Autologous Adipose Stem Cells Use for Skin Regeneration and Treatment in Humans

There is growing evidence that adipose stem cells contribute to the restoration of tissue vascularization, and have a potentially large therapeutic effect in the field of regenerative medicine. The purpose of this study was to assess the clinical effectiveness of lipoaspirate transplantation on the treatment of skin lesions in humans. This study began with surgical procedures in 2009 followed by a follow-up plan for 4 months. Twenty clients underwent therapy for skin lesions and follow-up. Adipose derived stem cells can promote human dermal fibroblast, proliferation, and re-epithelialization of cutaneous wounds, rejuvenation of the aging skin and related skin lesions. These stem cells replenish dying cells, and have the capacity to regenerate new tissues. Adverse events including pain, swelling and allergy were minimal. All participants expressed their satisfaction of the results. This surgical procedure is a low-invasive therapeutic approach that can resolve the problem of depressed skin, skin lesions, and wrinkles. Adopting this procedure decreases the cost of skin care, and improves client’s long-term outcome. Furthermore, it facilitates cell-mediated skin repair and regeneration. Keywords: Adipose stem cells, Lipoaspirate, skin diseases

Effect of Boost Simulated Session on CPR Competency among Nursing Students: A Pilot Study

Effective cardiopulmonary resuscitation effort can lead to saving lives. This skill is especially important to nursing practice. The aim of this quasi-experimental, control group, pilot study was to measure the effect of boost training session supported by simulation on the retention of CPR knowledge and skills in 40 nursing students. Participants attended a pretest, 3-hour workshop CPR then completed posttest I. The experimental group attended simulation-supported boost training at week six. Findings indicated that the experimental group achieved significant improvement in CPR procedure compared with the control group in posttest II. Boost training sessions using simulation facilitate learning CPR knowledge and skills. This teaching strategy may apply on other competencies requiring both psychomotor and cognitive engagement. Keywords: Cardiopulmonary resuscitation, boost session, simulation, nursing students

Psychometric Testing of the Arabic version of the Pittsburgh Sleep Quality Index (A-PSQI) among Coronary Artery Disease Patients in Jordan

The purpose of this study was to test the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) among cardiac patients in Jordan. The data was collected from 130 Arabic cardiac patients during their routine visit to the cardiology clinic using the Arabic versions of the Pittsburgh Sleep Quality Index, the Insomnia Severity Index and the Medical Outcome Study Short Form 36. The mean Pittsburgh Sleep Quality Index score was 9.14 (SD = 2.34). Internal consistency reliability was 0.74. The correlations between the global Pittsburgh Sleep Quality Index score and the components ranged from .25 to .49. Also, PSQI showed a moderate correlation with the Insomnia Severity Index scores (r= .36, p <.001), and a small negative correlation with Medical Outcome Study Short Form 36 pain subscale (r= -.19, p= .032).  Psychometric estimates show that the Pittsburgh Sleep Quality Index is reliable and valid for measuring sleep disturbances among Arabic clinical population. Keywords: Reliability, validity, cardiac, slee

Validating the psychiatric nurses methods of coping questionnaire: Arabic version

Background: The aim of the study was to undertake a psychometric analysis of the Psychiatric Nurses Methods of Coping Questionnaire (PNMCQ) - Arabic version when used to measure coping skills in psychiatric nurses in Jordan. Method: A descriptive, cross-sectional design was adopted in this study. A demographic questionnaire and the 35-item PNMCQ -Arabic were the measures used to collect data. Result: The PNMCQ demonstrated valid and reliable values when administered to psychiatric nurses in Jordan after it had been submitted to factor analysis. Conclusion: The development of PNMCQ: Arabic Version adequately measures coping skills in psychiatric nurses from a culturally appropriate context. Use of the tool can determine coping skills in psychiatric nurses with the view to positive staff development. Strategies identified based on results of the PNMCQ could ultimately result in better nurse retention and patient outcomes

