Introduction: Organizational Silence (OS) is one of the major challenges in the workplace, including healthcare systems, which affects quality of services. Determining the association of factors such as moral literacy and Organizational Ethical Climate (OEC) with OS is of particular importance. Objective: This study aimed to determine the relationship between moral literacy, OEC, and OS among nurses working in the Emergency Departments (EDs) of medical/teaching hospitals in Rasht, northern Iran. Materials and methods: This analytical cross-sectional study was conducted on 215 ED nurses who were selected by a census sampling method. Data collection tools included a four-part questionnaire, including a demographic/occupational form, Organizational Silence Scale (OSS), Moral Literacy Questionnaire (MLQ), and Ethical Climate Questionnaire (ECQ). Data were analyzed using independent t-test, Pearson’s correlation test and multiple linear regression. Results: Among participants, 74% were female, and the mean age of participants was 33.51 ± 8.16 years. The mean OSS score was 30.14 ± 9.54. OS was significantly predicted by employment status (b = 3.30, 95%CI; 0.29-6.32, P = 0.032), job position (b = -9.58, 95%CI; -15.03 to -4.13, P = 0.001), and intention to immigrate (b = 5.12, 95%CI; 2.10-8.13, P = 0.001). Moral literacy and OEC did not significantly predict OS; however, their inclusion in the regression model increased the explained variance by 0.9% (ΔR² = 0.009). Conclusion: The OS among Iranian ED nurses is at a moderate level and is influenced by occupational factors. Moral literacy and OEC among nurses are not significantly associated with their OS. These findings highlight the need to consider additional organizational and contextual factors when addressing OS among ED nurses, while maintaining focus on moral literacy and OEC as key elements of ethical practice.
Introduction: Proper interpersonal communication between midwives and women facilitates a positive pregnancy and birth experience. In Ondo State, Nigeria, studies have reported an association between midwives’ poor communication skills and women’s dissatisfaction with care and their consequent choice not to attend public maternity care centers. Objective: This study aimed to explore the experiences of the women in Ondo State, Nigeria, of midwives’ interpersonal communication skills and the influence thereof on women’s utilization of reproductive maternal, newborn, child, and adolescent health (RMNCAH) care services. Materials and Methods: This qualitative study with an exploratory, contextual design was conducted in 2019. Ten focus group discussions were conducted with 59 women, aged 20-49, in purposively selected health facilities across six local government areas in Ondo State, Nigeria. Thematic data analysis was conducted based on the six phases outlined by Braun and Clarke. Results: All participants were married, and the majority had 3-5 children and a secondary school education. Four themes were generated: midwives’ effective interpersonal communication, midwives’ ineffective interpersonal communication, the impact of midwives’ interpersonal communication on receiving the care, and challenges to midwives’ effective interpersonal communication with women. Women who had experienced poor communication and were dissatisfied with their care were more likely to choose alternative options, such as asking for the help of traditional birth attendants or visiting faith-based facilities, which can increase the risks for poor maternity outcomes. Conclusion: Midwives’ empathic and respectful communication can improve women’s maternity care experiences. Enhancing midwives’ communication skills is crucial for better RMNCAH care service provision and reproductive health outcomes, particularly in lowincome countries.
Background: Sleep, as one of the vital needs, plays an important role in physical, emotional, behavioral, and cognitive development. Sleep habits, which are formed during school age under the influence of family and cultural factors, can affect the quality and pattern of sleep. Objective: This study aimed to determine the effect of a Sleep Education Program (SEP) presented with blended and face-to-face methods on the sleep habits of school-age children. Materials and Methods: This is a randomized clinical trial that was conducted in 2024 on 62 male and female children who selected from primary schools using cluster and stratified sampling methods and were randomly divided into blended and face-to-face methods. The blended learning group underwent four sessions of blended learning using a mobile app while the face-to-face learning group underwent one session of learning using PowerPoint. The data collection tools included a sociodemographic form and the Children’s Sleep Habits Questionnaire (CSHQ). Data analysis was performed using descriptive statistics (standard deviation, mean, percentage) frequency), Analysis Of Covariance (ANCOVA), change score analysis, independent t-test, and paired t-test. Results: The mean age of the children was 9.73±1.80 years. The majority were boys (58.1%) and were studying in grades 4 to 6 (64.5%). The mean total CSHQ score in the post-test phase decreased by 8.32 and 1.77 units in the blended and face-to-face groups, respectively. Although sleep habits improved in both groups, the improvement in total score was significantly greater in the blended learning group (by 6.55 units) than in the face-to-face learning group (P=0.001), indicating greater effectiveness of the blended learning method. Conclusion: The effectiveness of the SEP presented with blended method on improving sleep habits of school-age children is greater than that presented with face-to-face method due to its flexibility, integrated structure, and high interaction.
