Journal of Education and Health Promotion
Volume:13 Issue: 2, Feb 2023

Breast cancer is the most common type of cancer and the second leading cause of death among women. Religion and spiritual behaviors are effective strategies for maintaining human health. The aim of this study was to determine the relationship between religious orientation and spiritual intelligence with general health dimensions in women with breast cancer.

The present study is a correlational study that was performed on 50 women with breast cancer referred to medical centers affiliated to Isfahan University of Medical Sciences in 2020. Data were collected through questionnaires of religious orientation, spiritual intelligence, and general health. Data were analyzed by Spearman and regression tests.

The results showed that religious orientation had a significant positive relationship with the overall score of general health, but the components of religious orientation had a significant negative relationship with the number of components of public health (p < 0.05). Spiritual intelligence also had a significant positive relationship with general health. However, the number of components of spiritual intelligence has a significant negative relationship with the number of components of general health (p < 0.05).

Considering the relationship between religious orientation and spiritual intelligence with public health and considering educational programs based on spiritual intelligence and religious orientation in this group of people can be an important step in promoting their general health.

The mortality rate of non‑communicable diseases (NCDs) contributes more in low‑income and middle‑income countries, also among individuals with lower socioeconomic status in high‑income countries, making NCDs a big hurdle to minimizing global and national health disparities. Among 55 million fatalities worldwide in 2019, NCDs accounted for about 41 million (71%) deaths. The purpose of this scoping review was to comprehend the available literature on the burden of NCDs in India. This review included the studies that have been published between the period of 2009–2020. For this review, 18 full‑text articles have been selected. A preliminary search was done to obtain articles from the search engines such as PubMed, Google Scholar, web of science, and Scopus. Our scoping review was focused on five major NCDs which are cardiovascular, hypertension, diabetes, cancer, and stroke. In 2019, around 17.9 million individuals died from cardiovascular disease (CVD), which is accounting for 32% of all deaths. As compared to Chandigarh and Jharkhand (0.12 million and 0.96 million, respectively) Tamil Nadu and Maharashtra (4.8 million and 9.2 million, respectively) have a higher percentage of the population affected by diabetes. In India, stroke is the fifth‑significant cause of disability and the fourth‑leading cause of fatality, which is accounting for 3.5 percent of all disabilities. India should construct a higher‑level coordinating framework and devise an overarching policy or strategy tailored to NCDs. To limit risk factor exposure, it is necessary to emphasize health promotion and preventive actions.

Educational policymaking is a kind of public policy that is done in order to achieve the goals of the educational system in fields areas such as education and students’ health. The purpose of this study was to determine the components of educational policymaking model in education. The method of the present study is systematic review. This is done using the SPIDER framework. The statistical population of the study included all related Persian and English articles published in the years 2010–2021 consisting of 98 articles that are indexed in ScienceDirect, Sage, Springer, Wiley, Eric, and PMC English language databases and SID, Irandoc, and Magiran Persian language databases. The research sample included 52 articles selected in the article screening stage. The number of Persian language references was 12 and English language references was 40. Sterberg thematic analysis was used for coding the selected texts of articles. Results of coding the selected texts of the articles showed that the components of the educational policymaking model are included in 11 themes: quiddity of policy and public policy, educational policy’s necessity, quiddity of educational policy, process of educational policy, consequences, factors, obstacles, stakeholders, evaluation criteria, and change in educational policies. Paying attention to all the dimensions and factors interacting in educational policy can lead to better education and improve the quality of education in all dimensions, especially in the field of health education.

To motivate students toward the path of lifelong learning, it is important to train them for a self‑directed learning (SDL) approach, where they identify the need of learning the content as well as look forward to attaining the learning outcome, independently. The level of readiness for SDL will allow the learner to be self‑disciplined, self‑organized, an effective team builder and communicator, a self‑assessor, and a self‑reflector, thus being a self‑learner with the ability to accept and give constructive feedback. The aim of the study was to develop, validate, and implement the SDL readiness scale for health professional students.

The readiness scale of 43 items was used in four sub‑titles (awareness, learning strategies, and style, motivation, team building) was developed using the Delphi method with 12 experts and was implemented for the medical students at Karamsad, Gujarat as a cross‑sectional survey after a pilot trial scale from May 2021 to September 2021, using mean, the standard deviation for each item, and arrived sub‑titles. The ANOVA test was used to find differences in readiness scores as per different years of the medical program.

The result demonstrates that the maximum score was obtained for the first‑year medical student (149.89 ± 24.72), which dropped in year 2 (136.35 ± 32.26) but increased by the final year (147.67 ± 56.66), although not as high as the initial joining year. However, a statistically significant difference per gender was identified for a few items of the scale [(items 24 (P < 0.034), 26 (P < 0.0005), 37 (P < 0.035), and 40 (P < 0.013)]. The logistic regression analysis showed no statistical significance for the DSVS‑self‑directed learning readiness scale (SDLRS) score and demographic variables.

The outcome of the study strongly suggests training/sensitization sessions for students to highlight the importance of a SDL approach in a digital millennium. Moreover, a longitudinal follow‑up needs to be conducted for the readiness score of the students based on the developed scale and subsequent training sessions need to be organized for students as well as faculty for better outcomes for the students toward SDL sessions.

Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty.

This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in‑depth semi‑structured interviews, and a qualitative content analysis was applied for data analysis.

Data analysis revealed four categories, namely, ineffective teaching–learning, inapposite/ unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories.

To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.

Mobile phones have become a widely accepted learning mode due to the impact of COVID‑19. This study explores the mobile technology acceptance, among nursing students at selected educational institutions in South India.

