Jordanian Hospitals Research Articles

Nurses valued domains of living: Exploring gender differences.

This study explores gender-specific aspects of nurses' valued domains of living, examining differences in importance and consistency between male and female nurses in Jordanian hospitals. A cross-sectional study recruited 206 nurses (103 females, 103 males) from two major hospitals in Jordan. Data were collected using a demographics questionnaire and the Valued Living Questionnaire (VLQ), assessing 10 domains of living. The mean age of the sample was 35.4, ranging between 27 and 59 years old. The highest rank order valued domain of living for females was family, with 88.3% of females considering it a very important living domain. Parenting was the highest-ranked domain of living for males, with 76.7% reporting it as a very important domain of living. Significant gender differences were found in valued domains' rank order, importance, and consistency. Female nurses prioritized work, education/training, spirituality, and citizenship/community more than males, while males prioritized marriage/couples/intimate relations. Females consistently aligned actions with values related to work, education/training, spirituality, and citizenship/community. Parenting emerged as a problematic valued domain, particularly for females. Understanding gender differences in nurses' valued domains is essential for creating equitable and supportive work environments. Tailored interventions should address gender-specific needs and challenges, promoting workplace satisfaction and improving patient outcomes. Future research should explore factors contributing to gender differences and evaluate interventions promoting gender equity and diversity in nursing.

Nurses' continuance intention to use electronic health record systems: The antecedent role of personality and organisation support.

Nurses play a crucial role in the adoption and continued use of Electronic Health Records (EHRs), especially in developing countries. Existing literature scarcely addresses how personality traits and organisational support influence nurses' decision to persist with EHR use in these regions. This study developed a model combining the Five-Factor Model (FFM) and the Unified Theory of Acceptance and Use of Technology (UTAUT) to explore the impact of personality traits and organisational support on nurses' continuance intention to use EHR systems. Data were collected via a self-reported survey from 472 nurses across 10 public hospitals in Jordan and analyzed using a structural equation modeling approach (Smart PLS-SEM 4). The analysis revealed that personality traits, specifically Openness, Experience, and Conscientiousness, significantly influence nurses' decisions to continue using EHR systems. Furthermore, organisational support, enhanced by Performance Expectancy and Facilitating Conditions, positively affected their ongoing commitment to EHR use. The findings underscore the importance of considering individual personality traits and providing robust organisational support in promoting sustained EHR usage among nurses. These insights are vital for healthcare organisations aiming to foster a conducive environment for EHR system adoption, thereby enhancing patient care outcomes.

Prevalence of Malnutrition among Hospitalized Pediatric Patients in a Tertiary Hospital in Jordan: Pilot Study

Prevalence of Malnutrition among Hospitalized Pediatric Patients in a Tertiary Hospital in Jordan: Pilot Study

Extended Spectrumbeta-Lactamase Bacteria and Multidrug Resistance in Jordan are Predicted Using a New Machine-Learningsystem.

The incidence of microorganisms with extended-spectrum beta-lactamase (ESBL) ison the rise, posing a significant public health concern. The current application of machine learning (ML) focuses on predicting bacterial resistance to optimize antibiotic therapy. This study employs ML to forecast the occurrence of bacteria that generate ESBL and demonstrate resistance to multiple antibiotics (MDR). Six popular ML algorithms were initially trained on antibiotic resistance test patient reports (n = 489)collected from Al-Hussein/Salt Hospital in Jordan. Trained outcome models predict ESBL and multidrug resistance profiles based on microbiological and patients' clinical data. The results were utilized to select the optimal ML method to predict ESBL's most associated features. Escherichia coli (E. coli, 82%) was the most commonly identified microbe generating ESBL, displaying multidrug resistance. Urinary tract infections (UTIs) constituted the most frequently observed clinical diagnosis (68.7%). Classification and Regression Trees (CART) and Random Forest (RF) classifiers emerged as the most effective algorithms. The relevant features associated with the emergence of ESBL include age and different classes of antibiotics, including cefuroxime, ceftazidime, cefepime, trimethoprim/ sulfamethoxazole, ciprofloxacin, and gentamicin. Fosfomycin nitrofurantoin, piperacillin/tazobactam, along with amikacin, meropenem, and imipenem, had a pronounced inverse relationship with the ESBL class. CART and RF-based ML algorithms can be employed to predict the most important features of ESBL. The significance of monitoring trends in ESBL infections is emphasized to facilitate the administration of appropriate antibiotic therapy.

