Inaam Khalaf

The pain of childbirth: perceptions of culturally diverse women.

The pain experiences of culturally diverse childbearing women are described based on a secondary analysis of narrative data from phenomenologic studies of the meaning of childbirth. Study participants were interviewed in the hospital after giving birth or in their homes within the first weeks after having a baby. Transcripts of interviews with childbearing women who lived in North and Central America, Scandinavia, the Middle East, the Peoples Republic of China, and Tonga were analyzed. Participants described their attitudes toward, perceptions of, and the meaning of childbirth pain. Culturally bound behavior in response to childbirth pain was also articulated. A variety of coping mechanisms were used by women to deal with the pain. Understanding the meaning of pain, womens perceptions of pain, and culturally bound pain behaviors is fundamental in order for nurses to facilitate satisfying birth experiences for culturally diverse women.

Cultural Meanings of Childbirth: Muslim Women Living in Jordan

This descriptive, ethnographic study focuses on the experience of childbirth for Muslim women living in Jordan. Thirty-two childbearing women were interviewed in the early postpartum weeks. The audiotaped interviews were transcribed and translated. Themes were identified from the rich, narrative data. Motivations for having children, as well as what constitutes the motherhood feeling, were described. Themes also included the importance of relying on God or Allah for support in childbearing and child rearing. A strong sense of the spiritual dimensions of giving birth within womens traditional, religious, and cultural context was identified. Findings from this study provide insight into the meanings of childbirth for Muslim women living in Jordan. These meanings assist nurses in providing culturally competent care.

Spirituality in childbearing women.

Childbearing is the ideal context within which to enrich spirituality. The purpose of this study was to generate themes regarding spirituality and religiosity among culturally diverse childbearing women. A secondary analysis was performed, using existing narrative data from cross-cultural studies of childbearing women. The following themes emerged from the data: childbirth as a time to grow closer to God, the use of religious beliefs and rituals as powerful coping mechanisms, childbirth as a time to make religiosity more meaningful, the significance of a Higher Power in influencing birth outcomes, and childbirth as a spiritually transforming experience. In clinical settings, understanding the spiritual dimensions of childbirth is essential. Assessments of childbearing women may include the question, “Do you have any spiritual beliefs that will help us better care for you?”

Women's Help Seeking for Intimate Partner Violence in Jordan

Little is known about Jordanian womens help seeking for intimate partner violence (IPV), despite local and international investment in victim services. Using a clinic based survey (n = 517; response rate 70%) and focus group discussions (FGDs, n = 17) we explored Jordanian womens nonfamily help seeking for physical or sexual IPV. We evaluated survey data using bivariate and multivariate regression and examined FGD transcripts using open coding methodology. Nonfamily help seeking was uncommon, an option only in serious circumstances after familial help was ineffective, and correlated with violence severity and relative violence. Nonfamily resources are underutilized but critical for vulnerable Jordanian women.

Collaborative International Research

The current age of globalization poses challenges as to how to promote professional interaction to further international scholarly efforts in nursing. Models of global research are defined. Global health priorities are explicated, with recommendations for the conduct of outcomes-focused research leading to the generation of cost-effective interventions that contribute to the health and well-being of individuals, families, communities, and nations throughout the world. The challenges and opportunities in international collaborative nursing research are described based on the experiences of the authors during nearly two decades of collaborative work. International partnerships in globally relevant research, which respect and value equity between nurse researchers practicing in developed and developing countries, are essential.

A Mixed Methods Study of Participant Reaction to Domestic Violence Research in Jordan

Research on domestic violence against women has increased considerably over the past few decades. Most participants in such studies find the exercise worthwhile and of greater benefit than emotional cost; however, systematic examination of participant reaction to research on violence is considerably lacking, especially in the Middle East region. This study begins to fill this gap by examining women’s reactions to domestic violence research in Jordan and whether a personal history of violence is associated with unfavorable experiences. This sequential exploratory mixed methods study included 17 focus group discussions (FGD) with women in Amman followed by a survey conducted in reproductive health clinics throughout the country (pilot n = 30; survey n = 517). Open coding was used to identify the theme related to participant reaction in the FGD data. This construct was further examined by the subsequent survey that included dichotomous questions inquiring whether the respondent thought the study questions were important and whether they were angry or felt resentment as a result of the survey. One open-ended question on the survey provided additional qualitative data on the theme that was combined with the FGD data. Themes identified in the qualitative data pertained to expressions of gratitude and comments on the survey’s value. Findings of this study indicate that Jordanian women’s responses to the research process are similar to women currently represented by the extant literature in that a vast majority of its participants felt that the study was important (95%) and it did not evoke anger or resentment (96%). Many even found the study to be useful to them personally or to society. Among those who had a negative emotional reaction, most still found the research to be important. This study’s findings highlight the safety and potential benefits of ethically conducted violence research.

Culturally Diverse Women Giving Birth: Their Stories

Sixteen-year-old Anna gave birth to her second child in the Salvation Army Clinic in the Ashanti Province of Ghana, having lost her first. She thanked God for safe passage for herself and for the child. “Whether I cried or shouted I was going to give birth to the baby, so there’s no need for us to cry or shout. All that I needed to do was to keep calm and be praying in my mind to God so that He could help me to have a safe delivery.” Birth stories are a means of accessing the social context and meaning of bearing and rearing children in women’s lives. Birth stories document the profound experiences of culturally diverse childbearing women.

