Nurses' beliefs and perceptions regarding family-centered care services in acute pediatric healthcare settings

OBJECTIVES

To describe pediatrics nurses' beliefs about family-centered services (FCS) as a model of providing healthcare to children in acute care settings in Jordan.

DESIGN AND METHODS

This is a cross-sectional descriptive study. Nurses who provide direct acute care to children (n = 246) completed the 'Measure of Beliefs about Participation in Family-Centered Service' questionnaire. Descriptive statistics were used to describe nurses' beliefs about participation, practical feasibility, implementation self-efficacy, principles, and potential adverse outcomes of FCS.

RESULTS

Many nurses feel confident (70%) about their ability to work with others in providing FCS and perceive having the ability to operate according to family-centered care (FCC) principles (68%). Many (75%) nurses believed parents should be encouraged to decide how much they want to be involved in the child's care. However, only 46% of the nurses valued attending to family priorities if the health decisions made by the family differed from the healthcare providers' priorities. Many nurses (70%) believed that healthcare professionals' competencies and capacities to work utilizing FCC are more important than their personal preferences and opinion.

CONCLUSIONS

The findings of this study clearly indicate that nurses positively viewed providing children's care within a FCS. This supports the efforts to reasonably integrate FCC as an operating model in the pediatric healthcare settings in Jordan.

PRACTICE IMPLICATIONS

FCS is a complex task requiring integrating multidisciplinary effort and healthcare providers' positive attitudes toward families as care partners. Steps should help maximize the organizational resources to facilitate family presence and create opportunities for professional-families partnerships for children's care.

Gender as a Moderator of Spirituality and Spiritual Care in ICU Nurses During COVID-19 Pandemic

Background

Earlier research has found that female healthcare providers often report greater spirituality and spiritual care than males. This would evoke attention toward factors contributing to such differences, particularly gender.

Aim

To examine the moderating effects of gender on the relationships between demographic characteristics of ICU nurses and their perceived spirituality and spiritual care.

Methods

A cross-sectional correlational design was used to recruit a national sample of 865 nurses working in ICUs in Jordan and providing care to patients diagnosed with COVID-19. Data were collected using a self-report bilingual version of Spirituality and Spiritual Care Rating Scale (SSC) and analysed using the SPSS software package.

Results

Social status, monthly income, and receiving previous courses or lecture training on spirituality and spiritual care were predictors of higher SSCRS scores. Working with COVID-19 patients was a positive predictor (B = 0.074, p = 0.023), suggesting that working with COVID-19 patients is more likely to have a higher level of SSC. Gender was a negative predictor (B = -0.066, p = 0.046), suggesting that female participants are likelier to have a lower SSC score.

Conclusion

Working with patients during the COVID-19 pandemic positively impacted nurses' perception of SCC, but female nurses had lower score than male nurses indicating the need for more emphasis on training female nurses and exploring further the areas in which they need more training and to be able to provide an effective SSC. A sustainable up-to-date training and in-service education programs responding to nurses' needs and emerged emergencies crisis need to be integrated into nursing quality of care policy development.

Systematic review and meta-analysis: Prevalence of hypertension among adolescents in the Arab countries

PROBLEM

Hypertension (HTN) is one of the non-communicable diseases which prevalence is rising in both developed and developing countries. There is a scarcity of data on the prevalence of HTN in Arab countries. This review outlines what is currently known about prevalence and risk factors of HTN in adolescence in Arab world.

ELIGIBILITY CRITERIA

A systematic review and meta-analysis were conducted using PubMed, Cochrane Library, Scopus, CINAHL, Science Direct, and Google Scholar databases from 2011 to 2021.

SAMPLE

Fourteen studies from 9 Arab countries met inclusion criteria. Studies included a total of 777 adolescents with HTN and 2147 adolescents with pre-HTN.

RESULTS

The overall prevalence of HTN among adolescents in the Arab World was estimated at 12.6% (95CI 0.083-0.176), while pre-HTN was 13.9% (95CI 0.084-0205). Overweight and obesity resemble the higher risk of developing hypertension. Family history, high consumption of salt, smoking and low physical activity also increase the risk of HTN. The development of adolescent HTN can be predicted through anthropometric measurements such as Body Mass Index (BMI), wrist circumferences, and high waist circumference.

