The mediating role of emotional intelligence on nursing students' coping strategies and anxiety during the COVID-19 pandemic.

Anxiety among nursing students documented during the COVID-19 pandemic reflected their fear of contracting infections, adhering to the mandatory use of masks in public, engaging in the new experience of distance learning, having financial problems, and so on. The purpose of this study was to examine the mediating role of emotional intelligence (EI) on nursing students' coping strategies and anxiety during the pandemic. This cross-sectional correlational study was conducted in a university in Jordan. An online survey was used to obtain data from a sample of 282 nursing students who had returned to on-campus learning during the summer semester of 2019/2020. The survey held four parts: (a) questions about sociodemographics, (b) the General Anxiety Disorder-7 (GAD-7) scale, (c) the Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF), and (d) the Brief-Coping Behavior Questionnaire (Brief-COPE). The results showed that EI had a fully mediating role in the relationship between problem-focused coping strategies and anxiety, and it partially mediated the emotion-focused and avoidant/dysfunctional coping strategies and anxiety relationships. Nursing students who used the problem-focused coping strategies had high levels of EI, and with increasing levels of EI, anxiety levels decreased. Promoting the development of EI among nursing students would enable them to manage their emotions effectively and control their anxiety, particularly in new circumstances such as those that occurred during the COVID 19 pandemic.

Association of Ageism With Death Anxiety, Self-Esteem, Interpersonal Reactivity, and Symbolic Immortality Among Nurses.

According toterror management theory (TMT), older adults may often be a reminder of death for younger adults. Therefore, dealing with older adults may be associated with increased levels of death anxiety and decreased levels of self-esteem, interpersonal reactivity, and symbolic immortality, leading younger adults to develop ageist attitudes and behaviors in defense. However, to date, these associations have not been empirically examined, especially among nurses. Self-report questionnaires were used on a sample of 163 nurses to explore the issue of ageism among nurses from the TMT perspective. The results indicated that, after controlling for sociodemographic variables, high levels of death anxiety and low levels of self-esteem, interpersonal reactivity, and symbolic immortality were associated with increased levels of ageism among nurses. Thus, the current study uses TMT to explain ageism among nurses, and the study findings may contribute to the development of psychological interventions aimed at reducing nurses' ageism.

Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia.

Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.

Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain.

Psychiatric comorbidity and abusive experiences in chronic pelvic pain (CPP) conditions may prolong disease course. This study investigated the psychometrics of the Depression Anxiety Stress Scale 8 (DASS-8) among women with CPP (N = 214, mean age = 33.3 ± 12.4 years). The DASS-8 expressed excellent fit, invariance across age groups and menopausal status, good know-group validity (differentiating women with psychiatric comorbidity from those without comorbidity: U = 2018.0, p = 0.001), discriminant validity (HTMT ratios < 0.85), excellent reliability (alpha = 0.90), adequate predictive and convergent validity indicated by strong correlation with the DASS-21 (r = 0.94) and high values of item-total correlations (r = 0.884 to 0.893). In two-step cluster analysis, the DASS-8 classified women into low- and high-distress clusters (n = 141 and 73), with significantly higher levels of distress, pain severity and duration, and physical symptoms in cluster 2. The DASS-8 positively correlated with pain severity/duration, subjective symptoms of depression/anxiety, experiences of sexual assault, fatigue, headache severity, and collateral physical symptoms (e.g., dizziness, bloating, fatigue etc.) at the same level expressed by the parent scale and the DASS-12, or even greater. Accordingly, distress may represent a target for early identification of psychiatric comorbidity, CPP severity, experiences of sexual assault, and collateral physical complaints. Therefore, the DASS-8 is a useful brief measure, which may detect mental distress symptoms among women with CPP.

COVID-19 related stigma, empathy and intention for testing in Jordan.

