Midwives' attitudes toward the use of cardiotocograph (CTG) machines in labor units: A study in Jordan.

BACKGROUND: The purpose of cardiotocograph (CTG) usage is to detect any alterations in fetal heart rate (FHR) early before they are prolonged and profound. However, the use of CTG machines on a routine basis is not an evidence-supported practice. There is no Jordanian study that assesses the midwives' attitudes toward this machine. This study aimed to identify Jordanian midwives' attitudes towards the use of cardiotocograph (CTG) machines in labor units, alongside examining the relationships between midwives' personal sociodemographic characteristics and such attitudes. METHODS: A descriptive research design was used to identify Jordanian midwives' attitudes towards the use of CTG machines in both public and private labor units in Jordan. Data were collected using the valid and reliable tool designed by Sinclair (2001), and these were used to identify midwives' attitudes towards CTG usage. A total of 329 midwives working in the labor units of governmental and private hospitals in the center and north of Jordan participated in the study from May to July 2022. RESULTS: The total mean score for the attitude scale was M = 3.14 (SD = 0.83). More than half of the sample (N = 187, 58.4 %) demonstrated a mean score greater than 3.14, however, which indicates generally positive attitudes toward CTG usage in labor units. Midwives working in private hospitals and those holding Bachelor's degrees had more positive attitudes toward the use of CTG machines. CONCLUSION: This study provides new insights into the attitudes of Jordanian midwives towards CTG use in labor units. These suggest that it is critical to conduct training courses for registered midwives to help them develop and/or regain confidence and competence with respect to various key aspects of intrapartum care, including intermittent auscultation and the appropriate use of CTG.

Using Social Media Platforms to Enhance the Delivery of a Childbirth Education Program.

OBJECTIVE: This study aimed to evaluate the effectiveness of a childbirth education program on self-efficacy and state anxiety among first-time Jordanian mothers. METHODS: A randomized controlled trial was conducted using pretest/posttest design with 128 low-risk, first-time Jordanian mothers. The experimental group (N = 64) received a childbirth education program, while those in the control group (N = 64) received standard care in antenatal clinics. Data were collected at two different time points: at recruitment and 3 weeks after attending the program. RESULTS: The mean score of the experimental group on outcome expectancy (posttest) (139.91, SD = 15.586) was significantly higher than that of the control group (110.16, SD = 28.33) (F = 72.356, P = .003, partial Eta squared = .37). On the efficacy expectancy, the mean score of the experimental group (133.33, SD = 16.246) was also higher than that of the control group (92.06, SD = 27.07) (F = 144.282, P = .000, partial eta squared = .54). On the state anxiety scale, the mean score of the experimental group was significantly lower than that of the experimental group (F = 89.715, P = .002, partial eta squared = .42). CONCLUSION: The childbirth education program improved the coping ability of mothers during childbirth and decreased their state of anxiety.

Personal attributes and attitudes to substance use disorder: A study among Jordanian undergraduate medical majors students.

BACKGROUND: Emerging health professionals in undergraduate programs should be equipped to provide care to people with substance use disorder (SUD). The students' personal attributes may impact their attitude toward those with SUD. This study aims to evaluate the impact of personal attributes of Jordanian undergraduate health students on their attitudes toward SUD and examine the relationship between the personal attributes and their devaluation and discriminatory (stigmatory) behaviour toward those with SUD. METHOD: A cross-sectional descriptive design was used to examine the attitudes and stigmatory behaviours. The data were collected between May to October 2017 with a structured questionnaire that consisted of three parts: 1) a data sheet to collect the socio-demographic characteristics of the participants, 2) the Acute Mental Health Scale (ATAMHS), and 3) the Devaluation-Discrimination Scale (DDS). FINDINGS: Younger and females demonstrated a positive attitude toward those with SUD compared to older or male students. Age, gender, and previous experience with SUD are significant factors that affect their attitude. CONCLUSION: Identifying the attitude to people with SUD and personal attributes of emerging health professionals in Jordan will help identify the need to educate them prior to their entry into practice.

Undergraduate health profession students attitudes toward illicit substance users in Jordan.

