Knowledge, attitudes, and practices toward COVID-19 among pregnant women in Jordan during the COVID-19 outbreak.

BACKGROUND: COVID-19 is highly infectious and can cause harmful effects in pregnant women. As COVID-19 is a relatively new disease, there is a continuing need to assess the knowledge, attitudes, and practices (KAP) toward this virus among pregnant women globally in order to identify any gaps and suggest ways to address them. Little is known about how pregnant Jordanian women responded to the pandemic. OBJECTIVE: The purpose of this study was to investigate the level of KAP toward COVID-19 among pregnant women in Jordan and to detect the variables associated with a satisfactory KAP level. METHODS: A cross-sectional online survey based on a predesigned KAP survey was modified for use among pregnant women in Jordan. The data obtained from 574 participants were analyzed using the Statistical Package for the Social Sciences, version 23. RESULTS: Overall, pregnant women in Jordan were found to be knowledgeable, to have a positive attitude, and to exhibit good practices in relation to COVID-19. Some demographic factors were significantly associated with high levels of knowledge, positive attitudes, and safer practices. CONCLUSIONS: Results suggest that special attention should be given by the government to pregnant women with respect to any future emergent situations such as additional COVID-19 surges or other novel respiratory conditions in order to ensure that they are fully informed and prepared.

Psychometric properties of the Arabic version of the Fertility Quality of Life (FertiQoL) questionnaire tested on infertile couples in Jordan.

BACKGROUND: The Fertility Quality of Life (FertiQoL) questionnaire assesses the quality of life of people with fertility problems. The present study aimed to assess the psychometric properties of the Arabic version of the FertiQoL in infertile couples in Jordan. METHODS: This study used a cross-sectional design among 212 participants with infertility problems. An exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA) were conducted to investigate the underlying structure of the novel Arabic version of the FertiQoL tool. RESULTS: The Cronbach's alpha values for the FertiQoL core domain, the FertiQoL treatment domain, and the total FertiQoL scale were 0.93, 0.74, and 0.92, respectively. The EFA indicated a two-domain model, with the first factor having 24 items and measuring "Core QoL". The second factor has 10 items and measures "Treatment QoL" in the context of infertility. The EFA and the CFA supported a two-factor model whereby the two factors explained 48% of the shared covariance between the analyzed quality of life indicators. The indices of goodness-of-fit of the model showed acceptable fit as follows: the chi-squared test (χ2) = 7.943, the comparative fit index (CFI) = 0.999, the root mean square error of approximation (RMSEA) = 0.001, and the Tucker-Lewis index (TLI) = 0.989. CONCLUSION: The study's findings demonstrated the reliability and validity of the Arabic version of the FertiQoL for assessing the quality of life of infertile couples or those in Jordan with no pregnancy or childlessness.

The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery.

Objectives: This study aimed to evaluate the effectiveness of slow deep breathing relaxation exercise (SDBRE) in reducing patients' pain levels during chest tube removal (CTR) post coronary artery bypass grafting (CABG) surgery. Methods: In 2019, fifty post-CABG patients were conveniently selected from a cardiac intensive care unit in Jordan's major referral heart institute. The patients were randomly assigned to either an intervention group or a control group. A total of 25 patients were assigned into the experimental group who received slow deep breathing relaxation Exercise (SDBRE) alongside the conventional care before CTR. The remaining 25 patients constituted the control group (50%) that had CTR following conventional care. The Visual Analogue Scale (VAS) was used to measure the participants' pain levels during three phases: before CTR (Time 1), 5-min post CTR (Time 2), and 15-min post CTR (Time 2) to compare the intervention effect between the two groups. Results: The data analysis findings for the control and intervention group of patients showed that there was a statistically significant decline in their pain level across time for both groups (H = 32.71, P < 0.01; H = 47.23, P < 0.01) respectively. The intervention group had significantly lower pain levels than the control group at Time 2 (3.50 [1.20, 5.30] vs. 7.90 [7.00, 9.00], P < 0.01) and Time 3 (0.00 [0.00, 1.30] vs. 3.60 [2.40, 4.10] P < 0.01). Conclusions: Using SDBRE during CTR is an effective technique for reducing pain which can minimize the need for analgesics and their associated adverse effects.

