Symptom Clusters and Their Impact on Spiritual Well-Being Among Women with Breast Cancer.

Purpose: To explore symptom experience and symptom clusters among Jordanian women with breast cancer and investigate whether these clusters predict patients' spiritual well-being. Patients and Methods: A sample of 142 Jordanian women with breast cancer were asked to complete the Memorial Symptom Assessment Scale (MSAS), Functional Assessment of Chronic Illness Therapy- Spiritual Well-being (FACIT-Sp) scale, and socio-demographic questionnaire. Exploratory factor analysis was used to group symptoms into clusters, and multiple linear regression was used to explore the symptom clusters that predict spiritual well-being. Results: The most prevalent symptoms among women with breast cancer were fatigue, anxiety, tension, and pain. All these symptoms have a prevalence greater than 50%. Three clusters were found: treatment-related symptom cluster consisting of eight symptoms, gastrointestinal symptom cluster consisting of seven symptoms, and psychological symptom cluster consisting of five symptoms. The psychological symptom cluster was the only cluster predicting the women's spiritual well-being (t (141) = -3.049; p < 0.01). Conclusion: Women with breast cancer experience several concurrent symptoms and symptom clusters. Screening for psychological symptom clusters and their treatment improves patients' spiritual well-being. The majority of women with breast cancer did not receive any complementary therapies and hardly any spiritual or psychological support, which should be provided in the future to support their spiritual well-being.

The effect of spiritual well-being on symptom experience in patients with cancer.

PURPOSE: To explore the effect of spiritual well-being on the symptom experience of patients with cancer. METHODS: This is a cross-sectional survey that enrolled 459 patients with cancer from three large hospitals in Jordan in 2018. Participants completed questionnaires related to demographic data, spiritual well-being, and symptom experience. Additional information was obtained from the medical record review. We then conducted multiple regression to evaluate if spiritual well-being predicts the patients' reported symptom distress. RESULTS: Patients reported thirty-six symptoms. Of which 15 have a prevalence of more than 30%. Fatigue was the most prevalent symptom (n = 282, 61.4%), followed by pain (n = 243, 52.9%) and anxiety (n = 230, 50.1%). Spiritual well-being predicted 7.1% of the total variance in patients' symptom distress (F, 19.650; p < 0.0001). Additional predictors were gender, education level, having a problem covering the treatment cost, family cancer history, and whether taking a complementary treatment or not. CONCLUSIONS: Patients with cancer experience multiple symptoms related to the disease and its treatment. Improving patients' spiritual well-being through an increased sense of meaning and peace can improve cancer symptom experience by decreasing symptom distress. In general, hospitals in Jordan focus on direct symptom management and do not look after patients' spiritual needs. Raising awareness about the importance of patients' spiritual well-being and providing appropriate spiritual assessment and interventions to patients with spiritual distress can improve patients' symptom experience.

Jordanian nurses' perception and interventions related to promoting smoking cessation.

AIMS AND OBJECTIVES: To determine nurses' perceptions related to smoking cessation, health promotion and interventions provided to hospitalised patients. BACKGROUND: Smoking is a major health problem in Jordan. The cost for treating smoking-related health conditions is a significant strain on the healthcare system. Nurses are in an ideal position to encourage smoking cessation. Little is known about Jordanian nurses' perceptions related to smoking cessation issues. METHODS: A qualitative design was used to collect data from 22 Jordanian nurses using focus groups. Purposive sampling was used to select the study participants. Content analysis was conducted, to determine themes related to the research questions. RESULTS: Nurses indicated that smoking cessation counselling is important. However, they did not feel that their counselling was very effective. Nurses indicated that the presence of a well-defined hospital policy regarding smoking was a facilitator to smoking cessation and antismoking clinics would also help to decrease smoking. Challenges to nurses' interventions included lack of hospital policy, lack of time and nurses who smoke could not be role models or provide effective counselling. Regarding decreasing smoking in Jordan, nurses had suggestions that included scare techniques and increasing taxes on cigarettes as well as enforcing policies that prevent cigarette sales to children under 16. CONCLUSIONS: Nurses are well aware of the hazards of smoking and indicate a belief that encouraging smoking cessation is an appropriate activity. Changes in smoking rules and the enforcement of rules, as well as increased public health efforts related to smoking cessation, are necessary to decrease smoking prevalence in Jordan. RELEVANCE TO CLINICAL PRACTICE: Training in smoking cessation counselling and increased awareness of the resources may increase nurses' ability to have an impact on decreasing the smoking prevalence in Jordan.

