Fidaa Almomani

Effects of an Oral Health Promotion Program in People with Mental Illness

More knowledge is needed regarding what works to prevent oral health problems and reduce disparities in oral health. Motivational interviewing (MI) has demonstrated utility for improving health behavior, including among those with severe mental illness. This study tests whether MI enhances the efficacy of an oral health education intervention in individuals with severe mental illness. Sixty individuals were randomly assigned to MI plus oral health education or oral health education alone. Plaque scores, oral health knowledge, and self-regulation were assessed at baseline and at 4 and 8 weeks. Repeated-measures ANOVA showed improvement (p < 0.05) in plaque, autonomous regulation, and oral health knowledge across time for both groups; however, individuals receiving MI improved significantly more when compared with those receiving oral health education alone. Results suggest that MI is effective for enhancing short-term oral health behavior change for people with severe mental illness and may be useful for the general population.

The effect of an oral health promotion program for people with psychiatric disabilities.

Oral health programs for people with psychiatric disabilities are rare. This study examined the feasibility efficacy of an oral health intervention for people with psychiatric disabilities. Fifty individuals were recruited and randomly assigned to receive education, reminder system and mechanical toothbrush or just the mechanical toothbrush. 42 completed the study. Plaque index scores recorded at baseline and after 4 weeks indicate a statistically significant improvement for both groups but those in the enhanced intervention improved significantly more. The results suggest the mechanical toothbrush improves the oral hygiene of people with psychiatric disabilities. The combination of mechanical toothbrush, dental instructions and reminders result in additional improvements.

Health-related quality of life and physical, mental, and cognitive disabilities among nursing home residents in Jordan

PurposeTo describe the physical, cognitive, psychological, and medical status of nursing home residents in Jordan. We also investigated the perceived health-related quality of life of this population.MethodsA sample of 221 nursing home residents in Jordan was recruited to participate in this study. Demographic variables and medical history were collected. In addition, all participants were assessed using health-related quality of life items (HRQOL), mini-mental state examination (MMSE), Geriatric Depression Scale (GDS), Tinetti assessment battery for gait and balance (TAB), and disability of arm, shoulder, and hand assessment (DASH).ResultsTAB and DASH scores were related to the following HRQOL items: self-reported general health status, the need for personal care, the need for help from others in handling routine needs, the number of days of pain, feeling sad, depressed, worried, and not getting enough sleep, and the number of days feeling very healthy and full of energy. MMSE scores were related to self-reported need for personal care, the need for help from others in handling daily routine needs, and the number of days feeling pain, sad, worried, and depressed. GDS scores were related to self-reported general health status, the need for personal care, the need for help from others for handling daily routine needs, the number of pain, sad, worried, and not getting enough sleep days, and the number of days feeling healthy and full of energy.ConclusionsThis study revealed a substantial impact of physical, cognitive, and psychological disabilities on HRQOL of nursing home residents in Jordan

Factors related to cognitive function among elementary school children

Abstract Objective: The purpose of this study was to investigate cognitive functioning among elementary school children in Jordan. Methods: A total of 468 children aged 6–12 years were recruited to participate in this study. Cognitive functioning was assessed using the LOTCA battery (Loewenstein Occupational Therapy Cognitive Assessment; Itzkovich et al., 2000). Information obtained from the parents included demographics, work and income data and childs daily behavior and school achievement. Results: The results of this study showed that the cognitive functioning increased by 3.8 points for each increase in the childs GPA and increased by 2.35 points when the child ate breakfast regularly. By contrast, living in rural areas and smoking by a parent decreased cognitive functioning. Conclusions: Understanding of the childs cognitive abilities is critical to establishing intervention goals and to planning therapeutic activities. Screening of cognitive abilities and associated factors is essential for a comprehensive and accurate understanding of the childs abilities and limitations. Further research is recommended to investigate other factors in different populations.

Factors related to gait and balance deficits in older adults.