Ethical Leadership and Employees’ Creativity: The Mediating Role of Organizational Pride

Abstract The purpose of the current study is to examine the mediating role of organizational pride on the relationship between ethical leadership and employees’ creativity. Using a convenience sample of (130) managers, heads of the department, and their employees from private hospitals in Jordan, the data were gathered by questionnaire. The current study adopted a quantitative approach. Furthermore, structural equation modeling (SEM) was used to test the study hypotheses. The current study reveals that ethical leadership has a significant and positive impact on employees' creativity. On the other side, the results of the study showed that ethical leadership has a significant and positive impact on organizational pride. Additionally, the current study also showed that organizational pride has a significant and positive impact on employees' creativity. Finally, it has been found that there is a mediation impact on the relationship between ethical leadership and employees' creativity. These findings may help the leader to focus heavily on organizational pride to foster the relationship between ethical leadership and employees’ creativity.

Asthma–COPD overlap syndrome among smoker subjects with asthma: A cross-sectional study

This study aimed to assess the prevalence of asthma–chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) in asthmatic outpatients with smoking exposure (smokers or ex-smokers with ≥10 pack-year history) and to evaluate quality of life (QoL) and adherence among the study sample. This cross-sectional study was conducted at outpatient respiratory clinics in governmental hospitals in Jordan. Asthmatic outpatients were interviewed to assess their spirometric readings, patients’ adherence, and patients’ QoL [using the Mini Asthma QoL questionnaire (MiniAQLQ)]. The prevalence of ACOS was found to be 33% among asthmatic smoker patients in the outpatient setting (n = 65 out of 200 subjects with asthma-diagnosed patients recruited into the study). For subjects with ACOS, 47.7% of them were older than 60 years old. Smoking history for more than 30 years was prevalent among most subjects with ACOS (67.7%). The MiniAQLQ average score was found to be low (mean ± SD = 3.23 ± 1.01, score out of 7) and similarly for patients’ adherence to their treatment modalities (mean ±SD = 1.76 ± 1.2, score out of 6). A significant positive relationship between adherence to treatment and QoL was found among subjects with ACOS (correlation coefficient = 0.171, p-value = 0.018). In conclusion, a moderate prevalence of ACOS was estimated among asthmatic smoker patients. Low levels of QoL and adherence to treatment were significantly correlated.

Investigating the interplay between supply chain agility, human capital and supply chain performance in the healthcare sector of Jordan

This study investigates the impact of supply chain agility on supply chain performance in Jordan’s healthcare settings. The moderation role of human capital in this relationship was also investigated. This study adopted a quantitative approach and utilized an online questionnaire to collect data from 139 managers at different levels in various hospitals in Jordan. The Statistical Package for Social Sciences (SPSS) version 23 was used for data analysis. The results of hypothesis testing using multivariate regression analysis showed that human capital has a positive and statistically significant impact on supply chain performance and supply chain agility. Human capital has been identified as an important organizational resource that can result in favorable performance. Such an organizational resource may also help healthcare institutions obtain a competitive edge by responding to patients’ treatment, which is urgently required.

