" It [Diabetes] is From God and I Need to Take Care of Myself": Type 1 Diabetes Self-Management Among Adolescents and Their Parents in Jordan
Authors : Momani, A.M., Callery, P., Lin, Y.L., Abduelkader, R.H. and Al Akash, H.Y
Abstract : Type 1 diabetes is the most common endocrine condition among adolescents. Diabetes self-management can be challenging during adolescence. The objective of this study is to understand how adolescents and their parents manage type 1 diabetes in Jordan. Constructivist grounded theory methodology principles were used to achieve the study aim. A total of 48 participants were recruited using purposive and theoretical sampling techniques, including adolescents and their parents. Data were collected (October 2016 - April 2017) using 38 semi-structured, audio-recorded interviews (one-to-one or joint interviews based on participants' preferences). Data were collected and analyzed concurrently using different levels of coding, constant comparative analysis, and memo writing. This study was approved by relevant ethics committees from the University of Manchester and Jordan University Hospital. The theme of living with diabetes is presented and discussed in this article. Culture emerged as the central theme; two aspects of culture are presented in this article: collectivism and cultural beliefs. This study identified that diabetes self-management could be influenced by the culture in which Jordanian adolescents live in as well as being shaped by their religious beliefs. These findings are potentially transferable to other Arab and non-Arab countries that share similar cultural aspects and religious beliefs.
Keywords : Type 1 diabetes, adolescents, qualitative, grounded theory, Jordan
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Women’s health concern in Jordan: knowledge, practice and barriers toward cervical cancer screening
Authors : Roqia Saleem Maabreh, Raya Yousef Al-Husban, Hekmat Yousef Al-Akash, and Noha Al-Shdayfat
Abstract : Purpose – Cervical cancer (CC) is one of the most important health issues faced by women worldwide. The purpose of this study is to identify Jordanian women’s knowledge, barriers and measures pertaining to risk factors and screening choices of CC (Pap smear tests). Design/methodology/approach – This study applied a cross sectional design by collecting data from a convenient sample of 200 women between 20 and 70 years of age in health and public centers in Jordan. Data was then analyzed using the descriptive statistical tools of SPSS, version 21. Findings – The findings revealed that 55.5% of the participants had no information about the Pap smear, and 75% did not know the risk factors. Moreover, 50% of the sample did not know where to take the test, and 50% reported a lack of encouragement from the husband to undertake the test. More than half of the participants (56.5%) expressed fear that cervical screening would be a painful examination even though they reported not having any previous experience with the test. Originality/value – Based on these findings, public education about CC screening is essential, including advertising and a campaign similar to the breast cancer awareness programs in Jordan, as a way of encouraging early screening to improve the health of women.
Keywords : Cervical cancer, Screening tests, Knowledge and barriers
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Jordanian Patients’ Family Members Need Perceptions in the Critical Care Settings: Nurses’ Perspectives versus Family Members’ Perspectives in the Context of Health Informatics
Authors : Hekmat Al-Akash , Roqia Maabreh , Mohannad AbuRuz , Khaled Khader , and Abedalmajeed Shajrawi
Abstract : Background. An unexpected hospitalization in any of the Critical Care Units (CCUs) is a stressful condition, not only for patients but also for other family members. Research in this field in Jordan is not available. *e main objective of this study was to identify the most important needs as perceived by these family members in the light of this stressful event and compare them with the nurses’ perceptions of the importance of these needs and also to determine the perception of the needs’ importance with the sociodemographic characteristics of both family members and caring nurses. Methods: this was a cross-sectional study conducted in the period between February and August 2020 among adult family members of patients admitted to the CCUs in hospitals of Jordan from all sectors (public, private, and teaching). “Critical Care Family Needs Inventory (CCFNI)” questionnaire was administered to 82 family members and 99 CCU nurses to determine the importance of the needs on the inventory. The data were analyzed using descriptive statistics. Results. The most important need identified by the family members was relevant to the need for proximity (3.64 ± 0.45), followed by information (3.57 ± 0.58), assurance (3.44 ± 0.43), support (3.31 ± 0.62), and comfort (3.21 ± 0.56). Nurses identified the needs for assurance as the highest, followed by information, comfort, and support, whereas proximity was the least need perceived as very important. The top 10 important needs for both family members and nurses were identified. Family members and nurses were only common in 2 of the need statements on the scale. *ere was no significant association between the sociodemographic characteristics of the sample and the perception of the needs’ importance (p = 0.05). Conclusion. This study has shown that nurses and family members of patients admitted to CCUs have different perspectives relevant to needs’ importance. This should warn nurses to set the needs viewed by family members as a priority. Implications. In the CCU settings, in the context of advancing health informatics, families of patients in the ICUs have different needs other than those viewed by nurses. Their needs must be identified and considered.
