Khulood Shattnawi | Anglia Ruskin University (original) (raw)

Papers by Khulood Shattnawi

Objetivo: Comparar los resultados del embarazo entre mujeres refugiadas sirias y mujeres jordanas... more Objetivo: Comparar los resultados del embarazo entre mujeres refugiadas sirias y mujeres jordanas. Antecedentes e introduccion: En los ultimos anos, miles de sirios huyeron de Siria a paises vecinos, como Jordania, como resultado del conflicto continuado en su pais. Las mujeres refugiadas embarazadas se enfrentan a muchas dificultades que aumentan la prevalencia de complicaciones prenatales. Sin embargo, hay muy poco conocimiento sobre si las mujeres refugiadas sirias tienen diferentes riesgos de resultados en el embarazo frente a las mujeres jordanas. Metodos: Utilizando un diseno de cohorte retrospectivo, examinamos los resultados del embarazo en refugiadas sirias (N=616) y mujeres jordanas (N=644) que dieron a luz en dos hospitales publicos en el norte de Jordania entre ell de enero de 2014 y el31 de diciembre de 2014. Se utilizo una lista de control de 13 variables. Las medidas primarias de resultado fueron parto por cesarea, complicaciones maternas, bajo peso al nacer «2500 g),...

Child Abuse & Neglect, 2019

The purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) ... more The purpose of this study was to estimate the prevalence of adverse childhood experiences (ACEs) among children in the United States and to examine the relationship between child and family characteristics and the likelihood of reported exposure to ACEs. Methods: Data were drawn from the nationally representative 2016 National Survey of Children's Health (NSCH). Parent-reported child ACE exposure was measured using counts of those reporting zero ACEs, one to three ACEs, and four or more ACEs. Results: The study sample included 45,287 children. The most prevalent types of ACE exposure experienced by children were economic hardship (22.5%) and parent or guardian divorce or separation (21.9%). Older children (34.7%), Non-Hispanic African American children (34.7%), children with special health care needs (SHCN; 36.3%), children living in poverty (37.2%), and children living in rural areas (30.5%) were more likely to be exposed to parental divorce or separation than their counterparts. Five cross-cutting factors emerged as important across outcomes: child's age, family structure, poverty, type of health insurance, and SHCN status. Conclusions: We found high prevalence rates of economic hardship on a national level. Our findings of higher prevalence among rural children further suggest the importance of the intersection of place and ACEs. Therefore, the geographic component of ACEs must be considered by policymakers. The identification of predictive factors related to high ACE exposure can inform early interventions at the national level. 1. Introduction Adverse childhood experiences (ACEs) are traumatic events of childhood that include physical, sexual, and emotional abuse, as well as the experience of household dysfunction, such as divorce/separation, domestic violence, or living with an adult experiencing mental illness, substance use/misuse, or incarceration (Felitti et al., 1998). Studies drawing from adult surveys have found exposure

International nursing review, Jan 25, 2017

To compare pregnancy outcomes of Syrian refugee women and Jordanian women. In the past few years,... more To compare pregnancy outcomes of Syrian refugee women and Jordanian women. In the past few years, thousands of Syrians fled Syria to neighbouring countries such as Jordan as a result of the continuing conflict in their country. Pregnant refugee women are facing many difficulties that increase the prevalence of antenatal complications. However, there is limited awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental hospital in northern Jordan, between 1 January 2014 and 31 December 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birthweight (<2500 g), APGAR score and preterm delivery (<37 weeks' gestational age). Statistical analysis revealed that refugee mothers had a signi...

Clinical Nursing Research, 2021

The diagnosis of childhood cancer is one of the most serious and unexpected experiences a mother ... more The diagnosis of childhood cancer is one of the most serious and unexpected experiences a mother can endure. A descriptive phenomenological approach was used to explore the experiences of mothers of children diagnosed with cancer in Jordan. Themes that emerged include (1) Emotional response on knowing the diagnosis (feelings of shock, lack of preparedness, denial, and feelings of “paralysis”), (2) Fear of the dreaded disease (fear of suffering and fear of death), and (3) The challenges of the treatment journey (inadequate financial resources, role transition, and feeling socially isolated). This study describes the experiences of Jordanian mothers who care for their children diagnosed with cancer so that health care providers can develop strategies to provide adequate psychological support to these mothers.

