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Elham Othman

Research

​​​​​​Factors associated with death anxiety and nurses’ preparedness to care for the dying patients with COVID-19

Authors : ​Alrafati, S.A., Zeilani, R. & Othman, E.H.

Abstract : Death is the most traumatic life experience among humans. Nurses' caring for dying patients increases their death anxiety, especially during pandemics. This study examined factors associated with nurses' death anxiety and preparedness to care for dying patients diagnosed with COVID-19 in Jordan. A cross-sectional correlation study recruited 400 nurses from six hospitals with specialized COVID-19 units in Jordan. Nurses have moderate levels of death anxiety and preparedness to care for the dying. Furthermore, the result revealed statistically significant differences in death anxiety levels and nurses’ readiness to care for dying patients according to their demographic and professional characteristics. As nurses’ death anxiety is negatively associated with their preparedness to care for dying patients, implementing adequate assessment of nurses' death anxiety to encourage early intervention through counseling and organizing training programs to improve their preparedness to care for the dying is highly recommended.

Keywords : COVID-19, Death anxiety, Hospice care, Nursing, Terminal care

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​​​​​Public awareness and knowledge of palliative care in Jordan

Authors : ​Abu Elzait A., Zeilani R., Othman E.O.

Abstract : Background: Public perceptions of palliative care (PC) are crucial to enhance access to palliative care services and foster a sense of control over health decisions for people at the end of life. Purpose: To assess public knowledge of palliative care in Jordan. Method: A descriptive cross-sectional design with a stratified self-administered sample of 430 Jordanian citizens from all sectors in Jordan. Participants filled out the Palliative Care Knowledge Scale questionnaire. Data were analysed using IBM Statistical Package for the Social Sciences Statistics; descriptive, t-test, Analysis of Variance and regression test. Results: The mean score on the 13-item Palliative Care Knowledge Scale was 3.51±4.71 (out of 13). This indicates a low level of knowledge about PC among participants, and 78.6% (n=338) of the participants had not heard about PC. Participants who worked in health fields, had post-graduate degrees and a high incomes showed higher awareness of PC than others in the study. Most participants learnt about PC from family members. Conclusion: There is a lack of knowledge of palliative care in Jordanian public society. There is a crucial need to raise public awareness, and implement educational interventions to improve public awareness about palliative care.

Keywords : palliative care, knowledge, public, Jordan

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​​​​​Do nurses participate in end-of-life decision making?

Authors : Othman E.O., Zeilani R. Alosta M., Khalaf I.,​

Abstract : Background: To explore how Jordanian nurses participate in the end-of-life (EoL) decision-making process. Methods: Interviews with 10 patients and family caregivers, and focus group discussions with seven healthcare professionals (HCPs), were conducted. Interviews were audio-recorded, transcribed and analysed following inductive thematic analysis. Findings: The participants agreed that nurses are not fully engaged and did not have a direct role in the EoL decision-making process. However, the participants highlighted that ‘nurses bridge the gaps in the decision-making process’, where nurses act as mediators to facilitate the decision-making process. Lastly, nurses were viewed as ‘nurturers and supporters during the journey of the patient’s illness’; they were always available to answer their questions, offer help and advise when necessary during palliative referral and throughout the illness. Conclusions: Although nurses did not directly participate in EoL decisions, they have several vital contributions that need to be rearranged into structured decisional coaching.

Keywords : end of life, decision making, nurse

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​​​​​Jordanian nursing students’ engagement and satisfaction with e-learning during COVID-19 pandemic

Authors : AlOsta M., Khalaf I., Othman E.O.​

Abstract : Background Nursing education was affected by the COVID-19 pandemic as most institutions shifted to e-learning. The aim of the current study was to examine students’ engagement and satisfaction levels with e-learning during the COVID-19 pandemic. Methods A descriptive correlation design was used to guide this study. A voluntary response sampling method was used to recruit undergraduate nursing programs in Jordan. Data were collected using an electronic link to a self-reported questionnaire. Results A total of 1,562 undergraduate nursing students responded to the questionnaire. The study showed that most students have high engagement in the emotional, skills, and performance subscales and low engagement in the participation subscale. Further, they were moderately satisfied with e-learning during the COVID-19 pandemic. Conclusions Students identified several issues regarding their e-learning, which must be considered to improve their engagement and satisfaction. Further, the study revealed several shortcomings in preparing students to attend e-learning classes.

Keywords : COVID-19; e-learning; education outcomes; nursing students; students engagement; students satisfaction

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​​Death and Dying Through the Lens of Jordanian Muslim Patients and Caregivers

Authors : ​Othman E.O., Khalaf I., Alosta M., Abualruz H., & Zeilani R.

Abstract : The current phenomenological-qualitative study explored the meaning of death and dying from a Jordanian-Muslim perspective. Data were collected through face-to-face interviews with eight patients and five family caregivers, then analyzed following the Braun and Clarke steps. The analysis revealed two main themes; confronting death and preparing for a good death. The experience of terminal illness compelled the patients and their family caregivers to think of imminent death and want to prepare for it. On the other hand, Muslim terminally-ill patients accepted death and surrendered to God’s decree; however, they feared the unknown of the dying experience. Furthermore, the patients were concerned about being a burden to their families during the last days of their lives. Additionally, Muslim patients and caregivers identified five components of a ‘good death’ from the Arab-Muslims’ perspectives, including having a good closure, dying with dignity, coming to peace, not dying alone, and having a religious engagement.