Introduction: Preterm Birth (PTB) is a major contributor to neonatal morbidity and mortality worldwide. Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder that is associated with systemic inflammation, immune dysregulation, and stress-related pathways. These mechanisms may overlap with those implicated in PTB. Objective: This study aimed to compare the prevalence of IBS in women with PTB versus those with term birth. Materials and Methods: This case–control study was conducted during 2022-2023 at a teaching hospital affiliated with Hormozgan University of Medical Sciences in Bandar Abbas, Iran. Participants were 993 married women with IBS, selected via convenience sampling and divided into two groups: Cases with PTB (n=503) and controls with term birth (n=490). They completed a socio-demographic/obstetric checklist, the ROME III diagnostic questionnaire, and the Bristol form scale. Comparison of the groups was performed by Chi-square test, Mann-Whitney U test, t-test and logistic regression. P≤0.05 was considered statistically significant. Results: There was no significant difference between the two groups in age, education, occupation, body mass index, gravida, or parity. The prevalence of IBS was significantly higher in the case group (36.4%; n = 183) than in the control group (29.9%; n = 147) . In terms of IBS types, the majority had mixed IBS(81.97% in case group and 80.27% in control group ), while the least common was diarrhea-predominant IBS. The prevalence of IBS types did not show significant differences between the two groups . Logistic regression model demonstrated that the presence of IBS significantly increased the risk of PTB (OR=1.33, 95% CI; 1.20-1.74, P=0.028). Conclusion: The presence of IBS symptoms may predict PT in married women
Introduction: Effective human resource allocation, particularly in nursing management, is essential for organizational success. Succession planning serves as a strategic tool to enhance performance and optimize talent utilization. Objective: This study aimed to develop a succession planning model for nursing managers in Iran. Materials and Methods: This is a mixed-method study with an exploratory sequential design. In the qualitative phase, data were collected through discussions with 20 experts in nursing management and human resource planning and using the Delphi technique, followed by content analysis to extract the core themes of succession planning. Based on the themes identified in the qualitative phase, a researcher-developed questionnaire was designed and used in the quantitative phase. The study population in this phase included 200 nursing managers and supervisors (64% female) from teaching hospitals in Razavi Khorasan Province. Content validity of the questionnaire was evaluated by 10 experts, construct validity was assessed using Confirmatory Factor Analysis (CFA), and reliability was assessed using Cronbach’s α. Quantitative data were analyzed using descriptive statistics and Structural Equation Modeling (SEM). Results: Of 200 participants, 64% were female and the majority had a Bachelor’s degree in nursing (62%) and had more than 9 years of work experience (37%). In the Delphi phase, 10 experts in nursing management and healthcare leadership participated, including head nurses, nursing supervisors, and academic experts. The qualitative findings identified five main dimensions: managerial, organizational, individual, process, and policy. CFA results confirmed the construct validity of the proposed model, and all dimensions demonstrated acceptable reliability. SEM results confirmed the significance of all five dimensions. The managerial dimension had the strongest effect (β=0.913, P=0.001), followed by individual (β=0.884, P=0.001), organizational (β=0.823, P=0.001), policy (β=0.777, P=0.001), and process (β=0.686, P=0.001) dimensions. Conclusion: The succession planning model, designed based on the identification and prioritization of factors influencing program success, provides a systematic and evidence-based framework for developing nursing leadership in the Iranian hospitals. Given the managerial dimension’s highest impact on the success of succession planning programs, there is a need to develop leadership and strategic management skills among nursing managers.
