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Aims and objectives: To assess and compare the quality of paper-based and electronic- based health records. The comparison examined three criteria: content, documentation process and structure. Background: Nursing documentation is a significant indicator of the quality of patient care delivery. It can be either paper-based or organised within the system known as the electronic health records. Nursing documentation must be completed at the highest standards, to ensure the safety and quality of healthcare services. However, the evidence is not clear on which one of the two forms of documentation (paper-based versus electronic health records is more qualified. Methods: A retrospective, descriptive, comparative design was used to address the study’s purposes. A convenient number of patients’ records, from two public hospitals, were audited using the Cat-ch-Ing audit instrument. The sample size consisted of 434 records for both paper-based health records and electronic health records from medical and surgical wards. Results: Electronic health records were better than paper-based health records in terms of process and structure. In terms of quantity and quality content, paper-based records were better than electronic health records. The study affirmed the poor quality of nursing documentation and lack of nurses’ knowledge and skills in the nursing process and its application in both paper-based and electronic-based systems. Conclusion: Both forms of documentation revealed drawbacks in terms of content, process and structure. This study provided important information, which can guide policymakers and administrators in identifying effective strategies aimed at enhancing the quality of nursing documentation. Relevance to clinical practice: Policies and actions to ensure quality nursing documentation at the national level should focus on improving nursing knowledge, competencies, practice in nursing process, enhancing the work environment and nursing workload, as well as strengthening the capacity building of nursing practice to improve the quality of nursing care and patients’ outcomes. [ABSTRACT FROM AUTHOR]

Introduction: Although Jordan has made significant progress toward expanding the utilization of facility‐based intrapartum care, prior research highlights that poor service quality is still persistent. This study aimed to identify quality gaps between women's expectations and perceptions of the actual intrapartum care received, while exploring the contributing factors. Methods: Utilizing a pre–post design, quality gaps in intrapartum care were assessed among 959 women pre‐ and postchildbirth at a prominent tertiary hospital in northern Jordan. Data were gathered using the SERVQUAL scale, measuring service quality across reliability, responsiveness, tangibles, assurance, and empathy dimensions. Results: The overall mean gap score between women's expectations and perceptions of the quality of intrapartum care was −0.60 (±0.56). The lowest and highest mean gap scores were found to be related to tangibles and assurance dimensions, −0.24 (±0.39) and −0.88 (±0.35), respectively. Significant negative quality gaps were identified in the dimensions of assurance, empathy, and responsiveness, as well as overall service quality (p < 0.001). The MLR analyses highlighted education (β = 0.61), mode of birth (β = −0.60), admission timing (β = −0.41), continuity of midwifery care (β = −0.43), physician's gender (β = −0.62), active labour duration (β = 0.37), and pain management (β = −0.33) to be the key determinants of the overall quality gap in intrapartum care. Conclusion: Our findings underscore the importance of fostering a labour environment that prioritizes enhancing caregivers' empathetic, reassuring, and responsive skills to minimize service quality gaps and enhance the overall childbirth experience for women in Jordan. Patient or Public Contribution: This paper is a collaborative effort involving women with lived experiences of childbirth, midwives, and obstetrics and gynaecologist physicians. The original idea, conceptualization, data generation, and coproduction, including manuscript editing, were shaped by the valuable contributions of stakeholders with unique perspectives on intrapartum care in Jordan. [ABSTRACT FROM AUTHOR]

Background: Poor medication adherence is a concern among patients with hypertension. However, few studies have assessed the effect of health literacy on medication adherence among refugee patients. Aim: The aim was to examine the effect of health literacy and associated factors in explaining medication adherence among Syrian refugee patients with hypertension. Methods: A cross‐sectional study was used, recruiting 150 Syrian refugees with hypertension in February 2020. The Hill‐Bone scale and the Health Literacy Questionnaire were used to collect data, which were analysed using descriptive and inferential statistics. Results: Participants had low levels of medication adherence and had low mean scores in eight of nine subscales of the health literacy scale, except in the appraisal of health information subscale. Factors including patient's age, marital status, the number of medications and co‐morbid diseases were significantly associated with medication adherence. Age, understanding written health information and ability to engage with healthcare providers were predictive of medication adherence. Conclusion: To increase medication adherence among refugee patients with hypertension, nurses need to improve patients' health literacy and understanding of health information about their disease. Summary statement: What is already known about this topic? Refugees report a higher prevalence of chronic diseases than non‐refugees due to a lack of available medications and limited access to health‐care services.Adherence to antihypertensive drugs is the cornerstone for accomplishing hypertension control.Health literacy is closely associated with better adherence to medications. What this paper adds? Syrian refugees diagnosed with hypertension showed low medication adherence.Age and level of understanding of health information were found to be factors that explained the level of medication adherence.Medication adherence was associated with the number of prescribed medications, the presence of other medical problems and marital status. The implications of this paper: To enhance medication adherence, healthcare providers, including nurses, should educate their patients about their diseases and medical regimes to enhance their health and health literacy.Further research is required to explain other personal factors, including patients' beliefs about their health and medications.Nurses, nurse managers and other healthcare professionals should develop and implement programs that address the individual needs of refugees to increase patients' levels of health literacy and medication adherence. [ABSTRACT FROM AUTHOR]

