Nurses' beliefs and perceptions regarding family-centered care services in acute pediatric healthcare settings.

OBJECTIVES: To describe pediatrics nurses' beliefs about family-centered services (FCS) as a model of providing healthcare to children in acute care settings in Jordan. DESIGN AND METHODS: This is a cross-sectional descriptive study. Nurses who provide direct acute care to children (n = 246) completed the 'Measure of Beliefs about Participation in Family-Centered Service' questionnaire. Descriptive statistics were used to describe nurses' beliefs about participation, practical feasibility, implementation self-efficacy, principles, and potential adverse outcomes of FCS. RESULTS: Many nurses feel confident (70%) about their ability to work with others in providing FCS and perceive having the ability to operate according to family-centered care (FCC) principles (68%). Many (75%) nurses believed parents should be encouraged to decide how much they want to be involved in the child's care. However, only 46% of the nurses valued attending to family priorities if the health decisions made by the family differed from the healthcare providers' priorities. Many nurses (70%) believed that healthcare professionals' competencies and capacities to work utilizing FCC are more important than their personal preferences and opinion. CONCLUSIONS: The findings of this study clearly indicate that nurses positively viewed providing children's care within a FCS. This supports the efforts to reasonably integrate FCC as an operating model in the pediatric healthcare settings in Jordan. PRACTICE IMPLICATIONS: FCS is a complex task requiring integrating multidisciplinary effort and healthcare providers' positive attitudes toward families as care partners. Steps should help maximize the organizational resources to facilitate family presence and create opportunities for professional-families partnerships for children's care.

Gender as a Moderator of Spirituality and Spiritual Care in ICU Nurses During COVID-19 Pandemic.

Background: Earlier research has found that female healthcare providers often report greater spirituality and spiritual care than males. This would evoke attention toward factors contributing to such differences, particularly gender. Aim: To examine the moderating effects of gender on the relationships between demographic characteristics of ICU nurses and their perceived spirituality and spiritual care. Methods: A cross-sectional correlational design was used to recruit a national sample of 865 nurses working in ICUs in Jordan and providing care to patients diagnosed with COVID-19. Data were collected using a self-report bilingual version of Spirituality and Spiritual Care Rating Scale (SSC) and analysed using the SPSS software package. Results: Social status, monthly income, and receiving previous courses or lecture training on spirituality and spiritual care were predictors of higher SSCRS scores. Working with COVID-19 patients was a positive predictor (B = 0.074, p = 0.023), suggesting that working with COVID-19 patients is more likely to have a higher level of SSC. Gender was a negative predictor (B = -0.066, p = 0.046), suggesting that female participants are likelier to have a lower SSC score. Conclusion: Working with patients during the COVID-19 pandemic positively impacted nurses' perception of SCC, but female nurses had lower score than male nurses indicating the need for more emphasis on training female nurses and exploring further the areas in which they need more training and to be able to provide an effective SSC. A sustainable up-to-date training and in-service education programs responding to nurses' needs and emerged emergencies crisis need to be integrated into nursing quality of care policy development.

Systematic review and meta-analysis: Prevalence of hypertension among adolescents in the Arab countries.

PROBLEM: Hypertension (HTN) is one of the non-communicable diseases which prevalence is rising in both developed and developing countries. There is a scarcity of data on the prevalence of HTN in Arab countries. This review outlines what is currently known about prevalence and risk factors of HTN in adolescence in Arab world. ELIGIBILITY CRITERIA: A systematic review and meta-analysis were conducted using PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar databases from 2011 to 2021. SAMPLE: Fourteen studies from 9 Arab countries met inclusion criteria. Studies included a total of 777 adolescents with HTN and 2147 adolescents with pre-HTN. RESULTS: The overall prevalence of HTN among adolescents in the Arab World was estimated at 12.6% (95CI 0.083-0.176), while pre-HTN was 13.9% (95CI 0.084-0205). Overweight and obesity resemble the higher risk of developing hypertension. Family history, high consumption of salt, smoking and low physical activity also increase the risk of HTN. The development of adolescent HTN can be predicted through anthropometric measurements such as Body Mass Index (BMI), wrist circumferences, and high waist circumference. CONCLUSION: The prevalence of HTN among adolescents in the Arab world was significant, ranging from 4 to 26%. The heterogeneity between studies was high. IMPLICATION: Local governments and policymakers must consider strengthening regulations to address environmental risk factors and improve public awareness about risk factors to HTN. A combined use of nurse- and patient targeted educational interventions could also help in reducing the burden of HTN in this population.

The impact of somatic and cognitive depressive symptoms on medical prognosis in patients with end-stage renal disease.