CONCLUSION

The prevalence of HTN among adolescents in the Arab world was significant, ranging from 4 to 26%. The heterogeneity between studies was high.

IMPLICATION

Local governments and policymakers must consider strengthening regulations to address environmental risk factors and improve public awareness about risk factors to HTN. A combined use of nurse- and patient targeted educational interventions could also help in reducing the burden of HTN in this population.

The impact of somatic and cognitive depressive symptoms on medical prognosis in patients with end-stage renal disease

PURPOSE

To determine whether somatic or cognitive depressive symptoms affect hospitalization and death in patients with end-stage renal disease.

DESIGN AND METHOD

In an observational retrospective design, the patients (n = 190) completed the Beck Depression Inventory-II at baseline and were followed for 5 years to collect data all-cause mortality and hospitalization.

FINDINGS

High somatic (53.7%, n = 102) and cognitive (52.1%, n = 99) depressive symptoms scores significantly associated with mortality (38% vs. 19%; hazard ratio [HR] = 2; 95% CI, 1.1-3.7; p = 0.02) and hospitalization (62.5% vs. 49.4%; HR = 1.6; 95% CI, 1.0-2.6; p = 0.03), respectively.

PRACTICE IMPLICATIONS

In the context of diagnosing and intervening, awareness of depressive symptoms dimensionality is crucial.

Nurses' Perceptions and Attitudes toward Family-Centered Care in Acute Pediatric Care Settings in Jordan

PURPOSE

Perceptions and attitudes toward working with parents may influence nurses' family-centered clinical care practices. There is a paucity of research measuring family-centered care among nurses working with children and their parents in Jordan. The purpose of this study was to explore nurses' perceptions of family-centered care by examining nurses' attitudes toward working with children and their parents, as well as toward family-centeredness. Also investigated was the extent to which the selected demographic characteristics of nurses explain the discrepancies between their child- and parent-focused attitudes.

DESIGN AND METHODS

Using a cross-sectional descriptive study, 246 nurses completed the 'Working with families' questionnaire. A paired t-test used to compare the working with children versus working with parents' attitude scores, and independent t-test and ANOVA to explore the influence of nurses' demographic characteristics attitude scores.

RESULTS

The nurses scored higher for working with children than with parents, suggesting more positive attitudes toward the former than the latter (p < 0.001). The family-centeredness scores varied with nurses' years of clinical experience (p < 0.001) and years of employment (p < 0.005).

CONCLUSIONS

The applicability of the family-centered care model in Jordan's hospitals is challenged by the fact that pediatric nurses register more positive attitudes for working with children than with parents.

PRACTICE IMPLICATIONS

Nurses' attitude toward working with children's families requires more evaluation prior to implementing family-centered care in practice. Further research is needed to explore factors contributing to discrepancies between child- and parent-focused attitudes among nurses.

Perceived barriers to healthcare utilization among Jordanian families: A family centered approach

AIM

This study aimed to understand the barriers to health services utilization by Jordanian families.

BACKGROUND

Access to quality healthcare services is a significant issue facing healthcare systems. Healthcare systems must identify and apply measures to overcome barriers that face utilizing health services and thus increase clients' satisfaction.

METHODS

A cross-sectional qualitative research design was used in this study. Semi-structured interviews were conducted with twenty-five families to elicit the model of health services barriers.

RESULTS

The analysis of the family interviews led to four main themes related to health services barriers: service system, structural/physical barriers, equipment and medication, and staff competency. This study would increase awareness about underserved populations that avoid seeking medical care.

CONCLUSION

Public health efforts are required to increase awareness about the importance of contacting the healthcare system as early as possible. However, public health policy may require developing new initiatives that reduce these perceived barriers, such as enhancing communication skills among healthcare workers, increasing supervision and inspection of healthcare quality, and enhancing patient engagement by using phone calls and messages as appointment reminders and careful follow-up.

Perception and predictors of school climate among Jordanian adolescents

Background

School climate has great effects on adolescents’ outcomes. It offers possible protective or harmful sets of factors that have significant contributions to adolescents’ health, development, and academic outcomes.

Purpose

The purpose of this study was to investigate adolescents’ perception of school climate and its predictors.

