Suha Omran

Knowledge and beliefs of Jordanians toward colorectal cancer screening.

Background: Colorectal cancer is a significant health problem; it is the most common malignancy of the gastrointestinal tract. Colorectal cancer is closely related to the clinical and pathological stage of the disease at diagnosis, which can be detected early through screening tests. Objective: This descriptive cross-sectional study was conducted to investigate the knowledge and beliefs of Jordanians toward colorectal cancer (CRC) screening using the Health Belief Model. Methods: One hundred sixty participants, 50 years and older, were identified in the outpatient clinics at the 2 largest Jordanian hospitals located in the north of the country; the King Abdullah University Hospital and the Princess Basma Hospital. Results: Data analyses revealed that most participants are not well informed about CRC and screening. Less than half perceived themselves as susceptible to developing CRC. Half comprehended the seriousness of CRC, the majority understood the benefits of CRC screening, and one-third realized the barriers of CRC screening. Moreover, most understood the importance of preventative medicine and was highly motivated. Conclusion: Most Jordanians treated at outpatient clinics comprehend the benefits from CRC screening, understand the seriousness of CRC, and perceive barriers, and more than half of the patients perceive the general health motivation beliefs and outcomes. Implication for Practice: The healthcare system and the decision makers must develop strategies to increase the general populations awareness about CRC and the accompanying screening tests.

Potential risks associated with traditional herbal medicine use in cancer care: A study of Middle Eastern oncology health care professionals.

The authors assessed the use of herbal medicine by Middle Eastern patients with cancer, as reported by their oncology health care professionals (HCPs). Herbal products identified by the study HCPs were evaluated for potential negative effects.

Symptom distress of Jordanian patients with cancer receiving chemotherapy

Omran S, Saeed AMA, Simpson J. International Journal of Nursing Practice 2012; 18: 125–132 Symptom distress of Jordanian patients with cancer receiving chemotherapy The purpose of this study was to explore the prevalence of symptom distress among Jordanian patients with cancer who are receiving chemotherapy. A total of 112 patients with cancer were evaluated using the Distress Thermometer and clinical symptom problem list, and Demographic and Clinical Characteristic Data Sheet. Patients in the sample were mostly female, and recently diagnosed with cancer during the past 6 months, with a variety of types of cancer with breast cancer being the most common. Patients reported several symptoms with nausea, fatigue, anorexia and daily activity disorder being reported most frequently. Most of the patients (71%) reported distress at a clinically significant level. Distress was correlated with clinical characteristics as treatment number and time. Problems in the areas of family relationships, emotional functioning and physical functioning were associated with higher reports of distress. Identification of the presence of distress is the first step towards referral and treatment of the symptoms that may contribute to the distress of the patient with cancer.The purpose of this study was to explore the prevalence of symptom distress among Jordanian patients with cancer who are receiving chemotherapy. A total of 112 patients with cancer were evaluated using the Distress Thermometer and clinical symptom problem list, and Demographic and Clinical Characteristic Data Sheet. Patients in the sample were mostly female, and recently diagnosed with cancer during the past 6 months, with a variety of types of cancer with breast cancer being the most common. Patients reported several symptoms with nausea, fatigue, anorexia and daily activity disorder being reported most frequently. Most of the patients (71%) reported distress at a clinically significant level. Distress was correlated with clinical characteristics as treatment number and time. Problems in the areas of family relationships, emotional functioning and physical functioning were associated with higher reports of distress. Identification of the presence of distress is the first step towards referral and treatment of the symptoms that may contribute to the distress of the patient with cancer.

Osteoporosis knowledge among female school students in Jordan.

Although osteoporosis is a preventable disease affecting millions of people, public awareness remains low. This study used a pretest-posttest quasi-experimental design to explore osteoporosis knowledge among adolescent female students in Jordan. A questionnaire was administered to 148 students recruited from a secondary school in the city of Irbid before and after a series of health education sessions based on the health belief model. A significant increase in overall scores for osteoporosis knowledge was seen (mean score pretest = 24.1 and posttest = 29.8, P < 0.001). Further research geared toward the follow-up of attained knowledge and behavioural change over time is greatly needed.

Multidisciplinary care team for cancer patients and its implementation in several Middle Eastern countries

This article introduces palliative care to cancer patients in Middle Eastern countries. It considers the importance of the multidisciplinary team in providing an adequate service to the patient and his/her family. It provides views of professionals from the various countries with regard to the role of the nurse in such teams; whereby the three elements of palliative care nursing entail: 1. Working directly with patients and families; 2. Working with other health and social care professionals to network and co-ordinate services; and 3. working at an organizational level to plan, develop and manage service provision in local, regional and national settings. This article also details the challenges that nurses face in the Middle East and outlines the preferable ways to overcome such challenges. The latter include more focused educational activities at the undergraduate and graduate levels and continuous clinical training throughout their work as palliative care nurse specialists.

