A narrative inquiry into the communication experiences of mothers caring for children with cancer in Jordan.

BACKGROUND: This study aims to investigate the parenting experiences of mothers who care for children with cancer in Jordan and specifically focuses on the communication experiences of mothers who care for children with cancer. METHODOLOGY: A qualitative research design employing a narrative inquiry methodology was adopted; it employed the implementation of twenty semi-structured interviews with the mothers of children with cancer recruited from one pediatric hospital located in Amman, Jordan. FINDINGS: The findings of this study reveal that the majority of mothers attempted to conceal or delay any discussion regarding the diagnosis with their child, particularly during the immediate post-diagnosis period. Additionally, the mothers expressed that their relationships with the parents of children diagnosed with the same illness contain positive and negative aspects. Finally, most mothers participating in this study praised the role of hope in helping them cope with the challenging health condition of their children. CONCLUSIONS: The findings of this study reveal that mothers would withhold diagnostic information from their children for several reasons: firstly, they wished to safeguard their children from feelings of distress; secondly, they perceived that their children were too immature to fully comprehend the seriousness of their diagnosis; and, finally, they desired to protect their children from unnecessary fear and negative emotions. PRACTICAL IMPLICATIONS: Pediatric cancer care requires effective communication between physicians, pediatric nurses, caregivers, and children; clear and accurate communication between healthcare providers and parents of children with cancer ensures that they fully understand the diagnosis and can make values-based decisions.

Neonatal Intensive Care Unit Nurses' Knowledge and Use of Sucrose for Neonatal Pain Management in Saudi Arabia.

Introduction: Sucrose is an evidence-based intervention used for short-term pain management and distress from minor procedures. Limited research exists on nurses' knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. Objective: To assess nurses' knowledge and use of sucrose in Neonatal Intensive Care Units in Saudi Arabia. Methods: A cross-sectional online survey was used to collect data from a convenience sample of 68 neonatal intensive care nurses in Saudi Arabia. A modified tool assessed the knowledge and use of sucrose. Logistic regression analysis was used to find the predictors for sucrose use. Results: Most respondents never used sucrose for neonatal pain management and did not receive any training on sucrose. The mean knowledge of nurses regarding sucrose and its use was very low (38%): 16% had a high level of knowledge regarding sucrose, 13% moderate, 19% low, and 52% very low. Nurses who received training on sucrose use and nurses who read or heard about sucrose predicted the use of sucrose. Conclusion: Nurses' knowledge and use of sucrose were inadequate. Interventional programs are needed to enhance the nurses' knowledge regarding sucrose and its use and to enhance the utilization of sucrose as a pain management intervention in the Neonatal Intensive Care Units in Saudi Arabia.

The Influence of Social Support on Self-Care Behavior among T2DM Patients.

Introduction: T2DM is a chronic health condition that requires routine self-care. Despite T2DM patients being able to manage self-care behaviors, psychosocial factors, including social support, have been considered effective in improving diabetic self-care behaviors. Objective: This study aimed at examining the influence of social support on self-care behavior among T2DM patients in Dr. Soliaman Fakeeh Hospital. Methods: This was a cross-sectional study. The study was carried out at Dr. Soliaman Fakeeh Hospital using a sample size of 192 T2DM patients. Data were collected using a self-administered questionnaire comprised of a demographic section, the Scale of Perceived Social Support (MSPSS) section, and the Diabetes Self-Care Activities Questionnaire (DSCAQ) section. The data were analyzed using descriptive statistics and inferential statistics. Results: The study analyzed data from 192 complete responses (91.86%) out of 209 respondents. Regarding gender, most of the respondents were female T2DM patients (n = 103, 53.6%), while males (n = 89, 46.4%) The highest level of social support was from the family (mean of 5.49). The highest performing self-care activity performed by the respondents was blood glucose monitoring (mean of 6.01). Analysis of the correlation between the Scale of Perceived Social Support (MSPSS) and the DSCAQ revealed positive and significant correlations (r = 0.370, p = 0.001). Conclusions: This study showed that social support influenced self-care behaviors in patients with T2DM. Therefore, interventions should be developed focused on enhancing the levels of social support and self-care behaviors.