The Impact of Educational Interventions on Nurses’ Perceptions of Parental Support and Attitudes toward Parental Involvement in Neonatal Intensive Care Units

Aim. To determine the efficacy of interventional programs on nurses’ perceptions of parents’ support and attitudes toward parents’ participation in neonatal care in the neonatal intensive care unit (NICU). Methods. An experimental design was used to determine the efficacy of the interventional program on NICU nurses’ perceptions of parents’ support and attitudes toward parents’ participation in their neonatal care in three hospitals. Nearly 160 nurses from hospitals in North and Middle Jordan participated in the study and were divided into 80 intervention and 80 control groups. Results. The study displayed that nurses had a lower score in the perception of parents’ support and attitude towards their participation in neonatal care in pretest scores than in posttest scores. The mean perception score of parents supported in the control group was 59.17 (SD = 10.1) and in the intervention group was 64.16 (SD = 7.47) (P ≤ 0.01). The mean attitude score of parents’ participation in neonatal care in the control group was 37.08 (SD = 5.76) and that in the intervention group was 38.93 (SD = 5.92) (P = 0.04). Conclusion. The results of the study showed a positive impact of the intervention on nurses’ perceptions of parental support and attitudes toward their participation in neonatal care. Moreover, the study found that the only predictor of NPST and PPAS enhancement among nurses was the implementation of an education program.

Evaluation of Clotting Parameters in Pregnant Women with Placental Blood Clots: Impact of Patient Characteristics and Assessment of Clexane Efficacy

Background: Clexane is used in pregnant women (PW) to minimize placental blood clotting (PBC) and fetal danger. Standard coagulation tests such as prothrombin time (PT), activated partial thromboplastin time (APTT), and international normalized ratio (INR) are critical for anticoagulant medication optimization. As a result, the study's goal was to evaluate the efficacy of clexane as well as adherence to the American Heart Association's recommended limits for routine coagulation tests. Methods: The study included forty normal PW as controls and forty PW with PBC as patients from Al-Mafraq Hospital in Jordan. Patients were administered daily subcutaneous injections of 40 mg of clexane as an anticoagulant, in conjunction with a daily 75 mg aspirin regimen. During the first trimester, 5 ml of venous blood were drawn from each participant. The PT, INR and APTT were measured. This assessment also considered variables including plasma fibrinogen concentration (PFC), age, body mass index (BMI), blood type, and fetal gender. Results: The mean age \(\pm\) SD were 29.6 \(\pm\) 6.2 for the patient group and 28.3 \(\pm\) 5.9 years for the control group. The changes in PT, INR, APTT and PFC between the control and patient groups were statistically significant independent of mother's age, BMI, baby gender, or blood type. Patients displayed inadequate anticoagulation with an INR of 0.8, falling below the recommended therapeutic range of 2-3 for anticoagulant treatment. Surprisingly, by the end of the clinical study, all patients under investigation had safely delivered their babies without difficulties. Conclusion: The observed rise in fibrinogen levels among patients may contribute to PBC formation, necessitating further investigation. Evaluation of the safety and efficacy of a combined 40 mg Clexane and 75 mg aspirin regimen in PW from the Al-Mafraq region, Jordan, is warranted.

The Effect of Service Quality, Patient Trust and Hospital Reputation on Patient Satisfaction in Jordanian Public Hospital

This study aims to investigate the impact of service quality, patient trust, and hospital reputation on patient satisfaction within public hospitals in Jordan. Employing the partial least squares structural equation modelling (PLS-SEM) tool, the authors analysed a survey sample comprising 400 patients. The findings indicate that service quality, patient trust, and hospital reputation positively influence patient satisfaction. The results of this research have significant implications for healthcare practitioners in Jordan, underscoring the importance of not only providing excellent medical care but also implementing marketing strategies to cultivate lasting relationships with patients.