Quantitative cross‑sectional descriptive design. First‑year 176 B.Sc. nursing students who underwent blended learning were selected by the purposive sampling method. The tool “Technology Acceptance Model” was used to collect responses. Bivariate analysis was used to determine the relationship between the demographic and study‑related variables with the mobile technology acceptance using SPSS version 25.0.

The majority 73.9% of the students belonged to the age group of 18–19 years, females 76.7% and, 98.9% were unmarried. Among the constructs of TAM, a mean (SD) value of 22.08 (2.26) was found for material (mobile device audio/video) characteristics the mean (SD) value was 22.08 (2.26), attitude about use 17.58 (1.95), behavioral intention 17.46 (1.78) and system characteristics 17.21 (2.27). The mobile technology acceptance revealed that 126 (71.6%) strongly agreed, 49 (27.8%) agreed, and 1 (0.6%) was neutral with a mean (SD) of 105.19 (8.68), respectively. A positive correlation was found between the system characteristics, material characteristics, perceived ease to use, perceived usefulness, attitude about the use, behavioral intention with a P value <0.001. There was a statistically significant association between Mobile technology acceptance and time spent by the students for independent studies shown the Chi‑square value of 12.7, with P value <0.05.

Nursing students had a positive acceptance and behavior toward smartphone use.

Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help‑seeking behaviors in Iranian family caregivers of cancer patients.

This qualitative study was conducted through in‑depth semi‑structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

The requirements of promoting help‑seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual‑psychological‑cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.

Healthcare professionals have fought hard to restrain the COVID‑19 pandemic by providing high‑quality care for their infected patients, but in doing so they have developed fears of becoming sick and feelings of isolation and loneliness. The lived experience of respiratory therapists (RTs) in Saudi Arabia who works with these infected patients needs further investigation. The study sought to describe the experiences and coping strategies of Saudi RT managing patients with COVID‑19.

The study utilized qualitative research methods, specifically employing a phenomenological research design. A total of 25 Saudi RT (RTs) who were in direct contact with COVID‑19 patients were selected after they agreed to participate in this study. The study followed a one‑on‑one semi‑structured interview process using the Zoom platform. This qualitative data collection technique focuses on the participants’ lived experiences and feelings to discover shared patterns. The data were analyzed via an inductive approach.

Six themes were found in the RT perceptions including stress while treating COVID patients, managing the fear of catching of Covid 19, feelings towards COVID‑19 patients, challenges faced by female RTs, workplace experiences, and excessive workload.

RTs feelings dramatically changed throughout the COVID‑19 pandemic. All the RTs have developed a self‑copying style that has helped them improve their psychosocial behavior to face the pandemic. During the outbreak, frontline RTs’ positive and negative emotions intertwined and coexisted. Negative emotions predominated in the beginning, while good feelings emerged gradually. Self‑coping methods and psychosocial development were significant factors in RTs mental health while caring for COVID‑19 patients.

The COVID‑19 pandemic has had considerable consequences in many areas of life, including the social area and childbearing plans. The present narrative review aimed to examine the childbearing decisions and its related factors during the COVID‑19 pandemic. This review was conducted by searching in scientific databases, including Web of Science, Science Direct, Google Scholar, Scopus, Cochrane, PubMed, ProQuest, Scientific Information Database (SID), Iranian Research Institute for Information Science and Technology (IranDoc) and Iranian Journal Database (Magiran) in June 2022. The search resulted in 111 sources, of which 16 were in line with the research objective. Couples have mainly cancelled or delayed their previous plans related to childbearing decisions. There are two groups of direct and indirect factors related to childbearing decisions during the COVID‑19 pandemic: The former includes (1) well‑being‑related factors such as economic conditions, interpersonal relationships and gender roles in terms of task division; and (2) health‑related factors, including health emergencies and physical and psychological health. The latter includes factors such as social distancing and social media. Based on the results, governments should facilitate childbearing by adjusting existing policies, addressing economic insecurity and protecting the livelihoods of those affected by the crisis. Health policymakers and planners must also prioritize women’s access to reproductive health services in a safe environment while promoting equity in access. It is also necessary to promote the quality and quantity of indirect care and virtual counseling based on the needs of women in crisis.

The usage of smartphones has become common among adolescents, despite knowing the health‑related problems of the user. Currently, the availability of electronic gadgets has become economical and this has an impact on society, especially on the behavior of adolescents.

A cross‑sectional survey design was used to find the pattern of smartphone usage, smartphone addiction, and subjective health problems associated with smartphone usage. The data were obtained from 270 nursing students using the convenient sampling technique using a sociodemographic proforma, semi‑structured questionnaire on the pattern of smartphone usage, Smartphone Addiction Scale, self‑reported subjective health problems questionnaire, and study habits scale. STATISTICAL ANALYSIS: Descriptive and inferential statistics was used for the analysis using SPSS 16.0.

The study findings revealed that most of the participants 243 (90.0%) were using 4G phones. The majority 88 (32.60%) of the participants were using a smartphone for less than 2 hours at a stretch in a day. Most uses of a smartphone were in the night 155 (57.40%). The main usage of a smartphone was for entertainment purposes 213 (78.90%). Most of the participants 196 (72.6%) were moderately addicted to smartphones. One‑third 109 (40.2%) of the participants complained of headache, followed by straining of the eyes 83 (30.6%).

The awareness of smartphone addiction and health‑related problems associated with smartphone usage has been shown to decrease its impact. The study concluded that it is very much necessary to identify the pattern of smartphone usage, to prevent the consequences of addiction and health problems associated with smartphone usage.