Stigmatization of COVID-19 disease has been speculated due to misinformation about the disease, fearing of contracting the infection, absence of available cure, and holding responsibility for infecting others. We aimed to establish the prevalence of COVID-19 related stigma and its association with empathic responding, in addition to exploring predictors of stigma and testing intention among Jordanian people. A quantitative, descriptive and predictive design was used and data were collected using a web-based survey from 1074 adults. Findings showed that participants had high stigmatization against COVID-19 infection. Higher empathic responding (both cognitive and affective), being a female participant, and older age resulted in higher stigmatization. Only stigmatization of COVID-19 negatively predicted individuals' intention for testing. These findings warrant intensive efforts from the Jordanian government on a local and national level to provide ongoing public education related to several aspects of COVID-19 disease, in order to reduce or prevent the associated stigma and increase people's intention for testing.

The moderating role of social support on workplace violence and stress among psychiatric nurses.

Exposure to violent acts is considered one of the major stressful events psychiatric nurses are exposed to. Social support has been found to reduce nurses' stress and alleviate their experience of workplace violence; however, no accounts are available on whether social support moderates the relationship between workplace violence and stress. Therefore, the aim of this study was to examine the moderating role of social support on workplace violence and stress among psychiatric nurses. A cross-sectional descriptive and predictive design was utilized. A total of 195 psychiatric nurses were recruited from two governmental mental health hospitals. The results showed that psychiatric nurses were frequently exposed to violence, both verbally and physically, whether during their entire career or within the past 12 months. Verbal violence was more common among participants than physical abuse. Male nurses and nurses working mix-shift were more likely to experience violent acts. Regression analysis showed that only workplace violence and social support predicted psychiatric nurses' stress. On the other hand, social support did not moderate the relationship between workplace violence and stress. Further research is needed to investigate whether similar findings will conform with the results of this study. Meanwhile, healthcare institutions need to implement strategies to reduce or prevent nurses' exposure to workplace violence and lower their stress levels. Mobilizing and activating social support resources at work are considered other avenues to reduce stress experienced by psychiatric nurses.

Depression and adherence to healthy lifestyle behaviors among patients with coronary artery diseases in Jordan.

Background: It is well-established in the literature that coronary artery disease (CAD) is a risk factor for depression and that depressive symptoms inversely affect the development and progression of CAD. No published studies have examined the relationship between depression and adherence to healthy lifestyle behaviors among patients with CAD in Jordan. Therefore, the purpose of this study is to investigate the impact of depression on adherence to healthy lifestyle behaviors among CAD patients in Jordan. Methods: A correlational, cross-sectional study of convenience sample of 130 patients with CAD was conducted from out-patient cardiac clinics in a university-affiliated hospital and government-operated hospital in Northern Jordan. Data were collected using self-administered questionnaires on depression and adherence to healthy lifestyle behaviors among CAD patients. Results: Our data showed that 41% of the participants were non-adherent to healthy lifestyle behaviors, especially in the areas of physical activity (6.2%), maintaining a healthy diet (24.6%), and weight loss (26.15%). Gender, smoking status, and number of cardiac catheterization procedures were found to be significant predictors of patient adherence to healthy lifestyle behaviors. Although depressive symptoms were present in 56.9 % of the participants, depression was not found to be a significant predictor of adherence to healthy lifestyle behaviors among our sample. Conclusion: There was no significant relationship between depression and adherence to healthy lifestyle behaviors among CAD patients in Jordan. Physical activity, maintaining a healthy diet, and weight loss were the least lifestyle behaviors that were adopted, while quitting smoking and medication compliance were the most adopted behaviors among the patients. Our study provides valuable data regarding the levels and predictors of adherence to healthy lifestyle behaviors among CAD patients with CADs. Implications for future research and practice are addressed.

Anxiety and coping strategies among nursing students returning to university during the COVID-19 pandemic.

