Journal of Research Development in Nursing and Midwifery
Volume:20 Issue: 1, Spring-Summer 2023

The curious, unplanned, and aimlessly searches of students on the internet result in a type of addiction to the internet and can have negative effects on their academic performance. This study aimed to investigate the effects of cyberspace addiction on the academic performance of nursing and midwifery students.

This cross-sectional study was performed on 302 nursing and midwifery students of Golestan University of Medical Sciences, Iran. Data were collected online using the Internet Addiction Test and a cell phone addiction questionnaire. The collected data were analyzed using descriptive statistics and Spearman’s, Mann-Whitney, and Kruskal-Wallis tests. The statistical significance level was set at 0.05.

The average score of internet addiction was 44.61±12.77 (at a low level), and the average score of cell phone addiction was 51.46±14.59 (at a moderate level). There was a significant relationship between cell phone addiction and marital status (P=0.038) and age (P=0.011). The average score of internet addiction was significantly higher in dormitory students than in non-dormitory students (P = 0.011).

Considering the existence of cyberspace addiction among nursing and midwifery students, it is recommended to hold educational workshops to increase awareness about the consequences of this problem.

Recirculation is a phenomenon in hemodialysis where purified blood re-enters the dialyzer and is cleaned again, which can negatively impact the adequacy and quality of hemodialysis. As quality hemodialysis is crucial for the treatment of hemodialysis patients, this study aimed to determine the prevalence of recirculation and its related factors in patients undergoing hemodialysis in medical centers in Golestan province, Iran in 2019.

A cross-sectional study was conducted in 2019 on patients with end-stage renal disease (ESRD) undergoing hemodialysis in medical centers in Golestan province, northeastern Iran. The study included 324 patients, selected using a stratified sampling method. Demographic and clinical data were recorded, and recirculation was measured by assessing urea levels based on the two-needle method, with a cut-off point of 10%. Patients were categorized into two groups based on recirculation percentage, with and without recirculation. Data were analyzed using SPSS (version 16) with descriptive statistics (mean, standard deviation, frequency) and inferential statistics (chi-square test and Fisher's exact test for low frequency cases, and t-test to compare quantitative variables) at a confidence level of 0.05.

The study found that the prevalence of recirculation in hemodialysis patients in Golestan province, Iran was 22.5%. There was a significant relationship between pump speed, arterial needle location (above the venous needle), venous-arterial needle distance from each other, and recirculation. The mean pump speed was 251.64 rpm, and the venous-arterial needle distance was 4.12 cm significantly lower in the recirculation group than in the no-recirculation group. There was also a significant relationship between recirculation and the way catheter lines were connected (arterial line connected to venous line) (P=0.0001).

Given the high prevalence of recirculation, and the ability to modify some of its related factors, nurses should take strategies and create suitable conditions for efficient hemodialysis for patients undergoing hemodialysis.

Available evidence on the efficacy of sweet solutions for reducing pain in infants is insufficient. This study aimed to assess the effects of 10% oral dextrose on the pain of infants during venipuncture.

This randomized controlled clinical trial was done on 60 infants undergoing venipuncture. Eligible infants were randomly assigned into an intervention and control group. Two minutes before venipuncture, 2 ml of 10% oral dextrose solution and 2 ml of water were given to the intervention and control groups, respectively. The infants' pain intensity during the procedure was measured by two independent experts based on the Face, Legs, Activity, Cry, and CONSOL ability Behavioral Pain Scale. Data were analyzed using independent t-test and ANOVA tests. A P-value of ≤0.05 was considered statistically significant.

The mean (±standard deviation) age of infants in the intervention and control groups were 6.37 (2.96) and 9.03 (3.10) months, respectively (P0.05). In addition, the standardized mean difference in pain score between the two groups was -0.2 (95% confidence interval: -0.30 to 0.71). Despite a significant difference (P=0.003) in the pain score between females and males, the effect of intervention after gender effect correction was not statistically significant.

Using 2 ml of 10% oral dextrose 2 minutes before venipuncture has a weak and non-significant effect on the pain of infants. Based on the effect size and 95% confidence interval, conducting further trials with a larger study population is recommended.

It is believed that COVID-19 has caused significant fear among older adults. The province of Golestan has a unique ethnic diversity, which requires examining the beliefs and concerns of older adults about health and disease. The aim of this study was to compare the fear of COVID-19 among Persian and Turkmen older adults.

