Comparing the effects of education through compact disk and social media on knowledge and practice regarding the assessment of preterm infant behavior among nurses in neonatal intensive care units

Background: Nurses in neonatal intensive care units (NICUs) need adequate professional knowledge and skills for providing quality developmental care to premature newborns. Objectives: This study aimed to compare the effects of education through compact disk (CD) and social media (SM) on knowledge and practice regarding the assessment of preterm infant behavior (APIB) among nurses in NICUs. Methods:This quasi-experimental study was conducted on fifty NICU nurses. They were randomly allocated to a CD and a SM group. The intervention for both the groups was the same and consisted of education about APIB. Participants' APIB-related knowledge and practice were assessed before and after the intervention using a researcher-made knowledge questionnaire and the APIB checklist, respectively. Data were analyzed through the Chi-square, the independent-samples t, and the paired-samples t-tests as well as the analysis of covariance. Results: The pretest mean scores of knowledge and practice were, respectively, 9.72 ± 4.95 and 207.64 ± 109.49 in the SM group and 9.16 ± 5.94 and 209.88 ± 110.46 in the CD group. After the study intervention, these values significantly increased to 14.80 ± 1.80 and 361.96 ± 38.24 in the SM group (P 0.05), the posttest mean scores of knowledge and practice in the SM group were significantly greater than the CD group (P < 0.05). Conclusion: SM-based education is more effective than CD-based education in improving APIB-related knowledge and practice among NICU nurses

The effectiveness of solution-oriented couple therapy on marital burnout, marital forgiveness and communication styles of couples affected by extramarital relationships

Background: Extramarital affairs is one of the main reasons for divorce and disintegration of marital life and ultimately reduce the health of society. This study aimed to determine the effectiveness of solution-oriented couple therapy on boredom, marital forgiveness and communication styles of couples affected by extramarital relationships. Materials and Methods: The quasi-experimental research design was pretest-posttest with a control group. The statistical population included all those who referred to the problem of extramarital affairs of the spouse to the counseling centers of Bahar, Bavar and Elixir in Sari. Thirty people were selected by convenience sampling method as a sample and randomly assigned to an experimental group (15 people) and a control group (each containing 15 people). The intervention group underwent 90-minute routine couple therapy in 7 sessions. But no action was taken on the control group. The Pains (1996) Marital Boredom Questionnaire, the Ray et al. (2001) Forgiveness Questionnaire, and the Christensen &amp; Salawai Communication Styles Questionnaire (1984) were administered. Data analysis was performed covariance analysis. Results: The results showed that the effect of solution-based technique training was on forgiveness (F= 55.63, P&lt;0.001) and on marital boredom (F= 0.85, P&lt;0.001). Conclusion: Solution-oriented couple therapy focuses on salient, achievable, tangible, and measurable goals and effective on boredom, marital forgiveness and communication styles of couples affected by extramarital relationships

The effects of an interdisciplinary supportive educational program on anxiety among patients undergoing cataract surgery

Background: In most ophthalmic surgeries, patients are conscious or semi-conscious, and hence, they may experience varying levels of anxiety during surgery. Objectives: The aim of this study was to evaluate the effects of an interdisciplinary supportive educational program on anxiety among patients undergoing cataract surgery (CS). Methods: This quasi-experimental study was carried out in February-August 2019 using a two-group pretest-posttest design. Participants were 64 patients with cataract who were referred to Feiz Hospital, Isfahan, Iran, for undergoing CS. They were consecutively recruited and randomly assigned to either a control or an intervention group. Data were collected using a demographic questionnaire and Spielberger State-Trait Anxiety Inventory. Participants in the intervention group received an interdisciplinary supportive educational intervention, while their counterparts in the control group received routine care services. State anxiety and trait anxiety were assessed both on the sampling day and after regaining full postoperative consciousness. Data analysis was done via the independent and the paired samples t-, the Mann-Whitney U-, and the Chi-square tests. Results: There were no statistically significant differences between the intervention and the control groups respecting the pretest mean scores of state anxiety (35.25 ± 8.51 vs. 35.72 ± 9.43; P = 0.83) and trait anxiety (38.25 ± 7.002 vs. 39.16 ± 8.58; P = 0.64). However, there were statistically significant differences between the groups regarding the posttest mean scores of state anxiety (28.66 ± 10.39 vs. 34.84 ± 9.36; P = 0.02) and trait anxiety (31.76 ± 8.51 vs. 38.13 ± 10.29; P = 0.01). Conclusion: As a simple and inexpensive intervention, an interdisciplinary supportive and educational program through both face-to-face communication and telecommunication methods is effective in significantly reducing anxiety among patients undergoing CS

