BACKGROUND:Burnout among emergency healthcare providers, including physicians, nurses, and paramedics, is a growing global concern, particularly in developing countries where prevalence rates can reach 70%-80%. Burnout negatively impacts healthcare systems and patient outcomes. However, limited studies compare burnout rates across these professions or focus on the Middle Eastern context, including Jordan. This study aims to assess burnout prevalence among emergency physicians, nurses, and paramedics in Jordan and identify associated demographic and work-related factors. METHODS:A cross-sectional descriptive study was conducted using a paper-based, self-administered questionnaire incorporating the Copenhagen Burnout Inventory (CBI). Participants were drawn from emergency departments in 15 hospitals and 13 ambulance stations. Data were analyzed using SPSS Version 25, employing descriptive statistics, ANOVA, and logistic regression to identify burnout predictors. RESULTS:A total of 560 participants completed the survey (response rate: 70%). The prevalence rates for personal, work-related, and patient-related burnout were 83.7%, 79.2%, and 64.0%, respectively, with overall high burnout rates (75.6%). Sleep deprivation (p ≤ 0.002), poor supervisor relationships (p ≤ 0.01), and attempts to change workplaces (p ≤ 0.03) were associated with all burnout dimensions. Female participants and those with one to three children showed higher burnout odds (p = 0.004, p = 0.045, respectively). No significant differences in burnout rates were observed among professions. CONCLUSIONS:This study highlights alarmingly high burnout prevalence rates among emergency healthcare providers in Jordan, stressing the need for tailored strategies to mitigate burnout and improve the resilience of the healthcare system. Future research should explore the long-term impacts of systemic factors and post-COVID-19 dynamics.

In the early morning of February 6 th , 2023, a 7.8 magnitude earthquake struck southeastern Türkiye and parts of Northern Syria. The earthquake was followed by multiple high-magnitude aftershocks (5.6 - 7.5). The earthquake caused 50,339 deaths and 311,000 collapsed or severely damaged houses. In the wake of this disaster, the Turkish government appealed for international assistance to expedite search and rescue operations and medical assistance. This study aims to explore the experiences and insights of the first responders during their deployment to Türkiye in the aftermath of the devastating earthquake. A semi-structured interviews were performed with 18 first responders from the Jordan International Search and Rescue team (JSAR) who deployed to Türkiye and participated in the search and rescue operations. The JSAR team is certified as a heavy international team and works under the International Search and Rescue Advisory Group (ISARAG). The results revealed a success in coordinating the international response of over 90 teams. However, numerous obstacles and difficulties were encountered due possibly to the sheer scale of the disaster. These obstacles can be categorized into resource allocation and time management. Resources allocation issues include the selection of the operation site; suboptimal use of teams’ capabilities and capacities; and suboptimal coordination and collaboration with local authorities and volunteers. Time management issues include the deployment decision time, transportation to the operation site, and the scheduled roster of deployed personnel. These findings stress the urgent need to reevaluate and reform current approaches to ensure more efficient and impactful future disaster relief efforts.

Objectives Self-directed learning has been encouraged as an effective training method for healthcare students. This study aims to assess the level of self-directed learning readiness (SDLR) among paramedic students in Jordan and identify any associated factors. Methodology This is a cross-sectional survey using an online questionnaire on a sample of paramedic students in Jordan. All enrolled undergraduate paramedic students in the three institutions were included as potential participants. Results A total of 529 participants completed the questionnaire. The overall mean score was 141.9 (SD ± 35.5) and a total of 302 (57.1%) participants had a high level of SDLR (score > 150). Students with a high level of SDLR were more likely to be male (p = 0.039) and have high academic performance levels (p = 0.006). Conclusions This study found that even though the majority of our participants achieved a high level of SDLR, the overall mean score was among the lowest in the literature.