Supplemental material, ISSM_COREQ_Checklist for Parenting a Child With Autism Spectrum Disorder: ... more Supplemental material, ISSM_COREQ_Checklist for Parenting a Child With Autism Spectrum Disorder: Perspective of Jordanian Mothers by Khulood Kayed Shattnawi, Wafa'a M. Bani, Saeed, Ahlam Al-Natour, Mohammed M. Al-Hammouri, Manar Al-Azzam and Rachel A. Joseph in Journal of Transcultural Nursing

Additional file 1: Appendix 1: Question guide.

BACKGROUND Stillbirth and neonatal mortality declined significantly in high- and some middle- inc... more BACKGROUND Stillbirth and neonatal mortality declined significantly in high- and some middle- income countries because of the significant improvements in obstetric and neonatal care. Yet, stillbirth and neonatal mortality rates remain high in low-income countries. The main reason for low progress in reducing such stillbirths and neonatal deaths in Jordan is the scarcity of data on causes and contributing factors leading to these deaths. OBJECTIVE This study aimed to determine the rates, causes and risk factors of stillbirth and neonatal mortality in Jordan. METHODS An electronic stillbirth and neonatal deaths surveillance system was established in five large hospitals in Jordan. Data on all births, stillbirths and neonatal deaths and their causes during the period May 2019 – December 2020 were exported from the system and analyzed. RESULTS A total of 29,592 women gave birth to 31,106 babies during a period of 20 months in the selected hospitals. The stillbirth rate was 10.5 per 1,00...

Archives of Public Health, 2021

Background Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly develop... more Background Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals’ perception about the usability of JSANDS. Methods A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan. Results Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses’ competencies strengthened, the sustainability of the JSANDS, and COVID-19 impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced. Conclusions JSANDS wa...

Journal of Transcultural Nursing, 2020

Introduction: Parenting a child diagnosed with autism spectrum disorder (ASD) is challenging for ... more Introduction: Parenting a child diagnosed with autism spectrum disorder (ASD) is challenging for mothers because of concerns related to behavior, difficulties in accessing specialized care, and lack of community acceptance, yet their stories in Jordanian context are still unknown. Common challenges in Jordan include financial burdens, lack of public awareness, and lack of specialized knowledge even among health care providers, which may lead to delays in obtaining the diagnosis and interventions for ASD. Method: A phenomenological descriptive approach was used to explore and understand the mothers’ everyday lived experiences of raising a child with ASD. Semistructured interviews were conducted with 14 mothers to identify their challenges so that nurses can identify gaps in services, empower families, and facilitate optimum care to these Jordanian families. Findings: The main themes that emerged were (1) mothers’ journeys with the diagnosis, in which mothers recognized the abnormalit...

International Journal of Community Based Nursing and Midwifery, 2021

Background: Some cultural and social factors may discourage the use of modern family planning (MF... more Background: Some cultural and social factors may discourage the use of modern family planning (MFP) methods. The purpose of this study was to better understand the barriers and social norms that might affect women’s ability to take optimal advantage of the free family planning services offered by the Jordanian Ministry of Health (MOH). Methods: Using a qualitative descriptive design, 7 focus group discussions were conducted from January to February 2018, with a purposive sample of 52 married women. Each group consisted of 6-12 participants. Ethical approvals were obtained. Data were analysed using inductive thematic analysis. Results: Data analysis revealed three main themes and four subthemes. The first theme ‘conforming to social and cultural norms’ included the following subthemes: ‘to conform to family and social pressure to bear children’ and ‘to prioritize having male children’. The second theme ‘unmet needs in expected family planning counselling’ included the following subth...

American journal of perinatology, 2021

OBJECTIVE This study employed the "three-delay" model to investigate the types of crit... more OBJECTIVE This study employed the "three-delay" model to investigate the types of critical delays and modifiable factors that contribute to the neonatal deaths and stillbirths in Jordan. STUDY DESIGN A triangulation research method was followed in this study to present the findings of death review committees (DRCs), which were formally established in five major hospitals across Jordan. The DRCs used a specific death summary form to facilitate identifying the type of delay, if any, and to plan specific actions to prevent future similar deaths. A death case review form with key details was also filled immediately after each death. Moreover, data were collected from patient notes and medical records, and further information about a specific cause of death or the contributing factors, if needed, were collected. RESULTS During the study period (August 1, 2019-February 1, 2020), 10,726 births, 156 neonatal deaths, and 108 stillbirths were registered. A delay in recognizing th...