BACKGROUND: Despite the continued expand of the coronavirus disease 2019 (COVID-19) pandemic, nursing students are returning to on-campus learning and training in clinical settings. The COVID-19 pandemic might constitute a new source of anxiety that increases the already high anxiety levels of nursing students. This study aimed to assess the COVID-19 infection-related anxiety and coping strategies among nursing students returning to university campuses during the COVID-19 pandemic in Jordan. METHODS: A cross-sectional study was conducted on a sample of 282 nursing students who returned to campus during the summer semester of the academic year 2019/2020. The returning students were invited to complete an online questionnaire consisting of three parts: 1) sociodemographic variables and infection-related information, 2) the Generalized Anxiety Disorder 7 (GAD-7) Scale, and 3) the Brief-Coping Behavior Questionnaire (Brief-COPE). RESULTS: Of the participating students, 70.6% reported mild to severe anxiety levels. Female students and students who had fears of becoming infected with COVID-19 were found to be at higher risk of anxiety than were other students. A positive correlation was found between students' anxiety levels and their dysfunctional coping strategies, which included denial, behavioral disengagement, venting, and self-blame. Students who had chosen to study nursing willingly used coping planning. Further, other sociodemographic variables and infection-related information were associated with dysfunctional and emotion-focused coping strategies. CONCLUSIONS: The participating nursing students showed significant COVID-19-related anxiety upon returning to on-campus learning. Unfortunately, the students were found to use some dysfunctional coping strategies which were associated with increased levels of anxiety. The results highlight the important role of universities and nursing faculty members in supporting students emotionally and ensuring their personal safety inside the classroom and in clinical settings.

Barriers related to COVID-19 testing intention.

OBJECTIVES: Although vaccination against the COVID-19 disease has recently become available, individuals are expressing fear and hesitancy towards receiving it. As a result, testing for COVID-19 is still considered a vital method to contain infection. For testing to be effective, barriers towards testing intention need to be investigated; and available literature on the challenges are scarce. This study aimed to investigate barriers of COVID-19 testing among a sample of Jordanian adults and predict testing intention within the context of these barriers. METHODS: A cross-sectional, descriptive, and predictive design was employed in this study among a sample of 1074 Jordanian adults. RESULTS: Three clusters of barriers predicted testing intention; perceived discrimination at work, concerns of individual's privacy, and having negative feelings towards testing. While perceived discrimination at work and privacy concerns were negatively associated with individuals' intention for testing, experiencing negative feelings towards COVID-19 testing was a positive predictor. CONCLUSION: Within the context of the study findings, public health nurses need to promote safety at the workplace, protect an individual's privacy, and eliminate negative feelings towards testing uptake through the provision of accurate and up-to-date information regarding the COVID-19 disease.

Voicing Jordanian Adolescents' Suicide.

BACKGROUND: Studies focusing on adolescent suicide in Arab countries are particularly scarce, with the few available undertaken from within an epidemiological paradigm. OBJECTIVE: This study aimed to understand Jordanian adolescents' perceptions, beliefs, and attitudes toward suicide. METHODS: A qualitative design using 12 dual-moderator focus group discussions was conducted in public schools. Participants were selected from the three main regions of the country (rural southern, urban central, and suburban northern). Participants included Jordanian adolescent boys and girls, aged 14-17 years, who reported experiencing mild to moderate depressive symptoms. A relational content analysis approach was used for coding data, and a content analysis was used to identify salient thematic categories. Data were analyzed using NVivo software. RESULTS: Four themes emerged, including perceived risk factors, perceived protective factors, active and passive suicidal ideations, and e-games and Internet influences. Main risk factors were depression; anxiety; stigma, shame, and isolation; family issues; life pressures; and guilt. Conversely, religiosity, perceived positive family functioning, and availability of long-term goals seemed to confer resilience to adolescents' suicidal ideation and behavior. Passive suicidality (having death wishes without any plans to complete suicide) was noticed most among participants who feared jeopardizing the family's reputation if they committed suicide. Several boys with active suicidal ideations used the Blue Whale Challenge e-game to learn how to complete suicide and relinquish their problems. DISCUSSION: Suicide is a multifactorial problem requiring multimodal strategies. Evidence from this research suggests that those most passionate about the outcome of interest are encouraged to redouble efforts to reduce modifiable risk factors, enrich protective factors, target the underlying psychiatric illness that informs suicidal ideations and behavior, and research the effect of social media and Internet activity more deeply. Parents are advised to monitor the online activities of their children and familiarize themselves with the digital applications they use.