Objective:This study aimed to estimate the incidence and outcomes of cardiac arrest treated in the emergency department (ED), and identify factors associated with survival to hospital discharge. Methods:This was a single-center observational study of all adult cardiac arrest patients treated in the ED between 2015 and 2022. Patients were categorized into out-of-hospital cardiac arrest (OHCA) and in-ED events based on whether the patients arrived at the ED in cardiac arrest or developed during the ED visit. Annual incidence rates were calculated per 10,000 ED visits. Changes in the temporal trend for incidence were assessed using Poisson regression and factors associated with survival to hospital discharge among admitted patients were identified using logistic regression models. Results:A total of 613 patients received cardiopulmonary resuscitation in the ED, resulting in an incidence rate of 9.3 per 10,000 visits with an annual incidence decreasing by 3.9% (95% CI: 0.7%─7.1%). Compared to OHCA events (n = 373), in-ED events (n = 240) had a lower and decreasing incidence rate (6.1 vs. 3.2 per 10,000 visits) and had higher rates of return of spontaneous circulation (19.3% vs. 47.1%), survived to hospital admission (17.2% vs. 37.5%), and survived to hospital discharge (1.9% vs. 7.9%). Among admitted patients, predictors of survival to hospital discharge included in-ED event, younger age, cardiac etiology, receiving defibrillation, and fewer epinephrine doses. Conclusions:Clinical outcomes following OHCA and in-ED cardiac arrests were poor in Jordan. Efforts should be directed toward improving the performance of community and healthcare practitioners with significant emphasis on prehospital emergency care.

Introduction: Many international search and rescue teams were deployed to the devastating earthquake of Southeastern Turkey and Northern Syria on February 6th, 2023, including the Jordan International Search and Rescue Team (JSAR). This study aims to explore the challenges faced by the JSAR team members during their deployment. Methods: We employed a qualitative face-to-face semi-structured interview approach. Eighteen respondents were interviewed using an interview guide. Interviews took between 25 and 60 minutes (mean 45 minutes). Data were transcribed verbatim and an inductive thematic approach was used to analyze data and develop codes, categories, and themes. Results: The challenges were categorized into three main themes; logistical, coordination, and environmental. Logistical challenges included delays in deployment due to government and flight arrangements, difficulties in transporting excess equipment, and a lack of fuel upon arrival that led to delays in setting up camp and heating. Coordination challenges involved disruption in operation schedule and difficulties working with local volunteer responders. Environmental challenges encompassed extreme cold temperatures, which affected personnel comfort and performance, and recurrent aftershocks, which complicated rescue operations and posed safety risks. Conclusion: The JSAR experience highlights that technical readiness alone is insufficient for effective disaster response. Findings from this study underscore significant gaps in logistics, coordination, and environmental adaptation. These gaps can be addressed through improved pre-deployment coordination, context-specific resource planning, and better collaboration mechanisms between host countries and international teams, which would be crucial for enhancing the effectiveness of international search and rescue operations. Host governments, International Search and Rescue Advisory Group (INSARAG) stakeholders, and emergency management bodies can build on these lessons to better integrate specialized teams, reduce procedural delays, and enhance global disaster response systems.

Introduction: Many international search and rescue teams were deployed to the devastating earthquake of Southeastern Turkey and Northern Syria on February 6th, 2023, including the Jordan International Search and Rescue Team (JSAR). This study aims to explore the challenges faced by the JSAR team members during their deployment. Methods: We employed a qualitative face-to-face semi-structured interview approach. Eighteen respondents were interviewed using an interview guide. Interviews took between 25 and 60 minutes (mean 45 minutes). Data were transcribed verbatim and an inductive thematic approach was used to analyze data and develop codes, categories, and themes. Results: The challenges were categorized into three main themes; logistical, coordination, and environmental. Logistical challenges included delays in deployment due to government and flight arrangements, difficulties in transporting excess equipment, and a lack of fuel upon arrival that led to delays in setting up camp and heating. Coordination challenges involved disruption in operation schedule and difficulties working with local volunteer responders. Environmental challenges encompassed extreme cold temperatures, which affected personnel comfort and performance, and recurrent aftershocks, which complicated rescue operations and posed safety risks. Conclusion: The JSAR experience highlights that technical readiness alone is insufficient for effective disaster response. Findings from this study underscore significant gaps in logistics, coordination, and environmental adaptation. These gaps can be addressed through improved pre-deployment coordination, context-specific resource planning, and better collaboration mechanisms between host countries and international teams, which would be crucial for enhancing the effectiveness of international search and rescue operations. Host governments, International Search and Rescue Advisory Group (INSARAG) stakeholders, and emergency management bodies can build on these lessons to better integrate specialized teams, reduce procedural delays, and enhance global disaster response systems.