A qualitative study of the comfort care experience from the perceptions of health care providers providing care for terminally ill infants in neonatal intensive care unit at the end of life

PurposeThe purpose of this study was to describe the comfort care experiences of health care providers at the NICU at end of life. Designand Method: The study used a qualitative phenomenological approach, to collect data from 20 health care providers (nurses and physicians) who were selected purposively from the NICUs settings in three Jordanian hospitals utilizing semi-structured interviews. The data was recorded and analyzed thematically. ResultsFour distinct themes captured the comfort care experiences of health care providers: (1) Reality vs. Hope, (2) Beliefs and Emotions, (3) Provision of Comfort Care, (4) Passion of Attachment. ConclusionThe finding of the study indicated that the experience of the health care providers was very stressful and challenging. There was a lack of prior education on comfort care and a lack of comfort care policies to provide quality comfort care. This study supports need for adjustments in staffing to meet the complex needs of terminally ill infants at the NICU.

Evaluation of Antimicrobial Stewardship Programs and antibiotic prescribing patterns among physicians in ambulatory care settings in Jordan

ABSTRACT Objectives Currently, there is an urgent need to implement an Antimicrobial Stewardship Program (ASP) in outpatient settings since nearly half of the antibiotic prescribing is inappropriate or unnecessary. The implementation of ASP should emphasize educational interventions that are more interactive. This study examines the adoption of outpatient ASP by physicians in Jordan. Methods A cross-sectional study was conducted between 2 March 2022 and 20 May 2022 at major hospitals in Jordan. The survey was distributed randomly among (n = 187) Jordanian physicians. Results It was found that more than half of the physicians were females (51.9%). The participants who reported not including antibiotic stewardship-related duties in position descriptions were (40.1%). While (46.5%) of participants reported writing and displaying public commitments supporting antibiotic stewardship in ambulatory care settings. Physicians’ adoption of (action) core elements of ASPs in ambulatory care settings was positive. Almost (24.6%) reported a lack of self-evaluation of their antibiotic-prescribing practices. It was reported that (69.5%) of physicians used effective communication strategies to educate patients about when antibiotics are necessary. Conclusion It was fair adoption of the core elements in the ambulatory care settings among Jordanian physicians. Progress necessitates a comprehensive strategy tailored to the needs of the health system.

Normative MRI for Lumbar Spinal Canal and Vertebral Body Dimensions in a Jordanian Population Sample

Aim: To provide normal values for the lumbar spinal canal, lumbar vertebral body and dural sac dimensions and canal body ratio by MRI for a Jordanian population sample.
 Material and methods: Three well trained observers reviewed 218 lumbar MRI scans performed between 2019–2021 (1090 lumbar levels) and obtained from the central computerized medical archive of three main governmental hospitals in north, central and south Jordan. All MRIs with alignment abnormalities (scoliosis and kyphosis), canal compression, vertebral disease (including fractures) or technical artifacts were excluded. The following were measured from L1 to L5 levels: the midsagittal diameters of the spinal canal and vertebral body, axial anteroposterior (AP), and transverse diameter of the vertebral body, dural canal and dural canal area. Data on sex and age were also documented.
 Results: The studied MRI scans included 113 males (51.8%) and 105 females (48.2%). Age ranged between 23–86 years old (mean 52.23 ± 13.125). The mid sagittal mid vertebral AP diameter of the lumbar spine range was 2.8–3.1 cm. The mid sagittal spinal canal diameter range was 1.3–1.5 cm. Canal body ratio was 3.3–3.6. The AP, transverse dural sac diameter ranges were 1.2–1.4 cm and 1.5–1.9 cm, respectively. Finally, the dural sac area ranged from 331–362 mm2.
 Conclusion: The dimensions of the lumbar spinal canal, vertebral bodies, and vertebral canal ratio at all levels were documented for a Jordanian population sample. Dimensions varied according to sex and when compared with other ethnic groups (Asian and African). The findings suggest that canal stenosis criteria should take these differences into consideration.

Total hip arthroplasty for adult patients with hip arthritis in Jordan: clinical profiles and patient characteristics.

