Factors influencing quality of life among syrian refugees pregnant women in Jordan: A cross-sectional study.

Background: Pregnancy is a critical period of transition incorporating important normal physical, emotional, hormonal, and physiological status changes. These changes might affect the quality of life (QOL) of pregnant woman. This study aimed to examine the levels of quality of life and perceived social support of Syrian refugees' pregnant women in Al-Zaatari Refugee Camp in Jordan. Methods: A cross-sectional survey design was used. A sample of 319 pregnant women was recruited from two maternal health clinics at Al-Zaatari Refugee Camp. Data were collected from June to August 2020 using the Arabic version of World Health Organization Quality of Life (WHOQOL-BREF), the Multidimensional Perceived Social Support (MSPSS) questionnaires, and two sheets were used to assess sociodemographic and obstetric variables. Results: The study reveals that Syrian refugees' pregnant women had good satisfaction with their overall QOL and health status and social support. A significant relationship was found between the socioeconomic index and QOL. Also, age, being in the third trimester, and parity correlated negatively with QOL. In contrast, those who stayed in Jordan as a refugee for a longer period reported better QOL. Conclusion: Syrian women in Jordan, in general, have a good QOL and high level of social support. However, women were least satisfied with their physical health domain. Several factors affected QOL including income, employment status, age, number of children, and pregnancy trimester. Social support is an important factor in improving the QOL among Syrian refugees' pregnant women.

The effect of health education on second-hand smoke knowledge and exposure among pregnant women in Jordan: A quasi-experimental study.

Second-Hand Smoke (SHS) is a significant health issue. For non-smoker pregnant women, SHS exposure can lead to harmful consequences on the fetus. This study aimed to examine the effectiveness of a health education program in decreasing SHS exposure and increasing pregnant women's knowledge of its harmful effects. A quasi-experimental (pretest-posttest control group) design and the second-hand exposure questionnaire (SS-A) were used. A convenience sample of 136 pregnant Jordanian women from the antenatal clinic was recruited and assigned to an intervention group (n = 70) and a control group (n = 66). The intervention group received a health education program, while the control group received the usual antenatal care. The data were collected from October to December 2018. The results revealed that the highest exposure to SHS was in the home setting, with an average of 8.7 ± 2.21 hours daily for both groups. After the educational program, there were significantly lower scores of exposure and a higher score of knowledge in the intervention group, compared to the control group (p < 0.001). There was also a significant decrease in the scores of exposure and a significant increase in the score of knowledge of the intervention group from pretest to posttest (p < 0.001). The study provides evidence about the importance of a program to educate pregnant women about the negative impact of SHS. Nurses need to assess SHS exposure and provide health education for pregnant women.

Attitudes of midwives and obstetricians towards midwives practiced roles in hospitals: A national study in Jordan.

AIMS: The aims of this study were to identify midwives' and obstetricians' attitudes towards midwives practised roles in hospitals and to identify the differences in their attitudes towards midwives practiced roles. MATERIALS AND METHODS: A descriptive, cross-sectional, study design was used. A convenience sample of 303 midwives and 143 obstetricians were recruited. Participants were from 12 Ministry of Health (MOH) and Royal Medical Services (RMS) hospitals distributed across seven governorates. Two reliable and valid self-administered questionnaires were used to collect data including socio-demographic data-related characteristics of participants and obstetricians' and midwives' attitudes towards midwives' practiced role in hospitals. RESULTS: There were significant differences between obstetricians in the three subscales of attitudes: midwives women relationship attitude subscale, midwives trust and mutual respect subscale and work environment attitudes subscale. A significant difference by the institution was reported: obstetricians and midwives who worked in MOH reported more positive attitudes than those who worked in RMS. CONCLUSION: The results show that obstetricians recognise that midwives are qualified and competent professionals but still lack the competencies/skills to make them independent practitioners. The findings also confirm the need to improve midwives' practices by moving from being able to perform a specific task to possess all three attributes of "competencies," where they can intervene, manage and make decisions with confidence in each situation. IMPLICATION FOR PRACTICE: Based on the current study findings, parallel cooperation between educational/academic policymakers from both midwives and obstetricians may re-evaluate and upgrade the midwifery curriculum to meet the ICM competencies and health sector needs as a step to graduate competent midwives where their responsibility is recognised and organised.

