The Effect of Mobile Health Applications on the Knowledge of Patients of Heart Failure

Background: A lack of knowledge among patients with Heart Failure represents a significant problem that could lead to an increase in adverse outcomes, such as the length of hospitalization; and readmission rate. Objective: This study aimed to identify the effects of mobile health education applications on the knowledge of patients with Heart Failure and identify the associated factors that would contribute to patients’ knowledge. Methods: A Quasi-experimental design (two groups pretest-posttest design). A non-probability convenient sample of 160 patients was recruited. The participants were assigned randomly to an experimental group and a control group. The Dutch Heart Failure Knowledge scale was used to assess patients’ levels of knowledge. Descriptive statistics, independent t-tests, and multiple regression analysis were used to analyze the data. Result: The total number of participants was 126. The overall Jordanian patients’ level of knowledge regarding the non-pharmacological management of Heart Failure was moderate (M= 9.4, SD=2.07). Significant differences between study groups were found in terms of levels of knowledge. The intervention group (M=12.26, SD=2.36)  had significantly higher mean scores of knowledge level about Heart Failure compared to the control group (M=9.76, SD=2.01); t=6.361, p=.000). The result of the regression analysis was significant (adjusted R2  =.222, F(16,109)= 3.226, P=.000). Conclusion: Mobile health education applications could be a promising solution for managing different chronic diseases, particularly patients with HF. The implication to Nursing: Mobile health could be a more cost-effective approach to patient education than other traditional approaches recently applied in clinical practice

The effectiveness of serious games in alleviating anxiety : systematic review and meta-analysis

Anxiety is a mental disorder characterized by apprehension, tension, uneasiness, and other related behavioral disturbances. One of the nonpharmacological treatments used for reducing anxiety is serious games, which are games that have a purpose other than entertainment. The effectiveness of serious games in alleviating anxiety has been investigated by several systematic reviews; however, they were limited by design and methodological weaknesses. This study aims to assess the effectiveness of serious games in alleviating anxiety by summarizing the results of previous studies and providing an up-to-date review. We conducted a systematic review of randomized controlled trials (RCTs). The following seven databases were searched: MEDLINE, CINAHL, PsycINFO, ACM Digital Library, IEEE Xplore, Scopus, and Google Scholar. We also conducted backward and forward reference list checking for the included studies and relevant reviews. Two reviewers independently carried out the study selection, data extraction, risk of bias assessment, and quality of evidence appraisal. We used a narrative and statistical approach, as appropriate, to synthesize the results of the included studies. Of the 935 citations retrieved, 33 studies were included in this review. Of these, 22 RCTs were eventually included in the meta-analysis. Very low-quality evidence from 9 RCTs and 5 RCTs showed no statistically significant effect of exergames (games entailing physical exercises) on anxiety levels when compared with conventional exercises (P=.70) and no intervention (P=.27), respectively. Although 6 RCTs demonstrated a statistically and clinically significant effect of computerized cognitive behavioral therapy games on anxiety levels when compared with no intervention (P=.01), the quality of the evidence reported was low. Similarly, low-quality evidence from 3 RCTs showed a statistically and clinically significant effect of biofeedback games on anxiety levels when compared with conventional video games (P=.03). This review shows that exergames can be as effective as conventional exercises in alleviating anxiety; computerized cognitive behavioral therapy games and exergames can be more effective than no intervention, and biofeedback games can be more effective than conventional video games. However, our findings remain inconclusive, mainly because there was a high risk of bias in the individual studies included, the quality of meta-analyzed evidence was low, few studies were included in some meta-analyses, patients without anxiety were recruited in most studies, and purpose-shifted serious games were used in most studies. Therefore, serious games should be considered complementary to existing interventions. Researchers should use serious games that are designed specifically to alleviate depression, deliver other therapeutic modalities, and recruit a diverse population of patients with anxiety. [Abstract copyright: ©Alaa Abd-alrazaq, Mohannad Alajlani, Dari Alhuwail, Jens Schneider, Laila Akhu-Zaheya, Arfan Ahmed, Mowafa Househ. Originally published in JMIR Serious Games (https://games.jmir.org), 14.02.2022.