Keywords : Death, dying, good death, hospice, Muslims, terminally ill

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​​​​​Preventive and Avoidant Behaviors Followed by Jordanians During COVID-19 Pandemic

Authors : ​Darawad M., Othman E.O., Saleh A., & Rezk-Hanna M

Abstract : Objective: During the coronavirus disease 2019 (COVID-19), individuals’ compliance with protective behaviors was the most effective strategy to break the infection chain and prevent disease spread, even with vaccine availability and use. Understanding protective behaviors within the Jordanian context will shape health promotion campaigns and guide decision-makers to facilitate required resources and support Jordanian citizens. The objective of this study was to identify personal protective (preventive and avoidant) measures used by the Jordanian population during the COVID-19 pandemic to protect themselves from infection. Methods: A cross-sectional study with an exploratory, descriptive design was used to collect data using an online self-reported questionnaire from Jordanian people. The survey included the Protection from Infection Scale and the Infection Avoidance Scale. Results: A total sample of 1053 Jordanian citizens was included in the study. The participants exhibited a moderate level of self-care behaviors and high levels of protective and infection avoidance behaviors. Their most common behaviors were getting enough sleep, wearing masks, washing hands, and avoiding travel to infected areas. Contrariwise, the least adopted behaviors were exercising, wearing gloves, and leaving their jobs or schools. Conclusions: During pandemics, policy-makers must understand public concerns and protective behaviors, then provide them with tailored education through health promotion campaigns to enhance healthy behaviors.

Keywords : COVID-19, Jordan, preventive behaviors, protective factors, public health practice

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Fatigue among post–hematopoietic stem cell transplant patients in Jordan: prevalence and associated factors

Authors : ​Abdalrahman, O.A., Othman, E.H., Khalifeh, A.H. & Suleiman, K.

Abstract : Background: During hematopoietic stem cell transplant (HSCT), patients underwent various serious prolonged treatments, including conditioning and immunosuppressive drugs, resulting in several symptoms and alterations in the patient’s functioning. One of the most commonly reported symptoms is fatigue. Aim: To assess fatigue levels and associated factors during the first 100 days post-HSCT among Jordanian patients. Methods: A descriptive cross-sectional design assessed fatigue and associated factors during the first 100 days post-HSCT among Jordanian patients. A convenient sample was used to recruit post-HSCT patients. Data were collected using the demographic survey and the Brief Fatigue Inventory (BFI) scale. Results: The findings of this study demonstrated that 40.5% of the participants had severe total fatigue scores, while the mean BFI intensity average score was 5.01 and the mean interference of fatigue with patients’ daily life was 5.06. In terms of fatigue interference with daily activities, the highest interference was with the patient’s mood and normal work, while the lowest interference was with the walking ability. The analysis revealed a strong positive correlation between the fatigue intensity and its interference with the daily activities (r = .98, p ˂.001). Besides, a significantly strong negative correlation was found between the number of days post-HSCT and fatigue scores (r =  − .92, p ˂.001). Conclusion: Post-transplant, patients experienced increased fatigue intensity, reduced physical activity, interference with the patient’s mood, and diminished functional capacity. Patients who have HSCT require a significant nursing care immediately post-transplant.

Keywords : Fatigue, Cancer, Hematopoietic stem cell transplant, Physical activity

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​​​​​Attitude and Associated Factors toward End of life Care among Nurses Working in Kuwait Hospitals: A Cross-sectional Study

Authors : Alenezi, E., Zeilani R., Othman E.H. ​

Abstract : Objective: The current study assessed the attitude toward end of life (EOL) care among nurses working in Kuwait hospitals. Material and Methods: A descriptive, cross-sectional design was used to recruit 900 nurses from nine public, private and military hospitals in Kuwait. Data were collected using a self-administered questionnaire of the Frommelt Attitude Toward the Care of Dying questionnaire. Results: The results showed that nurses in Kuwait had a favourable and supportive attitude towards EOL care, mainly toward the families’ need for emotional support, care for the dying patients, involving the family in care, and accepting death. Further, attitude scores differed significantly based on nurses’ age, year of experience, education level, nationality, type of hospital, and place of work. Conclusion: Nurses working in Kuwait have a favourable attitude toward care for dying patients but an unfavourable perception toward making conversation with patients about death. Hence, providing appropriate awareness to nurses about death and dying in Kuwait might be a promising intervention to improve their attitude and sensitise the concept of death among them.

Keywords : Attitude to death, End of life, Kuwait, Nurses, Terminal care

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​​​​​An Islamic cultural perspective of family presence during resuscitation. Letter to Editor

Authors : ​Othman, E. H., Al Omar S., Abualruz H., Safadi R.

Abstract :

Keywords : Cardiopulmonary resuscitation, Family, Islam

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​Title: Decision Making Near End of Life. A Qualitative Exploration of the Lived Experiences of Jordanian Healthcare Providers

Authors : Othman, Elham H.; Khalaf, Inaam; Zeilani, Ruqayya; Majali, Sawsan; Nabolsi, Manar; Abdalrahim, Maysoon​

Abstract : Background: Discussions related to a patient's prognosis and interventions near end of life are challenging and stressful for healthcare providers. Many reported experiencing emotional distress and discomfort during the decision-making process. Objectives: The aim of this study was to describe the lived experience of nurses and physicians who participate in decision making near the end of a patient's life. Methods: A descriptive, phenomenological approach was used with a purposive sample of 7 nurses and 6 physicians from 2 palliative and end-of-life care institutions in Jordan. Data derived from focus group discussions conducted online via the ZOOM video communication application, and analysis followed Colaizzi's qualitative methodology. Results: Three major themes emerged from the healthcare providers' experiences. Initially, the participants described how they "strive toward optimal decision-making near end of life," "the overwhelming experience of decision making near end of life," and finally, their struggle in sharing details about the end of life when patients ask and whether to tell or not to tell them as "the time for hard talk." Conclusions: The healthcare providers' experiences revealed several issues of decision making near a patient's end of life, such as a lack of appropriate training and administrative support, emotional distress, fear of legal liability, and the burden of a hard talk with patients. These findings necessitate institutional support of setting appropriate policies and guidelines, staff counseling, and healthcare provider support. Implications for practice: Institutions providing palliative and end-of-life care can use this study's findings to support their staff by setting appropriate practice guidelines and providing staff training and counseling.