This study aims to evaluate medical students' impressions and attitudes toward scientific journal articles, and their accessibility to them in one of the developing countries, Jordan. Fourteen questions were asked to medical students to assess their knowledge and accessibility to papers, and to discover the impact of low interest in scientific papers on students' dealing with COVID-19. Data were analyzed using descriptive and analytical statistics. The study found that there is an unsatisfactory reading for scientific journal articles among medical students, with only 47.2% of students reading them. Furthermore, there are unsatisfactory results regarding students' knowledge about journal types from the trust perspective (i.e., predatory and reliable journals). This was mainly because of a lack of adequate universal teaching about scientific journal articles, as 86.7% of medical students reported that their universities do not teach them about scientific journal articles. The absence of comprehensive learning about scientific journal articles had a potential negative impact on the medical student's handling of COVID-19 socially (i.e., advising people in the community about vaccination importance, social distancing, and other preventive measures). Librarians should be involved primarily in undergraduate education related to scientific journal articles, and their role in providing subscription-based journals free of charge, as well as protecting students from predatory journals through suitable library instructions, is essential. [ABSTRACT FROM AUTHOR]

Aim: To explore the validity and reliability of the Missed Nursing Care Survey after translating it into the Arabic language. Methods: We employed a cross‐sectional design. We recruited 260 Jordanian nurses, and data were collected between May and July 2020. Translation, acceptability, construct, convergent, discriminant validity and reliability were investigated. Results: The factor analysis showed an adequate fit (three subscales) between the proposed missing care survey model and the observed data. This model reflected the survey's construct, convergent and discriminant validity, explaining 58.88% of the variance collectively. Confirmatory factor analyses showed adequate goodness‐of‐fit results (goodness of fit index = 0.91, comparative fit index = 0.94, increment fit index = 0.94, Tucker Lewis index = 0.92 and root mean square error of approximation = 0.06). The total Cronbach alpha and composite reliability achieved the criterion for all constructs in this survey. Conclusion: This Arabic version of the Missed Nursing Care Survey achieved the required level of validity and reliability. Measuring missed care and its reasons may help to improve quality of health services and assist nurse managers in designing appropriate interventions to reduce it. Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety. Summary statement: What is already known about this topic? The Missed Nursing Care Survey was designed to identify reasons for missed nursing care.The Missed Nursing Care Survey has been shown to be a reliable and valid measure among various populations and different languages. What this paper adds? The Arabic version of the Missed Nursing Care Survey was shown to be a valid and reliable tool.Measuring the quality and procedures of nursing care in the Arabic region will aid in understanding the differences between countries. The implications of this paper: Adoption of culturally acceptable instruments by health‐care policymakers may support patient safety.Measuring missed care and its reasons may help to improve the quality of health services and assist nurse managers in designing appropriate interventions to reduce it. [ABSTRACT FROM AUTHOR]

