Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan.

PURPOSE: The spiritual dimension of a patient's life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress. DESIGN: A quantitative, cross-sectional correlational study. METHOD: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models. FINDINGS: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables. CONCLUSIONS: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored.

Prevalence of Symptoms and Quality of Life Among Jordanian Cancer Patients.

In Jordan, little is known about cancer-related symptoms prevalence, severity, and its impacts on patients' quality of life. Therefore, this study was conducted to estimate cancer-related symptoms prevalence, severity, and predictors of quality of life of cancer patients in Jordan. A descriptive cross-sectional survey design was used. The sample consisted of 498 Jordanian cancer patients. There were slightly more males (51.6%) and a mean age of 44.3 (SD = 15.3) years. The mean of the number of symptoms reported by patients was 11 (SD = 3.3). The most prevalent symptoms were fatigue (92.5%), feeling drowsy (87.1%), lack of appetite (86.3%), being distressed (86.1%), and pain (85.5%). Furthermore, Jordanian cancer patients had low mean total scores for quality of life at a level of 18.5 (SD = 4.9). A comprehensive palliative care program is recommended, led by a representative from the Ministry of Health, to integrate palliative care within the current health care system in Jordan.

Evaluating palliative care needs in Middle Eastern countries.

BACKGROUND: Cancer incidence in Middle Eastern countries, most categorized as low- and middle-income, is predicted to double in the next 10 years, greater than in any other part of the world. While progress has been made in cancer diagnosis/treatment, much remains to be done to improve palliative care for the majority of patients with cancer who present with advanced disease. OBJECTIVE: To determine knowledge, beliefs, barriers, and resources regarding palliative care services in Middle Eastern countries and use findings to inform future educational and training activities. DESIGN: Descriptive survey. SETTING/SUBJECTS: Fifteen Middle Eastern countries; convenience sample of 776 nurses (44.3%), physicians (38.3%) and psychosocial, academic, and other health care professionals (17.4%) employed in varied settings. MEASUREMENTS: Palliative care needs assessment. RESULTS: Improved pain management services are key facilitators. Top barriers include lack of designated palliative care beds/services, community awareness, staff training, access to hospice services, and personnel/time. The nonexistence of functioning home-based and hospice services leaves families/providers unable to honor patient wishes. Respondents were least satisfied with discussions around advance directives and wish to learn more about palliative care focusing on communication techniques. Populations requiring special consideration comprise: patients with ethnic diversity, language barriers, and low literacy; pediatric and young adults; and the elderly. CONCLUSIONS: The majority of Middle Eastern patients with cancer are treated in outlying regions; the community is pivotal and must be incorporated into future plans for developing palliative care services. Promoting palliative care education and certification for physicians and nurses is crucial; home-based and hospice services must be sustained.

Jordanian nurses knowledge and attitude regarding pain management.

Optimal pain management requires knowledgeable and trained nurses. The aim of this study is to investigate nurses' knowledge and attitudes regarding pain treatment in Jordan. The sample included 211 nurses from 4 hospitals in Jordan. The Nurses' Knowledge and Attitudes Survey Regarding Pain was used to measure the nurses' pain management knowledge and attitudes. Data were analyzed using descriptive statistics, unpaired t test, and Spearman correlation test. The results indicate that 51.7% of participants were male and the average age was 27.2 (SD 4.7) years. In addition, most nurses had a bachelor's degree (90.5%) and worked in medical and surgical wards. Furthermore, 52% of nurses reported no previous pain education in the last five years. The average of correct answers was 19.3 out of 40 (SD 4.7) and the rate of correct answers ranged from 10% (item 38) to 72% (item 22). It was found that there were no significant differences between nurses' gender and educational level and the total knowledge and attitude score, except for exposure to previous pain education (t = -3.64; df = 195; p < .001). Nurses with previous pain education got higher mean scores on the questionnaire. Jordanian nurses expressed a lower level of pain knowledge than that reported worldwide. Continuous education and reforming undergraduate curricula to address pain management are recommended.

Pain management in Jordan: nursing students' knowledge and attitude.

