Missed Nursing Care in Medical and Surgical Wards in Jordan: A Cross-Sectional Study.

Missed nursing care is a multifaceted patient safety issue receiving increased attention among healthcare scholars worldwide. There is limited research on missed nursing care in the Jordanian healthcare context. The current study sought to examine the perceptions of Jordanian nurses toward the amount and types of missed nursing care in medical and surgical wards. We also examined the differences in missed care items between public, private, and university hospitals in Jordan. This was a cross-sectional study using the MISSCARE Survey tool. Data collection spanned 4 months between March and July 2021. The final study sample consisted of 672 registered nurses employed in five public, three private, and two university hospitals in Jordan. Data were analyzed using descriptive statistics, Analysis of variance, and Pearson correlation coefficent test. Of the 672 registered nurses who participated, the majority were females (n = 421; 62.6%). Most participants held a bachelor's degree in nursing (n = 577; 85.9%). The three most common missed nursing activities in the participating hospitals were: ambulation, oral care, and emotional support. Nurses working in public hospitals reported the highest missed nursing care. The age and number of patients under care significantly correlated with missed nursing care. The findings could help nursing managers develop plans to reduce missed nursing care in their healthcare institutions.

Postpartum depression among first-time Jordanian mothers: levels and associated factors.

Postpartum depression among first-time mothers is a sensitive issue and few studies were conducted related to this topic in developing countries including Jordan. Thus, this study purposed to assess postpartum depression levels and associated factors among Jordanian first-time mothers. A cross-sectional design was adopted, and 193 postpartum first-time mothers living in Amman governorate were recruited. A questionnaire consisting of two parts was used to record data, sociodemographic and maternal health, and Patient Health Questionnaire (PHQ-9). Findings showed that 34.1% of the women experienced postpartum depression. The employment, gravida, antenatal health problems, breastfeeding problems, newborn health problems, and availability of assistance during the postpartum period significantly correlated with postpartum depression. Thus, the understanding of postpartum depression and related factors would provide important empirical evidence for healthcare professionals and policy-makers when planning to develop strategies and measures to minimize postpartum depression among first-time mothers.

The Lived Experience of Critically-Ill Muslim Patients in Isolation.

PURPOSE: This study explored critically ill Muslim patients' experiences and perceptions related to confinement to isolation rooms. METHODS: The descriptive-interpretive lens of phenomenology was employed to explore and illuminate the isolation experience of critically ill Muslim patients). Semi-structured, face-to-face, audiotaped interviews were conducted . Colaizzi's method of data analysis, in combination with an interpretive analysis supported by van Manen's "lifeworld constituents" were used. RESULTS: Data analysis revealed four themes: Feeling isolated and imprisoned; losing basic patients' rights; feeling rejected by healthcare providers; and accepting isolation and its adversity. Findings were illuminated by applying van Manen's lifeworld constituents: spatiality, temporality, relationality and corporeality. The patients described the overwhelming impact of isolation on their physical, emotional, social and spiritual health. CONCLUSIONS: This study provides healthcare providers with an in-depth understanding of critically ill patients' physical, psychological and spiritual needs. Although the unique needs of Muslim patients are highlighted, it is evident that patients' suffering in isolation is universal. Healthcare providers are encouraged to consider creative measures to support and help patients cope with the adversity of isolation.

Fears and uncertainties of expectant mothers during the COVID-19 pandemic: trying to reclaim control.

