Manal Ibrahim Al-Kloub

Predictors of non-adherence to follow-up visits and deferasirox chelation therapy among jordanian adolescents with Thalassemia major.

Poor adherence to treatment can have negative effects on outcomes and heath care cost. However, little is known about the factors that impact adherence to deferasirox chelation therapy. The aims of this study were to identify rates and predictors of non-adherence to medical regimen among thalassemia major adolescents on deferasirox oral chelation therapy by using subjective (self-reporting) and objective (serum ferritin and follow-up visits) measures. Convenient samples of 164 adolescents, aged 12–19 years were recruited from three National Thalassemia Centers in Jordan. Patients were interviewed using a four-section questionnaire and the medical records were checked. Results indicated that rate of adherence according to self-report was (73%); while to follow-up medical appointments and serum ferritin level rates was 57% and 47%, respectively. One-third of participant adolescents (n = 52) were psychologically impaired. Multivariate analysis showed that factors affecting adolescent non-adherence to deferasirox chelation therapy is different from that affecting adherence to follow-up visits. In general, adolescents more than 16 years old, presence of sibling with thalassemia, lack of parental monitoring, lower family income, decrease frequency of blood transfusion, and psychological impairment were found significant predictors of non-adherence among adolescents. Disease knowledge was not associated with adherence status of the adolescents. Clinician should be aware of high prevalence of low adherence to chelation therapy during adolescent years. Nurses need to regularly assess, monitor, and promote adherence behavior that might impact patients’ outcomes.

Epidemiology of Nonfatal Injuries Among Schoolchildren.

Nonfatal injuries are considered as one of the major public health hazards affecting schoolchildren, and the majority of these injuries occur at school or in the home. A cross-sectional study was conducted over a period of 3 months, March–May 2015. The participants were 4,355 Jordanian schoolchildren in Grades 7–12. The Pearson χ2 test was computed, and the odds ratio was used to determine the magnitude of various risk factors for nonfatal injuries among schoolchildren. The overall incidence of nonfatal injury was 33.9%. The group most likely to sustain nonfatal injuries was boys, aged 12–15, in Grade 7, whose parents had a low level of education or a high family income. Injury prevention in schools and at homes is a cornerstone for protection or reducing the incidence of injuries. School nurses have a duty to follow up and examine the accident reports and evaluate whether safety policies are applied and are effective in different school settings. Furthermore, health and education authorities should develop a national program for preventing injuries.

Impact of psychosocial status and disease knowledge on deferoxamine adherence among thalassaemia major adolescents

This cross-sectional study aimed to explore the relationship between psychosocial status, disease knowledge and adherence to deferoxamine treatment in adolescents with thalassaemia major. A purposive sample of 36 adolescents with transfusion dependence, ages 12-19 years, was recruited. A semi-structured interview and two structured questionnaires were used. In this sample, 56% were low adherence and 36% were psychologically impaired. Statistically significant factors associated with psychological impairment were: adolescents more than 16 years; low deferoxamine adherence; mean ferritin more than 2500 μg/L; family size more than six; family income equal or less than 350 Jordanian dinar and having sibling with thalassaemia. Additionally, adolescents with high level of knowledge had significantly lower scores on Pediatric Symptom Checklist.

Young women’s experience of adolescent marriage and motherhood in Jordan

Abstract Adolescent pregnancy and early motherhood are associated with poor social and physical outcomes. This study explored the experiences of marriage and motherhood among Jordanian young women. A descriptive qualitative design was employed. Participants (n = 15, age 15–37 years) who had experienced adolescent marriage and motherhood and who lived in eastern Amman, the capital of Jordan, were selected via snowball sampling. Data were collected by tape-recorded face-to-face interviews and analysed thematically. Five themes were identified: lost opportunities for personal development, learning to be submissive and indecisive, uncertainty toward cultural norms, ambivalent feelings toward a maternal role and empowering oneself to face life demands. The findings indicate that the experience of marriage and motherhood among Jordanian adolescents was mostly negative; they felt that they had been deprived of their rights, respect and the experience of being a young person. Additionally, they felt that the transition into motherhood was very difficult, and that they were prematurely forced into adult social roles and responsibilities, which caused them to experience numerous challenges. Adolescent mothers are a vulnerable group that should be better targeted by prevention and intervention measures.