Understanding Jordanian Midwives' Experiences of Providing Care during the COVID-19 Pandemic Crisis: A Phenomenological Study.

BACKGROUND: Midwives are at high-risk during the coronavirus disease (COVID-19) pandemic outbreak. Risks include virus exposures, extra working hours, psychological stressors, fatigue, work burnout, stigma, and physical and psychological violence. However, attention is needed to prepare the midwives during this crisis and help them overcome their challenges. The current study aims to explore Jordanian midwives' experiences of providing health care during the COVID-19 pandemic crisis. METHODS: A descriptive phenomenological qualitative study was used. Semi-structured interviews using telephone calls were conducted to collect data from April to May 2020. Each interview lasted for 30-45 minutes. Purposive and snowball sampling strategies were used to recruit 20 midwives from two hospitals. Colaizzi's method was used to analyze the data manually. RESULTS: Four main themes and eight subthemes were obtained. The main themes included: "Living in turmoil"; "Communication dilemma"; "Positive experience over time", and "Seeking support". CONCLUSION: Jordanian midwives experienced a stressful and interruptive routine life while providing care to their clients during the COVID-19 pandemic. This study recommends more attention towards the psychological state and factors that might affect the midwives during this crisis. The management and administrative teams should do their best to reduce the work pressure and arrange holidays appropriately. Policymakers and the government should provide the midwives with a safe work environment, good information resources, and financial rewards.

Effects of a health education intervention on knowledge and attitudes towards chronic non-communicable diseases among undergraduate students in Jordan.

Aim: To assess the effect of a health promotion course on knowledge and attitudes towards chronic non-communicable diseases (CNCDs) among undergraduate students in a Jordanian university. Design: A one-group pre-test-post-test study design was used. Methods: A convenience sample of 178 undergraduate students registered in a 3-credit health promotion course was enrolled in the study and completed both pre- and post-tests. This course is offered as an elective course for undergraduate students by the Faculty of Nursing at a large public university in Jordan. Twelve, one-hour interactive sessions regarding CNCDs topics were delivered over 3 weeks as part of the health promotion course. A computer-based questionnaire was used to evaluate students' knowledge and attitudes towards CNCDs including diabetes, hypertension and cancer, before and after undertaking the course. Results: There was a significant improvement in the overall knowledge (Cohen's d effect size (d) = 1.08) and attitudes (d = 0.62) among all the students, regardless of gender. The overall knowledge and attitudes scores were significantly higher among females in the pre-test, but the differences in their overall scores became insignificant in the post-test. Education on specific topics was effective in improving university students' knowledge and attitudes about health-promoting behaviours, thereby preventing CNCDs. It is important to incorporate health promotion education regarding CNCDs into university curricula using innovative approaches to enhance healthy behaviours in young adults.

Sexual educational needs of Jordanian women after giving birth.

BACKGROUND: Pregnancy and birth entail many bodily changes, including changes in sexual activity. The postpartum period is a time of considerable recovery and adaptation for women, yet women do not always receive adequate information, especially in countries where such topics may be considered taboo. The purpose of this project was to explore the sexual educational needs of Jordanian women after giving birth. METHODS: A qualitative, phenomenological approach was used. A purposive sample of 25 women were recruited from two health care centers. Semi-structured, in-depth interviews were conducted in person in Arabic between August and November 2015. Transcripts were independently analyzed and coded by each researcher. RESULTS: Two major themes with six subthemes emerged. Theme 1, sexual education, included discussions about the women's needs for scientific information and the husband's involvement, and their psychological needs. Theme 2, professional approaches, involved discussions about the most appropriate person to deliver education, preferred place and time for education, and effective educational approaches to be used. DISCUSSION: Congruent with previous studies, findings indicated that issues related to sexuality are often ignored in this population. CONCLUSIONS: Jordanian women have many unmet educational needs with respect to sexuality after giving birth. More efforts are needed from health care professionals and other stakeholders to help improve Jordanian women's sexual health education after giving birth. These should include greater access to classes, websites with scientific information, and informational handouts that target husbands, and postpartum women themselves.