Factors associated with antenatal depression in the Kingdom of Jordan during the COVID-19 pandemic.

Fear of infection and measures taken to mitigate infection, such as social distancing, lockdown and isolation can lead to anxiety and depression across the life course, but especially in pregnancy. We set out to identify the prevalence of depression in pregnancy, using Edinburgh Postnatal Depression Scale (EPDS) during national quarantine and to examine women's knowledge, attitude, and practices (KAP) in regard to potential COVID-19-related depression. Following ethical approval, an observational design, with an online questionnaire and snowball sampling was used to recruit 546 pregnant women (231 primi and 315 multiparous) in Jordan via common social media platforms (facebook, WhatsApp). Over one third (36.7%) reported depressive symptoms. There were significantly lower depression scores among pregnant women who exhibited more knowledge about COVID-19 (in high [vs low] knowledge groups, mean EPDS = 10.8 [vs 12.2]; p = 0.007). Depression scores were not significantly associated with attitude nor with practice. This suggests that enhanced knowledge levels may protect pregnant women against depression. Our findings contribute to understanding of the experience of pregnant women in developing countries during the COVID-19 pandemic. Healthcare Professionals should provide health education to all pregnant women and timely services to pregnant women with depressive symptoms. This may lead to the prevention of serious symptoms and reduce negative consequences on the next generation, not only in Jordan, but worldwide.

Sociocultural, political, and health system-related determinants of perinatal deaths in Jordan from the perspectives of health care providers: a qualitative study.

BACKGROUND: Perinatal mortality is a fundamental indicator of the quality of the healthcare provided to women during pregnancy and childbirth, as well as the healthcare provided to neonates in the first week of life. At the national level, determining the direct and indirect causes of these deaths is vital, as it will assist in tracking the quality of antenatal, natal and postnatal care and help to detect the areas for avoidance. This study aimed to identify the main determinants of perinatal deaths in Jordan from the perspectives of health care providers (HCPs). METHODS: A descriptive qualitative approach using focus group discussion was used. Four focus groups were conducted in each of the four hospitals where the approached HCPs are employed. An average of 5 HCPs were interviewed in each focus group with a total of 80 HCPs participating in the 16 focus groups. Thematic analysis was carried out to analyze the data. RESULTS: The HCPs provided a detailed description of the determinants of perinatal and neonatal death from their points of view. Four main themes with multiple subthemes emerged, namely maternal factors (ignorance, concealment of medical condition, and husbands' negligence), sociocultural factors (socioeconomic status, tribal and consanguineous marriage, and harmful cultural practices), political factors (early marriage driven by displacement and war consequences on maternal health), and health system-related factors (services management including capabilities and logistics, overcrowding of emergency rooms, discharge against medical advice, and unskilled general practitioners in private maternity clinics). CONCLUSIONS: As perceived by HCPs, maternal factors, sociocultural factors, political factors, and health system-related factors are the main determinants of perinatal deaths in Jordan. Improvement in the quality of maternal and neonatal health care services, maternal health education, and maternity staff training are strongly recommended.

Intimate Partner Violence Against Pregnant Jordanian Women at the Time of COVID-19 Pandemic's Quarantine.

