Suicide Trends in Jordan in Correlation With the COVID-19 Pandemic: A Forensic Medicine Perspective

Background This study aimed to examine the suicide trends among Jordanians who died by suicide before and during the coronavirus disease 2019 (COVID-19) pandemic and assess their correlation with demographic data, including gender, age, marital status, and the method used for suicide, from a forensic medicine perspective. Methodology This was a retrospective, observational, autopsy-based study. Of the 731 medicolegal autopsies performed at the Al-Hussein New Hospital at Al Salt City between 2017 and 2022, 41 confirmed cases of suicide were identified. Results The study indicated that 75% of the subjects committed suicide during the COVID-19 pandemic period, of whom 13% were children. The average age of those who died by suicide was 32.1 (SD = 12.2) years. Overall, 58.5% were single, 61.0% unemployed, and 53.7% had a mental illness. Males were four times more likely to commit suicide than females. Hanging represented 60.61% of all male suicides, followed by firearms (27.27%); however, females used poisoning. Around 60% and 25% of the study subjects were in the age group of 21-40 years and 41 and more, respectively. The study also identified a statistically significant association between gender, age, and the time of suicide (during COVID-19). The findings of this study could not confirm any association between suicide and mental illness, marital status, and employment status. Conclusions The suicide rate in Jordan increased during the COVID-19 pandemic, and it is alarming that most of those who committed suicide were at a young age and in their productive years.

Psychosocial factors correlate with adherence to medications among cardiovascular outpatient clinics in Jordan

BACKGROUND

Adherence to medications is a significant element of self-care behaviors for patients with cardiovascular diseases (CVDs). Non-adherence to cardiovascular medications is the major risk for poor outcomes following any cardiac event. However, there is a lack of studies that addressed medication adherence among patients with CVDs attending outpatient clinics in Arabic countries, including Jordan. Thus, this study purposed to assess the psychosocial factors (e.g. depression, anxiety, stress, social support and self-esteem) and their correlation with adherence to medications among patients with CVDs attending outpatient clinics in Jordan.

METHODS

A total of 395 Jordanian patients attending CVDs outpatient clinics at government, military and private healthcare facilities were recruited.

RESULTS

Our study findings showed that 31.4% of the patients reported complete adherence to their medications. The proportion of psychological reactions reported by the participants was 72.1% for depressive symptoms, 62.6% for anxiety and 50.1% for stress; 79.7% had moderate and normal social support, and 44% had low self-esteem. Depression, anxiety and stress had a significant negative correlation with adherence to medications; however, self-esteem had a significant positive relationship with adherence to medications. In addition, depression, anxiety and stress were the main predictors of adherence to medications.

CONCLUSION

Our findings might aid in paving the road for designing and developing strategies and interventions to increase adherence to medications and minimize these psychosocial problems among CVD patients in outpatient clinics.

Arab nursing students' perception of the emotional experience of patient care: A phenomenological study

BACKGROUND

A shared emotional response helps with understanding what other people are feeling and/or thinking; and it is a vital skill in clinical settings. Collectivist communities place more emphasis on the emotional components of their feelings in comparison to the cognitive aspects of their emotions.

PURPOSE

This study aimed to explore the emotions experienced by students at their first clinical placement.

METHODS

A hermeneutic phenomenological approach was used among nine baccalaureate students.

RESULTS

Three major themes emerged from the data: overwhelming emotions; unbalanced perception of professional identity; and adjustment and adaptation.

CONCLUSIONS AND DISCUSSION

It is evident that nursing students from collectivist communities encounter challenges in dealing with their emotions and managing their patients' emotions; however, they were capable of empathizing with their patients using the two components of their empathy; affective (emotion) and cognitive (cognition), with prominence given to the affective part. As countries become increasingly multi-cultural, which in turn influences the characteristics of people entering pre-registration nursing programs, nursing leaders are invited to address both dimensions of empathy as part of the nursing curriculum. Attention should also be given in clinical settings to appropriate channeling of clinical empathy to cultivate a professional identity.