BACKGROUND:Studies that have the attitudes of healthcare workers toward stuttering and people who stutter (PWS) in different parts of the world and in Jordan mainly focused on SLPs. However, no studies have examined Jordanian healthcare workers' attitudes in general. AIM:This study explored the attitudes of Jordanian healthcare workers toward stuttering and PWS using the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) and compared them to each other and to people on the POSHA-S database, people from the same culture (i.e., Middle Eastern) and Jordan. METHODS:241 healthcare workers in Jordan were invited to answer the Arabic version of the POSHA-S online. They were divided into six groups, i.e., doctors, pharmacists, speech-language pathologists (SLPs), occupational and physical therapists (OTs and PTs), nurses, and other health professionals. ANOVA and post hoc tests were utilized to analyze the data. RESULTS:The overall stuttering score for the whole sample of the study was relatively low compared to the POSHA-S database, but slightly positively higher than the scores of the general population from the same culture and Jordan. SLPs and OTs and PTs had the highest overall stuttering scores. Group mean differences were significant between SLPs and the other groups. CONCLUSIONS:Jordanian healthcare workers had low positive attitudes toward stuttering and PWS. SLPs' higher positive attitudes than the rest of the healthcare workers might reflect their training and knowledge gained through working with PWS. However, there is still a need to raise awareness and knowledge about stuttering among all healthcare workers in Jordan.

Background Several methods have been developed to increase the efficiency of triaging the victims of mass casualty incident (MCI). In teaching MCI that use mock patients, such as standardized patients (SPs), the live disaster drill is considered as primary teaching tool. However, this teaching method is expensive and requires a lot of resources. Virtual reality (VR) is a valuable evolving tool for teaching and testing mass casualty triage. Aim The aims of this study were to compare VR disaster drill with live disaster drill using SPs in terms of triage knowledge and performance for Jordanian paramedic students. Method A randomized controlled parallel design was used. The sample comprised 102 selected students of the Paramedic Diploma program at Amman’s Civil Defense College. A convenience sampling method was used to select participants and a simple random assignment was used to distribute participants into the study arms (VR vs. SPs). Triage knowledge was measured at baseline and two weeks after the intervention. Triage performance was measured during the disaster drills. Results Paired t-tests showed that there was a statistically significant increase in the triage knowledge between the pretest and post-test in VR and SP groups. The independent t-test revealed that there were no statistically significant differences in the mean knowledge and triage performance scores between the SP and VR groups. Conclusion VR-based training demonstrated noninferior outcomes compared to SP drills, supporting its utility as a complementary triage education tool when live simulations are logistically constrained.