PURPOSE: The novel coronavirus disease (COVID-19) outbreak has exponentially spread across the globe and formed one of the greatest health threats in history. Pregnant women are vulnerable, and their vulnerability is amplified by the associated containment measures of the pandemic. In this study, we aim to explore and describe expectant mothers' experiences during the lockdown of COVID-19. METHOD: A qualitative descriptive design was used. Eighteen pregnant and postpartum women were recruited through purposive and snowball sampling. Semi-structured phone call interviews were conducted by a female researcher. Braun and Clarke's thematic data analysis was followed. RESULTS: Three main themes are developed: (1) Living with fears and uncertainties amid the COVID-19 pandemic, (2) Lockdown disrupting the normalcy of pregnancy, (3) Trying to control the chaos of life. Five subthemes underlined the three themes. CONCLUSION: Findings portrayed expectant mothers' uncertainties, fears, and the fragility of the healthcare systems in responding to mothers' needs during the COVID-19 pandemic. Although the pandemic has resulted in disruption of the normalcy of pregnancy, mothers sought adaptive means to protect themselves and maintain control. Governmental authorities and healthcare providers are directly responsible to maintain considerate perinatal care services for expectant mothers during lockdown and crises.

Parents' Experience of Having an Infant in the Neonatal Intensive Care Unit: A Qualitative Study.

INTRODUCTION: Admission to the neonatal intensive care unit (NICU) is usually unexpected and can be stressful to the parents causing strenuous psychosocial effects. Parents of these infants are subject to suffering stress, depression, and feelings of powerlessness. This study aimed at describing parents' experience of having their infant in the neonatal intensive care unit. METHOD:  A qualitative descriptive design was used. Parents (six couples and four mothers) of infants hospitalized for at least ten days regardless of gestational age, gender, or medical diagnosis were selected from a teaching hospital in Amman, Jordan. Semi-structured interviews were conducted between June 2019 and November 2019. RESULTS:  Thematic analysis of the data revealed four emerging themes: (1) Living the ambiguities of the admission to the NICU, (2) Living the burdens of their infants' hospitalization, (3) Coping with the stresses of a hospitalized infant, and (4) Reflecting on interactions with healthcare staff and the environment. DISCUSSION AND CONCLUSION:  The study findings demonstrated parents' worries and needs and highlighted the use of spirituality/religiosity as a coping mechanism. The findings will guide healthcare providers and policymakers to develop caring strategies that enhance care delivered to parents of infants in intensive care units.

The health-related quality of life of Syrian refugee women in their reproductive age.

BACKGROUND: Health-Related Quality of Life (HRQoL) for refugee women in reproductive age is highly affected by physical, political, psychosocial and environmental conditions in countries of asylum. HRQoL is enormously affected by the satisfaction of this vulnerable group with the physical, psychological, emotional and social care services provided in this critical time. Therefore, this study aimed toassess the HRQoL among Syrian refugee women of reproductive age living outside camps in Jordan. METHODS: A cross-sectional correlational study was conducted with a convenience sample of 523 Syrian refugee women in the host communities in Jordan.Health-related quality of life (HRQOL) was measured using the short-form 36 (SF-36) questionnaire. RESULTS: Significant negative correlations were found between SF-36 individual subscales score and the length of marriage, the number of children, parity and family income. The strongest correlations were between pain scale and length of marriage (r =  - .21), and between Energy/Fatigue and 'number of children' (r =  - .21). Conversely, antenatal care was positively correlated with physical, role emotional, pain, and general health. Physical functioning and general health were predicted significantly with less years of marriage, younger age at marriage, less violence and by higher family income. CONCLUSION: This study suggests low HRQoL scores for women of reproductive age across all domains. Several factors such as years of marriage, age at marriage, the number of children, violence, antenatal care and family income affected the women's general health. The provision of appropriate and accessible reproductive and maternal healthcare services in antenatal visits is critical for ensuring the immediate and long-term health and wellbeing of refugee women and their families.

Knowledge, Attitudes And Practices Of Syrian Refugee Mothers Towards Sexually Transmitted Infections.