BACKGROUND: The use of illicit substances is a critical international issue that must be addressed by healthcare systems worldwide. Today, the problem of illicit substance use is increasingly becoming a burden on healthcare systems in both developed and developing countries. The aims of this study were: (1) to describe the attitudes of health major undergraduate students (the study participants) toward illicit substance users; (2) to describe the discriminatory behaviors among the study participants toward illicit substance users; and (3) to examine the relationship between the attitudes and the actual discriminatory behaviors of the study participants. METHOD: A cross-sectional descriptive design was used to investigate the attitudes and behaviors of health professional undergraduate students enrolled at university in Jordan. RESULTS: Students who were younger and identified as female were generally more positive toward illicit substance users versus those students who were older and identified as male. CONCLUSION: The findings of this study supported the literature that students who were younger and identified as female were generally more positive toward illicit substance users versus those students who were older and identified as male. It is therefore important to determine whether the type of courses in health majors available for undergraduate students affects their attitudes toward illicit substance users.

Effect of the Helping Babies Breathe Training Program: An Experimental Study on Jordanian Midwives' Knowledge and Skills.

The Helping Babies Breathe (HBB) training program trains providers in effective resuscitation of infants in developing countries. This study evaluated the effectiveness of the HBB training program on midwives' knowledge and skills in Northern Jordan. Using a nonequivalent control group design, 50 midwives (control, n = 25; experimental, n = 25) from 3 public hospitals in Northern Jordan were recruited and their knowledge and skills were evaluated before and after the training. The program has 3 aspects: 2 hours of teaching, 1 hour of testing, and 25 minutes of skills assessment per participant. The skills were tested individually for each participant, and they were reevaluated at 8 months after. The control and experimental groups significantly differed in posttest scores on knowledge, Objective Structured Clinical Examination A and B skills, and bag-mask application after adjusting for covariates. The HBB training program significantly enhanced knowledge of midwives in the experimental group (P < .05) and demonstrated skills. The HBB training program was helpful in improving midwives' knowledge and practices on immediate care of a newborn baby. Therefore, training midwives using the HBB training program can improve their knowledge and skills and thereby improve infant outcomes in Jordan.

Maternal request for cesarian birth without medical indication in a group of healthy women: A qualitative study in Jordan.

OBJECTIVE: To explore women's reasons for requesting an elective cesarian birth without medical indication and to describe the factors that affect their decision to choose a cesarian birth. DESIGN: A descriptive qualitative content analysis approach was used for the gathering and analysis of data. Interviews were held with 35 first-time mothers. The participants were recruited by using a purposive sampling method. Interviews were begun with the same question which sked about women's reasons for requesting cesarian birth without medical indication. Other questions were used to facilitate the interview and elicit the factors that led this group of first-time Jordanian mothers to choose a cesarian birth. SETTING: A private hospital in Amman, the capital of Jordan, was selected as the location for the data gathering process. Data collection and analysis were conducted concurrently and interviews were discontinued when data saturation was reached. PARTICIPANTS: The participants consisted of 35 first-time mothers recruited by using a purposive sampling method. FINDINGS: Socio-demographic, economic status, and childbirth culture played an important role in influencing women's requests for an elective cesarian. Women made their decision based on the lived negative experience of other women and were driven and supported by their social network. Five themes that reflected the reasons for elective cesarian birth without medical indication were identified: (1) fear of vaginal birth process, (2) concerns about future sexual life, (3) need for humanized birth, (4) personal reasons, and (5) decision-making process. CONCLUSIONS AND IMPLICATIONS: The women's reasons for choosing cesarian birth without medical indication and the factors influencing the women's decision-making process were complex and interrelated and reflect a lack of appropriate informed choice about elective cesarian. The findings therefore suggest that healthcare policy makers need to attend to the reasons and the factors that influence women's decision-making about cesarian birth in order to promote the trend of women having a vaginal birth. Evidence-based knowledge and strategies to reduce elective caesareans should be disseminated to healthcare providers in maternity settings. Future explorations of this issue should address obstetricians' and midwives' views and attitudes about cesarian birth without medical indication.

The effects of a childbirth preparation course on birth outcomes among nulliparous Jordanian women.

