Sleep quality and associated factors among critical care nurses in Jordan: A cross-sectional study

Background: Sleep disturbances among critical care nurses have been widely recognized as a significant concern, affecting both individual well-being and patient care outcomes. Understanding the factors influencing sleep quality in this population is crucial for developing effective interventions and policies to promote better sleep health. Objective: This cross-sectional study aimed to investigate the demographic and work-related factors associated with sleep disturbances among critical care nurses in Jordan. Methods: A total of 182 critical care nurses from governmental, private, and military healthcare sectors in Jordan participated in this study. Data were collected using a structured questionnaire, including demographic variables and the Arabic version of the Insomnia Severity Index (ISI). Descriptive statistics and inferential analyses, including independent t-tests and ANOVA tests, were conducted to identify factors influencing insomnia severity among critical care nurses. Results: The study findings revealed a moderate level of insomnia severity among critical care nurses, with several demographic and work-related factors significantly associated with sleep disturbances. Educational level, smoking status, regular physical activity, weekly working hours, and working overtime were identified as significant predictors of insomnia severity among participants (all p <0.05). Conclusion: Our study underscores the importance of addressing various demographic and occupational factors in understanding sleep disturbances among critical care nurses. Targeted interventions aimed at promoting better sleep hygiene and addressing modifiable risk factors are essential for improving sleep quality and overall well-being in this vital healthcare workforce.

Factors associated with adherence to prevention guidelines of pressure injuries among Jordanian nurses in critical care units.

Background. Breaking bad news (BBN) is one of the most difficult tasks faced by healthcare providers. In addition, breaking bad news is stressful for both; healthcare providers and patient. Nurses can play an important role in the process of BBN. Whereas, effective communication by critical care nurses improves patients' understanding of their health status and decreases their stress level. Furthermore, effective BBN process requires effective communication skills. Aims. To assess critical care nurses' knowledge level regarding breaking bad news process, assess their involvement in the process of BBN, andto determine the barrier of practicing breaking bad news process as perceived by critical care nurses to identify the factors that affect nurses' practice of breaking bad news in the critical care units. Methods. Descriptive cross-sectional design, using self-reported questionnaires. Results. The study showed that most critical care nurses in Jordan are highly involved in BBN process 77% (n=157), Also, nurses are highly perceived themselves as an active part in BBN process 76% (n=155). The major barrier in providing BBN was relatives requesting that a patient is not told bad news 75% (n=152). Conclusion. Current study revealed that Jordanian critical care nurses took different roles in the process of breaking bad news and they are highly involved in BBN news, creating a base of knowledge regarding BBN among critical care nurses in Jordan. Thus, the study recommends the policymakers to empower nurses role in this process through design an educational program regarding practice BBN and clarify nurses’ role in this process.

Continuing professional development (CPD) is essential for maintaining high nursing care standards, yet critical care nurses in Jordan face significant barriers, including financial constraints, lack of institutional support, and time limitations that impact the quality of patient care and nursing competency. A cross-sectional descriptive design was used for this study that surveyed 190 critical care nurses from five public hospitals in Jordan. Nurses prioritize CPD for knowledge enhancement, improvement in the quality of care, and professional growth. Hands-on training and online courses were the most valued CPD activities, and research engagement had low scores because of systemic barriers. Employer-funded CPD and supportive policies emerged as critical enablers, emphasizing the need for structured support mechanisms. Overcoming challenges to CPD through financial reimbursement, flexible scheduling, and institutional support can enhance participation and improve nursing competency. Targeted CPD initiatives are necessary to strengthen patient outcomes and professional development for critical care nurses in Jordan. [J Contin Educ Nurs. 2025;56(6):231-236.].

What's in this issue.

BackgroundThe global nursing shortage continues to strain healthcare systems, with the intention to leave (ITL), which is defined as the likelihood of leaving one's job or profession, emerging as a key contributor to workforce instability.ObjectiveThe study aims to assess the correlation between sociodemographic characteristics, professional quality of life (ProQoL), critical care nurses’ intention to leave their units, and their intention to leave the nursing profession.MethodsA cross-sectional descriptive study of 135 critical care nurses in Jordan was conducted between February and May 2024 using an electronic questionnaire that included ITL and ProQoL Version 5. Associations between variables were examined using point-biserial correlation and the Chi-square test. A logistic regression was performed to ascertain the effects of ProQoL and demographics on the likelihood that nurses intended to leave.ResultsOf the 135 nurses surveyed, 56% reported an intention to leave the nursing profession, and 55% expressed intent to leave their current critical care units. Most participants demonstrated moderate levels of compassion satisfaction (85%), compassion fatigue (86%), and burnout (94%). Female nurses reported higher levels of compassion satisfaction, burnout, and compassion fatigue than males. Regression analysis showed that intention to leave the profession was significantly predicted by intention to leave the unit (B = −2.268, p < .05), though burnout was not a significant predictor.ConclusionsBurnout and compassion fatigue were significantly predictive of ITL, while compassion satisfaction mitigated its likelihood. These findings demonstrate the necessity of proactive and strategic policies designed to address nurses’ physical and mental health conditions and restructure their staffing and scheduling frameworks to retain critical care nurses.