PURPOSE: Refugee women are vulnerable to sexually transmitted infections (STIs) due to risk factors associated with displacement. This study aimed to assess the knowledge, attitudes, and practices related to STIs among Syrian refugee mothers in Jordan. METHODS: A cross-sectional correlational study was conducted with a convenience sample of 523 Syrian refugee mothers in host communities in Jordan. RESULTS: A moderately positive relationship between the mothers' knowledge of and attitudes towards STIs (p<0.001) was found. Although Syrian refugee mothers' attitudes towards STIs were reasonably good, they had poor knowledge about non-HIV causes of STIs and clinical symptoms. Spousal acceptance of using a condom was significantly associated with mothers' STIs knowledge, attitude, length of being a refugee in Jordan and duration of marriage (p<0.05). Almost all Syrian refugee mothers (91.6%) and their spouses (95%) did not follow regular check-ups for STIs. Two-thirds of mothers'- spouses (66.6%) did not accept the usage of a condom during sexual intercourse. CONCLUSION: Syrian refugee mothers have poor knowledge about non-HIV causes of STIs and clinical symptoms. They have poor practices concerning STI screening and prevention. It is imperative that nurses address these issues especially among refugees where in locales where resources are scarce.

Assessing the association between fatigue and functional status during postpartum.

OBJECTIVE: Fatigue and decreased functional status are common health concerns during postpartum. Although studied separately in the past, this study assessed levels and explored the relationship between these two variables. METHODS: A cross-sectional correlational study was conducted with a convenience sample of 315 women to measure levels and assess the association between fatigue and functional status during postpartum. RESULTS: Moderate levels of fatigue and functional status were found. Fatigue levels and functional status were significantly higher in multiparas compared to primiparas, and fatigue was significantly higher in women who had cesarean births compared to vaginal births. Additionally, no significant correlation was found between fatigue and functional status during postpartum in this study. CONCLUSION: The lack of a statistically significant association between fatigue and functional status warrants further research since limited studies have been conducted. Findings of this study may assist healthcare providers in planning and implementing holistic assessment and care for women in postpartum.

Initiation and continuation of breastfeeding among Jordanian first-time mothers: a prospective cohort study.

OBJECTIVE: This study aimed to examine the rates of initiation and continuation of breastfeeding (BF) and their relationship with mothers' sociodemographic, obstetric, neonatal, and medical interventions. METHODS: Data were collected from 199 first-time Jordanian mothers using medical records, face-to-face interviews within 24 hours of birth, and two telephone interviews at 6 weeks and 6 months after birth. RESULTS: The rate of BF initiation within the first 4 hours after birth was only 13%. The rate of exclusive BF at 6 weeks was 25.5%, and this rate dropped to 2.1% at 6 months. Mothers who initiated BF before discharge were older, were employed, had normal vaginal birth, and had undergone antenatal or after-birth BF education. Infants' birth weight or gender was not interrelated with BF initiation. There was no relationship between initiation and continuation of BF and use of medications for labor pain or for induction/augmentation. The only significant relationship was found between the dose of ergometrine and BF failure and painful BF at 6 weeks. CONCLUSION: There is a need for increasing health care providers and public awareness about the role of intrapartum medications and procedures on the initiation and continuation of BF at 6 weeks and 6 months after birth.

Mindfulness-Based Interventions Among Adolescents With Chronic Diseases in Clinical Settings: A Systematic Review.

INTRODUCTION: We aimed to determine the benefits/efficacy of mindfulness-based interventions (MBIs) implemented among adolescents with chronic diseases in clinical settings. METHODS: An electronic search of PubMed, CINAHL, and PsycINFO databases was conducted in November 2017 to identify studies in which mindfulness was the primary intervention delivered for adolescents with chronic diseases to improve psychological and physical health. RESULTS: Nineteen eligible studies were included in this review. Fifteen studies included adolescents with psychiatric or pain disorders, and four included adolescents with a chronic physical disorders. Psychological outcomes and pain were examined in most studies with effect sizes for MBIs ranging from small to large. DISCUSSION: MBI studies conducted in clinical settings mainly engaged adolescents with psychiatric or pain disorders. The effectiveness of MBIs on improving psychological outcomes were inconsistent. Large randomized trials are needed to examine the effectiveness of MBIs and should expand to include adolescents with chronic physical diseases.

