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BACKGROUND: Effective medication adherence is vital for managing acute myocardial infarction (AMI) and enhancing patient well-being. This study aimed to evaluate medication adherence levels and associated factors among AMI patients using standardized assessment tools. METHODS: Employing a cross-sectional descriptive design, the study involved 210 patients diagnosed with acute myocardial infarction. Participants completed the General Medication Adherence Scale (GMAS), Hospital Anxiety and Depression Scale (HADS), and provided socio-demographic details. RESULTS: The study revealed partial adherence to medications among AMI patients, with mean scores of 24.89 (± 3.64) out of 33. Notably, good adherence was observed in non-adherence due to patient behavior (mean ± SD = 11.8 ± 2.3 out of 15) and additional disease burden (mean ± SD = 8.65 ± 2.21 out of 12), while partial adherence was noted in non-adherence due to financial constraints (mean ± SD = 4.44 ± 1.34 out of 6). Patients reported mild anxiety (mean ± SD = 8.38 ± 2.81) and no depressive symptoms (mean ± SD = 7.43 ± 2.42). Multiple linear regression analysis indicated that employed status, younger age, shorter duration of MI, lower anxiety, and depression levels were associated with higher medication adherence. However, factors such as monthly income, gender, educational level, and marital status did not predict medication adherence. CONCLUSION: The study highlights the significance of addressing anxiety and depression levels and considering socio-demographic factors when designing interventions to enhance medication adherence among AMI patients. Further research is needed to explore additional determinants of medication adherence and develop tailored interventions to improve patient outcomes post-AMI.

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BACKGROUND: This study aimed to evaluate the effectiveness of a respiratory care bundle, including deep breathing exercises, incentive spirometry, and airway clearance techniques, on the quality of life (QoL) of chronic obstructive pulmonary disease (COPD) patients in Jordan. MATERIALS AND METHODS: A quasi-experimental study design and convenience sampling method was used to recruit 120 COPD patients, with 54 in the intervention group and 66 in the control group. The intervention group received additional respiratory care bundle training, while the control group received only discharge instructions and an education program. The St. George's Respiratory Questionnaire (SGRQ-C) was used to assess participants' QoL before and after the intervention. Independent t-tests, paired t-tests, and analysis of covariance (ANCOVA) analysis were used to analyze the data. RESULTS: The study found no significant differences between patients' characteristics, health status, and SGRQ-C scores between the two groups at baseline. After the intervention, there were statistically significant differences in all SGRQ-C subscales, which were lower in the intervention group compared to the control group. The paired t-test showed significant reductions in all SGRQ-C symptoms components (t = 7.62, P < .001), activity component (t = 7.58, P < .001), impact component (t = 7.56, P < .001), and total scores post-intervention (t = 7.52, P < .001) for the intervention group. The ANCOVA analysis showed significant differences in scores of SGRQ-C components and total scores (f = 11.3, P < .001) post-intervention between the two groups. CONCLUSION: The study's findings suggest that providing additional respiratory care bundle training for COPD patients can significantly improve their QoL, as measured by the SGRQ-C scores. The respiratory care bundle intervention was effective in reducing COPD symptoms and improving the QoL of COPD patients. Healthcare providers should consider implementing respiratory care bundles as part of COPD management to improve patients' outcomes.