OBJECTIVE: This study aimed to examine the effectiveness of a childbirth preparation course on birth outcomes among nulliparous Jordanian women. DESIGN: A randomized control trial pre-test/post-test design was used to assess the effects of a childbirth preparation course conducted in a military hospital in Amman, Jordan from 1 July to 15 September 2016. A total of 133 low-risk nulliparous women were recruited and randomly assigned to either (1) a control group who received standard care in antenatal clinics or (2) an intervention group who received standard care in antenatal clinics as well as a childbirth preparation course specifically designed for the purpose of this study. Data were collected at two different time points: at recruitment and within 24 to 48 h after giving birth. The chi-square test and independent sample t-test were used to compare birth outcomes. PARTICIPANTS: Low-risk nulliparous women in their third trimester of pregnancy attending antenatal clinics at King Hussein Medical Centre in Amman, the capital of Jordan. MEASUREMENTS AND FINDINGS: The childbirth preparation course had a positive effect on three birth outcomes. Specifically, more women in the intervention group than in the control group had spontaneous onset of labour (89.0% vs 70.3%, p = .02), the average of cervical dilation was greater in the intervention group than in the control group [(mean = 3.8, SD = 1.55) vs (mean = 3.2, SD = 1.61); t = 2.24, p = .03] and there was earlier initiation of breastfeeding in the intervention group than in the control group [(mean = 6.2, SD = 0.4.43) vs (mean = 17.8, SD = 18.08); t = 4.90, p ≤ 01]. KEY CONCLUSIONS: The findings suggest that the childbirth preparation course increased the likelihood of pregnant women having spontaneous onset of labour and arriving at the maternity ward in active labour. Moreover, it helped them to initiate breastfeeding earlier after birth. No effect was found for other birth outcomes or neonatal outcomes. Further studies with a larger sample are needed to obtain more definitive conclusions. IMPLICATION FOR PRACTICE: It is recommended that policymakers and administrators facilitate the embedding of this childbirth preparation course into antenatal care to improve maternal and neonatal health.

The impact of a planned health educational program on the compliance and knowledge of Jordanian pregnant women with anemia.

Iron deficiency anemia is a major public health problem among pregnant women in developing countries. This study aimed to use a randomized controlled trial to evaluate the effectiveness of a health information package in Jordanian anemic pregnant women's knowledge regarding anemia, compliance with iron supplementation, and hemoglobin level. Two hundred pregnant anemic women were recruited and randomly assigned into intervention or control group from April to July 2016. The intervention group received a video presentation of the Health Information Package Program (HIPP), narrated by a midwife, combined with PowerPoint slides to educate women about anemia in pregnancy. The participants in the control group received standard care in antenatal clinics, including iron supplementation. No significant differences were observed between the groups in age, gestational age, health problems, and total income. Only education and source of information differed significantly between the groups. Women in the intervention group had higher scores on the compliance checklist, knowledge, food selection ability, and hemoglobin level than women in the control group. The health information package program was effective. Policymakers should adopt a health information package program and apply it as a comprehensive national strategy for the prevention of anemia during pregnancy.

Correlates and Predictors of Stigmatization of Patients With Mental Illness Among Nursing Students.

The purpose of the current study was to explore knowledge of, attitudes about, and perception of stigma among nursing students in relation to mental illness, and to identify the predictors of stigma toward patients with mental illness based on nursing students' characteristics, knowledge, and attitude. A cross-sectional survey was conducted on 169 participants from a university in Jordan. The regression model predicted a relatively moderate proportion of variance in stigma perception. Significant predictors in the model were family income, father's educational level, and experience with mental health patients. Findings of the current study showed that undergraduate nursing students who had experience with patients with mental illness hold relatively positive perceptions toward mental health patients. Enhancing the content of nursing curriculum regarding issues related to patients with mental illness could help students develop better assessment skills, have more positive attitudes, and gain more accurate knowledge about mental illness. [Journal of Psychosocial Nursing and Mental Health Services, 57(1), 43-51.].

Characteristics of pregnant Jordanian women dissatisfied with life: A comparison between satisfied and dissatisfied women's demographics.