Editorial: Nurses and Artificial Intelligence Implementation

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The Relationship between Intensive Care Unit’s Nurses’ Informatics Competency and Quality of Patients’ Electronic Health Record’s Documentation

Background: Nursing Informatics (NI) and the development and growth of Health Information Technology (HIT) are becoming a necessary part of all aspects of the nursing practice, especially in critical care settings. In addition, researchers agree on using standardized and electronic documentation to support the nursing process and promote nursing documentation quality. Purpose: To examine the relationship between Intensive Care Unit Nurses' Informatics Competency and Quality of Patients' Electronic Health Record Documentation. Method: A descriptive, correlational, retrospective, cross-sectional design was used. Three hospitals that implemented the Electronic Health Records (EHRs) system were included in this study, using non-probability convenience sampling technique to recruit a total of 176 nurses. The nursing informatics competency was measured by the Self-Assessment of Nursing Informatics Competencies Scale (SANICS). The Quality of Electronic Health Record Documentation was assessed by the Audit instrument for nursing care plans in the patient record (Cat-ch-Ing). Descriptive and Inferential statistics were utilized to answer research questions. Results: The overall mean informatics competency score among nurses was 2.49 (SD = .73), with most of the nurses (81.79%) reporting a low competency score of less than three. The highest percentage of participants 29.4% (n = 52) have moderate quality of EHR documentation. Also, personal and clinical related characteristics accounts for 93.7% of the variance in quality of patients’ electronic health record documentation (R2 = .937, F = 8.707, p = .004). Once nursing informatics competency were entered into the model R2 still the same, making a total explained variance 93.7% (R2 = .937, F = 6.907, p = .013). Conclusion: The present study revealed low levels of nursing informatics competency among nurses, and the highest percentage of participants have moderate quality of EHR documentation. In addition, personal and clinical related characteristics accounts for 93.7% of the variance in quality of patients’ electronic health record documentation Implication to Nursing: This study provides evidence to guide nursing leaders, supervisors and policymakers in their planned actions and policies to support nursing capacity, nursing education, and nursing practice in the area of nursing informatics and electronic nursing documentation. &nbsp

Barriers to Implementing Palliative Care in Intensive Care Units: Perceptions of Physicians and Nurses in Jordan

Background: Palliative care (PC) aims to relieve a person\u27s suffering and provide the best possible quality of life (QoL) to people with chronic illnesses. Despite the significant impact of PC services on the QoL of patients, barriers exist that prevent healthcare providers from facilitating PC in intensive care units (ICUs). Aim: The purpose of this study was to explore the perceived barriers to implementing PC in ICUs. Methods: A qualitative approach was used to conduct 17 semi-structured interviews with clinicians across two ICUs (urban and suburban) in Jordan. Thematic analysis was used for the transcribed interviews. Results: Five main themes emerged: the ICU is a demanding and complex care environment; lack of preparation to implement PC; PC is a nicety, not a necessity; healthcare system-related barriers; and lack of cultural acceptance of PC. Lack of knowledge and training was identified as a major barrier for the effective implementation of PC by both physicians and nurses. Conclusion: Equipping healthcare providers with the knowledge and expertise to provide PC is essential to dispel myths related to PC and facilitate PC provision. Developing an interdisciplinary care team will support the effective implementation of PC services in any setting. Establishing national PC policies will foster the ethical and legal practice of PC in Jordan

Impact of Obesity on Clinicopathologic Characteristics and Disease Prognosis in Pre- and Postmenopausal Breast Cancer Patients: A Retrospective Institutional Study