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Background: This systematic review explores the impact of cardiac rehabilitation programs (CRPs) on health-related quality of life (HRQoL) and physiological outcomes post-coronary artery bypass graft (CABG) surgery. Acknowledging the increasing importance of CRPs in post-CABG care, the study emphasizes the need for a comprehensive evaluation of their effectiveness. The primary objective is to investigate how CRPs influence HRQoL and physiological outcomes in post-CABG patients, offering insights into the multifaceted impact of these rehabilitation programs. Methods: A systematic literature review approach was employed to identify relevant studies published between 2013 and 2023. Inclusion criteria encompassed clinical randomized trials and quasi-experimental studies, with a focus on CRP interventions and their impact on HRQoL and physiological parameters. Results: The review reveals a diverse array of CRP approaches, including exercise training, home-based programs, and telemonitored interventions. Despite methodological variations, a consistent positive impact on HRQoL and physiological outcomes is observed across studies. Noteworthy interventions, such as those incorporating family caregivers, demonstrate holistic benefits. However, limitations include methodological variability and the exclusion of qualitative studies. Conclusions: This systematic review underscores the substantial positive impact of CRPs on HRQoL and physiological outcomes in post-CABG patients. The diverse approaches and consistent improvements across studies provide a robust foundation for healthcare practitioners and researchers. Future efforts should focus on standardizing CRP interventions and conducting well-designed trials to further enhance the evidence base, facilitating more targeted and effective rehabilitation strategies for CABG patients.

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BACKGROUND: Triage nurses' pivotal role in initial assessment makes their competence crucial. However, the specific impact on Acute Coronary Syndrome (ACS) recognition and outcomes remains unclear in Jordanian healthcare. Understanding this relationship could enhance ACS management and patient outcomes in Jordanian Emergency Departments (EDs). OBJECTIVE: To assess how triage nurses' recognition of ACS diagnosis affects patient outcomes in Jordan. METHODS: This retrospective study examined records of 150 ACS patients admitted to the coronary care unit (CCU). Data extraction assessed triage nurses' accuracy in recognizing ACS symptoms and the timelines for diagnosis procedures (e.g., electrocardiogram [ECG]) and treatment provision (e.g., thrombolytic) based on triage decisions. It also evaluated the impact on treatment outcomes, including length of stay in the ED and hospital. Multiple linear regression analyses quantified the influence of under-triage on treatment outcomes. RESULTS: The sample comprised 150 patients. Most were female (78.7%), aged 45-59.9 years (37.3%). ACS classifications: unstable angina (52.0%), STEMI (38.0%), NSTEMI (10.0%). The study included a cohort of ACS patients, with findings indicating varying degrees of under-triage by triage nurses. Analysis of timelines revealed significant delays in diagnosis and treatment initiation for patients subjected to under-triage. Multiple linear regression analyses demonstrated a robust association between under-triage and prolonged time to essential treatment outcomes, including delays in physician assessment, ECG performance, thrombolytic administration, and extended ED length of stay. CONCLUSION: Triage nurses' knowledge and competency are crucial determinants of accurate ACS recognition and subsequent clinical outcomes for patients presenting to the ED in Jordan. Investing in ongoing education and training programs for triage nurses may lead to improved ACS recognition rates and better patient outcomes in Jordanian healthcare settings.

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AIM: To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs. BACKGROUND: Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care. METHODS: A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach. RESULTS: The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity. CONCLUSIONS: The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.

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BACKGROUND: Quantitative studies have provided valuable statistical insights into Health-Related Quality of Life (HRQoL) among patients with Heart Failure (HF), yet they often lack the depth to fully capture the nuanced, subjective experiences of living with HF particularly in the specific context of Jordan. This study explores the personal narratives of HF patients to understand the full impact of HF on their daily lives, revealing HRQoL aspects that quantitative metrics often miss. This is crucial in developing regions, where the increasing prevalence of HF intersects with local healthcare practices, cultural views, and patient expectations, providing key insights for tailored interventions and better patient care. METHODS: Utilizing a phenomenological qualitative design, this study conducted face-to-face semi-structured interviews with 25 HF patients to deeply explore their lived experiences. Thematic analysis was employed to identify major themes related to their perceptions of HF as a disease, its impact on various HRQoL domains, and their recommended strategies to enhance HRQoL. RESULTS: The study involved 25 participants (13 males, 12 females), aged 26-88 years (mean 63), with diverse education and heart failure (HF) severities. It revealed three themes: HF perceptions, its impact on health-related quality of life (HRQoL) across physical, psychosocial, spiritual, cognitive, and economic domains, and HRQoL improvement strategies. Participants had varied HF knowledge; some lacked basic understanding. The physical impact was most significant, affecting daily life and causing symptoms like breathing difficulties, coughing, edema, and fatigue. This physical aspect influenced their psychosocial and spiritual lives, cognitive functions, and economic stability, leading to fear, frustration, worry, social isolation, spiritual and cognitive challenges, and employment problems. CONCLUSIONS: The results underscores the need for holistic healthcare approaches, integrating medical, psychological, and social support. Key recommendations include integrated care models, comprehensive patient education, support networks, and policy interventions to enhance HF patient care.

