Nurses' Experiences of Caring for Patients with COVID-19: A Qualitative Study

The purpose of this study was to explore nurses' experiences, abilities, and willingness to care for patients with Coronavirus Disease 2019 (COVID-19). A descriptive qualitative study was conducted among 12 nurses working with patients with COVID-19. Purposive sampling was used to recruit participants from two national hospitals in Jordan. Semi-structured interviews (45-90 minutes each) with open-ended questions were held via Zoom to collect data. Four major themes emerged from the data analysis. The first theme, uncertainty, consisted of two subthemes: new experience and lack of training. The second theme was related to social stigma by society and other staff members. The third theme of front-line fighters consisted of two subthemes: empowering the main health caregiver and community acknowledgment. The fourth theme was related to challenges and consisted of two subthemes: physical and psychological challenges. At the beginning of the outbreak of COVID-19, the nurses had experienced a lack of certainty, physical and psychological challenges, and social stigmatization, which had negatively affected their willingness and ability to fight the outbreak. However, the nurses reported growing professionally and psychologically with time and becoming more knowledgeable, skillful, powerful, and confident care providers during the pandemic. Being able to fulfill their responsibilities and being acknowledged by others gave the nurses a sense of achievement. Early education and training about COVID-19, clear infection control protocols and guidelines, psychological counseling, and adequate social support are essential steps for enhancing nurses' mental well-being and willingness and ability to fight COVID-19.

Barriers to implementing palliative care in intensive care units: perceptions of physicians and nurses in Jordan

BACKGROUND

Palliative care (PC) aims to relieve a person's suffering and provide the best possible quality of life (QoL) to people with chronic illnesses. Despite the significant impact of PC services on the QoL of patients, barriers exist that prevent healthcare providers from facilitating PC in intensive care units (ICUs).

AIM

The purpose of this study was to explore the perceived barriers to implementing PC in ICUs.

METHODS

A qualitative approach was used to conduct 17 semi-structured interviews with clinicians across two ICUs (urban and suburban) in Jordan. Thematic analysis was used for the transcribed interviews.

RESULTS

Five main themes emerged: the ICU is a demanding and complex care environment; lack of preparation to implement PC; PC is a nicety, not a necessity; healthcare system-related barriers; and lack of cultural acceptance of PC. Lack of knowledge and training was identified as a major barrier for the effective implementation of PC by both physicians and nurses.

CONCLUSION

Equipping healthcare providers with the knowledge and expertise to provide PC is essential to dispel myths related to PC and facilitate PC provision. Developing an interdisciplinary care team will support the effective implementation of PC services in any setting. Establishing national PC policies will foster the ethical and legal practice of PC in Jordan.

Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study

PURPOSE

To investigate the association between obesity and breast cancer clinicopathologic characteristics at presentation along with prognostic impact among Jordanian breast cancer patients. Such data are lacking in Arabian countries.

METHODS

In this retrospective study, 348 breast cancer patients were included. Analyses were conducted for associations between body mass index (BMI) and age at diagnosis, tumor clinicopathologic characteristics, and molecular subtypes. Eight prognostic factors were considered, and total prognostic scores were calculated. The analysis was stratified by menopausal status. Multivariate logistic stepwise regression analysis was conducted to identify predictors for breast cancer recurrence and death.

RESULTS

Mean age at diagnosis was 50.98 ± 10.96 years. Mean BMI at diagnosis was 29.52 ± 5.32 kg/m². Mean age at diagnosis was significantly higher for overweight and obese patients compared to underweight/normal patients (P < 0.001). A significant positive correlation was observed between patient age and BMI at diagnosis (r = 0.251, P < 0.001). Grade of carcinoma was significantly correlated with BMI in the whole population examined (P=0.003). Obese breast cancer patients had significantly higher prognostic scores compared to nonobese cases, indicating worse prognostic features at presentation (P=0.034). Stratification of data analysis based on menopausal status revealed significant associations between obesity and each of tumor stage and grade among postmenopausal but not premenopausal patients (P=0.019 and P=0.031, respectively). Similarly, postmenopausal obese patients had significantly higher prognostic scores compared to nonobese counterparts (P=0.007), indicating worse prognosis, a finding which was also absent among premenopausal breast cancer patients. No significant association between BMI with expression status of hormone receptors, HER2, lymphovascular invasion, and molecular subtypes was found among patients. BMI was a significant predictor for disease recurrence in which obese breast cancer patients had greater odds (2-fold) to develop locoregional and distant recurrence compared to nonobese cases (P=0.011).

CONCLUSIONS

Obesity was associated with advanced stage and grade of breast carcinoma at diagnosis. The impact of BMI on clinicopathologic characteristics and prognosis was confined to postmenopausal cases. Jordanian obese breast cancer patients are at greater risk of breast cancer recurrence and reduced survival compared to their nonobese counterparts.

Exploring changes in nursing students' attitudes towards the use of technology: A four-wave longitudinal panel study

BACKGROUND

It is essential for nursing students to be equipped with the necessary technology skills throughout and after their study period. Their acceptance of this technology depends largely on their attitudes towards technology.

OBJECTIVES

To explore the evolution in nursing students' attitudes towards technology, and to determine whether there was a change in participants' formal education in technology over their four years of study.

METHODS

A longitudinal panel study was conducted in a single school of nursing in Jordan. A total of 140 students were followed over their four years of undergraduate study. They completed the same tool (the Technology Attitude Scale) each year, to capture any changes in their attitudes towards technology across the years.

