Panic disorder during pregnancy: A scoping review.

Background: Panic Disorder is a serious anxiety disorder, and one of the severe mental problems that impacts mothers' mental health and fetal health as well. Aim: The current scoping review aims to provide a wide overview of the literature regarding panic disorder during pregnancy. Methods: Twenty-five eligible articles were selected for full review from SAGE, CINAHL, PubMed, Medline, Research Gate, Science Direct, and Google Scholar literature searches. This review followed the framework suggested by Arksey and O'Malley for a scoping review. Results: Content analysis of the studies was done, and five categories have been identified: Panic disorder course during pregnancy; prevalence of panic disorder during pregnancy; factors associated with pregnancy panic disorder; impact of panic disorder during pregnancy; and treatment of panic disorder during pregnancy. Conclusion: A significant gap in the literature, and inconsistent and mixed findings regarding prevalence, impact, associated factors, and treatment of PD during pregnancy exist. This scoping review revealed that more studies need to be conducted to further understand and examine PD during pregnancy.

The Effectiveness of P6 and Auricular Acupressure as a Complimentary Therapy in Chemotherapy-Induced Nausea and Vomiting Among Patients With Cancer: Systematic Review.

BACKGROUND: Chemotherapy-induced nausea and vomiting (CINV) is one of the most prevalent and distressing side effects of chemotherapy among patients with cancer worldwide. Despite continuing advances in antiemetic medicines, nausea and vomiting associated with cancer chemotherapy remain a substantial therapeutic concern for many patients. However, P6 and Auricular acupressure (AA) have been recognized as potential therapy for managing chemotherapy-induced nausea and vomiting. AIM: This study aimed to evaluate the effectiveness of P6 and Auricular acupressure (AA) in reducing chemotherapy-induced nausea and vomiting among patients with cancer. And to explore a prominent and effective evidence-based protocol for implementing acupressure to treat chemotherapy-induced nausea and vomiting. METHOD: This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Several databases were used to search for eligible studies using specific keywords. Only systematic reviews and clinical trials on acupressure for managing CINV among adults with cancer were included. This review covered articles published in English from 2015 to 2022. RESULTS: A total of 14 published studies were included in this review study; 10 articles were trial studies, and the other 4 were systematic review and meta-analysis studies. The quality of 10 included clinical trials were assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for quantitative studies, the overall result showed that 40% of study rated with moderate quality, no study was rated with low quality, and (60%) studies rated as high-quality study. As well as the quality assessment of all review studies showed that the majority of included systematic reviews and meta-analysis with a low risk of bias and high to moderate power of evidence. In all included studies the acupressure was utilized as a primary complementary intervention for chemotherapy induced nausea and vomiting. The result of this extensive and comprehensive review the P6 and auricular acupressure is an effective complementary therapy in reducing and controlling chemotherapy-induced nausea and vomiting among participants with various types of cancer and receiving various types of chemotherapy. CONCLUSION: The successful and effective application of acupressure in managing CINV for certain types of cancer had been supported in previous literature as a safe, affordable, and non-invasive alternative to pharmaceutical medications. However, standardization guidelines regarding the use of acupressure independently or in combination with other pharmacological therapies to address CINV in various cancers require immediate attention.

Effectiveness of blended learning basic life support module on knowledge and skills: A systematic review of randomized controlled trials.

Aim: To examine the effectiveness of the BLS blended learning module on knowledge and skills of BLS compared to the traditional module. Method: Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were utilized using key words to searched PubMed, Web of Science, and Cochrane Library for the studies published between January 2018 to May 2022. The risk of bias was assessed utilizing the Joanna Briggs Institute (JBI) critical appraisal checklist. Two reviewers separately extracted data from the included trials using a standardized data extraction form. Results: From 400 articles retrieved by the initial search, 11 studies were found to be eligible. Most studies' participants were laypersons (80.9 %), and the rest were either nursing (12.6 %) or medical students (6.5 %). The review shows superiority of utilizing the blended strategy in applying the BLS module in skills and knowledge retention, rather than using the traditional learning, which could improve the quality and outcomes of patients. Conclusions: Blended learning is effective in teaching BLS like the traditional face-to-face method, but more advantages of the blended learning module include improvement in retaining knowledge, skills acquisition, patient outcomes, and cost saving. The COVID-19 pandemic made blended learning crucial and using this method in BLS was effective and efficient. Future research to assess the effectiveness of blended learning on patient outcomes is recommended.