OBJECTIVE:The aim of this study was to summarize the literature on the applications of machine learning (ML) and their performance in Emergency Medical Services (EMS). METHODS:Four relevant electronic databases were searched (from inception through January 2024) for all original studies that employed EMS-guided ML algorithms to enhance the clinical and operational performance of EMS. Two reviewers screened the retrieved studies and extracted relevant data from the included studies. The characteristics of included studies, employed ML algorithms, and their performance were quantitively described across primary domains and subdomains. RESULTS:This review included a total of 164 studies published from 2005 through 2024. Of those, 125 were clinical domain focused and 39 were operational. The characteristics of ML algorithms such as sample size, number and type of input features, and performance varied between and within domains and subdomains of applications. Clinical applications of ML algorithms involved triage or diagnosis classification (n = 62), treatment prediction (n = 12), or clinical outcome prediction (n = 50), mainly for out-of-hospital cardiac arrest/OHCA (n = 62), cardiovascular diseases/CVDs (n = 19), and trauma (n = 24). The performance of these ML algorithms varied, with a median area under the receiver operating characteristic curve (AUC) of 85.6%, accuracy of 88.1%, sensitivity of 86.05%, and specificity of 86.5%. Within the operational studies, the operational task of most ML algorithms was ambulance allocation (n = 21), followed by ambulance detection (n = 5), ambulance deployment (n = 5), route optimization (n = 5), and quality assurance (n = 3). The performance of all operational ML algorithms varied and had a median AUC of 96.1%, accuracy of 90.0%, sensitivity of 94.4%, and specificity of 87.7%. Generally, neural network and ensemble algorithms, to some degree, out-performed other ML algorithms. CONCLUSION:Triaging and managing different prehospital medical conditions and augmenting ambulance performance can be improved by ML algorithms. Future reports should focus on a specific clinical condition or operational task to improve the precision of the performance metrics of ML models.

Objectives Emergency medical services (EMSs) personnel are at high risk for developing work-related musculoskeletal disorders (WMSDs). However, no studies have yet investigated the prevalence and effect of these disorders on the Jordanian EMS personnel. Therefore, this study aimed to determine the prevalence of WMSDs among Jordanian EMS personnel and its associated factors.Design This study used a cross-sectional design. Participants were asked to complete a self-administrated and validated questionnaire to measure the WMSDs, including a demographic survey and the Nordic Musculoskeletal Questionnaire. Descriptive and multivariable regression analyses were used.Setting The Jordanian Civil Defence stations in the main cities of Jordan.Participants The sample consisted of 435 EMS workers which were obtained across the country of Jordan. A total of 79.0% of the participants were male, with a mean age of 27.9 (±4.3 SD) years.Results The pain in the lower back (308, 70.8%) and neck (252, 57.9%) were the most reported in the last 12 months. Furthermore, about half of the participants reported having pain in their upper back (234, 53.8%), knee (227, 52.2%) and shoulder (226, 52.0%) pain in the last 12 months. Overall, WMSDs in at least one body part were significantly associated with age, experience, being a male, increased body mass index and lower educational level.Conclusions There is a high prevalence of musculoskeletal complaints among EMS personnel. Multiple variables may be incorporated into a national prevention campaign and professional development programme to educate EMS personnel on avoiding WMSDs.

Introduction: Emergency medical service (EMS) providers use ambulance lights and sirens (L&S) to expedite their travel and to warn road users. This study aimed to assess the attitude and behavior of road users in response to EMS ambulances with warning L&S in use. Methods: This was a cross-sectional survey distributed to road users in Northern Jordan. The questionnaire included 19 items addressing demographics, attitudes, and behavior toward emergency ambulances. We described the participants’ responses and assessed the association between demographics and attitude statements using logistic regression. Results: A total of 1302 questionnaires were available for analysis. The mean age of participants was 34.2 (SD± 11.4) years, and the majority were males (72.6%). About half of road users (47.9%) would perform inappropriate actions in response to EMS ambulances with L&S in use. The multivariate logistic regression model showed that being female (OR: 0.63; 95% CI = 0.48-0.81), more educated (OR: 0.68; 95% CI = 0.53-0.86), or public transport driver (OR: 0.55; 95% CI = 0.34-0.90) was significantly associated with inappropriate response to EMS ambulances. Additionally, a significant proportion of road users may perform inappropriate and lawless driving practices such as following the passing by EMS ambulances. Conclusions: A large proportion of road users in Jordan may respond inappropriately to the EMS ambulances and many engage in risky driving behaviors, perhaps due to the lack of procedural knowledge. Policy-related interventions and educational programs are crucially needed to increase public awareness of the traffic law concerning EMS ambulances and to enhance appropriate driving behavior.