The association between hope and quality of life in haemodialysis patients.

BACKGROUND: Hope is important for patients with end-stage renal disease receiving haemodialysis (HD) and hope is associated with quality of life (QoL). Studies examining hope among the HD population are limited and, as far as the authors know, have not been undertaken in Jordan. AIMS: To examine levels of hope and QoL and to examine the association between hope and QoL in HD patients in Jordan. METHODS: A cross-sectional design was used. A convenience sample of 202 patients from six different dialysis centres was recruited. The World Health Organization QOL-BREF and the Herth Hope Index were used. FINDINGS: Moderate levels of hope (M=32.3±4.1) were reported. Respondents reported low mean scores for the physical domain of QoL (M=48.3±21.1) but not for the psychological and social relationship domains. Higher hope scores were associated with better QoL. CONCLUSION: The findings suggest a positive relationship between the level of hope and QoL in people receiving HD. Encouraging hope while caring for HD patients in clinical settings may improve their QoL. Understanding the relationship between hope and QoL may help healthcare providers to improve the quality of care for patients and their families.

Social support predicted quality of life in people receiving haemodialysis treatment: A cross-sectional survey.

Aims: To examine levels of social support and quality of life (QOL) and to examine the association between social support and QOL in patients receiving haemodialysis (HD) treatment. Design: A cross-sectional study. Method: social support and QOL were measured using the Multidimensional Scale of Perceived social Support (MSPSS) and the World Health Organization QOL-BREF questionnaires, respectively. A convenience sample of 195 patients receiving HD from different dialysis units across Jordan completed the questionnaires. Results: Respondents scored highest on the social relationships domain of QOL (55.5 SD 21.4) compared with the lowest mean scores of the physical and environmental domains (48.6 SD 20.4; 46.2 SD 17.3, respectively). social support had a positive significant association with quality of life. Multiple linear regression identified age and social support as influencing factors, explaining 24.6% of the total variance in the social domain of quality of life.Understanding the relationship between social support and QOL in patients receiving HD may provide guidance to the healthcare providers, family members and social services about the importance of social support to this group of patients.

A phenomenological study of Jordanian women's experience of sexual intercourse after giving birth.

AIM: to explore the sexual experiences of Jordanian women on the first occasion after giving birth. METHODS: phenomenological qualitative research. Twenty-five Jordanian women were purposively recruited from two maternal health centres and interviewed. FINDINGS: four themes emerged: "culture and religion v/s health professionals in resumption of sexual intercourse"; "enduring physical and psychological discomforts"; "husbands' role in resumption of sexual intercourse"; and "newborn babies' role in the experience of sexual intercourse". CONCLUSION: health professionals need to adopt appropriate maternal clinical guidelines to meet women's needs. There is a need to give greater emphasis on sexual health care provided to women during pregnancy and after giving birth.

"Resumption of Sexuality and Health Education in Postpartum Period: From Jordanian Health Care Professionals' Perspectives".

Objective: to explore Jordanian health care professionals' perspectives about sexual education after giving birth. Methods: a descriptive qualitative approach was used to address the study aim. A purposive sampling method was used to recruit seven midwives, 13 nurses and two obstetricians from three Primary Health Centres. The inclusion criteria were: midwives, nurses or obstetricians with at least two years' experience and currently working at a maternity health centre. Focus group discussions were used to collect data. A manual Thematic Content Analysis Tool was used to analyse the data. Results: five major themes emerged. Silence; resumption of sexuality after giving birth/area of conflict; men's authority in resumption of sexuality; the importance of sexual education (what, when and whom) and suggestions for sexual education approaches. Conclusions: Healthcare professionals were hesitant to open sexuality topic with the women during antenatal and postnatal visits due to cultural limitations and lack of knowledge. Therefore, in a time of global migration, the healthcare professionals have the need to understand cultural differences in attitude towards health care issues involving sexuality.