Introduction: Non-adherence to treatment is one of the main problems in depressed patients, leading to serious consequences. The use of new technologies can facilitate family-oriented education to achieve this goal. Objective: This study aimed to determine the effect of distance family-oriented education and follow-up using social networks through the WhatsApp application on treatment adherence of depressed patients. Methods: This semi-experimental study was conducted in the psychiatric clinic of Razi hospital in Urmia from November 2021 to July 2022. Eighty patients were selected using convenience sampling and randomly divided into intervention and control groups. Patients in the intervention group received virtual family-oriented education through the WhatsApp application. Patients in the control group received only non-education files in the virtual group. The tools used were a demographic questionnaire and the Modanloo Adherence to Treatment Questionnaire. The data was analyzed in SPSS software ver. 22.0. Results: The total mean score of adherence to treatment and sub-scales had no significant difference before the intervention (P=0.499). There was a significant difference in mean scores of treatment adherence immediately (P=0.001), one month (P=0.001), and three months after the education (P=0.002) between the two intervention and control groups. Conclusion: Using a family-oriented education through distance education using social networks such as WhatsApp applications positively affects treatment adherence in depressed patients. Nursing managers are suggested to move towards tele-nursing through social networks in chronic diseases. It is also suggested to health policymakers to help speed up this process by creating a suitable platform.
Introduction: The clinical competence of nurses working in Intensive care units (ICUs) has a direct impact on patient safety. Objective: This study aimed to determine the clinical competency of nurses in intensive care units of teaching hospitals in the north of Iran, and find its associated factors. Materials and Methods: This is a descriptive-analytical study with a cross-sectional design that was conducted on 188 ICU nurses from teaching hospitals in Guilan, north of Iran, who were selected using a census sampling method in 2020. The instrument was the Intensive and critical care nursing competence scale (ICCN-CS-1), comprising four domains: knowledge base, skill base, attitude/value base, and experience base. The data was analyzed using descriptive statistics, Spearman’s correlation test, Mann-Whitney U test, Kruskal-Wallis test, and logistic regression. Results: The mean age of nurses was 31.54±5.2 years. Most of them were ≥30 years old (55.85%), female (81.91%), with a bachelor’s degree (97.34%). The total ICCN-CS-1 score was 647.27±50.43. The highest and lowest mean scores were related to attitude/value (164.06±17.12) and knowledge base (160.73±13.56) dimensions, respectively. The total ICCN-CS-1 score was significantly different based on age (P=0.038) and sex (P=0.015). The adjusted multiple logistic regression model showed that formal employment was the only significant predictor of clinical competency (OR=2.382, 95% CI; 1.174%, 4.833%, P=0.016). Conclusion: The clinical competence of ICU nurses at teaching hospitals in Guilan is high in the attitude & value domain but low in the knowledge domain. Attention and planning to improve their knowledge is recommended.
Introduction: The transition to motherhood during adolescence has been associated with many difficult conditions compared to the transition for adult women. However, there is limited research on the health-promoting behaviors of Thai postpartum Adolescent mothers. Objective: This study aimed to study the ability of the constructs of Pender’s Health Promotion Model (HPM) in predicting the health-promoting behaviors among Thai postpartum adolescent mothers. Materials and Methods: This cross-sectional study was conducted from January to May 2022. Participants were 120 Thai postpartum adolescent mothers who were selected using a purposive sampling method from all adolescent mothers who visited a clinic for postnatal follow-up during the 6-week postpartum period at four hospitals in northern Thailand. Data were collected using a sociodemographic questionnaire, the perceived benefits and barriers scales, the interpersonal and situational influences scales, the perceived self-efficacy scale, and the health-promoting behaviors scale. Data were analyzed using Pearson’s correlation test and hierarchical regression analysis. Results: The mean age of the participants was 17.2 ± 1.50, ranged from 13 to 19. Most of them were married (76.7%), living with their extended family (85.8%), and graduated from junior high school or high school (70%). The results of regression analysis indicated that perceived benefits (β=0.38, 95%CI; 0.24-0.46, P=0.01) and perceived self-efficacy (β=0.58, 95%CI; 0.39-0.70, P=0.01) were positive significant predictors of health-promoting behaviors, while perceived barriers (β= -0.20, 95%CI; -0.15 to -0.05, P=0.01) and situational influences (β= -0.22, 95%CI; - 0.36 to -0.09, P=0.01) were negative significant predictors of health-promoting behaviors. These four variables together explained 76% of the variance in health-promoting behaviors of adolescent mothers. Conclusion: The findings highlight the significant effects of perceived benefits, perceived barriers, situational influence, and perceived self-efficacy on the health-promoting behaviors of adolescent mothers during the postpartum period. Comprehensive early postpartum programs for health promotion should be integrated into existing postpartum services to promote maternal and infant well-being.