PURPOSE: To determine whether somatic or cognitive depressive symptoms affect hospitalization and death in patients with end-stage renal disease. DESIGN AND METHOD: In an observational retrospective design, the patients (n = 190) completed the Beck Depression Inventory-II at baseline and were followed for 5 years to collect data all-cause mortality and hospitalization. FINDINGS: High somatic (53.7%, n = 102) and cognitive (52.1%, n = 99) depressive symptoms scores significantly associated with mortality (38% vs. 19%; hazard ratio [HR] = 2; 95% CI, 1.1-3.7; p = 0.02) and hospitalization (62.5% vs. 49.4%; HR = 1.6; 95% CI, 1.0-2.6; p = 0.03), respectively. PRACTICE IMPLICATIONS: In the context of diagnosing and intervening, awareness of depressive symptoms dimensionality is crucial.

Nurses' Perceptions and Attitudes toward Family-Centered Care in Acute Pediatric Care Settings in Jordan.

PURPOSE: Perceptions and attitudes toward working with parents may influence nurses' family-centered clinical care practices. There is a paucity of research measuring family-centered care among nurses working with children and their parents in Jordan. The purpose of this study was to explore nurses' perceptions of family-centered care by examining nurses' attitudes toward working with children and their parents, as well as toward family-centeredness. Also investigated was the extent to which the selected demographic characteristics of nurses explain the discrepancies between their child- and parent-focused attitudes. DESIGN AND METHODS: Using a cross-sectional descriptive study, 246 nurses completed the 'Working with families' questionnaire. A paired t-test used to compare the working with children versus working with parents' attitude scores, and independent t-test and ANOVA to explore the influence of nurses' demographic characteristics attitude scores. RESULTS: The nurses scored higher for working with children than with parents, suggesting more positive attitudes toward the former than the latter (p < 0.001). The family-centeredness scores varied with nurses' years of clinical experience (p < 0.001) and years of employment (p < 0.005). CONCLUSIONS: The applicability of the family-centered care model in Jordan's hospitals is challenged by the fact that pediatric nurses register more positive attitudes for working with children than with parents. PRACTICE IMPLICATIONS: Nurses' attitude toward working with children's families requires more evaluation prior to implementing family-centered care in practice. Further research is needed to explore factors contributing to discrepancies between child- and parent-focused attitudes among nurses.

Perceived barriers to healthcare utilization among Jordanian families: A family centered approach.

AIM: This study aimed to understand the barriers to health services utilization by Jordanian families. BACKGROUND: Access to quality healthcare services is a significant issue facing healthcare systems. Healthcare systems must identify and apply measures to overcome barriers that face utilizing health services and thus increase clients' satisfaction. METHODS: A cross-sectional qualitative research design was used in this study. Semi-structured interviews were conducted with twenty-five families to elicit the model of health services barriers. RESULTS: The analysis of the family interviews led to four main themes related to health services barriers: service system, structural/physical barriers, equipment and medication, and staff competency. This study would increase awareness about underserved populations that avoid seeking medical care. CONCLUSION: Public health efforts are required to increase awareness about the importance of contacting the healthcare system as early as possible. However, public health policy may require developing new initiatives that reduce these perceived barriers, such as enhancing communication skills among healthcare workers, increasing supervision and inspection of healthcare quality, and enhancing patient engagement by using phone calls and messages as appointment reminders and careful follow-up.

Perception and predictors of school climate among Jordanian adolescents.

BACKGROUND: School climate has great effects on adolescents' outcomes. It offers possible protective or harmful sets of factors that have significant contributions to adolescents' health, development, and academic outcomes. PURPOSE: The purpose of this study was to investigate adolescents' perception of school climate and its predictors. DESIGN AND METHODS: A cross-sectional design was used to recruit a convenient sample of 567 students with mean age of 14.6 years. Health Behavior in School-Aged Children questionnaire subscales of perceived school climate, peer support, and teacher support were used to collect data. Descriptive, parametric, bivariate, and regression analysis tests were used in the analyses of the study data. RESULTS: The study showed that less than half of the students felt that they belonged to their schools. One-third of responding students were involved in making rules. Perceived academic performance, adolescents' age, peer support, and teacher support were the predictors of school climate. Significant differences existed between adolescents' perception of school climate in relation to age, gender, and perceived academic performance. CONCLUSION: Some aspects of school climate should be further addressed by the school nurse, policy makers, and school administrators in order to improve Jordanian adolescents' outcomes in term of their developmental needs and academic performance.

Newborn Care Practices of Mothers in Arab Societies: Implication for Infant Welfare.