This descriptive-analytical study was conducted on 500 older adults of Persian and Turkmen ethnicities covered by health centers in Bandar Turkmen (Golestan-Iran) from 2021 to 2022. Sampling was done by availability, and the samples were extracted from the list of older adults in the NAB system. Demographic data and the COVID-19 fear questionnaire were used to collect information. Data were analyzed using SPSS version 18 and Mann-Whitney U, Chi-square, and ANOVA tests at a significance level of 0.05.

The mean and standard deviation age of the participants in the Persian and Turkmen ethnicities were 70.99±6.91 and 73.66±7.66, respectively. The mean score of fear of COVID-19 in Persian older adults was 20.59±2.24, and in Turkmen older adults was 22.02±1.34, which showed a statistically significant difference (p<0.001). Fear of COVID-19 had a significant statistical relationship with occupation, education level, history of COVID-19 infection, hospitalization history, and having a COVID-19 patient in the family (p<0.001).

The results of this study showed that fear of COVID-19 was higher among Persian older adults. Ethnic and clinical differences in COVID-19 can have an impact on preventive care in the healthcare system.

The prevalence of the coronavirus has had various psychological effects on families with patients suffering from COVID-19, including depression. Depression can also affect the physical health of family members. This study was conducted with the aim of comparing the level of depression and its relationship with physical health among families with and without COVID-19 patients in comprehensive health centers.

This case-control study was conducted in 2022 in comprehensive health centers in Gorgan (Iran) among 98 families with and without COVID-19 patients, using simple random sampling. The data collection tools included the Beck Depression Inventory and the PHQ physical health questionnaire. The data were analyzed using descriptive statistics and tests such as the Mann-Whitney U test, Chi-square test, and Spearman's correlation test at a significance level of 0.05.

The study revealed that the mean scores of depression and physical health in family members with COVID-19 patients were 11.56±7.50 and 7.60±4.32, respectively, while in families without COVID-19 patients, they were 8.01±4.67 and 3.98±3.43, respectively. The odds of depression (OR=5.11, p=0.001) and physical symptoms (OR=4.68, p=0.002) were higher in families with COVID-19 patients compared to those without. The findings also showed a direct and significant linear correlation between depression and physical health in both groups (p<0.001, r=0.44).

These findings increase the awareness of health managers about the prevalence of depression and physical health disorders among families with COVID-19 patients and can help provide economic, social, and psychological support programs for these families.

Fatigue and indifference among critical care nurses due to intermittent and sometimes false alarms are common problems associated with working with alarming equipment. This study aimed to determine the prevalence of alarm fatigue and its relevant factors among critical care nurses in Golestan province, Iran.

This descriptive-analytical study examined critical care nurses in Golestan province in 2019. A total of 308 critical care nurses (working in ICUs and CCUs) from 11 hospitals were included in the study using the census method based on the inclusion criteria. Data were collected through a 13-item questionnaire assessing nurses’ alarm fatigue. The researcher randomly recorded the number and type of alarms per hour during morning, afternoon, and evening shifts. Simple and multiple linear regression tests analyzed the association between alarm fatigue and nurses’ demographic and professional characteristics as underlying factors. Data analysis was conducted at a significance level of 0.05 and a confidence interval of 95% using SPSS16.

Most nurses, who were predominantly female (79.2%) and had a clinical work experience of 5 years or less in critical care units (69.5%), reported a mean alarm fatigue score of 24.1±6.52. Additionally, 63.3% of the nurses experienced moderate alarm fatigue. It was found that female nurses (87.5%), those working as compulsory medical service workers (35.9%), those assigned to variable shifts (87.2%), and those required to work mandatory overtime (81.5%) reported higher levels of moderate alarm fatigue compared to others. When multiple linear regression analysis was conducted, controlling for the effects of confounding variables, it was observed that among all independent demographic and occupational variables, only gender (b=-0.18, p=0.01), education level (b =0.14, p=0.02), and type of overtime (b=0.15, p=0.01) had statistically significant effects on the response variable, namely the alarm fatigue score (b=-0.18, p=0.01)

Given that most nurses experience moderate alarm fatigue, it is recommended to implement strategies to enhance the quality of care and patient safety, such as providing critical care nurses with appropriate training on the practical and safe management of alarm systems.

Organizational knowledge management requires a structure or framework to identify, extract and document knowledge. The review of knowledge management sources shows that since the late 1980s, several cycles have been introduced in the field of knowledge management, and the Mayer and Zack cycle has been one of the most important cycles. The purpose of this study was to design a model for documenting organizational experiences based on the view of point of Iranian libraries managers in medical sciences universities by using Mayer and Zack model.

