Haya Ibrahim Ali Abu Maloh

Background: ST-elevation myocardial infarction (STEMI) complications are widespread and have a direct effect on the length of stay (LOS) and mortality of patients. Reperfusion therapy via Percutaneous Coronary Intervention mainly impacts outcomes within the first few hours. Consequently, delaying this procedure is a key concern in STEMI management. The door-to-balloon (D2B) time is a crucial predictor of clinical outcomes. This study investigates whether D2B time can predict post-STEMI complications and length of hospital stay, accounting for sociodemographic and clinical variables. Methods: This prospective observational study involved 536 patients with confirmed STEMI, recruited consecutively from 8 hospitals in Amman, Jordan. Patients were classified as delayed if their D2B time was ≥2 h. Logistic regression analyzed the impact of delay on complications, while multiple regression assessed how delay time affected LoS. Results: The median D2B time was 108 min (IQR 65–395). The delayed group and patients with a previous AMI had 2.22- and 1.41-times higher risks of complications, respectively, compared to their counterparts. Patients with a history of HTN and DM faced 1.24- and 1.18-times higher risks of complications versus their respective groups. Each additional hour of door-to-balloon delay was associated with an increase of 0.294 days in hospital length of stay. Conclusions: D2B ≥ 2 h is linked to increased complications and longer LoS. Timely management can reduce complications, shorten LoS, and lower hospital resource use.

Background: Coronary artery bypass graft (CABG) surgery is an invasive procedure done to resolve symptoms and improve quality of life in patients with coronary artery disease. However, it is a major operation that has its own complications and risks. Delayed extubation (DE) after surgery has been associated with higher-than-average rates of morbidity and mortality. The objective of this study was to determine the incidence and most important predictors of DE following CABG surgery. Methods: This prospective observational study was conducted on 300 adult patients who underwent non-urgent CABG. Data were collected from 4 hospitals in Alexandria, Egypt, by trained research assistants and were analyzed using logistic regression, independent t-testing, and Fisher's exact test. Results: Seventy-five participants (25%) developed DE. Patients with age ≥60 years, operation time ≥7 hours, cardiopulmonary bypass time ≥120 minutes, or body mass index ≥28 kg/m2 had a 1.71, 1.88, 2.25, or 2.33 times higher risk of developing DE than those in the counterpoint groups. The only protective variable was the ejection fraction (EF). Patients with EF ≥50% were 21% less likely to develop DE than those with EF less than 50%. Participants who developed DE stayed longer in the intensive care unit (mean±standard deviation [SD], 7.9±1.60 vs. 3.1±1.2; P<0.001) and in the hospital (mean±SD, 22.6±3.1 vs. 15.1±2.9; P<0.001) than those who did not develop DE. Conclusions: Performing CABG as early as possible, controlling body mass index, shortening the operation and cardiopulmonary bypass times, and enhancing EF might decrease the occurrence of postoperative DE and its associated mortality.

Background: Postpartum depression can have serious consequences for maternal, neonatal, and family well‐being. Identifying women at risk of postpartum depression is crucial. Additionally, promoting increased husband participation in prenatal visits may enhance women’s mental health and reduce their vulnerability to postpartum depression. PURPOSE: This study seeks to investigate the relationship between husband participation in prenatal care and the risk of postpartum depression. This study fills a critical gap by examining the link between husbands’ involvement in antenatal care and postpartum depression among Jordanian women. It offers original, culturally relevant insights that can inform maternal health policies and interventions in Jordan and similar Arab contexts. This study addresses a critical gap in research within Arab and Islamic cultures by examining the relationship between husbands’ involvement in antenatal care and postpartum depression among Jordanian women. It offers culturally specific evidence that enhances understanding of paternal roles in maternal mental health, informing future health policies and interventions in male‐dominated societies. Methods: A descriptive correlational study was conducted in Jordan from June to September 2020, involving a convenient sample of 315 women who completed self‐administered questionnaires. These questionnaires collected demographic information about the women and their husbands, utilized the Edinburgh Postnatal Depression Scale (EPDS), and assessed the level of husband involvement in maternal antenatal care. Results: The findings indicated that 83.2% of Jordanian husbands were actively engaged in the antenatal care of their pregnant partners. Furthermore, 73.7% of Jordanian women reported a high risk of experiencing postpartum depression. The study also revealed a significant negative correlation between husbands′ involvement and the risk of postpartum depression. Conclusions: The level of husband involvement is inversely related to the risk of postpartum depression. These findings underscore the importance of healthcare providers implementing intervention and educational programs aimed at promoting husbands’ active participation in antenatal care, with a specific focus on reducing the risk of postpartum depression among Jordanian women.