INTRODUCTION: There are at least 22 Arab league states and sections in Northern Africa, southwestern Asia, and Europe that incorporate the vast Middle Eastern culture. The purpose of this study was to identify the cultural variations in newborn care practices, self-management of common illnesses, and their potential impact on infant welfare. METHOD: A qualitative design using a focus group approach with 37 Arab mothers in Jordan was used. RESULTS: Findings revealed strong similarities in terms of beliefs, care practices, and the experience of intergenerational conflict in establishing and maintaining traditional practices among mothers. Potentially harmful practices included restrictive swaddling, rubbing a newborn's body with salt, and encouraging the ingestion of herbs in newborns. DISCUSSION: It is important for nurses and midwives to be aware of traditional practices, cultural beliefs, and the implications for infant welfare if they are to effectively engage with families to promote the well-being of the newborn.

The 12-year prevalence and trends of childhood disabilities in Australia: Findings from the Survey of Disability, Aging and Carers.

AIM: This paper contributes to knowledge on the prevalence and nature of disabilities in Australian children over a 12-year period (2003-2015). Understanding the current state of childhood disability is imperative for predicting future needs for long-term care and early intervention services for this population. METHODS: We used data on children 0-14 years from the 2003, 2009, 2012, and 2015 survey of Disability, Aging and Carers, which is an ongoing national survey covering both rural and urban areas of all States and Territories of Australia. RESULTS: Using the test for trends in population, no significant increases were noted in the prevalence of childhood disabilities over the last 12 years, although the prevalence of any developmental disability increased from 6.9% to 7.42% between 2009 and 2015. The rate and severity of disability was higher among boys compared with girls of the same age for a number of selected disabilities and higher for children aged 5-14 years. CONCLUSIONS: With the anticipated rise in psychological related disability among Australian children, there is a need to ensure availability of a flexible and responsive model of service delivery for this population. This also implies that respite service coverage may need to be substantially increased to meet children and caregivers' needs.

Prevalence and correlates of substance use among psychiatric inpatients.

PURPOSE: This study aimed at examining correlates of substance use among patients diagnosed with psychiatric disorders in Jordan. METHODS: This study used a nonexperimental descriptive survey design. Data were collected through using DUSI-R scale obtained through a self-designed questionnaire. A total of (203) subjects satisfied the inclusion criteria. RESULTS: Most used substances prior to admission were caffeine (78.2%), cigarette (60.9%), and alcohol (22.2%), while the least were heroin (1.2%) and inhalants (0.08%). Patients diagnosed with schizophrenia had higher percentages among all other disorders (n = 16, 21.9%), although there was no statistical difference among patients related to their psychiatric disorders. CONCLUSION: We recommend that mental health professionals be equipped with necessary skills to manage substance use among patients with psychiatric disorders.

Impulsivity and Sensation-Seeking Personality Traits as Predictors of Substance Use Among University Students.

The purpose of the current study was to investigate the relationship between substance use and impulsivity and sensation-seeking personality traits among 655 university students using a cross-sectional, descriptive, correlational design. A significant correlation was found between students' impulsivity level scores and frequency of substance use (r = 0.11, p < 0.05). A positive correlation was found between frequency of substance use and sensation-seeking levels (r = 0.2, p < 0.05), as well as impulsivity levels (r = 0.31, p < 0.01). Multiple linear regression analysis showed that the two predictors model was able to account for 12.4% of variation in substance use. Impulsivity and sensation-seeking personality traits are significant predictors of substance use among university students. [Journal of Psychosocial Nursing and Mental Health Services, 56(1), 57-63.].

The Impact of a Mother's Emotional Strains and Disclosure of Cancer on Her Child's Defensiveness and Adjustment to Cancer.

BACKGROUND: Defensiveness is one of the strategies that children with cancer use against psychosocial difficulties, yet it remains unclear what factors may impact children's use of defensiveness. OBJECTIVE: The aim of this study was to explore the psychological adjustment, including use of defensive behaviors, in children who may or may not be told about the diagnosis of cancer. METHODS: A total of 58 children and 51 mothers participated in the study. Children answered questionnaires about defensiveness, anxiety, and depression, whereas mothers completed a questionnaire of anxiety, depression, and stress and a question about disclosure of cancer to child. RESULTS: Significant differences were found in the defensiveness and depression scores between children with full disclosure and those with no disclosure about their cancer. Although children's adjustment has been directly related to that of their mother's adjustment, we did not find this variable to be a predictor of child's adjustment. The child's defensiveness scores were a strong predictor of child's anxiety and eventually for a high risk for depression. CONCLUSIONS: Mothers' emotional strains and lack of open disclosure about cancer significantly affect the psychosocial well-being of children. IMPLICATIONS FOR PRACTICE: It is essential for nurses to assess the emotional adjustment and defensiveness strategies that children with cancer use. We believe that nurses caring for children with cancer have a professional responsibility to identify and understand defensive behaviors and other characteristics of psychosocial distress and advocate for psychological interventions that will help mothers and their children cope with cancer.