Critical Care Nurses' Experiences During the Illness of Family Members: A Qualitative Study

Introduction

A loved one's hospitalization in a critical care unit is a traumatic experience for families. However, because of their status and professional competence, a family member who is also a critical care nurse has additional obstacles and often long-term consequences.

Objectives

To describe the experiences of critical care nurse-family members when a loved one is admitted to a critical care unit at the Hotel-Dieu de France hospital.

Methods

A qualitative path based on van Manen's hermeneutic phenomenology combining both descriptive and interpretive models were adopted.

Results

The lived experience of critical care nurses in providing care for their family members admitted into the same critical care were summarized in five themes. Nurses were torn between roles, consisting of confounding roles, their registered nurse status, and watchfulness. The lived experience of critical care nurses in providing care for their family members admitted into the same critical care was summarized into specialized knowledge that included a double-edged sword of seeking information and difficulty delivering the information. Critical nurses compete for expectations, including those placed on self and family members, resulting in emotional and personal sacrifice while gaining insight into the experiences.

Conclusions

Critical care nurse-family members have a unique experience compared to the rest of the family, necessitating specialized care and attention. Increased awareness among healthcare providers could be a start in the right direction.

An analysis of nursing and medical students' attitudes towards and knowledge of Alzheimer's Disease (AD)

OBJECTIVES

Little is known about how Jordanian undergraduate medical and nursing students perceive Alzheimer's disease (AD) care. This study aimed to investigate nursing and medical students' AD knowledge, attitudes, and associated factors with their knowledge to inform reforms to multidisciplinary AD education undergraduate programs in Jordan.

METHODS

Cross-sectional research was carried out using a self-administered questionnaire. Students' knowledge was measured using the Alzheimer's Disease Knowledge Scale (ADKS) and attitudes were measured using the Dementia Care Attitude Scale (DCAS). The survey was completed by 423 nursing and medical students.

RESULTS

The overall mean score on the ADKS for students' AD knowledge was 17.50 (SD=3.08) out of 30 and the DCAS for students' attitudes toward AD was 26.76 (SD=6.19) out of 40.

CONCLUSIONS

Medical students had a higher level of AD knowledge and a lower level of positive attitude than nursing students (p<0.05).

Depressive Symptoms among Older Jordanian Patients with Cancer Undergoing Treatment

OBJECTIVES

To date, predictive and risk factors for depression among older patients with cancer have not been adequately studied in the Middle Eastern countries including Jordan. Therefore, this study aimed to assess the levels of depressive symptoms, anxiety, and hope among older Jordanian patients with cancer aged 60 years and over who are currently undergoing treatment, and to identify the relationship between selected factors (socio-demographic, treatment, and psychological) and depressive symptoms.

METHODS

A cross-sectional design was conducted on a convenience sample consisting of 150 patients with cancer from one of the biggest governmental hospitals in Jordan.

RESULTS

The findings revealed that almost 34% and 27% of the patients experienced anxiety and depression and had a moderate level of hope. Correlating factors with depression were age, duration of treatment, hope, anxiety, educational level, and health insurance. However, low duration of treatment, high anxiety, and low hope were the significant predictors of high depression.

CONCLUSION

Understanding the risk factors correlated with depression could help develop early interventions to enhance the psychological consequences for patients with cancer at risk for depression.

CLINICAL IMPLICATIONS

Health-care providers need to develop psychological care for older patients with cancer and interventions directed at minimizing depression. Also, nurses should focus on providing holistic care including physical, social, psychological, and spiritual dimensions. Depression care should be an important part of the comprehensive treatment care plan for older patients undergoing cancer treatment.

Evaluation of psychological reactions among teenage married girls in Palestinian refugee camps in Jordan

INTRODUCTION

Girls married at an early age are more likely to be victims of violence from their husbands or their in-laws. This may lead them to experience mental problems such as post-traumatic stress, depression, and/or anxiety. There are a lack of data related to the psychological reactions among teenage married girls living at the Palestinians refugee camps.

AIM

This study aimed to evaluate depression, anxiety, and stress symptoms among teenage married girls in Palestinian refugee camps in Jordan. It also aimed to identify factors correlating with the study selected psychological reactions.

