Muntaha K. Gharaibeh

Cultural Validation of Pediatric Pain Assessment Tools: Jordanian Perspective

The purpose of this study was to examine the cultural validity, reliability, and preference of three pain assessment tools among 95 Jordanian children. Pain intensity was assessed using the Poker Chip, the Faces, and the Word Description Scales. The test-retest reliability and the convergent validity were supported for the three scales. Jordanian children preferred the Poker Chip Tool to the Faces Scale and the Word Descriptive Scale. Gender differences in relation to scale preference were evident: female children preferred the Poker Chip Tool and male children preferred the Faces Scale; such differences were contributes of the socialization process within the Arab culture. The three scales are valid, reliable, and can be used with confidence to assess pain among Jordanian children. Findings also showed that children have a subculture of their own regardless of their cultural orientation. Findings have implication to nurses in Jordan as well as to transcultural nursing.

Why Do Jordanian Women Stay in an Abusive Relationship: Implications for Health and Social Well-Being

PURPOSE The purpose of this study was to explore why Jordanian women stay with an abusive husband. DESIGN The study used a qualitative approach to collect data from 28 abused women who were recruited through their community during the summer and fall of 2007. METHODS Data were collected using an open-ended question through one-on-one in-depth interviews. FINDINGS Results from analysis of the qualitative data revealed that abused Jordanian women identified five main reasons for staying with an abusive husband: the inherited social background, financial dependency, lack of family support, sacrificing self for the sake of the children, and the adverse social consequences of divorce. CONCLUSIONS The results indicate that Jordanian women are strongly bound by traditions and cultural rules and lack all means of empowerment. Results of the study have implications for healthcare providers, social workers, policy makers, and educators to enhance the health and social well-being of Arab Muslim women in Jordan. The findings may also apply to Arab families immigrating to the United States, Canada, and Europe who tend to bring their cultural beliefs, values, and norms, and may help healthcare professionals dealing with violence against women in these countries. CLINICAL RELEVANCE Healthcare professionals worldwide need to play an instrumental role in providing culture-specific and evidence-based care to empower women staying in abusive relationships, taking into consideration the influence of Arab Muslim culture.

Severity of menopausal symptoms of Jordanian women

Introduction Menopause is a transitional period that every woman goes through if she lives beyond the age of 52 years. The health care of women during this stage requires special attention to the identification of their health needs in order to provide competent care. The aim of the study was to assess severity of symptoms related to the menopausal period and to describe the differences in severity of menopausal symptoms according to menopausal status. Methods and design A descriptive cross-sectional design was used. Data were collected from 350 Jordanian women using a self-administered questionnaire consisting of a sociodemographic, medical and obstetrical history form and the Greene Climacteric Scale. Results Results on the severity of menopausal symptoms showed that 15.7%, 66.9% and 17.4% were experiencing severe, moderate and mild menopausal symptoms, respectively. Vasomotor signs were reported to have the highest scores for severity as manifested by hot flushes and night sweating. In addition, women in the perimenopausal period complained more frequently of menopausal symptoms compared to premenopausal and postmenopausal women, except for vasomotor and sexuality symptoms for which postmenopausal women reported higher scores. There was a significant relationship between the severity and occurrence of menopausal symptoms and age, family income, level of education, number of children, perceived health status and menopausal status. Implications The study has implications for research, practice and education. Health-care providers need to play a more visible and instrumental role in continuously assessing menopausal womens needs as well as to implement appropriate health educational programs. Further research addressing womens health needs is also essential for improving the quality of life of menopausal women in Jordan.

Violence Against Women: Unveiling the Suffering of Women With a Low Income in Jordan

The descriptive qualitative study documents experiences of Jordanian women abused by their husbands. Thirteen married women living with an abusive husband were recruited from a major primary healthcare center. The women described forms, intensity, and consequences of their husbands acts. Despite their anguish, women justified, normalized, and tolerated abuse; this acceptance reflected their cultural values and norms. Implications for nursing practice include (a) identifying abused women, (b) empowering them with knowledge to change their sociocultural perceptions of marital relationships, (c) designing interventions that address their needs, and (d) educating health care providers to take a role in addressing spousal abuse.

Prevalence of Violence During Pregnancy: Findings from a Jordanian Survey

Background Violence during pregnancy is a significant health and social problem. In the last few years several factors have contributed to the emergence of family violence as a high priority social and health issue in Jordan, and the acknowledgement that abuse during pregnancy is a harmful act to the mother and the fetus. The purposes of this study were to investigate the prevalence of physical, emotional, verbal, and sexual violence on pregnant women, and to describe the relationships between violence and selected study variables. Methods A descriptive study was conducted using a self-administered questionnaire. A convenience sample of 316 pregnant women was recruited from five Maternal and Child Health Centers, located in Irbid City in the North of Jordan. Results The prevalence of physical, emotional, verbal and sexual violence by husbands during pregnancy was 10.4%, 23.4%, 23.7%, and 5.7%, respectively. Prevalence of physical, emotional and verbal violence by a family member other than the husband was 1.9%, 11.1% and 13.9%, respectively, and most perpetrators were the mother in-law. Data also showed that there was a significant association between prevalence of violence and unplanned pregnancy, the pregnant women’s perception of their husband’s violent attributes and the women’s low self-esteem. Pre- and post-natal visits should include assessment for family violence and intervention when violence or abuse is identified. The findings support continued public awareness of family violence to bring about social and political changes that increase reporting and reduce incidence of violence in Jordan.