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Perceived control and length of stay post coronary artery bypass graft surgerybr/>
Authors : Ruz, MEA., Dahger, N., Al-Akash, HY., Momani, A., Ahmed, FR
Abstract : Background & Aim: Patients undergoing CABG might have increased complications postoperatively, especially prolonging postoperative Length of Stay (LOS). Perceived Control (PC) affects LOS post CABG and complications among different cardiac populations. However, this relation is not well-studied post CABG. This study aimed to determine whether PC was an independent predictor of LOS among patients post CABG. Methods & Materials: A prospective observational design was used. A consecutive sample consisted of 220 patients from four hospitals in Amman, Jordan, who underwent elective CABG between July 2020 and January 2021. PC was assessed using the Arabic Version of the Control Attitude Scale-Revised. LOS and other necessary information were retrieved from the patients' medical records. Data were analyzed using stepwise multiple regression. Results: 169 males and 51 females participated in this study. Age, female gender, as well as PC were found to be independent predictors for the hospital LOS. On the one hand, advanced age and female gender increased the hospital LOS, while higher levels of PC were protective. A one-year increase in age increased hospital LOS by 0.16 days, being female increased hospital LOS by 0.17 days, and a one-point increase in PC levels decreased LOS by 0.33 days. On the other hand, only female gender and PC were independent predictors for the ICU LOS. Similarly to hospital LOS, the female gender increased ICU LOS by 0.18 days while the one-point increase in PC decreased the ICU LOS by 0.21 days. Conclusion: PC was an independent predictor that affects LOS after CABG. Increasing PC among this population, especially females and the elderly, might improve outcomes of their CABG surgery decrease hospital's LOS, and the resultant morbidity
Keywords : Perceived control, length of stay, post coronary artery bypass graft surgery
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The effect of food safety training program on food safety knowledge and practices in hotels’ and hospitals’ food services
Authors : Hekmat Al-Akash, Abu Arrah Abdelhakeem, Bhatti Feyza, Maabreh Roqia, Abu Arrah Riham
Abstract : Food Safety Knowledge (FSK) among Food Handlers (FHS) in the food services in both hotels and hospitals has a crucial role in food protection and combating against foodborne diseases. The aim is to check the food safety (FS) training program upon FSK in the Jordanian hotels’ and hospitals’ food services. A pre-test-post-test design was used. A convenience sample of 412 food handlers from randomly selected hotels and hospitals were recruited. Data were collected using 118-questions Food Safety Knowledge Questionnaire (FSKQ); 40- questions tool for FS Practices. A significant improvement in FSK mean scores in the post-test (85.48±17.07/118 points corresponded to 72.44%) compared with the pretest (78.50±13.69/118 points, corresponding to 66.66%). The overall mean FSK score was considered to be “moderate” in pre and post-tests. FS Practice level mean was 26.86±4.38/40 points (67.14%), regarded as “moderate” in the pre-test and continued to be “moderate” after the training despite a significant increase in the post-test scores (27.92±4.45/40 point, corresponded to 69.80%, P=0.000). FHS worked in organizations where HACCP principles are implemented, possessed higher FSK and better FS practices. Although continued to be “moderate”, FSK and FS Practices among FHS in the Jordanian hotels and hospitals have been significantly improved after the FS Training Program
Keywords : Food Safety, Training Program, Jordan Hospitals, Jordan Hotels
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Food Safety Knowledge among Food Handlers in Hospitals of Jordan
Authors : Abu Arrah Abdelhakeem, Bhatti Feyza, Al-Akash Hekmat