Burnout Syndrome in ICU Caregivers: Time to Extinguish!

Resilience in critical care nurses-is it desirable?

Critical care nurses experience high levels of burnout compared to other nurses, due to daily exposure to extremely stressful situations, critically ill patients, and high workload. Emotional intelligence (EI) is considered a protective factor against burnout. There is a dearth of literature on the association between these 2 variables among critical care nurses including those in Jordan. To explore the relationship between EI and burnout among critical care nurses in Jordan, a descriptive, cross-sectional, and correlational design was used. A convenience sample of 284 critical care nurses working in Jordanian governmental hospitals was recruited. Data were collected using Maslach burnout inventory to assess burnout level, and Genos Emotional Intelligence Inventory (concise version) to assess EI level. Nurses' burnout level was moderate with respect to emotional exhaustion (44.5%), while high burnout was reported for depersonalization (66.9%) and low personal accomplishment (48.4%). In terms of hierarchical regression analysis, emotional exhaustion was predicted negatively as a function of working hours, other marital status group, and emotional intelligence, with 26.2% of variance explained, and similar results were observed in depersonalization burnout with 15.5% of variance explained. Finally, EI alone had a positive impact on personal accomplishment with 38.8% of variance in personal accomplishment explained by nurses' emotional intelligence. This study showed a negative and significant correlation between EI and burnout levels among nurses in critical care units in Jordan. Starting to prepare nurses to be emotionally competent is highly recommended to reduce their burnout.

Quality of life of critical care nurses and impact on anxiety, depression, stress, burnout and sleep quality: A cross-sectional study

Self-awareness, empathy, and patient-centered care are essential components for nurses for improving nurse-patient relationship and providing high-quality care for the patients. There is limited research regarding these components among critical care nurses in Arab countries, including Jordan. Thus, this study purposed to evaluate the self-awareness, empathy, and patient-centered care among critical care nurses in Jordan. A cross-sectional, descriptive correlational design was applied. Data were collected from 140 registered nurses from six hospitals in different health sectors. Findings showed that the mean scores for self-awareness, empathy and patient-centered care were as follows: 1.92 (SD = 0.27), 4.87 (SD = 0.88), and 3.71 (SD = 0.80), respectively. These results indicate that nurses had a high level of self-awareness and empathy and a low level of patient-centered care. There was no relationship between self-awareness and socio-demographic variables, perceived stress, and social support. Also, there was a positive relationship between empathy and social support (r = 0.310, p < 0.001). Patient-centered care had a positive relationship with social support (r = 0.202, p < 0.05) and perceived stress (r = 0.175, p < 0.05), also, male nurses had higher patient-centered care than female encounters. Social support was a predictor of empathy, while social support and perceived stress were the main predictors for patient-centered care. The results of the study reflect the need for educational programs to promote self-awareness and empathy to enhance patient-centered care and achieve high-quality patient care. Additionally, correlating factors with PCC (social support and perceived stress) should be taken into consideration upon implementing any interventional programs.

Nurses with high self-efficacy and emotional intelligence can provide effective clinical decision-making, which could influence the quality of healthcare. Also, there is a lack of studies about these variables in Arab countries including Jordan. Thus, this study purposed to assess the relationship between emotional intelligence, self-efficacy, and clinical decision-making among critical care nurses in Jordan. A descriptive correlational design was conducted on a sample of 407 nurses who work in critical care units in government, private, and educational health hospitals. The data were collected using a structured questionnaire during the period from March to May 2022. The results revealed that the participants’ mean scores of emotional intelligence, self-efficacy, and clinical decision-making were as follows: M = 5.22 (SD ± 0.18), M = 3.71 (SD ± 0.481), and M = 3.88 (SD ± 0.518), respectively, which reflected high levels of these variables. Emotional intelligence, self-efficacy, age, and marital status were positively correlated with clinical decision-making (β = 0.218, p < .001; β = 0.328, p < .001; β = 0.182, p = .01; β = 0.092, p < .05, respectively). Self-efficacy had the greatest association with clinical decision-making (T-Statistics = 6.37). Therefore, it is important to encourage and continuously implement strategies for critical care nurses to enhance their emotional intelligence and self-efficacy, and take into consideration age and marital status to improve their clinical decision-making skills to provide high-quality patient care. The main practical contribution originates from improving emotional intelligence and self-efficacy may increase the critical care nurses’ competencies in clinical decision-making, which will reflect positively on nurses’ health and patients’ outcomes.