Objectives: The prehospital emergency triage rapid algorithm (PETRA) method was designed to overcome the deficiencies of the earlier described simple triage and rapid treatment (START) method. This study has compared the START and PETRA triage methods regarding the appropriateness of triaging victims following a simulated mass casualty incident in terms of accuracy and time efficiency. The two triage systems were compared. Methods: This was a prospective study using a convenience sample of randomly distributed paramedic students between September 2022 and December 2022 at the Civil Defense College in Amman. Sample 102 students of the paramedic diploma program at the College. Total time of prehospital triage, accuracy of prehospital triage, level of under triage, and level of over triage were measured for both study groups. Results: Independent t-test revealed that there was no significant difference between the PETRA and START methods in terms of the prehospital triage accuracy, time spent in prehospital triage, and level of over triage. However, the level of under triage in the PETRA group was lower compared to the START group. Conclusion: The study proposes that the paramedic should adopt the PETRA method as an improved alternative to the START method during a massive causality incident. In the same way, this research encourages the incorporation of the PETRA method in the curricula of paramedics and nurses. More research is required to support the existing findings.

ObjectivesThis study aimed to assess the cardiopulmonary resuscitation (CPR) knowledge and willingness of schoolteachers in Jordan.DesignThis was a cross-sectional study conducted using an online questionnaire.SettingFor inclusion in this study, schoolteachers must be currently teaching at any level in schools across the country. Responses were collected from 1 April 2021 to 30 April 2021.ParticipantsAll schoolteachers actively working in public or private schools were included in our study.Primary and secondary outcome measuresContinuous variables were summarised as means and SD, whereas categorical variables were reported as frequencies and percentages (%). A χ2test for independence, independent sample t-tests and analysis of variance were used appropriately. A p-value less than 0.05 was used to determine statistical significance.ResultsA total of 385 questionnaires were eligible for analyses. Only 14.5% of the participants received CPR training and overall correct knowledge answers were 18.8% of the total score. Those participants with previous CPR training had higher mean knowledge scores (2.34 vs 1.15, p<0.001). Trained participants were also more likely to provide hands-only CPR to various patient groups than untrained participants (p<0.05). Participants were more willing to provide standard CPR to family members than hands-only CPR (p<0.001), but more willing to provide hands-only CPR to friends (p<0.001), students (75.1% vs 58.2%, p<0.001), neighbour (p<0.001), stranger (p=0.001) and patient from the opposite gender (p<0.001).ConclusionsSchoolteachers in Jordan possess limited knowledge of CPR. However, the study participants showed a positive attitude towards performing CPR. The study revealed that they were more inclined to provide hands-only CPR than standard CPR. Policymakers and public health officials can take advantage of these findings to incorporate CPR training programmes for schoolteachers, either as a part of their undergraduate studies or as continuing education programmes with an emphasis on hands-only CPR.

Introduction: This study aimed to assess perceptions of duty to work among health care providers during the coronavirus disease 2019 response and to identify factors that may in fl uence their perceptions. Methods: This was a cross-sectional study conducted from April 1, 2020, to April 20, 2020, using an online survey distrib-uted to health care providers in Jordan. Descriptive statistics were used, as well as chi-square test for independence to assess relationships between variables. Results: A total of 302 questionnaires were included. Commitment to serve the community was the primary reason for coming to work (36%), followed by commitment to faith (29.6%). The major perceived barriers for coming to work were lack of appropriate personal protective equipment and appropriate training (62.6% and 53.5%, respectively). Males perceived higher work obliga-tions than females in all potential barriers ( P < .05), except for the lack of appropriate training. Nurses perceived higher work ob-ligations than other health care providers despite the lack of appropriate training ( x 2 ¼ 11.83, P ¼ .005), lack of effective vaccine or treatment ( x 2 ¼ 21.76, P < .001), or reported infection among coworkers ( x 2 ¼ 10.18, P ¼ .03). Discussion: While the majority of health care providers perceive an obligation to work during the coronavirus disease 2019 pandemic, speci fi c conditions, mainly lack of protective gear and training, may signi fi cantly alter their perception of work obligation. Providing training and proper personal protective equipment are among the vital measures that could improve the work environment and work obligation during pandemic conditions.