Keywords : Decision making; End-of-life; Qualitative study

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​​​​​The experience of nurses caring for patients with infectious diseases in isolation rooms: A qualitative approach

Authors : ​Abdelrahim Z., Abu Tabar N., Abualruz H., Othman E.H., Sawalha M., Alqurneh M., Alshraideh J., Al-Hussami M

Abstract : Background: Nurses proved unique experiences while caring for patients with several infectious diseases in isolation rooms. Purpose: This study aimed to explore the experiences of nurses caring for patients with infectious diseases in isolation rooms. Methodology: The study used a descriptive phenomenological approach using face to face in depth interviews from recruiting ten participants. The data were analyzed using Moustakas thematic analysis approach. Findings: The experiences of being a nurse caring for isolated patients were reflected in four major themes: (a) Risk perception and negative emotions, (b) Challenged with limited resources, (c) Isolation precautions interfere with optimum care, and (d) Knowledge and education. Discussion: Nurses encounter many challenges in caring for patients in isolation rooms, including fear and stress, inability to use precautions that increase disease transmission, and communication difficulties. Nurses should update their knowledge and competence regarding infection control precautions through a new standard of education and training.

Keywords : Infectious diseases, Isolation rooms, Jordan, Distress and uncertainty

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​​​​​Nursing Diagnoses among Oncology Patients in Medical Units, a Study of Patients’ Records

Authors : ​Othman, E. H., Alosta, M. R., & Alshraideh, J. A

Abstract : Objective: Nursing care plans for oncology patients are complex and overlapping enough to warrant the need for systematized documentation that ensures high quality, flawless and comprehensive care. Addressing the patients’ needs through nursing diagnoses is the initial step that shapes the subsequent care. Therefore, the current study aimed to identify the frequent NANDA-I diagnoses reported in nursing care plans for medical oncology patients. Data sources: A retrospective design was used to collect data from 260 electronic nursing care records of oncology patients admitted to medical floors at an accredited oncology center in Jordan. Conclusion: The complexity of nursing care for oncology patients can be inferred from the high number of reported nursing diagnoses. This study summarizes the most common nursing diagnoses and their combinations that can be used as a guide to formulate nursing care plans for oncology patients in medical units. Implications for nursing practice: Oncology nurses may refer to this study to guide and support their care and documentation to maintain a high standard of nursing practice. Besides, the reported diagnoses can be integrated to generate pre-printed, standardized nursing care plans, where diagnoses are listed for nurses to select the applicable ones for their patients. Similarly, the combinations of nursing diagnoses may guide nurses to search for a concurrent diagnosis, thus improving patients’ outcomes. This study revealed the complexity of patients’ care in medical oncology units, which alarms the nursing managers to reconsider the nurse–patient ratio in these settings to meet patients’ care demands and maintain their safety.

Keywords : classification, documentation, nursing diagnosis, oncology nursing, patient care planning, standardized nursing terminology

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​​​​​The Psychological Impact of the COVID-19 Pandemic on Jordanian Healthcare Workers

Authors : ​Fawaris, F., Othman, E.H., AlBashtawy, M., Abu Alfwares, A

Abstract : Introduction: Healthcare workers face incomparable work and psychological demands that are amplified throughout the COVID-19 pandemic. Aim: This study aimed to investigate the psychological impact of the COVID-19 pandemic on health care workers in Jordan. Method: A cross-sectional design was used. Data was collected using an online survey during the outbreak of COVID-19. Results: Overall, of the 312 healthcare workers, almost 38% and 36% presented with moderate to severe anxiety and depression consecutively. Nurses reported more severe symptoms than other healthcare workers. And both anxiety and depression were negatively correlated with well-being. Getting infected was not an immediate worry among healthcare workers; however, they were worried about carrying the virus to their families. Implications for Practice: Stakeholders must understand the impact of COVID-19 on healthcare workers and plan to provide them with the required psychological support and interventions at an early stage.

Keywords : Anxiety, COVID-19, Depression, Healthcare Workers, Jordan, Psychological Impact

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Involvement of Jordanian Patients and their Families in Decision-making near End of Life, Challenges and Recommendations

Authors : ​Othman, E., Khalaf I., Zeilani R., Nabolsi M., Majali s., Abdalrahim M., Shamieh O

Abstract : This study aims to explore the challenges in involving patients and their families in decision making near end of life and to provide recommendations to overcome these challenges. A qualitative descriptive phenomenological approach was used with a purposive sample of 8 patients, 7 family caregivers, 7 nurses, and 6 physicians from 2 institutions that provide palliative and end-of-life care services in Jordan. Data were collected using interviews with patients and family caregivers and focus group discussions with nurses and physicians. Colaizzi's method was used to analyze the data. The thematic analysis revealed 5 themes representing the participants' experiences of challenges with decision making near end of life. The identified challenges are (1) struggle with lack of information; (2) improper communication; (3) patient's or family's decision: the cultural taboo; (4) health care providers prefer staying in their comfort zone; and (5) the paradox of surviving and letting go. In addition, the participants endorsed several recommendations to raise public awareness of palliative and end-of-life care, amplify the patients' voice, and raise the bar of communication sensitivity. Decision making near the end of life is a challenge. However, the current study highlighted several areas for improvement that can improve the process and optimize patients' and their families' involvement.