There is a lack of studies regarding job-related stress, quality of work life, and quality of nursing. This study proposed to examine job-related stress, quality of work life, and quality of nursing care among critical care nurses in Jordan. A cross-sectional study was adopted. Data were collected from 480 registered nurses working in critical care units from three health sectors, including government, private, and educational hospitals, using the Expanded Nursing Stress Scale, Quality of Nursing Work Life Survey, and Quality of Nursing Care Instrument. Findings showed that the mean scores of job-related stress, quality of work life, and quality of nursing care were 2.96 (SD = 0.65), 4.01 (SD = 0.60), and 3.70 (SD= 0.61), respectively. Results indicated that nurses had occasionally to frequent job-related stress, a moderate quality of work life, and a very good quality of nursing care. A positive relationship existed between quality of nursing care and quality of work life (β = 0.638, p < 0.001) in model 1 and quality of nursing care and quality of work life (β = 0.639, p < 0.001) and gender (β = 0.093, p < 0.05) in model 2. Thus, this study reflected the need for induction programs and strategies to control job stress and enhance the quality of work life to achieve high-quality nursing care.

Family presence during resuscitation was introduced into clinical practice 30 years ago. Despite adoption of family-centered care by several health organizations and support for family presence during resuscitation by professional organizations such as the American Heart Association, critical care nurses' attitudes about family presence during resuscitation vary widely. To examine current evidence on critical care nurses' attitudes about, perceptions of, and behaviors related to practicing family presence during resuscitation. The method of Whittemore and Knafl guided the integrative review. Databases searched were CINAHL, PubMed, and Scopus. Articles included were English-language studies published from 2008 to 2022 that examined the perceptions of critical and emergency care nurses from adult units regarding family presence during resuscitation. Twenty-two articles were included. Levels and strength of evidence were assessed with the Johns Hopkins nursing evidence-based model. The articles in this integrative review included a total sample size of 4780 health care professionals; 3808 were critical and acute care nurses. Themes synthesized from current evidence included attitudes, benefits, barriers, demographic influence, cultural influence, and facilitators. Barriers and facilitators were associated with nursing practice in rural versus urban settings, age-related factors, years of experience, and unit-based differences in practice. Developing interventions to address identified factors can increase the practice of family presence during resuscitation in critical care settings. Several factors influence the practice of family presence during resuscitation in critical care settings. Nurse leaders should consider these factors to enhance the practice of family presence during resuscitation.

Background: Healthy lifestyle is important in promoting health and reducing risk of chronic diseases. Nurses’ lifestyle could be affected negatively by working night shifts or always rotating shifts, long working hours and high exposure to work-related stress. Purpose: This study aims to assess nurses’ lifestyle and factors associated with it. Methods: A cross-sectional design with an online survey was used in this study. The sample included 203 Jordanian nurses from four hospitals. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, while dietary habits were assessed using the Rapid Eating Assessment for Participants-Shortened Version. Physical activity was assessed using the International Physical Activity Questionnaire. Results: Nurses’ mean age was 32.7±5.66 years and on average, they have 8.27±5.63 years of experience. Approximately, 25% of nurses were tobacco smokers. The majority of nurses reported poor sleep quality (n = 174, 85.5%). Approximately, 58% of nurses were overweight or obese and 41.9% of nurses had poor dietary habits. Only 39.5% of nurses reported moderate or high levels of activity. Conclusion: Jordanian nurses’ lifestyle showed poor quality in most aspects. Implications for Nursing: Nurses should be aware of the importance of adopting a healthier lifestyle to prevent possible complications. Nurse leaders should consider the health status of nurses and prevent illnesses by encouraging a healthier lifestyle of nurses. Keywords: Nurses, Lifestyle, Sleep quality, Dietary habits, Nutritional status, Physical activity.