Introduction: Falls are one of the most common causes of injury in the elderly. The overall prevalence of falls among the elderly population in Iran is unclear. Objective: This study aims to review the prevalence of falls in Iranian older adults. Materials and Methods: This is a systematic review and meta-analysis of the related crosssectional studies in Iran published from March 2001 to July 2022, searched in the Barakat Knowledge Network System, MagIran, SID, Medline (PubMed), ScienceDirect, Scopus, and Google Scholar. The review, case, cohort, and interventional studies were not included. The heterogeneity of the studies was investigated using the I2 test. A random-effect model was applied to combine the study results. Publication bias was assessed using Egger’s rank test and Begg and Mazumdar’s rank correlation test. To investigate factors affecting heterogeneity in meta-analysis, meta-regression analysis was used. Results: In 17 articles reviewed, the total number of participants was 43728, aged 60-85 years. The overall prevalence of falls was 38.3% (95% CI: 30.1%, 47.2%). Meta-regression was applied for the two factors of sample size and the year of study. Based on the results, it was predicted that an increase in the sample size and year of study would cause a decrease in the prevalence of falls among Iranian older adults (P=0.001). Conclusion: Given the high prevalence of falls in Iranian older adults, it is necessary for the health policy makers in Iran to take effective measures and policies to control and reduce the occurrence of this event. They should pay more attention to nursing care, education, and community-based interventions for the elderly to increase their quality of life (QoL).
Introduction: COVID-19 mainly affects the respiratory system, often leading to hypoxia and acute respiratory failure. In the absence of definitive treatments, respiratory physiotherapy has been widely applied as a supportive measure. Objective: This study aimed to compare the effects of incentive spirometry (IS) and diaphragmatic breathing (DB) on arterial oxygen saturation (SpO2 ) in hospitalized COVID-19 patients. Materials and Methods: This is an open-label randomized clinical trial with a pre-test/post-test design. Eighty COVID-19 patients hospitalized at one of teaching hospitals in Tehran, Iran, were selected using a convenience sampling method and randomly assigned to DB (n=40) and IS (n=40) groups. Each intervention consisted of three sets of 10 breaths per minute, with a 30‑second rest interval. The SpO₂ levels and vital signs were measured at baseline, immediately after, and 5 and 10 minutes after the interventions. Data were analyzed using independent t‑test, ANOVA, chi‑square test, and post‑hoc test. Results: Most of participants were male (60%) with lower than high school education (41.2%). The mean age of patients was 54.87±16.713 years in the IS group and 54.25±13.23 years in the DB group. There was no statistically significant difference between the SpO₂ levels over time in any groups; both groups showed a non-significant increase in SpO₂ immediately after and 10 minutes after the intervention. No significant change was observed 5 minutes after intervention. There was no significant differences between the two groups at any time points. However, the IS led to a smaller decline and greater overall improvement in SpO₂. Conclusion: Respiratory physiotherapy techniques, particularly the IS, can enhance oxygen saturation of COVID-19 patients within a short period but these changes were not significant. These techniques offer clinical value for both patients and healthcare providers by facilitating the management of acute respiratory responses and reducing disease-related burdens through non-invasive strategies.