Design and methods

A cross-sectional design was used to recruit a convenient sample of 567 students with mean age of 14.6 years. Health Behavior in School-Aged Children questionnaire subscales of perceived school climate, peer support, and teacher support were used to collect data. Descriptive, parametric, bivariate, and regression analysis tests were used in the analyses of the study data.

Results

The study showed that less than half of the students felt that they belonged to their schools. One-third of responding students were involved in making rules. Perceived academic performance, adolescents’ age, peer support, and teacher support were the predictors of school climate. Significant differences existed between adolescents’ perception of school climate in relation to age, gender, and perceived academic performance.

Conclusion

Some aspects of school climate should be further addressed by the school nurse, policy makers, and school administrators in order to improve Jordanian adolescents’ outcomes in term of their developmental needs and academic performance.

Traditional methods for managing illness in newborns and infants in an Arab society

AIM

This study explored self-management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health.

BACKGROUND

Self-medication with folk remedies is believed to have short- and long-term impacts on well-being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self-managing their newborns' and infants' health.

METHODS

Data were collected from five focus groups using open-ended questions with 37 mothers. Participants were selected using snowball sampling and were recruited from four different cities in Jordan between June 2016 and August 2016.

ETHICAL APPROVAL

All identifying information regarding the study participants has been omitted, and this study was approved by the Academic Research Committee at the University of Jordan.

FINDINGS

Mothers were more willing to try herbal remedies, traditional massage and certain foods to self-manage their infants' health. Folk remedies were not restricted to traditions handed down through generations, but included a representation of newly emerged trends towards 'safety' or 'nature'.

CONCLUSIONS

While the use of folk remedies have been handed down generations as customs, today, virtual support groups and social media provide modern resources for folk remedies' promotion in care and self-management.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Nursing and health policymakers can use our findings for planning and developing strategies and health policies that increase public awareness about adverse health effects associated with herbal remedies. Such strategies are likely to be facilitated through partnerships between nursing and midwifery education institutions, antenatal clinics and social media in the region.

The 12-year prevalence and trends of childhood disabilities in Australia: Findings from the Survey of Disability, Aging and Carers

AIM

This paper contributes to knowledge on the prevalence and nature of disabilities in Australian children over a 12-year period (2003-2015). Understanding the current state of childhood disability is imperative for predicting future needs for long-term care and early intervention services for this population.

METHODS

We used data on children 0-14 years from the 2003, 2009, 2012, and 2015 survey of Disability, Aging and Carers, which is an ongoing national survey covering both rural and urban areas of all States and Territories of Australia.

RESULTS

Using the test for trends in population, no significant increases were noted in the prevalence of childhood disabilities over the last 12 years, although the prevalence of any developmental disability increased from 6.9% to 7.42% between 2009 and 2015. The rate and severity of disability was higher among boys compared with girls of the same age for a number of selected disabilities and higher for children aged 5-14 years.

CONCLUSIONS

With the anticipated rise in psychological related disability among Australian children, there is a need to ensure availability of a flexible and responsive model of service delivery for this population. This also implies that respite service coverage may need to be substantially increased to meet children and caregivers' needs.

Newborn Care Practices of Mothers in Arab Societies: Implication for Infant Welfare

INTRODUCTION

There are at least 22 Arab league states and sections in Northern Africa, southwestern Asia, and Europe that incorporate the vast Middle Eastern culture. The purpose of this study was to identify the cultural variations in newborn care practices, self-management of common illnesses, and their potential impact on infant welfare.

METHOD

A qualitative design using a focus group approach with 37 Arab mothers in Jordan was used.

RESULTS

Findings revealed strong similarities in terms of beliefs, care practices, and the experience of intergenerational conflict in establishing and maintaining traditional practices among mothers. Potentially harmful practices included restrictive swaddling, rubbing a newborn's body with salt, and encouraging the ingestion of herbs in newborns.

DISCUSSION

It is important for nurses and midwives to be aware of traditional practices, cultural beliefs, and the implications for infant welfare if they are to effectively engage with families to promote the well-being of the newborn.

Prevalence and correlates of substance use among psychiatric inpatients

PURPOSE

This study aimed at examining correlates of substance use among patients diagnosed with psychiatric disorders in Jordan.