Social and Health Determinants of Adolescents' Wellbeing in Jordan: Implications for Policy and Practice.

PURPOSE: This study examined the extent to which health related aspect, health outcome, behaviour outcomes and social connectedness may predict adolescents' wellbeing at the schools of Jordan. METHODS: Using a two-stage cluster sampling technique 1166 adolescents completed the Health Behaviour of School Children survey. RESULTS: Stepwise Regression Analysis showed that the adolescents' wellbeing was predicted by academic achievements, bullying behaviour, eating habits, psycho-somatization, parent support and ease of communication with parents. These predictors explained 40% of the variance in the emotional wellbeing scores. CONCLUSION AND PRACTICE IMPLICATIONS: This study provides baseline information to build the evidence base for surveillance of health behaviors among adolescents in Jordan. Students' experiences of secondary school and their relationships at school continue to predict their emotional wellbeing.

Oral glucose efficacy on neonate's pain responses at the NICU: A quasi experimental trial of two clinical procedures.

AIM: This research was undertaken with the purpose of testing two research hypotheses regarding the efficacy of 10% oral glucose solution on procedural pain associated with venepuncture and nasopharyngeal suctioning within three neonatal intensive care units (NICU). The hypotheses were formulated from previous conclusions reached by other researchers highlighting the efficacy of sucrose solutions on neonates' pain responses during minor painful procedures. METHOD: A quasi-experimental trial utilising a time series design with one group was used. Data from a total of 90 neonates included 60 neonates who underwent a venepuncture and 30 neonates who underwent a nasopharyngeal suctioning procedure for clinical purposes. The neonate's pain response for each procedure was scored using the Neonatal Pain Assessment Scale (NPAS) on two separate occasions over three time periods. The pre-procedural score (T0) when the neonate received no sucrose, the inter-procedural score (T1) when the neonate was given 2ml of 10% glucose solution two minutes before the procedure (intervention group) or where oral glucose was withheld (control group) and the post-procedural score (T2) being at the end of the procedure. RESULTS: The results showed the mean NPAS scores in response to venepuncture or nasopharyngeal suctioning were significantly lower in the intervention group than the control group. CONCLUSION: This showed that oral glucose (10%) had a positive effect on the pain response during venepuncture and nasopharyngeal suctioning procedures.

Parents' Perceived Satisfaction of Care, Communication and Environment of the Pediatric Intensive Care Units at a Tertiary Children's Hospital.

This study aims to identify parental perceptions on pediatric intensive care-related satisfaction within three domains: environment, child's care provided and communication. In addition, it aims to identify whether parent's socio-demographics and child's clinical variables predict parents' perceived satisfaction. In this study, a total of 123 parents whose child received care in the PICU of a tertiary children's hospital in Amman completed the Arabic version of the parents satisfaction survey (PSS). A cross-sectional, descriptive-correlational design was used to collect data. All data were collected between June and October of 2013. Central tendency measures and percentages of replies for each domain revealed that at least 7 items were rated poorly satisfied. More than half of the parents were not satisfied with the noise level of the PICU, the time nurses spent at the child's bedside, as well as the way the healthcare team prepare them for the child's admission. Almost 90% of the parents believed that the nurses ignored their child's needs by not listening to parents and by responding slowly to child's needs. Stepwise regression analysis showed that that the number of hospital admissions, health insurance and the severity of illness was the main predictor of parents' satisfaction. In conclusion, the availability of health care professionals, the support and the information they share with the child's parents are all significant to parent's satisfaction and hence to better quality of care. Targeting the domains of low satisfaction reported by the parents could increase parent's satisfaction and achieve quality improvement required for this population.

Socio-demographic correlates of parents' participation in care of a hospitalized child: A perspective from a developing country.

Studies on parents' participation in care of a hospitalized child are rare and have not sufficiently addressed the factors prompting parents' participation in their child's care. This study investigated the relative contributions and predictive value of parents' and children's demographics on parents' participation in care. A convenience sample of 294 parents participated from four major hospitals in a metropolitan area in Amman. Parents completed two sets of measures, a socio-demographic form and the Arabic version of the Index of Parent Participation/Hospitalized Child. A series of bivariate analyses were completed to investigate associations between socio-demographic variables and parents' participation in care. The multiple regression analysis identified four variables as the optimal set of predictors for parent participation in the care of a hospitalized child: hospital experience, type of illness, child's age and type of hospital. The importance of interpreting these findings in a cultural context is discussed.