Purpose The aim of this study was to investigate the effects of physical, mental, and cognitive disabilities on gait and balance deficits among nursing home residents with different diseases in Jordan and also to find the risk of fall associated with or without these diseases. Methods A sample of 221 nursing home residents aged 18–100 years in Jordan was recruited for this study. All participants were assessed using the Arabic versions of the Tinetti assessment battery (TAB) for gait and balance, mini–mental state examination, and disability of arm, shoulder, and hand assessment test. Results A total of 221 nursing home residents were included in this study. Different chronic diseases were medically reported in this study. Psychiatric disorders (45.7%) were shown to be the most prevalent disease seen among the participants, followed by hypertension and diabetes mellitus affecting 33.5% and 23.5% of the participants, respectively. However, the least prevalent diseases were stroke (17.2%), joint inflammation (17.2%), and arthritis (9.0%). Based on TAB scores, the participants were classified into three groups: high risk of falls (≤18; n=116), moderate risk of falls (19–23; n=25), and low risk of falls (≥24; n=80). The correlation between physical activity and mental health problems with risks of falls was reported in all participants. The data showed that participants with over 50% upper extremity disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension recorded higher risks of falls as measured by TAB test compared to those with low and moderate TAB scores. Also, impairment in cognitive abilities and psychiatric disorders was shown to be associated with gait and balance problems, with a higher risk of falls in 47.5% and 46.1% of the residents, respectively. Conclusion This study revealed a significant impact of upper limb disability, stroke, heart disease, arthritis, joint diseases, diabetes, and hypertension as well as psychiatric disorders and cognitive disabilities on gait and balance deficits among home-resident older adults.

Cross cultural adaptation of the adolescent/adult sensory profile: establishing linguistic equivalency and psychometric properties of the Arabic version

Abstract Background: Cross-cultural adaptation of standardized outcome measures between different languages is a common procedure that allows healthcare professionals around the world to utilize such measures in their own languages. The purpose of this study was to investigate the accuracy of translating and cross-culturally adapting the Adolescent/Adult Sensory Profile from English to Arabic and to assess the psychometric properties of the Arabic version. Methods: A backward–forward translation process was used to translate the measure. Eighty-seven bilingual participants completed an English and an Arabic translated version of the measure. Results: The percent agreement for each of the Arabic and English items ranges from 0.77 to 0.98. The kappa values range from 0.79 to 0.84. Test–re-test reliability of the Arabic version was tested on 35 participants. The percent agreement between the first and the second assessment using the Arabic version of the Adolescent/Adult Sensory Profile ranges from 0.80 to 0.96. The kappa values range from 0.82 to 0.88. Internal consistency for the Arabic version was 0.84 and 0.82 for the English version. Construct validity of the Arabic version (n = 560) was tested using factor analysis. Four factors were rotated using a Varimax rotation procedure. The factors’ classification and the items’ distribution related to these factors were very similar to the English version of the Adolescent/Adult Sensory Profile. Only 9 items of the 60 items (15%) had different distribution than the original version. Conclusion: The Arabic version of the Adolescent/Adult Sensory profile has very good psychometric properties and can be utilized with confidence with Arabic-speaking individuals. Implications for Rehabilitation Arabic-speaking countries lack standardized rehabilitation assessments written in Arabic. The Adolescent/Adult Sensory Profile is a widely used measure with good psychometric properties and one of rare instruments that measures sensory processing in adult and adolescent. The translation and cross-cultural adaptation of the Adolescent/Adult Sensory Profile yielded an Arabic version of the profile with very good psychometric properties. The Adolescent/Adult Sensory Profile – Arabic is now one of a few, and much needed, assessments with established psychometric properties that are available to occupational therapists in Arabic-speaking communities. The instrument can be administered with confidence among Arabic speakers.