RESULTS

In all four waves of data collection, students showed positive attitudes towards technology, with the highest attitude scores being in their final year (M=6.19, SD=0.72). As the students spent more time on their nursing education, they were found to have a more positive attitude. Thus, a strong positive relationship existed between this formal education in technology and attitudes: as the students' education in technology increased, their attitudes were more positive.

CONCLUSION

A remarkable development in students' attitudes towards technology is reported in this study. The positive attitudes displayed by the students should be enhanced by providing technology-related subjects during their studies in nursing schools at a very early stage.

Nurses' perceptions of patient safety culture in Jordanian hospitals

BACKGROUND

Patients' safety culture is a key aspect in determining healthcare organizations' ability to address and reduce risks of patients. Nurses play a major role in patients' safety because they are accountable for direct and continuous patient care. There is little known information about patients' safety culture in Jordanian hospitals, particularly from the perspective of healthcare providers.

AIM

The study aimed to assess patient safety culture in Jordanian hospitals from nurses' perspective.

METHODS

A cross-sectional, descriptive design was utilized. A total number of 658 nurses participated in the current study. Data were collected using an Arabic version of the hospital survey of patients' safety culture.

FINDINGS

Teamwork within unit dimensions had a high positive response, and was perceived by nurses to be the only strong suit in Jordanian hospitals. Areas that required improvement, as perceived by nurses, are as follows: communication openness, staffing, handoff and transition, non-punitive responses to errors, and teamwork across units. Regression analysis revealed factors, from nurses' perspectives, that influenced patients' safety culture in Jordanian hospital. Factors included age, total years of experience, working in university hospitals, utilizing evidence-based practice and working in hospitals that consider patient safety to be a priority.

LIMITATIONS

Participants in this study were limited to nurses. Therefore, there is a need to assess patient safety culture from other healthcare providers' perspectives. Moreover, the use of a self-reported questionnaire introduced the social desirability biases.

CONCLUSION

The current study provides insight into how nurses perceive patient safety culture. Results of this study have revealed that there is a need to replace the traditional culture of shame/blame with a non-punitive culture.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Study results implied that improving patient safety culture requires a fundamental transformation of nurses' work environment. New policies to improve collaboration between units of hospitals would improve patients' safety.

Media use for seeking health/cancer-related information: findings from knowledge, attitudes and practices towards cancer prevention and care survey in Jordan

Understanding of public health/cancer information-seeking behaviour could play key role in promoting health behaviour and reducing cancer burden. In the current study, data from 'Knowledge, Attitudes and Practices toward Cancer Prevention and Care Survey in Jordan' were used. A total of 3196 participants (18 years and older) were included in the study. The results indicated that 82% (n = 2609) of the participants had never looked for health/cancer information from any sources. The majority of those surveyed (97%) reported watching TV habitually, whereby 948 participants (26%) indicated that they watched health information on the local/satellite TV channels, whereas 1603 (45%) reported doing so on non-local/satellite TV channels. Internet was the most searched source for information (36%); however, it is one of least preferred sources. Health-care providers are the most preferred source for cancer-related information, followed by TV and someone with cancer. The majority of participants (82%; n = 489) indicated the absence of barriers in seeking information about cancer. The results suggest that although the Jordanian public use of different media and channels for seeking health/cancer-related information, health-care providers and TV might be effective tools for health education. In addition, joint efforts must be established to initiate awareness programmes at the local and regional levels.

Baccalaureate nursing students’ anxiety related computer literacy: a sample from Jordan

The learning environment extends beyond the classroom, in a way, necessitating integration of computer literacy with education, establishing e-learning culture within future nursing education and facilitating life-long learning, which goes hand in hand with reshaping the future of the nursing practice. Despite the rapid integration between computers and different health care issues, studies indicated that nursing students have extremely low levels of computer literacy. Therefore, the purpose of this study was to assess the anxiety-related computer literacy rates of a few nursing students in Jordan. A convenient sample of 441 undergraduate nursing students was selected. A descriptive study utilised a self-administered questionnaire of the Arabic version of the Computer Anxiety Rating Scale and Computer Literacy Scale Data between 20 May and 30 July 2009. Study results indicated that there was a significantly negative relationship between computer anxieties and computer literacy rates. This implies the need for frequent use of computers in various educational and training activities. Frequent use of the computer would reduce computer anxiety and thus enhance computer literacy rates.

Jordanian nurses' knowledge and practice of breast self-examination

AIM

This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self-examination.

BACKGROUND

Studies have shown that women who have learned about breast self-examination have positive attitudes toward breast cancer and practise breast self-examination more frequently, and that nurses who teach their clients about methods of early detection and breast self-examination are more knowledgeable about breast cancer screening and breast self-examination techniques than those who do not. Therefore, it is important to understand nurses' knowledge about breast cancer and its early detection.

METHODS

A cross-sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self-administrated questionnaire with three parts and based on the American Cancer Society's guidelines: demographics, knowledge, and practice of breast self-examination.

RESULTS

Nurses reported high levels of knowledge of breast self-examination (M = 7.6, SD. 2.7). A high proportion of nurses reported doing breast self-examination in the past 12 months (85%), but only 17.7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self-examination.

CONCLUSION

More health education about monthly breast self-examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women.