Seeking care behavior of men with sexual dysfunction in Jordan: patients’ perspective

BACKGROUND: Sexual health problems are common among different health conditions such as cancer, diabetes mellitus and heart diseases. Little has been published on why and what factors behind hesitance to seek help and hiding the problem. METHODS: The study explored the extent to which men suffering from sexual dysfunction are willing to discuss their sexual concerns and care needs with nurses. A qualitative exploratory approach was used to explore men’s perspectives on nurses’ role in providing men’s sexual healthcare in Jordan. Data were collected through semi-structural interviews from 16 men with sexual health problems secondary to chronic health conditions. RESULTS: Four themes were derived from the data; men’s perceptions about sexual healthcare, ability of men to seek help from nurses, barriers to seeking help, and desired sources for help. Men reported that they would not seek help from nurses; they preferred using other sources, including internet, friends and other men with similar experiences. CONCLUSIONS and discussion: closed social and family structure limited men’s willingness to seek help for their sexual problems in Jordan leaving them untreated, which might then threaten their general health and wellbeing. RELEVANCE TO CLINICAL PRACTICE: Nursing is a profession that deals with human as a whole and the sexual health care was not part of nurses’ daily care for men. Therefore, this study added a view to nurses and health care professionals to consider sexual health care as part of their sexual health care for men. This might be through developing a multidisciplinary service for men. KEY WORDS: Sexual healthcare, Men’s health, Nurses, Jordan

Critical thinking and disposition skills among nurse educators in Jordanian universities: Perception, description, achievement and experience

Critical thinking is an expected educational process and outcome of the Jordanian strategy to develop nursing education. This descriptive-explorative study examined the critical thinking experience of 100 nurse educators working in six Jordanian Universities purposively-selected to reflect a representative sample. A survey questionnaire consisting three parts was used in this study; the California Critical thinking Skill Test (CCTST), the California Critical Thinking Disposition Inventory (CCTDI), and the experience survey (ES). The CCTST measured critical thinking skills and the ES asked the participants to rate their practice of critical thinking. The ES included a qualitative component that invited nurse educators to describe a situation, which illustrated their experience of critical thinking in practice. The CCTDI measured disposition towards critical thinking. The overall response rate was 73% (n=73) and 25% (n=25) for the qualitative part. The results of this study demonstrated that nurse educators had a positive disposition towards applying critical thinking in their practice; yet, their scores were not high on the skill test. These results indicated that they might require further professional development to support their work in enhancing critical thinking. Furthermore, age, gender, degree and educational experience of educational concepts were found to affect the results on the three parts of the survey. For the qualitative part, thematic analysis was performed and five key themes were identified. These were analysis, logical reasoning, evaluation, inference and reflexivity. This study suggests that nurse educators have positive inclination towards and high perceived practices of critical thinking

An agreement among nurse educators on infection prevention and control practices to ensure safe clinical training post-COVID-19

Background: Infection Prevention and Control (IPC) practices during nursing students' clinical training are based on standardized precautions. However, the spread of COVID-19 raised the need to revise these practices. We aimed in this study to assess nurse educators' agreement on items that represent precautionary guidelines, which enhance safety during clinical training of students. It aimed to reach an agreement among nurse educators on IPC practices to ensure safe clinical training. Materials and Methods: This descriptive explorative, cross-sectional study included 243 Jordanian and Omani educators. The study questionnaire was based mainly on evidence reported in the literature. The study questionnaire comprised items for trainers to practice and items to supervise students. It was developed based on available evidence and recommended training practices during COVID-19 suggested by the WHO and the literature. Both the face and content validity processes were adopted to validate the study questionnaire. The final version was composed of 26 items for trainers and 20 items for students subsumed in the following themes: protecting self, protecting others, and essential training needs. Results: All questionnaire items were rated above the midpoint indicating agreement among participants on including the new IPC practices. All suggested practices (26 items for the trainers and 20 items for the students) were supported by the study participants. Conclusions: Clinical training is an important component of nursing students' preparation. Findings suggest the importance of adding new IPC practices to improve student IPC practices, protect themselves and others, minimize cross-infections, and enhance students' training within a safe clinical environment