Approach to Developing a Core Competency Framework for Student Nurses in Saudi Arabia: Results from Delphi Technique.

BACKGROUND: Competence, while firmly established as a primary conceptual framework in nursing education, continues to lack clarity and uniformity across borders and contexts. While a wealth of research has been carried out on the various dimensions of this concept, including the drafting and implementation of frameworks for nursing competence, no unifying international framework has been forthcoming. Indeed, the continued development of more localized approaches, based on geography or specialization, would appear to be the most realistic objective. It is incumbent on nurse educationalists and researchers to build on existing frameworks and develop evidence-based tested methodologies for competence assessment in localized contexts. Currently, there is a dearth of such evidence-based frameworks in the Middle East and in the Kingdom of Saudi Arabia (KSA) in particular. This study aimed to formulate and validate a competence framework for undergraduate nursing students in KSA. RESULTS: Following documentary analysis, framework drafting and a three round Delphi process, a consensus was reached as to elements, comprising six discrete domains, to be included. The identified competence domains provide a framework to guide the implementation of a competence-based assessment and move towards a competency-based curriculum for nursing education in KSA. CONCLUSIONS: The study concluded that providing a competency-based model and expanding and standardization of competency concept in different dimensions of nursing profession is a necessity; considering that clarification of the concept of competency, the recognition of its dimensions, characteristics and the factors affecting it help in determining the criteria and standardizing the competency tools.

Knowledge, Attitudes and Practices of Undergraduate Nursing Towards Novel Corona Virus (COVID 19).

BACKGROUND: The recent emerging respiratory disease caused by the novel type of Coronavirus has been named as COVID-19. This respiratory illness has received international attention and it is categorized as a high-threat disease in the US by the Center for Disease Control and Prevention. The purpose of the study was to assess the knowledge, attitude and practice of undergraduate nursing students towards COVID-19. METHODS: Descriptive cross-sectional design was used to assess knowledge, practice and attitudes of 255 undergraduate nursing students towards COVID-19. Study participants were recruited from the nursing college to Fakeeh College for Medical Sciences, between April and July, 2020. RESULTS: The results of study participants showed that undergraduate nursing students had moderate knowledge of COVID-19. Also, participants had high level of knowledge regarding nature of diseases and precautionary measures by health care providers' dimensions however, they expressed limited knowledge towards modes of transmission. Moreover, study participants demonstrated an optimistic attitude toward disease and good practice towards COVID-19. CONCLUSION: The study results revealed that the study's participants demonstrated good knowledge with favorable and accepted practice. This study suggests the importance of emphasis on infectious disease in the nursing curriculum.

Evaluation of the impact of a self-stigma reduction programme on psychosocial outcomes among people with schizophrenia spectrum disorder.

BACKGROUND: Self stigma is assumed to be more prominent in Jordanian society than in Western countries, reflecting a poor understanding of mental illness, collectivistic culture, and delay in accessing psychiatric care. AIM: The purpose of the study is to evaluate the effectiveness of a self-stigma reduction programme on self-stigma. METHODS: A randomized controlled trial was conducted from November 2017 to December 2018 with 278 people diagnosed with schizophrenia (PDwS). Participants were randomly assigned to receive a self-stigma reduction programme (psychoeducation, cognitive behavioural therapy and social skills training), or treatment as usual (TAU). RESULTS: PDwS in the intervention group experienced a greater reduction in the level of self-stigma (20.19 vs -0.62; p < 0.001) at post-intervention and (37.35 vs -0.66; p < 0.001) at six-month follow-up. CONCLUSIONS: The findings suggest that the self-stigma reduction programme has the potential to reduce self-stigma levels. TRIAL REGISTRATION: NCT04087954.

Psychometric evaluation of the Arabic version of the Irish Assertiveness Scale among Saudi undergraduate nursing students and interns.