Background: Given the impact of mode of delivery on maternal and neonatal health and the rising Cesarean Section (CS) rate, identifying factors associated with mode of delivery is of considerable importance. Objective: This study aimed to investigate the relationship between maternal health-promoting lifestyle and mode of delivery among postpartum women in Iran. Methods: This cross-sectional study was conducted in 2023 among 322 postpartum women admitted to a specialized teaching hospital for women in Rasht, north of Iran. They were recruited using a convenience sampling method. They had an age of <40 years with a singleton pregnancy, no apparent fetal congenital anomalies, no history of pregnancy-related complications (e.g., asthma, psychosis, preeclampsia, and gestational diabetes), and no use of assisted reproductive technologies in the current pregnancy. Data were collected using a sociodemographic/obstetric questionnaire and the Maternal Health-Promoting Lifestyle Profile (MHPLP). Data were analyzed using descriptive statistics, Mann–Whitney U test, Chi-square test, Kruskal–Wallis test, and multiple logistic regression analysis. Results: Most participants were aged 21–30 years, were housewives (86.3%), from urban areas (67.7%), and had a family income below the adequate level (83.5%). The mean age at first pregnancy was 21.76±4.35 years, the mean gestational age at delivery was 37.42±2.42 weeks, the mean gestational weight gain was 12.8±3.79 kg. The mean overall MHPLP score was 199.02±12.24 in women with CS and 182.51±19.68 in those with vaginal delivery. Significant differences were observed between the two groups across all MHPLP domains, including nutrition, physical activity/rest, self-care, interpersonal relations, and stress management (P = 0.001). Multiple logistic regression analysis demonstrated that, among the five MHPLP domains, only nutrition and self-care were significant predictors of Vaginal Delivery (VD). Each one-unit increase in nutrition and self-care scores was associated with 1.177( 95% CI; 1.1-1.25,p=0.001 )fold and 1.091-fold (95% CI; 1.27-1.160,p=0.005 )higher odds of VD, respectively. Conclusion: The findings of this study underscore the importance of developing targeted educational and counseling interventions to promote health-promoting lifestyle behaviors during pregnancy, to improving maternal health outcomes and potentially reducing unnecessary CS.
Introduction: Sexual myths in medical students as future healthcare professionals are important. These beliefs have a potential negative impact on clinical practice. There is a lack of studies in Iran regarding the sexual myths of medical students. Objective: This study aimed to investigate sexual myths and associated factors among female students of Kashan University of Medical Sciences (KAUMS). Materials and Methods: This cross-sectional study included 400 female students at KAUMS in 2023, selected via stratified random sampling. Data collection tools included a sociodemographic form and the Sexual Myths Scale (SMS). Data analysis was carried out by one-way analysis of variance (ANOVA), independent t-tests, and multiple linear regression, considering a significance level set at 0.05 Results: The mean total SMS score was 68.29±16.05. Friends and the internet were identified as the primary sources of sexual information. Based on the linear regression model, age (b=0.652, 95% CI, 0.122%, 1.181%, P=0.016), 214-321 USD monthly income (b=-5.424, 95% CI; -9.055%, -1.793%, P=0.004) and >321 USD monthly income (b= -6.631, 95% CI; -12.061%, -0.202%, P=0.017), living in parents’ home (b=5.168, 95% CI; 1.575%, 8.760%, P=0.005), and being married (b=-8.533, 95% CI; -13.875%, -3.191%, P=0.002) were among the factors predicting the sexual myths. These independent variables explained 13.9% of the changes in the total SMS score. Conclusion: The sexual myths of KAUMS female students are at a moderate level. Older and married students, those living with their parents, and those with a lower family income level showed higher sexual myths.
Introduction: Sexuality education is one of important rights of children. Mothers, as the first caregivers of children, often do not have the necessary knowledge and competence to provide sexuality education to their children. Objective: The present study aimed to determine the effect of an educational program based on the Health Belief Model (HBM) on mothers' performance in providing sexuality education to their children. Materials and Methods: This quasi-experimental study was conducted on 72 mothers referring to four comprehensive health centers in Isfahan, Iran, in 2020. They were selected by a convenience method and randomly divided into two groups of intervention (n=36) and control (n=36). In the intervention group, four training sessions were held regarding child sexual education based on the HBM. Individual characteristics and constructs of the HBM were measured by a researcher-made questionnaire before, immediately after, and 6 weeks after the intervention. The data were analyzed using independent t-test, chi-square test, Mann-Whitney U test, repeated measures analysis of variance, Bonferroni’s post-hoc test, and Wilcoxon signed-rank test. Results: Most of mothers in the intervention (63.9%) and control (72.2%) groups had a university education. In both groups, the number of children were equally 18 girls and 18 boys. In the intervention group, the mean scores of perceived threats, perceived benefits, perceived barriers and self-efficacy before intervention were ;1.61±7.64 , 19.89±0.67, 7.92±2.8 and 19.97±0.17, immediately after intervention were; 19.92±0.50 ,19.94±0.23 ,15.42±1.18, 19.92±0.28 and 6 weeks after the intervention were; 16.11±1.53 , 15.33±1.24, 4.25±0.60 and 19.83±0.38, respectively. There was statistically significant difference in two groups in perceived threats (p= 0.001), benefits (p= 0.001), barriers (p= 0.043), and self-efficacy (p= 0.001), immediately and 6 weeks post-intervention (p= 0.001). Also, after the educational intervention, a significant difference was observed in all HBM constructs between the two groups (p= 0.001) except for the perceived barriers . Conclusion: The results highlighted the effectiveness of the HBM-based education program in promoting mothers’ performance in providing sexuality education to their children. The findings can be beneficial for teachers and health counselors who are involved in designing educational and counseling programs related to children's mental health.
