Background: Pressure injuries represent an important problem in palliative care. Lack of knowledge and skills among informal caregivers on pressure ulcer prevention and management contributes significantly to the happening or deterioration of pressure injuries. Aim: The aims of this study were to: (1) determine the level of knowledge and practices of informal caregivers on pressure ulcer prevention and treatment. (2) explore the socio-demographic characteristics of informal caregivers that influence pressure ulcer prevention and treatment among patients who need palliative care. Methods: the quantitative cross-sectional descriptive design was used to collect data conveniently from 146 informal caregivers, and a valid and reliable questionnaire was used. Results: One hundred and forty-six informal caregivers completed the study. Most participants had a relativelylow level of pressure ulcer prevention, treatment knowledge, and practice. Participants older than 28 years, government workers, and married had significantlybetter knowledge and practice of PU prevention and treatment than other participants. Conclusion information for informal caregivers in different settings about pressure ulcer prevention and treatment is needed by focusing on young married ones. Informal caregivers need to acquire more professional practices and knowledge to improve the quality of patient care.

Background: Information is presently lacking about the end-of-life care in intensive care unit (ICU). We explored the characteristics, mortality rates, and treatments received in the last few days of life for patients who died in ICU. Methods: This was a retrospective multicenter cohort study. We included patients who died from different medical illnesses between January 2014 and January 2017 in 8 medical ICUs across 3 major health-care systems in Jordan. Of 11 029 patients who were admitted for the study in ICUs, data from 3885 health records were retrieved and analyzed. Pediatric patients aged younger than 18 years and patients admitted to an ICU for less than 4 hours were excluded. Results: The mean ICU mortality rate was 34.6% (29%-38%), with a slight decline from 2014 through 2016. Most of the patients who died were male (56.6%), transferred from the emergency department (46.8%), and had multiple comorbidities (74%). Cardiopulmonary resuscitation, invasive mechanical ventilation, pharmacological hemodynamic support, and artificial hydration were pursued until death for most patients (91.5%, 80.1%, 78.8%, and 94.1%, respectively). Conclusions: Aggressive treatment modalities were usually pursued for critically ill patients at the end of their lives. There is a need to explore further the current end-of-life care needs and practices in ICUs in Jordan and to tailor end-of-life care and management suitably to meet the needs of Islamic and Arabic cultures.

Background and Aims During the coronavirus pandemic (COVID‐19), healthcare providers confronted risks of disease transmission to themselves and their family members, resulting in physical and psychological burdens. This might affect their decisions to leave their jobs temporarily or permanently, fearing infection and protecting their families. This study examined the factors related to the intention to leave a job among healthcare providers during the COVID‐19 pandemic in Jordan. Methods A cross‐sectional correlational design was used to collect data using a convenience sample of 557 healthcare providers working in different sectors across Jordan. Data were collected using a self‐administered questionnaire about the intention to leave jobs during the pandemic. Results The sample included 368 females (63.8%) and 209 males (36.6%) participants. The mean age of participants was 30.8 years (SD = 6.65). Differences found in intention to leave job during COVID‐19 in relation to age ( t = 2.60, p < 0.05), gender ( X 2 = 4.25, p < 0.001), and marital status ( X 2 = 18.2, p < 0.001). Participants with a high risk of exposure to COVID‐19 and who experienced higher workloads had higher scores of intention to leave their job during COVID‐19, while being married had lower scores. Conclusions Policy‐makers need to pay attention to young and single healthcare providers during the COVID‐19 pandemic to prevent them leave their job. Crucial guidelines for managing workload during the COVID‐19 pandemic are needed. Policy‐makers during pandemics have to protect healthcare providers who feel they are at high risk of infection.