BACKGROUND: Irish Assertiveness Scale is commonly used to examine the individual' level of assertiveness. There is no adequately validated Arabic instrument that examines the level of assertiveness among Arabic-speaking undergraduate nursing students. OBJECTIVES: The purpose of this study was to translate, then evaluate the psychometric properties of the Arabic version of the Irish Assertiveness Scale among Saudi undergraduate nursing students and interns. DESIGN: Cross-sectional survey. SETTINGS: Three nursing colleges from three provinces in Saudi Arabia: Riyadh, Eastern and Makkah provinces. PARTICIPANTS: 283 questionnaires were completed by 3rd and 4th year undergraduate nursing students, and nursing interns. METHODS: A standard procedure including forward-backward translation, cultural adaptation and pilot testing was adopted to translate the Irish Assertiveness Scale into Arabic language. Content validity was measured using content validity index. Scale reliability was measured using cronbach's alpha coefficient and mean inter-item correlation. The sample was randomly split, and exploratory and confirmatory factor analysis was then conducted on each sample to examine the construct validity of the proposed scale. A subsequent convergent validity and discriminant validity were also tested. RESULTS: The item-level content validity index ranged from 0.9 to 1.0, and the overall content validity index was 0.93. The exploratory factor analysis resulted in 23-items, four-factor solution explaining 49.4% of the total variance. The mean inter-item correlation for each factor ranged between 0.22 and 0.4. Cronbach's alpha coefficients for the overall scale was 0.80. The confirmatory factor analysis showed that the proposed four-factor solution had the best model fit. Whilst discriminant validity was supported in the new model, convergent validity was partially met. CONCLUSIONS: This study contributed toward establishing the Arabic version of the Irish Assertiveness Scale. Considering the limitations of the convergent validity demonstrated in the new instrument, a modified version of the Irish Assertiveness Scale might be needed to ascertain the most feasible model which best captures the level of assertiveness in Arabic cultural context.

Cancer related emergencies with the chief complaint of pain: Incidence, ED recognition, and quality of care.

BACKGROUND: Pain is the most common reason for cancer-related emergency department (ED) visits and a precursor of the urgency of oncological emergencies. PURPOSE: To identify the incidence of oncological emergencies with the chief complaint of pain and evaluate ED recognition and quality of care in managing the associated emergency. METHODS: This was a retrospective observational study of cancer patients presented to three EDs during the four-year study period. RESULTS: The study's sample consisted of 252 patients admitted with oncological emergencies with a chief complaint of pain. Some oncological emergencies were more likely to be prioritized appropriately, such as febrile neutropenia and increased intracranial pressure. However, most patients with spinal cord compression and cardiac tamponade were more likely to be triaged to less urgent triage categories. Timeliness of ED care was suboptimal for most patients, particularly among those assigned to less urgent triage categories. Indicators for the low quality of care extended beyond ED with multiple adverse events in the hospital. CONCLUSION: Triage nurses are expected to use the oncological emergencies' prevalent symptoms to allocate the patients to high triage urgency accurately. Patient waiting to be seen expected to be reassessed periodically to ensure waiting remain safe. Hospitals can adopt or establish pathways, protocols, or standardized order sets to fast-track patients with oncological emergencies. The health information system should be available to monitor and improve the delivered care continuously.

Primary caregivers experience of anti-psychotic medication: A qualitative study.

BACKGROUND: Management of schizophrenia is now shifted to the community setting and family caregivers are the primary caregivers. Managing medications is a complex responsibility of family caregivers caring for patients with mental illness. Medication compliance contributes to improve health outcomes and reduced hospitalization for the care service users; however, little is known about attitudes and perception of family caregivers. AIMS AND OBJECTIVES: To explore family caregivers experience towards antipsychotic medications. METHODS: A purposeful sampling of 21 family caregivers was included in the study. Semi-structured interview was employed to collect data from the participants between May and October 2015. Thematic analysis approach was used to identify the common pattern in the data. RESULTS: Four main themes emerged from the study: insight into illness (poor understanding of illness), treatment factor (thinking about medication, poor guidance for medication compliance), resources and support (availability of medication and cost of medication), health care provider factors (communication gap and poor assessment with follow-up, social dysfunction (social isolation, disruption in life routine) of the primary caregivers. CONCLUSIONS: Responsibility for providing care for patients with mental illness are taken place in the community setting and cared by family caregivers. More information resources are required for this role, which requires specific medication management skills and knowledge.

