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War has an immediate and long-term effect on children’s mental health. The purpose of this study was to assess post-traumatic stress and social anxiety among children of Syrian refugees in Jordan. A cross-sectional explorative design was used to collect data from 250 children of Syrian refugees regarding post-traumatic stress and social anxiety. Analysis showed that children had moderate levels of social anxiety and moderate level of PTS. Significant difference was found between males and females in social anxiety (p > 0.05), while significant differences are found related to PTS. Integration of mental health needs is a priority for children of Syrian refugees.

Background Multiple Sclerosis (MS) is associated with poor quality of life (QOL). Individuals suffering from MS must make multiple adjustments as their condition changes. To date, little is known about the role of psychosocial adjustment in improving QOL of patients with MS. Purpose The purpose of this study is to identify the relationship between psychosocial adjustment and HRQOL controlling for demographic variables among patients with MS. Methods This study used a descriptive-correlational design. A sample of 160 patients from two hospitals participated in the study. Self-reported data were collected using the demographic survey, Multiple Sclerosis Quality of Life (MSQoL-54) tool and Psychosocial Adjustment to Illness Scale–Self Report (PAIS-SR). Results Participants reported poor QOL and difficulty with psychosocial adjustment. The QOL and psychosocial adjustment were correlated with various demographic variables. After controlling for demographic variables, psychosocial adjustment explained a large variance in the mental health composite of QOL (r square change = 44%) and the physical health composite of QOL = (r square change = 38%). Conclusion Psychosocial care could play a vital role in improving quality of life among MS patients.

Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) and depressive symptoms are each associated with functional status in patients with heart failure (HF), but their association together with functional status has not been examined. Objective The aim of this study was to determine whether functional status scores differ as a function of depressive symptoms and NT-proBNP levels considered together. Methods We studied 284 patients with HF who were divided into 4 groups based on the median split of NT-proBNP levels and cut point for depressive symptoms (Beck Depression Inventory ≥ 14): (1) low NT-proBNP of 562.5 pg/mL or less without depressive symptoms, (2) low NT-proBNP of 562.5 pg/mL or less with depressive symptoms, (3) high NT-proBNP of greater than 562.5 pg/mL without depressive symptoms, and (4) high NT-proBNP of greater than 562.5 pg/mL with depressive symptoms. The Duke Activity Status Index was used to assess functional status. Results Nonlinear regression demonstrated that patients without depressive symptoms were more than twice as likely to have higher (better) functional status scores than patients with depressive symptoms regardless of NT-proBNP levels after controlling for age, gender, prescribed antidepressants, and body mass index. Functional status levels of patients with low NT-proBNP did not differ from those with high NT-proBNP in the presence of depressive symptoms. Conclusion When examined together, depressive symptoms rather than NT-proBNP levels predicted functional status. Clinical implications Adequate treatment of depressive symptoms may lead to better functional status regardless of HF severity.

Objectives To describe the daily physical activity of Arab men living in the United States and to understand how perceptions of cardiovascular disease (CVD) risk influence their inclusion of physical activity into their daily routine. Methods A qualitative descriptive method using a semi-structured face-to-face interview with each participant was conducted. Twenty young college males (age 26 ± 4 years) were recruited from Arab American community centers. Results The qualitative inductive content analysis revealed three main themes: impact of perceived CVD risk on physical activity behavior and perceived barriers and motivators to be physically active. Arab men primarily perceived gaining weight as the most important CVD risk factor that could promote their physical activity behavior. Conclusions These findings demonstrate that unawareness about CVD risk and barriers to regular physical activity must be considered in any intervention to engage Arab men in regular physical activity.

Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs. A total of 161 participants completed the study questionnaires. Participants showed a moderate level of uncertainty, less cardiac symptom distress, and high learning needs. Uncertainty was significantly correlated with learning needs while less correlated with symptom distress. Hierarchal multiple regression revealed that gender, employment status, education level, and learning needs are factors associated with uncertainty among CABG patients. It was concluded that symptom distress does not necessarily induce uncertainty. Intensive care professionals should undertake individual's characteristics to anticipate uncertainty.