Dissatisfied pregnant women who are at higher risk of negative outcomes perinatally have not been identified in Jordan. The purposes of the researchers were to identify and compare sociodemographic characteristics of satisfied pregnant women with dissatisfied pregnant women. A non-experimental, descriptive, comparative design was employed. Jordanian pregnant women (n =203) were consecutively selected. We found that younger, better educated pregnant women with a high economic status and a small number of children were more satisfied with their lives. Practitioners can identify dissatisfied women and develop an educational and interventional package that focuses on improving satisfaction with life for pregnant mothers.

Evaluating the experience of Jordanian women with maternity care services.

Evaluation of women's experiences about the care they receive during childbirth is important to assess the quality of maternity services. We explored the experiences of Jordanian women to examine whether they were satisfied with their childbirth experiences. Semistructured interviews were conducted with 460 women after giving birth. A content analysis was conducted on the qualitative data. Four themes were identified that represented the women's poor experiences of care during childbirth, including seeing childbirth as a dehumanized experience, feeling that childbirth was processed technologically, a lack of human support, and being in an inappropriate childbirth environment. The findings of this study may help policymakers to provide quality care to women during childbirth.

Female public Jordanian university undergraduate students' intentions and attitudes toward breastfeeding: application of self-objectification theory.

BACKGROUND: Breastfeeding is the natural way of feeding infants and an important public health issue. Representation women as sexual objects by highlighting their bodies as mainly for the desire of men causes women to prioritise their physical appearance and internalise sexual objectification of their bodies. Such ideologies make women less comfortable to accept other functions of their bodies such as the reproductive functions, including breastfeeding and childbirth. OBJECTIVES: To describe, in a sample of female undergraduate students, attitudes toward breastfeeding, level of self-objectification and to examine whether women's attitudes and the intention of breastfeeding is related to the level of self-objectification. METHODS: An exploratory, cross-sectional design was used. All female undergraduate university students, attending a large university in the Northern part of Jordan were eligible to participate. A convenience sample of 600 female students from both health professional and non-health professional schools were invited to complete a self-administered questionnaire designed to collect data on students' intentions and attitudes toward breastfeeding and self-objectification, with a response rate of 82.6% (n=496). Ethical approval was obtained from the Scientific Research Board of the Jordan University of Science and Technology prior to the start of the study. RESULTS: The majority of the students gave favourable responses towards the attitude statements and reported a commitment to breastfeeding Students' attitudes toward breastfeeding correlated significantly with self-objectification. Participants with negative attitudes towards breastfeeding were more likely to internalise and accept the socio-cultural attitudes towards appearance (r = -0.098, p = 0.029). Participants' intention to breastfeed correlated negatively with self-objectification and those who intended to breastfeed were more likely to reject the socio-cultural attitudes towards the "apearance" subscale (r = 0.097, p = 0.031). CONCLUSION: The results of this study support the relationship between self-objectification and Jordanian young women's attitudes and intention to breastfeed and reinforce that in a culture where breastfeeding is encouraged, accepted and widely practised, positive attitudes to breastfeeding intention prevail.

Childbirth practices in Jordanian public hospitals: consistency with evidence-based maternity care?

BACKGROUND: In 1996, the World Health Organization stated that 'childbirth is a natural process and in normal birth, there should be a valid reason to interfere with this natural process' and encouraged practices that are evidence-based. The practices encouraged included avoiding unnecessary augmentation of labour, facilitating upright position for birth and restricting the use of routine episiotomy. Many countries have been slow to fully implement evidence-based practice in maternity care. The aim of this study was to examine maternity hospital practices in Jordan and assess their consistency with evidence-based maternity care. METHODS: An explorative research design with non-participant observation was used. Data were collected from low-risk women during labour and birth using a questionnaire for maternal characteristics and an observational checklist. A proportional stratified sample was selected to recruit from three major public hospitals in Jordan. Data were analysed using descriptive statistics. RESULTS: A total of 460 women were observed during labour and birth. The majority were multiparous (80%). A range of interventions were observed in women having a normal labour including augmentation (95%), continuous external fetal monitoring (77%), lithotomy position for birth (100%), and more than one third (37%) had an episiotomy with varying degrees of laceration (58%). CONCLUSIONS: Childbirth practices were largely not in accordance with the World Health Organization evidence-based practices for normal birth. High levels of interventions were observed, many of which may not have been necessary in this low-risk population. Further work needs to occur to explore the reasons why evidence-based practice is not implemented in these hospitals.