Assessing Intimate Partner Abuse: Associated Factors and Health Consequences among Jordanian Women.

In this cross-sectional study, we assessed levels and types of psychological and physical intimate partner abuse (IPA), and the association of IPA with socio-demographic factors and health consequences. The Abusive Behavior Inventory was completed by 471 Jordanian women. IPA was higher among older women who were: of older age, of younger age at marriage, married to unemployed spouses, living in urban residence, and of lower educational level. IPA was associated with most of the health problems except dental injuries and burns. We recommend educational programs that raise women's awareness to their rights to education, free choices in marital age, and policies that mitigate IPA in Jordan and similar patriarchal societies.

'Half a woman, half a man; that is how they make me feel': a qualitative study of rural Jordanian women's experience of infertility.

Infertility is a health problem encompassing physical, psychological and social consequences that may threaten women's quality of life. Few studies have been conducted in Jordan examining rural women's experiences of infertility. This study aimed to explore responses to infertility and its consequences in the Jordanian rural sociocultural context. Using a descriptive qualitative design, data were collected between April and September 2016 from a fertility clinic in a military hospital in Northern Jordan. Semi-structured interviews were conducted with 14 purposively selected Jordanian women. Data were analysed using thematic analysis. Findings revealing women's responses to infertility included: submission and docility, self-isolation, internalisation and persistence in getting pregnant by seeking modern and traditional methods of treatment. The impact of infertility complicated women's everyday living through their experiences of violence, kinship and patriarchal interference, stigma, negative perceptions of the infertile woman, and other's surveillance of their sexuality. Women living in rural areas of Jordan have negative experiences of infertility that are ingrained in sociocultural beliefs about fertility and reproduction. Healthcare professionals are encouraged to raise public awareness about infertility's adverse consequences and to help families by enhancing positive responses to infertility.

Demographic, maternal, and infant health correlates of post-partum depression in Jordan.

This cross-sectional correlational study examined post-partum depression and its relationship with demographic, maternal, and infant health problems in urban Jordanian women. Participants (n = 315) were selected from five maternal child healthcare centers and one major hospital in Amman, Jordan. Patient Health Questionnaire-9 was used to measure post-partum depression within 12 weeks of birth. A number of socio-demographic and health problems were examined for an association with post-partum depression. Results showed that 25% of post-partum women suffered moderate to severe depression and 50% of the sample had mild depression. None of the socio-demographic variables (age, education, employment, income) were significantly related to post-partum depression; however, two obstetric/infant variables (mode of birth and breastfeeding), were significantly associated with post-partum depression. There was a significant association between post-partum depression and 15 health problems of obstetric, gynecologic (i.e. episiotomy pain, infection), and general health conditions (i.e. fatigue, headache). Nurses and midwives need to emphasize post-partum depression screening, follow-up, and proper management of maternal and infant health factors predisposing to post-partum depression rather than merely focusing on women's inherent demographic factors.

An ethnographic-feminist study of Jordanian women's experiences of domestic violence and process of resolution.

We interviewed 12 Jordanian women who had experienced domestic violence (DV) and were receiving assistance at the Jordanian Women's Union (JWU). Our aim was to explore the history and factors supporting attainment of freedom from DV. Narratives revealed themes of DV toward girls; forced marriage; physical, psychological, or sexual abuse before and during marriage; and escalation and enduring DV. Escaping from DV required family and JWU support. In the context of a strongly patriarchal, religious society, we observed a process of resolution by shifting cultural values and themes of empowerment, with an undercurrent of suffering blamed on inequalities in the legal process.

Evaluating the mental health of Jordanian women in relationships with intimate partner abuse.