Sexually transmitted infections (STIs) have always been considered as a health problem in the world. Also, vulnerable women (addicts, jail breakers, and prostitutes) are at the highest risk. According to the World Health Organization’s (WHO) approach, the only effective way to prevent and control this disease is public health education, and high‑risk and vulnerable groups should be prioritized in educational programs. The aim of the study was to investigate the effect of health belief model (HBM)‑based education on changing the behaviors related to STIs in vulnerable women.

The present study is an intervention (field trial) study in vulnerable women. Convenience sampling method was used in this study and the sample size was determined to be 84 subjects. Through tossing a coin, the social support center was selected as the intervention group and the drop‑in center as the control group. Quantitative data analysis was performed, and descriptive and inferential statistical methods were used.

The mean scores of perceived threat, perceived benefits, perceived barriers, and perceived self‑efficacy and changes in performance between the three measurement stages, as well as changes in the scores of perceived threat, perceived benefits, perceived barriers, and perceived self‑efficacy over three measurement times were significantly different between the two groups (interaction) (P < 0.001). The mean score of performance 3 months after the intervention was significantly higher than before the intervention (P = 0.001).

The present study confirmed the effectiveness of the HBM in promoting behavioral modifiers that lead to STIs. Therefore, educational interventions with emphasis on understanding the threats, benefits, barriers, and self‑efficacy and, ultimately, performance improvement in relation to STIs are recommended.

E‑learning is the delivery of learning and training through digital resources. Although e‑learning is based on formalized learning, it is provided through computers, tablets, and even cellular phones those are connected to the Internet. This makes it easy for users to learn anytime, anywhere, with few, if any restrictions.

A cross‑sectional study was done, and data was obtained through an online survey method from September 14, 2020 to October 08, 2020. Questions were created in “Google Forms.” The targeted population was all nursing students from all over Nepal. There were a total of 365 respondents. A pilot study was done on 10 students. After the pilot study, the same question was distributed to all the respondents.

Almost half (40.8%) got disturbed in their online class because of electricity; around half of the respondents (41.9%) are disturbed in their online class because of Internet problems. Moreover, around half of the respondents (44.4%) use the data pack daily, and 38.6% use the data sometimes.

The study concludes that most students suffered from Internet disturbance and electricity problems during online classes. Because of electricity and Internet problems, most students feel anxious during class, and most of the students are not able to attend classes. Most students are compelled to use data packs for online classes. However, the course may not be completed if the problems arising during online classes are not solved.

Emotions are universal in academic and clinical settings. A student is likely to hope for success, maybe be worried about failure, or may feel comfortable after an exam. These feelings undoubtedly affect his/her motivation, effort, academic performance, and progress. This study aimed to investigate the role of emotion in the learning and performance of medical students and its mechanism. This study was a scoping review conducted in 2022 to examine the role of emotions in medical education. The three databases PubMed, ERIC, and Science Direct and the search engine Google Scholar were searched using the following keywords: “emotion,” “medical student,” “teaching,” “learning,” and “medical education.” English articles published from 2010 to 2022 were reviewed, and finally, 34 articles that met the inclusion criteria were reviewed. Review of the selected articles showed that there was a significant relationship between the cognitive system and emotions in the brain. The conceptual framework of the relationship between cognition and emotion can be explained in the form of dimensional and discrete views of emotions and based on cognitive load theory. Emotions affect cognition with the four mechanisms of memory, cognitive resources, cognitive strategies, and motivation and can be effective in learning self‑regulation, clinical reasoning, and academic achievement of medical students. Emotions in medical education is a double‑edged sword. In other words, it is highly recommended to divide emotions into activating and inactivating, instead of dividing them into positive and negative ones. In this context, medical educators can use the positive aspects of nearly all emotions to improve the quality of their teaching.

A teacher’s appropriate use of nonverbal communication skills, mainly kinesics, can play a crucial role in the success of the students. Medical educators are unaware of the effective use of nonverbal communication as an instructional skill that can be used to engage learners, balance learners’ participation by controlling the classroom environment, and motivate them to have a passion for learning. The purpose of the study was to explore the students’ perceptions regarding the effect of teachers’ kinesics on students’ learning and their learning environment. This can be helpful for teachers in modifying their teaching styles and delivering quality education.

A qualitative study with an exploratory design was conducted at a private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered to participate in the study. Focus group discussions were conducted with the students to explore the experiences of the medical students regarding the use of nonverbal communication skills by their teachers and its effect on their learning in the classroom. The data collected was analyzed manually.

The results of the study revealed that teachers’ nonverbal behaviors in the classroom significantly influence students’ motivation, engagement, and learning in the classroom. Students preferred interaction with the teachers who were friendly and confident and used their nonverbal communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict and judgmental teachers.

Teachers need to motivate their students by improving their teaching styles and incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning environment, students’ participation and learning will increase, which will, in turn, improve their academic performance.

Because of the spread of coronavirus disease 2019 (COVID‑19), the preventive measures have increased, such as focusing on the use of medicinal plants in most communities, including Iran. The purpose of this study was to identify the knowledge, attitude, and performance of individuals toward the use of medicinal plants and to identify the predictors of the use of medicinal plants in the prevention of COVID‑19.

This descriptive‑analytical study (February–April 2021) was performed on 3840 Iranian men and women aged 20–70 years selected as a multi‑stage cluster study. At the first stage, all provinces were divided into five regions: North, South, East, West, and Center. In the second stage, a provincial center and a city were randomly selected from each region (North: Sari, Babol; South: Bushehr, Bandar Genaveh; East: Mashhad, Sabzevar; West: Hamedan, Toisarkan; Center: Yazd, Ardakan). Data were collected by a researcher‑made scale based on the Health Belief Model (HBM). Data analysis was performed applying Pearson correlation coefficient, logistic regression, and linear regression.