Background: Healthcare institutions aim to enhance medication error reporting. A “just culture” is recognized as a safety subculture, with numerous studies affirming its contribution to improving safety standards in hospitals. However, its influence on motivating nurses to report medication errors remains ambiguous. Aims and Objectives: This study aimed to evaluate the perception of “just culture” and the willingness to report medication errors among nurses in Jordanian hospitals, as well as to examine the relationship between Jordanian nurses’ perception of “just culture” and their willingness to report medication errors. Methods: A descriptive, correlational, cross‐sectional study was conducted in four Jordanian hospitals using self‐report questionnaires. A convenience sample of 190 nurses participated in this study. Data were collected using an online survey platform using the Just Culture Assessment Tool (JCAT) to assess the perception of “just culture,” and hypothetical scenarios were employed to determine the nurses’ willingness to report medication errors. Results: The majority of participants were female (70%), held a bachelor’s degree (88.4%), and had 1–10 years of experience (77%). The findings indicated that nurses perceived their units as having a high degree of “just culture” (114.05 out of 189). However, more than two‐thirds of the nurses ( n = 131, 68.9%) expressed an unwillingness to report their own medication errors. The study also identified a weak positive correlation between “just culture” and willingness to report medication errors ( r = 0.192, p < 0.01). Conclusion: The study’s findings provide essential evidence for nursing managers and supervisors to develop policies and strategies that foster a “just culture,” which may significantly influence nurses’ willingness to report medication errors. The culture of blame must be replaced with a culture of trust and accountability. Reported errors and incidents should be viewed as opportunities for learning and improvement, with lessons learned being disseminated across hospitals to prevent future occurrences. Educators should incorporate “just culture” into the nursing curriculum, enhance the learning environment, and prepare nursing students to address the challenges of patient care and safety issues.

Background: Anxiety, depressive symptoms and delirium are common among patients undergoing coronary artery bypass graft surgery (CABG). Postoperative delirium is associated with diverse negative outcomes among those patients, including delayed extubation and prolonged length of stay (LoS). Existing literature has recorded the incidence and associated risk factors with delirium among patients undergoing CABG, but limited studies have checked the particular impacts of preoperative anxiety and depressive symptoms (ADS) on the incidence of postoperative delirium. Aim: To determine the impact of ADS on the incidence of postoperative delirium among patient undergoing elective CABG. Study design: This was a prospective cohort study among 400 patients, 220 (55%) males and 180 (45%) females, who underwent elective CABG. The sample was recruited from six major hospitals in Jordan. ADS were measured prior to the operation using the Hospital Anxiety and Depression Scale. Delirium was screened using the Confusion Assessment Method for the Intensive Care Unit by trained research assistants twice daily from the second to the fifth day postoperatively. Data were analysed using logistic and multiple regression analyses. Results: 160 patients (40%) developed delirium postoperatively. Regression analysis showed that older age, female sex, duration of surgery ≥7 h, depressed, anxious, and anxious and depressed categories were independent predictors for higher incidence rates of delirium. Additionally, the occurrence of delirium was an independent predictor for longer hospital/ICU LoS. Conclusions: CABG patients may experience delirium more frequently and require a longer hospital stay if they have prior anxiety or depression. Controlling ADS might decrease delirium incidence and shorten the LoS. Relevance to clinical practice: Our findings underscore the critical role nurses play in identifying and addressing psychological issues before CABG. By recognising and managing preoperative ADS, nurses can potentially reduce the risk of delirium following CABG.