Pain management requires knowledgeable and trained nurses. Because nursing students are the nurses of the future, it is important to ensure that students receive adequate education about pain management in nursing schools. The purpose of this study is to evaluate nursing students' knowledge and attitudes regarding pain management. A cross-sectional survey was used. The sample comprised 144 students from three nursing colleges in Jordan. Sixty-one percent were female and the average age was 21.6 years (SD 1.7). The students' Knowledge and Attitudes Survey Regarding Pain was used. The rate of correct answers ranged from 11.1% to 64%. Students showed a low level of knowledge regarding pain management-the average score was just 16 (SD 5.11) out of 40. Students were weak in their knowledge of pain medications pharmacology (actions and side effects). Less than half of students (47.9%) recognised that pain may be present, even when vital signs are normal and facial expressions relaxed. Finally, students showed negative attitudes towards pain management, believing that patients should tolerate pain as much as they can before receiving opioids; almost half (48%) of students agreed that patients' pain could be managed with placebo rather than medication. In conclusion, Jordanian nursing students showed lower levels of pain knowledge compared with other nursing students around the world. This study underlines the need to include pain-management courses throughout undergraduate nursing curricula in Jordan.

Jordanian nurses' perceptions of their preparedness for disaster management.

AIM: To assess Jordanian RNs' perceptions regarding their knowledge, skills, and preparedness for disaster management. BACKGROUND: Current disaster knowledge, skills, and preparedness levels need to be evaluated to guide plans for effective educational programs. There is also a need to know where RNs received their knowledge, skills, and preparation, to enhance or improve future educational opportunities. METHODS: Cross-sectional survey where the Disaster Preparedness Evaluation Tool (DPET(®)) was distributed to Jordanian RNs who work in three randomly selected Ministry of Health hospitals and two university hospitals. RESULTS: Four hundred and seventy-four participants completed the survey. Sixty-five per cent of respondents described their current disaster preparedness as weak: 18% medium: 12% good; and 5% felt their preparation was very good. Thirty-one per cent received disaster education in undergraduate programs; 8% in graduate nursing programs; 31% in facility drills, and 22% in continuing education courses. Eleven per cent had participated in a real disaster. Four hundred and thirty RNs wanted to learn more about RNs role in disasters, including knowledge and skills. CONCLUSION: Knowledge,skills, and disaster preparedness need continual reinforcement to improve self efficacy for disaster management. RECOMMENDATIONS: There is a need for a consistent national nursing curriculum for disaster preparedness and nationwide drills to increase disaster knowledge, skills, preparedness, and confidence.

Barriers to cancer pain management: Jordanian nurses' perspectives.

BACKGROUND: Adequate management of cancer pain is a human right. However, cancer pain is still not well medicated, and some of the barriers to achieving relief are related to nursing. Identifying these barriers would help the development of interventions to improve pain management. AIM: To explore barriers to cancer pain management among Jordanian nurses. METHOD: A convenience sample of 96 nurses from 3 hospitals participated in a cross-sectional survey using an Arabic translation of Ward and colleagues' barriers questionnaire II. RESULTS: The nurses expressed high levels of barriers on the questionnaire, with a mean score of 2.5 for the questionnaire as a whole (standard deviation (SD) 0.8).The harmful and physiological effects of medications subscales received the highest mean scores: 2.7 (SD 1.1) and 2.6 (SD 0.9) respectively. CONCLUSIONS: Many nursing-related barriers to cancer pain management were found.These barriers need to be addressed and eliminated, for example through education and training.

The Disaster Preparedness Evaluation Tool: psychometric testing of the Classical Arabic version.

AIM: This paper is a report of a study conducted to translate the Disaster Preparedness Evaluation Tool into Arabic and to determine its psychometric properties, including reliability, validity and factorial structure. BACKGROUND: Worldwide numbers of natural and man-made disasters have greatly increased in recent years. Since disaster strikes without warning, all healthcare providers, especially nurses, must be prepared with appropriate skills and resources for disaster procedures and management during the three phases of disaster: pre disaster, during disaster and post disaster. Knowledge levels need to be evaluated to plan effective educational programmes. METHODS: The Disaster Preparedness Evaluation Tool was translated into Classical Arabic using Beaton's guideline for translation and validated by experts and a pilot study with 20 Registered Nurses from the target population. Data were collected in 2008 using self-administered questionnaires from 474 (79% return rate) Jordanian Registered Nurses who worked in randomly selected Ministry of Health hospitals and two university hospitals. RESULTS: Principal component analysis (Promax rotation with Kaiser Normalization procedure, SPSS version 15) was used to determined construct validity, and three factors explained 64% of the variance: knowledge, skills and post disaster management. Cronbach's alpha was 0.90, which demonstrated internal consistency. CONCLUSION: These results support the reliability and validity of the Disaster Preparedness Evaluation Tool as a measure of knowledge, skills and post disaster management. It can be used with confidence with an Arabic-speaking nursing population to measure their preparedness for disasters. Based on the results of such studies, effective disaster preparedness programmes could be developed to enhance nurses' disaster preparedness.