The results showed that people have relatively high knowledge and positive attitude toward the use of medicinal plants in prevention of COVID‑19. The most important reason for positive attitude was the perceived benefits with the mean of 75.06%. Also, half of the people had poor performance. Correlation coefficient showed that the use of medicinal plants with perceived sensitivity (p = 0.000, r = 0.3), perceived benefits (p = 0.012, r = 0.126), perceived barriers (p = 0.000, r = 0.179), and perceived self‑efficacy (p = 0.000, r = 0.305) had a significant correlation. The strongest correlation between perceived self‑efficacy was observed with the use of herbs in prevention of COVID‑19. The HBM constructs can predict 26% of the variance for the use of medicinal plants in the prevention of COVID‑19, among which perceived self‑efficacy (β = 0.230) was the most powerful predictor.

Based on the results, the predictive role of self‑efficacy constructs for the use of medicinal plants in prevention of COVID‑19 has been confirmed according to the HBM. Therefore, methods of increasing self‑efficacy such as training programs and providing appropriate intervention models can be used not only as promoters of using medicinal plants in prevention of COVID‑19 but also for improving people’s performance in the proper use of medicinal plants.

Simulation debriefing influences learning from healthcare simulation activities. Health sciences educators must be competent in conducting simulation debriefing for healthcare students. A structured faculty development intervention for health sciences educators must be informed by educator needs to enhance its utility. This paper describes the needs of health sciences educators regarding simulation debriefing at a faculty of health sciences.

A parallel convergent mixed methods study design was applied on a selected population of 30 health sciences educators at the University (x) who integrate immersive simulation for first‑ to final‑year students in their undergraduate programs. The Objective Structured Assessment of Debriefing tool underpinned observations which informed the quantitative strand of the study, while semi‑structured interviews were conducted as part of the qualitative strand. Descriptive statistics and thematic analysis were used to analyze the data.

Health sciences educators struggled to establish the learning environment for simulation (median 1), facilitate learning (median 3), and evaluate their debriefing activities. However, they were able to apply an appropriate approach toward simulation (median 4). They identified the need to be educated on the fundamentals of simulation‑based education.

A continuing professional development program must be developed aimed at transforming approaches toward facilitating learning, explaining the fundamentals of simulation‑based education, modeling of best‑practices related to debriefing, and applying appropriate strategies for evaluating debriefing activities.

Gestational diabetes is the most common medical complication and a common metabolic disorder during pregnancy. Increasing people’s self‑efficacy is one of the best ways to control this disease. As there is a lag of intervention in this regard, the purpose of this study was to determine the effect of couple supportive counseling on self‑efficacy in women with insulin‑treated gestational diabetes.

In this randomized clinical trial, 64 women with gestational diabetes who referred to diabetes clinic of Mashhad Ommolbanin Hospital were divided into intervention and control groups through block randomization during 2019. Their gestational age was in 26–30 weeks. For the couples in the intervention group, three couple supportive counseling session was held. Each session lasted 1 h and was held one time per week. The instruments were diabetes self‑efficacy questionnaire, fasting and 2‑h postprandial checklist and Cassidy social support, which were assessed before and 4 weeks after intervention in both groups. Data was analyzed by SPSS software version 25 through Mann–Whitney and Wilcoxon test. P values of < 0.05 were reported to be significant.

In the preintervention, the diabetes self‑efficacy score had no significant difference in the intervention (30/6 ± 38/50) and control groups (09/8 ± 56/51) (P = 515/0). However, in the postintervention, the diabetes self‑efficacy score was significantly higher in the intervention group (58/6 ± 41/71) compared to the control group (15/7 ± 31/51) (P < 001/0). Also, before the intervention, there was no significant difference between the intervention (30/2 ± 72/10) and control group (87/1 ± 63/11) (P = 137/0) regarding social support. However, after the intervention, there was a significant difference between the intervention and control groups (879/0 ± 53/13, 03/2 ± 41/11, P < 0/001 respectively). Also, data analysis showed a significant correlation between self‑efficacy and social support (r = 0.451, P < 0.001), self‑efficacy and fasting blood sugar (P < 0.001, r = ‑0.577), and 2 h post prandial (r = ‑0.778, P < 0.001).

Couple supportive counseling leads to increased self‑efficacy and social support in pregnant women with gestational diabetes. Therefore, it is recommended to use this counseling as an effective method in the management of diabetic pregnant women during their prenatal care to have a healthier pregnancy.

Preclinical students often fail to appreciate the clinical relevance of basic sciences during the first year of undergraduate medical training, leading them to lose interest in the subject, and preventing them from achieving the desired goals. In order to rectify this gap in the curriculum, Medical Council of India (MCI) in 2011 published a document announcing curricular strategies including Early Clinical Exposure (ECE) to effectively modify the Indian system of education. Lack of proper guidance prevented many institutions from implementing ECE. Since our institution had run a similar program of “Clinical Observership” as early as 2001, we were able to implement ECE in an efficient way.

Early clinical exposure was implemented as a structured program, with the participation of 10 clinical departments since 2013. Feedback from the students, soon after ECE and also from the batch of CRRIs, who had undergone this program while they were preclinical students amply support the effectiveness of ECE in its contents and methods of implementation. Manual content analysis was performed on open comments. After reading the responses, they were broken down to meaning units, and these were then condensed. The condensed meaning units were labeled with codes. The codes were grouped into categories. Themes were derived from the categories.

Out of the 70 CRRIs, 52 responded to the questionnaire. All the CRRIs except one said that ECE was very helpful during their clinical postings and internship period. They suggested that the number of hours of posting should be increased and also reiterated the fact that a greater number of clinical departments could be included in the program. Though the beneficial effects were felt in all the domains of learning, the most remarkable impact was felt in the affective domain, wherein changes are not easy to come by.