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Introduction: Sleep disturbances are common among older adults and can have detrimental effects on their overall well-being. Tai Chi exercise has shown promise in improving sleep quality, quality of life (QoL), and psychological well-being in various populations. Objective: To investigate the effect of a home-based simplified Tai Chi exercise program on sleep quality, daytime sleepiness, QoL, and psychological well-being in Egyptian older adults. Methods: A quasi-experimental design was employed, with 152 participants aged 60 years and above assigned to either an experimental group (n = 87) or a control group (n = 65). Thecontrol group received a health education program to improve their sleeping quality and life-style, while the experimental group received a similar health education program and Tai Chi exercise training program. The participants in the experimental group were instructed to perform 3 months Tai Chi exercise. Data on sleep quality, daytime sleepiness, QoL, generalized anxiety disorder (GAD), and depression symptoms were collected at baseline, and one month, and 3 months post-intervention using validated questionnaires. Repeated measures ANOVA was done to investigate the effectiveness of the intervention programsover 3 time periods. Results: The results showed significant improvements in sleep quality (p < .001), QoL (p < .005), GAD (p < .005), and depression symptoms (p < .005) post-interventions. Also, there were significant difference in the effectiveness of the intervention programs between both the experimental and control groups. The experimental group exhibited greater improvements compared to the control group. Conclusion: The findings support the beneficial effects of a home-based simplified Tai Chi exercise program on sleep quality, QoL, and psychological well-being in Egyptian older adults. These results have important implications for promoting healthy aging and improving overall well-being in this population. Further research is recommended to validate these findings and explore the underlying mechanisms of Tai Chi exercise on the outcomes of interest.

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BACKGROUND: Catheter-associated urinary tract infection is a global problem but it can be prevented with the appropriate implementation of evidence-based guidelines. This study was conducted to assess the level of compliance of healthcare workers with the catheter-associated urinary tract infection prevention guidelines during the insertion of a urinary catheter. METHODS: An observational study using a descriptive cross-sectional design was conducted at Sana'a City hospitals, Yemen. All the nurses and physicians from the governmental, teaching, and private hospitals were eligible to participate in the study. The data collection was performed through convenience sampling from March 2020 to December 2020, using a structured observational checklist prepared specifically for this study. RESULTS: The majority of the urinary catheter insertions were performed by nurses. There were no written policy or procedures for an urinary catheter insertion and no in-service education or training departments in the majority of the hospitals. The overall mean score of compliance was 7.31 of 10. About 71% of the healthcare workers had a high or acceptable level of compliance and 29% had an unsafe level of compliance. Compliance was low for maintaining aseptic technique throughout the insertion procedure, using a single use packet of lubricant jelly, performing hand hygiene immediately before insertion, and securing the urinary catheter once inserted. Factors affecting the healthcare workers compliance were gender, the working ward/unit of the healthcare workers, the availability of a written policy/procedure and a department or unit for in-service education. CONCLUSION: Yemeni healthcare workers' overall compliance was acceptable but it was unsafe in several critical measures. There is an urgent need for developing, implementing, and monitoring national guidelines and institutional policy and procedures for catheter-associated urinary tract infection prevention. Periodical in-service education and training programs and adequate access to the necessary materials and supplies are paramount.