In Jordan, women experience considerable levels of different types of violence. The emerging data from different countries indicate that intimate partner violence (IPV) has intensified since the COVID-19 outbreak. The main purpose of the current study is to find out whether there is any difference in the incidence of IPV during and before the COVID-19 pandemic quarantine and whether any sociodemographical factors are related to the incidence of IPV against pregnant women during quarantine. A cross-sectional, correlational design was in this study. The snowball sampling technique was adopted to select the participants, which produced a nonrepresentative sample of 215 pregnant women. The participants completed the Arabic version of the World Health Organization's Domestic Violence Questionnaire Screening Tool (DVQST). We found that women were exposed to different types of IPV before and during the quarantine. The most prevalent form of IPV was control and humiliation (n 172, 80%) and the least prevalent was sexual violence ((n 33, 15.3%), (n 24, 11.2%), respectively). However, there were statistically significant lower DVQST scores during the COVID-19 quarantine than before the quarantine. All types of IPV are significantly correlated with each other and with relationship problems (marital conflict, verbal fighting, understanding each other). While the findings are not generalizable to the general population of pregnant women in Jordan because the sample consisted only of women of high socioeconomic status due to the use of a nonprobability sampling technique, national campaigns should be developed and implemented in order to reduce IPV and change community behaviors and attitudes toward violence against women. It is also recommended that policymakers develop plans to help pregnant women during quarantine by, for example, training care providers on how to access vulnerable women.

The effect of intraoperative glycemic control on surgical site infections among diabetic patients undergoing coronary artery bypass graft (CABG) surgery.

OBJECTIVE: Perioperative poor glycemic control in diabetic patients undergoing Coronary Artery Bypass Graft (CABG) surgery has been associated with infectious complications, particularly surgical site infections that are linked with adverse health surgical outcomes. The purpose of this study was to investigate the effect of two different intraoperative glycemic control protocol, tight and conventional, on thirty-day postoperative surgical site infection (SSI) rates among diabetic patients undergoing CABG surgery. DESIGN: A randomized controlled trial (RCT) design was employed in the study, with a convenience sample of 144 adult patients who were scheduled to undergo coronary artery bypass grafting surgery. SETTING: A main referral heart institute in Amman, Jordan. PARTICIPANTS: Subjects were randomly assigned to either the tight glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 110-149 mg/dl via continuous intravenous insulin infusion, or the conventional glycemic control group (n = 72), which maintained an intraoperative blood glucose level of 150-180 mg/dl via continuous intravenous insulin infusion. The postoperative SSIs among both groups were evaluated and compared by independent blinded physicians. RESULTS: The primary findings of this study indicated no statistically significant difference between the two treatment groups in terms of SSI rates and their potential adverse surgical outcomes (p = 0.512). CONCLUSION: Nurses should consider the glycemic stability and glycemic control approach to minimize adverse surgical outcomes post CABG surgery. Healthcare providers should also carefully consider diabetic patients who have undergone CABG surgery and are at risk of developing postoperative SSIs. CLINICALTRIALSGOV IDENTIFIER: NCT04451655 was retrospectively registered in 30/06/2020.

Cardiac cachexia among patients with chronic heart failure: A systematic review.

INTRODUCTION: Despitecardiac cachexia being a prevalent health problem among heart failure (HF) patients, it has been given little attention by nursing researchers. Therefore, this study aims to conduct a systematic review that investigates cardiac cachexia among patients with HF. METHODOLOGY: A systematic review will be performed according to the PRISMA guidelines to assess the findings of twelve selected studies which meet the inclusion criteria of the systematic review research. The selected articles were published between 2000 and 2020 across three databases: PubMed, CINAHL, and MEDLINE. RESULTS: In comparison to cancer cachexia, cardiac cachexia has been insufficiently studied and is poorly understood. No definitive diagnostic method for cardiac cachexia has been identified in the literature. Age, smoking, and hypertension have been reported to be risk factors for cardiac cachexia. Cardiac cachexia has been significantly associated with lethal structural changes in the heart and has been measured using anthropometric measures and laboratory biomarkers. A combination of pharmacological and nonpharmacological treatments has been effectively implemented to manage cardiac cachexia. CONCLUSION: A focused multidisciplinary approachthat takes culture into consideration is required to set a variety of assessment and interventional strategies for the early detection and proper management of cardiac cachexia.

Nutritional status and its determinants among community-dwelling older adults in Jordan.