Background: Nursing students are at risk for committing medication administration errors (MAEs), which significantly alter the delivery of safe and effective healthcare. Purpose: To identify the medications most frequently involved in medication errors as reported by Jordanian nursing students, as well as to identify the level of nursing students’ adherence to best-practice when administering high-risk medications. Methods: A cross-sectional design was used among a convenience sample of 74 nurses. Results: A total of 74 of 110 (67.3%) questionnaires were returned. The most frequent medications subjected to MAEs were Dopamine, Dobutamine, and Insulin continuous intravenous infusion (17.2%, 16.0% and 13.5% respectively). Regarding the adherence to best-practice, nursing students adhered the most to the following best-practices: checking the patient armband prior to medication administration with a mean of 3.81 (±0.6) and bringing the MAR sheet with them when preparing a medication with a mean of 3.46 (±1.1). Conclusion: Developing an effective medication training programs in all undergraduate nursing programs in Jordanis is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of adherence to medication management best-practice in all courses. Close and effective supervision of students needs to be maintained throughout nursing students’ clinical training, especially during medication preparation and administration.

Introduction: Overweight and obesity is major health challenge worldwide. Purpose: The purpose of the study was to estimate the prevalence of overweight and obesity and assess knowledge on the health risks associated with obesity among female adolescents in the Jordanian capital Amman. Method: A cross-sectional survey of 782 female adolescents was conducted using random sampling technique. Height and weight were measured and body mass index for age was used to determine overweight and obesity depending on International Obesity Task Force standers. Obesity risk knowledge-10 scale was used to assess knowledge level among female adolescents. Results: The prevalence of overweight and obesity among female adolescents were 34.9% and 12.5% respectively. Knowledge about health risk associated with obesity among female adolescents was low. Ninety five percent of participant had low to moderate knowledge about health risk associated with obesity. Conclusions: Prevalence of overweight and obesity among Jordanian female adolescents was high. Overweight and obesity is a serious public health problem among female adolescents in Jordan.

Background Medication administration errors (MAEs) have short- and long-term implications on patients' health as well as on hospitals' accreditation and financial status. Purpose The purpose was to explore Jordanian nurses' perceptions about MAEs. Methods A cross-sectional design was used with a convenience sample of 470 nurses. Results The most common types of MAEs were wrong time (32.6%) and wrong patient (30.5%). In addition, night shifts accounted for 42.9% of MAEs; the factor that contributed the most to MAEs was workload. Conclusion Developing effective quality assurance programs in relation to medications and medication administration in all Jordanian health care settings is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of medication rights as well as medication calculation. A distraction-free zone should be created and reinforced in all medication rooms.

The purposes of this study were to describe the decision making process and decision activities of critical care nurses in natural clinical settings. An exploratory descriptive approach utilizing both interview and observation methods, was used for data collection. The study involved twenty four critical care nurses from three hospitals in Jordan. Participant observation was performed to understand the routine clinical decisions made by Intensive Care nurses. About 150 hours of observations were spent in the involved Intensive Care Units. Nurses were interviewed to elicit information about how they made decisions about patient’s care. The study revealed that the most common model nurses tend to use was intuitive model in order to observe the cues relating to the patient’s situation. Data revealed that the decision making process is continuous and that experience is one of the main factors that determine nurses’ ability to take decisions. Five themes were generated from the data: on-going process, autonomy, experience/power, joint/ethical decisions, and advocacy. Critical care nurses were seen to be sensitive to the patient’s verbal and non-verbal cues; they were able to respond to these evidences to ensure that the patient’s condition did not deteriorate. Critical care nurses are likely to be more confident and effective when dealing with patient’s changing situations with more experience.

Objectives To describe self-reported stress level, cognitive appraisal and coping among patients with heart failure (HF), and to examine the association of cognitive appraisal and coping strategies with event-free survival. Methods This was a prospective, longitudinal, descriptive study of patients with chronic HF. Assessment of stress, cognitive appraisal, and coping was performed using Perceived Stress Scale, Cognitive Appraisal Health Scale, and Brief COPE scale, respectively. The event-free survival was defined as cardiac rehospitalization and all-cause death. Results A total of 88 HF patients (mean age 58 ± 13 years and 53.4% male) participated. Linear and cox regression showed that harm/loss cognitive appraisal was associated with avoidant emotional coping (β = -0.28; 95% CI: -0.21 – 0.02; p = 0.02) and event free survival (HR = 0.53; 95% CI: 0.28 – 1.02; p = 0.05). Conclusions The cognitive appraisal of the stressors related to HF may lead to negative coping strategies that are associated with worse event-free survival.

Coronary artery disease accounts for over 7.9% of total healthcare expenditure in all industrialized countries and is a global concern (WHO, 2007). The common surgical treatment method for CAD, and a life saving intervention since the 1960s is Coronary Artery Bypass Graft surgery (CABG) (Gao, et al., 2009; Wijns, et al., 2010). Globally, on average one in every 500 individuals annually undergoes a CABG procedure (WHO, 2007). Surgery for CAD may be indicated for symptomatic or prognostic reasons. The decision to advise CABG is based on the balance between the expected benefit and the risks that the patient faces.