Diana H. Arabiat

Cross-cultural Validation of the Pediatric Quality of Life Inventory™ 4.0 (PedsQL™) generic core scale into Arabic Language

BACKGROUND A range of scales is available to measure health-related quality of life. Recently, established quality of life scales have been translated for use in a wide range of Western and non-Western cultures. One of the most widely used health-related quality of life scales for use with children is the PedsQL™ 4.0. In this paper, we describe the process of translating this scale into Arabic and establishing its reliability and validity. AIM This paper has three aims: first, to explain the process of translating the PedsQL™ (4.0) self- and proxy-reports for the ages 8-12 and 13-18, from English into Arabic; second, to assess the reliability of the new Arabic version of the scale and third, to assess its validity. METHOD The scale was translated from English to Arabic and back-translated to ensure accuracy. The Arabic version was administered to healthy children and those with cancer and a range of chronic illnesses in Jordan. Statistical methods were used to test the psychometric properties (reliability and validity) of the Arabic version of the PedsQL™ (4.0) and its ability to discriminate between children in the above groups. RESULTS Cronbachs alpha coefficients for child self- and parent proxy-reports exceeded 0.7 for the total scores, health summary scores and psychological health summary scores. Testing for discriminant validity showed that the healthy (control) group had a higher health-related quality of life than children and young people with cancer and chronic illness. The children with chronic illnesses had the lowest scores for physical, emotional and school functioning. CONCLUSION Initial testing of the Arabic version of the PedsQL™ (4.0) suggests that the scale has satisfactory psychometric properties.

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.

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.

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.

Cultural Perspective from Middle Eastern Countries on the Ethics of Involving Children with Cancer in Research

This paper is concerned with ethical issues that have to be considered when conducting research with children in nonwestern cultures. It sets the discussion in the context of current debate about researching children with cancer and explores the extent to which these ethical issues are similar to, or different from Western countries. A number of culturally sensitive issues encountered with children in Jordan while investigating their psychological wellbeing is discussed. These issues are discussed with relation to obtaining informed consent from children for participation in the research; issues of assuring confidentiality; and assuring no harm. Concern with children’s rights has been extended to the question is it ethical to provide full information about the study for children who were not informed about their cancer diagnosis. Such issues are often overlooked and for future studies with children acknowledging these issues can help provide a basis for reasoning and direct actions. The ethical issues that are discussed in this paper exemplify that exploring children’s psychological distress in a culture where this is not recognized provides the researcher with a number of concerns; the communication approaches of illness diagnosis, the wisdom of their elders, and the importance of their family which may result in reluctance to show emotion or to question decisions made on their behalf. The necessity for researchers to take an ethical stance in such cases may encounter difficulty and a number of issues had to be addressed and sorted case by case.

Development and psychometric evaluation of the Chronic Kidney Disease Screening Index

Abstract 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.

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.

Exercise Self-Efficacy Scale: Validation of the Arabic Version Among Jordanians With Chronic Diseases

This study assessed the psychometric properties of the Arabic version of Exercise Self-Efficacy scale (ESE-A) among Jordanian outpatients with a variety of chronic diseases using descriptive cross-sectional design. Participants’ scores of ESE-A significantly correlated with their reported weekly exercise frequency (r = .23, p< .001), duration (r = .31, p< .001), and evaluation of their physical exercise (r = .39, p< .001). The construct validity was tested using exploratory factor analysis, which retained all items, and the scree plot showed one meaningful factor with an eigenvalue of 10.38 and an explained variance of 57.7%. Furthermore, Cronbach’s alpha was .89 and split-half coefficient was .83 indicating that the ESE-A is a reliable scale. The ESE-A was found to be a robust measure to evaluate exercise self-efficacy among Arabic patients with chronic diseases. Arabic researchers interested in exercise self-efficacy are invited to utilize the ESE-A in their studies to confirm its psychometric properties.

Measuring Care Needs of Parents of Children With Cancer: Psychometric Properties of the FIN-PED II Arabic Version.

Background and Purpose: This study was conducted to test the Arabic version of the Family Inventory of Needs-Pediatrics II (FIN-PED II). Methods: The Arabic FIN-PED II was developed using the translation/back-translation method. Then, an expert panel of 5 parents of children with cancer rated the tool for clarity and content validity. Internal consistency and test–retest reliability was evaluated in a convenience sample of 113 parents of children with cancer. Results: The FIN-PED II was found to be acceptable and clear to almost all parents. The FIN-PED II demonstrated good psychometric properties. The internal consistency was high with alpha values >0.70 and high test–retest correlations. Conclusions: Although the Arabic FIN-PED II needs further psychometric testing, it is an acceptable, reliable, and valid measure of perceived parents need during child’s treatment.

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.