Hanan Al-Modallal

Premenstrual syndrome and premenstrual dysphoric disorder among Jordanian women

The objectives of this study were to detect the prevalence, severity and factors associated with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) among Jordanian women, and to identify the most common self-treatment strategies used by women to alleviate the symptoms associated with PMS and/or PMDD. Data were collected from 254 women studying or working at one of the largest Jordanian governmental university using Shortened Premenstrual Assessment Form (SPAF), Perceived Stress Scale (PSS) and Diagnostic and Statistical Manual of Mental Disorders 4th Edition-Text Revision (DSM-IV-TR) research criteria for diagnosis of PMDD. The findings indicated that the prevalence of PMS and PMDD were 80.2%, 10.2% respectively. Abdominal cramp, lower back pain and breast pain were reported to be the most severe symptoms associated with PMS and PMDD. Significant correlations were found between severity of premenstrual symptoms and perceived stress level, age, body mass index, marital status, perception of health in general and absent from work. The most frequently reported self-treatment strategies used by women to alleviate PMS and PMDD symptoms were: taking analgesics, increasing hot fluids intake, wearing heavy and warm clothes, and lying down on the abdomen. Understanding the prevalence, severity and self-treatment strategies for women experiencing PMS and PMDD symptoms help in improving womens quality of life and decrease their suffering from these symptoms.Accessible summary The prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) among Jordanian women were 80.2% and 10.2% respectively; which is higher than most published literature. The most severe symptoms of PMS and PMDD were abdominal cramp, lower back pain and breast pain. Taking analgesics was the most frequently used method to alleviate the symptoms of PMS and PMDD. High stress levels affected the symptoms of PMS and PMDD negatively; therefore, controlling stress level will reduce the severity of symptoms. Abstract The objectives of this study were to detect the prevalence, severity and factors associated with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) among Jordanian women, and to identify the most common self-treatment strategies used by women to alleviate the symptoms associated with PMS and/or PMDD. Data were collected from 254 women studying or working at one of the largest Jordanian governmental university using Shortened Premenstrual Assessment Form (SPAF), Perceived Stress Scale (PSS) and Diagnostic and Statistical Manual of Mental Disorders 4th Edition-Text Revision (DSM-IV-TR) research criteria for diagnosis of PMDD. The findings indicated that the prevalence of PMS and PMDD were 80.2%, 10.2% respectively. Abdominal cramp, lower back pain and breast pain were reported to be the most severe symptoms associated with PMS and PMDD. Significant correlations were found between severity of premenstrual symptoms and perceived stress level, age, body mass index, marital status, perception of health in general and absent from work. The most frequently reported self-treatment strategies used by women to alleviate PMS and PMDD symptoms were: taking analgesics, increasing hot fluids intake, wearing heavy and warm clothes, and lying down on the abdomen. Understanding the prevalence, severity and self-treatment strategies for women experiencing PMS and PMDD symptoms help in improving womens quality of life and decrease their suffering from these symptoms.

Screening Depressive Symptoms in Jordanian Women: Evaluation of the Center for Epidemiologic Studies-Depression Scale (CES-D)

This study examined the psychometric qualities of the Center for Epidemiologic Studies-Depression scale (CES-D) in Jordanian women. Cronbachs alpha for the 20-item CES-D was .90. Factor analysis yielded three components. Four of the items had poor factor loadings and, therefore, were dropped. Cronbachs alpha for the remaining 16 items was .85. Validity testing using independent samples t-test provided evidence of discriminant validity for the 20-item and the 16-item CES-D. Attributes of the CES-D items indicated that depression status can be easily identified by clinicians. Co morbidity of depressive symptoms with physical and mental problems necessitates routine screening for depressed mood.

Predictors of antenatal depression among Jordanian pregnant women in their third trimester.

Antenatal depression has not been well studied worldwide. The objective of this study was to identify the prevalence and predictors of antenatal depression among Jordanian pregnant women in their third trimester. A correlational design was used with a convenience sample of 218 Jordanian pregnant women. Data were collected using valid and reliable measures and were analyzed with regression. Fifty-seven percent of the women displayed symptoms of depression. Thirty-seven percent (34% adjusted) of the variability in depression levels was predicted by knowing scores on life satisfaction, perceived stress, family and nonfamily stressful relationships, education, and parity. For that, antenatal depression needs early detection and treatment.

Determinants of depressive symptoms in Jordanian working women

Depressive symptoms are an epidemic problem affecting different subgroups of women in clinical and non-clinical settings. However, depressive symptoms experienced by working women have rarely been studied. This study aimed at identifying depressive symptoms and their determinants in a sample of 101 Jordanian working women recruited from a higher educational institution. Data about womens depressive symptoms, their educational level, presence of children, sharing a job with an intimate partner, health status, diagnosis with chronic illnesses, and complaints of spousal abuse were collected. Logistic regression analysis was used to test for the significance of the selected factors on womens experiences of depressive symptoms. Findings indicated that 51.2% (n = 42) women complained of moderate and severe levels of depressive symptoms. Factors identified as significant in predicting depressive symptoms were womens experiences of spousal abuse (odds ratio adjusted = 3.5, 95% confidence interval = 1.05-11.7) and being diagnosed with chronic illnesses (odds ratio adjusted = 7.09, 95% confidence interval = 1.2-42.2). It was concluded that causes of womens depressive symptoms were imbedded in their familial and social environment, rather than their job per se. Mental health nurses can change the practice of nursing to better standards. Being familiarized with causes of depressive symptoms can empower nurses to be active advocates for depressed women.