Jordanian Women's Experiences With the Use of Traditional Family Planning

The United Nations Population Fund (UNFPA) and the Hashemite Kingdom of Jordan Ministry of Health (MOH) have identified the importance of strengthening national capacity through the integration of reproductive health (RH) services into the primary health care system. It is reported that a high percentage of Jordanian women use traditional family planning (TFP) methods, frequently using them incorrectly. Our purpose in this qualitative descriptive study was to explore the issues and challenges related to the use of TFP among Jordanian women. Six focus groups with women of childbearing age (18–44 years of age; n = 51) were held in the northern, central, and southern regions of Jordan. Study participants used traditional methods such as withdrawal, periodic abstinence, and breastfeeding. Often TFP methods were used incorrectly, resulting in a high failure rate with unplanned pregnancies occurring within short inter pregnancy intervals. Women preferred using TFP because of side effects experienced while using modern family planning (MFP) methods, misconceptions, and lack of correct information about MFP methods. Husbands often declined to use condoms but supported the use of TFP methods. Women indicated that they have unmet needs for family planning and that they would consider using MFP methods if accurate information was available at health centers. They emphasized the importance of competent and knowledgeable health care providers (HCPs) who contribute to decision making regarding use of family planning.

Development of nursing research in Jordan (1986–2012)

AIM To provide an overview of nursing research in Jordan based on the topic researched, source and setting of data collection, methodology, theoretical framework used and source of funding. BACKGROUND Nursing research contributes to nursing education, clinical practice, health policy and the establishment of nursing research priorities in Jordan to guide future research. METHODS Databases such as MEDLINE, CINAHL, Google Scholar, PubMed and national sources were searched for published articles related to nursing in Jordan through a range of keywords. Articles were included in the analysis if they were published in English or Arabic through December 2012. FINDINGS The search resulted in the identification of 999 publications, from which 462 articles met the inclusion criteria and were included in the review. The highest percentage of studies (23% of articles) focused on nursing management issues. Forty-four per cent were conducted in a hospital setting; only six studies used a nursing theory. Seventy-seven per cent of the studies were quantitative and 29.0% were funded mostly by universities. Twenty-one per cent were not directly related to improving nursing education or practice in Jordan. A Jordanian Database for nursing research was developed as a result of this review. DISCUSSION Jordanian nurses have slowly started to build nursing research, the real nursing research work in Jordan started with the return of the first PhD graduate to Jordan in 1986. CONCLUSION Jordanian nurses in collaboration with international colleagues were motivated to publish research and build the body of nursing knowledge.Aim To provide an overview of nursing research in Jordan based on the topic researched, source and setting of data collection, methodology, theoretical framework used and source of funding. Background Nursing research contributes to nursing education, clinical practice, health policy and the establishment of nursing research priorities in Jordan to guide future research. Methods Databases such as MEDLINE, CINAHL, Google Scholar, PubMed and national sources were searched for published articles related to nursing in Jordan through a range of keywords. Articles were included in the analysis if they were published in English or Arabic through December 2012. Findings The search resulted in the identification of 999 publications, from which 462 articles met the inclusion criteria and were included in the review. The highest percentage of studies (23% of articles) focused on nursing management issues. Forty-four per cent were conducted in a hospital setting; only six studies used a nursing theory. Seventy-seven per cent of the studies were quantitative and 29.0% were funded mostly by universities. Twenty-one per cent were not directly related to improving nursing education or practice in Jordan. A Jordanian Database for nursing research was developed as a result of this review. Discussion Jordanian nurses have slowly started to build nursing research, the real nursing research work in Jordan started with the return of the first PhD graduate to Jordan in 1986. Conclusion Jordanian nurses in collaboration with international colleagues were motivated to publish research and build the body of nursing knowledge.

The influence of family violence and child marriage on unmet need for family planning in Jordan

Background Risk for unmet need for contraception is associated with mens perpetration of intimate partner violence (IPV) against women and may be influenced by violence perpetrated by other family members (family violence, FV). Women who married as minors may be most vulnerable to the potential compounding effect of IPV and FV on unmet need. Aim Using nationally representative data from the 2012 Jordan Population and Family Health Survey we examined unmet need by exposure to IPV and FV by womens age at marriage (<18, 18+ years). Design Logistic regression was used to test whether IPV and FV were independently associated with unmet need, by age at marriage. Interaction terms (IPV×FV) were tested in both models. Stratification by FV was employed to clarify the interpretation of significant interactions. Results IPV increased the odds of unmet need by 87% [adjusted odds ratio (AOR) 1.87; 95% confidence interval (95% CI) 1.13–3.10] and 76% (AOR 1.76; 95% CI 1.30–2.38) among women who married prior to and after the age of 18 years, respectively. Women married as minors who experienced IPV and FV had a four-fold higher likelihood of having an unmet need (AOR 6.75; 95% CI 1.95–23.29) compared to those experiencing only IPV (AOR 1.49; 95% CI 0.84–2.38). No interaction between IPV and FV was detected for women married at or above majority. Conclusions Laws that prohibit child marriage should be strengthened and health sector screening for violence experience could help identify women at risk of unmet need and improve womens reproductive agency.