Journal of Medical Internet Research, 2021

Background The Jordan Stillbirth and Neonatal Mortality Surveillance (JSANDS) is an electronic su... more Background The Jordan Stillbirth and Neonatal Mortality Surveillance (JSANDS) is an electronic surveillance system that automatically transfers the data on births, stillbirths, and neonatal deaths to the concerned authorities in the Ministry of Health. JSANDS was implemented and tested in 5 maternity hospitals during the period spanning May 2019 through December 2020. Objective This study aimed to evaluate the usefulness and performance of JSANDS to register births, stillbirths, and neonatal deaths, and determine their causes. Specifically, this study examined the JSANDS attributes of acceptability, simplicity, flexibility, stability, representativeness, sustainability, penetration, data quality, sensitivity, and adoption. Methods An evaluation study was conducted after 18 months of the JSANDS implementation using the Updated Guidelines for Evaluating Public Health Surveillance Systems. The evaluation focused on how well the system operated to meet its purpose and objectives. The in...

Journal of Pediatric Nursing, 2021

PURPOSE Little research has explored the experiences and perspectives of neonatal intensive care ... more PURPOSE Little research has explored the experiences and perspectives of neonatal intensive care unit (NICU) nurses who have also experienced being NICU parents. The purpose of this study was to explore the experiences of these nurses who have or have ever had an infant hospitalized in a NICU. DESIGN AND METHODS A qualitative descriptive design using semi-structured interviews with a purposive sample of 9 registered Jordanian NICU nurses who have or have had a child admitted to a NICU. RESULTS Findings suggest an oscillation between the role of being a nurse and the role of being a mother. The nurses' background clinical experience has an impact on how they provided and received care and on the decisions they made regarding their infants' care plans. Nurses reported fears of the "recommended patient syndrome" and tried to avoid being labeled as "nagging" by other healthcare providers. CONCLUSIONS Study findings shed light on the needs of NICU nurses with NICU admitted infants and the struggle faced by nurses-mothers as a result of their dual role, and highlights the importance of the family centered developmental care approach that recognizes the family as the cornerstone of the NICU health care team. PRACTICE IMPLICATIONS Findings highlight issues related to the shared needs between mothers and nurse-mothers in relation to proximity and involvement in newborn care plan.

Archives of Medical Science, 2021

IntroductionFerritin has been implicated in body physiology and pathology. Smoking cigarettes (Cg... more IntroductionFerritin has been implicated in body physiology and pathology. Smoking cigarettes (Cg) alters ferritin metabolism. Waterpipe (Wp) smoking has recently reemerged as a global epidemic and is linked to the most devas�tating diseases. However, the effect of smoking Wp on ferritin is not known. Therefore, the current study compared plasma ferritin in adolescents smok�ing Cg, Wp, both (CgWp) versus never smoked.Material and methodsSelf-reported smoking status and plasma ferritin lev�els were obtained from 849 boys (n = 470) and girls (n = 379) in the 7th–10th grade (age range = 13–17 years).ResultsThe ANCOVA revealed a main effect for gender (p < 0.000) and smoking status (p < 0.02) without an interaction effect (p > 0.9). Post-hoc analysis showed greater plasma ferritin in the adolescents smoking Wp (p < 0.03) and CgWp (p < 0.004) versus never smoked. Gender-stratified ANCOVA showed a main effect for smoking status in the boys (p < 0.02) and girls (p < 0....

Health and Academic Achievement, 2018

Background It has been estimated that 27.8 million neonates will die between 2018 and 2030 if no ... more Background It has been estimated that 27.8 million neonates will die between 2018 and 2030 if no improvements in neonatal mortality take place. The aim was to determine the rate, determinants, and causes of neonatal mortality in Jordan.Methods In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 – January 2020 were exported from the JSANDS and analysed.Results A total of 10328 births were registered in the study period, with a rate of 14.1 deaths per 1000 LBs; 76% were early neonatal deaths and 24% were late deaths. 25%of all deaths occurred in the first day of life. Multivariable analysis showed that the odds of neonatal deaths was 20.8 (95% CI 2.8,153.1) in Ministry of Health hospitals compared to private hospitals, OR 31.8 (95% CI 18.8,53.8) for very low birth (

BioMed Research International, 2021

Background. Facility-based death review committee (DRC) of neonatal deaths and stillbirths can en... more Background. Facility-based death review committee (DRC) of neonatal deaths and stillbirths can encourage stakeholders to enhance the quality of care during the antenatal period and labour to improve birth outcomes. To understand the benefits and impact of the DRCs, this study was aimed at exploring the DRC members’ perception about the role and benefits of the newly developed facility-based DRCs in five pilot hospitals in Jordan, to assess women empowerment, decision-making process, power dynamics, culture and genderism as contributing factors for deaths, and impact of COVID-19 lockdown on births. Methods. A descriptive study of a qualitative design—using focus group discussions—was conducted after one year of establishing DRCs in 5 pilot large hospitals. The number of participants in each focus group ranged from 8 to10, and the total number of participants was 45 HCPs (nurses and doctors). Questions were consecutively asked in each focus group. The moderator asked the main question...