Measuring the Quality of Life among Head-and/or-Neck Cancer Patients with Oral Mucositis Using the Functional Assessment of Cancer Therapy-General in Jordan

Objective: Quality of life (QOL) in cancer patients can be influenced by the presence of medical conditions, such as oral mucositis (OM). There is still limited knowledge about this issue among patients in Jordan, and this could be related to the absence of research instruments testing QOL among cancer patients with OM. This study measured the QOL among cancer patients using the Functional Assessment of Cancer Therapy-General (FACT-G), Arabic version. Methods: This was a cross-sectional study on 118 head-and/or-neck cancer patients with OM in Jordan. Data were submitted to measures of normality, reliability, and validity using exploratory factor analysis. The study also measured QOL among the study sample. Results: FACT-G demonstrated good internal consistency reliability and validity. Factor analysis indicated the presence of four factors explained by 24 items representing a valid FACT-G, Arabic version. Scores reflected low QOL compared to reported normative values in the literature. The values used to compare findings from this study were extracted from international literature; no similar values were present in published literature. Conclusions: FACT-G, Arabic version, is valid and reliable when applied to this study population. Further testing is recommended, which would include the establishment of normative values

The impact of stress associated with caring for patients with COVID‐19 on career decisions, resilience, and perceived self‐efficacy in newly hired nurses in Jordan: A cross‐sectional study

Abstract Background and Aims The decision to stay in nursing has been challenged by the recent coronavirus disease 2019 (COVID‐19) pandemic. New nurses joined the workforce and provided care to patients with COVID‐19 although they received limited training, which could have influenced their intention to stay in nursing. We aimed in this study to examine the impact of caring for patients with COVID‐19 on career decisions, resilience, and perceived self‐efficacy among newly hired nurses in Jordan. It also tested the predictors of intentions to stay among new nurses. Methods This cross‐sectional quantitative study was conducted using an online electronic questionnaire form. The sample included newly hired nurses (n = 300) working in public hospitals and providing care to patients with COVID‐19 in different levels of acuity units. The perceived stress scale and Connor−Davidson resilience scale 25 were used to measure stress and resilience among nurses. Results The majority chose nursing as their career, but they were not satisfied with the current work conditions or autonomy in decision‐making. Many nurses reported having moderate to high work‐related stress and low to moderate resilience. Among all variables in this study, financial income predicted mild intention to stay in nursing. Conclusions Nurses expressed the presence of work‐related stress and low to moderate levels of resilience. As new nurses, exposure to these stress levels might lead to burnout. Nursing managers should take necessary measures to promote better work conditions and improve resilience to avoid nurses leaving the profession at times when there is a shortage

Compassion Fatigue in Critical Care Nurses in Saudi Arabia and its Impact on Nurse-Sensitive Patient Outcome: A mixed methods study