Keywords : challenges, decision making, patient participation, qualitative research, recommendations, terminal care

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​​​​​Shared Decision-Making Measures: A Systematic Review

Authors : ​Ahmad, M., Tabar, N. A., Othman, E. H., & Abdelrahim, Z

Abstract : This review used the recent COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) rating system, which gives the reader the ability to find appropriate instruments in a simple way. Shared decision-making (SDM) is part of health professionals', nurses', and patients' interaction about fundamental and special nursing care issues. The objective of this study was to critically appraise instruments that measure SDM in health care–related decisions according to the COSMIN criteria. Methods: This review was reported in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guideline. A thorough search identified SMD measures via PubMed, Cochrane Library, MEDLINE, EBSCO Host, Ovid journals, SAGE journals, and Google Scholar search engine through November 2018 and updated on March 24, 2019. A rating system with “very good,” “adequate,” “doubtful,” or “inadequate” for COSMIN was used. Results: The 17 instruments reported in this review are varied in the measured perspectives; observer-based viewpoint, patient questionnaires, provider questionnaires, and physician questionnaires, or even mixed perspectives. Only one instrument (OPTION 12 Scale) received an excellent rating across all 5 COSMIN validity rating sections in content, structural, and criterion validity. Conclusion: Most of the instruments scored poorly on the COSMIN checklist. Despite the vast number of instruments measuring SDM, researchers must undertake critical appraisal before selecting an acceptable instrument that meets the specific research goal, as well as the quality requirements.

Keywords : COSMIN systematic review , health care , psychometric properties , shared decision-making measures

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​​​​​Nurses' Compliance With Bar-code Medication Administration Technology: Results of Direct Observation of Jordanian Nurses' Practice

Authors : ​Othman, E. H., & Darawad, M. W

Abstract : Medication administration using bar-code medication administration technology enhances the verification of medication administration rights. Nurses' compliance with bar-code medication administration procedure is essential to maximize the benefits. This study evaluated the current rate of nurses' compliance with bar-code medication administration use through direct observation. A descriptive design was used and 134 RNs were recruited from two public hospitals located in the middle region of Jordan. Compliance with bar-code medication administration was evaluated using an evidence-based checklist of 17 items. Participants' compliance with the bar-code medication administration was 55%, which had a significant positive correlation with their level of comfort using bar-code medication administration, usefulness, and ease of use, perceived job productivity, and overall rating of bar-code medication administration. Stakeholders can benefit from assessing end-user acceptance and perceptions regarding the bar-code medication administration technology to promote acceptance and compliance.

Keywords : BCMA , Jordan , Medication administration technology , Nurses' compliance , Observational study

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​​​​​Reporting Nursing Interventions Classification and Nursing Outcomes Clas-sification in Nursing Research: A Systematic Review

Authors : ​Othman, E. H., Shatnawi, F., Alrajabi, O., & Alshraideh, J. A

Abstract : Background: Nursing classification systems are used to report nursing practices and maintain a unified documentation language. Nursing interventions classification (NIC) and nursing outcomes classification (NOC) are among the recognized terminology systems. Aim: To examine the extent of reporting NIC/NOC in nursing research. Design: A systematic review following PRISMA guidelines. Data Sources: A literature search in three electronic databases was performed. Results: A total of (18) articles were included. Nine studies were conducted to describe the commonly used NIC/NOC, six studies validated the effectiveness of classification systems, and two studies compared different nursing classification systems. Conclusion: The available evidence is limited by the quality of the studies. We recommend examining the use of NIC/NOC in nursing documentation using an experimental design.

Keywords : International classification for nursing practice, NIC terminology, NOC terminology, nursing classification systems, nursing interventions classification, nursing outcomes classification, standardized nursing terminology, systematic review

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Patients' Involvement in Decision Making at End of Life; a Systematic Literature Review

Authors : Othman, E.H, Khalaf I., Zeilani R​

Abstract : Background: involving patient in end of life decision is important to understand their wishes and preference, which will help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review; examined patient involvement in end of life discussions; full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review; there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end of life decision making through; describing current practices; understanding perspectives of end of life discussions; investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end of life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in EOL decisions were recognized; lack of awareness; lack of education, training and experience; concerns about ethical and legal issues; and personal preferences of doctors or nurses were among the most commonly identified barriers.

Keywords : Advance Directives, Advance Care Planning, Decision Making at End of Life, Patients’ Involvement, Patients’ Preferences, and Systematic Review

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Nurses’ satisfaction with barcode medication-administration technology: Results of a cross-sectional study

Authors : Darawad, M. W., Othman, E. H., & Alosta, M. R​

Abstract : Medication administration is a critical task of nurses that, if not done appropriately, can lead to fatal errors. New technologies, including barcode medication administration, are intended to decrease medication errors and enhance verification of medication-administration rights. Therefore, in this study, we examined the effect of introducing barcode medication administration on nurses' satisfaction and identified correlates of nurses' satisfaction with barcode medication administration. A descriptive, cross-sectional design using self-reported questionnaires was utilized to recruit 207 nurses from three public hospitals. Participants reported being moderately satisfied with barcode medication administration, especially with its efficacy and safety aspects. Their satisfaction had a significant negative correlation with their age, nursing experience, and experience using barcode medication administration, and a significant positive correlation with barcode medication-administration training satisfaction, computer competence, comfort with using barcode medication administration, and perceived job productivity using barcode medication administration. This study provides important information about Jordanian nurses' satisfaction with barcode medication-administration technology and provides greater understanding of different clinical correlates to barcode medication-administration satisfaction. It is recommended that effective barcode medication-administration training and computer skills training be provided prior to establishing barcode medication administration in hospitals and that the safety features of barcode medication administration be integrated in clinical education and training.

