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Purpose This paper aims to describe and understand the family experience of caregiving to their Alzheimer patients and to explore the impact of caregiving on the family’s caregiver well-being. Design/methodology/approach The study involved eight family caregivers from the outpatient department, specifically from the neurology-medical clinic. A descriptive phenomenological approach was used for data collection through in-depth semi-structured interviews. Findings Four themes emerged: caregiver perception, tension, the sense of duty and commitment and altruism and sacrifice. The experience of family caregivers was different from their experiences with other chronic illnesses. Originality/value The family caregivers experience new life when providing care to their patients with Alzheimer's. The impact of the process of caregiving on whole life appeared in both positive and negative aspects. The perception and awareness of family caregivers toward Alzheimer’s disease were poor.

Background and purpose Health warning messages specific to waterpipe smoking (WPS) have not been tested enough in literature. This study evaluated university students' response to such messages. Specifically, this study (1) assessed the extent to which certain warning messages and pictorial signs motivate participants to quit WPS smoking; (2) identified the best location to place the warning signs of waterpipe as perceived by participants; and (3) assessed participants' intention to quit WPS. Methods A descriptive, cross-sectional design was used to collect data from 397 university students in Jordan using an Internet-based survey. The following data were collected: intentions regarding WPS, response to nine warning messages, and responses to four pictorial signs. Results The message that had the highest motivation to quit smoking was " WPS during pregnancy can harm your baby" (79.3%), whereas the highest pictorial sign was regarding "Protect your children" (64.2%). Most (69.5%) participants believed that WPS products and accessories should contain warnings, and the best suggested location was the pipe handle (52.4%). Participants who reported quitting WPS and those who had an intention to quit had significantly higher responses to both types of health warning labels (HWLs). Conclusion Both text-only and pictorial HWLs were found to encourage quitting WPS among university students. Knowing that participants are having an intention to quit mandates extra efforts to make WPS experience less appealing through reminding them regarding its harms. Implications for practice Support is needed by health care providers to put those effective health warning messages in action. Furthermore, providers can use such health warnings in motivating their patients to quit WPS.

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.

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.

Purpose The aim of this study was to describe Jordanian critical care nurses’ experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse’s autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses’ job satisfaction. Therefore, improving nurses’ clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

Background: Cancer-related fatigue (CRF) is considered to be one of the most common symptoms reported by cancer patients. However, little information is available regarding the variables associated with CRF among Jordanian patients. Aims: To assess the prevalence of CRF and explore its predictors among Jordanian patients. Methods: A cross-sectional survey design was used. Findings: Of the 240 patients surveyed, 210 (87.5%) had fatigue at the time of the survey. The total mean fatigue score was 6.2 (SD=1.7) out of a maximum possible score of 10. The results also showed that being unemployed, with longer hospitalisation, low haemoglobin, and having lung cancer seem to predict higher levels of CRF. Conclusion: Several variables and factors associated with CRF were identified. In response to these results, healthcare providers should pay more attention to CRF, which needs to be assessed on a regular basis and to be managed with the available pharmacological and non-pharmacological interventions.

This study explored cardiac patients' perceptions of the factors affecting the quality of cardiac services in outpatient departments in Jordanian hospitals. Semi-structured face-to-face interviews were conducted with 17 patients attending appointments at two cardiac care centres in Amman, Jordan. Thematic analysis of the data resulted in the identification of three themes: physicians spending insufficient time with patients; inadequate explanations by physicians; and organisational issues. Attention to these factors could improve the quality of healthcare. This could include a role for nurses in giving patients information about their condition and treatment, and educating them on lifestyle issues. Health professionals and decision makers should consider patients' views to improve the quality of cardiac care in OPD.

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.

This study is aimed to investigate exercise behaviors (frequency and duration) among Jordanian diabetic patients, and their correlation with their physical characteristics and perceived exercise benefits and barriers, exercise self efficacy, and exercise planning. An exploratory descriptive design was utilized using the cross-sectional survey with self-reported questionnaires (Demographics, Charlson Comorbidity Index, Exercise Self-Efficacy Scale, Exercise Benefits and Barriers Scale, and Commitment to a Plan for Exercise Scale). A convenience sample of 115 Jordanians with diabetes mellitus was recruited from diabetes outpatient clinics. Participants reported an average number of 3.2 physical activities per week (average of 2.9 hours), with walking being the most common activity. Participant’s body mass index, comorbidity index, and exercise self-efficacy were correlated with both frequency and duration of exercise (r = -0.393, -0.286, 0.219 and -0.272, 0.383, 0.260, respectively). A predictive model of five predictors (age, BMI, CCI, exercise self efficacy, and perceived exercise barriers) that significantly predicted exercise duration (R2 = 0.34, F = 9.14, P < 0.000) was found. Diabetic patients were found to exercise less than optimum. Illness itself was not a cause of not exercising compared to lack of time and desire. Factors that can enhance or inhibit participants’ engagement in exercise should be included in designing tailored exercise educational programs.

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.

Burnout among nurses is well documented in literature. Precursors of burnout such as time pressure need further study for better understanding. In Jordan literature, studies regarding time pressure and burnout among Jordanian nurses are scarce. This study aimed to 1) evaluate the relationship between time pressure and burnout, and 2) identify participants’ characteristics that may have relationship with time pressure and burnout. A descriptive correlational design was utilized using a self-reported cross-sectional survey to collect data from 175 Jordanian nurses. Participants reported high level of time pressure (24.8 out of 126) and burnout (72.9 out of 126). Time pressure was correlated with emotional exhaustion and depersonalization (r = 0.561, 0.491, P < 0.01, respectively). Burnout was highest on the emotional exhaustion (72%) compared to 53.9% for depersonalization and 49.2% for personal achievement. Depersonalization showed the most frequent correlation with participants’ characteristics. Burnout was found to be common among Jordanian nurses, and time pressure is a precursor of this phenomenon, giving rise to the consequences on both patients’ and nurses’ health. Healthcare administrators have to modify the nursing work environment to be less stressful and more appealing to overcome the causes of nurses’ burnout.

Purpose This paper aims to set a leadership guidance program that can promote nurses’ knowledge of leadership and, at the same time, to enhance their leadership competencies and quality of work to promote their readiness for change in healthcare organizations. Design/methodology/approach A pre-experimental, one-group pretest-posttest design was utilized. Out of 90 invited to participate in this study, 61 nurses were accepted to participate. Findings The statistical analyses suggested several significant differences between pre- and in-service nurse managers about leadership competencies, quality of work and readiness for change. Yet, findings from the background characteristics were not found to be significant and had no effects on the perceived readiness for change. Research limitations/implications The present study highlights the importance of leadership competencies and quality of work that healthcare policymakers identify for the success of organizational change efforts. Practical implications Healthcare policymakers, including directors of nursing, should focus on applications that increase leadership competencies and overall satisfaction of the nurse managers to support the changes in hospitals and supporting learning organization. Hence, they should establish policies that decrease the possible negative impact of planned change efforts. Originality/value Competent nurse managers enhance their readiness for change, which in turn helps nurses in constructive change processes. A leadership guidance program should be set for nurse managers. This study has important implications for hospital administrators and directors of nursing.