Abstract : Food safety knowledge (FSK) plays an important role in guiding food handlers (FHs) practices during food operations. The aim of this research was to investigate the level of FSK among FHs in hospitals' food services in Jordan. Up to 245 food handlers work in hospitals were purposefully selected from 6 public and private hospitals. A published FSK questionnaire included 120 items in 6 subscales was used to collect data. Most of the hospitals' FHs were male (91.84, n=225), of mean age 35.89 ± 9.26 years, with average experience of 12.55 ± 8.1 years, education of less than high school, and worked in public hospitals. The overall FSK was found to be "moderate" (71.20%). Food handlers were having the highest knowledge in the areas of "personal hygiene and hand washing" (80.87%), "health problems affecting FS" (86.10%), and "cross- contamination control and sanitation" (75.96%). FSK was "moderate" in "thawing, safe storage, transfer, catering, holding, heating, and re-heating" was (68.06%), "foodborne diseases and symptoms" (67.05%), and "poor" in "foodborne pathogens" (30.60%). Male FHs possessed higher FSK than female's counterparts (p=.036). There was a significant negative relationship between FSK and age (p=.044), positive relationship with previous exposure to FS training (p=.000), while there was no significant mean difference of FSK based on the years of experience or hospital sector (p=.090). One-way ANOVA with post-hoc revealed that FHs with higher educational qualification possessed higher FSK (p= .00). Food Safety Training is recommended for certain areas in food operations and foodborne pathogens.
Keywords : Food Safety, Food Hygiene, Food Safety Knowledge, Food Handlers, Hospitals, Jordan
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Knowledge, Attitude and Practice about Evidence-Based Practice: A Jordanian Study
Authors : Mohannad Eid AbuRuz , Haneen Abu Hayeah , Ghadeer Al-Dweik, and Hekmat Yousef Al-Akash
Abstract : Background: Evidence-based practice has become a worldwide concern for healthcare staff and administrators as well as researchers. Evidence-based practice has been considered as critical element to improve quality of health services and achieving excellence in patient care. The implementation of Evidence-based practice in clinical environments has been challenging. One of the most important barriers to implement Evidence-based practice is knowledge deficit. Objective: The aim of this study was to describe Jordanian nurses' knowledge, attitudes, and practice regarding evidence-based practice. Methods: A descriptive cross-sectional correlational study was conducted in seven major hospitals in Amman/ Jordan. Five hundred nurses answered a self-reported questionnaire. Descriptive statistics and multiple linear regressions were used to analyze the data. Results: Attitudes toward Evidence –Based Practice had the highest mean followed by the knowledge/skills and finally the practice. Female nurses practice research less, have less positive attitude, and less knowledge about research compared to male nurses. Nurses with MSc degree, working in ICU and private hospitals have more positive attitude, reported higher levels of knowledge and skills compared to nurses with BSc, nurses working in other units, and nurses working in ministry of health and Royal Medical Service respectively. Conclusion: Ongoing education for nurses and minimizing barriers are recommended to promote the use of Evidence –Based Practice in Jordan
Keywords : Evidence-based Practice; Nurses; Attitudes; Knowledge
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Checking the moderating effect of perceived control on the relationship between anxiety and postoperative hospital length of stay among coronary artery bypass graft patients
Authors : Mohannad Eid AbuRuz; Ghadeer Al-Dweik; Hekmat Yousef Al-Akash
Abstract : Background: Coronary artery disease (CAD) is the most common cardiovascular disease (CVD). Coronary artery bypass graft (CABG) surgery is the most common treatment used for CAD. Patients undergoing this surgery are always anxious, which might increase complications in the postoperative period, especially prolongation of postoperative length of stay (LOS). It has been shown that perceived control (PC) moderated the relationship between anxiety and complications in a cardiac population, but its effect has not been studied in post-CABG. Aim: The aim of this study was to check if there is a moderating effect for the PC on the relationship between anxiety and LOS post-CABG. Patients and methods: A non-experimental, prospective, observational study was conducted with a consecutive sample of 250 patients who underwent elective CABG from four