The Effect of a Diabetes Self-Management Mobile Application on Self-Efficacy, Self-Care Agency, and Self-Care Management Among Patients With Type 1 Diabetes Mellitus.

Background: Diabetes mellitus is a chronic disease that needs long-term management. Mobile health is an emerging field that is being used for diabetes self-management. Aim: Evaluate the effect of a diabetes self-management mobile application on self-efficacy, self-care agency, and self-care management among 128 Jordanian patients with Type 1 Diabetes Mellitus. Methods: The study utilized a non-equivalent controlled groups quasi-experimental design, with 64 patients in the control and in the intervention groups. Results: There was significant improvement in mean self-efficacy in the intervention group, improved self-care agency between the groups, and improved self-care management both within the intervention group and between the groups, after controlling for self-efficacy and self-care agency. Conclusion: Using a diabetes self-management mobile application may help improve patients' confidence in managing diabetes, and better commitment to and performance of self-care activities.

Investigating Saudi Nursing Students' Health Beliefs about Testicular Cancer and Testicular Self-Examination: A Cross-Sectional Study Using the Health Belief Model.

INTRODUCTION: Testicular cancer (TC) is a serious health issue, which requires early detection through testicular self-examination (TSE). OBJECTIVES: To investigate Saudi nursing students' health beliefs about TC and TSE using the Health Belief Model (HBM) scale and assess the validity and reliability of the HBM scale. METHODS: This cross-sectional study recruited a convenience sample of 374 nursing students from six nursing colleges in different cities in Saudi Arabia. Data were collected through self-report questionnaires that included demographic and academic information, as well as a valid and reliable HBM scale for TC and TSE. RESULTS: Most participants were single (88.8 %), in their third year of nursing education (43.9 %), had excellent or very good health (83.2%), had no family history of TC (88.9%), and had no medical problems with their testicles (92.8%). The participants had low susceptibility to TC and moderate beliefs about the seriousness of TC. Furthermore, participants reported moderate levels of perceived benefits and health motivation for preventing TC and practicing TSE, but high levels of perceived barriers and low levels of self-efficacy for practicing TSE. The internal reliability (Cronbach's alpha) of susceptibility, benefits and health motivation, seriousness, barriers, self-efficacy, and health motivation and promotion sub-scales was 0.91, 0.89, 0.88, 0.84, 0.67, and 0.65, respectively. Significant relationship between students' performing TSE and their health beliefs about Susceptibility (t=1.93, p=0.04) and Seriousness of having TC (t=2.88, p=0.03), and self-efficacy (t=3.91, p<0.001) and barriers (t=-2.51, p=0.04) to practice TSE. CONCLUSION: The study concluded that Saudi nursing students had moderate levels of health beliefs about TC and TSE, with high perceived barriers and low levels of self-efficacy for practicing TSE.

Factors affecting the caring performance of newly graduated Nurses' working in critical care units.

BACKGROUND: Although many studies have discussed nurses' caring performance, few have focussed on critical care nurses. Also, none have studied this among newly graduated nurses despite their very different circumstances. AIM: The purpose of this study was to examine factors affecting the caring performance of newly graduated nurses in critical care units. METHOD: A descriptive cross-sectional design, using self-reported questionnaires, was used among a sample of 209 nurses interviewed in Jordanian hospitals. The Mental Health Professionals Stress Scale was used for measuring work-related stress and the Caring Behaviours Assessment tool to assess caring performance. Data collection was conducted from March to May 2018. RESULTS: The participants had moderate levels of caring performance (M = 182.6/315, SD = 15.46). The highest score was reported for 'Supportive/Protective/Corrective Environment' subscale, while the lowest for 'Teaching/Learning' subscale. Many significant differences were noticed in caring performance based on participants' demographics. Only working in private hospitals was a significant predictor for caring performance (P < .05) predicting 14% of variance. CONCLUSION: Caring performance of newly graduated nurses in critical care units was affected by many factors including workload, self-doubt, income and area of working. The significance was flagged of developing nursing policies concerned with stress relief and improvement of caring performance.

Management of Distal Fibular Fractures With Minimally Invasive Technique: A Systematic Review.