METHODS

A cross-sectional, descriptive correlational design was used. The participants were recruited using non-probability sampling methods. The mental health symptoms were measured using the Depression, Anxiety, and Stress Scale (DASS).

RESULTS

A total of 205 participants were included in the study. Their mean age was 16.90 (SD ± 0.96) years. Of the participants, 39.6%, 35.6%, and 9.8% experienced moderate to extremely severe levels of depression, anxiety, and stress symptoms, respectively. There were significant relationships between all the mental health symptoms and participant age, parent's educational level, and exposure to previous trauma.

CONCLUSION

A high proportion of females living in Palestinian refugee camps married in their teenage years experienced moderate to severe mental health symptoms, particularly anxiety and depression. These results inform the need for psychological support to girls who are affected by teenage marriage.

Depression among adults with diabetes in Jordan: risk factors and relationship to blood sugar control

OBJECTIVES

The aims of this study were to estimate the prevalence of undiagnosed depression among adults with diabetes mellitus in Jordan and to determine the factors that may indicate the presence of depression and to examine the relationship between depression and blood sugar control among Jordanian subjects with diabetes.

METHODS

A systemic random sample of 649 type 1 and type 2 diabetic patients aged 18-75 years was selected during the period from July 2009 to January 2010. A prestructured questionnaire was used for collecting the information about sociodemographic data and clinical characteristics. Depression was evaluated using the Patients' Health Questionnaire-8 (PHQ-8). A PHQ-8 score ≥10 has been recommended as a cutoff point for depression. Self-care management behaviors and barrier to adherence were collected. Weights and heights were measured. Glycated hemoglobin was abstracted from each patient directly after the interview.

RESULT

Of the 649, 128 (19.7) have depression according to the PHQ-8 scores. According to the multivariate analysis, females are more likely to develop depression than males with [odds ratio (OR), 1.91; P=001] and low-educated people versus educated people (OR, 3.09; P≤.002). Being on insulin treatment also has a significant association with depression (OR, 3.31; P=.001). Not following eating plans as recommended by dietitians, lacking self-monitoring blood glucose and increased barriers to adherence scale scores were also associated with depression among the subjects with diabetes.

CONCLUSION

The prevalence of depression among Jordanian subjects with type 1 and type 2 diabetes is high compared with some developed countries. This was associated with gender, educational level, insulin treatment, low self-management behaviors and increased barriers to adherence. This result shows the urgent need to include the routine screening of depression during outpatient visit, which might help prevention, early detection and management of depression.

Prevalence and risk factors of diabetic retinopathy among Jordanian patients with type 2 diabetes

OBJECTIVE

To estimate the prevalence of diabetic retinopathy among patients with type 2 diabetes mellitus (DM) who attended the National Center of Diabetes, Endocrinology and Genetics (NCDEG) in Jordan, and to determine the relationship between duration of DM, hyperglycemia, smoking, hypertension, age, gender, body mass index (BMI) and diabetic retinopathy.

METHODS

This is a cross-sectional study that investigates a sample of 1000 diabetic patients suffering from type 2 DM who attended the NCDEG between September 2006 and January 2007. Eye examination by an ophthalmologist under adequate dilatation was performed in all patients. Socio-demographic, clinical and laboratory data were obtained. Diabetic Retinopathy was defined according to the International Clinical Diabetic Retinopathy Severity Scale adopted by American Academy of Ophthalmology (AAO) and the International Council of Ophthalmology (ICO). Statistical analysis was carried out using the Statistical Package for Social Sciences (SPSS, version 11.5).

RESULTS

Out of 1000 patients; 51 percent were male, 49 percent were female. The mean age and duration of diabetes were 57.8 and 9.6 years, respectively. The prevalence of diabetic retinopathy in patients was 34.1 percent. Non-proliferative diabetic retinopathy was documented in 24.5 percent, while 9.6 percent had proliferative diabetic retinopathy. Duration of DM and hyperglycemia, as measured by HbA1C, were statistically significantly associated with diabetic retinopathy.

CONCLUSION

Diabetic retinopathy is highly prevalent among Jordanian patients with type 2 DM. Serious national efforts should be directed towards increasing primary prevention through regular ophthalmic examinations and strict glycemic control in patients with type 2 DM.