Adversities of being infertile: the experience of Jordanian women

OBJECTIVE To describe and interpret the experiences of and adversities faced by infertile Jordanian women as described from their own perspectives. DESIGN A qualitative descriptive design. SETTING The women were interviewed at a nonprofit womens organization in the north of Jordan. The organization focuses on empowerment and health issues. PATIENT(S) This study included a purposive sample of 25 infertile Jordanian women who were unsuccessfully trying to conceive for a minimum of 1 year, and who were receiving treatment for infertility. INTERVENTION(S) Face-to-face, in-depth, semistructured interviews were conducted, audiotaped, and transcribed using thematic analysis. MAIN OUTCOME MEASURE(S) Outcomes were measured using thematic analysis of the interview transcripts. RESULT(S) Four key adversity themes emerged from the data: the adversity of incomplete being, the social adversity of being infertile, the adversity of another wife, and the adversity of changes in the marital relationship. CONCLUSION(S) Jordanian women are seriously affected by infertility and experience personal, social, and marital adversities, which affect their well-being. These adversities need to be conceptualized within a framework that can be used to empower and counsel infertile women in all aspects of life.

Maternal mortality in Jordan: role of substandard care and delays

Understanding the factors that operate during pregnancy, delivery and postpartum is the key to success in the prevention of maternal mortality. This cross-sectional survey in Jordan for the years 2007-2008 aimed to identify the role of substandard care and delays in maternal deaths. All maternal deaths among women aged 15-49 years over this period (n = 76) were investigated retrospectively through file review and household interviews in all hospitals (n = 102) and forensic medicine departments in Jordan; elements of substandard care and delays at hospital, home and transport levels were evaluated. Substandard care accounted for 52.6% of deaths, delay in seeking care 55.3%, delay in transport 15.8% and delay in hospital care 17.1%. Women who did not recognize the danger signs of pregnancy (OR 6.32), refused medical advice to terminate the pregnancy (OR 1.78) or at a gestational age > 37 weeks (OR 1.85) were significantly more likely to delay seeking care, as were those with larger mean family size.

Factors influencing maternal attachment of first-time Jordanian mothers:

The purposes of this study were to identify differences in maternal attachment according to maternal characteristics (socio-demographic, perinatal and self-efficacy variables) and identify factors influencing maternal attachment of first-time Jordanian mothers. A cross-sectional correlational design was used in this study. A convenience sample of 220 first-time Jordanian mothers was recruited during a period of three months in the summer of 2008. Participants completed a socio-demographic and perinatal data sheet, the Parental Self-efficacy scale and the Perceived Maternal Attachment Inventory. ‘Pleasure of proximity’ was the maternal attachment dimension that received the highest mean score, and the highest mean score on the maternal self-efficacy (MSE) measure was reported for the ‘situational belief’ subscale. A significant positive correlation was found between maternal attachment and maternal self-efficacy (r = 0.54, p < 0.001). Factors influencing maternal attachment were maternal self-efficacy, perception of marital relationship and pregnancy and delivery experience, which together explained 33% of the variance in maternal attachment (R2 = 0.33). Maternal self-efficacy, a good marital relationship and difficulties during pregnancy and delivery are important factors that influence maternal attachment of first-time Jordanian mothers. Health care providers from Jordan and other parts of the world need to acknowledge these factors when dealing with the health and social well-being of mothers and their infants.

Parenting From a Jordanian Perspective: Findings From a Qualitative Study

PURPOSE The main purpose of this qualitative descriptive study was to explore Jordanian parents understanding of parenting. METHODS A convenient sample of 110 Jordanian parents recruited from four health centers participated in the study. A semi-structured one-on-one interview with open-ended questions was used to collect the data. RESULTS Three thematic areas reflecting parent understands of parenting were identified; parenting as embraced by Islam, transferring of cultural values and traditions, and parenting as a challenge. CONCLUSIONS Parenting behavior and its effectiveness are reflected by the strong interplay of Islamic teachings, socio-cultural values and traditions in addition to the challenges and difficulties of being a parent. CLINICAL RELEVANCE As the ultimate goal of parenting is to promote the wellbeing and the development of children, it is crucial that health care providers involved in the design and delivery of family and childrens services have a thorough understanding of how parents perceive parenting and how their understanding can be integrated in programs to enhance parental roles.

Attitudes Toward and Justification for Wife Abuse Among Syrian Medical and Nursing Students

Purpose: To explore the perceptions of and attitudes toward violence and beliefs of contextual justification of wife abuse among Syrian medical and nursing students. Design and Method: A descriptive, cross-sectional design was used. The Perceptions of and Attitudes toward Wife Abuse Questionnaire was used to collect data from a convenience sample of 621 medical and nursing students from three public universities in Syria. Results: Only 18.4% of the students had positive attitudes toward interpersonal violence reflecting low tolerance to wife beating and use of physical force for problem solving and child discipline, and 16.1% did not justify wife beating. Medical, older, female students, from urban areas, with more educated parents, and those who did not experience violence or witness violence between their parents had significantly more positive attitudes toward wife abuse and significantly less justification of wife beating (p < .05). Conclusion and Implications: Education about violence against women of future medical and nursing students is the responsibility of medical and nursing educators and health policy makers, who have to acknowledge the influence of the sociocultural factors in shaping student’s attitudes toward wife abuse and develop strategies to enhance these attitudes at the early stages of professional preparation.