Exclusive breast feeding (EBF) in Jordan: prevalence, duration, practices, and barriers.

OBJECTIVE of this study is to investigate the prevalence, duration, practices and barriers of Exclusive breast feeding (EBF) among Jordanian mothers in three major governorates. DESIGN longitudinal, prospective design was used in this study. SETTINGS AND PARTICIPANTS convenience sample of 572 pairs of postpartum mothers-infants were recruited from postpartum wards at three governmental hospitals and three private hospitals in major Jordanian governorate. MEASUREMENTS AND FINDINGS data were collected in two phases. In the first phase, trained research assistants conducted face to face structured interviews with participating mothers at the hospital. In the second phase, the research assistants conducted follow up phone interviews at the end of first, fourth and sixth months after birth. The findings of this study showed that the prevalence of EBF as recommended by WHO was 1%. The average duration of EBF was one month. The main barriers of EBF were: infants feel hungry after breast feeding, short period between pregnancies, and breast problems. KEY CONCLUSIONS postpartum mothers initiated EBF practice within the first hour after giving birth; however, this practice declined gradually as the infant grew up within the first six months after birth. IMPLICATIONS FOR PRACTICE antenatal education sessions in the Jordanian governmental hospitals about EBF are required to meet the WHO recommendations. Furthermore, midwives and nurses have to focus on effective breast feeding process to overcome the barriers of EBF during antenatal education and postnatal care.

Nursing students' perceived stress and coping behaviors in clinical training in Saudi Arabia.

Abstract Background: Clinical training has been recognized as a stressful experience for nursing students. Aims: The aims of this study were to identify levels and types of stressors among nursing students during their clinical training and their coping behaviors. Methods: Data were collected using a purposive sampling method from 100 nursing students using a self-reported questionnaire composed of Perceived Stress Scale and Coping Behavior Inventory. Results: Results showed that “assignments and workload” as well as “teachers and nursing staff” were the highest sources of stress in clinical training. The most common coping behaviors used were “problem-solving” and “staying optimistic”. There was a significant difference in perceived stress among students in regard to the way of choosing nursing. There were significant differences in coping behaviors in regard to the presence of relatives in nursing, living status and mothers’ educational level. The predictors of perceived stress were self-choosing for nursing and the presence of relatives in nursing, while the predictors for coping behaviors were stress from peers and daily life as well as mothers’ educational level. Conclusions: Nursing teachers and staff are encouraged to develop strategies that decrease level of stress and promote adaptive coping behaviors among nursing students during their clinical training.

Prevalence of intimate partner violence among women visiting health care centers in Palestine refugee camps in Jordan.

This study was conducted to investigate the prevalence of intimate partner violence (IPV) among a sample of women visiting health care centers in Palestine refugee camps in Jordan. We found that different types of IPV, including physical, emotional, sexual, economic, and control behaviors by the partners were experienced by the participants. This study was among a number of studies that investigated this phenomenon in residents of Palestinian camps. It adds to existing studies in this field, however, as it focuses on the prevalence of the top five types of IPV in these women. Cooccurrence of IPV, that is, experiencing two or more types of partner violence at the same time, was noticed in these women. Experiencing control by ones partner and the presence of different attitudes between men and women toward the use of violence were factors contributing to the occurrence of this phenomenon in these women. National efforts aiming at breaking the cycle of violence should be fostered through media and public awareness campaigns. Changing peoples attitudes concerning mens use and womens acceptance of violence should be the aim of these efforts.

Psychological Outcomes of Intimate Partner Violence Experienced by Jordanian Working Women

This study aimed at investigating psychological health problems experienced by working women as a result of their experiences of intimate partner violence (IPV). One hundred one working women participated in the study. Results indicated that nearly half of the participants reported partner violence. Compared with nonabused women, abused women showed significantly higher levels of depressive symptoms (t (78) = −3.4, p = .001) and stress (t (93) = −4.8, p < .0001), while self-esteem did not differ significantly between the two groups. Acknowledgment of this problem and early recognition of the victims may result in improving the health of working women in Jordan.

Depressive Symptoms in College Women Examining the Cumulative Effect of Childhood and Adulthood Domestic Violence

The purpose of this study was to examine the cumulative effect of childhood and adulthood violence on depressive symptoms in a sample of Jordanian college women. Snowball sampling technique was used to recruit the participants. The participants were heterosexual college-aged women between the ages of 18 and 25. The participants were asked about their experiences of childhood violence (including physical violence, sexual violence, psychological violence, and witnessing parental violence), partner violence (including physical partner violence and sexual partner violence), experiences of depressive symptoms, and about other demographic and familial factors as possible predictors for their complaints of depressive symptoms. Multiple linear regression analysis was implemented to identify demographic- and violence-related predictors of their complainants of depressive symptoms. Logistic regression analysis was further performed to identify possible type(s) of violence associated with the increased risk of depressive symptoms. The prevalence of depressive symptoms in this sample was 47.4%. For the violence experience, witnessing parental violence was the most common during childhood, experienced by 40 (41.2%) women, and physical partner violence was the most common in adulthood, experienced by 35 (36.1%) women. Results of logistic regression analysis indicated that experiencing two types of violence (regardless of the time of occurrence) was significant in predicting depressive symptoms (odds ratio [OR] = 3.45, p < .05). Among college women’s demographic characteristics, marital status (single vs. engaged), mothers’ level of education, income, and smoking were significant in predicting depressive symptoms. Assessment of physical violence and depressive symptoms including the cumulative impact of longer periods of violence on depressive symptoms is recommended to be explored in future studies.

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.