Analysis of the pattern of acute poisoning in patients admitted to a governmental hospital in Palestine.

The objectives were to (i) analyse the pattern of poisoning and (ii) study gender distribution and management protocol of poisoning in patients diagnosed with acute poisoning. A retrospective analysis of cases diagnosed with acute poisoning and admitted to the emergency department of Al-Wattani governmental hospital during the year of 2008 was carried out. Data from patients' medical files were collected and then analysed using Statistical Package for Social Sciences (spss; SPSS Inc., Chicago, IL, USA), version 16. There were 674 cases diagnosed with acute poisoning in 2008 which accounted for 1.5% of the total admission to the hospital. The mean age of the cases was 21.8 ± 18.1 years. Approximately, 58% of poisoning cases occurred at home. Male to female ratio was 1.5:1. The maximum number of poisoning occurred during summer season. Poisoning cases were maximum in the age category >18 years. More than half (92%) of the cases were of unintentional type of poisoning. Unintentional poisoning was significantly more common among males (61.3%; p < 0.01), while intentional was more common among females (64.8%; p < 0.001). The causative agents encountered were mainly biological agents (77.4%), pharmaceuticals (11.6%), and other chemicals (10.9%). The most common route of poisoning was through stings (72.3%), followed by oral ingestion (23.5%) and inhalation (3.4%). The majority (91.1%) of cases did not undergo any decontamination methods. Of those who had decontamination procedure, gastric lavage was the most commonly used. This is the first study in Palestine that presents data on the pattern of acute poisoning. Awareness campaigns should be held about potentially toxic materials in the region, and methods of poison prevention should be spread among the public.

Seizures and sodium hydrogen exchangers: potential of sodium hydrogen exchanger inhibitors as novel anticonvulsants.

Advances in the understanding of mechanisms underlying the pathophysiology of epilepsy have led to the identification of sodium hydrogen exchanger (NHE) as one of the possible targets for future antiepileptic drugs (AEDs). There are indicators from several experimental studies that NHE inhibitors could be of significant value as potential anticonvulsants. Various in-vitro reports (brain slices) have suggested anticonvulsant potential of these agents. Recently we provided the in-vivo data on anticonvulsant efficacy of amiloride (an NHE inhibitor) in different animal models of seizure and epilepsy. In addition to blocking NHE, these agents are known to affect other traditional targets like voltage-gated Na(+) channels, Ca(2+) channels, glutamate concentration, etc. Thus NHE inhibitors may represent a novel class of AEDs and surely deserve more scientific attention. In this review, we focus on the role of NHE in epilepsy and provide the experimental evidence available so far on the effect of NHE inhibitors in various animal models.

Anticonvulsant effect of amiloride in pentetrazole-induced status epilepticus in mice.

Inhibition of sodium hydrogen exchangers (NHE) has been shown to diminish seizure activity in various in vitro and in vivo models of epilepsy. In the present study, we examined the effect of amiloride, a sodium hydrogen exchanger inhibitor, against pentetrazole (PTZ)-induced status epilepticus (SE). The study was conducted in mice and status epilepticus was induced by administering ip 50 mg/kg of phenytoin followed 2 hour later by PTZ, 100 mg/kg sc. Amiloride produced dose-dependent protection against PTZ-induced SE.