Nurse-guided incentive spirometry use and postoperative pulmonary complications among cardiac surgery patients: A randomized controlled trial.

AIMS: To assess the effect of nurse-guided use of incentive spirometer on postoperative oxygenation and pulmonary complications after coronary artery bypass graft surgery. BACKGROUND: Deep breathing exercises have been shown to improve postoperative lung expansion and reduce pulmonary complications. An incentive spirometer is a deep breathing exercises device that imitates continuous sigh-like maximal inspiration. DESIGN: Randomized control trial, two groups nonblinded parallel design. METHODS: A total of n = 89 eligible patients were randomized to either control or intervention group. Patients in the intervention group received bihourly nurse-guided incentive spirometry for 48-h postextubation. The endpoints were: the number and duration of hypoxic events during the first 24-hr postsurgery, pneumonia and pulmonary function parameters. Data were collected May to September 2019. RESULTS: Patients in the intervention group had a significantly lower mean number of hypoxic events with shorter duration and shorter length of stay in the hospital and the ICU. Patients in the intervention group also had greater postoperative forced expiratory volume in 1 second. CONCLUSION: Nurse-guided use of the incentive spirometer reduces the risk of pulmonary complications and hospital length of stay after cardiac surgery.

Patients' experiences in the intensive care unit in Jordan: A cross-sectional study.

AIMS: The purpose of this study was to describe the experiences of Jordanian patients during their stay in intensive care unit (ICU) and to explore associated factors. BACKGROUND: Various factors can negatively affect patients' experiences and lead to negative consequences that can affect their outcomes. MATERIALS & METHODS: A descriptive, correlational design was used to collect data from 150 patients using the Intensive Care Experience Questionnaire through structured interviews after being transferred from medical and surgical ICUs to general wards. RESULTS: The results showed that the longer the length of ICU stay (LOS) (>7 days) the higher frightening experience (r = 0.2, p < 0.05), the lower awareness of surrounding (r = -0.28, p < 0.01), and the lower satisfaction with care (r = -0.22, p < 0.01). The results showed a negative correlation between receiving sedation and awareness of surroundings (r = -0.33, p < 0.01), and recall of ICU experiences (r = -0.23, p < 0.01), and a positive correlation with frightening experiences (r = 0.2, p < 0.05). CONCLUSION: Health care activities, clinical and socio-demographic factors can affect the psychological experiences of patients in the ICU. Longer ICU stay is associated with more negative experiences.

Health-Related Quality Of Life, Uncertainty, and Anxiety among Patients with Chronic Obstructive Pulmonary Disease.

Patients' with Chronic Obstructive Pulmonary Disease suffer from serious respiratory symptoms that increase anxiety, stress, and uncertainty, and affect quality of life. The aim of this study was to assess level of anxiety, uncertainty, and health related quality of life (HRQoL) among COPD patients in Jordan. Correlational cross-sectional survey design was used to collect data from 153 COPD patients. The study was conducted at pulmonary clinics in three major referral hospitals in Jordan that provide care for COPD patients from different parts of the country. To assess HRQoL, St. George Respiratory Questionnaire was completed. Uncertainty and anxiety level was measured by Mishel's uncertainty of illness scale and state anxiety inventory respectively. The mean age of participants was 66.8 (SD= 10.3) and most participants were males (94.1%) with. The mean score of HRQoL was 57.9 (SD = 20.5). The mean score of participants' level of anxiety was 38.1 (SD = 11.1). The mean score of uncertainty was 66.1 (SD= 11.1). There is a statistically significant positive relationship between HRQoL and anxiety (r =.433, p< .01), and uncertainty (r=.483, p<.01). Increased anxiety and uncertainty among COPD patients was associated with low HRQoL. Health care providers need to pay attention the effect of anxiety and uncertainty on COPD patients' quality of life and institute appropriate management.