Background: Although many studies have discussed nurses' caring performance, few have focussed on critical care nurses. Also, none have studied this among newly graduated nurses despite their very different circumstances. Aim: The purpose of this study was to examine factors affecting the caring performance of newly graduated nurses in critical care units. Method: A descriptive cross‐sectional design, using self‐reported questionnaires, was used among a sample of 209 nurses interviewed in Jordanian hospitals. The Mental Health Professionals Stress Scale was used for measuring work‐related stress and the Caring Behaviours Assessment tool to assess caring performance. Data collection was conducted from March to May 2018. Results: The participants had moderate levels of caring performance (M = 182.6/315, SD = 15.46). The highest score was reported for 'Supportive/Protective/Corrective Environment' subscale, while the lowest for 'Teaching/Learning' subscale. Many significant differences were noticed in caring performance based on participants' demographics. Only working in private hospitals was a significant predictor for caring performance (P <.05) predicting 14% of variance. Conclusion: Caring performance of newly graduated nurses in critical care units was affected by many factors including workload, self‐doubt, income and area of working. The significance was flagged of developing nursing policies concerned with stress relief and improvement of caring performance. Summary statement: What is already known about this topic? Newly graduated nurses are known to have more work‐related stress compared to experienced nurses, which may lead to lower commitment toward work requirements and lower quality of nursing care.Nurses' caring performance is known to be affected by several factors which lead to impaired nursing performance and overall organizational productivity and quality of care. What this paper adds? This study explored the predictors of caring performance of newly graduated nurses' working in critical care units, which provides baseline data for future research.Lower levels of caring performance by newly graduated nurses was found to be associated with higher levels of work‐related stress.Working conditions seem to affect the caring performance of newly graduated nurses. The implications of this paper: More attention is needed regarding newly graduated nurses' caring performance by nursing management, which might influence their ability to provide higher quality nursing care.Policy makers and nursing managers should consider establishing specific interventional programmes directed toward reducing factors that affect newly graduated nurses' caring performance in critical care units. [ABSTRACT FROM AUTHOR]

Background: Secondary prevention is a priority after coronary revascularization for effective long‐term cardiovascular care. Coronary Heart Disease is a major health problem in Jordan, but little is known about the current provision of secondary prevention. Aim: The aim of this study was to evaluate risk factors and explore the current provision of secondary Coronary Heart Disease prevention among patients presenting with first‐time Coronary Heart Disease at two time points: during hospitalization (Time 1) and 6 months later (Time 2), in multicentre settings in Jordan. Methods: A descriptive, repeated measures research study design was applied to a consecutive sample of 180 patients with first‐time Coronary Heart Disease. Demographic and clinical details were recorded from medical files. Self‐administered questionnaires developed by the researchers were used to measure secondary prevention information related to Coronary Heart Disease, including secondary prevention services, lifestyle advice received and medical advice topics. A short form of the International Physical Activity Questionnaire was used to measure physical activity. Participants were assessed at Times 1 and 2. Results: Unstructured lifestyle advice given to the patients at Times 1 and 2 most frequently related to medications, smoking, diet and blood lipids control advice topics, with no statistically significant improvement in cardiovascular risk factors among patients between Times 1 and 2. Conclusion: Despite an extremely high prevalence of risk factors in this population, the provision of secondary prevention is poor in Jordan, which requires urgent improvement, and the contribution of nurses' to secondary prevention should be enhanced. Summary statement: What is already known about this topic? Cardiovascular diseases have relatively earlier onset and higher prevalence in the Middle East and North Africa. However, there is a limited knowledge about the prevalence of risk factors of cardiovascular diseases in the region.There is strong evidence that behavioural modification should be given high priority to help patients with Coronary Heart Disease to be compliant with healthy lifestyle behaviours.The prevalence of Coronary Heart Disease and premature mortality in the Middle Eastern countries is progressively increasing, indicating a lack of effective strategy. What this paper adds The prevalence of Coronary Heart Disease risk factors is still egregiously high in the Jordanian population.The secondary prevention strategy and lifestyle changes are insufficient among patients with Coronary Heart Disease in Jordan.Health policy makers are strongly recommended to establish cardiac rehabilitation programmes to reduce cardiac events and mortality in Jordan. The implications of the study Nursing administrations need to focus on secondary prevention strategies to minimize the risk factors of cardiovascular disease in developing countries.Nursing leaders in Jordan should develop health intervention programmes to help patients with Coronary Heart Disease change their lifestyles.Greater efforts are needed to stop progression of risk factors and improve secondary prevention in Jordan, and further studies are warranted, such as interventional studies to enhance secondary prevention for patients with Coronary Heart Disease. [ABSTRACT FROM AUTHOR]