BACKGROUND: The elderly population of Jordan is growing, due to the low mortality rate, high total fertility rate, and the high rate of forced migration from neighboring countries to Jordan in recent years. However, the prevalence of chronic illnesses associated with other comorbidities among the elderly population in Jordan is high. Maintaining a good nutritional status is essential for maintaining general health and well-being among older people. AIM: The aim of this study is to identify the nutritional status of community-dwelling older adults in Jordan and determine its possible associated factors. METHODOLOGY: A cross-sectional, descriptive design was utilized. Proportional multistage nonprobability sampling was employed to obtain a convenient sample of 225 Jordanian community-dwelling older adults. The participants were asked to complete a set of questionnaires related to nutritional status, which included a demographic information sheet, and the Mini Nutritional Assessment (MNA). RESULTS: Among the sample, only 60 participants (26.7%) showed normal nutritional status. Most of the participants (n = 156; 68.3%) were found to be at risk of malnutrition, and nine participants (4%) were found to suffer from malnutrition. Advanced age (r = -0.631; p = 0.001), body mass index (BMI) (r = 0.546; p = 0.001), being single (mean (M) = 20.43, SD = 3.55), being male (M = 21.10, SD = 3.73), being unemployed (M = 21.71, SD = 3.51), being dependent in activities of daily living (ADLs) (M = 21.35; SD = 3.62), eating only two meals per day (M = 19.60; SD = 3.39), having suffered from illness or anxiety in the preceding 3 months (M = 21.11; SD = 2.39), having a mid-arm circumference of less than 31 cm (M = 19.51; SD = 3.47), low consumption of fruit and vegetables (M = 20.79; SD = 2.53), and polypharmacy (M = 20.62, SD = 4.09) were found to predict susceptibility to malnutrition among the participating older adults. Amongst the variables, age was identified as the most significant predictor of nutritional status and explained approximately 40% of the variance in nutritional status. CONCLUSION: Malnutrition in older adults is a multifaceted phenomenon that needs to be integrated into the comprehensive assessment of older adults. It is essential that health-care professionals, particularly nurses, are fully aware of the associated risks of malnutrition among the elderly population. The high prevalence of the risk factors for malnutrition warrants conducting a controlled national-based assessment, using probability sampling, of the nutritional status among older adults in Jordan. Specifically, there is a real need to assess nutritional status among older adults who are at high risk of malnutrition, including senior, unmarried, male, unemployed, ADL dependent, and/or poly-medicated older adults.

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.

Marital Violence affecting female nurses and its physical and mental health consequences.

THE AIM: To investigate the relationship between marital violence and Jordanian nurses' physical and mental health. BACKGROUND: Despite the negative impact of marital violence on female nurses' health, few studies have investigated its physical and mental aspects. METHOD: A descriptive correlational design was used to investigate the relationship between marital violence and the physical and mental health of female Jordanian nurses. One hundred ninety-eight female Jordanian nurses from five governmental hospitals were recruited. The Women Abuse Screening Test was used to measure forms of violence, and the SF-36 V2 instrument was used to examine physical and mental health. The prevalence of violence was calculated, and the linear relationship between violence and physical and mental health was measured using Pearson correlation. RESULTS: Female nurses reported a high percentage of different forms of violence. The study results revealed a negative relationship between violence and mental health and physical health. CONCLUSION: Jordanian female nurses suffered hazardous physical and mental health consequences of violence that adversely affect their entire life. IMPLICATIONS FOR NURSING POLICY AND EDUCATION: Nursing educators should establish clear guidelines and training policies on marital violence for nurses through creation of an effective and cooperative networking and resources. Also, nursing/health policymakers should create responsive healthcare environment through raising the awareness on marital violence against nurses and providing counselling services for emergency and concurrent cases.

Prevalence of depression and its associated factors in patients post-coronary artery bypass graft surgery.