Keywords : barcode medication administration, cross-sectional study, electronic health solutions, Jordan, nurses' satisfaction

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​​​​​Knowledge and nursing practice of critical care nurses caring for patients with delirium in intensive care units in Jordan

Authors : ​Hamdan-Mansour, A. M., Farhan, N, Othman, E. H., & Yacoub, M. I

Abstract : Delirium can have serious consequences in terms of morbidity, mortality, and increased health care costs. An extensive literature review showed that delirium is not well understood, recognized, or managed by medical and nursing professionals. The goal for this study was to determine the level of knowledge and management skills among critical care nurses caring for patients with delirium who were treated in intensive care units (ICUs) in Jordan. A total of 232 critical care nurses, employed in different ICUs in Jordan, completed self-reported questionnaires. The nurses in critical care units who completed the questionnaires identified a need for more delirium-specific knowledge and skills to assess and manage this condition more effectively. To enhance health outcomes for patients treated in the ICU who have delirium, nurses ​need to receive education on current assessment and management modalities. These regular education programs should be complemented with evaluative research focusing on both nursing care and patient outcomes.

Keywords : Delirium, Intensive care, Knowledge, Nurses, Practice

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​​​​​Research Title :Public knowledge about and attitudes toward organ donation, and public barriers to donate in Jordan: A cross-sectional study

Authors : Adham Al-Salhi, Elham H Othman​

Abstract :BACKGROUND: Organ donation is a critical issue that is receiving greater attention worldwide. In Jordan, the public’s knowledge about and attitudes toward organ donation play a significant role in the availability of organs for transplantation. AIM To assess the public knowledge about and attitudes toward organ donation in Jordan. METHODS A cross-sectional design was used to collect data from 396 Jordanian citizens via an online self-reported questionnaire. RESULTS Overall, 396 participants were recruited. Of the entire sample, 93.9% of the participants had heard about and had sufficient knowledge about organ donation but they had limited knowledge about brain death. The most common source of information about organ donation was social media networks. Females were found to score significantly higher than males for attitude. Those who had thought about organ donation or registered their names to donate scored significantly higher in terms of attitudes to donation than their counterparts who had not. The most common reasons for limited organ donation practices in Jordan were a lack of awareness programs and insufficient knowledge in society. CONCLUSION Greater public understanding of organ donation appears to be associated with more positive attitudes toward organ donation. Most participants responded positively regarding their attitude toward organ donation as they believed that this action could give another person a chance to live. Moreover, most agreed that they would donate their organs after their death. Otherwise, the participants had limited general knowledge about brain death, and most had not registered their names to donate their organs. These findings indicate the need for public awareness campaigns and educational programs to encourage more people to become organ donors

Keywords :: Attitude; Barriers; Jordan; Knowledge; Organ donation; Public

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​​​​​Research Title :Experiences of Academic Women in Jordan on Their Return to Work After Childbirth

Authors :Ruqayya S Zeilani, Alia Mahadeen, Khadeejeh Y Aldasoqi, Maysoon S Abdalrahim, Elham H Othman ​

Abstract :Objective To describe the experiences of women living in Jordan returning to work at their academic positions after giving birth to their first newborns. Design Qualitative descriptive phenomenological design. Setting Various schools within a governmental university in Jordan. This study describes the challenges women in academia experience in the context of Jordan’s Arabic patriarchal communities. Participants A purposive sample of 15 women returning to their academic positions. Methods Unstructured, face-to-face, in-depth interviews of women returning to their academic positions within 3 months after giving birth to their first newborns. The recorded interviews were analyzed using Braun and Clarke’s thematic analysis process. Results Three major themes emerged: Living in Chaos, The Urgent Need for Transitional Time, and Calling for Help and Support. Participants described their return to work as a period marked by a sense of chaos and instability, in which they felt a loss of control over their lives. They expressed a pressing need for a transitional period before resuming full-time academic roles, highlighting the importance of a gradual return. Finally, participants shared their struggles with the extra demands added to their daily routine. As working mothers, participants experienced extreme distress while attempting to fulfill their daily responsibilities. They emphasized the lack of adequate support in this challenging period. Conclusion Women returning to their academic work after giving birth to their first newborns need to be prepared physically and emotionally for the changes and responsibilities of their new life. A longer period of maternity leave or a transitional period may help women working in academia to manage the demands of multiple maternal roles alongside their professional commitments. These findings highlight the absence of formal policies needed to support women in academia in their return to work after maternity leave

Keywords : academia, academic, childbirth, employment, Jordan, maternal health, postpartum, qualitative research, return to work

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​​​​​Research Title :An Evidence-Based Measure to Assess Self-Efficacy Among Adolescents With Type 1 Diabetes Mellitus in Jordan

Authors :Huda M Atiyeh, Mohammad R AlOsta, Elham H Othman, Randa Y Khirfan, Falastine R Hamdan ​