Spirituality, Anxiety and Depression Among People Receiving Hemodialysis Treatment in Jordan: A Cross-Sectional Study.

Spirituality is an important factor that may mediate the detrimental impacts of hemodialysis on mental health. Lack of research examining spirituality and mental health in the Arab world in general and Jordan in particular encouraged this research. The study examined levels of spirituality, depression and anxiety and explored the association between them among patients receiving hemodialysis treatment in Jordan. A cross-sectional design was used to recruit 202 patients receiving hemodialysis treatment. Self-administered questionnaires including spiritual well-being scale, depression and anxiety and a demographic data sheet were used. The data were analyzed using SPSS and descriptive, inferential statistics and linear multivariate regression. The majority of respondents reported moderate mean levels of spirituality well-being (62.4%), while 60.9% and 80.2% scored low-to-moderate levels of depression, respectively. Only 22.3% reported moderate-to-severe anxiety levels. Increasing anxiety and number of co-morbid conditions were predictors of depression. No significant correlations were found between spirituality neither with the sample characteristics nor with depression and anxiety. It was found that depression and anxiety are common among respondents. Spirituality was of medium importance to them, yet it was not significantly associated with depression and anxiety. The implications of this study for holistic clinical practice are explored.

Examining the associations between smartphone use and mother-infant bonding and family functioning: A survey design.

Excessive smartphone use has been found to be associated with dysfunctional social and family relations. While most studies of this phenomenon have focused on adolescent and adult addiction, none has yet to focus on mothers with infants. This study examined the association of excessive smartphone use with mother-infant bonding, maternal mental health, and family functioning in Jordan. The predictive value of the study variables with respect to the level of smartphone use was evaluated. A descriptive correlational cross-sectional survey design was used. A sample of 114 mothers with infants was interviewed in person and completed a web-based questionnaire. Approximately 16% reported using smartphones 5 to 14 hours per day; 6.7% described themselves as smartphone addicts. The results suggest that excessive smartphone use may be linked to unhealthy family functioning. No associations were found between smartphone use and mother-infant bonding or maternal mental health. Raising awareness of this linkage and limiting smartphone use are recommended as precautionary measures. Although this study failed to find any association between smartphone use and mother-infant bonding, further studies using empirical methods might have better success.

Neonatal nurses' knowledge and beliefs about kangaroo mother care in neonatal intensive care units: A descriptive, cross-sectional study.

The aim of this study was to assess Jordanian neonatal nurses' knowledge and beliefs toward the application of kangaroo mother care in the neonatal intensive care unit. A cross-sectional, descriptive survey was performed using a convenience sample of 229 nurses. The findings revealed that the majority of the nurses agreed that kangaroo mother care was beneficial to both mothers and infants; however, 47.2% believed that it was not feasible for all preterm infants. The majority of nurses believed that kangaroo mother care should be restricted to infants on intravenous treatment, intubated, or with an umbilical catheter. The majority of the nurses correctly answered questions regarding kangaroo mother care. A significant relationship was found between the nurses' knowledge and their beliefs toward kangaroo mother care. The findings of this study provide insights into Jordanian nurses' knowledge and beliefs toward the kangaroo mother care approach. If addressed, these findings will help improve the practice and nursing care for preterm infants.

Exploring woman -Nurse interaction in a Jordanian antenatal clinic: A qualitative study.