Introduction: Moral Distress (MD) is one of the common problems of nurses, which can have negative effects on their mental health and patient care. Measuring the level of MD based on psychological capital (PsyCap) may help predict MD in nurses and develop appropriate interventions to reduce this problem. Objective: This study aimed to determine the relationship between PsyCap and MD among nurses working in medical-teaching hospitals in Rasht, north of Iran. Materials and Methods: This cross-sectional study was conducted on 347 nurses working in 8 hospitals affiliated to Guilan University of Medical Sciences in Rasht city in 2024. The nurses were selected through stratified random sampling. Data collection tools included a sociodemographic form, the Moral Distress Scale - Revised (MDS-R), and the Psychological Capital Questionnaire (PCQ). Data were analyzed using descriptive and inferential statistics (Mann-Whitney U test, Kruskal–Wallis test, Spearman’s correlation test, and multiple linear regression). Results: The mean age of the nurses was 35.01±7.73 years. The majority were female (80.7%) and had 10-20 years of work experience (34.3%). The total MDS-R and PCQ scores were 79.73±42.43 and 101.8±13.94, respectively. A significant negative relationship was observed between MD and PsyCap (r= -0.353, P=0.001). The factors including gender (B= 10.189, 95% CI; -0.028-20.405, P=0.051), work experience of 5-10 years (B= 25.726, 95% CI; 12.573-38.879, P=0.001),) and PsyCap (B= -0.744, 95% CI; -1.042 to -0.446, P=0.001) together explained 27.3% of the variance in MD (R2 = 0.273, P=0.001). Conclusion: PsyCap is an important predictor of MD in nurses. Therefore, it is necessary to pay more attention to the PsyCap of nurses in formulating appropriate intervention and training programs for nurses, to increase their mental health and prepare them to deal with work problems, pressure, and stress, and finally prevent the occurrence of MD.
Introduction: Spiritual well-being influences overall health and encourages healthy behaviors, especially in medical students. Objective: This study aimed to investigate the relationship between spiritual well-being and health-promoting behaviors among medical students in Qom, Iran. Materials and Methods: This cross-sectional study was conducted from December 2023 to July 2024 on 220 medical students from Qom University of Medical Sciences, Qom, Iran. Participants were selected using a stratified random sampling method. Data were collected using Spiritual Well-being Scale (SWS) and the Health-Promoting Lifestyle Profile II (HPLP II). Descriptive and inferential statistics, including Pearson’s correlation test and linear regression analysis, were performed to assess the relationship between spiritual well-being and health-promoting behaviors. Results: The mean age of the participants was 22.5±2.1 years, and 60% were female. The majority of students reported moderate levels of spiritual well-being (73.1%) and health-promoting behaviors (74.8%). Among the subscales of HPLP II, interpersonal relationships had the highest score, while stress management had the lowest score. Regression analysis revealed that existential well-being (β = 0.383, 95% CI; 0.458-1.308, p =0.001) was the most significant predictor of health-promoting behaviors. Age (β = 0.196, 95% CI; 0.083-3.313, p = 0.021) and female gender (β = 0.317, 95% CI; 5.014-18.812, p = 0.003) were other significant predictors of health-promoting behaviors. Conclusion: Spiritual well-being, particularly its existential well-being domain, is positively associated with health-promoting behaviors in Iranian medical students. These results underscore the importance of promoting spiritual well-being in healthcare education for enhancing medical students' healthy lifestyle and, subsequently, quality of life
Introduction: Behavioral disorders in childhood are very important because early life experiences lay the foundation for people's health in adulthood. In addition, behavioral disorders greatly affect the educational and social performance of children. Objective: This study aimed to investigate the prevalence of toxic socialization and behavioral disorders among primary school children in Rasht, north of Iran, and determine their association. Materials and Methods: This is an analytical study with a cross-sectional design. Data were collected from 260 students (130 boys and 130 girls) who were selected from elementary schools (3-6 grades) in Rasht city, using a multistage cluster sampling method. Also, 16 teachers were included as assessors of