The research method was survey and correlation schemes are used. The population of the study consisted of 209 managers and heads of central and hospital libraries. Sampling was a stratified random sampling method. data gathering was done in 2022 by questionnaire. path- analyses and structural equation modeling was used to data analyses. RMS-Theta measure was used to test the model.

The results of the partial least squares test showed that the gathering knowledge and Knowledge refinement has a significant effect on knowledge documentation. Knowledge refinement had the highest and knowledge application had the lowest impact on knowledge documentation.

The results confirmed the effects of knowledge collection and refinement on knowledge documentation. Therefore, it is possible to rely on the designed model and effective factors of knowledge documentation and generalize the obtained results for knowledge documentation in libraries and information centers.

Nurses may be threatened with professional moral courage while providing care to patients with Covid-19. The present study aimed to evaluate the professional moral courage of nurses caring for patients with Covid-19.

This study was a cross-sectional study. In this study, 200 nurses working in COVID wards participated by convenience sampling method. Data collection tools were personal profile forms and valid and reliable tool of professional moral courage. Data were analyzed using descriptive statistics and inferential statistics (ANOVA And T-TEST) under SPSS software version 16.

The overall score of nurses' professional moral courage was 56.25±7.02. Other findings of the study indicated that among the personal characteristics of nurses, professional moral courage and organizational position (P = 0.005) and nursing work experience in the COVID ward (P = 0.003) had a statistically significant relationship.

Considering the average state of moral courage and the fact that the average score of supervisors is lower than that of nurses, it is obligatory for nursing managers to plan for the promotion of professional moral courage of nurses to face future crises. The most important of these actions can be holding educational workshops with ethical themes for nurses and students so that they can obtain professional moral courage in their profession in more desirable way.

Adhering to nursing professional ethics codes and being familiar with these codes enables nurses to make sound ethical decisions in challenging circumstances. Recognizing the significance of awareness regarding professional ethics codes and their continuous growth, this study was conducted to determine and compare the influence of classroom-based and short message service (SMS) training on the ethical sensitivity of nursing students.

This study employed a quasi-experimental design and was conducted in 1401 at Yasuj University of Medical Sciences in Iran. The participants included 120 nursing students who were selected using convenience sampling based on criteria such as enrollment in the bachelor's nursing program, ability to communicate effectively, willingness to participate in the study, and scoring 50 or lower on the ethical sensitivity questionnaire. The samples were randomly assigned to three groups: intervention 1, intervention 2, and control. After obtaining the necessary ethical approvals, data were collected using the Lützen Ethical Sensitivity Questionnaire. Data were collected immediately before and one month after the completion of interventions. The intervention group received a blended teaching approach, which included concept mapping, small group discussions, and role-playing sessions conducted twice a week for one month. Data analysis was performed using descriptive statistics (mean, standard deviation, frequency, and percentage) and inferential statistical methods (paired t-test, chi-square test, and ANOVA) using SPSS software version 21.

There was a significant difference in the mean age of students among the three groups, flipped classroom, short message service, and control (p = 0.047). However, no significant difference was observed in terms of gender distribution among the three groups (p = 0.291). Prior to the intervention, there was no statistically significant difference in the overall mean score of ethical sensitivity among the three groups (p < 0.05). However, after the intervention, a significant difference was observed (p < 0.05). Post-hoc comparisons revealed a significant difference in the ethical sensitivity scores of students among the flipped classroom, short message service, and control groups (p = 0.001).

Based on the effectiveness of both the flipped classroom and short message service methods in enhancing the ethical sensitivity of nursing students, it is recommended to incorporate these educational approaches into the nursing curriculum for planning and implementation.

Retaining skilled nurses is paramount in providing quality nursing care for patients and thus improving their satisfaction. This study aimed to determine the intention to stay (ITS) in the profession of nurses and its related factors.

This multicenter cross-sectional study was conducted on 263 nurses working in teaching hospitals affiliated with Zanjan University of Medical Sciences, Iran, from September 2020 to February 2021. Participants were selected by simple randomization. A researcher-made ITS questionnaire was used to collect data, which were then analyzed using descriptive statistics, independent t test, analysis of variance (ANOVA), and Pearson correlation via SPSS version 16.