Distance Learning-Related Stress Among Undergraduate Nursing Students During the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has forced universities all over the world to transition to distance learning. The aim of this study was to examine the stress levels, stressors, and associated sociodemographic variables among undergraduate nursing students as a result of the transition to distance learning amid COVID-19. METHOD: This study used a mixed-methods embedded design. A total of 355 nursing students were recruited. The Higher Education Stress Inventory was used to assess stress levels, and an open-ended question was used to examine the sources of stress. Descriptive statistics and one-way ANOVA tests were used for data analysis. RESULTS: Statistically significant differences in stress levels were found based on some of the sociodemographic characteristics of the students. Four themes representing the stressors related to distance learning emerged from the qualitative data. CONCLUSION: Distance learning-related stress and stressors among nursing students were found to vary based on students' sociodemographic characteristics. [J Nurs Educ. 2020;59(12):666-674.].

Acute stress disorder, coping self-efficacy and subsequent psychological distress among nurses amid COVID-19.

PURPOSE: Health care professionals, particularly nurses, are considered a vulnerable group to experience acute stress disorder (ASD) and subsequent psychological distress amid COVID-19 pandemic. This study aims to establish the prevalence of acute stress disorder and predictors of psychological distress among Jordanian nurses. METHODS: A quantitative, cross-sectional, descriptive and comparative design was used. Data were collected using a Web-based survey. A total of 448 Jordanian nurses (73% females) completed and returned the study questionnaire. RESULTS: The majority of nurses (64%) are experiencing ASD due to the COVID-19 pandemic and thus are at risk for PTSD predisposition. More than one-third of nurses (41%) are also suffering significant psychological distress. Among our sample, age, ASD and coping self-efficacy significantly predicted psychological distress. More specifically, younger nurses are more prone to experience psychological distress than older ones. While higher scores on ASD showed more resultant psychological distress, coping self-efficacy was a protective factor. CONCLUSION: Given that individuals who suffer from ASD are predisposed to PTSD, follow-up with nurses to screen for PTSD and referral to appropriate psychological services is pivotal. Coping self-efficacy is found to ameliorate the effect of psychological distress on nurses' traumatic experience. Such findings warrant intensive efforts from health care institutions to provide psychosocial support services for nurses and ongoing efforts to screen them for traumatic and psychological distress symptoms. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing leaders and managers are in the forefront of responding to the unique needs of their workforces during the COVID-19 crisis. They need to implement stress-reduction strategies for nurses through providing consecutive rest days, rotating allocations of complex patients, arranging support services and being accessible to staff. They also need to ensure nurses' personal safety through securing and providing personal safety measures and undertake briefings to ensure their staff's physical and mental well-being, as well as providing referrals to appropriate psychological services.

Psychometric properties of two Arabic Suicide Scales: stigma and literacy.

Suicide is one of the leading causes of death. Suicide stigma and literacy may affect the rate of suicide and help-seeking behaviors. This study examined the psychometric properties of the Arabic version of the Stigma of Suicide Scale-short form (SOSS-SF) and Literacy of Suicide Scale (LOSS). The sample included 160 Jordanian university students. Reliability analysis showed acceptable Cronbach's alpha levels of the three SOSS-SF subscales (stigmatization, isolation, and glorification subscales). Factor analysis supported the construct validity of the SOSS-SF by showing three factor structure similar to the three original subscales. LOSS scores showed low literacy level about suicide with a passing rate of 55% and a mean score of 5.63 out 12. Students had more difficulty in answering questions related to signs/symptoms and risk factors of suicide. This study will enable Arabic clinicians to use these tools which assess important aspects about suicide.