The value of caring behavior and its impact on students' self-efficacy: Perceptions of undergraduate nursing students.

BACKGROUND: Clinical instructors are the key mediators in helping students conquer clinical experiences by preparing them for clinical workplaces. The caring behavior of instructors plays an important role in the instructor-student relationship. OBJECTIVE: This study aimed to (a) assess the perception of nursing students of clinical instructors' caring behavior and (b) explore the correlation between their perception of instructors' caring behavior and their self-efficacy. DESIGN: A quantitative descriptive correlation design was adopted. SETTING: The sample was collected from the faculty of nursing at a major governmental university for females in the Kingdom of Saudi Arabia. PARTICIPANTS: A sample of nursing students (N = 200) was recruited. METHODS: The data were collected using the inventory for nursing students' perceptions of instructor caring (NSPIC) and general self-efficacy (GSE) scale. Descriptive and inferential statistics, such as Pearson r correlation and regression analysis, were used. RESULTS: The total mean of NSPIC was moderate to high (mean = 3.06, SD = 1.04). The level of GSE among students was high (mean = 3.45, SD = 0.849). NSPIC is significantly correlated with its GSE (r = .282). In addition, GSE turned out to be a major indicator of caring behavior, with P = .021 and R2 = 0.642. CONCLUSION: Caring relationships between clinical instructors and nursing students enable students to grow as caring professionals. Therefore, nursing programs must have highly qualified clinical instructors to teach and train students and be a good role model in the workplace.

The relationship between Internet addiction, psychological distress, and coping strategies in a sample of Saudi undergraduate students.

PURPOSE: This study aimed to investigate the relationship between Internet addiction (IA), psychological distress, and coping strategies. METHODS: Data were collected using a convenience sample of 163 student nurses. FINDINGS: The results showed that there was high prevalence rate of IA among students. In addition, the use of avoidance and problem-solving coping mechanism was statistically significant among the IA group compared with the non-IA group (P < .05). This was associated with a more negative impact on psychological distress and self-efficacy (P < .05). CONCLUSIONS: IA is an increasing problem in the general population and among university students. It can affect many aspects of a student life. PRACTICAL IMPLICATIONS: The results will raise awareness of the deleterious effects of IA on a wide range of student life.

Prevalence of internet addiction, its association with psychological distress, coping strategies among undergraduate students.

PURPOSE: This study aimed to describe the prevalence of Internet addiction (IA) among undergraduate students, and its impact on psychological distress and coping strategies. METHODS: Data were collected using a convenience sample of 163 student nurses. FINDINGS: The results showed that there was high prevalence rate of IA among students. In addition, the use of avoidance and problem-solving coping mechanism was statistically significant among the IA group compared with the non-IA group (p < 0.05). This was associated with a more negative impact on psychological distress and self-efficacy (p < 0.05). CONCLUSIONS: IA is an increasing problem in the general population and among university students. It can affect many aspects of a student's life and performance. PRACTICAL IMPLICATIONS: The results will raise awareness of the deleterious effects of IA on a wide range of student life.

Psychoeducational Interventions for People with Schizophrenia: Findings from the Systematic Reviews.

Aims: This systematic review examines the effectiveness of the psycho-educational interventions (PEIs) targeted at people diagnosed with schizophrenia and their primary caregivers on improving knowledge level of schizophrenia and health-related outcomes.Methods: A total of 28 studies were reviewed from December 1999 to May 2015. The methods described by Centre for Reviews and Dissemination were used to guide this review.Results: The PEIs showed consistent improvement in the knowledge level of schizophrenia among participants for various follow-up intervals. In addition, PEIs were found to be superior to treatment as usual in influencing health-related outcomes.Conclusions: Implications of the findings for mental health care practice and education and recommendations are discussed.

The effect of a family intervention on primary caregivers psychological outcomes: Findings from the integrative literature review.

AIMS: This literature review examines the effectiveness of the family interventions (FIs) targeted at the primary caregivers of people diagnosed with schizophrenia on improving the knowledge level of schizophrenia and health-related outcomes. METHODS: A total of nine studies were reviewed from December 1999 to May 2017. The methods described by the Center for Reviews and Dissemination were used to guide this review. RESULTS: The FIs showed consistent improvement in the knowledge level of schizophrenia among participants for various follow-up intervals. In addition, FIs were found to be superior to treatment as usual in influencing health-related outcomes. CONCLUSIONS: Implications of the findings for mental healthcare practice to include primary caregivers with the patient in the treatment process.