This study evaluated the mental health consequences of abuse among Jordanian women and tested the effectiveness of using cognitive behavioral interventions to change the level of depression and level of stress among Jordanian women experiencing intimate partner abuse (IPA). A mixed methods design using phenomenology and quasi-experimental research data collection and analysis was implemented. The most commonly reported form of abuse was psychological abuse. Prior to cognitive behavioral intervention, participants demonstrated moderate to severe levels of depression, low levels of perceived social support, moderate to high levels of self-efficacy, and used approach coping skills more frequently than avoidance coping. Cognitive behavioral interventions resulted in decreased depression (p = .003) and decreased stress levels, although this finding did not reach significance (p > .05). Cognitive behavioral interventions are effective interventions when working with women experiencing IPA.

Plunging arteriovenous malformation in the floor of the mouth: a case report.

An arteriovenous malformation (AVM) is composed of abnormal communications between arteries and veins without the normal intervening capillary bed. An 11-year-old male presented with a painless, doughy submandibular mass. Surgical excision was performed through an intraoral approach; the mass and the surgical field, did not exhibit any significant intraoperative bleeding typical of vascular lesions. Histopathological examination of the specimen revealed a diagnosis of an AVM, with the presence of organizing thrombi within arteries and veins. These abundant thrombi, previously unreported in the arterial part, may explain the negligible intraoperative bleeding.

Competence assessment of nursing graduates of Jordanian universities.

This cross-sectional survey assessed the level of competence of nursing graduates of Jordanian universities (2001-2004 cohorts) in relation to the type of university, sex, hospital type, and working area. A convenience sample (n = 258) of full-time nurses (6 months-4 years' experience) was selected from public, private, and teaching hospitals. A specifically designed tool with a rating scale of 1-5 was used to evaluate the nurses' competence in five nursing competencies (management, professionalism, problem-solving, nursing process, and knowledge of basic skills). The findings showed a satisfactory competency level with no significant differences related to the type of university or sex. General ward nurses scored significantly better than those in intensive care units in relation to management, professionalism, and nursing process, while the teaching hospital nurses showed significantly better performance in professionalism and management skills than did the nurses in the other two sectors. We recommend that nurse recruitment policies should consider individual competencies rather than innate characteristics in their selection of employees.

Jordanian nursing students' knowledge of osteoporosis.

The aim of this study was to explore baccalaureate nursing students' knowledge of osteoporosis for beginning practice in the community. A cross-sectional study design was used. Students were selected by convenience sampling (n = 85) from one University in Jordan in the final of 4 years. Students were asked to complete a 23-item-knowledge questionnaire based on two earlier published studies of osteoporosis. Results indicated poor level of knowledge of osteoporosis on all dimensions: prevention (11 items) 62.6%; SD 14.2; general (5 items) 59.5%; SD 20.6; and the pathophysiology (7 items) 39.6%; SD 15.6, and an overall mean grade of 54.9%; SD 10.3. This result provides information that graduating nursing students have limited knowledge to undertake the role of health promotion and disease prevention in the community.

An epidemiological overview of diabetes across the world.

Once the Cinderella of chronic diseases, diabetes mellitus is now fast emerging as one of the biggest health catastrophes the world has ever witnessed. Almost 6% of the world's adult population now live with diabetes (Sicree et al, 2003; International Federation of Diabetes, 2006). It has been predicted that the total number of people with diabetes will rise to 366 million in less than 30 years if preventative action is not taken (Wild et al, 2004). Diabetes is no longer a concern of an individual country. It has huge global and societal implications, particularly in developing countries where the development of diabetes at an early age can lead to untoward human suffering, disability and socioeconomic cost. An internationally coordinated effort is required to improve human behaviour and lifestyle to halt the global diabetes epidemic and the development of such complications as retinopathy, nephropathy, neuropathy, cardiovascular diseases, peripheral vascular diseases and stroke. For such a formula to be successful, it is important for nurses to be proactive in their political role in ensuring that people with diabetes become expert in their condition. In so doing, healthcare systems and resources could be used more effectively to reduce real human and economic costs.