Background: Job demand and job satisfaction in nursing profession have been identified as significant indicators of quality of nursing care. Job demand is the most influential job stressor and has been connected to negative consequences on nurses' ability to function. Purpose The purpose of this study was to examine the moderating effect of work locus of control on the relationship between job demand and job satisfaction among nurses working at public hospitals. Methods: A quantitative, cross‐sectional, correlational design was utilized to randomly recruit 427 registered nurses working at two major public hospitals. Data were collected using a self‐administered questionnaire regarding job demand, job satisfaction and work locus of control. Results: Work locus of control had a significant moderating effect on the relationship between job demand and satisfaction. External locus of control had a negative effect on the job demand and job satisfaction relationship, whereas internal locus of control positively buffered this correlation. Conclusion: This study adds a novel contribution to the body of knowledge that buffering effect of job demand among nurses is much dependent on appropriately enhancing internal locus of control, consequently improving job satisfaction. SUMMARY STATEMENT: What is already known about this topic? Nurses' job satisfaction is associated with nurses' job demand.Job demand is a multifaceted factor and interferes with quality of nursing care. What this paper adds? Enhancing locus of control will contribute to increase nurses' job satisfaction and buffer effects of job demand.External locus of control has negative effects whereas internal locus of control has positive effects on the relationship between job demand and job satisfaction among nurses.The domains of job demand vary in their influence on job satisfaction among nurses depending on its internal or external effect. The implications of this paper: Nurse managers and decision makers are required to focus largely on the external forces that influence nurses' job satisfaction.Domains of job demand need to be addressed by nurse managers in terms of how to effectively enhance internal locus of control and suppress external locus of control factors to improve nurses' job satisfaction.To improve quality of nursing care and practice, internal locus of control has to be sustained and external locus of control has to be managed. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to evaluate the compliance of Jordanian nurses with ventilator‐associated pneumonia prevention guidelines and the barriers to compliance. Method: A descriptive, cross‐sectional design was used. A convenience sample of 294 nurses from nine hospitals in Jordan completed a self‐reported questionnaire. Results: According to the study compliance categories, 45.6% of the participants reported 'insufficient compliance,' 24.8% 'weak compliance' and 29.6% 'sufficient compliance.' Nurses with more experience and previous education on ventilator‐associated pneumonia reported higher compliance scores than their counterparts with less experience and no previous education. Nurses reported several barriers that limited their own compliance, such as lack of education, lack of policies and protocols, lack of resources and the shortage of staff. Conclusion: The compliance of nursing staff with the prevention guidelines was poor. Applying tailored educational programs may help improve their level of compliance. These programs must target new graduate nurses and be conducted in those hospitals with limited resources. SUMMARY STATEMENT: What is known about this topic? Assessment of nurses' compliance with ventilator‐associated pneumonia (VAP) prevention guidelines is essential.Identifying barriers to compliance with VAP guidelines is the first step to improve the practice. What this paper adds? Compliance with VAP prevention guidelines in developing countries, such as Jordan, is still modest.Educational programs on VAP prevention improve the nurses' practice.Incidence of VAP rate should be linked to compliance rate with the prevention guidelines.Several barriers such as lack of resources and policies and shortage of staff interfere with nurses' compliance.Education and training of nurses would help to improve compliance and overcome barriers. The implications of this paper: Educating nurses in the clinical settings is imperative in order to prevent the occurrence of VAP.Providing human resources and supplies would help to prevent VAP. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to cross‐culturally translate and adapt the Cardiac Self‐Efficacy Questionnaire into Arabic and subsequently evaluate the psychometric properties of that translation in a population of Arabic patients. Method: The original English version of the Cardiac Self‐Efficacy Questionnaire was translated into Arabic following a process recommended by the World Health Organization. A convenience sample consisting of 268 Jordanian patients with coronary heart disease was recruited from a university‐affiliated hospital in Amman, Jordan. Data were collected from October 2018 to March 2019. The factor structure, face and content validities, and internal consistency of the Arabic Cardiac Self‐Efficacy Questionnaire (A‐CSEQ) were evaluated. Results: The factor structure analysis supported a three‐factor high‐order structure of the A‐CSEQ. Face validity showed that the language used, style, and format were clear. The content validity demonstrated a very good content validity index. The reliability was good with ranging from 0.89 to 0.93 for all questionnaire subscales. Conclusion: The A‐CSEQ is a valid and reliable instrument to assess the cardiac self‐efficacy of Arabic patients diagnosed with coronary heart disease. Further assessment of the psychometric properties of the A‐CSEQ with different cardiac problems is now recommended. SUMMARY STATEMENT: What is already known about this topic? Globally, cardiovascular diseases are the leading cause of death and are increasing progressively particularly in the Middle Eastern countries.High self‐efficacy level is associated with the adoption of a healthy lifestyle by patients with coronary heart disease (CHD).There is no valid and reliable Arabic tool to measure cardiac self‐efficacy among CHD patients comparable with the Cardiac Self‐Efficacy Questionnaire (CSEQ). What this paper adds? The Arabic version of the Cardiac Self‐Efficacy Questionnaire (A‐CSEQ) is a valid and reliable instrument to assess cardiac self‐efficacy level among patients with CHD.Using Modern Standard Arabic (Fusha) during the translation and cross‐cultural adaptation process makes the A‐CSEQ more broadly applicable for a range of cardiac patients in Arabic‐speaking countries. The implications of this paper: Nursing leaders can use the translated version of Cardiac Self‐Efficacy Questionnaire to evaluate cardiac self‐efficacy and to improve self‐management skills of patients with CHD in Arabic‐speaking countries.Measuring the self‐efficacy levels of Arabic speakers using the A‐CSEQ can help nurses applying secondary prevention intervention measures and developing cardiac rehabilitation programmes in Arabic‐speaking countries.The A‐CSEQ can be used in further research in the future, through implementing comparisons between study outcomes in Arabic contexts. [ABSTRACT FROM AUTHOR]