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INTRODUCTION: Testicular cancer (TC) is a serious health issue, which requires early detection through testicular self-examination (TSE). OBJECTIVES: To investigate Saudi nursing students' health beliefs about TC and TSE using the Health Belief Model (HBM) scale and assess the validity and reliability of the HBM scale. METHODS: This cross-sectional study recruited a convenience sample of 374 nursing students from six nursing colleges in different cities in Saudi Arabia. Data were collected through self-report questionnaires that included demographic and academic information, as well as a valid and reliable HBM scale for TC and TSE. RESULTS: Most participants were single (88.8 %), in their third year of nursing education (43.9 %), had excellent or very good health (83.2%), had no family history of TC (88.9%), and had no medical problems with their testicles (92.8%). The participants had low susceptibility to TC and moderate beliefs about the seriousness of TC. Furthermore, participants reported moderate levels of perceived benefits and health motivation for preventing TC and practicing TSE, but high levels of perceived barriers and low levels of self-efficacy for practicing TSE. The internal reliability (Cronbach's alpha) of susceptibility, benefits and health motivation, seriousness, barriers, self-efficacy, and health motivation and promotion sub-scales was 0.91, 0.89, 0.88, 0.84, 0.67, and 0.65, respectively. Significant relationship between students' performing TSE and their health beliefs about Susceptibility (t=1.93, p=0.04) and Seriousness of having TC (t=2.88, p=0.03), and self-efficacy (t=3.91, p<0.001) and barriers (t=-2.51, p=0.04) to practice TSE. CONCLUSION: The study concluded that Saudi nursing students had moderate levels of health beliefs about TC and TSE, with high perceived barriers and low levels of self-efficacy for practicing TSE.

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BACKGROUND: The interaction between healthcare professionals (HCPs) and family members during cardiopulmonary resuscitation (CPR) in critical care units (CCUs) has received significant attention. In the Arabic region, family members are typically excluded from participating in critical care treatments, despite the cultural and religious significance of their presence. This highlights a lack of policies and research addressing the cultural factors related to family involvement in CPR within this context. OBJECTIVES: The purpose of this study was to explore the nature of the relationship between HCPs and family member relations during CPR in Jordanian CCUs. METHODS: This study employed a qualitative research design. Data were collected through semi-structured interviews with 45 participants, including 31 HCPs and 14 family members of patients who had undergone CPR in Jordan. Data was managed, organized, and thematically analyzed using NVivo. RESULTS: The study revealed three main themes: Family-Witnessed Resuscitation (FWR) through the eyes of HCPs, FWR through the eyes of family members, and the relationship between HCPs and family members during CPR. The last theme has three subthemes: "Looking out for the Patient," "Looking out for Ourselves," and "Looking out for Each Other." These themes highlighted the complex and dynamic relationships between HCPs and family members during CPR in Jordan. Participants emphasized the importance of clear communication, mutual respect, and a collaborative approach to decision-making during CPR. CONCLUSION: The resultant study model uniquely explains the relationship between Jordanian health professionals and family members during CPR, with important implications for clinical practice and healthcare policies regarding family involvement during resuscitation in Jordan. Further research is needed to explore the cultural and societal factors influencing family involvement in resuscitation in Jordan and other Arab countries.