Abstract :Purpose The purpose of the study was to assess self-efficacy among adolescents with type 1 diabetes mellitus and to identify its contributing factors using a new measure based on the International Society for Pediatric and Adolescent Diabetes Guidelines: the Type 1 Diabetes Mellitus Self-Efficacy Scale (T1DM-SES). Method A descriptive, cross-sectional design was used to collect data from 161 adolescents ages between 12 and 18 via an online questionnaire survey, including demographic and management-related variables and the 21 items of T1DM-SES. Results Results demonstrated that adolescents had high self-efficacy levels regarding the basic needs to manage their diabetes and relatively moderate and low levels regarding more sophisticated needs, such as adjusting insulin dose to correct fluctuated glucose levels, covering carbohydrates, and managing ketoacidosis at home. Adolescent females and adolescents who have working mothers or caregivers demonstrated higher levels of self-efficacy, whereas adolescents who have another family member with T1DM reported lower levels. Conclusion Assessing adolescents’ self-efficacy using evidence-based measures is crucial for informing health education plans. There should be a greater focus on acquiring the advanced knowledge and skills necessary for adolescents to manage the constantly evolving challenges of diabetes management. Access to health care and sufficient health insurance coverage that encompasses modern technology are fundamental for the effective management of T1DM.

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​​​​​Research Title :The relationship between emotional intelligence, resilience, and psychological distress among nurses in Jordan

Authors : Hasan Abualruz, Ferial Hayajneh, Elham H Othman, Mohammad A Abu Sabra, Malek M Khalil, Anas H Khalifeh, Islam Yasin, Sajeda Alhamory, Amr H Zyoud, Ali D Abousoliman​

Abstract :Background Nurses have significant levels of depression, anxiety, and stress as a result of their exposure to various stressors at work. Emotional intelligence and resilience are relatively new notions essential for nurses to naturalize high levels of psychological problems. The study aimed to investigate the relationship between emotional intelligence and resilience and their impact on depression, anxiety, and stress among nurses. Methods A cross-sectional descriptive design was used and recruited 152 nurses from three private hospitals in Jordan. Variables were measured using the Depression Anxiety Stress Scale, Brief Resilience Scale, and Brief Emotional Intelligence Scale. Results The participants' average age was 27.6 years, and they were mostly female (66.4 %). Resilience earned an average of 3.1, while emotional intelligence averaged 31.7. Depression, anxiety, and stress were all significantly higher among nurses. Also, negative relationships were found between emotional intelligence, resilience, and psychological problems (p < .001). Emotional intelligence is positively associated with resilience (r = 0.83, p < .001). In addition, emotional intelligence and resilience were both significant predictors of depression, anxiety, and stress. Conclusion Emotional intelligence is critical to nurses' well-being. Higher emotional intelligence is associated with higher resilience and lower levels of depression, anxiety, and stress among nurses. Interventions and education programs emphasizing emotional intelligence and resilience are essential to improving their mental health. Healthcare organizations and governments should promote these attributes to enhance nurses' psychological wellness in challenging healthcare settings.

Keywords :Emotional intelligence, Resilience, Depression, Anxiety, Stress, Jordan

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​​​​​Research Title :Factors influencing Jordanian parents' COVID-19 vaccination decision for children: A cross-sectional study

Authors :Mohammad R Alosta, Mohammad Alsadi, Elham H Othman, Anas H Khalifeh, Huda Atiyeh ​

Abstract :Background Vaccine hesitancy is a major public health problem that emerged post-COVID-19 pandemic, especially for children. Different factors influence parents' perspectives about vaccinating their children and can vary across different populations and contexts. Purpose This study aimed to explore the vaccine hesitancy among parents in Jordan to vaccinate their children between the ages of 5 and 18. Design and methods A descriptive cross-sectional design was used. A convenient sample was used to recruit Jordanian parents. Data was collected via an online questionnaire including demographic data, the Vaccine Hesitancy Questionnaire, the Questionnaire of Vaccine Hesitancy Reasons, and the Vaccine Conspiracy Beliefs Scale. Results Over 177 parents, the mean age was 37.74 years (SD = 8.39); the majority of them were females (74%). 51.4% of the participants refused to give the COVID-19 vaccine to their children. Concerns about the safety and efficacy of the vaccine and lack of information about disease and vaccine were the common reasons for the parents' hesitancy. In addition, 54.2% of participants agreement was with the conspiracy theory that pharmaceutical companies cover up the dangers of vaccines. Parents' younger age and fewer children were associated with hesitancy to vaccinate their children with COVID-19. Conclusions Many parents are hesitant to vaccinate their children against COVID-19. Concerns about the vaccine's efficacy and safety as well as potential long-term negative effects were the main reasons for vaccine hesitancy. Practice implications Nurses play a critical role in determining parental hesitancy. Providing detailed, accurate, evidence-based vaccine information is essential to reduce this hesitancy.

Keywords : Vaccine hesitancy, Parents, Children, COVID-19, Jordan

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​​​​​Research Title :Public Attitudes and Beliefs About Organ Donation: Development and Validation of a New Instrument.

Authors :Elham H Othman, Adham Al-Salhi, Mohammad R AlOsta ​

Abstract :Background and Purpose: The number of patients in need of lifesaving organ transplants continues to exceed the number of available. One of the most critical factors influencing peoples' practices and rates of organ donation is their attitude and beliefs. This study aimed to develop and validate an instrument that evaluates peoples' attitudes and beliefs about organ donation. Methods: A cross-sectional methodological study was used to guide the development of a questionnaire after reviewing the literature. Results: The initial items (n = 45) were evaluated by 15 nonexperts pilot to verify face validity; then, content validity was established by three experts, and exploratory factorial analysis established construct validity. Afterward, internal consistency was checked using Cronbach's α analysis. Eventually, 31 items were included in the questionnaire, comprising four subscales. Conclusion: According to the results, we found that the "Public Attitudes and Beliefs about Organ Donation" questionnaire has adequate validity and reliability to assess peoples' attitudes and beliefs about organ donation.