behavioral disorders in students. The measurement tools were the Strengths and Difficulties Questionnaire (SDQ) and the teacher report version of the Child Exposure to Domestic Violence Scale (CEDVS). Data were analyzed using descriptive statistics and hierarchical multiple linear regression. Results: The mean age of students was 10.5±1.1 years. Among the forms of toxic socialization, the highest score was related to violence in school or community (75%), followed by family risk factors (61.2%), and violence due to the use of violent video technologies (61.2%). The prevalence of behavioral disorders was as follows: Peer relationship problems= 34.6%, emotional problems = 10.4%, inattention/hyperactivity = 10%, prosocial behavior = 8.8%, and conduct disorder = 6.2%. Exposure to various forms of toxic socialization explained 17.8% of the variance in conduct problems, 11.8% in inattention/hyperactivity, 32.1% in emotional problems, 7.5% in peer relationship problems, and 6.5% in prosocial behavior. Conclusion: Toxic socialization is a predictor of behavioral disorders in primary school children. Accordingly, children exposed to violent behaviors show more symptoms of behavioral disorders.
Introduction: The use of advanced technologies in education has positive effects on learning outcomes. There is scant research on the effectiveness of virtual simulation (VS) for nursing education among Indonesian nursing students. Objective: This study aimed to investigate the effects of VS-based education (vSIM for Nursing™) on critical thinking (CT) and decision-making (DM) of nursing students in Indonesia. Materials and Methods: This is a quasi-experimental study with a pre-test/post-test design. Participants were 60 nursing students enrolled in the medical-surgical nursing course at the Universitas Pendidikan Indonesia, selected via census sampling and randomly assigned to the intervention (n=30) and control (n=30) groups. The intervention group received VS-based education using vSIM for Nursing™ for six weeks, whereas the control group received education through a conventional pedagogical approach. The nursing DM instrument (NDMI) and the California CT disposition inventory (CCTDI) were used to collect data. The ANCOVA was used to analyze the data. Results: Most of the respondents were female (77.77% in the intervention group, 90% in the control group) and 19 years old (80% in the intervention group and 63% in the control group). After controlling for the pre-test scores, the vSIM significantly improved the DM score in the intervention group compared to the control group (P=0.004; η²=0.14). Although the intervention group showed higher adjusted post-test scores for CT, the between-group difference was not statistically significant (P=0.119). Conclusion: The VS-based education (vSIM for Nursing™) is effective in enhancing the DM of Indonesian nursing students, but has no significant effect on their CT.
Introduction: Nursing students often face intense academic pressures and high expectations, which can exacerbate perfectionistic tendencies. Objective: This study evaluates the effectiveness of Acceptance and Commitment Therapy (ACT) in addressing imposter syndrome, obsessive-compulsive disorder (OCD), and perceived stress among nursing students with perfectionistic tendencies. Materials and Methods: The research employed a semi-experimental, pre-test-post-test design with a control group. The statistical population comprised students with perfectionism from universities in Tehran Province in 2023. 34 students with perfectionism were selected using purposive sampling and divided into experimental (n=17) and control (n=17) groups. The experimental group attended eight 90-minute ACT sessions, while the control group received no intervention. Data collection involved administering the Perfectionism Questionnaire, Imposter Syndrome Scale, Obsessive-Compulsive Disorder Questionnaire, and Perceived Stress Scale. The data were analyzed using multivariate analysis of covariance in SPSS-27. Results: The results indicated that ACT significantly decreases imposter syndrome (F=55.43, η²=0.65), OCD (F=42.36, η²=0.59), and perceived stress (F=32.11, η²=0.52) in students with perfectionism (P<0.001). Conclusion: This study highlights ACT as an effective therapeutic approach for addressing the psychological challenges nursing students with perfectionistic tendencies face. By significantly reducing symptoms of imposter syndrome, OCD, and perceived stress, ACT shows promise in improving these students' overall well-being and academic performance.