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INTRODUCTION: Testicular cancer (TC) incidence is increasing worldwide. This study aimed to investigate Saudi nursing students' knowledge and perception about TC. METHOD: This cross-sectional study was done using convenience sampling method. In this study, 280 nursing students from different nursing schools in six cities of Saudi Arabia were recruited. A structured self-report questionnaire was used to collect data. RESULT: About 49.2% of the participants received education about TC in their nursing schools. The findings showed lack of enough knowledge about TC among Saudi nursing students. Mostly, the participants reported that heredity factor and having family history of TC (48.9%) and age between 56 and 70 years (41.8%) were the most common risk factors of TC. According to the participants, physical examination was the most common diagnostic test usually used for early detection of TC (40.4%) and biopsy test was the most accurate test to confirm TC diagnosis (45.4%). Only one third of the participants (34.6%) knew that between 75% and 100% of TC cases can be cured in case of early detection. About half of the participants (51.8%) reported that surgical procedure was the most common treatment for TC. The nursing students who had high GPA (r=0.86, p<0.001), were unwilling to get more information on TC (r=0.24, p=0.04), had family history of TC (r= 0.53, p=0.02), medical problems with testicles (r= 0.69, p=0.01), received education about TC in their school of nursing (r=0.65, p=0.02), and were more self-confident in assessing and managing TC (r=0.38, p=0.03) had higher level knowledge about TC.  Conclusion: Despite the importance of nurses' roles in assessing and managing TC, nursing students in Saudi Arabia still did not have enough knowledge about TC. Improving nursing programs' curricula and conducting health education programs are recommended.

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BACKGROUND: Physical activity behavior change is considered one of the most challenging lifestyle modifications in patients with heart failure. Even after participation in a cardiac rehabilitation program, most patients do not engage in the recommended level of physical activity. OBJECTIVE: To determine which baseline demographic, physical activity levels, psychological distress, and clinical variables predicted physical activity behavior change to increasing light-to-vigorous physical activity by 10,000 steps/day following participation in home-based cardiac rehabilitation intervention. METHODS: A prospective design involving secondary analysis was used to analyze data obtained from 127 patients (mean, 61; range, 45-69 years) enrolled in and completed an 8-week home-based mobile health app intervention. The intervention was designed to encourage health behavior change with regard to decreasing sedentary behavior and increasing physical activities performed at light or greater intensities. RESULTS: None of the participants accumulated 10,000 steps or more per day pre-intervention (mean, 1549; range, 318-4915 steps/day). Only 55 participants (43%) achieved an average daily step count of 10,000 or more at week 8 of the intervention (10,674 ± 263). The results of the logistic regression showed that higher pre-intervention physical activity levels and anxiety symptoms and lower depressive symptoms were associated with a higher likelihood of achieving physical activity behavior change (p < .003). CONCLUSION: These data highlight that determining pre-intervention physical activity levels and depressive symptoms can be the key to designing an effective home-based cardiac rehabilitation intervention in patients with heart failure.

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BACKGROUND: The use of mobile health applications (apps) is an effective strategy in supporting patients' self-management of heart failure (HF) in home settings, but it remains unclear whether they can be used to reduce sedentary behaviors and increase overall physical activity levels. AIM: The aims of this study were to determine the effect of an 8-week home-based mobile health app intervention on physical activity levels and to assess its effects on symptom burden and health-related quality of life. METHOD: In this study, we collected repeated-measures data from 132 participants with HF (60.8 ± 10.47 years) randomized into a usual care group (n = 67) or an 8-week home-based mobile health app intervention group (n = 65). The intervention was tailored to decrease the time spent in sedentary behavior and to increase the time spent in physical activities performed at light or greater intensity levels. Physical activity levels were monitored for 2 weeks before the intervention and during the 8-week intervention using the Samsung mobile health app. Heart failure symptom burden and health-related quality of life were assessed at baseline, 2 weeks from baseline assessment, and immediately post intervention. RESULTS: At week 8, all participants in the intervention group demonstrated an increase in the average daily step counts above the preintervention counts (range of increase: 2351-7925 steps/d). Only 29 participants (45%) achieved an average daily step count of 10 000 or higher by week 6 and maintained their achievement to week 8 of the intervention. Repeated-measures analysis of variance showed a significant group-by-time interaction, indicating that the intervention group had a greater improvement in physical activity levels, symptom burden, and health-related quality of life than the usual care group. CONCLUSION: Home-based mobile health app-based interventions can increase physical activity levels and can play an important role in promoting better HF outcomes.

