Muhammad W. Darawad

Predicting nurses' turnover intentions by demographic characteristics, perception of health, quality of work attitudes.

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions.The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self-reported cross-sectional survey design was used to collect data from Jordanian registered nurses who were working between June 2011 and November 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health-care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions.

Patients' Adherence to Healthy Behavior in Coronary Heart Disease: Risk Factor Management Among Jordanian Patients.

Background:Poor adherence to risk factor management behaviors for coronary heart disease (CHD) patients increases the risk for a further cardiac event. There is a scarcity of literature about the level of adherence to risk factor management behaviors after CHD diagnosis in Jordan. Objective:The aim of this study was to explore which demographic, psychosocial, and clinical factors predict better adherence to risk factor management behaviors, particularly smoking cessation, physical activity, healthy diet, and medication adherence. In addition, we sought to explore the association of poor adherence to hospital readmission. Method:A cross-sectional survey was performed using a sample of 350 patients who visited the outpatient clinics in 4 hospitals in Jordan. Result:Data were obtained from 254 patients (response rate, 73%). Most were overweight (47.8%) or obese (28.5%), and 30% remained smokers after CHD diagnosis; 53 (21.5%) described themselves as ex-smokers. One-third of participants (88, 34.8%) performed regular walking exercise. Only 16% of participants reported that they had been instructed to perform regular activity. Stepwise multiple regressions revealed younger age and lower body mass index as independent predictors for more physical activity. Only 51 (20.9%) reported always following a low-fat dietary regimen, and participants who received dietary recommendation advice were significantly more likely to be on a healthy diet (odds ratio, 10.3; 95% confidence interval, 3.79–30.80; P < .001). Most of the participants (183, 72%) reported low medication adherence (score ⩽6), based on the Morisky scale, and only 5 (2%) reported a high adherence score (score = 8). Male gender and having chronic back pain were independent predictors for better medication adherence. About one-third of participants had been hospitalized for cardiac reason at last 2 times in the past 12 months. Rehospitalization was significantly more common among patients who were not following a dietary regimen (Mann-Whitney Z = −2.54, P = .011) or regular physical activity (Mann-Whitney Z = −3.60, P = .001) and in those who had more comorbidity diseases (r = 0.34, P = .001). Conclusion:Our findings highlight poor adherence to secondary prevention behaviors among Jordanian CHD patients. Most participants did not adopt healthy behaviors in managing their CHD risk factors and they demonstrated a higher risk of hospital readmission. There is an urgent need for aggressive and targeted strategies to enhance adherence levels.

Decreasing sedentary behavior by 30 minutes per day reduces cardiovascular disease risk factors in rural Americans

Regular physical activity has been associated with reduced cardiovascular disease (CVD) risk factors; however, a decrease in the amount of time spent during the remainder of the day in sedentary behavior may be equally important. The aim of this study was to examine the effects of a decrease in sedentary behavior on CVD risk factors among 205 individuals living in rural Appalachia. All participants received a comprehensive CVD risk reduction life-style intervention and measurement of major CVD risk factors and physical activity levels. Participants were divided into: 1) Adopters: those who decreased their sedentary behavior by 30 min or more per day post-intervention and 2) Non-adopters: those who did not. Repeated measures analysis of variance showed a significant group by time interaction showing that Adopters had a greater reduction in body weight and BMI than Non-adopters. These findings demonstrate that decreasing sedentary behavior is important for achieving optimal body weight.

Violence Against Nurses in Emergency Departments in Jordan: Nurses’ Perspective

Violence against nurses in emergency departments (EDs) has become a widespread phenomenon affecting nurses’ job satisfaction and work performance. Literature is scarce regarding prevalence rates and causes of violence directed toward nurses in Jordan. The present study investigated violence experienced by Jordanian nurses in EDs and causes of violence from their perspectives. This descriptive study collected data from 174 Jordanian ED nurses. The majority of the participants (91.4%) reported experiencing violence (verbal 95.3% vs. physical 23.3%). According to participants, the most common causes of violence in the ED were crowding and workload (75.9%), and the least was care of patients with dementia or Alzheimer’s disease (35.6%). Violence is common in Jordanian EDs, giving rise to many heath and behavioral consequences. Health care administrators are obligated to protect nurses from violent incidents by providing adequate safety measures, beneficial administrative procedures, and sincere efforts to overcome the causes of this phenomenon.

Slowing the progression of chronic kidney disease: comparison between predialysis and dialysis Jordanian patients

Abstract Background: The prevalence of chronic kidney disease (CKD) and end-stage renal disease (ESRD) has increased worldwide; however, data regarding the prevalence of CKD in Jordan are limited. Therefore, the present study investigated the associated risk factors of both CKD and ESRD in Jordanian patients. Methods: A convenience sample of 161 patients with CKD (n = 92) and ESRD (n = 69) was recruited through randomly selected hospitals from the governmental, private and educational sectors in Jordan. A sociodemographic data and behavioral variables (exercise frequency per week, body mass index, and smoking status) were collected and compared between the two groups to obtain the needed information. Results: ESRD in amounted to relatively 68% in males and 52% in the unmarried patients (p = 0.01). In addition, patients with poor physical activity were more likely to be on the postdialysis phase. Patients with ESRD were characterized with low BMI when compared with patients CKD (t = 3.1, p = 0.004). Conclusion: National CKD and ESRD risk assessment is important in considering primary prevention for CKD progression. At the front line in health care, the nurse can play a vital role in assessing patient’s risk for renal disease progression.