Introduction: Respectful Maternity Care(RMC), as one of the fundamental rights of women, can be effective in creating a positive experience of pregnancy and childbirth and increasing women's desire to have children and give vaginal birth. Objective: This study aims to determine the RMC status and its associated factors among women who delivered at public hospitals in Guilan, north of Iran. Materials and Methods: This is an analytical cross-sectional study. Participants were 317 pregnant women in the postpartum units of public hospitals in Guilan province, selected via a non-random, multistage sampling method. The data collection tools were a questionnaire surveying sociodemographic/obstetric characteristics and the RMC questionnaire, which was completed 6-8 hours after delivery. Data analysis was done using independent t-tests, one-way analysis of variance, Pearson's correlation test, and multiple linear regression. The significance level was set at 0.05. Results: The mean ages of women and their husbands were 28.92 ± 5.79 and 33.03 ± 5.63 years, respectively. The education levels of 25.9% women and 21.5% of spouses were at the academic level. The mean total RMC score was 70.4 ±19.4. The domains of abuse-free care (75.5 ± 19.2) and timely care (66.1 ± 21.8) had the highest and the lowest scores, respectively. Women’s educational level (b=-3.62, 95% CI: -6.99 to –0.26, P=0.035), having a companion during birth (b=2.76, 95% CI: 0.05-5.48, P=0.046), and gestational age (b=0.77, 95% CI: 0.07-1.46, P=0.030) were significant predictors of the RMC score (R2=0.088). Conclusion: The pregnant women admitted to public hospitals in Guilan province receive a relatively high level of RMC. Healthcare workers, especially midwives, should pay attention to the identified factors in providing RMC to women.
Introduction: Insulin is the cornerstone treatment for hyperglycemia among individuals with Diabetes Mellitus (DM). Despite being one of the most commonly prescribed medications in clinical practice, insulin can be highly hazardous if misused. Objectives: This study aimed to assess the level of knowledge and practices regarding insulin therapy among nursing students in Jordan. Materials and Methods: This is a cross-sectional study was conducted on 500 nursing students at Jordanian universities in 2024. A researcher-made online self-report questionnaire was used to collect data. It surveys three main types of information: demographic information, knowledge of insulin, including side effects, complications, and storage conditions (18 items), and practices related to insulin therapy (9 items). Data were analyzed by using descriptive statistics and logistic regression analyses (to identify the predictors of knowledge and practice scores). P< 0.05 (two-tailed) was considered statistically significant. Results: Among participants, the majority were female (66.6%), aged 20–25 years (91.4%), in their third academic year (61.2%), and unemployed (87.2%). The mean knowledge score was 12.60 ± 2.84 (out of 20), with 84.4% demonstrating moderate knowledge. The mean practice score was 8.32 ± 1.35 out of 9. Ordinal logistic regression model showed that the university was significantly associated with knowledge scores. For example, education at Al-Hussein Bin Talal University was significantly associated with higher knowledge than education at Mutah University (b = 1.92, 95% CI: 1.59-2.25, p = 0.001). Higher academic year (fourth year) was also a significant predictor of knowledge (b = 0.85, 95% CI: 0.09-1.6, p = 0.03). Additionally, a history of DM treated with insulin (b = 1.88, 95% CI: 0.75–3.00, p = 0.001), a history of DM in first-degree relatives (b = 0.87, 95% CI: 1.13–2.60, p = 0.001) and history of attending DM-related educational courses or workshops (b= 0.79, 95% CI: 0.16–1.42, p = 0.01) showed significant association with knowledge scores. Conclusion: Enhancing DM-related education through curriculum modification and practical training can substantially improve Jordanian nursing students’ knowledge of insulin therapy and, consequently, patient outcomes.