Total Hip Arthroplasty (THA) is one of the most commonly performed orthopaedic surgeries, with hip arthritis being the main indication. This procedure is usually performed when other non-surgical methods fail to relieve patients' hip pain and improve their quality of life. However, limited information exists to identify and compare the demographics and clinical characteristics of patients undergoing this procedure in Jordan. This study aims to identify these demographic and clinical characteristics and compare the findings in terms of gender differences. This is a retrospective study that analysed the hospital records of 650 patients undergoing THA in tertiary referral hospital in Jordan over a four-year period from January 2019 to December 2022. The collected data were classified into three categories: demographic characteristics, perioperative variables, and patients' related health profiles. IBM's Statistical Package for the Social Sciences (SPSS) version 23 software (IBM, USA) and descriptive analysis were used for data analysis. Two-thirds of the sample studied were female (63.4%). In terms of bleeding profiles, the mean intraoperative blood loss was 542 millilitres. The major indication for THA was degenerative hip arthritis (50.5%), followed by hip dysplasia (40.3%).. Comparing the findings of the two gender groups, females were more likely to have degenerative and dysplastic hip arthritis (221 and 157, p = 0.04 and p = 0.1, respectively) when compared to males. Although males were more likely to lose more blood during the surgery (557 ml vs. 533 ml, p = 0.33, females needed more blood transfusions both during (21 vs. 6 patients, p = 0.12) and after the surgery (57 vs. 16 patients, p = 0.006). Furthermore, females were more likely to have comorbidities such hypertension (293 vs. 179 patients, p = 0.20), and hypothyroidism (313 vs 187, p = 0.36), and diabetes (85 vs. 38 patients, p = 0.15), among many other health conditions. However, in the study sample, male smokers outnumbered female smokers (132 vs. 63). Gender highly impacted the immediate surgical outcomes of patients who underwent THA. Females were more likely to need blood transfusions both during and after the surgery and had lower post-operative haemoglobin readings. In addition, females had more comorbidities and degenerative hip osteoarthritis. We believe that raising awareness about comorbidity management, preoperative smoking cessation, and perioperative blood transfusion management can improve medical and surgical outcomes.

Attic reconstruction techniques in cholesteatoma surgery: a comparative analysis of cartilage versus bone pate

Background Cholesteatoma surgery involves canal wall down (CWD) and canal wall up (CWU) mastoidectomy. CWU is associated with higher cholesteatoma recurrence, often linked to attic retraction pockets. Attic reconstruction with cartilage or bone pate lacks comparative evidence. Aims/Objectives To compare the effectiveness of cartilage and bone pate in attic reconstruction during CWU mastoidectomy for cholesteatoma. Material and Methods We conducted a retrospective study at King Abdullah University Hospital (KAUH) in Jordan, analyzing surgeries performed from 2011 to 2021. Patients who underwent CWU mastoidectomy with attic reconstruction using tragal cartilage with perichondrium or bone pate were included. Results Of 48 patients analyzed, 26 had cartilage graft attic reconstruction, and 22 received bone pate. Recurrent cholesteatoma occurred in 19.23% of the cartilage group but none in the bone pate group (p = .001). Ear discharge was observed in 19.23% of the cartilage group and 18.18% of the bone pate group, while tympanic membrane perforations and external auditory canal cholesteatoma were more prevalent in the cartilage group. Conclusions and Significance Our study indicates that bone pate results in significantly lower cholesteatoma recurrence than cartilage grafting in CWU mastoidectomy attic reconstruction. Bone pate offers stability and favorable long-term outcomes for outer attic wall repair.

Self-reported urinary urgency in association with vitamin D and psychiatric symptoms among patients with musculoskeletal pain.