The incidence of depression among residents of assisted living: prevalence and related risk factors

Aim This study aims to recognize and estimate the prevalence of depression and its risk factors among residents of assisted living facilities (ALs) in Jordan. Background Depression is commonly experienced by residents of ALs. The condition is, however, often misunderstood as a part of normal aging and may be overlooked by health care professionals. Little is known about the extent of depression and its risk factors among AL residents in Jordan. Subjects and methods A national representative sample of 221 residents selected from all AL units across Jordan was recruited to the study. Data on expected risk factors for depression were collected, including sociodemographics; smoking status; number of roommates; number of family members; assessments for cognitive functioning, for lower limb functioning, for hand, shoulder, and arm impairments; and oral health status. Levels of depression among the sample respondents were also assessed. Results The study found that around 60% of the participants reported depressive manifestations, with 48.0% of AL residents exhibiting impaired cognitive functions, one-third (33.2%) having >50% upper limb disability, two-thirds (63.2%) being at moderate risk of falls, and 69.7% having fair to poor oral health status. Being female, and having a higher level of education, disability of the upper limbs, and impairment of cognitive functions were found to be independent risk factors for depression in participants. Conclusion Depression is relatively common among residents of AL units in Jordan. Health care professionals, nurses, physiotherapists, and dentists working in these facilities need to work cooperatively to identify the manifestations of depression in residents and collaboratively implement the best practice in the treatment of depression and circumvent its long-term impacts on the health of residents.

Construct validity and internal consistency reliability of the Loewenstein occupational therapy cognitive assessment (LOTCA)

BackgroundCognitive abilities are essential for children’s development and independence. Various cognitive assessments, standardized in Western cultures, have yet to be investigated for their multicultural suitability.AimsTo explore the suitability of the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) for a Jordanian population.MethodsObserved cases of 442 Jordanian children aged 6–12 were used to perform exploratory factor analyses using principal components with Varimax rotation (construct validity evidence) and to compute Cronbach’s α coefficient (internal consistency reliability).ResultsHigh total performance on four subscales and a slightly lower total performance on two subscales were observed. Observed performance increased with age on three subtests, whereas a more modest increase was observed on the other three subscales. The expected one-factorial solution confirming the LOTCA’s subscales homogeneity (unidimensionality) structure was found on five of six subscales. Variance explained by the subscales ranged from 39 to 82% and internal consistency reliability measured by Cronbach’s alpha ranged from .42 to .78.ConclusionsSatisfactory construct validity and internal consistency reliability were demonstrated on two subscales applicable to Jordanian children without adaptation. With adequate cross-cultural adaptation, increasing internal consistency reliability in other subscales could make the LOTCA an effective tool for assessing cognitive abilities in this population.

Physical, mental and cognitive disabilities in relation to utilization of dental care services by nursing home residents.

OBJECTIVE The main purpose of this study was to investigate factors affecting dental care utilization among nursing home residents in Jordan. METHODS A total of 221 subjects with a mean age of 62.4 years (121 males and 100 females) taken from among nursing home residents across Jordan were recruited and composed a convenience sample for this study. The Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Tinetti Assessment Battery for gait and balance (TAB), Disability of Arm, Shoulder, and Hand test (DASH) were administered and oral health status was assessed for all subjects and examined as expected correlates of dental care utilization among nursing home residents. RESULTS The response rate was about 88%. One-third of residents suffered from total edentulism and most of the remaining dentate residents exhibited periodontal disease (90%). Of the dentate sample, 90% of residents had bleeding upon probing, 85% were diagnosed with tooth mobility, 88% had presence of dental calculus, and 30% were diagnosed with root caries. Of the denture wearers, 59.1 % reported having soreness with their dentures and 32% of denture wearers reported having poor quality dentures. MMSE score, suffering from tooth sensitivity and having diabetes mellitus were identified to be indicators for utilization of dental care services among the study population. CONCLUSION Regular oral care, assessments, and rehabilitation services are considered to be limited for nursing home residents in Jordan. Based upon these findings, future interventions should address oral health among nursing home residents in Jordan.