Background: Information is presently insufficient about using Acute Physiology and Chronic Health Evaluation (APACHE) mortality predicting models for cancer patients in intensive care unit (ICU). Objective: To evaluates the performance of APACHE II and IV in predicting mortality for cancer patients in ICU. Interventions/Methods: This was a retrospective study including adult patients admitted to an ICU in a medical center in Jordan. Actual mortality rate was determined and compared with mortality rates predicted by APACHE II and IV models. Receiver operating characteristic (ROC) analysis was used to assess the sensitivity, specificity and predictive performance of both scores. Binary logistic regression analysis was used to determine the effect that APACHE II, APACHE IV and other sample characteristics have on predicting mortality. Results: 251 patients (survived=80; none-survived=171) were included in the study with an actual mortality rate of 68.1%. APACHE II and APACHE IV scores demonstrated similar predicted mortality rates (43.3% vs. 43.0%), sensitivity (52.6% vs. 52.0%), and specificity (76.3%, 76.2%), respectively. The area under (AUC), the ROC curve for APACHE II score was 0.714 (95% confidence interval [CI] 0.645–0.783), and AUC for APACHE IV score was 0.665 (95% CI 0.595–0.734). Conclusions: As APACHE ӀӀ and ӀV mortality models demonstrate insufficient predicting performance, there is no need to consider APACHE IV in our ICU instead of using APACHE ӀӀ as it has more variables and need longer data extraction time. Implications for Practice: We suggest that other approaches in addition to the available models should be attempted to improve the accuracy of cancer prognosis in ICU. Further, it is also required to adjust the available models.

Background: Prophylactic laxatives were associated with decreasing the incidence of Opioid-induced constipation among patients with cancer. This study aims to evaluate the effectiveness of early prophylactic laxatives therapy on the severity of constipation and quality of life among patients with cancer receiving opioids. Methods: Using a quasiexperimental design with 64 patients assigned to control group and 66 patients assigned to intervention group. The final sample was composed from 112 patients (57 in control group and 55 in intervention group), who were selected from an oncology clinic. Patients in the intervention group have received prophylactical laxatives The intervention included an oral colonic stimulant laxative (i.e., Bisacodyl, Dose= 3 tab/ day and/or Senna 6.8 mg twice daily) and an oral colonic osmotic laxative (i.e., Lactulose, Dose = 15 ml three times per day). Patients in the control group continue to receive their routine care without laxatives. Results: Patients in the intervention group have reported a significant reduction in the severity of constipation symptoms at eight weeks post the intervention (p < 0.001). Furthermore, the patients in the intervention group have revealed a significant improvement in their quality of life (QoL) (p< 0.001). Conclusions: Patients with cancer need to use the first line of laxatives as prophylactic alongside with opioids to minimize the severity of Opioid-induced constipation symptoms and to enhance the QoL.

Patients with HMs complain of several symptoms that are associated with a high level of burden, and distress (Richter et al., 2021;Senf et al., 2020), in addition to ongoing unmet needs relating to their illness which lead to the inability to achieve satisfying psychological well-being (Pereira et al., 2020; Stevenson et al., 2020; Zomerdijk et al., 2021). Previous studies were conducted to explore their experience with illness trajectory revealed that many patients with HMs experienced physical impacts such as fatigue, impaired physical functioning, delirium, drowsiness, stomatitis, diarrhea, in addition to infection, fever, dyspnea, tiredness,

Purpose This study aims to gain a deeper understanding of triggers of psychological distress among Jordanian patients with heart failure (HF). Design/methodology/approach A phenomenological study was adopted. In-depth, semi-structured, audio-taped interviews were conducted for 25 patients with HF. The analysis was done using interpretative phenomenological analysis. Findings The main theme of the findings can be expressed as “faced with stressors that are unable to cope with”, which encompasses circumstances and contexts associated with the psychological distress they faced. The following four sub-themes emerged from the data: being endorsed in significant life changes, feeling guilty about being a burden, financial burden aggravating stress and feeling overwhelmed by the fear of death. Originality/value The findings revealed that psychological distress is affected directly by many triggers. The findings indicate the need for informing health-care providers to support these patients and address the challenges and develop clinical guidelines to assess psychological distress among these patients.

Objective The current systematic review examined whether elderly patients who received amiodarone were at risk for developing myxedema coma. Methods The Cochrane guidelines were used for a systematic review of Medline (PubMed), Science Direct, CINAHL Cochrane database, and Google Scholar for case reports on the Amiodarone-induced myxedema coma. Results A total of 12 case reports were found to meet the determined inclusion criteria. Patients who received amiodarone highly risk of developing myxedema coma. Case reports showed that patients received 100–200 mg of amiodarone orally and developed bradycardia and hypothermia with elevation in thyroid stimulating hormone. Most patients were treated with levothyroxine and hydrocortisone medication upon diagnosis. Conclusion The various possible causes of Myxedema coma make diagnosis difficult. Through clinical symptoms and serum TSH, the diagnosis could be confirmed. Amiodarone-induced Myxedema coma was successfully treated with levothyroxine and glucocorticoids.