Rami Masa'Deh

Predictors of Stress of Parents of a Child with Cancer: A Jordanian Perspective

Background: Most paediatric oncology studies agree that being parents of a child with cancer is an emotionally stressful event. Although an increasing number of studies have investigated psychological stress of parents of a child with cancer, few of these studies have included both parents or investigated the predictors of high stress levels for the mothers and the fathers. Moreover, studies published over the last few decades were limited to Western countries and have shown inconsistent findings about parental perceived stress whose children have cancer. This study explored differences in predictors of perceived stress between Jordanian mothers and fathers of children with cancer. Methods: This study involved a survey of 300 couples parenting a child with cancer. Participants answered the Arabic version of the Perceived Stress Scale 10-items, demographic and characteristics check list questionnaires. The main aims were to measure perceived stress levels for mothers and fathers, explore the predictors associated with high perceived stress levels and make a comparison between them. Findings: Mothers reported significantly higher stress levels than fathers (p<0.001), with a large effect size (0.30). Some of the factors associated with mothers and fathers high stress levels affected both parents whereas employment status affected only fathers’ stress levels. Conclusions: These findings indicate the need to work with the mothers and the fathers with a child with cancer in Jordan to recognise their psychological needs at the time of diagnosis and followed by on-going psychological support for both parents.

The impact of a mental health clinical placement on the clinical confidence of nursing students in Jordan

OBJECTIVES To examine the impact of clinical placement in a mental health setting on the clinical confidence of nursing students in Jordan. DESIGN AND SETTING A non-experimental descriptive survey design was used. Data was collected using the Mental Health Nursing Clinical Confidence Scale (MHNCCS) in Jordan. RESULTS Data indicates that, as a result of clinical placement, nursing students had improved perceived confidence regarding the concept of mental health and mental illness, felt better able to conduct a mental health status examination, create nursing care plans, administer medication and provide health education to patients in mental health settings. CONCLUSIONS Improving the clinical confidence among Jordanian nursing students in relation to mental health nursing skills may provide a safer environment for students and patients as well as lead to enhanced well-being and function of patients. In addition, the results of this study may have practical implications for positive changes to the mental health nursing curriculum clinical placement goals.

Families' Stressors and Needs at Time of Cardio-Pulmonary Resuscitation: A Jordanian Perspective

Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members’ needs during resuscitation in adult critical care settings. Methods: This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study. Findings: The study findings revealed three main categories: families’ need for reassurance; families’ need for proximity; and families’ need for support. The need for information about patient’s condition was the most important need. Updating family members about patient’s condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one. Conclusions: This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.

Post Traumatic Stress Disorder in Parents of Children With Cancer in Jordan

Aim To investigate levels of post traumatic stress disorder (PTSD) of those parenting children with cancer and make a comparison between mothers and fathers. Background Parenting a child with cancer is traumatic. Maternal and paternal roles and responsibilities change after the cancer diagnosis of their child, adding more stress to the lives of all concerned. The gender of the parent may have an effect on their PTSD. However, there is a lack of studies in Arabic countries on the differences between parents in their PTSD levels. Methods A sample of 416 biological parents (comprising 207 mothers and 209 fathers) of children with cancer in Jordan completed a demographic checklist and the PTSD Checklist Civilian (PCLC). Results There was a significant difference in PTSD levels between mothers and fathers, with mothers having significantly higher PTSD levels than fathers. The mean PTSD levels for mothers was (M = 59.68, SD = 4.86) compared to (M = 52.76, SD = 5.81) for fathers. The magnitude of the differences in the means was very large (eta squared = 0.29). Additionally, results indicated that there was a significant negative correlation between parental PTSD levels with their age and the time since their child was diagnosed with cancer (r = −0.68, r = −0.62 respectively and p < 0.001). An increase in parental PTSD levels was associated with a decrease in parental age and short time duration since the cancer diagnosis of the child. Conclusion The study concluded that parenting children with cancer is traumatic and mothers were at higher risk of PTSD than fathers. Risk of PTSD was found to decrease with time. Implications for nursing EBP Investigating differences in PTSD between mothers and fathers in Jordan may be helpful when designing interventions to reduce the risk of PTSD. An individual parental support program is important, taking into consideration that mothers are at higher risk of PTSD, and both parents need thorough attention and care.