Purpose. To investigate the association between obesity and breast cancer clinicopathologic characteristics at presentation along with prognostic impact among Jordanian breast cancer patients. Such data are lacking in Arabian countries. Methods. In this retrospective study, 348 breast cancer patients were included. Analyses were conducted for associations between body mass index (BMI) and age at diagnosis, tumor clinicopathologic characteristics, and molecular subtypes. Eight prognostic factors were considered, and total prognostic scores were calculated. The analysis was stratified by menopausal status. Multivariate logistic stepwise regression analysis was conducted to identify predictors for breast cancer recurrence and death. Results. Mean age at diagnosis was 50.98 ± 10.96 years. Mean BMI at diagnosis was 29.52 ± 5.32 kg/m2. Mean age at diagnosis was significantly higher for overweight and obese patients compared to underweight/normal patients (P<0.001). A significant positive correlation was observed between patient age and BMI at diagnosis (r = 0.251, P<0.001). Grade of carcinoma was significantly correlated with BMI in the whole population examined (P=0.003). Obese breast cancer patients had significantly higher prognostic scores compared to nonobese cases, indicating worse prognostic features at presentation (P=0.034). Stratification of data analysis based on menopausal status revealed significant associations between obesity and each of tumor stage and grade among postmenopausal but not premenopausal patients (P=0.019 and P=0.031, respectively). Similarly, postmenopausal obese patients had significantly higher prognostic scores compared to nonobese counterparts (P=0.007), indicating worse prognosis, a finding which was also absent among premenopausal breast cancer patients. No significant association between BMI with expression status of hormone receptors, HER2, lymphovascular invasion, and molecular subtypes was found among patients. BMI was a significant predictor for disease recurrence in which obese breast cancer patients had greater odds (2-fold) to develop locoregional and distant recurrence compared to nonobese cases (P=0.011). Conclusions. Obesity was associated with advanced stage and grade of breast carcinoma at diagnosis. The impact of BMI on clinicopathologic characteristics and prognosis was confined to postmenopausal cases. Jordanian obese breast cancer patients are at greater risk of breast cancer recurrence and reduced survival compared to their nonobese counterparts

Distribution of Study Clusters.

<p>Distribution of Study Clusters.</p

Health Service Utilization among Syrian Refugees with Chronic Health Conditions in Jordan

<div><p>Introduction</p><p>The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system, particularly in treating chronic health conditions. This study was undertaken to assess utilization of health services for chronic health conditions among Syrian refugees in non-camp settings.</p><p>Methods</p><p>A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care for hypertension, diabetes, cardiovascular diseases, chronic respiratory diseases, and arthritis. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households.</p><p>Results</p><p>Of 1363 cases with a chronic health condition diagnosis, 84.7% had received care in Jordan. Public facilities faced a heavy burden serving over half (53.9%) of care-seekers; the remainder received care in the private (29.6%) and NGO/charity (16.6%) sectors. Individuals with non-communicable diseases (NCDs) in the central region of Jordan and with arthritis had the lowest rates of care-seeking when compared to other regions and conditions. Overall, 31.6% of care-seekers had an out-of-pocket payment for the most recent care-seeking event which averaged 18.8 USD (median = 0 USD), excluding cost of medications.</p><p>Discussion</p><p>Forced displacement presents major challenges to those with NCDs, which have the potential to seriously impact both the quality of life and life expectancy amongst refugees. NCD patterns among Syrian refugees indicate the importance of continuing support to public sector services in Jordan to adequately meet expanding needs and ensure appropriate prevention and control of priority NCDs.</p></div

Facility Type Utilized for Most Recent Chronic Disease Care in Jordan by Condition*.

<p>Facility Type Utilized for Most Recent Chronic Disease Care in Jordan by Condition*.</p

Most Recent Medical Care Received in Jordan for Chronic Health Conditions.

<p>Most Recent Medical Care Received in Jordan for Chronic Health Conditions.</p