hospitals in Amman, Jordan. PC was measured by the Arabic version of the Control Attitude Scale-Revised (CAS-R), and anxiety was measured by the Arabic version of the anxiety subscale of Hospital Anxiety and Depression Scale. LOS and other needed information were obtained from patients’ medical records. Results: Preoperative anxiety was significantly higher than postoperative anxiety (mean [SD]: 12.80 [6.70] vs 11.01 [6.74], (P <0.001). Female patients were more anxious and had longer LOS compared to male patients. In stepwise regression, anxiety and PC scores were independent predictors for LOS. Every unit increase in preoperative anxiety increased LOS by 0.381 days, and every unit increase in PC decreased the postoperative LOS by 0.210 days. Moderating effect was checked by simple slope analysis for high (+1 SD) and low (−1 SD) levels of PC. Patients with high anxiety and low PC had the longest LOS, and patients with low anxiety and high PC had the shortest LOS, indicating the moderating effect of PC on the relationship between anxiety and LOS. Conclusion: High levels of anxiety were associated with longer LOS after CABG. PC moderates this relationship. Enhancing PC in this population can improve outcomes and decrease LOS and morbidity
Keywords : Depressive symptoms, perceived control, coronary artery bypass graft, length of stay
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Perceived Stress in Nurses: A Comparative Study
Authors : Rami Masa’Deh , Fadwa Alhalaiqa , Mohannad Eid AbuRuz , Ghadeer Al-Dweik, & Hekmat Yousef Al-Akash
Abstract : Purpose: The purpose of this study is to assess the perceived stress in nurses working in various departments including mental health and psychiatric nurses in Jordan and compare the all together. Methods: Using a non-random convenience sample, 310 nurses working in various departments in Jordan representing five different hospitals were included. Nurses answered the Arabic Version of Perceived Stress Scale 10-Items Questionnaire (PSS10) and a Characteristic Checklist. Results: This study showed that nurses working in psychiatric departments perceived the highest stress levels followed by oncology nurses (ONs), ICU/CCU, and ER nurses respectively. Medical and surgical nurses reported the lowest level of stress. Conclusions: This study showed that psychiatric nurses have the highest levels of stress among all participated nurses. This might lead to dissatisfaction with the work and high rates of burn out and turn over. All these factors can easily affect patients care and safety issue, especially psychiatric patients. It is highly recommended that nurse managers and policy makers pay a particular attention to this phenomenon and looking for causes of such high level of stress is important
Keywords : department, Jordan, nurse, psychiatric, stress
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Persistent (Anxiety and Depression) Affected Academic Achievement and Absenteeism in Nursing Students
Authors : Mohannad Eid Abu Ruz; Hekmat Yousef Al-Akash; and Samiha Jarrah
Abstract : Background: Anxiety and depression are common among nursing students due to different factors. When they are minimal and not persistent, they work as stimuli for good achievement. However, when they are high or persistent they have negative consequences (i.e. low academic achievement and higher absenteeism rates). Objective: The purpose of this study was to check the effect of persistent anxiety and depression on nursing student academic achievement and absenteeism rate. Methods: A prospective observational correlational design with a convenience sample of 170 students enrolled in the undergraduate and graduate programs-college of nursing at a private university in Amman, Jordan. Anxiety and depression were measured twice at the beginning of the semester and then two months later by Hospital Anxiety and Depression Scale. Data regarding grade point average, number of absenteeism and the gender of the students; were collected from the electronic system of the university. Results: Persistently anxious group has lower grade point average than persistently non-anxious group (mean [SD], 64.1 [13.8] vs. 73.1 [12.3], P< .001). Moreover, they have higher absenteeism rate than persistently non-anxious group (7.62 [5.7] vs. 4.0 [3.4], P< .001) and higher than transiently anxious group (7.62 [5.7] vs. 4.7 [4.6], P< .05). Persistently depressed group has lower grade point average than persistently non-depressed group (64.0 [13.8] vs. 73.2 [13.0], P< .001) and lower than transiently depressed (64.0 [13.8] vs. 71.7 [10.6], P< .01). Conclusion: Nursing administrators should search for the underlying causes for these negative emotions. Furthermore, setting strategies to control these negative emotions is highly recommended