Background: People around the world look hesitant to get the coronavirus disease‐2019 (COVID‐19) vaccine. Identifying factors behind people's hesitancy is of great importance. Aim: This paper aimed at examining the predictors of the intention to get the COVID‐19 vaccine in a sample of 281 Jordanians. Methods: A cross‐sectional online survey was employed to collect data on the intention to vaccination, knowledge and attitudes toward COVID‐19, the perception of measures taken by the government to control COVID‐19, self‐rated health, and perceived susceptibility and severity of COVID‐19. Results: The subjects were hesitant to get the vaccine. Intention to get the vaccine was predicted by being male, working in the education field, and having a poor perception of health, better perception of the adequacy of governmental measures, positive attitudes towards COVID‐19, and higher levels of perceived susceptibility to the disease. These predictor variables accounted for 25.5% of the total variance. Conclusion: This study demonstrated that this sample of Jordanian people had some hesitancy to take the COVID‐19 vaccine; variables in the study partially explained that. Several implications have been discussed, including further research is needed to fully understand the relationships between different variables and the intention to get the vaccine. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood.FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals.While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees. What does the paper add to existing knowledge?: The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact.Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post‐traumatic stress disorder correlated with a higher FM impact. What are the implications for practice?: The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees.Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM.Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions. Introduction: Fibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees. Aim: To assess the impact of FM and its associated factors in female refugees. Methods: A cross‐sectional study was conducted. The impact of FM, anxiety, post‐traumatic stress (PTSD) and insomnia was investigated. Results: 288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact. Conclusion: Mental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD. Implications for practice: Mental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions. [ABSTRACT FROM AUTHOR]

Background: Evidence-based practice (EBP) has become of great interest to policymakers, health care practitioners, and researchers. Objective: This study aimed at assessing knowledge associated with, attitudes toward, and implementation of EBP among Jordanian registered nurses (RNs) in critical care units. Method: A descriptive, correlational, and cross-sectional study was conducted in 5 hospitals: 3 public and 2 private. A convenience sample of 200 RNs was invited. Data were collected using a paper-based and self-administered questionnaire, in 2 sections; the first section was the demographic and contextual characteristics and the second was the Evidence-Based Practice Questionnaire (J Adv Nurs. 2006; 53(4):454-458) to measure RNs' knowledge, attitudes, and EBP. Results: A total of 187 RNs were included in this study. Findings revealed that Jordanian RNs in critical care units perceived themselves as having a satisfactory level of knowledge and practice of evidence-based interventions. In addition, RNs strongly recognized the value of EBP. There were significant positive associations between EBP and knowledge associatedwith EBP (r = 0.708, P < .001) and attitude toward EBP (r = 0.490, P < .001). Conclusion: Knowledge associated with EBP, a positive attitude toward EBP, higher educational qualifications, and training in EBP all increased the implementation of EBP. It is recommended that continuing education programs on EBP for nurses be conducted. Nursing educators in clinical settings have to consider a number of strategies to improve EBP. A qualitative research design and/or including open-ended questions are encouraged to gain more in-depth views about EBP. [ABSTRACT FROM AUTHOR]