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BACKGROUND: Although obesity is a risk factor for cardiovascular disease, higher body mass index is related to longer event-free survival in patients with heart failure (HF). While previous research demonstrated that higher levels of inflammatory mediators were associated with shorter event-free survival, the effect of inflammation on the association between obesity and outcomes of HF have not been considered. HYPOTHESIS: Based on the obesity paradox, we hypothesized that patients with higher baseline body mass index (BMI) would experience better event-free survival than those with lower BMI regardless of inflammatory status. METHOD: A sample of 415 patients with HF (age 61 ± 11.5 years; 31% female) provided blood to measure soluble tumor necrosis factor receptor1 (sTNFR1), a biomarker of inflammation. Patients were divided into 4 groups based on BMI and a median split of sTNFR1 levels: (1) high BMI ≥ 30 and sTNFR1 > 1804 pg/ml, (2) high BMI ≥ 30 and low sTNFR1 ≤ 1804 pg/ml, and (3) low BMI < 30 and high sTNFR1 > 1804 pg/ml vs. (4) low BMI < 30 and sTNFR1 ≤ 1804 pg/ml. Patients were followed for an average of 365 days to determine the time to first event of either all-cause hospitalization or death. RESULTS: There were 177 patients (43%) who experienced either an all-cause hospitalization or death. In a Cox regression, high BMI and high sTNFR1 category predicted time to event (hazard ratio = 1.7, 95% confidence interval = 1.01-2.9) with age, gender, race, left ventricular ejection fraction, New York Heart Association functional class (I/II versus III/IV), log-transformed N-terminal Pro-B-type natriuretic peptide levels, prescribed statin (yes/no), and comorbidity as covariates. CONCLUSION: Being in a higher inflammation group was associated with shorter event-free survival regardless of BMI. This study provides evidence that inflammation is an important consideration in the association between obesity and better outcomes in patients with HF.

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The current cross-sectional study was conducted to investigate nurses' and midwives' opinions about their roles in caring for women with postpartum depression (PPD) in Saudi Arabia. Convenience sampling was used to recruit 181 nurses and 141 midwives. A self-administered questionnaire was used to collect data. Participants lacked experience assessing and managing PPD and providing health education and counseling to mothers about PPD. Moreover, participants underestimated the importance of their roles in preventing PPD risk factors, and detecting, assessing, and managing PPD. Findings show significant differences between nurses' and midwives' opinions, with more frequency of agreement among nurses than midwives regarding their roles in caring for women with PPD. Continuing health education programs for nurses and midwives are recommended to improve knowledge, skills, and awareness of their roles in assessing and managing PPD. [Journal of Psychosocial Nursing and Mental Health Services, 58(7), 42-51.].

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BACKGROUND: Ostomates have several physical, psychological and social health problems. These problems negatively impact the ostomates' quality of life. AIMS: This study aims to identify Jordanian ostomates' health problems and their self-care ability to manage their ostomies. METHODS: This is a cross-sectional study. A convenience sampling method was used to recruit 168 Jordanian patients with intestinal ostomies. A self-report questionnaire was used to collect the data. RESULTS: On average, the participants' physiological ostomy-related problem scores were 8.76 ± 2.37 (out of 13 problems) and the total score of self-care ability to manage their ostomies was 16.56 ± 2.62 (out of 24). About 22% of the participants had 'moderately severe' to 'severe' depression (nine-item Patient Health Questionnaire score ≥15) and 33.9% had 'moderate' to 'severe' anxiety (seven-item General Anxiety Disorder questionnaire score ≥10). About half of the participants had exposure to teaching and/or training about ostomy care. About 85% of participants were willing to attend health education and training programmes about ostomy care. There was a significant correlation between high ostomates' self-care ability to manage their ostomies and a low number of physiological health problems (r = -0.67, p = 0.04), a low depression (Patient Health Questionnaire 9) score (r = -0.54, p = 0.039) and a low anxiety (seven-item General Anxiety Disorder questionnaire) score (r = -0.71, p < 0.027). CONCLUSIONS: Health teaching and training about intestinal ostomy management, psychosocial support, follow-up assessment and treatment for ostomy-related problems are recommended for all ostomates.