Quality of Life for Saudi Patients With Heart Failure: A Cross-Sectional Correlational Study

Introduction: Heart failure is a major public health issue and a growing concern in developing countries, including Saudi Arabia. Most related research was conducted in Western cultures and may have limited applicability for individuals in Saudi Arabia. Thus, this study assesses the quality of life of Saudi patients with heart failure. Materials and Methods: A cross-sectional correlational design was used on a convenient sample of 103 patients with heart failure. Data were collected using the Short Form-36 and the Medical Outcomes Study-Social Support Survey. Results: Overall, the patients’ scores were low for all domains of Quality of Life. The Physical Component Summary and Mental Component Summary mean scores and SDs were (36.7±12.4, 48.8±6.5) respectively, indicating poor Quality of Life. Left ventricular ejection fraction was the strongest predictor of both physical and mental summaries. Conclusion: Identifying factors that impact quality of life for Saudi heart failure patients is important in identifying and meeting their physical and psychosocial needs.

A descriptive study of adherence to lifestyle modificationfactors among hypertensive patients

BACKGROUND/AIM Healthy life style recommendations (e.g., physical activity, healthy diet, and decreased cholesterol levels) play an important role in controlling blood pressure (BP). This study aimed to assess lifestyle modification factors among patients diagnosed with hypertension. MATERIALS AND METHODS A descriptive-survey design was used. Data were collected using four questionnaires; one was the Beliefs about Medication questionnaire (BMQ) and the rest were developed to collect data about demographic and clinical characteristics and lifestyle modification factors. RESULTS In total 312 questionnaires were completed. The results revealed that our participants did not follow the healthy lifestyle recommendations; for example, the mean blood sugar (BS) level, body mass index (BMI), and cholesterol levels were 155 mg/dL (standard deviation (SD) = 71.9), 29 kg/m2 (SD = 5.4), and 197 mg/dL (SD = 86.6), respectively. A significant correlation was shown between age and BP (P = 0.000). Increase in diastolic BP (DBP) correlated with a significant increase in cholesterol level (P = 0.002) and BMI (P = 0.006). CONCLUSION Our study showed that somewhat hypertensive patients in Jordan did not follow a healthy lifestyle. Therefore, urgent action by addressing behavioral risk factors has a positive impact on preventing and controlling hypertension.

Quality of Life among Patients with Acute Coronary Syndrome

Objectives: The purposes of this study were to describe the quality of life for patients with acute coronary syndrome in Jordan, identify the mostly affected quality of life domains and if there was an association between quality of life socio-demographic and clinical characteristics. Methods: A non-experimental descriptive cross-sectional correlational design was used with a convenience sample of 372 patients with acute coronary syndrome. Data were collected from six different hospitals in Amman city by a self-reported questionnaire. Results: Overall, the patients’ quality of life mean score for all domains was low (4.06 ± 1.16). The physical domain was the most affected (3.87 ± 1.28), followed by the emotional (4.21 ± 1.18) and lastly is the social domain (4.26 ± 1.25). There were statistically significant differences in quality of life scores according to gender, level of education, employment status, physically activity, history of dyslipidemia and medical diagnosis. Conclusion: The results of this study indicated that Jordanian patients with acute coronary syndrome have poor quality of life especially in the physical domain. Social domain of their quality of life was the least affected indicating that there is a strong family support and relation. Different treatments to improve quality of life for those patients are warranted.

An exploration of the concepts of loss and grief as stress responses in Middle Eastern parents of children with cancer

BACKGROUND : Caring for a child with cancer has been found to have profound and sometimes long-lasting negative psychological effects on parents. Grief of those parents was less examined in Jordan than America and Europe. Many parents in studies carried out in other countries experienced shocke, disbelief and guilt about their child’s diagnosis. This pattern is similar to the stages of grief as identified by Kubler-Ross model and this association has been identified as potentially benefitting from being further explored in differing cultures such as the experiences of Middle-Eastern parents. Therefore, this study aims to examine the experience of mothers and fathers of children diagnosed with cancer in Jordan and explore whether their narratives reflect grieving as understood through the theoretical constructs of Kubler-Ross. This study investigated the applicability of the Western grief model in an Arab community. METHODS : Using a qualitative approach, 24 parents of children with cancer were interviewed. The participants were recruited recruited from the biggest cancer specialist centre in Jordan. Thematic analysis was use to analyse their results. RESULTS : It was clear that the emotional reactions of Jordanian parents of children with cancer fit with Kubler-Ross’ loss and grief model. Jordanian parents of children with cancer reported experiencing denial, anger, depression, bargaining and acceptance. CONCLUSIONS : The results of this study provide evidence that the reactions of Jordanian parents offer a clear direction for the applicability of care strategies from other communities with culturally different backgrounds. Jordanian parents, health care providers and particularly nurses should be aware that parental grieving process as identified by Kubler-Ross’ model can be experienced by those receiving a diagnosis of a life-threatening illness in their child and is individualised, normal and most often ends with acceptance. Therefore, a supporting framework to those parents should take into consideration their stage of grief. Nurses and parents should know that they do not have to push the stages; acceptance will be reached once the individual is ready