METHODS

This study used a nonexperimental descriptive survey design. Data were collected through using DUSI-R scale obtained through a self-designed questionnaire. A total of (203) subjects satisfied the inclusion criteria.

RESULTS

Most used substances prior to admission were caffeine (78.2%), cigarette (60.9%), and alcohol (22.2%), while the least were heroin (1.2%) and inhalants (0.08%). Patients diagnosed with schizophrenia had higher percentages among all other disorders (n = 16, 21.9%), although there was no statistical difference among patients related to their psychiatric disorders.

CONCLUSION

We recommend that mental health professionals be equipped with necessary skills to manage substance use among patients with psychiatric disorders.

Impulsivity and Sensation-Seeking Personality Traits as Predictors of Substance Use Among University Students

The purpose of the current study was to investigate the relationship between substance use and impulsivity and sensation-seeking personality traits among 655 university students using a cross-sectional, descriptive, correlational design. A significant correlation was found between students' impulsivity level scores and frequency of substance use (r = 0.11, p < 0.05). A positive correlation was found between frequency of substance use and sensation-seeking levels (r = 0.2, p < 0.05), as well as impulsivity levels (r = 0.31, p < 0.01). Multiple linear regression analysis showed that the two predictors model was able to account for 12.4% of variation in substance use. Impulsivity and sensation-seeking personality traits are significant predictors of substance use among university students. [Journal of Psychosocial Nursing and Mental Health Services, 56(1), 57-63.].

Correlates of treatment satisfaction and well-being among patients with type II diabetes

AIM

To examine the impact of patient characteristics, anthropometric measurement and patient clinical variables on their appraisal of treatment satisfaction and well-being.

BACKGROUND

Treatment satisfaction and well-being are instrumental in achieving diabetes care goals. Nursing practices and healthcare policies may inform interventions in these areas.

INTRODUCTION

The prevalence of diabetes is high in the Middle East. An understanding of relationships between clinical and socio-demographic variables and well-being and treatment satisfaction is needed to improve care and patient outcomes.

METHODS

A total of 1002 patients completed tools measuring well-being, treatment satisfaction and socio-demographic characteristics. A series of bivariate and multivariate analysis were conducted to identify factors associated with well-being and treatment satisfaction.

RESULTS

Males reported better treatment satisfaction and well-being than females. Older participants, those who were compliant to diet, with controlled diabetes, and no neuropathy reported higher treatment satisfaction scores and well-being scores. Insulin therapy was associated with better treatment satisfaction.

DISCUSSION

Females, participants who were not prescribed diabetic diets and those with complications were more likely to be negatively impacted by diabetes. Individuals with diabetes who were treated with insulin had higher treatment satisfaction than those who used oral hypoglycaemic agents.

CONCLUSION AND IMPLICATION FOR NURSING AND HEALTH POLICY

These findings are important in assisting nurses and other healthcare professionals in identifying patients with diabetes with low treatment satisfaction who may present a greater risk for poor well-being. Additionally, they lend support to developing policies for frequent screenings and special therapeutic interventions that are needed to maximize patients' treatment satisfaction and well-being in the Middle East and elsewhere.

Oral glucose efficacy on neonate's pain responses at the NICU: A quasi experimental trial of two clinical procedures

AIM

This research was undertaken with the purpose of testing two research hypotheses regarding the efficacy of 10% oral glucose solution on procedural pain associated with venepuncture and nasopharyngeal suctioning within three neonatal intensive care units (NICU). The hypotheses were formulated from previous conclusions reached by other researchers highlighting the efficacy of sucrose solutions on neonates' pain responses during minor painful procedures.

METHOD

A quasi-experimental trial utilising a time series design with one group was used. Data from a total of 90 neonates included 60 neonates who underwent a venepuncture and 30 neonates who underwent a nasopharyngeal suctioning procedure for clinical purposes. The neonate's pain response for each procedure was scored using the Neonatal Pain Assessment Scale (NPAS) on two separate occasions over three time periods. The pre-procedural score (T₀) when the neonate received no sucrose, the inter-procedural score (T₁) when the neonate was given 2ml of 10% glucose solution two minutes before the procedure (intervention group) or where oral glucose was withheld (control group) and the post-procedural score (T₂) being at the end of the procedure.