BACKGROUND: Effective woman-nurse interaction is critical in providing quality nursing care and would improve the health outcomes and the level of women's satisfaction with health and nursing services. AIM: To explore how Jordanian nurses and pregnant women perceive their interaction during antenatal visits. METHODS: A descriptive qualitative study was conducted using a purposive sample of twelve pregnant women and twelve nurses. Data were collected through four focus group discussions organized at an antenatal clinic of a large hospital in Jordan. The data were analyzed using Giorgi's four stages of data analysis. FINDINGS: Approaches to interaction; barriers to interaction; quality of interaction were the main themes emerged from the data. Nurses and pregnant women also provided suggestions for strengthening the womannurse interaction during antenatal visits. CONCLUSION: The different aspects of interaction described by the participants of this study may raise awareness and appreciation of the important roles health care providers can play in promoting the health outcomes of pregnant women when effective interaction is built and strengthened. Relevant policies and guidelines on improving appointment systems, and continuing education on communication skills and health education would be needed. More attention is required to adopt appropriate antenatal clinical guidelines and protocols to meet women's needs in Jordan.

The Association Between Maternal Factors and Preadolescent Breakfast Skipping: The Mediating Role of Preadolescent Attitudes Toward Breakfast.

BACKGROUND: Although skipping breakfast is common among children and adolescents, daily breakfast consumption is a healthy habit that is particularly important in childhood. There is a link between children's attitudes toward breakfast, breakfast-skipping behaviors, and maternal factors. Evidence demonstrating a clear relationship between maternal factors and preadolescent attitudes and behaviors toward breakfast skipping is scarce. AIMS: This study aims to examine the mediation effect of preadolescent attitudes toward breakfast on the associations between maternal involvement (encouragement and control of breakfast eating) and preadolescent breakfast skipping. METHODS: A cross-sectional descriptive study was conducted across Jordan in public and private primary schools in 2015. A sample of 1,915 preadolescent students (10-11 years) and their mothers (N = 1,299) was generated through proportional cluster stratification sampling. The interrelationships were examined among the participants' demographics, the number of preadolescent skipped breakfasts during a given week, self-reported attitudes toward breakfast, and perceived maternal encouragement and control of breakfast-eating variables. RESULTS: Analysis revealed that preadolescent attitudes toward breakfast and mothers' involvement in preadolescent breakfast were negatively correlated with preadolescent breakfast skipping. Linear regressions revealed that maternal involvement (i.e., encouragement and control of breakfast eating, and educational attainment levels) was predictive of preadolescent attitudes toward breakfast consumption. Multiple regressions using bootstrapping analysis showed that preadolescent attitudes partially mediated the effect of mothers' control and encouragement of breakfast consumption over preadolescent breakfast-skipping behavior. LINKING EVIDENCE TO ACTION: Results suggest that preadolescent attitudes, maternal encouragement, and control of breakfast eating influenced preadolescent breakfast skipping. These findings emphasize the importance of carefully assessing preadolescent attitudes toward breakfast, maternal encouragement, and control of breakfast consumption when developing interventions aimed at reducing breakfast-skipping behavior.

Effects of interactive teaching on university students' knowledge and attitude toward reproductive health: a pilot study in Jordan.

BACKGROUND: Youths in Jordan lack knowledge related to reproductive health (RH). Interactive teaching methods showed positive results in enhancing health awareness and adopting healthy practices among students. OBJECTIVES: The objective of this study was to examine the usefulness of interactive teaching in promoting health awareness of RH among nonmedical university students in Jordan. METHODS: We employed a quasi-experimental one group pretest and posttest design for a purposive sample of 210 students (18-24 years). Knowledge and attitudes regarding RH issues were assessed using a questionnaire developed by the researchers. RESULTS: A significant improvement in students' knowledge and attitudes toward RH was evident. Female students had higher scores on knowledge than male students in the pretest; this difference was smaller in the posttest. Also, female students had significantly more positive attitudes toward RH in pretest than males, although this difference vanished in the posttest. Study results indicated that students benefit from study intervention regardless their gender. CONCLUSION: Integrating RH into university's curriculum coupled with interactive learning approach is a powerful way to promote RH awareness among youths.

Spirituality in the Lives of Patients with End-Stage Renal Disease: A Systematic Review.

