symptoms of healthcare professionals. A cross-sectional descriptive design was utilized. Self-administered questionnaires were completed by a convenience sample of 211 participants (physicians, nurses, and pharmacists) from a Jordanian hospital. Bivariate analyses were used to examine the relationships between the study variables. Multiple regression analyses were used to determine if occupational stress, demographic characteristics, and social support predict depression, anxiety, and stress. Results showed that healthcare professionals with more social support showed less depression than those with a lower score of social support. Females had higher scores of depression and anxiety than males. Pharmacists had significantly higher occupational stress than both nurses and physicians. Occupational stress negatively influences healthcare professionals' mental health. To improve the productivity and psychological wellbeing of healthcare professionals, occupational stress should be diminished by implementing effective management approaches to facilitate social support for healthcare professionals.

Psychometric properties of the Arabic version of the cardiac depression scale tested on Jordanian patients with cardiovascular diseases.

BACKGROUND: The Cardiac Depression Scale (CDS) is an instrument to screen for depression, specifically in patients with cardiovascular diseases (CVD). The purpose of this study was to evaluate the psychometric properties of the Arabic version of the CDS in the Jordanian population. METHOD: A cross-sectional design was used for 304 participants diagnosed with CVD. An exploratory factor analysis (EFA) was performed to explore the underlying structure of the new Arabic version of the CDS tool. RESULTS: Cronbach's alpha for the total scale was 0.87. An EFA suggested a two-factor solution. The first factor has 18 items, measuring "My tolerance" of CVD, and the second factor has seven items, measuring "My activities" in the context of CVD. Based on the EFA simple structure, one item was removed due to its low factor loading (< 0.3). A confirmatory factor analysis (CFA) supported a two-factor model with the root mean square error of approximation (RMSEA = 0.06), comparative fit index (CFI = 0.856), and Tucker-Lewis index (TLI = 0.83) indicating acceptable fit. The Cronbach's alpha values for the first and second factors were 0.86 and 0.84, respectively. CONCLUSION: The Arabic version of the CDS is a reliable and valid instrument to screen for depression among Jordanian patients with CVD.