The consequences of child,s congenital heart disease for parents: A qualitative study

Background: Affliction of a child by a chronic disease can significantly affect the whole family. Identifying the consequences of a child,s congenital heart disease (CHD) for parents can help health-care providers provide better care services to them. Objectives: This study aimed at exploring the consequences of a child,s CHD for parents. Methods: This study was conducted in 2020 using conventional content analysis. The 30 parents of 15 children afflicted with CHD were purposively recruited from a hospital and a physician,s private office in Sanandaj, Iran. Data were collected via semi-structured interviews and continued up to data saturation. Data analysis was performed via conventional content analysis suggested by Graneheim and Lundman. Results: The consequences of a child,s CHD for parents were grouped into three main categories, namely threatened family integrity (with three subcategories), psychological turmoil (with five subcategories), and being in limbo (with three subcategories). The 11 subcategories of these three categories were the effects of CHD on parents, neglectful parenting for other family children, reluctance to have another child, anxiety, maternal depression and somatization, helplessness, fear over treatment failure, acceptance of an unchangeable reality, uncertain future, concern over hiding or not hiding a child,s CHD, and a heart full of pain, respectively. Conclusion: A child,s CHD can threaten family integrity, cause parents psychological turmoil, and put them in limbo. Health-care providers, particularly nurses, need to assess the needs of these parents and provide them with professional counseling and need-based emotional, informational, and financial support in order to reduce the negative effects of CHD on them

Clinical Belongingness and its Relationship with Clinical Self-Efficacy among Nursing Students: A Descriptive Correlational Study

Background: Clinical self-efficacy (CSE) plays a pivotal role in safe and quality nursing care delivery. Clinical Belongingness (CB) is a major factor in the clinical practice of nursing students. Objective: This study aimed to assess CSE and CB and their relationship among nursing students. Methods: This descriptive, correlational study was conducted in 2019 in the Faculty of Nursing and Midwifery of Urmia University of Medical Sciences, Urmia, Iran. Participants were 216 eligible 3rd and 4th-year nursing students. Data were collected using a demographic questionnaire, the Belongingness Scale-Clinical Placement Experience, and the Self-Efficacy in Clinical Performance Questionnaire. The Pearson correlation analysis, the independent-sample t-test, the one-way analysis of variance, and the linear regression analysis were performed for the data analysis. Results: The total mean scores of CSE and CB were, respectively, 134.02 ± 20.62 and 121 ± 16.79, indicating moderate CSE and high CB. CB had significant positive correlation with CSE and was a significant predictor of it (P< 0.05). Conclusion: Nursing students have high CB and moderate CSE, and their CB is a significant positive predictor of their CSE. University authorities are recommended to develop clear strategies to improve nursing students' CSE through improving their CB

The effects of an ethical empowerment program on nurses ability of ethical care delivery to patients with decreased level of consciousness in intensive care unit