Ankle fractures are extremely common, with isolated distal fibular fractures being the most common variant. The current gold standard in treating unstable distal fibular fractures is open reduction internal fixation. However, with potential risk of wound complications, minimally invasive techniques have been introduced. This systematic review was performed to evaluate the clinical and functional outcomes of varying minimally invasive techniques including minimally invasive plate osteosynthesis, intramedullary (IM) nailing, and IM screw fixation. A comprehensive English literature search on PubMed was performed yielding 543 studies. With specific study selection criteria, a total of 13 articles were selected. After studying the reference of each of the 13 studies, an additional 7 articles were included, resulting in a total of 20 studies reviewed. A total of 8 articles reviewed used IM nailing as the fixation of choice with a total of 211 patients. Of the 211 patients, 33 experienced complications. Six articles using minimally invasive plate osteosynthesis were reviewed with a total of 264 patients. Of the 264 patients, 39 experienced complications. IM screw fixation was used in 6 articles reviewed with a total of 219 patients. There were 30 cases of complications from the 132 patients. Additionally, mean American Orthopedic Foot and Ankle Society hindfoot-ankle scores among all fixation types was 88.4 ± 3.40 whereas the mean Olerud and Molander Score among all fixation types was 76.7 ± 16.58. The results of this study indicate that minimally invasive techniques for fixation of distal fibular fractures can provide excellent functional results with low complication rates compared with traditional open reduction internal fixation.

The Effect of Concept Mapping on Critical Thinking of Jordanian Nursing Students.

AIM: The aim of this study was to explore the effectiveness of concept maps in improving the critical thinking of nursing students. METHOD: This quasi-experimental study was conducted using a pretest-posttest design among two groups of a total of 115 nursing students. Participants were either exposed to concept mapping sessions or taught with traditional lecturing; the assessment tool was a test of critical thinking completed before and after the intervention. RESULTS: The mean scores for critical thinking were higher in the group that engaged in mapping sessions compared to the traditional lecture group. CONCLUSION: This study supports the usefulness of concept maps as a teaching strategy to promote development of nursing students' critical thinking abilities. These findings could provide valuable evidence for establishing concept mapping as a promising teaching strategy for nursing students.

The Gradual and Acute Correction of Equinus Using External Fixation.

Equinus is one of the most common deformities noted in foot and ankle biomechanics that, at times, if not identified and managed properly may lead to significant lower extremity pathology. With that being said, this deformity is also one that may be both underdiagnosed and undertreated. Treatment for equinus can range from conservative therapy to more aggressive surgical therapy. The purpose of this article is to review the clinical workup to properly identify the deformity and to explore the various treatment options for its timely management, which include gradual or acute correction of equinus using external fixation.

Predictors of delay in seeking treatment by Jordanian patients with acute coronary syndrome.

BACKGROUND: ACS management aims for early coronary reperfusion, which should be within one hour from symptoms onset. This time was found to be relatively long, and many patients died before hospital arrival. In Jordan, this phenomenon is not clearly understood with a discrepancy between the reported durations of delay time. AIMS: To evaluate Jordanian ACS patients' delay time in seeking medical care, along with predictors of delay. METHODS: A descriptive, cross-sectional design was utilized to conveniently recruit 160 Jordanian ACS patients. Data were collected using chart review and the Modified ACS Response Questionnaire. RESULTS: The mean delay time was 7.8 hours (SD =3.5), with none of participants presenting within one hour. Delay time correlated negatively with ACS history, knowledge, attitudes, beliefs, and perceived risk (r = -0.448, r = -0.400, r = -0.408, r = -0.261, r = -0.411, respectively) and positively with health perception (r = 0.469). A 4-predictor model (history, beliefs, health perception, STEMI diagnosis) was revealed explaining 40% of variance in delay time (R(2)=.400, F (14,145) = 6.908, P < .001). CONCLUSION: Improving ACS patients' health seeking behaviors can be achieved when all components of care are considered together.

The perception of hospital safety culture and selected outcomes among nurses: An exploratory study.

The objectives of this study were to examine nurses' perceptions of the hospital safety culture in Jordan and to identify the relationships between aspects of hospital safety culture and selected safety outcomes. Data from 242 registered nurses in five Jordanian hospitals were analyzed. Aspects of hospital safety culture and outcomes were measured using the Hospital Survey on Patient Safety Culture. Among various aspects of hospital safety culture, teamwork within units had the highest average percentage of positive responses (49.8%). Additionally, participants reported deficits in other aspects of safety culture, particularly in staffing and nonpunitive response to errors, with average percentages of positive responses of 30.4% and 30.7%, respectively. Pearson correlation analysis revealed that 9 of 10 subscales of hospital safety culture were significantly correlated to one or more of the hospital safety outcomes. The findings of this study can help policymakers and healthcare administrators identify the weaknesses and strengths of hospital safety issues in order to propose effective strategies to improve patient safety and quality of care.