Objectives This study aimed to explore the lived experience of Jordanian front-line healthcare workers (FHCWs), including their experienced challenges and adaptations amid the COVID-19 pandemic. Design A phenomenological qualitative design was used to highlight the experiences of a sample Jordanian FHCWs during the COVID-19 pandemic. Qualitative interviews were conducted using a semistructured guide with open-ended questions, audiotaped and then transcribed verbatim. Thematic analysis of the transcribed narratives was conducted using an open coding line by line to develop themes and related subthemes. Setting Mobile COVID-19 testing and contact tracing units during an active surge of cases in Jordan between May and September 2020. Participants Participants were recruited using purposive sampling method and consisted of 15 FHCWs (2 physicians, 10 nurses, 2 paramedics and 1 laboratory technician) who have worked in testing and contact tracing teams in the community and have dealt with suspected or confirmed cases of COVID-19 infection. Results Participant narratives were classified into two main overarching themes; challenges and adaptation themes. The challenges theme was exhibited as follows: (1) an excruciating encounter with an invisible enemy, (2) distorted knowledge about COVID-19 and (3) organisational and administrative challenges. The adaptation theme was exhibited as follows: (1) seeking relevant knowledge about the disease and (2) seeking more connectedness. Conclusions The COVID-19 pandemic exerted many challenges for FHCWs at multiple levels; intrapersonal and interpersonal, organisational and societal levels. Nevertheless, a number of adaptation strategies within these levels have been reported. This study helps to provide the base on which healthcare officials and public health personnel can formulate preparedness plans that tackle challenges faced by front-line workers, which ultimately enhance the resilience of healthcare systems to withstand future pandemics.

INTRODUCTION:Ambulance lights and sirens use has traditionally been an important strategy to shorten ambulance travel times. This study explored road users' perceptions toward the importance and risks of lights and sirens use by ambulances in Jordan. METHODS:A cross-sectional survey was used on a sample of 1700 adult road users in Northern Jordan. The questionnaire included 19 items addressing demographics, driving-related characteristics, and perception statements toward lights and sirens use. Continuous variables were summarized as means and standard deviation and categorical variables were reported as frequencies and percentages. Chi-square test was used to assess differences between categorical variable. RESULTS:A total of 1634 participants completed the questionnaire. The mean age was 32.4 (SD ± 11.4) years, and 65.4% were males. Most participants agreed on the importance of using lights and sirens for emergency medical services to function effectively (96.5%), and penalizing those who do not yield to emergency ambulances (90.2%). However, around half of the participants perceive that lights and sirens could be over-used by ambulance personnel (48.1%), provoke distraction (48.7%) and create stress (50.3%) for road users. These negative perceptions were reported more often among males, taxi/bus drivers, and novice drivers. CONCLUSIONS:Although the majority of road users, in our region, acknowledge the importance of ambulance lights and sirens use, about half of them perceive that ambulance lights and sirens put them under stress, distraction, and unacceptable risk. Policy-related and educational interventions might be necessary to monitor the use of ambulance lights and sirens and reduce negative road users' perceptions.