Background: Nurses should be empowered for ethical care delivery (ECD) to patients with decreased level of consciousness (LOC) in the intensive care unit (ICU). However, there are limited data about the effects of ethical empowerment programs on nurses ECD ability. Objectives: The aim of this study was to evaluate the effects of an ethical empowerment program on nurses ability of ECD to patients with decreased LOC in ICU. Methods: This quazi experimental study was conducted in 2019 in Al-Zahra University Hospital, Isfahan, Iran. Seventy-two nurses were randomly recruited from the ICUs and randomly allocated to an intervention and a control group. Participants in the intervention group were provided with an ethical empowerment program. A researcher-made questionnaire was used to measure participants ability of ECD to patients with decreased LOC at three time points, namely before, immediately after, and 1 month after the workshop. Data were analyzed through the Chi-square test, the independent-samples t-test, and the repeated-measures analysis of variance. Results: The difference between the intervention and the control groups respecting the pretest mean score of ECD ability was not statistically significant (124 ± 5.88 vs. 126.17 ± 9.07; P = 0.10). However, the mean score of ECD ability in the intervention group was significantly greater than the control group both immediately after the workshop (142.58 ± 7.22 vs. 127.14 ± 8.13; P < 0.001) and 1 month after the workshop (147.57 ± 5.45 vs. 128.51 ± 9.52;P < 0.001). Conclusion: Ethical empowerment is effective in significantly improving nurses ability of ECD to patients with decreased LOC in ICU. This program is recommended for improving nurses ECD ability

Development and psychometric evaluation of the Spiritual Health Questionnaire among Iranian Muslim adults

Background: Spiritual health (SH) has received great attention from nurses and other health-care providers in recent years. The existing instruments for SH measurement measure either some aspects of SH or SH-related concepts, and there is no specific SH measurement instrument, particularly for Muslim adults in Iran. Objective: This study aimed at the development and psychometric evaluation of the Spiritual Health Questionnaire (SHQ). Methods: This exploratory sequential mixed methods study was conducted in a qualitative and a quantitative phase in 2014-2016. In the qualitative phase, a concept analysis was conducted using the hybrid model and its results were used to develop the primary SHQ. In the quantitative phase, the face, content, and construct validity and reliability of SHQ were assessed. Exploratory factor analysis and concurrent validity assessment were performed for construct validity assessment. Test-retest stability and internal consistency were also assessed for reliability assessment. Results: The qualitative phase of the study showed that the concept of SH had six main components. In the quantitative phase, the number of primary SHQ items was reduced from 88 to 59 after face and content validity assessments. In construct validity assessment, 12 more items were excluded and the remaining 47 items were loaded on six factors which explained 45.2 of the total variance. The Cronbachs alpha values of the questionnaire and its six dimensions were 0.778 and 0.752-0.788, respectively. Convergent validity assessment showed that the mean scores of SHQ and the Spiritual Well-Being Index had a significant correlation with each other (r = 0.35; P = 0.032). Conclusion: The 47-item SHQ is a specific instrument for SH assessment with acceptable validity and reliability

The effects of competency-based education on midwifery students knowledge, skills, and self-confidence for postpartum hemorrhage management

Background: Hemorrhage is a leading cause of maternal death in the perinatal period. New teaching methods have been recommended for promoting midwives competence in maternal care delivery. Objectives: This study was conducted to determine the effects of a competency-based education (CBE) program on midwifery students knowledge, skills, and self-confidence for postpartum hemorrhage (PPH) management. Methods: This experimental study was conducted in 2018 on 86 third-, fourth-, and fifth-semester midwifery students recruited from the Faculty of Nursing and Midwifery of Iran University of Medical Sciences, Tehran, Iran. They were randomly allocated to either a control (n = 43) or an intervention group (n = 43). Participants in the control group received routine formal midwifery education, while their counterparts in the intervention group received CBE in addition to routine formal midwifery education. Participants knowledge, skills, and self-confidence for PPH management were assessed at three time points, namely before, immediately after, and six weeks after the study intervention. Data were analyzed through performing the Chi-square and the independent-samples t-tests and the repeated measures analysis of variance. Results: There were no significant differences between the intervention and the control groups regarding the pretest mean scores of knowledge (4.87 ± 1.58 vs. 5.05 ± 2.07), skills (80.12 ± 5.72 vs. 82.30 ± 6.89), and self-confidence (7.05 ± 1.19 vs. 6.62 ± 1.47) (P > 0.05). In the intervention group, the mean scores of knowledge, skills, and self-confidence were significantly greater than the control group both at the first posttest (10.17 ± 1.31 vs. 5.20 ± 1.55, 301.15 ± 19.30 vs. 80.50 ± 5.12, and 9.47 ± 1.19 vs. 6.80 ± 0.91, respectively) and the second posttest (9.37 ± 2.21 vs. 5.32 ± 1.50, 299.67 ± 17.58 vs. 81.07 ± 5.69, and 9.72 ± 1.28 vs. 6.52 ± 1.44, respectively) (P < 0.05). Conclusion: CBE is effective in significantly improving midwifery students knowledge, skills, and self-confidence for PPH management, and hence, it is recommended for promoting their competence