Recently, National Medical Council has come out with plans of including ECE in the syllabus with strict time schedule. It is felt that the faculty will find our experience of running the program for the past five years helpful in implementing this program, for the fullest benefit of the preclinical students.

Chemotherapy is a complex, multi‑disciplinary, and error‑prone process. Information technology is being increasingly used in different health care settings with complex work procedures such as cancer care to enhance the quality and safety of care. In this study, we aimed to develop a computerized physician order entry (CPOE) for chemotherapy prescribing in patients with gastric cancer and to evaluate the impact of CPOE on medication errors and order problems.

A multi‑disciplinary team consisting of a chemotherapy council group and system design and implementation team was formed for chemotherapy process evaluation, requirement analysis, developing computer‑based protocols, and implementation of CPOE. A before and after study was conducted to evaluate the impact of CPOE on the chemotherapy process and medication errors and problem orders. To evaluate the level of end‑user satisfaction, an ISO Norm 9241/110 usability questionnaire was chosen for the evaluation.

Before the implementation of the CPOE system, 37 medication errors (46.25%) and 53 problem orders (66.25%) were recorded for 80 paper‑based chemotherapy prescriptions. After implementation of the CPOE system, 7 (8.7%) medication errors and 6 (7.5%) problem orders were recorded for 80 CPOE prescriptions. The implementation of CPOE reduced the medication error by 37.55% and the problematic order by 58.75%. The results for usability evaluation indicate that the CPOE was within the first class of the ISONORM level rating; this shows that a CPOE is with very high satisfaction and a very high functionality rate.

Developing a CPOE system significantly improved safety and quality of the chemotherapy process in cancer care settings by reducing the medication error, deleting unnecessary steps, improving communication and coordination between providers, and use of updated evidence‑based medicine in direct chemotherapy orders. However, the CPOE system does not prevent all medication errors and may cause new errors. These errors can be human‑related factors or associated with the design and implementation of the systems.

The birth of a pre‑mature infant and subsequent hospitalization and separation from the family can impair maternal and neonatal attachment and quality of maternal care. This study aimed to assess the effect of instructing mothers in attachment behaviors on short‑term health outcomes of pre‑mature infants admitted to neonatal intensive care units (NICUs).

In this quasi experimental study, 80 mothers of pre‑mature infants who were admitted to NICUs at two referral health centers in northern Iran were studied in two groups in 2018. Attachment behaviors were taught to mothers in the test group during four consecutive sessions. Mother–infant attachment behaviors were evaluated at both the beginning and the end of this study using a checklist derived from Avant’s Maternal Attachment Assessment Strategy. Moreover, infants’ short‑term health consequences were investigated in two groups. SPSS 18 statistical software was used for data analysis.

On average, it took respectively 34.90 ± 12/65 and 31/15 ± 14/35 days for the infants in the control and the intervention group to reach full oral feeding and 38/5 (38/4–42/11) and 37 (31/85– 42/14) days to gain the minimum weight required for discharge. Moreover, the mean length of stay for the infants in the control and the intervention group was 41/80 ± 13/86 and 39/02 ± 16/01 days, respectively (P > 0/05).

Instructing mothers in attachment behaviors clinically improved short‑term health‑related outcomes. Hence, this intervention is recommended to be incorporated in the care program for mothers with pre‑mature infants.

The aim of this study was to investigate the living experience of coronary patients in Shiraz and the peak prevalence of the second stage in summer. This study could further examine these experiences in broader groups in subsequent studies. Identifying the psychological causes and effects of this disease with the help of patients involved in some countries has been considered.

The method, which was used in this study, was a qualitative method and content analysis. Participants in this study were 13 patients with COVID‑19, some of whom were members of the medical staff. The participants were selected purposefully. The semi‑organized interview with the participants continued until the theoretical saturation was reached.

After extracting the codes, researchers classify them, and then the results were examined in more depth and categorized. About 120 extracted codes were classified into seven general categories; three of them were directly related to psychological issues. The other four of them were related to the subject of psychological effects and consequences.

In general, during the interview process, it was proved that the more severe the symptoms of the disease, the psychological experiences of confronting the disease because of its outbreak, and the processes of coping with it were deeper.

The safety of patients remain at risk due to a higher workload and lower nurse‑to‑patient ratio. However, in India, most hospitals still adhere to long‑known nurse staffing norms set by their statutory or accreditation bodies. Therefore, the present study was undertaken to recommend a standard workload‑based estimation of nursing manpower requirement in the ICU of a tertiary care teaching hospital.

It was a descriptive, observational, time and motion study was conducted in the medicine ICU of a tertiary care teaching hospital. Data collection was done by using demographic and clinical profile sheet of patients, NPDS‑H dependency assessment scale, time and activities record sheet, and WHO WISN tool. The nurses’ activities were observed by nonparticipatory and non‑concealment technique. Data analysis was done using descriptive statistics and the WHO WISN tool.

The bed occupancy rate and the average length of stay in the medicine ICU were 93.23% and 7.18 days respectively. Distribution of dependency level of the medical ICU patients was very high (41.67%), low‑high (33.33%), and medium‑high (25.0%) dependency level. Considering available resources and workload in tertiary care hospitals in India, the study recommended a nurse‑to‑patient ratio of 1:1.2 in each shift for the medicine ICU of a tertiary care hospital.

The study suggested minimum nurse-to-patient ratio in medical ICU should be 1:1.2 with provision of power to ICU incharge nurse to allocate nurses according to the workload in different shifts. Also, nurse staffing norms in hospitals need to be estimated or selected with serious consideration of health care demands when employing nurse staffing norms.