Compassion in the context of healthcare provision refers to the health professional’s internal feelings and emotions, which drive them to help others. Sometimes described as the ‘essence’ of nursing, compassion is acknowledged as integral to the provision of good nursing care and patient satisfaction within the care process. Compassion fatigue (CF) refers to accumulated negative feelings such as emotional exhaustion and disinterest in the care process, which may result from the continuous demands of providing care. A number of factors may have a role in the onset of this type of fatigue, including the nature of the care environment; the relationship the carer has with patients; and general caregiving activities. These factors can in turn lead the nurse or other caregiver to experience reduced capacity for empathy, or interest in being empathic. Indeed, CF is generally linked to nurses who provide direct, intimate care to patients with complex care needs, especially critical care nurses (CCNs) who are often required to provide care to individuals with life-threatening conditions. CF is also known to affect the wellbeing of nurses and patient safety outcomes. The aim of this study was to examine the relationship between nurse demographic characteristics and the development of CF as indicated by level of compassion satisfaction (CS), burnout (BO) and secondary traumatic stress, in CCNs in Saudi Arabia. This was achieved by addressing five research questions. Firstly, what is the current level of CF among CCNs in Saudi Arabia? Secondly, what are the demographic factors that affect CF and BO in CCNs in Saudi Arabia? Thirdly, what are the predictors of CF among CCNs practising in Saudi Arabia? Fourthly, what are the nurse-sensitive indicators that show the relationship between CF and patient safety? Finally, what strategies can be employed to mitigate the effects of CF, promote higher levels of compassion and decrease the sense of BO among CCNs in Saudi Arabia? To address these questions, a mixed methods study was conducted. A survey using a crosssectional design consisting of three tools was administered to CCNs (n = 321) in four Saudi public hospitals. Focus group interviews were then conducted with CCNs and their nurse managers. The survey instruments included the Professional Quality of Life Scale, which aimed to simultaneously measure CF and CS among the nurse participants; theCoping Strategy Indicator questionnaire, to tap into the ‘common denominators of coping’ strategies by the nurse participants; and the Connor–Davidson Resilience Scale questionnaire to measure the level of resilience of the participants. This research study also sought to identify a relationship between the occurrence of three nurse-sensitive indicators—namely, pressure injuries, patient falls and medication errors—and the level of CF among CCNs. A non-experimental descriptive research design was adopted to collect and analyse data on these three nurse-sensitive indicators. The three indicators were selected because they are linked to critical care wards and reflect the broader issues of quality of patient care in a health organisation that is dependent on the level of personal attention in a critical care unit. The two data collection phases (survey and focus group interviews) were conducted concurrently in this study. Based on the quantitative data, this study found that male CCNs reported higher levels of stress than female nurses, while female nurses scored significantly higher for avoidance and problem solving behaviours. Years of experience was also found to significantly influence avoidance behaviours: nurses with 16–20 years of experience achieved higher mean scores than all other groups. Nationality was also found to be important, with Saudi nurses reporting significantly higher levels of CS, as well as higher levels of stress than non-Saudi nurses. In addition, non-Saudi nurses were found to score significantly higher than Saudi CCNs for avoidance and problem solving behaviours. In terms of work setting, nurses working in coronary care, intensive care and neonatal intensive care units reported the highest levels of CS, whereas nurses working in burns units reported the lowest levels of CS. Last, nurses with a diploma qualification reported significantly lower CS than nurses with other degrees, and nurses working on 8-hour shifts reported lower CS than those on 12-hour shifts. From the qualitative data generated through the focus group interviews, the three main issues arising were nationality-based treatment as a major source of BO and stress; career opportunities associated with the level of stress and BO; and management practices associated with stress and BO. In terms of the relationship between the occurrence of the three nurse-sensitive indicators and the level of CF among CCNs, the study found that the most prevalent nurse-sensitive indicator across all four hospital settings was pressure injuries. In addition, the relationship between CF, CS and BO, and nurse-sensitive indicators revealed that workplace culture had a significant impact on wellbeing and rates of CF within Saudi hospitals. In particular, this study found that there were significant challenges in communication between management and staff based on nationality and position. This outcome led to a negative workplace culture in terms of promotion prospects, which in turn negatively affected motivation and workplace satisfaction. Further, a number of implications emerged from the findings for CCNs and critical care work environments in Saudi Arabia, spanning four key domains: the physical state of the nurse; the emotional state of the nurse; the working conditions in the unit; and the systems in place to overcome/prevent CF. Firstly, the findings point to the importance of CCNs’ monitoring practices and ability to manage their work patterns to reduce the risk of the onset of CF. In addition, it is apparent that nurse managers can play an important role in reducing the onset of CF and BO among CCNs on the ward. Specifically, this thesis recommends that nurse managers consider changing their approach to managing nurses in these settings by adopting more open, flexible and participatory models of management such as a shared governance model where nurses are central to decision-making processes, particularly in terms of addressing cultural bias in the workplace