Measuring Care Needs of Parents of Children With Cancer: Psychometric Properties of the FIN-PED II Arabic Version.

BACKGROUND AND PURPOSE: This study was conducted to test the Arabic version of the Family Inventory of Needs-Pediatrics II (FIN-PED II). METHODS: The Arabic FIN-PED II was developed using the translation/back-translation method. Then, an expert panel of 5 parents of children with cancer rated the tool for clarity and content validity. Internal consistency and test-retest reliability was evaluated in a convenience sample of 113 parents of children with cancer. RESULTS: The FIN-PED II was found to be acceptable and clear to almost all parents. The FIN-PED II demonstrated good psychometric properties. The internal consistency was high with alpha values > 0.70 and high test-retest correlations. CONCLUSIONS: Although the Arabic FIN-PED II needs further psychometric testing, it is an acceptable, reliable, and valid measure of perceived parents need during child's treatment.

Development and psychometric evaluation of the Chronic Kidney Disease Screening Index.

OBJECTIVE: Public understanding of chronic kidney disease (CKD) is important to ensure informed participation in CKD prevention programs. This study aimed to develop and to test the psychometric profile of the CKD Screening Index that measures patient's knowledge, attitudes, and practices regarding CKD prevention and early detection. METHODS: A cross-sectional design was implemented and a total of 740 Jordanian patients recognized at risk for CKD were recruited by convenience sampling from out-patient departments. Development and psychometric validation of the CKD Screening Index were conducted in four phases: (1) item generation, (2) pilot study, (3) preliminary psychometric validation study to examine factor structure, and (4) final psychometric validation with 740 participants. RESULTS: On factor analysis, 24 items categorical knowledge items loaded into one factor and yielded a Guttman Split-Half Coefficient of 0.80. In a separate factor analysis, 15 items were loaded on two attitude factors (Cronbach alpha coefficient = 0.69), and nine items loaded on two practice factors (Cronbach alpha coefficient = 0.68). The CKD Screening Index associated significantly and negatively with depressed and anxious patients compared to their counterparts. PRACTICE IMPLICATIONS: This promising CKD Screening Index can be used for an early identification of patients at risk for CKD, thus, allowing the development of interventions to raise these patients' awareness. Future studies are needed on other populations with different cultural background to support reliability and validity of this new instrument.

Jordanian mothers' beliefs about the causes of cancer in their children and their impact on the maternal role.

BACKGROUND: Arab culture and Islamic beliefs contribute to values and practices regarding cancer. Mothers in Jordanian society are expected to be the primary caregivers to children. PURPOSE: The purpose of this study was to explore Jordanian mothers' beliefs regarding the causes of cancer in their children and their impact on their role as mothers. DESIGN: A descriptive, qualitative design was used. Individual interviews were conducted with Jordanian mothers (n = 51) of hospitalized children with cancer. RESULTS: Causes of cancer were attributed to supernatural explanations and biomedical explanations. The impact of cancer on these mothers' lives varied. For some, their child's illness resulted in stronger family bonds, whereas for others, the families suffered a state of disequilibrium. CONCLUSIONS: Cultural beliefs helped assign meaning to their children's illness. The maternal role of Jordanian women was partially fulfilled or inadequately performed, which in turn affected the functioning and coping abilities of the entire household.

Screening for anxiety symptoms and social desirability in children and adolescents living with chronic illnesses in Jordan.

This research aims to investigate the rate and nature of anxiety symptoms in a group of children and adolescents living with chronic illnesses in Jordan, and their relation to social desirability in a cultural sample not previously researched. Using the Revised Children's Manifest Anxiety Scale (R-CMAS), anxiety and social desirability data were obtained from 114 children diagnosed with chronic illnesses and 162 healthy control participants. Based on children's self-report, participants were categorized according to their adaptive style paradigm as either high anxious, low anxious, or repressor. It was proposed that children who score high on social desirability and low on anxiety are repressors. The prevalence of these categories was compared across the two groups. Anxiety was reported in 9.64 percent of the chronic illnesses and 12.34 percent of the healthy peers. Using the data obtained in the present study, the rate and nature of anxiety in children with chronic illnesses were lower for children in Jordan when compared to previous studies. However, social desirability values were similar to those established in Western societies suggesting a significantly higher percentage of children identified as repressors in children with long-term illnesses. These results supported the hypothesis regarding the relationship between social desirability and expressed anxiety symptoms.