Introduction: Stress and pain are high among patients undergoing hemodialysis. Benson's Relaxation technique affected a wide range of physical and psychological signs and symptoms among patients undergoing hemodialysis. Objective: To evaluate the effectiveness of Benson's Relaxation Technique in reducing stress and pain among patients undergoing maintenance hemodialysis. Materials and Methods: A systematic review of randomized controlled trials was conducted. A systematic literature search was carried out from 2000 to 2023. Searched databases included EBSCO-Host “Academic Search, Cochrane, CINAHL, Health Business, MEDLINE, Psychology and Behavioral Sciences, SPORTDiscus”, PubMed, Ovid, and Google Scholar. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were conducted. RCTs were critically appraised using the Cochrane's Risk of Bias Tool. Four RCTs met the inclusion criteria and included in this review since they were applicable to practice. Results: Four randomized controlled trials were identified supporting the use of Benson's relaxation technique as a nursing treatment in managing stress and pain among patients undergoing maintenance hemodialysis, as it achieved a significant decrease in stress and pain scores. The overall quality of the randomized controlled trials was judged to be low to relatively moderate. Conclusions: Most of the randomized controlled trials lacked details on intervention adherence. It is recommended to conduct additional longitudinal randomized controlled trials in different countries with bigger sample sizes, to provide more evidence for generalizing outcomes.

Review question / Objective: The aim of this systematic review is to investigate the effectiveness of comprehensive CR programs in improving outcomes for patients who had undergone CABG. The explicit statement of the research question considered for this systematic review is formulated by using (PICOS) criteria; Population (patients who had undergone CABG), Intervention (comprehensive CR programs), Comparator (control groups), Outcome (HRQoL, stress, anxiety, depression, readmission, and the occurrence of major adverse cardiac/ cerebrovascularevents MACCE)and Study (RCTs). Condition being studied: The effectiveness of comprehensive cardiac rehabilitation programs in improving the outcomes for patients with coronary artery disease who had undergone coronary artery bypass graft surgery.

Introduction: Intensive care unit patients and families experience significant stress. It creates frustrations, nervousness, irritability, social isolation for patients, anxiety, and depression for families. An open visitation policy with no time or duration limits may assist in reducing these negative experiences. However, most Jordanian and regional hospitals within the Middle-East and Northern Africa (MENA) have not implemented this strategy. Purpose: To evaluate nurse managers' and nurses' perspectives on the effects of an open visitation policy at intensive care units (ICUs) on patients, families, and nurses' care. Method: A cross-sectional, descriptive, and comparative survey design was used. Results: A total of 234 nurses participated in the study; 59.4% were males, and 40.6% were females. The mean of their age was 28.6 years, with a mean of 4.1 years of experience. Nurses generally had negative perceptions and attitudes toward the open visitation policy and its consequences on the patient, family, and nursing care. Conclusions: ICU managers and staff nurses did not favor implementing an open visitation in their units despite its known benefits, international recommendations, and relevance and compatibility with the local religious and cultural context. A serious discussion regarding this hesitation from the side of the healthcare professionals should be started to find a suitable solutions that consider the benefits of the open visitation policy and the challenges that prevent its implementation in the Jordanian and Arabic cultures.

Benson’s relaxation affects many symptoms among hemodialysis patients. A cluster-randomized active control clinical trial with three repeated measures; pre, 1-week, and 1-month post-intervention sought to evaluate the effectiveness of Benson’s Relaxation on pain and perceived stress (P&PS) among hemodialysis patients. Two governmental hospitals were randomly assigned to intervention and control. Thirty-six participants were randomly selected; 18 were intervention, and 18 were controlled. The intervention group performed Benson’s Relaxation twice a day for 10 minutes for 8 weeks after a training session. The control group received an educational session about Progressive Relaxation. Findings revealed a statistically significant reduction in the PSS-10 and PRI scores between pre-intervention and 1 month after-intervention ( p < .001) and at 1 week after intervention and 1 month after-intervention ( p < .001). A non-statistically significant reduction between pre-intervention and 1 week after-intervention ( p > .05). Benson’s Relaxation significantly relieved P&PS among hemodialysis patients but not after only 1 week of practicing.

This study aimed to evaluate the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis. A systematic review of randomized controlled trials was conducted. Searching databases included EBSCO Host, PubMed, ProQuest, Science Direct, Sage Journals, Ovid, and Google Scholar from January 2000 to September 2020. Five randomized controlled trials were identified. Findings revealed a statistically significant decrease in anxiety score. Concerning depression; one RCT showed a statistically significant decrease and two RCTs revealed a non-significant difference in depression level. The overall quality of the RCTs was not high. Despite that the RCTs showed benefits of BRT in managing anxiety. However, this is not the same for depression. The lack of high-quality scientific evidence supporting its retinue use indicates that additional well designed randomized controlled trials in multiple countries are warranted to support the efficacy of Benson’s relaxation technique on anxiety and depression among patients undergoing hemodialysis.