Palliative Care Nursing in Jordan

Palliative care is progressively more existing and the importance of its role is increasingly acknowledged by many countries. This paper identifies and examines main stepladders taken by Jordan for the development of palliative care. In palliative care, the primary goal is alleviating symptom distress resulting from multiple symptoms and enhancing quality of life for patients and their families. To meet patients’ multiple needs, it is generally believed that the care should be holistic, multidisciplinary, and patient as well as family centred. Countries should develop and implement educational programs for multidisciplinary healthcare providers so as to be able to enhance the quality of care provided to patients and families at all levels of care. Unfortunately, in Jordan, skill development among health care providers; few educational and training opportunities exist to this point; and specialty acknowledgement also has not yet occurred. Research capacity is also inadequate. Policy to develop, improve, and sustain palliative care is also lacking in Jordan. Palliative care in Jordan is evolving but has far to go. Adequate resources provision, educational programs, credentialed healthcare providers are crucial elements that palliative care in Jordan needs.

Assessment of Jordanian Patient's Colorectal Cancer Awareness and Preferences towards CRC Screening: Are Jordanians Ready to Embrace CRC Screening?

BACKGROUND Colorectal cancer (CRC is increasingly becoming a major cause of cancer morbidity and mortality in Jordan. However the populations level of awareness about CRC, CRC screening test preferences and willingness to embrace screening are not known. The aim of this study was to assess the level of CRC awareness and screening preferences among Jordanian patients. MATERIALS AND METHODS A survey assessing the CRC knowledge levels was distributed among patients attending outpatient gastroenterology clinics in public hospitals throughout Jordan. A total of 800 surveys were distributed and of these 713 (89.1%) were returned. RESULTS Only 22% of the participants correctly judged CRC among the choices provided as the commonest cause of cancer related deaths. The majority of participants (68.3%) underestimated their risk for CRC. Only 26.8% correctly judged their life time risk while 5% overestimated their risk. Two thirds of participants (66%) were willing to pay 500 Jordanian Dinars (equivalent to 706 US

Symptom Severity, Anxiety, Depression, Self- Efficacy and Quality of Life in Patients with Cancer

) in order to get a prompt colonoscopy if recommended by their physician, while 25.5% reported that they would rather wait for 6 months in order to get a free colonoscopy. CONCLUSIONS Although the participants tended to underestimate their risk for CRC, they were mostly aware of CRC as a major cause of mortality and were willing to embrace the concept of CRC screening and bear the related financial costs. These findings about CRC awareness and propensity for screening provide a good foundation as the Jordanian health system moves forward with initiatives to promote CRC screening and prevention.

Symptom Clusters and Quality of Life in Hospice Patients with Cancer

Background: Despite advances in cancer disease prevention, diagnosis, and treatment patients with cancer suffer from a variety of sometimes severe physical and psychological symptoms regardless of the stage of the disease. The aim is to determine the relationship of antecedent factors and mediating variables to the quality of life (QOL) of patients with cancer. Materials and Methods: The study included 341 patients with cancer and symptoms. Data collection used the Cancer Symptom Scale, State-Trait Anxiety Inventory, Centers for Epidemiologic Study-Depression, Cancer Behavior Inventory, Multidimensional Quality of Life Index, and a Demographic Form. Results: A multiple regression equation containing all the variables explained 68% of the variance in QOL. Overall four variables accounted for the majority of the total variance: anxiety, depression, self-efficacy, and symptom severity. Three of these variables were mediating variables. Of the antecedent factors symptom severity had a significant indirect effect on QOL through the mediating variables. Symptom severity also had direct effect on QOL. Conclusion: Data indicate that anxiety, depression, and self-efficacy play major roles in determining the perception of QOL of cancer patients. These mediating variables either buffered or enhanced the impact of the antecedent factors of symptom severity on QOL. Nursing interventions should focus on enhancing self-efficacy. Nurses can use health promoting programs to assist patients who are physically impaired. Further research should be aimed at identifying other influential variables, with the ultimate goal of developing interventions to aid patients in their efforts to maintain their QOL while living with cancer.

Gender differences in signs and symptoms presentation and treatment of Jordanian myocardial infarction patients

Background: Symptom control is an important part of palliative care and important to achieve optimal quality of life (QOL). Studies have shown that patients with advanced cancer suffer from diverse and often severe physical and psychological symptoms. The aim is to explore the influence of symptom clusters on QOL among patients with advanced cancer. Materials and Methods: 709 patients with advanced cancer were recruited to participate in a clinical trial focusing on symptom management and QOL. Patients were adults newly admitted to hospice home care in one of two hospices in southwest Florida, who could pass mental status screening. The instruments used for data collection were the Demographic Data Form, Memorial Symptom Assessment Scale (MSAS), and the Hospice Quality of Life Index-14. Results: Exploratory factor analysis and multiple regression were used to identify symptom clusters and their influence on QOL. The results revealed that the participants experienced multiple concurrent symptoms. There were four symptom clusters found among these cancer patients. Individual symptom distress scores that were the strongest predictors of QOL were: feeling pain; dry mouth; feeling drowsy; nausea; difficulty swallowing; worrying and feeling nervous. Conclusions: Patients with advanced cancer reported various concurrent symptoms, and these form symptom clusters of four main categories. The four symptoms clusters have a negative influence on patients’ QOL and required specific care from different members of the hospice healthcare team. The results of this study should be used to guide health care providers’ symptom management. Proper attention to symptom clusters should be the basis for accurate planning of effective interventions to manage the symptom clusters experienced by advanced cancer patients. The health care provider needs to plan ahead for these symptoms and manage any concurrent symptoms for successful promotion of their patient’s QOL.