Prevalence of post-traumatic stress disorder and its predictors following coronary artery bypass graft surgery.

BACKGROUND: Cardiac surgery can be traumatic and stressful, and as a result many people experience psychological difficulties following treatment. AIM: To assess the level of post-traumatic stress disorder (PTSD) 1 month after coronary artery bypass graft (CABG) surgery among Jordanian patients, and to examine the predictors of PTSD after 1 month. METHOD: A descriptive survey design was used. FINDINGS: 149 patients participated in the study. Their mean age was 59 years (SD=10.2) and most were male (87%) and married (93%). Some 44% of patients had PTSD. Length of stay in hospital (c² (1)=6.598, P<0.05), and age (c² (1)=4.920, P<0.05), predicted the occurrence of PTSD after 1 month. CONCLUSIONS: Nurses, who are usually in the frontline with patients, should consider using a robust tool and clinical interview to assess and evaluate the presence and the risks of PTSD to promote early detection and optimal management. Follow-up studies after 6 and 12 months would be beneficial.

Effect of noise and light levels on sleep of intensive care unit patients.

BACKGROUND: Previous studies emphasized that the noise and light levels in intensive care units (ICUs) exceeded the recommended levels by the World Health Organization and the Environmental Protection Agency. This might disturb patients' sleep in these units. AIMS AND OBJECTIVES: The aim of this study is to explore the effect of noise and light levels on the perceived quality of sleep (QOS) of patients in ICUs. DESIGN: A cross-sectional exploratory correlational design was used. METHODS: The noise and light levels were measured on an hourly basis from 10 pm to 6 am, and their impact on ICU patients' QOS was evaluated. RESULTS: The overall light level correlation with the overall QOS was statistically significant at an α level of .05, r (101) = - 0.35, P < .001. The Pearson correlation between the overall ICU nocturnal sound level and patients' overall perceived QOS was statistically significant at an α level of .05, r (101) = - 0.42, P < .001. CONCLUSION: The noise and light levels in the ICUs in the selected hospitals are higher than the recommended levels. High noise and light levels have a negative correlation with the patients' QOS. RELEVANCE TO CLINICAL PRACTICE: High levels of light and sound are associated with poor QOS among ICU patients.

Delirium post-cardiac surgery: Incidence and associated factors.

BACKGROUND: Post-operative delirium among cardiac surgery patients is a prevalent complication that associated with multiple negative outcomes. AIM: This study aimed to assess delirium incidence, associated factors, and outcomes for adult patients who underwent elective cardiac surgery. DESIGN: An exploratory prospective cohort design was used for this study. METHODS: Delirium was diagnosed by the Confusion Assessment Method for the Intensive Care Unit. Incidence, preoperative, intraoperative, and post-operative variables for 245 patients during 3-month period were collected and analysed. RESULTS: Delirium developed in 9% (n = 22) of the sample. Patients with delirium were significantly older (mean age = 65.7, SD = 8.1), t (243) = -3.66, P < .05); had longer surgery time (mean time = 286.3, SD = 82.2), t (243) = -2.25, P < .05); received more blood post-surgery (t (243) = -3.86, P < .05); spent more time on mechanical ventilation (t [21.6] = -2.2, P < .05); had longer critical care unit stay (t [21.7] = -4.0, P < 0.05); and had longer hospitalization than patients without delirium. CONCLUSIONS: The risk factors associated with development of delirium were advanced age and increased duration of surgery. Negative outcomes associated with delirium were increased duration of mechanical ventilation, increased volume of post-operative infused colloids and blood/products, increased critical care unit stay, and increased hospitalization. A multifactorial model for delirium risk factors should be considered to detect and work on potentially preventable delirium factors. RELEVANCE TO CLINICAL PRACTICE: Post-cardiac surgery delirium leads to longer mechanical ventilation time, increased ICU stay, and prolonged hospitalization. Delirium post-cardiac surgery is potentially preventable with appropriate identification of risk factors by nurses.