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INTRODUCTION: Taxi drivers experience frequent hassles that may contribute to mental exertion and depression symptoms. AIM: Mental exertion and depression symptoms in taxi drivers are explored in association with hassles, effort-reward imbalance, job strain, and iso-strain. METHODS: Personal interviews were conducted with 130 drivers in San Francisco. RESULTS: Mental exertion averaged 4.5 (±2.68) and physical exertion averaged 3.71 (±2.1) on 0 to 10 Borg scales. Based on the Center for Epidemiological Studies-Depression scale, 38% had depression symptoms. Mental exertion and depression symptoms correlated with job strain, iso-strain and effort-reward imbalance in anticipated directions, lending construct validity to the Borg mental exertion scale. Physical exertion, night shift, stressful personal events, and being uninsured for healthcare predicted mental exertion. Lack of respect by dispatchers and stressful personal events predicted depression symptoms. CONCLUSION: Selected hassles may be remedied by communication trainings, emphasizing mutual respect. Recognition and treatment of depression in taxi drivers are important.

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BACKGROUND: Sickle cell disease (SCD) affects millions of people worldwide and is associated with significant morbidity and mortality. Nurses can have a significant role in improving the outcomes of individuals with SCD. This study examined the effectiveness of an educational program on the knowledge and practice of nurses who provide care for individuals with acute sickle cell crisis. METHOD: A pretest-posttest control group design was used. The study was conducted at two hospitals in the northern region of Egypt. The sample included 77 RNs working in hematologic and genetic units. Data were collected using a self-administered knowledge questionnaire and a clinical performance checklist. RESULTS: Findings indicated a significant difference in nurses' knowledge and care practices after implementing the educational program. CONCLUSION: This educational program enhanced nurses' knowledge and practice for managing SCD. Training and continuing education programs need to be provided for nurses in hospital settings who provide care for individuals with SCD. Moreover, nursing curricula should reflect the standardized care for individuals with sickle cell crisis. [J Contin Educ Nurs. 2019;50(2):87-95.].

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We hypothesized that risk factors for cardiovascular disease (CVD) would be associated with worse health perceptions in prison inmates. This study included 362 inmates recruited from four medium security prisons in Kentucky. Framingham Risk Score was used to estimate the risk of developing CVD within the next 10 years. A single item on self-rated health from the Medical Outcomes Survey-Short Form 36 was used to measure health perception. Multinomial logistic regression showed that for every 1-unit increase in Framingham Risk Score, inmates were 23% more likely to have rated their health as fair/poor and 11% more likely to rate their health as good rather than very good/excellent. These findings demonstrate that worse health perceptions may serve as a starting point for discussing cardiovascular risk factors and prevention with inmates.

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The current study addresses lack of knowledge about assessment and management of postpartum depression (PPD) among nurses and midwives in Saudi Arabia. A descriptive, cross-sectional design was used to recruit a convenience sample of 181 nurses and 143 midwives. Data were collected using a self-administered questionnaire. Nurses and midwives lacked knowledge about various aspects of PPD, including its definition, prevalence, symptoms, risk factors, screening tools, and treatment. Only one third of participants were confident in their ability to provide education for women about PPD. Participants' self-confidence to educate women about PPD was significantly correlated with their level of knowledge about assessment and management of PPD. Continuing education is recommended for health care professionals to improve knowledge regarding PPD. Further studies are needed to determine the effectiveness of educational interventions on improving knowledge, practice, and self-confidence about PPD. [Journal of Psychosocial Nursing and Mental Health Services, 56(12), 36-46.].

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