Frontiers in Public Health, 2020

Background: It has been estimated that 27.8 million neonates will die worldwide between 2018 and ... more Background: It has been estimated that 27.8 million neonates will die worldwide between 2018 and 2030 if no improvements in neonatal and maternal care take place. The aim of this study was to determine the rate, risk factors, and causes of neonatal mortality in Jordan. Methods: In August 2019, an electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in in three large cities through five hospitals. Data on all births, neonatal mortality and their causes, and other characteristics in the period between August 2019 and January 2020 were exported from the JSANDS and analyzed. Results: A total of 10,328 births [10,226 live births (LB) and 102 stillbirths] were registered in the study period, with a rate of 14.1 deaths per 1,000 LBs; 76% were early neonatal deaths and 24% were late deaths. The odds of deaths in the Ministry of Health hospitals were almost 21 times (OR = 20.8, 95% CI: 2.8, 153.1) higher than that in private hospitals. Low birthweight and pre-term babies were significantly more likely to die during the neonatal period compared to full-term babies. The odds of neonatal mortality were significantly higher among babies born to housewives compared to those who were born to employed women (OR = 2.7; 95% CI: 1.2, 6.0). Main causes of neonatal deaths that occurred pre-discharge were respiratory and cardiovascular disorders (43%) and low birthweight and pre-term (33%). The main maternal conditions that attributed to these deaths were complications of the placenta and cord, complications of pregnancy, and medical and surgical conditions. The main cause of neonatal deaths that occurred post-discharge were low birthweight and pre-term (42%). Conclusions: The rate of neonatal mortality have not decreased since 2012 and the majority of neonatal deaths occurred could have been prevented. Regular antenatal

Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low... more Background: Annually, 2.6 million stillbirths occur around the world, with about 98% occur in low and middle-income countries. The stillbirth rates in these countries are 10 times higher than the rates in high-income countries.Methods: An electronic stillbirths and neonatal deaths surveillance system (JSANDS) was established in five large hospitals located in three of the largest cities in Jordan in August 2019. JSANDS was developed as a secure on-line data entry system to collect, organize, analyse, and disseminate data on stillbirths, neonatal deaths, and their causes. Data on births, stillbirths and their causes, and other demographic and clinical characteristics in the period between August 2019 – January 2020 were extracted and analysed.Results: A total of 10328 births were registered during the reporting period. Of the total births, 102 were born dead (88 antepartum stillbirths and 14 intrapartum stillbirths) with a rate of 9.9 per 1000 total births. The main fetal causes of a...

The Journal of Maternal-Fetal & Neonatal Medicine, 2020

BACKGROUND Perinatal mortality is a fundamental indicator of the quality of the healthcare provid... more BACKGROUND Perinatal mortality is a fundamental indicator of the quality of the healthcare provided to women during pregnancy and childbirth, as well as the healthcare provided to neonates in the first week of life. At the national level, determining the direct and indirect causes of these deaths is vital, as it will assist in tracking the quality of antenatal, natal and postnatal care and help to detect the areas for avoidance. This study aimed to identify the main determinants of perinatal deaths in Jordan from the perspectives of health care providers (HCPs). METHODS A descriptive qualitative approach using focus group discussion was used. Four focus groups were conducted in each of the four hospitals where the approached HCPs are employed. An average of 5 HCPs were interviewed in each focus group with a total of 80 HCPs participating in the 16 focus groups. Thematic analysis was carried out to analyze the data. RESULTS The HCPs provided a detailed description of the determinants of perinatal and neonatal death from their points of view. Four main themes with multiple subthemes emerged, namely maternal factors (ignorance, concealment of medical condition, and husbands' negligence), sociocultural factors (socioeconomic status, tribal and consanguineous marriage, and harmful cultural practices), political factors (early marriage driven by displacement and war consequences on maternal health), and health system-related factors (services management including capabilities and logistics, overcrowding of emergency rooms, discharge against medical advice, and unskilled general practitioners in private maternity clinics). CONCLUSIONS As perceived by HCPs, maternal factors, sociocultural factors, political factors, and health system-related factors are the main determinants of perinatal deaths in Jordan. Improvement in the quality of maternal and neonatal health care services, maternal health education, and maternity staff training are strongly recommended.