Introduction: This study aimed to assess perceptions of duty to work among health care providers during the coronavirus disease 2019 response and to identify factors that may influence their perceptions. Methods: This was a cross-sectional study conducted from April 1, 2020, to April 20, 2020, using an online survey distributed to health care providers in Jordan. Descriptive statistics were used, as well as chi-square test for independence to assess relationships between variables. Results: A total of 302 questionnaires were included. Commitment to serve the community was the primary reason for coming to work (36%), followed by commitment to faith (29.6%). The major perceived barriers for coming to work were lack of appropriate personal protective equipment and appropriate training (62.6% and 53.5%, respectively). Males perceived higher work obligations than females in all potential barriers (P < .05), except for the lack of appropriate training. Nurses perceived higher work obligations than other health care providers despite the lack of appropriate training (chi(2) = 11.83, P= .005), lack of effective vaccine or treatment (chi(2) = 21.76, P < .001), or reported infection among coworkers (chi(2) = 10.18, P= .03). Discussion: While the majority of health care providers perceive an obligation to work during the coronavirus disease 2019 pandemic, specific conditions, mainly lack of protective gear and training, may significantly alter their perception of work obligation. Providing training and proper personal protective equipment are among the vital measures that could improve the work environment and work obligation during pandemic conditions.

ObjectiveThis study aimed to explore the prevalence and factors associated with depression, anxiety and insomnia among frontline healthcare workers (HCWs) in Jordan.MethodsA cross-sectional design was conducted among 122 frontline HCWs who have dealt with suspected or confirmed cases of COVID-19. The study survey included standardised questionnaires of the 7-item Generalized Anxiety Disorder (GAD-7) Scale, 9-item Patient Health Questionnaire (PHQ-9) and the Insomnia Severity Index (ISI). Data were collected online during the active surge period of cases from 11 May 2020 to 13 June 2020. The statistical analysis included descriptive statistics, analysis of variance, bivariate correlation and multivariate linear regression analyses.ResultsA total of 122 HCWs participated in the study (response rate=64.2%). Among the participants, 44.3% were physicians, 32.8% were nurses and 17.2% were paramedics. The mean age of participants was 32.1 (±5.8) years, and the majority were males (80.3%). The mean scores for GAD-7, PHQ-9 and ISI were 8.5 (±5.2), 9.5 (±5.7) and 11.2 (±6.4), respectively. Results showed that the participants reported severe symptoms of anxiety (29.5%), depression (34.5%) and insomnia (31.9%), with no observed differences based on gender, job title, marital status or educational level. Moreover, in the multivariate linear regression, none of the independent factors were associated with GAD-7, PHQ-9 or ISI scores, and the only exception was increased severity of insomnia among paramedics.ConclusionThe COVID-19 pandemic has exerted strenuous emotional, psychological and physical pressures on the health of frontline HCWs.

1Department of Allied Medical Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan; 2Department of Paramedicine, Monash University, Melbourne, Victoria, Australia; 3Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan Aim: To investigate the structural validity and internal consistency of a cardiopulmonary resuscitation attitudes questionnaire among Allied Health Professions (AHP) university students. Methods: Structural validity of a 17-item questionnaire was tested using principal component analysis. A group of AHP university students completed the questionnaire. Internal consistency of the questionnaire was measured by Cronbach’s α. Results: A total of 856 AHP students completed the questionnaire (mean age= 20.8 (±1.1) years, 74.0% were females). The analysis reduced a 17-item questionnaire to an 11-item questionnaire. The final questionnaire had three distinct factors; (1) attitudes towards mouthto-mouth ventilation (MMV), (2) attitudes towards chest compressions (CC), and (3) the importance of cardiopulmonary resuscitation (CPR). It had factor loadings ranging from 0.629 to 0.878 and could explain 66% of the variance in the attitude. The questionnaire had acceptable internal consistency (Cronbach α=0.83; 95% CI=81.5) and was feasible with no floor or ceiling effect. Conclusion: The 11-item CPR attitude questionnaire had acceptable structural validity and internal consistency and good parsimony and unidimensionality. The questionnaire can be used to measure the university students’ attitude and assess the effectiveness of CPR training activities. Future studies are required to measure the responsiveness and applicability to other cohorts.