Objectives: In this paper, we examine the relationship between parental cigarette, waterpipe, or dual smoking behavior and the development of childhood cancer. Methods: We utilized a case-control design (200 in the case age- and sex-matched with 400 control group). The sample was selected from 3 main public hospitals in Jordan. We used a demographic data sheet to collect background information about the children and their parents, and a structured questionnaire to assess the children's exposure to second-hand smoking. Result: Children of women who smoke on occasional to daily levels were significantly more likely to have cancer (p = .007). Also, fathers who smoke on a daily basis were significantly more likely to conceive a child with cancer compared to nonsmokers (p < .001). The regression analysis showed that women who had past exposure to smoke were more likely to have a child with cancer compared to none-exposure women (OR = 2.9). Conclusions: Children who are exposed to smoking by family members during pregnancy are significantly more likely to develop cancer. Furthermore, children who are exposed to waterpipe and cigarette smoking combined during their neonatal period have a higher chance of developing cancer. [ABSTRACT FROM AUTHOR]

Background: The Syrian conflict has resulted in major humanitarian crises. The risk is particularly high amongst female children who face additional gendered risks, such as harassment and sexual violence, including a rise in prevalence of child marriage. Despite the importance of this topic, current literature remains relatively scarce. Objectives: This study aims to explore the social and healthcare repercussions of Syrian refugee child marriages in Jordan and Lebanon. Methods: A systematic review of the literature was carried out to gather evidence, from a total of eight articles. Data analysis was conducted using the Critical Appraisal Skills Programme check tool to systematically assess the trustworthiness, relevance and results of the included papers. Results: The findings of this research identify tradition, honour, economics, fear, and protection-related factors as drivers of child marriage of refugees in Jordan and Lebanon. These motives overlap with findings regarding access to reproductive health and reproductive rights. The lack of autonomy of the child to give informed consent is augmented in the context of protracted violence and displacement. Conclusion: There is a need for a holistic approach to provide safe spaces, education, and protection to young girls and their families to reduce their acceptance of child marriage. [ABSTRACT FROM AUTHOR]

This paper aims to elucidate the current status of nursing in Southern Jordan, and to identify strategies that would enable improvement in nursing within that region. A qualitative study using key informant focussed interviews was conducted in the south of Jordan during the first half of 2010. Purposeful sampling was used until saturation of the data occurred. This required involvement of eight informants in the study, drawn from various health institutions in the southern region. Major issues that affect the nursing profession in the region were identified through thematic analysis. Themes emerging included cultural issues, geographic isolation, sustainability and turnover of professional nurses, continuing professional development, and strategies for improvement. Future action to improve the status and position of the nursing profession is warranted in this region. Enhancing general conditions of employment may serve to attract and retain nursing staff. Incentives for them to live and practice in southern Jordan are needed. Nurses from the local community should be encouraged to pursue postgraduate study. [ABSTRACT FROM AUTHOR]

There is a dearth of research exploring the development of postdoctoral nursing research careers in non-Western contexts. This paper reports on a qualitative study of Jordanian graduates of UK PhD programs. Interviews were held with 16 graduates who worked in the nursing faculty of seven different universities in Jordan. Participants reported that their doctoral degree had equipped them with confidence and enthusiasm for developing a research career. Mentorship, leadership, and peer support were identified as essential to supporting ongoing research activity. Access to these sources of support was variable and participants also described a range of institutional and organizational structures that directly or indirectly discouraged them from developing research productivity. This research suggests that support for postdoctoral novice researchers is an important area for further attention - for Jordanian universities, for UK PhD supervisors (and their associated academic departments), and for the wider nursing community. [ABSTRACT FROM AUTHOR]