The aim of this systematic review was to answer these questions: What does spirituality means to patients with end-stage renal disease (ESRD)? And are there associations between spirituality and the health outcomes and general well-being of patients with ESRD? Thirty-three studies met the review criteria. Meaning of spirituality for patients with ESRD and spirituality in the lives of patients with ESRD were the main themes emerged. There is growing evidence that suggests a positive relationship between spirituality and the health outcomes and well-being of ESRD patients. However, the evidence is incomplete and there is a need for further research to enhance our understanding of the role of spirituality in improving the health outcomes and well-being of ESRD patients.

Egyptian and Jordanian nurse educators' perception of barriers preventing the implementation of evidence-based practice: A cross-sectional study.

BACKGROUND: Studies discussing nurse educators' attitudes, knowledge/skills, practicing of evidence-based practice (EBP) and barriers encountered towards implementation is somewhat limited. OBJECTIVE: The study aimed to identify the attitudes, perceived knowledge/skills, and implementation of evidence-based as perceived by nurse educators, in Egyptian and Jordanian universities, and to assess factors preventing them from adopting it in nursing program. DESIGN/SETTING/RESPONDENTS/METHODS: A cross-sectional design was conducted including two groups from Egypt and Jordan. Two questionnaires: (i) The Evidence-Based Practice Questionnaire (EBPQ) and (ii) The Developing Evidence-Based Practice Questionnaire (DEBPQ) and a demographic data sheet were used. Data were analyzed using SPSS version 20 and descriptive and inferential statistics tabulated. RESULTS: Majority of the respondents (85.5%) were females, <40 years old (62.1%), and from medical-surgical nursing departments (49.2%). The mean score of EBPQ was 4.96 ±â€¯standard deviation 0.91. Frequency of practicing EBP and attitudes toward EBP scores were similar between nurse educators in both countries (p > 0.05). However, the Jordanian staff had a remarkably higher perceived knowledge/skills of EBP than their Egyptian counterparts (Mean Rank = 79.98 & 57.63 respectively, at p = 0.004). There was a statistically significant positive, moderate correlation between attitudes, knowledge/skills and frequency of practicing EBP among nurse educators in both countries. The highest correlation observed for attitudes and frequency of practicing EBP was among Jordanian staff (r = 0.707, p < 0.000). Egyptian nurse educators had significantly higher perceived barriers to finding and reviewing evidence than their Jordanian counterparts (p = 0.000). However, both groups had similar perceived barriers related to changing practice and support from colleagues. CONCLUSIONS: Egyptian and Jordanian nurse educators, equally, hold positive attitudes toward adopting EBP. However, they encounter many barriers to implement it.

Maternal Sociodemographic Characteristics and Behaviors as Correlates of Preadolescent's Breakfast Habits.

PURPOSE: To explore factors affecting skipping breakfast rate, and to identify its perceived reasons among preadolescent students and their mothers in Jordan. DESIGN AND METHODS: Using cluster stratified sampling, preadolescent (10-11years) students (N=1915) and their mothers (N=1299) from 26 public and private schools completed a self-reported questionnaire. Breakfast skipping and its related habits were described. Children's and mothers' perceptions of regular breakfast eating and sociodemographic factors were analyzed in relation to breakfast skipping in children. RESULTS: Although the majority of both children and mothers perceived breakfast as very important, 23% of the children and mothers reported skipping breakfast. Male students skipped breakfast more than female students. Students whose mothers had a low level of education and students with a low value of breakfast consumption had a higher likelihood of skipping breakfast. Mothers' high value of breakfast and encouragement of children to eat breakfast were directly related to an increase in children's perceived importance of breakfast consumption. Preadolescents' and mothers' perceptions of the importance of breakfast and mothers' encouragement to eat breakfast were significant predictors of breakfast consumption among students. CONCLUSION: The high prevalence of breakfast skipping among students, and knowledge about association between mothers' perceived importance of breakfast consumption and encouragement highlighted the pivotal role of mothers in preadolescent's breakfast consumption. PRACTICAL IMPLICATIONS: The findings suggest that health care providers, including school health practitioners, are recommended to assess children's and mothers' perceived value of breakfast and to include mothers in health promotion interventions on breakfast consumption.