This research aimed to determine the depression level and its correlation experienced by post-coronary artery bypass graft patients after being discharged from cardiac intensive care units. A cross-sectional design was employed for assessing variables. The Self-rating Depression Scale, as proposed by Zung, was used by the researchers on a convenience sample of Jordanian patients (N = 143) who were approached soon after their discharge from the targeted units. The results suggested that the level of depression among Jordanian patients was relatively high (M = 62.7, SD = 5.6). Moreover, depression was significantly higher among female, unmarried and unemployed patients. Patients who received their information about coronary artery bypass graft surgery from nurses had a lower level of depression. Age, length of stay in the cardiac intensive care unit and hospital type significantly predicted the level of depression. The research concluded that the post-coronary artery bypass graft patients who experienced an early onset depression required more attention to highlight the importance of supportive interventions.

Parenting from a Jordanian perspective: findings from a qualitative study.

PURPOSE: The main purpose of this qualitative descriptive study was to explore Jordanian parents understanding of parenting. METHODS: A convenient sample of 110 Jordanian parents recruited from four health centers participated in the study. A semi-structured one-on-one interview with open-ended questions was used to collect the data. RESULTS: Three thematic areas reflecting parent understands of parenting were identified; parenting as embraced by Islam, transferring of cultural values and traditions, and parenting as a challenge. CONCLUSIONS: Parenting behavior and its effectiveness are reflected by the strong interplay of Islamic teachings, socio-cultural values and traditions in addition to the challenges and difficulties of being a parent. CLINICAL RELEVANCE: As the ultimate goal of parenting is to promote the wellbeing and the development of children, it is crucial that health care providers involved in the design and delivery of family and children's services have a thorough understanding of how parents perceive parenting and how their understanding can be integrated in programs to enhance parental roles.

Adversities of being infertile: the experience of Jordanian women.

OBJECTIVE: To describe and interpret the experiences of and adversities faced by infertile Jordanian women as described from their own perspectives. DESIGN: A qualitative descriptive design. SETTING: The women were interviewed at a nonprofit women's organization in the north of Jordan. The organization focuses on empowerment and health issues. PATIENT(S): This study included a purposive sample of 25 infertile Jordanian women who were unsuccessfully trying to conceive for a minimum of 1 year, and who were receiving treatment for infertility. INTERVENTION(S): Face-to-face, in-depth, semistructured interviews were conducted, audiotaped, and transcribed using thematic analysis. MAIN OUTCOME MEASURE(S): Outcomes were measured using thematic analysis of the interview transcripts. RESULT(S): Four key adversity themes emerged from the data: the adversity of incomplete being, the social adversity of being infertile, the adversity of another wife, and the adversity of changes in the marital relationship. CONCLUSION(S): Jordanian women are seriously affected by infertility and experience personal, social, and marital adversities, which affect their well-being. These adversities need to be conceptualized within a framework that can be used to empower and counsel infertile women in all aspects of life.

Jordanian nursing students' attitudes toward the elderly.

The purpose of this study was to identify Jordanian nursing students' attitudes towards older people and to consider whether the attitudes of the selected sample had any bearing on the care provided for this client group. A descriptive correlational design was employed and Kogan's [Kogan, N., 1961. Attitudes toward old people: the development of a scale and examination of correlates. Journal of Abnormal and Social Psychology, 62, 44-54.] attitudes toward older people scale was administered to a convenience sample of 250 nursing students enrolled in the BSN program at a governmental university in the northern region of Jordan. Students' attitudes were identified using descriptive and inferential statistics. The Jordanian nursing students who participated in this study displayed marginally positive attitudes toward older people. Age and the socio-economic status of the students correlated significantly with their attitudes. Senior and male nursing students had more positive attitudes toward this client group than their counterparts. Students who prefer to work with older people following graduation reported more positive attitudes toward older people than students who did not. The results of this study suggest that positive attitudes exist towards older people; despite this, it is clear that efforts are required to enhance them further. In addition, the Jordanian lecturers in schools of nursing should further consider the need to prepare the students for their roles as caregivers for this particular client group.