RESULTS

The results showed the mean NPAS scores in response to venepuncture or nasopharyngeal suctioning were significantly lower in the intervention group than the control group.

CONCLUSION

This showed that oral glucose (10%) had a positive effect on the pain response during venepuncture and nasopharyngeal suctioning procedures.

Socio-demographic correlates of parents' participation in care of a hospitalized child: A perspective from a developing country

Studies on parents' participation in care of a hospitalized child are rare and have not sufficiently addressed the factors prompting parents' participation in their child's care. This study investigated the relative contributions and predictive value of parents' and children's demographics on parents' participation in care. A convenience sample of 294 parents participated from four major hospitals in a metropolitan area in Amman. Parents completed two sets of measures, a socio-demographic form and the Arabic version of the Index of Parent Participation/Hospitalized Child. A series of bivariate analyses were completed to investigate associations between socio-demographic variables and parents' participation in care. The multiple regression analysis identified four variables as the optimal set of predictors for parent participation in the care of a hospitalized child: hospital experience, type of illness, child's age and type of hospital. The importance of interpreting these findings in a cultural context is discussed.

Parents' Perceived Satisfaction of Care, Communication and Environment of the Pediatric Intensive Care Units at a Tertiary Children's Hospital

This study aims to identify parental perceptions on pediatric intensive care-related satisfaction within three domains: environment, child's care provided and communication. In addition, it aims to identify whether parent's socio-demographics and child's clinical variables predict parents' perceived satisfaction. In this study, a total of 123 parents whose child received care in the PICU of a tertiary children's hospital in Amman completed the Arabic version of the parents satisfaction survey (PSS). A cross-sectional, descriptive-correlational design was used to collect data. All data were collected between June and October of 2013. Central tendency measures and percentages of replies for each domain revealed that at least 7 items were rated poorly satisfied. More than half of the parents were not satisfied with the noise level of the PICU, the time nurses spent at the child's bedside, as well as the way the healthcare team prepare them for the child's admission. Almost 90% of the parents believed that the nurses ignored their child's needs by not listening to parents and by responding slowly to child's needs. Stepwise regression analysis showed that that the number of hospital admissions, health insurance and the severity of illness was the main predictor of parents' satisfaction. In conclusion, the availability of health care professionals, the support and the information they share with the child's parents are all significant to parent's satisfaction and hence to better quality of care. Targeting the domains of low satisfaction reported by the parents could increase parent's satisfaction and achieve quality improvement required for this population.

Development and psychometric evaluation of the Chronic Kidney Disease Screening Index

OBJECTIVE

Public understanding of chronic kidney disease (CKD) is important to ensure informed participation in CKD prevention programs. This study aimed to develop and to test the psychometric profile of the CKD Screening Index that measures patient's knowledge, attitudes, and practices regarding CKD prevention and early detection.

METHODS

A cross-sectional design was implemented and a total of 740 Jordanian patients recognized at risk for CKD were recruited by convenience sampling from out-patient departments. Development and psychometric validation of the CKD Screening Index were conducted in four phases: (1) item generation, (2) pilot study, (3) preliminary psychometric validation study to examine factor structure, and (4) final psychometric validation with 740 participants.

RESULTS

On factor analysis, 24 items categorical knowledge items loaded into one factor and yielded a Guttman Split-Half Coefficient of 0.80. In a separate factor analysis, 15 items were loaded on two attitude factors (Cronbach alpha coefficient = 0.69), and nine items loaded on two practice factors (Cronbach alpha coefficient = 0.68). The CKD Screening Index associated significantly and negatively with depressed and anxious patients compared to their counterparts.

PRACTICE IMPLICATIONS

This promising CKD Screening Index can be used for an early identification of patients at risk for CKD, thus, allowing the development of interventions to raise these patients' awareness. Future studies are needed on other populations with different cultural background to support reliability and validity of this new instrument.

Jordanian mothers' beliefs about the causes of cancer in their children and their impact on the maternal role

BACKGROUND

Arab culture and Islamic beliefs contribute to values and practices regarding cancer. Mothers in Jordanian society are expected to be the primary caregivers to children.

