The Lived Experience of Jordanian Parents of Children with Cystic Fibrosis: Qualitative Study.

BACKGROUND: Cystic fibrosis (CF) is a common autosomal recessive disease with an incidence of 1:2560 live births in Jordan. It affects the quality of life for both the child and the parents. In Jordan knowledge about parents' experience with children diagnosed with CF is limited. PURPOSE: The purpose of this study was to describe and explore the lived experience of parents of children with CF, and the difficulties and challenges they face. DESIGN AND METHOD: A qualitative phenomenological method was used. Twenty-five parents of children with CF were interviewed. The Scribber thematic analysis was used in data analysis. RESULTS: Four themes emerged. First, "Falling into the circle of suffering", Second, "The circle of suffering", with two sub-themes: the challenges, and the limitations in daily life. Third, "Coping within the circle of suffering", with four sub-themes: focus on problems, focus on emotions, social and economic factors, and spirituality. Fourth, "Future outlook", with two sub-themes: optimism about the future, and pessimism about the future. CONCLUSION: Parents of children with CF suffer from difficulties and challenges that limit their daily lives. PRACTICE IMPLICATIONS: Education is needed for health care providers, society and parents about CF; and parents need support to improve their quality of life.

From Learning on Mannequins to Practicing on Patients: Nursing Students' First-Time Experience of Clinical Placement in Jordan.

INTRODUCTION: Although clinical nursing placement is an indispensable component of student nurses' education, data on students' first clinical experiences is scarce in developing countries. OBJECTIVES: The study aim is to uncover nursing students' first-time clinical placement experience and identify related influencing factors in Jordan.Methods: Focus group discussions (n=4) were used. RESULTS: The results showed that the transition from learning with mannequins to practicing on real patients in the clinical placement involved both effective learnings through hands-on practice to dealing with clinical challenges. Students perception of nursing ranged from positive comments such as "humanistic" and "nursing almost medicine" to negative images such as "nursing is all about bedside care" and "nursing has poor social status." CONCLUSION: Students' experience in their first clinical placement is multifaceted, and incorporation of student's perspective in the first clinical placement is a crucial component of educational planning.

Nursing students' experience of clinical supervision and contributing factors in Jordan.

BACKGROUND: Although clinical supervision is a vital component of nursing education, data on students' experiences of clinical supervision and contributing factors remain limited. AIM: The study explores nursing students' experience of clinical supervision and contributing factors in Jordan. DESIGN/METHODS: An explorative design with a qualitative approach using focus group discussions (n = 6) was used. A convenient sample consisting of 48 participants was recruited from second, third and fourth year nursing students. Data were thematically analysed using N VIVO 12. RESULTS: The analysis revealed two overlapping experiences. First, the empowering supervision experience comprising: "being willing and patient" and "working hand-in-hand" with students. Second, the disempowering supervision experience, including: abuse of power and grade obsession, incompetent supervision and lack of time detected for students. While the former has positivity which enhanced students' clinical learning, the latter reduced their motivation for gaining knowledge and skills and negatively impacted their self-confidence. CONCLUSION: Students' experience of clinical supervision is multifaceted. Thus, there is a pressing need for establishing a preparation programme for newly employed supervisors focusing on annual training updates, identifying their competency level and understanding the way their supervisory role is operationalised.

Do surgical patients' characteristics and behaviours affect nurses' pain management decisions? A qualitative inquiry.

BACKGROUND: Despite a growing body of literature investigating the impact of patients' age and sex differences on pain, there is little research on how patients' characteristics and behaviours affect nurses' pain management decisions. AIM: This study examined surgical nurses' views and experiences toward pain management in relation to the patients' characteristics and behaviours in a Jordanian university hospital. METHODS: Focus group discussions (n = 4) were used with a convenience sample of 27 female Registered Nurses. RESULTS: The study revealed differences in postoperative pain management related to patients' characteristics. Male patients were seen as more tolerant of postoperative pain than female patients and thus required less nursing attention. As a consequence, nurses might assess female surgical patients inaccurately or judgementally. Nurses label female patients as "demanding" or "over-sensitive" without intending to be judgemental. Nurses also reported that patients accompanied by relatives received quicker nursing responses and closer monitoring than unaccompanied patients. CONCLUSIONS: If patients' pain following surgery is to be treated effectively, health care policymakers and educators should work together to eliminate and prevent potential biases that might lead to disparities in pain management.

Barriers to nursing pain management in the emergency department: A qualitative study.

BACKGROUND: Although pain is a common complaint among patients presenting to emergency departments (EDs), there is a dearth of nursing literature about barriers to pain management. PURPOSE: The study aimed to uncover and understand barriers to pain management in the ED from the registered nurse (RN) perspective. METHODS: Semistructured interviews were conducted with 12 ED nurses in a Jordanian hospital. Data were collected throughout August 2016. RESULTS: Two broad categories with subcategories emerged. The first category describes the idea of types of patient, which included three particular groups. These were patients who are violent, patients with relatives who are, and patients with expectations of care that nurses view as unrealistic. The second category describes the taxing ED environment, with two subcategories of staff shortages and physician dominance of pain management. Nurses reported feeling as if they are the victims of external factors and perceived that barriers affected teamwork and led to distress which impairs pain management. CONCLUSIONS: The role of ED nurses in pain management is multifaceted. Therefore, implementing policies to overcome barriers such as violence among ED attenders and the perceived hostility of the ED environment through mandatory security systems, and continuing nursing education including for violence prevention may be beneficial.