The Psychometric Properties of the World Health Organization Quality of Life BREF Among Thai Women Who Have Experienced Intimate Partner Violence.

BACKGROUND AND PURPOSE: The World Health Organization Quality of Life BREF (WHOQOL-BREF) has been used in various populations and cultures. However, its psychometric properties are unknown among women who experienced intimate partner violence (WIPV). This study aimed to explore the reliability and validity of the WHOQOL-BREF among Thai WIPV. METHODS: Two hundred eighty-four female patients receiving care at a northeast hospital in Thailand responded to the WHOQOL-BREF and intimate partner violence (IPV) questions. Exploratory factor and consistency analyses were applied. RESULTS: Different from the original study, this study generated 5 factors, 1 of which is Medical Care Needs. The resulting scale and subscales showed good reliability and construct validity. CONCLUSION: The 5-factor scale can be used among WIPV by health care professionals to assess their quality of life (QOL) and appropriately address their needs.

Support for using five attributes to describe spirituality among families with a parent in hospice.

OBJECTIVE: The importance of spirituality in the dying process is well documented. However, what spirituality means in these situations is hard to discern because few people (patients, families, researchers, or caregivers) will view spirituality in the same way. The present research supports the use of a spiritual framework consisting of five common attributes (meaning, beliefs, connections, self-transcendence, and value) as a mechanism for viewing spirituality for people nearing the end of life. Using qualitative interviews from two related studies, our study aims to describe the prevalence of spirituality and its nature according to these five spiritual attributes. METHODS: Data from two previous studies were analyzed. The first employed the methods of grounded theory to understand the strategies adolescents used to manage the impending death of a parent. Some 61 participants from 26 families were interviewed, including ill parents/patients, well parents/caregivers, and adolescents. The second study consisted of 15 interviews with the surviving parent and adolescents from 6 of these families after the death of the parent. RESULTS: The original research from which these data were drawn did not seek to describe spirituality. However, spiritual themes were prevalent in the stories of many participants and included each of the five spiritual attributes. SIGNIFICANCE OF RESULTS: Our findings demonstrate the prevalence of spirituality in the everyday lives of these families and supports the use of the spiritual framework according to the five common attributes to describe spirituality.

Two worlds: Adolescents' strategies for managing life with a parent in hospice.

OBJECTIVE: This study aimed to generate an explanatory model of the coping strategies that adolescents employ to manage the stressors they experience in the final months of their ill parent's life and shortly after their death. METHOD: The sample included 26 families of adolescents with a parent receiving care in a large hospice program in northeastern Ohio. A semistructured interview was conducted with 14 ill parents, 17 well parents/guardians, and 30 of their adolescent children before the parent's death and, additionally, with 6 of these families after the death. The interviews were audiotaped, transcribed verbatim, and analyzed using a grounded-theory approach. RESULTS: The participants described two worlds that constituted the lives of the adolescents: the well world of normal adolescence and the ill world of having a parent near the end of life. The adolescents experienced a common challenge of living in two worlds and responded to the challenge with a process we labeled "managing two worlds." Five stages through which adolescents manage their worlds were identified: keeping the ill world and the well world separate; having the ill world intrude into the well world; moving between the ill world and the well world; being immersed in the ill world; and returning to the well world having been changed by the ill world. SIGNIFICANCE OF RESULTS: The explanatory model of "managing two worlds" outlines a complex and nuanced process that changes over time. The model can be used by health professionals who seek to help adolescents navigate this critical time when their parents are dying or have recently died. These results can also be used to inform the development of interventions that assist families with strategies tailored to an adolescent's specific needs. Future research should investigate associations among the process of "managing two worlds" and outcomes related to adolescent bereavement.