PURPOSE

The purpose of this study was to explore Jordanian mothers' beliefs regarding the causes of cancer in their children and their impact on their role as mothers.

DESIGN

A descriptive, qualitative design was used. Individual interviews were conducted with Jordanian mothers (n = 51) of hospitalized children with cancer.

RESULTS

Causes of cancer were attributed to supernatural explanations and biomedical explanations. The impact of cancer on these mothers' lives varied. For some, their child's illness resulted in stronger family bonds, whereas for others, the families suffered a state of disequilibrium.

CONCLUSIONS

Cultural beliefs helped assign meaning to their children's illness. The maternal role of Jordanian women was partially fulfilled or inadequately performed, which in turn affected the functioning and coping abilities of the entire household.

Screening for anxiety symptoms and social desirability in children and adolescents living with chronic illnesses in Jordan

This research aims to investigate the rate and nature of anxiety symptoms in a group of children and adolescents living with chronic illnesses in Jordan, and their relation to social desirability in a cultural sample not previously researched. Using the Revised Children's Manifest Anxiety Scale (R-CMAS), anxiety and social desirability data were obtained from 114 children diagnosed with chronic illnesses and 162 healthy control participants. Based on children's self-report, participants were categorized according to their adaptive style paradigm as either high anxious, low anxious, or repressor. It was proposed that children who score high on social desirability and low on anxiety are repressors. The prevalence of these categories was compared across the two groups. Anxiety was reported in 9.64 percent of the chronic illnesses and 12.34 percent of the healthy peers. Using the data obtained in the present study, the rate and nature of anxiety in children with chronic illnesses were lower for children in Jordan when compared to previous studies. However, social desirability values were similar to those established in Western societies suggesting a significantly higher percentage of children identified as repressors in children with long-term illnesses. These results supported the hypothesis regarding the relationship between social desirability and expressed anxiety symptoms.

Unmet care needs of parents of children with cancer in Jordan: implications for bed-side practice

AIMS AND OBJECTIVES

To evaluate the perceived care needs of parents of children with cancer in Jordan. (1) What are the parents' priority caring needs; (2) to what extent these needs are met by the healthcare team members; (3) the parents' need for further information (4) and whether socio-demographic, disease and treatment variables predict parents' needs for further information.

BACKGROUND

Providing support for families caring for a child with a long-term illness has been recognised all through literature, yet studies focusing on parent needs are lacking.

DESIGN

Descriptive survey.

METHODS

A total of 98 parents from a tertiary oncology hospital in metropolitan area in Amman completed the Arabic Family Inventory of Needs-Pediatric II.

RESULTS

Most of the 17 needs measured by the Family Inventory of Needs-Pediatric II were considered important. Only 78% of parents needs were met by the healthcare professionals; yet, the results clearly highlighted the importance of informing parents about the child's illness, treatment and outcome. The socio-demographic variables were not significant predictors for the family needs for further information, with two major exceptions; parents with lower level of education and parents of children undergoing bone marrow transplantation or surgery.

CONCLUSIONS

The needs of parents vary from family to another, and healthcare professionals must become familiar to these needs and acquire the skills to direct their interventions more appropriately. The Family Inventory of Needs-Pediatric II may be a useful adjunct in assessing the parents' needs for care and for information, as well as the quality of care services provided.

RELEVANCE TO CLINICAL PRACTICE

Priority needs should be central in the daily care of these families and support programmes should be adopted in Jordan for planning and developing the system of care for these families, as well as their children.

The Prevalence of Depression in Pediatric Oncology Patients Undergoing Chemotherapy Treatment in Jordan

The aim of this study was to investigate the prevalence of depression in pediatric oncology patients in Jordan, comparing them with peers who suffered from chronic conditions or were healthy. The authors investigated 58 children with cancer, 56 with chronic illnesses, and 64 healthy controls using the Arabic version of the Children’s Depression Inventory (CDI). There was no significant difference in CDI scores between children with cancer, children with chronic illnesses, and healthy controls. Using the conventional cutoff point of a score of 20 gives a prevalence of 20.68% for child-reported depression in the cancer group. This is toward the high end of the range for similar studies in other countries. The results suggest that children with cancer undergoing chemotherapy are no more likely to be depressed than children with chronic illnesses or healthy controls, although further research is warranted.