Spiritual Well-Being, Depression, and Stress Among Hemodialysis Patients in Jordan.

PURPOSE: The spiritual dimension of a patient's life is an important factor that may mediate detrimental impacts on mental health. The lack of research investigating spiritual well-being, religiosity, and mental health among Jordanian hemodialysis patients encouraged this research. This study explored levels of spiritual well-being and its associations with depression, anxiety, and stress. DESIGN: A quantitative, cross-sectional correlational study. METHOD: A sample of 218 Jordanian Muslim hemodialysis patients completed a structured, self-administered questionnaire. The data were analyzed using descriptive statistics and linear multivariate regression models. FINDINGS: The hemodialysis patients had, on average, relatively low levels of spiritual well-being, moderate depression, severe anxiety, and mild to moderate stress. The results of the regression models indicated that aspects of spiritual well-being were negatively associated with depression, anxiety, and stress, but only existential well-being consistently retained significant associations after controlling for religious well-being, religiosity, and sociodemographic variables. CONCLUSIONS: Greater spiritual and existential well-being of Jordanian hemodialysis patients were significantly associated with less depression, anxiety, and stress. It appears that these patients use religious and spiritual beliefs and practices as coping mechanisms to overcome their depression, anxiety, and stress. The implications for holistic clinical practice are explored.

The Disaster Preparedness Evaluation Tool: psychometric testing of the Classical Arabic version.

AIM: This paper is a report of a study conducted to translate the Disaster Preparedness Evaluation Tool into Arabic and to determine its psychometric properties, including reliability, validity and factorial structure. BACKGROUND: Worldwide numbers of natural and man-made disasters have greatly increased in recent years. Since disaster strikes without warning, all healthcare providers, especially nurses, must be prepared with appropriate skills and resources for disaster procedures and management during the three phases of disaster: pre disaster, during disaster and post disaster. Knowledge levels need to be evaluated to plan effective educational programmes. METHODS: The Disaster Preparedness Evaluation Tool was translated into Classical Arabic using Beaton's guideline for translation and validated by experts and a pilot study with 20 Registered Nurses from the target population. Data were collected in 2008 using self-administered questionnaires from 474 (79% return rate) Jordanian Registered Nurses who worked in randomly selected Ministry of Health hospitals and two university hospitals. RESULTS: Principal component analysis (Promax rotation with Kaiser Normalization procedure, SPSS version 15) was used to determined construct validity, and three factors explained 64% of the variance: knowledge, skills and post disaster management. Cronbach's alpha was 0.90, which demonstrated internal consistency. CONCLUSION: These results support the reliability and validity of the Disaster Preparedness Evaluation Tool as a measure of knowledge, skills and post disaster management. It can be used with confidence with an Arabic-speaking nursing population to measure their preparedness for disasters. Based on the results of such studies, effective disaster preparedness programmes could be developed to enhance nurses' disaster preparedness.

Thrombolysis utilisation in acute myocardial infarction in Bahrain.

We retrospectively studied 114 consecutive patients of acute myocardial infarction diagnosed in the Accident and Emergency department of our hospital, to determine the percentage of eligible patients who actually received thrombolytic therapy, the number of those excluded from receiving such therapy and the various exclusion criteria. We found that 66 patients (57.9%) received thrombolysis with either streptokinase or tissue plasminogen activator (tPA). The remaining 48 (42.1%) were excluded because of delayed presentation to hospital after the onset of symptoms (23.7%), old age or other contraindications. Although the percentage of thrombolysis utilisation in acute myocardial infarction in our centre is much higher as compared to others in the world, we find that there is a scope for improving these figures by reducing the number of patients excluded because of late presentation through health education and improved utilisation of ambulance services.