Background: Nurses working in emergency units are in direct contact with traumatic events. Trauma effects do not solely affect patients and their caregivers and, rather, extend to secondarily influence nurses themselves. Secondary exposure to trauma may result in symptoms similar to symptoms experienced by the patient themselves. No previous study investigated the secondary traumatic stress among emergency nurses in Jordan. Purpose To identify prevalence, predictors, and consequences of secondary traumatic stress among nurses working in emergency departments. Method: A descriptive correlation design was utilized to collect data using self‐report questionnaires from 202 nurses working at eight emergency departments in Jordan. Findings The study revealed that almost half of the sample reported high to severe levels of secondary traumatic stress. The analyses showed that nurses who demonstrated lower empathy (P =.016) and greater coping capacity (P <.001) tended to develop more secondary traumatic stress. Organizational factors were not significant predictors of secondary traumatic stress. Conclusion: A significant proportion of emergency nurses suffer secondary traumatic stress that is found also to be associated with psychical factors. Emergency nurses need to consider the consequences of secondary traumatic stress on their health and quality of care provided. SUMMARY STATEMENT: What is already known about this topic? Emergency nurses are susceptible to develop secondary traumatic stress due to nature of their work and being repetitively exposed to traumatic patients.No studies have examined existence of secondary traumatic stress among nurses in Jordan and in the Arab countries.The literature has contradicting findings on factors that can enhance or attenuate development of secondary traumatic stress symptoms. What this paper adds? More than half of the participants reported high to severe levels of secondary traumatic stress indicating that secondary traumatic stress is apparent among ER nurses in Jordan.Coping and empathy are important predictors of secondary traumatic stress among emergency nurses.Nurses who reported higher level of secondary traumatic stress symptoms tended to have more work‐related absenteeism and more sick days. The implications of this paper: There is a need to raise awareness of both nurses and health care leaders to existence of secondary traumatic stress among emergency nurses and to establish screening tools and referral procedures for risky nurses.Theory of secondary traumatic stress has to be revised to provide more robust view about the process by which secondary traumatic stress develops among helping professionals.Future studies have to examine factors that may contribute to secondary traumatic stress other than factors addressed in previous studies. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and identify the predictors of breakfast skipping among 14‐ to 16‐year‐old adolescents in Jordan, focusing on mother‐related variables. Background: Breakfast is an essential meal across one's entire lifespan and especially important during the adolescent years. The practice of skipping breakfast has become so prevalent among adolescents that it is now a well‐documented nutritional problem. Design A descriptive cross‐sectional correlational design. Methods: A proportional cluster stratified sampling protocol was used to select 1896 adolescents and their mothers (1013) during the period of March to June 2016. A self‐reported questionnaire was used to collect data on breakfast‐skipping rates, the perceived reasons for this behavior, the perceived importance of consuming breakfast, and maternal encouragement of breakfast consumption. Results: The prevalence of breakfast skipping was 34.3% among adolescents and 21.5% among their mothers. A significant association was found between breakfast skipping among adolescents and their mothers (χ2 [1, n = 998] = 37.90, P =.001). Maternal encouragement of breakfast consumption, gender, and adolescent perception of the importance of this meal were found to be significant predictors of adolescent breakfast skipping. Conclusion: The findings highlight the importance of involving mothers in developing nutritional health plans aimed at promoting regular breakfast consumption among adolescents. SUMMARY STATEMENT: What is known about the topic? Regular breakfast intake has been linked to positive benefits for adolescent health, including lower risk for obesity and fewer biomarkers of chronic illness.The practice of skipping breakfast is highly prevalent among adolescents, both in Jordan and across the globe.Parental eating habits and attitudes influence adolescent eating behaviors and attitudes. What the paper adds? Female adolescents in Jordan skipped breakfast more often than male adolescents and to a significant degree. For both groups, lack of appetite was reported as the main reason (39%) for skipping breakfast.The interrelationships found between maternal and adolescent variables related to breakfast consumption highlight the pivotal role of mothers in promoting this practice. When mothers valued eating breakfast, so did their adolescent children, a relation that translated into lower rates of breakfast skipping among the adolescents.Maternal encouragement of breakfast consumption, the adolescents' perceived value of this practice, and their gender proved significant predictors of breakfast skipping behavior. The implications of this paper: Health interventions to promote breakfast consumption among adolescents are likely to be more effective if based on a better understanding of the role of mothers in this regard.Nurses should involve mothers in developing nutritional health plans to promote regular breakfast consumptions among adolescents.Nurses should educate mothers and adolescents about the health costs for adolescents associated with skipping breakfast. [ABSTRACT FROM AUTHOR]