The findings revealed that 109 participants (41.45%) of the nurses intended to stay in their profession. The total mean ± SD score of ITS for the nursing profession was 60.44±12.39 out of 100. From the participants' perspective, 5 factors of high responsibility and commitment (86.01±13.71), professional competence (77.95±13.66), feeling useful in nursing (77.79±18.23), the importance of being employed for me (74.83±20.01), and the possibility of learning skills and acquiring new information by continuing nursing (74.30±18.22) had the highest average score. There was a statistically significant relationship between ITS and the demographic variables of education level, job position, marital status, working shift, age, and the number of children of participants (P < 0.05).

The frequency of nurses with ITS in the profession is a cause of concern, sounding the alarm for the Iranian nursing system. The findings of this study could be useful for health care policymakers to increase nurses' intention to stay in the profession and, as a result, improve retention rates.

Patient handover in the emergency department (ED) is a 2-way communication process between the paramedics and in-hospital emergency personnel, which can result in miscommunication and delivery challenges. This study aimed to explore the lived experience of paramedics on patient handover to the ED.

Over a period of 5 months, an interpretative phenomenological analysis (IPA) was used to explore the lived experiences of 15 paramedics in Tabriz, Iran. Semi-structured interviews were conducted in the emergency medical stations using the Smith approach for data collection and analysis. The researcher used 4 criteria to ensure rigor, including credibility, dependability, confirmability, and transferability, according to Lincoln and Guba.

Three main themes emerged from the data analysis, including “the hole of hope,” “the boring issues,” and “paramedics are only a driver.” A further 11 sub-themes emerged under the main themes.

The highlighted issues that need to be considered during the process are the presence of staff in front of the ED's door to welcome the patient, removal of structural defects and defective hospital equipment, the presence of medical supplies in emergency triage to prevent the paramedics from stumbling, and listening to paramedics by physicians and nurses to obtain the patients’ history.

Satisfactory knowledge about menopause is important for women to overcome related challenges. Women with greater knowledge about menopause are more likely to effectively manage its symptoms and navigate this life stage more successfully. This study aimed to determine the level of knowledge of Kurdish women about menopause, as well as to find its association with menopausal status and sociodemographic and obstetrical characteristics.

This cross-sectional study was conducted on perimenopausal (161) and menopausal women (751) who were recruited through non-probability convenient sampling in Kurdistan Region, Iraq, from April to June 2022. For the purpose of the study, a questionnaire was developed that included questions on demographic characteristics, obstetric and menstrual history, and knowledge about menopause. The data were analyzed by frequency, percentage, and chi-square test using SPSS version 25. Ordered logistic regression analysis was performed to determine the effect of demographic and obstetrical factors on some dependent’s variables of knowledge.

The mean age of menopausal and perimenopausal women was 54.81 ± 5.590 and 46.99±5.688 years, respectively. The participants had more knowledge about the concept and less about the health risks of menopause. On average, menopausal women were more knowledgeable about the definition of menopause compared with perimenopausal women; the difference was highly significant. Overall, the knowledge score indicated that 44% had fair knowledge, 37.6% had poor knowledge, and 18.4% had good knowledge about menopause.

Although many women view menopause as a positive life event, it is important to provide them with adequate education, so they can better understand the natural process of menopause to lead a healthy life.

Antiretroviral therapy (ART) has played a crucial role in minimizing the worldwide impact of HIV infection. Numerous HIV patients face challenges in adhering to their treatment due to various physical, social, and psychological factors. This study aimed to explore the correlation between psychosocial stress and treatment adherence among HIV/AIDS patients at a hospital in Nigeria.

In this study, a descriptive analytical design was utilized to select (n=171) HIV-infected clients attending the virology clinic at Uniosun Teaching Hospital (UTH). Convenient sampling was employed to choose participants from a total monthly population of 271 patients who visit the clinic. Data collection was performed using a questionnaire consisting of four sections and 57 items. Descriptive and inferential statistics, such as the Chi-square test and correlation analysis, were employed to present and analyze the data.

A significant proportion (61.4%) of the patients experienced a moderate level of stress. The most notable sources of stress reported by patients were the need for HIV status disclosure (71.9%) and rejection from family and friends (66.7%). Rejections by friends and family, stigma and discrimination, social and economic challenges, as well as antiretroviral therapy showed a significant association with HIV-related stress (p < 0.001). Furthermore, a significant inverse correlation was found between psychosocial stress and treatment adherence (r = -0.705, p < 0.001).

Individuals living with HIV/AIDS (PLWHA) face significant levels of stress and often encounter rejection and stigma. It is crucial for healthcare professionals to establish comprehensive support services aimed at alleviating the stress experienced by these patients and reducing the obstacles they face. Such measures will ultimately enhance treatment compliance and overall well-being.