Keywords : Anxiety, Depression, Academic achievement, Absenteeism, Collegial life, Education
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The University of Jordan Students' Concerns and Awareness about Trans-Fatty Acids
Authors : AbdElhakeem Abu Arrah; Hekmat Yousef Al-Akash; Mohannad Eid Abu Ruz
Abstract : Total Trans Fatty Acids (TFAs) intake was associated with an increased risk of coronary and cardiovascular diseases and their mortalities. The World Health Organization highlighted the seriousness of TFAs intake and called to ban TFAs from foods or to limit their intake to less than 1% of the total amount of the energy intake. Fast foods are considered to have a high percentage of TFAs. University students spend most of their time outside home which makes them the suitable population to consume these kinds of food. The purpose of this descriptive study was to assess the University of Jordan students' concerns and awareness about TFAs. Four hundred and seventeen students answered a self-reported questionnaire about TFAs from October, 2015-January, 2016. Descriptive statistics, independent sample t test and multiple regression were used to analyze the data. Results showed that students at the University of Jordan were found to have moderate concern relevant to TFAs (Mean± 64 SD; 20.0 ± 5.1), and moderate awareness relevant to TFAs health risks (Mean± SD; 51.5± 15.2). Awareness was predicted from the faculty of students (health faculties), female gender, living status, and family income, which explained 30% of the variance. In conclusion, it is known that high levels of TFAs are associated with increased risk of cardiovascular diseases and obesity, especially in young adults. The results of this study showed that concern and awareness of the students about health risks and dietary sources of TFAs was insufficient to make decisions of healthier food selection
Keywords : Total Trans Fatty Acids, concerns, awareness, knowledge, University Students, Jordan
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Transition to Motherhood after Childbirth Complications and ICU Admission
Authors : Al-Akash, H.Y., Safadi, R., Swigart, V., Maabreh R. and Momani, A
Abstract : Childbirth complications and admission to the intensive care units in the immediate postpartum period have the potential to impact transition to motherhood. Mothers in the intensive care units have special needs other than monitoring and resuscitation. This study aims to explore the subjective experience of transition into motherhood among Jordanian mothers who suffered childbirth complications that required postpartum hospitalization into the intensive care units. A descriptive phenomenological approach has been conducted to underpin this study among purposive seven mothers who developed childbirth complications and were admitted to the intensive care units at any of the Royal Medical Services Hospitals in Jordan. Data were generated through semi-structured qualitative interviews. The interviews were conducted at two points of time, within the first month and four to six months after birth. The results showed five major themes in relation to transition to motherhood after childbirth complications and admission to the intensive care units: Early Separation and Delayed Bonding, Unmet Needs of the Mothers by the Intensive Care Unit Environment and Healthcare Professionals, Devastation: Physical and Emotional and the Role of Spirituality and Sociocultural Influences. This study provided insight into risks of the childbirth complications upon mothers’ physical and psychological well-being, and maternal- infant relationship, it also highlighted the needs of mothers during their stay in the Intensive Care Unit
Keywords : Childbirth Complications, Intensive Care Unit, Motherhood, Phenomenology, Qualitative Approach, Transition to Motherhood
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