Urinary urgency (UU) is linked to musculoskeletal pain (MSP), and it is associated with mental health conditions. This study examined the prevalence of UU morbidity among outpatients with MSP, and the possible association of UU with psychological symptoms and vitamin D deficiency. A cross-sectional study was conducted among 169 participants recruited from outpatient clinics at King Abdullah University Hospital in Jordan. Participants completed self-guided questionnaires that included information about MSP and UU. Psychological symptoms were evaluated using the Hospital Anxiety and Depression Scale (HADS). A blood sample was collected for measuring vitamin D levels. Regression analysis was performed to explore predictors of MSP and UU. Vitamin D deficiency was presented in 64.5% of participants, while UU was reported among 35.4% of MSP patients. Approximately 1/3 of participants had psychiatric symptoms (HADS≥8). Regression analyses revealed a significant association between vitamin D deficiency, low calcium intake, and anxiety scores with MSP (p<0.05), while anxiety score was a significant predictor of UU among MSP patients (adjusted OR=4.26, p=0.038). A moderately significant correlation between anxiety score and frequency of UU per day was also observed (r=0.303, p=0.041). Urinary urgency was prevalent among MSP patients and was strongly associated with anxiety symptoms. The findings suggest the importance of assessment of MSP patients for UU and the associated psychological symptoms so interventions may be potentially implemented to improve patients' health conditions.

ARCHERY: a prospective observational study of artificial intelligence-based radiotherapy treatment planning for cervical, head and neck and prostate cancer – study protocol

IntroductionFifty per cent of patients with cancer require radiotherapy during their disease course, however, only 10%–40% of patients in low-income and middle-income countries (LMICs) have access to it. A shortfall...

Strategic Management’s Influence on Hospital Performance: A Comprehensive Study of Jordanian Healthcare Context

This study investigates the strategic management practices of Jordanian hospitals and their effect on hospital performance. The Jordanian healthcare system confronts complex obstacles, including limited resources, fragmented coordination, and rising demand for superior healthcare services. To address these issues, the study investigates the connection between strategic management and hospital performance indicators in an effort to provide actionable insights for enhancing healthcare delivery. The research is based on an exhaustive literature review and secondary data analysis. Prior research demonstrates a positive correlation between strategic management and hospital performance in multiple domains, including financial stability, patient outcomes, and employee satisfaction. The current study, situated in Jordan’s unique context, aims to fill a research void by investigating the applicability of these findings within the Jordanian healthcare environment. The research employs an exploratory methodology and includes qualitative components. Secondary data such as academic papers, reports, and statistical records are analyzed during the data collection process. The data are subjected to a rigorous analysis utilizing statistical methods and thematic classification to uncover patterns and associations. It is anticipated that the study’s findings will shed light on the strategic management practices prevalent in Jordanian hospitals and their effect on performance metrics.

Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan.

There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study's purpose was to examine nurses' knowledge and attitudes toward palliative care. A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data. We measured nurses' knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type. ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

The Characteristics of Respiratory Bocavirus Infection in Acutely Sick Children Admitted to a Tertiary Hospital in Jordan.

The clinical manifestations of human bocavirus infections are diverse, ranging from mild common cold to severe lower respiratory tract infections. Bocaviruses have frequently been codetected with other respiratory viruses. We aimed to estimate the burden of bocavirus and multiple viral infections and to investigate the risk factors associated with these infections. This study was a retrospective chart review of admitted patients. The medical records of the included children were searched, and data on demographics, clinical presentation, imaging, laboratory and nasopharyngeal swab results were collected. A total of 157 patients were included. Most of the patients were males (62.1%) and under 6 months of age (52%). The 3 most common symptoms presented in the patients were cough (81.8%), rhinorrhea (58.6%) and fever (55.8%). Bocavirus DNA was detected in 12.66% of the patients, while 22.30% had multiple viruses. Age distribution was significantly different between bocavirus and nonbocavirus groups, with a lower proportion of bocavirus infection in all age groups ( P = 0.032). The radiograph patterns significantly differed between the 2 study groups, with a lower number of patients in the bocavirus group having normal radiographs ( P = 0.007). Patients infected with multiple viruses had more severe respiratory distress symptoms and diarrhea than those infected with only 1 virus. The prevalence of multiple viruses and bocavirus respiratory infections is significant. This study can guide physicians toward the clinical presentation and characteristics of children with respiratory bocavirus and multiple viral infections and propose future studies conducted in this regard.