Self-care is an indicator of power and independence among older adults. Family can increase older adults’ motivation and desire for engagement in self-care activities. This study aimed to determine the effects of self-care education based on the family-centered empowerment model (FCEM) on functional independence and life satisfaction among community-dwelling older adults.

This randomized clinical trial was conducted on 126 community-dwelling older adults   from local sociocultural centers in 2021. They purposively recruited and randomly allocated to control (n = 63) and intervention (n = 63) groups. The intervention group received FCEM-based self-care education in six 1.5-hour weekly sessions. The education focused on the physical, psychoemotional, social, and spiritual aspects of self-care and was based on the 4 steps of FCEM: perceived threat, problem-solving, educational participation, and evaluation. Katz Index of Independence in Activities of Daily Living (Katz ADL Index) and Zest Life Satisfaction Index were respectively used for independence and satisfaction assessments before and 8 weeks after the study intervention. The data were analyzed using SPSS version 16 and through the Kolmogorov-Smirnov, Mann-Whitney U, Wilcoxon, and chi-square tests.

The mean age was 67.57 ± 4.62 years in the intervention group and 67.08 ± 4.62 years in the control group. There were no significant differences between the intervention and control groups respecting the pretest mean scores of life satisfaction (16.54 ± 4.46 vs 16.68 ± 4.23; P = 0.963) and functional independence (4.78 ± 1.15 vs 5.11 ± 1.00; P = 0.107). The posttest mean score of functional independence was also insignificant (5.52 ± 0.692 vs 5.24 ± 0.911; P = 0.92) between the 2 groups. However, the Mann-Whitney U test showed that the posttest mean score of life satisfaction was significantly greater in the intervention group than in the control group (18.95 ± 4.36 vs 16.13 ± 4.41; P = 0.001).

FCEM-based self-care education effectively improves life satisfaction among community-dwelling older adults.

Anxiety is a common experience in patients undergoing surgery. It is one of the major challenges for preoperative health care providers. The aim of this study was to explore the experience of health care providers in taking care of anxious patients under surgery with spinal anesthesia.

This qualitative content analysis study was conducted at a referral hospital in Gonbad-e-Kavous city, northeastern Iran, between 2020 and 2021. Data were collected through semi-structured individual interviews. The primary focus of this research was to explore the perspective of health care professionals when providing care to nervous patients who are being considered for surgery with spinal anesthesia. The study included 16 health care providers who had experience in caring for anxious patients undergoing surgery with spinal anesthesia. Participants were selected using purposive sampling. Interviews were implemented in MAXQDA 10 software and then analyzed by the conventional content analysis method.

Five main categories and 19 subcategories were extracted from data analysis. The categories included “emergence of anxiety,” “basis of anxiety formation,” “patient advocacy,” “abilities of health care providers,” and “anxiety management factors.”

Health care providers consider patient anxiety as a problem that can be affected by various factors. Different methods are used to manage patients' anxiety, but it is necessary to apply appropriate context-based interventions.

Food intake and metabolism might play central roles in causing and treating menstrual disorders. Vitamin D may lead to the improvement of folliculogenesis through anti-Mullerian hormone (AMH). This study aimed to compare the effect of vitamin D intake with that of the combined oral contraceptive (COC) capsules on ovulatory dysfunction.

This study was conducted on 60 eligible women referred to Kowsar Qazvin Hospital with a complaint of abnormal uterine bleeding (AUB). They had a history of excessive, long, and irregular bleeding. The participants in the control and intervention groups received 1 oral LD capsule and a combination of vitamin D and LD capsules on a daily basis for 3 months, respectively. The menstrual bleeding volume, the number of menstrual days, and the menstrual cycle length were evaluated before, during, and after the intervention. The Mann-Whitney U test, Friedman test, independent t test, and Cochran Q test were used in SPSS version 24 for data analysis. P values less than 0.05 were considered statistically significant.

The menstrual bleeding intensity decreased significantly in the intervention group (vitamin D–LD capsule; P = 0.001). Over time, both intervention and control groups showed a significant improvement in the number of menstrual days and menstrual cycle length, resulting in a more normal menstrual cycle. However, these 2 parameters remained more natural in the intervention group, a finding which did not indicate any significant differences.

Vitamin D can be used along with LD capsules as a supplementary treatment to lessen menstrual bleeding intensity.