The correlation between occupational stress, coping strategies, and the levels of psychological distress among nurses working in mental health hospital in Jordan.

PURPOSE: Psychiatric nurses encounter variety of demanding and stressful events such as dealing with aggressive patients, and hostile. This study purposed to assess workplace stress, coping strategies, and psychiatric distress among psychiatric nurses. DESIGN AND METHODS: A descriptive explanatory design was employed. One hundred and nineteen psychiatric nurses were recruited in the study and data were collected in the period between June and September 2017. FINDINGS: The results showed that participants experienced moderate level of occupational stress and psychiatric distress. In addition, they utilized different coping mechanism. PRACTICE IMPLICATIONS: Stress management techniques program is very effective in helping psychiatric nurse to deal with occupational stress which might influence their wellbeing. Moreover, this program assists them to use more effective coping strategies as problem solving.

Determinants of quality of life among people diagnosed with schizophrenia at outpatient clinics.

PURPOSE: The study examines the determinants of the quality of life (QoL) among outpatients with schizophrenia in Jordan. DESIGN AND METHODS: A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. FINDINGS: The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was correlated positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. PRACTICAL IMPLICATIONS: The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.

Psychiatric nurses' knowledge, attitudes, and practice towards the use of physical restraints.

PURPOSE: This study examines the knowledge, attitudes, and practice of psychiatric nurses towards the use of physical restraint in Saudi Arabia. DESIGN AND METHODS: Descriptive explanatory cross-sectional design, 101 participants were invited to complete a set of questionnaires to assess the knowledge, attitude, and practice towards the use of physical restraint. FINDINGS: Participants had a moderate knowledge and attitude as well as practice in using physical restraint. Less than half reported that they recognized alternative approaches to physical restraint and most of them did not understand the reasons for the restraint. PRACTICE IMPLICATIONS: This study highlights some important misunderstandings of nurses about using physical restraint. The findings serve as a supporting reason for recognizing the importance of educating nurses about its use.

The correlation between the quality of life and clinical variables among outpatients with schizophrenia.

The study identifies the correlation between the quality of life (QoL) among outpatients with schizophrenia and clinical outcomes. A cross-sectional study design was used with 157 people with schizophrenia treated in outpatient clinics. Demographic, clinical and psychosocial variables were examined for their influence on QoL. Data were analysed with descriptive statistics, Pearson product moment correlation and stepwise forward multiple linear regression. The majority of the study participants were female, single, unemployed, had secondary level of education or less and were being supported financially by family members. QoL correlated negatively with advanced age, male gender, longer duration of illness, high body mass index and prescribed typical anti-psychotic medication. However, it was related positively with employment and being married. Illness duration, recurrent hospitalisation, knowledge level about schizophrenia, psychiatric symptoms and coping mechanisms were found to be key significant predictors of QoL among participants. The study findings enhance our understanding of socio-demographic, clinical and psychosocial characteristics influencing the QoL in people with schizophrenia. Involvement of families in the management process may improve patients' ability to be integrated in the community and be more socially active.

Occupational stress, coping strategies, and psychological-related outcomes of nurses working in psychiatric hospitals.

AIMS: Psychiatric nurses experience a wide range of stressful events, evolving from the care of violent, aggressive patients, recurrent relapse, and poor prognosis of mental disorders. The aim of the study was to assess workplace stress, coping strategies, and levels of depression among psychiatric nurses. METHODS: A descriptive correlation design was conducted on psychiatric nurses working in mental health settings Port-Said, Egypt. Data were collected from 70 nurses at a mental health hospital. RESULTS: The results revealed that psychiatric nurses had moderate levels of work-related stress and depression, and exhibiting different coping strategies. Stress and depression are prevalent among psychiatric nurses. CONCLUSIONS: Implementing programs aimed at teaching them how to deal with stress at work and improving their coping strategies and problem-solving skills are recommended.