Sami Aloush

Use of Electronic Health-Related Datasets in Nursing and Health-Related Research

Datasets of gigabyte size are common in medical sciences. There is increasing consensus that significant untapped knowledge lies hidden in these large datasets. This review article aims to discuss Electronic Health-Related Datasets (EHRDs) in terms of types, features, advantages, limitations, and possible use in nursing and health-related research. Major scientific databases, MEDLINE, ScienceDirect, and Scopus, were searched for studies or review articles regarding using EHRDs in research. A total number of 442 articles were located. After application of study inclusion criteria, 113 articles were included in the final review. EHRDs were categorized into Electronic Administrative Health-Related Datasets and Electronic Clinical Health-Related Datasets. Subcategories of each major category were identified. EHRDs are invaluable assets for nursing the health-related research. Advanced research skills such as using analytical softwares, advanced statistical procedures, dealing with missing data and missing variables will maximize the efficient utilization of EHRDs in research.

Knowledge and self‐care behaviors among patients with heart failure in Jordan

Knowledge is known to affect self-care behaviors. However, little is known about the factors that influence self-care behaviors among patients with heart failure in Jordan. A cross-sectional descriptive-correlational design was used to describe the associations between knowledge, sociodemographics, and self-care behaviors. In a convenience sample of 226 patients with heart failure, the Dutch Heart Failure Scale and Self-Care of Heart Failure Index (SCHFI) version 6.2 were used to measure knowledge and self-care behaviors, respectively. The mean heart failure knowledge score was quite low at 5.29. The SCHFI self-care management subscale mean was 57.56 with an actual range of 10-90, and the SCHFI self-care maintenance subscale mean was 53.89 with an actual range of 13.33-86.66. The SCHFI self-care confidence subscale mean was lowest of the three at 45.07, with an actual range of 5.56-94.52. All three subscale mean scores were below the clinical target level (≥70) for the SCHFI. Lower knowledge, income, and educational level, shorter duration of disease, fewer people living at home, older age, and being unemployed were significant predictors of low self-care scores. Characteristics of the cultural, social, and healthcare environment in Jordan may help explain some results. Nurses may play a role in improving knowledge and self-care among patients with heart failure in Jordan. Studies of the effect of educational programs on knowledge and self-care among patients with heart failure are recommended.

Nurses’ compliance with central line associated blood stream infection prevention guidelines: observational study

Objectives: To assess nurses’ compliance with central line associated bloodstream infection (CLABSI) prevention guidelines related to maintenance of the central line and the predictors of compliance. Method: This was an observational study that used a descriptive cross-sectional design. A sample of 171 intensive care unit (ICU) nurses were observed and their compliance was recorded on a structured observational sheet. The study was conducted in the ICUs of 15 hospitals located in 5 cities in Jordan. Data were collected over a 5-month period from March to July 2017. Central lines were all inserted by physicians inside the ICUs. Results: One hundred and twenty participants (70%) showed sufficient compliance. The mean compliance scores were 14.2±4.7 (min=8, max=20); however, the rate of CLABSI was variable across the participating ICUs. Logistic regression with 4 independent variables (years of experience, previous education with CLABSI, nurse-patient ratio and the ICU’s bed capacity) was conducted to investigate predictors of sufficient compliance. The model was significant (χ2(4)=133.773, p=0.00). The nurse-patient ratio was the only significant predictor. Nurses with a 1:1 nurse:patient ratio demonstrated superior compliance over their counterparts with a 1:2 ratio. Conclusion: Further improvement in compliance and patients’ outcomes could be achieved by lowering the nurse-patient ratio.

Student Nurses’ Knowledge about Prevention of Ventilator-Associated Pneumonia

The rate of ventilator-associated pneumonia (VAP) worldwide is still high. There is increasing concern that nurses do not receive sufficient education in their undergraduate courses on VAP-prevention guidelines. The purpose of this study was to investigate student nurses’ knowledge of these guidelines; assessment of the level of knowledge is essential to provide evidence of the need to modify nursing curricula. A descriptive cross-sectional design was used in this study. A total of 434 participants from seven universities in Jordan completed a questionnaire that evaluated their knowledge about VAP-prevention guidelines. The participants demonstrated poor knowledge of the majority of topics in the questionnaire. The mean knowledge score was 6.4 out of 20 (SD=2.9). Participants who reported having been taught about VAP on their undergraduate courses achieved higher scores than those who had not: t (432) =-3.5, p=0.000. However, both groups’ scores were unsatisfactory. It is imperative that student nurses be knowledgeable about VAP-prevention guidelines, despite the gap in their education on this topic. Modification and updating of nursing curricula is indispensible to improve nurses’ knowledge.