Outcomes of a diabetes education program for registered nurses caring for individuals with diabetes.

BACKGROUND: Nurses from various setting lack sufficient knowledge about diabetes and diabetes management. Better understand of evidence-based practices by nurses who are involved in caring for hospitalized individuals with diabetes can positively influence care outcomes. METHOD: A pretest design was used to evaluate the effectiveness of a diabetes education program for RNs working voluntarily participated. A 1-day education program was developed and delivered to the participating nurses. Knowledge regarding diabetes was tested before and after the education program. RESULTS: a significant difference was noted in the modified diabetes basic knowledge mean test scores before and after implementation of the education program (t[128] = 17.95, P < 0.001). CONCLUSIONS: The diabetes education program had a positive on nurses' knowledge. This finding has implications for developing diabetes education content within nursing curricula, as well as continuing education courses for practicing nurses.

Violence against nurses in emergency departments in jordan: nurses' perspective.

Violence against nurses in emergency departments (EDs) has become a widespread phenomenon affecting nurses' job satisfaction and work performance. Literature is scarce regarding prevalence rates and causes of violence directed toward nurses in Jordan. The present study investigated violence experienced by Jordanian nurses in EDs and causes of violence from their perspectives. This descriptive study collected data from 174 Jordanian ED nurses. The majority of the participants (91.4%) reported experiencing violence (verbal 95.3% vs. physical 23.3%). According to participants, the most common causes of violence in the ED were crowding and workload (75.9%), and the least was care of patients with dementia or Alzheimer's disease (35.6%). Violence is common in Jordanian EDs, giving rise to many heath and behavioral consequences. Health care administrators are obligated to protect nurses from violent incidents by providing adequate safety measures, beneficial administrative procedures, and sincere efforts to overcome the causes of this phenomenon.

Predictors of ICU patients' pain management satisfaction: A descriptive cross-sectional survey.

PURPOSE: (1) To assess Jordanian ICU patients' pain characteristics (intensity and interference) and levels of pain management satisfaction; and (2) to determine potential predictors of pain management satisfaction among ICU patients. METHODS: A descriptive cross-sectional design was utilised using the American Pain Society-Patient Outcome Questionnaire to survey 139 Jordanian ICU patients from different health care sectors in Jordan. RESULTS: High levels of pain and pain interferences were reported by participants, which were higher than those reported by previous studies in other countries. However, participants were relatively satisfied with pain management approaches. Also, the results showed a predictive model of three potential predictors, which accounted for 36% of the variance in participants' satisfaction with pain management (adjusted R(2)=0.36, F=12.14, df=7129, p<0.005). The strongest predictor to participants' satisfaction with pain management was time needed to get analgesia (beta=-0.480, p<0.001), followed by average pain interference (beta=0.218, p=0.02), and being told about importance of reporting pain (beta=0.198, p=0.006). CONCLUSION: Jordanian ICU patients reported high pain levels, which supports the need for applying a caring attitude in managing patients' pain reports. Also, such a study is among the first pain management studies in Jordan aiming at setting the stage for future research studies. Finally, results can be included in planning pain management strategies and protocols within hospitals.

Jordanian patients' satisfaction with pain management.

Pain is still undertreated among hospitalized patients. Recently, patient satisfaction with pain management has received significant attention. This field has not yet been explored among Jordanian patients. The purpose of this study was to determine the knowledge regarding pain characteristics, beliefs, and satisfaction that can be included in planning pain management strategies and protocols within Jordanian hospitals. Using descriptive cross-sectional methodology, the American Pain Society Patient Outcome Questionnaire (APS-POQ) was used to survey 375 inpatients from Jordanian hospitals. Participants reported relatively severe pain and pain interferences while being hospitalized and seemed to be well informed regarding pain and pain management. Participants reported high levels of pain management satisfaction. Also, the Arabic version of the APS-POQ was found to be reliable among the Jordanian population. Findings of this study are similar to those reported by earlier studies in other countries and support the need for applying the caring attitude in managing patients' reports of having pain. This study is the first in Jordan, opening the door for future studies to be conducted in this important field.