Article Commentary: Secondhand Smoking in Jordan: Clearing the Air for One of the Highest Tobacco Prevalence Countries in the Middle East

Perceptions of Health and Illness: A Qualitative Study of Jordanian Mothers

PURPOSE

To explore: 1) the perceptions of Jordanian mothers of their children's health and illness; and 2) the strategies of Jordanian mothers regarding disease prevention and health promotion.

DESIGN AND METHODS

A qualitative descriptive design was used to select a sample of Jordanian mothers (n = 20) of children aged 6 to12 years. Semi-structured interviews generated data to which thematic analysis was applied.

RESULTS

Four central themes emerged for Jordanian mothers' perceptions of their children's health and illness: physical, functional, wellbeing, and coping. Mothers used a variety of biomedical and psychosocial strategies for health promotion and disease prevention for their children.

CONCLUSION

Jordanian mothers' perceptions of health and illness were multidimensional. Mothers used positive strategies to prevent disease and promote the health of their children. The mothers overlooked some important aspects related to promoting children's health, such as minimizing the harm from tobacco and the importance of regular dental checkups.

PRACTICE IMPLICATIONS

Community or school-based health programs that target both children and their parents are needed to address the effect of smoking on children's health, highlight the importance of oral hygiene and regular dental checkups, and emphasize the role of exercise and healthy nutrition on children's health.

Impact of pharmaceutical care on health outcomes in patients with COPD

BACKGROUND

Chronic obstructive pulmonary disease (COPD) treatment goals are often not achieved despite the availability of many effective treatments. Furthermore, clinical pharmacist interventions to improve clinical and humanistic outcomes in COPD patients have not yet been explored and few randomized controlled trials have been reported to evaluate the impact of pharmaceutical care on health outcomes in patients with COPD.

OBJECTIVE

The aim of the present study was to evaluate the impact of pharmaceutical care intervention, with a strong focus on self-management, on a range of clinical and humanistic outcomes in patients with COPD.

SETTING

Outpatient COPD Clinic at the Royal Medical Services Hospital.

METHOD

In a randomised, controlled, prospective clinical trial, a total of 133 COPD patients were randomly assigned to intervention or control group. A structured education about COPD and management of its symptoms was delivered by the clinical pharmacist for patients in the intervention group. Patients were followed up at 6 months during a scheduled visit. Effectiveness of the intervention was assessed in terms of improvement in health-related quality of life, medication adherence, disease knowledge and healthcare utilization. Data collected at baseline and at the 6 month assessment was coded and entered into SPSS(®) software version 17 for statistical analysis. A P value of <0.05 was considered statistically significant.

MAIN OUTCOME MEASURE

The primary outcome measure was health-related quality of life improvement. All other data collected including healthcare utilization, COPD knowledge and medication adherence formed secondary outcome measures.

RESULTS

A total of 66 patients were randomized to the intervention group and 67 patients were randomized to the control group. Although the current study failed to illustrate significant improvement in health-related quality of life parameters, the results indicated significant improvements in COPD knowledge (P < 0.001), medication adherence (P < 0.05), medication beliefs (P < 0.01) and significant reduction in hospital admission rates (P < 0.05) in intervention patients when compared with control group patients at the end of the study.

CONCLUSION

The enhanced patient outcomes as a result of the pharmaceutical care programme in the present study demonstrate the value of an enhanced clinical pharmacy service in achieving the desired health outcomes for patients with COPD.

Knowledge, attitudes, and behavior in avoiding secondhand smoke exposure among non-smoking employed women with higher education in Jordan

Secondhand smoke (SHS) exposure is a serious public health threat worldwide; in the developing world there are less serious efforts towards controlling women's and children's exposure to SHS. Knowledge, attitudes and avoidance practices among Jordanian women have never been thoroughly studied. The purpose of this study was to assess the knowledge, attitudes, and avoidance behavior towards SHS exposure among employed Jordanian women with higher education.

METHODS

A survey was conducted among employed Jordanian women at two universities. A total of 209 women were included in the analysis. Two questionnaires regarding SHS exposure were used to measure knowledge, attitudes and avoidance practices.

RESULTS

Most respondents were regularly exposed to SHS in various locations during daily life, even though they were very knowledgeable about the dangers of SHS exposure for women and children. However, the subject's attitudes and avoidance behavior did not reflect the level of knowledge about SHS risks. The results suggests there is a large discrepancy between SHS exposure, knowledge, attitudes and avoidance behavior among highly educated Jordanian women that is likely influenced by culture and traditional gender roles. Public health initiatives are needed in Jordan to address public policy, institutional practices and to empowerment of women to reduce SHS exposure.