Keywords :attitudes; instrument development and validation; organ donation; opinions

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​​​​​Research Title :Predictors and disturbances of sleep quality between men and women: results from a cross-sectional study in Jordan

Authors : Mohammad R Alosta, Islam Oweidat, Mohammad Alsadi, Mahmoud Mohammad Alsaraireh, Bayan Oleimat, Elham H Othman​

Abstract :Background Sleep disturbances, a public health concern that may lead to critical physiological conditions, are associated with personal characteristics such as gender. Limited evidence is available from the Middle East population on the gender disparities in sleep quality. Therefore, the current study examined gender-specific differences in sleep quality and disturbances among Jordanian citizens. Method A cross-sectional design was used to recruit a convenient sample of 1,092 adults from different Jordanian cities. Data was collected using a self-reported questionnaire comprising the Pittsburgh Sleep Quality Index (PSQI), which was distributed online via social media networks. The participants were categorized according to their global PSQI scores into poor (PSQI ≥ 5) and good sleepers (PSQI < 5). The analysis focused on finding differences between women and men in terms of sleep quality and the effects of demographic, lifestyle, and socioeconomic factors on reported sleep problems. Results Women were revealed to have a higher prevalence of all types of sleep disturbances than men. Women who were over 55 (compared to younger than 20 years), did not smoke, had multiple jobs or part-time employment (compared to unemployed women), and had a monthly income of more than 500 JD (compared to those with an income of < 500 JD) were less likely to experience poor sleep than other women. In contrast, men who neither smoked nor drank coffee, ate no sweets or only one to two pieces daily (compared to participants who ate more than two pieces daily), and worked fixed night shifts (compared to alternating shifts workers) were less likely to experience poor sleep than other men. Conclusion This study builds a more nuanced understanding of how different demographic, lifestyle, and socioeconomic factors - such as a participant’s age, time of working duty, income, daily sweet consumption, daily caffeine consumption, and smoking - affect the sleep quality of men and women. Thus, promoting a healthier lifestyle for both genders by modifying risk factors - such as smoking cessation, as well as reducing their intake of caffeine and sweets - is the first step toward improving their sleep quality. Further studies are needed to examine how the social role of Arabic women affects their sleep.

Keywords :Gender, Men, Pittsburgh Sleep Quality Index, Sleep, Sleep quality, Survey, Women

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​​​​​Research Title :Assessing self-efficacy among Jordanians with type 1 diabetes

Authors : Arwa Masadeh, Elham Othman, Aziza Salem, Ali M Saleh, Basema Nofal, Muhammad W Darawad​

Abstract :Self-efficacy, an individual's belief in their ability to perform self-care practices, is essential in the effective management of long-term conditions and their complications. There are, however, few studies examining the level of self-efficacy in people with diabetes. This study investigated the level of self-efficacy among people with type 1 diabetes in Jordan, what practices they are most and least confident in performing, and how demographic characteristics affect it. It highlights the importance of self-efficacy in this population, and suggests that efforts to improve it should focus on particular areas

Keywords :Diabetes Self-Efficacy Scale , - Self-efficacy , Type 1 diabetes

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​​​​​Research Title :The Effect of Holy Quran Audio Therapy on Depression and Anxiety Among Jordanian Patients Following CABG: A Randomized Control Trial

Authors : ​Mohannad Eid AbuRuz, Elham H Othman, Ghadeer Al-Dweik, Aaliyah Momani, Fatma Refaat Ahmed

Abstract :Background: The positive outcomes of the CABG procedure are affected by several factors, including the patient’s psychological status, measured by the level of depression and anxiety. The prevalence of depressive symptoms among Jordanian post-CABG patients is high. However, clinicians do not consider anxiety and depression and their impacts in the daily screenings. The effects of non-pharmacological interventions ( i.e. Holy Quran Audio Therapy and Music Therapy) on anxiety and depression have been investigated in some cardiac populations, although no single study was designed specifically to investigate the effect of Holy Quran Audio Therapy on anxiety and depression post-CABG. Objective: To examine the effect of Holy Quran audio therapy on anxiety and depression among Arabic-speaking post-CABG patients. Materials and Methods: A randomized controlled trial was conducted among 165 post-CABG ICU patients at four major hospitals in (in Amman), (Jordan). They were randomly distributed into control (N = 83) and intervention (N = 82) groups. The intervention group received Holy Quran audio therapy on two days (typically the second and third days after CABG, when patients were alert and not intubated). The therapy session was of ten minutes duration, with four hours in between sessions. Depression and anxiety were measured at baseline and follow-up using the Depression Anxiety Stress Scale. Independent and paired t-tests were used for data analysis. Results: Holy Quran audio therapy was linked to statistically significant positive effects. In which Intervention group of patients displaying lower mean depression and anxiety levels compared to the control group (M [SD]; 8.82 [6.35] vs. 13.38 [5.52]) (M [SD]; 6.26 [1.59] vs. 7.48 [3.44], respectively). Implications for Nursing: Holy Quran audio therapy is a non-invasively and non-pharmacologically intervention that might be used to decrease depression and anxiety. Conclusion: Holy Quran audio therapy significantly improved post-CABG patients’ anxiety and depression and is recommended for Muslim patients to improve their psychological status.