Job burnout among nurses in Iran: a systematic review and meta-analysis

Background: Job burnout is a major problem among nurses. The three dimensions of job burnout include emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA). Objectives: The aim of this study was to determine the mean of job burnout among nurses in hospitals affiliated to Medical Sciences Universities in Iran. Methods: This was a systematic review and meta-analysis. An online search was performed in the PubMed, Web of Sciences, Scopus, Google Scholar, Scientific Information Database, Medlib, Iranmedex, Magiran, Civilica, Noormags, and Irandoc databases. The search keywords were burnout,job burnout, occupational burnout, nurses, nursing staff, and Iran. Critical appraisal of eligible studies was performed using the Critical Appraisal Skills Program checklist. The first author's name, publication year, sample size, and the mean scores and standard error values of the different dimensions of job burnout were extracted from each included study. The random-effects and the fixed-effect models were used for the meta-analysis. The Cochran's Q test, the I2 index, and the Egger's regression analysis were used. Results: Nineteen studies with a total sample of 3926 nurses were included in the meta-analysis. The overall means of the EE, DP, and low PA dimensions of job burnout were 21.19 (95 confidence interval CI: 19.28-23.11), 7.85 (95% CI: 6.26-9.43), and 28.89 (95% CI: 27.10-30.67), respectively. The I2 index values of these dimensions were, respectively, 96.6%, 99.4%, and 97.8%, indicating high heterogeneity among the studies. The Egger's regression analysis showed that there was no evidence of publication bias in the studies (P = 0.08). Conclusion: Job burnout among nurses in Iran is moderate in the EE and the DP dimensions and high in the low PA dimension. Strategies are needed to improve nurses' work conditions, fulfill their needs, and thereby, reduce their job burnout

The association of Shift Work and Effort-Reward Imbalance with Gastrointestinal Symptoms among Female Nurses

Background: Shift work impacts workers' health, mainly by disrupting the circadian rhythm, and gastrointestinal (GI) disturbances are among the health effects of shift work. Objectives: The objective of this study was to assess the association between shift work, work stress, and GI disturbance among nurses. Methods: In July 2018, a cross-sectional study was conducted in Dammam Medical Complex, Saudi Arabia. A total of 250 nurses were selected through convenience sampling from several departments. They completed a validated questionnaire, which included questions about their demographic data, GI symptoms, and effort-reward imbalance (ERI). Work stress was classified into two groups based on the ERI ratio. GI symptoms were categorized into three indices: total, upper, and lower GI. The sampling plan was designed to cover most of the shifts in the included departments throughout nonspecified dates. The daytime nurses' group was selected from the same hospital as a comparison group to the shift workers. Means and standard deviations were calculated for continuous variables and frequencies and percentages were calculated for categorical variables. The associations were assessed using the Chi-squares and analysis of variance. Results: Work stress among nurses, as measured by the ERI scale, was strongly associated with both upper and lower GI symptoms, with odds ratios of 5.7 (CI: 3.3-7.9) and 2.2 (CI: 1.8-4.3), respectively. The total GI symptom score of the shift workers was greater than that for the daytime workers, with means of 7.8 ± 6.9 and 5.4 ± 5.1, respectively (P = 0.005). Multivariable regression analysis showed that ERI was associated with both lower and upper GI symptoms after adjusting for shift work and years on the job. Conclusions: Shift work was associated with the high prevalence of GI symptoms. Stress (ERI) increased the risk for GI disturbance. Controlling work stress is necessary because it affects nurses' physical and social health, as well as their performances at work and the quality of care they provide