Family caregivers of hemodialysis patients experience various physical, psychological, social, economic, and spiritual problems that reduce their quality of life. The present study aimed to determine the effect of a family‑centered education program on the quality of life of family caregivers of patients undergoing hemodialysis.

This was a randomized controlled trial that was performed on 70 caregivers of patients undergoing hemodialysis in the medical centers of Hazrate Ali Asghar and Hazrate Zahraye Marzieh in Isfahan. Caregivers were randomly divided into experimental and control groups, and the experimental group received an eight‑session family‑centered education program. Data were collected using the Quality of Life Scale (QOLS)‑short form immediately after and 1 month after the intervention. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software version 18 and analysis of variance and covariance.

The results showed that both experimental and control groups were homogeneous in terms of demographic information and there was no significant difference between them in this regard. Analysis of data on quality of life and its four domains showed that the mean scores of quality of life (P = 0.089) and its four domains including physical health (P = 0.367), mental health (P = 0.429), community relations (P = 0.132), and environmental health (P = 0.232) increased significantly immediately after and 1 month after the intervention (P < 0.001 in all cases).

Educational programs can improve the quality of life of family caregivers of hemodialysis patients. Therefore, it is recommended that programs be developed and evaluated in various studies in the future.

Clinical‑based mobile learning courses have great demand among the nursing graduates as learners look for possibilities to update skills. The present study explores the feasibility, familiarity, utility, and attitude of nursing graduates of South India toward mobile learning applications (m‑apps).

An online‑based cross‑sectional descriptive survey was conducted in May 2021 among the South Indian nursing graduates of Tamil Nadu and Kerala, using a questionnaire consisting 49 items categorized under six sections with items related to socio‑demographic information; m‑app usage; online learning experience; preference in using m‑apps for learning purposes before COVID‑19 and during COVID‑19; students’ engagement through e‑learning; and anxiety related to online assessment. Descriptive and inferential (ANOVA, Chi‑square, and t test) statistical data analysis were done using SPSS version 23.

A total of 447 student nurses responded. The result shows that most of them, 96% (432) used android phones and 94% (422) owned a mobile. Age was highly influencing mobile learning application (m‑learning apps) usage; students of less than 20 years of age used applications more frequently and possessed more educational applications. Majority of them, 84% (377) of them had started using m‑learning apps only after COVID. 57.7% (249) commonly used m‑learning apps for acquiring nursing knowledge resources, nursing exam preparatory, and drug resources. Students rated high for the interactive nature of these m‑learning apps, while abundant learning materials and usage with ease were rated as other attractive features. Sixty‑six percent (305) had mostly downloaded these apps from Google Play Store.

The findings would help the m‑learning application developers to offer customize solutions to address learning gaps that prevail among the South Indian nursing graduates and help with sustainable growth.

This study aimed to investigate and compare the efficacy of cognitive‑motor rehabilitation (CMR) with methylphenidate on cognitive functions and behavioral symptoms of children with attention deficit/hyperactivity disorder (ADHD) and specified the near‑transfer and far‑transfer effects.

The research was semiexperimental with posttest and follow‑up assessments, in a single‑blind design. Forty‑eight boys with ADHD, aged 9–12, were selected conveniently regarding the inclusion/exclusion criteria, matched base on severity and Intelligence quotient (IQ) and were randomly assigned to CMR (n = 16), methylphenidate medication (MED, n = 16), and placebo CMR groups (PCMR, n = 16). CMR and PCMR received 20 3‑h training sessions, and the MED group received 20 or 30 mg/day methylphenidate. Tower of London (TOL), Swanson, Nolan, and Pelham, Version IV Scale (SNAP‑IV), Wechsler’s digit span and mathematic subscales, dictation test, and restricted academic situation scale (RASS) were completed at posttest and follow‑up. The data were analyzed by repeated measures multivariate analysis of variance.

CMR outperformed PCMR on forward digit span, backward digit span, ToL score at both posttest, and follow‑up (P < 0.05). CMR scored lower than MED on ADHD‑PI and ADHD‑C at both posttest and follow‑up (P < 0.05). Moreover, CMR outperformed MED on dictation at both assessment phases (P < 0.01) and RASS at the follow‑up phase (P < 0.05). CMR outperformed PCMR on mathematics at post‑test (P = 0.038) and also, in dictation and RASS, at both post‑test (P < 0.001) and follow‑up (P < 0.05).

CMR Improves near‑transfer cognitive functions and behavior symptoms of ADHD as much as MED, but only CMR has more generalizable and endurable improvement on complex Efs and academic performance (far‑transfer effects).

Assessment of circulating and scrub skills is an important issue in operating room (OR) programs. However, there is a lack of well‑designed tools that are specifically developed for this purpose. Hence, this study aimed to develop and determine the validity and reliability of a checklist to measure the circulating and scrub skills of OR novices.

This cross‑sectional methodological study was conducted among 124 OR technology students who were selected during three consecutive academic years (2019–2020 to 2021–2022). The developed checklist was evaluated with face validity, content validity (quantitative and qualitative), construct validity (known‑groups validity), criterion‑related validity (concurrent and predictive validities), internal consistency (Kuder–Richardson 20, KR‑20), and inter‑rater reliability (intra‑class correlation coefficient, ICC). Known‑groups validity was evaluated by comparing the difference between the checklist scores of first‑semester and third‑semester students using independent samples t‑test. Additionally, concurrent and predictive validities were evaluated by ICC through measuring the correlation between the total score of checklist and grades of a multiple‑choice test and two clinical apprenticeship courses, respectively. Data were analyzed in the Statistical Package for Social Sciences software.