Nursing diagnoses among oncology patients in medical units: a retrospective study of patients' records.

OBJECTIVE: Nursing care plans for oncology patients are complex and overlapping enough to warrant the need for systematised documentation that ensures high quality, flawless and comprehensive care. Addressing the patients' needs through nursing diagnoses is the initial step that shapes the subsequent care. Therefore, the current study aimed to identify the frequent NANDA-I diagnoses reported in nursing care plans for medical oncology patients. DATA SOURCES: A retrospective design was used to collect data from 260 electronic nursing care records of oncology patients admitted to medical floors at an accredited oncology centre in Jordan. CONCLUSION: The complexity of nursing care for oncology patients can be inferred from the high number of reported nursing diagnoses. This study summarises the most common nursing diagnoses and their combinations that can be used as a guide to formulate nursing care plans for oncology patients in medical units. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses may refer to this study to guide and support their care and documentations to maintain a high standard of nursing practice. Besides, the reported diagnoses can be integrated to generate pre-printed, standardised nursing care plans, where diagnoses are listed for nurses to select the applicable ones for their patients. Similarly, the combinations of nursing diagnoses may guide nurses to search for a concurrent diagnosis, thus improving patients' outcomes. This study revealed the complexity of patients' care in medical oncology units, which alarms the nursing managers to reconsider the nurse-patient ratio in these settings to meet patients' care demands and maintain their safety.

Pain Management Knowledge and Attitudes of Healthcare Professionals in Primary Medical Centers.

BACKGROUND/AIM: To investigate the level of knowledge and attitudes related to pain management among nurses and physicians working in primary medical centres in Jordan. DESIGN: A descriptive cross-sectional design was used. SETTINGS: Study was conducted in seven medical centres affiliated to the Royal Military Medical Services. PARTICIPANTS/SUBJECTS: A sample of 56 physicians and 81 nurses were recruited. METHODS: The Knowledge and Attitudes Survey Regarding Pain questionnaire was used to assess participants knowledge and attitudes regarding pain management. RESULTS: Total knowledge scores were calculated and converted to a percentage for each participant, resulting in scores for nurses ranging from 9.51% to 90.24% (mean 45.26%, SD 9.9), and for physicians of 31.7% to 97.56%, (mean 50.6%, SD 13.6). The difference in the total mean scores between nurses and physicians was significant (t = -2.63, df = 135, P = .009), physicians having more knowledge of pain management than nurses. CONCLUSIONS: The result of this study indicated that Jordanian healthcare professionals have a low level of knowledge and negative attitudes toward pain management, so educational programmes related to the topic are strongly recommended. The findings also revealed a discrepancy between knowledge and practice. Therefore, guidelines and protocols related to pain assessment and management should be designed and implemented to bridge the gap between knowledge and practice.

Reporting Nursing Interventions Classification and Nursing Outcomes Classification in Nursing Research: A Systematic Review.

BACKGROUND: Nursing classification systems are used to report nursing practices and maintain a unified documentation language. Nursing interventions classification (NIC) and nursing outcomes classification (NOC) are among the recognized terminology systems. AIM: To examine the extent of reporting NIC/NOC in nursing research. DESIGN: A systematic review following PRISMA guidelines. DATA SOURCES: A literature search in three electronic databases was performed. RESULTS: A total of (18) articles were included. Nine studies were conducted to describe the commonly used NIC/NOC, six studies validated the effectiveness of classification systems, and two studies compared different nursing classification systems. CONCLUSION: The available evidence is limited by the quality of the studies. We recommend examining the use of NIC/NOC in nursing documentation using an experimental design.