This paper reports on an aspect of a larger ethnographic study that sought to investigate the impact of HIV/AIDS on the practice of primary care nurses in Jordan. Nursing leadership and the style of management adopted by senior nursing and medical administrators at the Ministry of Heath were identified as factors impacting on the practice of the nurses and their capacity to raise community awareness and contribute to the prevention and control of HIV/AIDS. The study was undertaken in three rural and three urban primary health care centres (PHCC). Data collection included participant observation, key informant interviews, and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. [ABSTRACT FROM AUTHOR]

Aim: This study aims to assess the effect of using a combination of eye mask and earplugs on the perceived quality of sleep among patients admitted to intensive care units. Design Control group, pretest and posttest, quasi‐experimental design was used. Methods: Data were collected from 103 intensive care patients in two governmental hospitals in Jordan. The participants were assigned either an experimental or a control group. The experimental group participants received routine care in the first night and used the eye mask and earplug during their sleep in the second night. Control group participants, on the other hand, received routine care only in both nights. The number of hours slept was reported by nurses, and the perceived quality of sleep was self‐reported by participants using the Richards‐Campbell Sleep Scale. Results: Experimental group participants slept more hours and reported significantly better perceived quality of sleep after the use of eye mask and earplugs, as compared both with themselves in the first night and with control group participants. Conclusion: Combining eye masks and earplugs is effective in prolonging the sleep of intensive care patients and improving its quality. SUMMARY STATEMENT: What is already known about this topic? Many strategies were tested and adopted in intensive care units (ICUs) worldwide in order to improve patients' sleep quality, but evidence of these strategies' effectiveness was scarce.Combining the use of eye mask and earplug has shown positive results on sleep length and quality in ICUs in a number of countries.What this paper adds? This study is the first one of its kind in Jordan and in the Arab world.This study combines the subjective self‐reported quality of sleep with objective length of sleep as assessed by nurses.The implications of this paper: This paper's findings will inform nursing practice in the ICUs in Jordan in terms of patient's sleep improvement strategies.This paper will inform policymaking and future research in the field of ICU patients' sleep length and quality. [ABSTRACT FROM AUTHOR]

Background: Disordered eating attitudes and behaviours are linked to poor physical and psychological outcomes. Aim: To examine the individual, psychological, and socio‐cultural factors associated with disordered eating attitudes among Jordanian adolescents. Methods: A stratified sampling method was used to select school students aged 15 to 18 years from three governates in Jordan in 2013/2014. Participants filled out questionnaires on socio‐demographic variables, the Eating Attitudes Test (EAT‐26; to discriminate adolescents with disordered eating); the Body Shape Questionnaire (BSQ; used to measure psychological factors associated with disordered eating); Body Mass Index was calculated and obesity evaluated according to international cut off points (to categorize normal weight, overweight, and obese adolescents, and these categories were used as individual factors associated with disordered eating). Results: A total of 963 (460 boys and 503 girls) participated in the study. Disordered eating (EAT score ≥ 20) was present in 389 (40.4%); body shape dissatisfaction (BSQ scores ≥110) was present in 161 (16.8%). Overweight and obesity were found in 332 (34.5%) participants. Unhealthy weight loss behaviours (such as self‐induced vomiting, substance abuse, and smoking) were very common. Multivariate logistic regression analysis demonstrated that female sex, urban residence, distorted perceptions of weight, BMI (excess weight), body dissatisfaction, and socio‐cultural variables (parents, peers and mass media) were significantly associated with disordered eating. Conclusion: Jordanian urban adolescents seem to embrace Western norms to fit in with the demands of Western culture. Socio‐cultural factors, particularly mass media, play a significant role in changing adolescents' norms. Prevention and intervention programs are needed to control these disorders. SUMMARY STATEMENT: What is already known about this topic? Worldwide, disordered eating among adolescents is a significant health issue with serious physical, psychological, and social consequences.Studies on the factors that lead to the development of disordered eating in Jordanian adolescents are limited What this paper adds? The rate of disordered eating in this study indicated that adolescents are being exposed to greater pressures to fit in with "Western" norms more than previously.Sociocultural factors appear to play a significant role in changing adolescents' norms.Adolescents who engage in dieting or weight loss behaviours might not necessarily be overweight and may in fact even be normal weight. The implications of this paper: School nurses have multiple opportunities to facilitate early detection, initiate prevention programmes, and develop culturally sensitive interventions.Offering school nurses an effective assessment tool like EAT‐26 will allow them to accurately assess students, identify those at risk, and develop appropriate prevention strategies. [ABSTRACT FROM AUTHOR]