After reconciling the preliminary checklist in terms of face and content validities, a checklist with 17 sub‑scales and 340 items called “Circulating and Scrub Skills of Operating Room Novices (CSSORN)” was developed. Regarding the known‑groups validity, the third‑semester students had higher scores compared to the first‑semester students (p < 0.001 in most sub‑scales). Besides, the total score of checklist showed a significant correlation with the criteria of concurrent and predictive validities (ICC = 0.64, ICC = 0.72; P < 0.001). The KR‑20 for the entire checklist was 0.90 (range: 0.60–0.93). The ICC for inter‑rater reliability was also 0.96 for the entire checklist (range: 0.76–0.99, P < 0.001 in all sub‑scales).

The CSSORN had appropriate validity and reliability to be used for measuring the circulating and scrub skills of OR novices. To shed light on the findings, further testing of this checklist on larger populations and in different contexts is suggested.

Online learning is the newest and most popular form of distance education today; within the past decade it has had a major impact on education. The aim of the present study was to know the effect of online learning basketball using social media on learners’ performance of some fundamental skills in basketball and determine difference between online learning and in‑person learning, knowing which one is better than the other.

The present experimental study was conducted in Sports Academy for Basketball in Zagazig‑Egypt during March–April 2022. Thirty two female junior basketball players volunteered to participate in the study from Sports Academy for Basketball (age: 16.23 ± 0.66 years; body height: 164.5 ± 3.32 cm; body mass: 65.25 ± 3.22 kg). They were divided into two equally sized experimental groups, online learning (ONL) group (n = 16) and in‑person learning (INL) group (n = 16), to perform (15) educational sessions for (5) weeks, (3) sessions per week, and the session time was 90 minutes. Junior basketball players were assessed before and after five‑week training period. Data were collected by Basketball Passing test, Dribbling Skill test, Lay Up Shoot test, Speed Spot Shooting, and Free‑Throw Shooting test. The collected data were analyzed using SPSS version 22 software using the descriptive statistical test. The level of significance was set at P ≤0.05.

The results showed that the two groups made significant improvements in all variables but INL group had significantly greater improvements than ONL group. The percentage of improvement ranged from 13% to 223% for INL group versus 8% to 158% for ONL group.

We conclude that in‑person basketball learning was better than online learning basketball. Therefore, teachers and trainers must rely primarily on in‑person learning and not rely on distance learning, especially with regard to learning motor skills, except in emergency cases.

Self‑medication is the use of unprescribed drugs to treat a disease. Elderly self‑medication can be more dangerous compared to other age groups because of changes in organ functions that occur due to senescence. This study aimed to estimate the prevalence of self‑medication in the elderly, its related factors, and common drugs used in this regard.

Electronic databases such as PubMed, Scopus, and Web of Science were searched between January 2016 and June 2021. The search strategy was built on two core concepts: “self‑medication” and “aged”. The search was limited to original articles in the English language. A random effect model was used to estimate the pooled prevalence of self‑medication. Heterogeneity among studies was assessed using both the I2 statistic and the χ2 test. Also, a meta‑regression model was used to investigate the potential sources of heterogeneity of the studies.

Out of 520 non‑duplicate studies, 38 were included in the meta‑analysis. Self‑medication in the elderly ranged from 0.3% to 82%. The pooled proportion of self‑medication was 36% (95% CI: 27%–45%). The result of the χ2 test and the I2 index (P < 0.001, I2 = 99.90%) revealed notable heterogeneity among the included studies in the meta‑analysis. The meta‑regression showed a significant association between the sample size (adjusted β = −0.01; P = 0.043) and the pooled proportion of self‑medication.

The prevalence of self‑medication in the elderly is high. Education through mass media to raise awareness about the dangers of self‑medication can help solve this problem.

Dentists are often overlooked resources in the workforce for disaster management (DM). To determine the knowledge, attitudes, willingness, and self‑perceived effectiveness to participate in DM among general dental practitioners (GDPs) of Eastern India.

A web‑based online survey was conducted among 256 Dental Council of India registered GDPs of Cuttack district, Odisha. The 45‑item survey comprised closed‑ended questions on the demographic data of the participants, years of practice, previous experience in DM, and willingness to participate. Other domains assessed were the participants’ objective knowledge of DM, attitude, and self‑perceived effectiveness toward participation during disasters. Data were analyzed descriptively, and the Chi‑square and Mann–Whitney U tests were used for statistical analysis, with a significance threshold of P < 0.05.

A total of 154 responses were analyzed, giving a response rate of 60.16%. The average age was ≤35 years, 59.1% were BDS dentists and 78.6% had less than 10 years of practice. Only 18% of them had previous experience with DM, and merely 3.2% were formerly trained; however, 95.5% of the dentists were willing to participate in DM. The mean DM knowledge and attitude scores were 16.12 (CI = 15.4–16.8) and 5.79 (5.45–6.13), respectively. Knowledge and attitude showed a significant correlation. About 56% indicated that they would be able to respond effectively to a disastrous event. Significant associations were observed between age group (P = 0.008), years of clinical practice (P = 0.001), qualification (P = 0.012), previous participation (P = 0.029), and self‑perceived effectiveness.

The knowledge regarding DM among respondents was at an average level. However, the majority of them were found to have a positive attitude toward participation in DM. Thus, including DM in dental curricula and drills for dental professionals might prove beneficial as almost all GDPs were showing greater self‑perceived effectiveness and willingness to participate in disasters.

Previous studies have shown that psycho‑spiritual state of mothers may have significant effects on their breastfeeding. The most common cause of nonexclusive breastfeeding is inadequate breastfeeding; therefore, this study examined the relationship between spiritual health and perceived stress with breastfeeding adequacy in mothers with infants aged 1–6 months.