Keywords : Anxiety, Audio therapy, Depression, CAD, post-CABG, Quran recitation.

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​​​​​Research Title :The effect of burdensome symptoms and functional status on quality of life among older patients with cancer: A correlational study

Authors :Elham H Othman, Mohammad AlOsta, Hana Mohammad Abu-Snieneh, Ruqayya Zeilani, Shaimaa Ali Shamoun ​

Abstract :Purpose The current study aimed to assess the effect of burdensome symptoms and functional status on QoL among Jordanian older patients with cancer presenting to outpatient clinics. Methods A correlational design was implemented to collect data from 165 older patients with cancer visiting outpatient oncology clinics. Results Generally, the participants have a relatively low quality of life (M = 52.22 ± 24.57). The highest needs according to their functional status were difficulty walking a long distance (M = 3.06 ± 1.004; physical functional status), feeling limited in pursuing hobbies or leisure time activities (M = 2.32 ± 1.05; role functional status), feeling nervous (M = 2.36 ± 1.01; emotional functional status), having difficulty concentrating (M = 2.15 ± 1.04; cognitive functional status), and that physical condition or medical treatment interfered with their social activities (M = 2.36 ± 1.10; social functional status). Further, the most common distressing symptom was insomnia (n = 90, 54%), followed by fatigue (n = 79, 47.9%). Lastly, quality of life improved with better functional status (the strongest correlation was with the role functional status: r = 0.503, p < .001) and declined with higher symptom severity (the strongest correlation was with fatigue: r = −0.566, p < .001). Conclusions To conclude, the current study sheds light on older patients with cancer burdensome symptoms and functional status and their effect on quality of life. The findings suggest that patients suffer from several functional limitations and distressing symptoms that affect their quality of life, necessitating screening and corrective actions from healthcare providers.

Keywords :Functional status, Health-related quality of life, Older adult, Oncology nursing, Symptom assessment

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​​​​​Research Title :Cardiovascular disease risk factors awareness among women with a history of preeclampsia in Jordan

Authors : ​Manal Kassab, Evan Fadel Sabrah, Ahmad Smadi, Ahmad Rayan, Manal Hassan Baqeas, Mohammad R. AlOsta, Elham H Othman, Shereen Hamadneh

Abstract :Introduction Preeclampsia is a pregnancy-specific hypertensive disease that affects 3–5% of pregnant women all over the world and 1.3% of pregnancies among Jordanian women. Objectives This study aims to assess the cardiovascular disease risk factors awareness among women with a recent history of preeclampsia in Jordan and assess the role of healthcare providers in providing counseling about cardiovascular disease risk factors. Methods A descriptive cross-sectional design was used to recruit 180 women with a recent history of preeclampsia during the last 12 months. Data were obtained from patients’ medical records and the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaires. Results The results revealed that 43.9% of women with a recent history of preeclampsia have hypertension, 6.7% have diabetes mellitus, 16.1% have dyslipidemia, 28.9% have a family history of cardiovascular disease, 66.1% are overweight or obese, and 7.2% are smokers. The mean total score of knowledge subscale was 5.5 (SD  =  1.21) out of 8. Only 20% of the participants had good cardiovascular disease knowledge. The mean total score of risk perception was 15.47 (SD  =  7.8). The mean score of perceived benefits and intention to change behaviors was 2.30 (SD  =  0.62). The mean score of healthy eating intentions was 2.54 (SD  =  0.81). Income, having diabetes mellitus, and receiving counseling about preeclampsia as cardiovascular disease risk factor were associated with some dimensions of cardiovascular disease risk factors awareness. Conclusion The prevalence of cardiovascular disease risk factors was relatively high among the study participants. The majority of participants had inadequate cardiovascular disease knowledge. In addition, the role of healthcare providers in providing counseling about cardiovascular disease and related risk factors, including PE was limited. Providing more counseling related to cardiovascular disease by nurses and doctors is essential to enhance women's cardiovascular disease knowledge and intention to change lifestyle.

Keywords : cardiovascular disease, cardiovascular disease awareness, and history of preeclampsia

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​​​​​Research Title :Care needs and symptom burden among oncology patients presenting to outpatients clinics in Kuwait

Authors :Ibrahim JM Mahdi, Ruqayya S Zeilani, Elham H Othman ​

Abstract :Background: Patients with serious illnesses, such as oncology patients, experience sophisticated and interrelated symptoms. Mostly, they are not given proper symptom management, negatively affecting their quality of life, functioning, and satisfaction. Aim: The current study aimed to assess the general patients’ health status, functioning needs, and the severity of symptoms among oncology patients in outpatient clinics in Kuwait. Methods: A descriptive cross-sectional design was used to collect data from 460 oncology patients recruited from the chemotherapy day-care center and the radiotherapy treatment clinics in a large oncology center in Kuwait. Data were collected using the EORTC QLQ-C30 questionnaire. Results: Kuwaiti patients diagnosed with cancer have poor well-being and functioning. The best level of functioning among the patients was cognitive functioning, followed by physical functioning, and the lowest functioning was emotional functioning. In terms of symptom burden, generally, the patients had low levels of symptom severity/burden (all symptoms scored less than 50%). Furthermore, the highest severity was insomnia, followed by fatigue. Conclusion: There is a need to develop a care model that adequately assesses oncology patients in outpatient settings and meets their needs. The implications of the current study are derived from the reported limitation in patients’ functioning; patients need to be assessed adequately and require psychosocial support referrals to improve their well-being and QOL.

Keywords : Care needs, Kuwait, Oncology, Symptoms, Quality of life, Patients, Chemotherapy.

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