Maysoon S. Abdalrahim

Knowledge, attitudes, and practices towards prevention and early detection of chronic kidney disease

OBJECTIVE To describe the knowledge, attitudes and practices of Jordanian patients with chronic illnesses towards prevention and early detection of chronic kidney disease. BACKGROUND Patients with chronic illnesses such as hypertension and diabetes need to adopt healthy attitudes and practices and gain knowledge regarding prevention and early detection of kidney disease to decrease the prevalence of dialysis-related complications and costs. METHODS A total of 740 patients were recruited from out-patients clinics in Jordan. Knowledge, attitudes and practices about kidney disease prevention and early detection were measured using the Chronic Kidney Disease Screening Index which was developed by the researcher and tested for validity and reliability. RESULTS The results revealed that most of the participants have knowledge about kidney disease; however, half of them had wrong information related to signs and symptoms of chronic kidney disease. The majority of the participants were not aware about the importance of discovering health problems at early stages. CONCLUSION AND IMPLICATIONS Improvement in population understanding about chronic kidney disease is needed to advance their awareness and practices to make appropriate decisions towards health promotion and better quality of life. IMPLICATION FOR POLICY DEVELOPMENT Nurses need to be involved in development of protocols for screening and intervention programmes, taking into consideration the cultural issues and the financial status of individuals at risk for kidney disease. Governments should adopt a public health policy for chronic kidney disease that supports programmes for screening and programmes for improving public awareness for kidney disease prevention.

Screening for breast cancer among young Jordanian women: ambiguity and apprehension

AIMS The goal of this study was to understand young Jordanian womens attitudes towards breast cancer screening practices in order to improve young womens uptake of screening and early detection. BACKGROUND The incidence of breast cancer is increasing annually among younger Jordanian women; however, little is known about their attitudes towards breast cancer and associated screening practices. Young womens attitudes towards breast cancer must be taken into account when designing screening strategies and interventions specifically for this age group. Screening strategies must also acknowledge young womens cultural context; however, little is known about how culture shapes their understandings and practices. METHODS A qualitative interpretive approach was utilized to interview 45 young educated women about their breast cancer views and screening practices. Data were analysed thematically. FINDINGS AND DISCUSSION Four overlapping themes emerged: (i) young women should not think about it, (ii) absence of a role model, (iii) cultural shame of breast cancer, and (iv) cancer means death and disability. The study found high levels of apprehension and ambiguity related to breast cancer. This was associated with the perceived impact of a cancer diagnosis on a young womans social status and family role. Family support was perceived to be a necessary prerequisite for seeking treatment or screening. CONCLUSIONS Understanding young womens perception about screening and early detection of breast cancer is essential for policy makers and healthcare providers to design culturally appropriate and age-appropriate health promotion campaigns and services.

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.

Cancer Pain Management at Oncology Units: Comparing Knowledge, Attitudes and Perceived Barriers Between Physicians and Nurses

Pain is a major symptom that causes suffering among patients diagnosed with cancer. Identifying physicians’ and nurses’ knowledge, attitudes, and their perceived barriers of cancer pain management is considered an essential step in improving cancer pain relief. The purposes of this study are to compare physicians’ and nurses’ knowledge and attitudes toward cancer pain management (CPM) and describe their perceived barriers to CPM at oncology units. A descriptive cross-sectional design was utilized to obtain data through self-report questionnaire. The total number of sample size was 207 participants (72 physicians and 135 nurses). Findings revealed that both physicians and nurses had fair knowledge and attitudes toward CPM. Physicians had significantly higher knowledge and better attitudes than nurses (62.3 vs. 51.5%, respectively). Physicians were knowledgeable about pharmacological pain management and opioid addiction but had negative attitudes toward pain assessment. Nurses’ knowledge was better in regard of CPM guidelines, while they had poor knowledge about pharmacological pain management and opioid addiction. Physicians and nurses perceived knowledge deficit, lack of pain assessment, opioid unavailability, and lack of psychological interventions as the most common barriers to CPM. It is recommended to integrate recent evidence-based guidelines about CPM in oncology units that aim to improve practice. Offering continuing education courses in hospitals guided by pain teams is another essential recommendation for effective CPM.

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.