Postoperative Patients in Jordan: Pain Prevalence, Characteristics, Beliefs, and Satisfaction.

BACKGROUND: Unrelieved postoperative pain contributes to soaring medical costs and poor quality of life. Whilst much has been written about postoperative pain prevalence in the literature, few empirical studies have explored pain care in Middle Eastern countries. AIMS: This study aimed to determine pain prevalence, its characteristics, beliefs and satisfaction among postoperative patients in Jordan. DESIGN: This is a descriptive survey design. SETTINGS: This study was conducted in a 200-bed Jordanian public hospital located in the southern province of Jordan. PARTICIPANTS: A convenient sample of 143 surgical patients was selected. METHODS: Data were collected by the American Pain Society Patient Outcomes questionnaire, Brief Pain Inventory scale and beliefs towards pain scale. Data were analyzed using SPSS version 21. RESULTS: Pain prevalence following surgery during the first 24 hours was 87%. The overall Mean of satisfaction of all participants was moderate (66.6%). The analysis found that the greatest interference of pain was with activity (Mean ± SD = 6.27 ± 3.30). The belief "people get addicted to pain medicine easily" was the most common misunderstanding (Mean ± SD = 3.48 ± 1.71). Male participants had worse average pain experience but were more satisfied with pain management than females (ps = .012, .017, respectively). Participants aged 30 or more had better pain management experience and satisfaction than those aged under 30 (p = .021). CONCLUSIONS: The study revealed high pain prevalence among surgical patients that remains undertreated. If patients' postoperative environment is to be a "Pain Free Zone", nurses' training programs and the application of various screening tools in the postoperative context taking into account the role of gender and culture are urgently needed.

Using Opioids With Surgical Patients: Nurses' Attitudes and Experiences.

Opioids such as morphine are effective analgesics and have been recognized worldwide for many years; yet, they are underutilized. The study explores the attitudes and experiences relating to opioids, in general, and morphine, in particular, among Jordanian surgical nurses. The Opioids Attitudes Scale was used. A total of 123 questionnaires were distributed, and 120 were returned, achieving a response rate of 96%. Focus group discussions (n = 4) were conducted with surgical nurses (n = 34). The majority of nurses believe that the addiction is the most serious side effects of opioids. Qualitative analysis revealed 2 major themes. The first theme was referred to as "not being in the same boat," highlighting a lack of teamwork, and comprised 2 subthemes: blame culture and physicians versus nurses. The second "morphine as the last on the list" was also made up of 2 subthemes: the lack of confidence and the fear of legal persecution. Nurses showed negative attitudes and misconceptions about opioids and morphine use within a fragmented surgical unit culture. Therefore, serious efforts must be made to create and sustain an effective unit culture reform and communications path from patient to nurse and doctor.

Nursing Documentation of Postoperative Pain Management: A Documentary Analysis.

BACKGROUND: Although proper documentation of pain for postoperative patients is essential to promote patient health outcomes, there is limited examination of nurses' documentation of pain management. PURPOSE: The purpose of this study was to qualitatively analyze nursing documentation of pain management among postoperative patients in Jordan. METHOD: A documentary analysis method was used. A purposive sample of 80 medical records were reviewed, and a total of 720 nursing records were analyzed. RESULTS: The analysis revealed that nurses' documentation of pain management was limited, vague, incomplete, and largely dependent on their subjective evaluation. Many of the documented goals were broad, not specific, not measurable, and with no time frame. CONCLUSIONS: Documentation patterns revealed a lack of proactive and systematic approach to pain assessment and management. Furthermore, there was little documented evidence of efforts to evaluate the effectiveness of pain management interventions. Findings have important implications for standardizing documentation of pain assessment, intervention, and evaluation.

Nurses' Knowledge, Attitudes, and Barriers Toward Pain Management Among Postoperative Patients in Jordan.

PURPOSE: The purpose of this study was to measure nurses' knowledge, attitudes, and barriers regarding pain management (PM) of postoperative patients in Jordan. DESIGN: A descriptive survey research design was used. METHODS: This descriptive study adopted a modified version of the "Knowledge and Attitudes Survey Regarding Pain" tool, administered to 120 nurses working in surgical wards. FINDINGS: Nurses had inadequate knowledge of PM, with a mean knowledge score of 63.9%. Knowledge of PM and attitudes toward PM were associated positively with the age of the participant (P = .001), years of experience in the surgical area (P = .026), and academic degree of participants (P = .026). CONCLUSIONS: Surgical nurses in this study had low knowledge levels and poor attitudes regarding PM in postoperative patients. Unless identified barriers to PM are seriously addressed, this vital aspect of holistic care will continue to be marginalized.