Predictors of Positive Outcomes in Pulmonary Rehabilitation

Aims: The study aims were to (1) determine the effect of participation in pulmonary rehabilitation on quality of life, severity of dyspnea, and exercise tolerance (2) evaluate predictors (number of pulmonary rehabilitation sessions attended, age, baseline quality of life, depression, and body mass index)of improvement in severity of dyspnea, exercise tolerance, and quality of life (3) to test if the amount of change in exercise tolerance and change in severity of dyspnea from the baseline to the end of pulmonary rehabilitation modifies the effect of the baselines variables on the change in quality of life from baseline to the end of rehabilitation. Study Design: A descriptive retrospective design was used. Methodology: We performed secondary analysis of records of 125 patients in the pulmonary rehabilitation registry in the University Hospitals of Cleveland / OH. The sample included all patients who completed six pulmonary rehabilitation sessions at least. Results: Pulmonary rehabilitation improved quality of life, alleviate severity of dyspnea and enhance exercise tolerance. Greater baseline body mass index was the only significant predictor Original Research Article Aloush et al.; BJMMR, 18(3): 1-7, 2016; Article no.BJMMR.28901 2 for the improvement in exercise tolerance (unstandarized β coefficient= 1.5, P= 0.02). None of the baseline variables predicted the change in severity of dyspnea. Better baseline quality of life was the only significant predictor for the improvement in quality of life (unstandarized β coefficient= 0.3, P=0.03). Changes in severity of dyspnea and change in exercise tolerance did not modify the effect of the baseline variables on the change in quality of life from baseline to the end of rehabilitation. Conclusion: Positive rehabilitation outcomes are predicted by better baseline quality of life and higher body mass index. More research is needed to identify additional interventions to implement during rehabilitation to achieve positive outcomes in participants who have lower BMI and lower baseline quality of life.

The relationship between physical activity and diet, and overweight and obesity, in young people

BACKGROUND Childhood obesity has a worldwide association with serious health problems and complications that increase the risk of illness and death. AIM To identify and assess the factors contributing to overweight and obesity among school students in north Jordan. METHOD A descriptive cross-sectional study involving 1,554 students was conducted between October 2014 and February 2015. RESULTS More than two thirds (70%) of participants were normal weight (5th percentile-<85th percentile), while 12% were overweight and 13% were obese. The prevalence of obesity was high (20%) among those eating snacks three times per day. The prevalence of overweight was high (12%) among those who followed no regular physical activity programme. CONCLUSION Collaboration is required between policymakers, healthcare professionals, business and community leaders, schools and local organisations to create suitable environments that support healthy lifestyles for children and young people.

Cardiopulmonary resuscitation training for undergraduates from nonmedical majors: Effectiveness of the three tiers model: ALOUSH et al.

BACKGROUND Integrating cardiopulmonary resuscitation (CPR) in undergraduate education would help to increase the rate of bystander CPR. However, few qualified trainers are available for this purpose. Training student nurses to become CPR trainers on campus could reduce this shortage. PURPOSE The purposes of this study were to assess CPR skills of students from nonmedical majors and to examine the effectiveness of the three tiers model for CPR training. SETTINGS One public university in Jordan. PARTICIPANTS Student nurses and undergraduates from nonmedical majors. METHOD Five student nurses attended CPR training courses based on the American Heart Association CPR guidelines. The trainees provided the same CPR training to a sample of 197 undergraduates from nonmedical majors. The participants were asked to imagine a real-life scenario of out-of-hospital cardiopulmonary arrest and to perform CPR on a manikin. Assessment of skills was made before and after training, using a structured observational checklist. RESULTS In the pretest, participants showed poor CPR skills with a pass rate of only 4%. In the posttest, participants demonstrated significant improvement: t(196) = 26.78, P = 0.00. CONCLUSION The three tiers model for CPR training would be an effective strategy to compensate for the shortage in the number of certified CPR trainers.

Effectiveness of Basic Life Support Training for Middle School Students

Bystander cardiopulmonary resuscitation improves survival after out-of-hospital cardiac arrest. This study aimed to assess the effectiveness of a basic life support (BLS) educational course given to 110 middle school children, using a pretest posttest design. In the pretest, students were asked to demonstrate BLS on a manikin to simulate a real-life scenario. After the pretest, a BLS training course of two sessions was provided, followed by posttest on the same manikin. Students were assessed using an observational sheet based on the American Heart Association’s BLS guidelines. In the pretest, students showed significant weakness in the majority of guidelines. In the posttest, they demonstrated significant improvement in their BLS skills. BLS training in the middle school was effective, considering the lack of previous skills. It is recommended that BLS education be compulsory in the school setting.

The Effectiveness of Cognitive Behavioral Therapy versus Psychoeducation in the Management of Depression among Patients Undergoing Haemodialysis

ABSTRACT The aim of this randomized controlled trial was to compare the effectiveness of psychoeducation versus cognitive behavioral therapy (CBT) in the management of depression among renal dialysis patients. A sample of 130 dialysis patients participated in the study and they were assigned at random to one of two therapies: psychoeducation (N = 65) or CBT (N = 65). Hamilton depression rating scale was completed by the participants in both groups prior to the therapies and after completion. Both therapies were effective in the management of depression, although psychoeducation was superior. Psychoeducation is recommended over CBT in the management of depression among renal dialysis patients.

The Most and the Least Performed Self-Care Behaviors Among Patients With Heart Failure in Jordan

Assessing self-care is important aspects among patients with heart failure. However, few studies were conducted to assess self-care among patients with heart failure in Jordan. Therefore, this study aimed to assess the most and the least performed maintenance self-care behaviors and to examine the relationship between maintenance self-care behaviors and selected sociodemographics. A cross-sectional design utilizing a convenience sample of 226 patients with heart failure was used. The maintenance self-care mean was 53.89 and considered below the clinical target level (≥70). Asking for low salt item and performing physical exercises were the most performed self-care behaviors, while “trying to avoid getting sick” and “checking ankles for swelling” were the least performed self-care behaviors. Limited self-care behaviors indicated the need to implement cardiac education that may improve self-care behaviors. Cardiac education should target mainly patients with low income, low educational level, elderly, living alone, unemployed, and who are using traditional treatment.