PREDICTING NURSES' TURNOVER INTENTIONS BY DEMOGRAPHIC CHARACTERISTICS, PERCEPTION OF HEALTH, QUALITY OF WORK, AND WORK ATTITUDES

The conducted clinical and instrumental study revealed that the aggregate group of the patients with chronic diseases of throat differs by increased frequency of isolated and combined disorders of gastrointestinal tract. If a patient has such symptoms as hoarseness, tickling, scratching, burning, feeling of dryness in throat, frequent variant of gastro-intestinal tract disorders is gastroesophageal reflux disease with pharyngolaryneal reflux. There are such severe pathologies of throat as pachydermia of vocal cords and nodules of vocal cords among more frequently met disorders at gastro-intestinal tract diseases. High probability of accompanied pathology of throat in the form of pachydermia and nodules of vocal cords at patients with gastro-intestinal tract disorders stipulates for the necessity of conducting fibrorhynolaryngoscopy in combination with fibergastroscopy.Study presents short overview of drug situation’s indicators during the first, or heroin decade of drugs, and then during the second, soft and synthetic drugs decade of drugs in Slovakia. Then the results of series of nation-wide school surveys, mapping development of licit and illicit drugs use among children and youth during nineties are outlined. The results indicated constant growth of licit and illicit drugs consumption among primary school pupils, and secondary school students until the fourth wave of nation-wide school surveys in the years 2006 – 2007. However, the next wave after four years has detected profound change in the expected pattern of further growth in the case of illicit drugs. Instead of this decline of use or at least stabilization occurred among Slovak youth. At the same time we have found growth of use in the case of licit drugs – alcohol and tobacco, more profoundly among girls. Also the use of new synthetic drugs among young people was revealed via traditional school survey.

Exercise Self-Efficacy Scale: Validation of the Arabic Version Among Jordanians With Chronic Diseases

This study assessed the psychometric properties of the Arabic version of Exercise Self-Efficacy scale (ESE-A) among Jordanian outpatients with a variety of chronic diseases using descriptive cross-sectional design. Participants’ scores of ESE-A significantly correlated with their reported weekly exercise frequency (r = .23, p< .001), duration (r = .31, p< .001), and evaluation of their physical exercise (r = .39, p< .001). The construct validity was tested using exploratory factor analysis, which retained all items, and the scree plot showed one meaningful factor with an eigenvalue of 10.38 and an explained variance of 57.7%. Furthermore, Cronbach’s alpha was .89 and split-half coefficient was .83 indicating that the ESE-A is a reliable scale. The ESE-A was found to be a robust measure to evaluate exercise self-efficacy among Arabic patients with chronic diseases. Arabic researchers interested in exercise self-efficacy are invited to utilize the ESE-A in their studies to confirm its psychometric properties.

Factors Associated with Inadequate Pain Control among Postoperative Patients with Cancer

Abstract Postoperative pain is considered a major, complex and multidimensional problem that affects the clinical and functional outcomes of patients and may contribute to increased postoperative complications. The goal of this study was to determine the prevalence of inadequate pain control and to investigate the factors associated with inadequate pain control among postoperative cancer patients. A descriptive correlational, cross‐sectional design was used. The study was conducted at four adult inpatient oncology departments at King Hussein Cancer Center, a nongovernmental, nonprofit, comprehensive hospital for treating cancer patients in Amman, Jordan. The convenience sample of 800 cancer patients selected comprised postoperative patients diagnosed with cancer and aged ≥18 years who were willing to participate and able to use the numeric rating scale. About 32.9% of patients had pain scores higher than 4/10 at rest, and 56.4% of patients had pain scores higher than 4/10 on movement. Data revealed that patients aged between 18 and 63 years (odds ratio [OR] = 0.196, p < .0005, and OR = 0.245, p < .0005) and chronic user patients (OR = 28.029, p < .0005, and OR = 10.332, p < .0005) had increased odds of poor pain control at rest and on movement, respectively. Administration of preemptive medications and of fentanyl and bupivacaine during the postoperative period was significantly associated with decreased odds of poor pain control. The intravenous route was associated with increased odds of poor pain control at rest and on movement (OR = 2.279, p = .016, and OR = 5.393, p = .012) compared with other routes, including combinations of the intravenous and oral or epidural route. Chronic use of pain medications and older age were predictors of inadequate pain control postoperatively. Administration of preemptive medications and of combinations of fentanyl and bupivacaine via the epidural route was associated with better pain control.

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.

Newborn Care Practices of Mothers in Arab Societies: Implication for Infant Welfare:

Introduction: There are at least 22 Arab league states and sections in Northern Africa, southwestern Asia, and Europe that incorporate the vast Middle Eastern culture. The purpose of this study was to identify the cultural variations in newborn care practices, self-management of common illnesses, and their potential impact on infant welfare. Method: A qualitative design using a focus group approach with 37 Arab mothers in Jordan was used. Results: Findings revealed strong similarities in terms of beliefs, care practices, and the experience of intergenerational conflict in establishing and maintaining traditional practices among mothers. Potentially harmful practices included restrictive swaddling, rubbing a newborn’s body with salt, and encouraging the ingestion of herbs in newborns. Discussion: It is important for nurses and midwives to be aware of traditional practices, cultural beliefs, and the implications for infant welfare if they are to effectively engage with families to promote the well-being of the newborn.