This cross‑sectional, descriptive, correlational study was performed on 186 mothers with infants aged 1–6 months, who referred to the health centers in Dorud city of Lorestan province, Iran, in 2021, which were selected based on cluster sampling. Data were collected through four questionnaires including demographic–fertility, spiritual health, perceived stress, and breastfeeding adequacy. Data was analyzed by Statistical Package for the Social Sciences (SPSS) software version 22 using descriptive and analytical statistics.

The mean ± standard deviation (SD) values of spiritual health, perceived stress, and breastfeeding adequacy were 99.59 ± 12.96, 23.8 ± 72.19, and 55.67 ± 7.67, respectively. There was a significant positive relationship between spiritual health and breastfeeding adequacy (P < 0.001, r = 0.268). In addition, there was a significant negative relationship between perceived stress and breastfeeding adequacy (P = 0.002, r = −0.231).

Breastfeeding adequacy has a significant positive relationship with spiritual health and a significant negative relationship with perceived stress. Since infants are one of the most vulnerable groups and breastfeeding is the best way to support their health and reduce infant mortality rates, breastfeeding adequacy can be improved by reducing stress and promoting spiritual health.

The number of older adults with bipolar disorder is increasing and medication non‑adherence is a major problem that negatively impacts the course of bipolar disorder. This study aimed to determine the effect of a comprehensive individual motivational‑educational program on medication adherence in elderly patients with bipolar disorder.

An experimental study with pretest‑posttest repeated measures with a control group was conducted on two groups of 62 elderly people with bipolar disorders hospitalized at Ibn Sina Hospital in Mashhad, Northeast Iran, 2019. For the elderly in the intervention group, a comprehensive motivational‑educational program was administered for one month (four 30–45 minute sessions), and for the elderly in the control group, routine clinical care was performed. Medication adherence in both elderly groups was measured before, immediately after, one and two months after the intervention. Data were analyzed by SPSS statistical software (version 16) using descriptive statistics and independent t‑test, Mann‑Whitney, paired t‑test, repeated measures analysis of variance (ANOVA), and Chi‑square tests.

The mean age of elderlies in the intervention and control groups were 69.03 ± 5.75 and 68.50 ± 6.73 years, respectively. Regardless of the groups to which the patients were assigned, a significant difference in medication adherence scores was observed during the study period (time effect; P < 0.001). Also, the medication adherence score was significantly lower in the intervention group, compared to the control group (group effect; P < 0.001). Also, there was a group time interaction between the medication adherence score and the time of evaluation (P < 0.001).

The results of the present study confirm the positive effect of a comprehensive educational‑motivational program on improving medication adherence in elderly patients with bipolar disorder.

Recent findings show that a longer breastfeeding duration and proper dietary management could lower the risk of postnatal diabetes. An excellent and interactive education module on breastfeeding and diet may effectively improve breastfeeding practices and dietary knowledge among women with gestational diabetes mellitus (GDM). Therefore, this study delves into developing and validating the content of Breastfeeding and Dietary Education Package (BFDEP) for women with GDM.

The development of the module involved three phases: need assessment, module development, and validation. Six experts deployed a content validity index (CVI) to evaluate three areas of the module, including objectives, structure or presentation, and relevance. Sixteen women with GDM were involved in the face validation process by assessing the “literacy presentation,” “illustrations,” “material is sufficiently specific,” and “quality of information.”

Generally, I‑CVI, S‑CVI/Ave, and S‑CVI/UA of the objectives, structure or presentation, and relevance revealed an excellent level of content validity. No alteration was needed for the domains of objective and relevance (S‑CVI/Ave: 1.0, S‑CVI/UA: 1.0). However, a minor revision was required in the structure or presentation domain (S‑CVI/Ave: 0.98, S‑CVI/UA: 0.90). The experts also thought that some module pages were wordy, and a change of font color was needed. The module was thus modified accordingly. For face validation, “literacy presentation” and “material is sufficiently specific” had a 99% positive response, while “illustrations” and “quality of information” had 100% positive feedback.

A BFDEP with excellent content validity was developed and can be implemented to improve breastfeeding practices and dietary knowledge among women with GDM.

The educational environment plays a very important role in determining the overall performance of students. The aim of this study is to determine the perceptions of undergraduate medical students about their educational environment in a Nigerian university.

This was an observational, cross‑sectional study conducted among final‑year (600 level) undergraduate medical students. The Dundee Ready Education Environment Measure (DREEM) questionnaire was used for the study to assess the educational environment of the medical students.

A total number of 100 final‑year (600 level) undergraduate medical students participated in the study, out of which 27 (27.0%) were males and 73 (73.0%) were females with a male‑to‑female ratio of 0.37 to 1. The age range of the respondents was 21–30 years with a mean (±SD) of 23.54 (±1.403). The total mean DREEM score was 116.2/200. The total score of SPL domain was 30.2/48 (62.9%). The total score of SPT domain was 27.3/44 (62.0%), while that of SASP was 19.2/32 (60.0%). The total score of SPA domain was 26.6/48 (55.4%) and that of SSP was 13.1/28 (46.8%). For the SPL, SPT, SASP, and SPA domains, the score was above 50%. However, for the SSP domain the score was less than 50%.

The total mean DREEM score in this study was 116.2/200, more positives than negatives, with the students’ social perspective having the least domain score. There is a need to provide adequate social support system for medical students in general and particularly for those who get stressed.

Due to the COVID‑19 pandemic, online learning has become the main method of instruction. This study aimed to evaluate Moroccan medical students’ perceptions of medical online learning experience and to list its probable related advantages and barriers.

A cross‑sectional study on 400 medical students randomly selected from the different national medical institutions was conducted. A questionnaire evaluating the online learning experience during the pandemic was distributed via institutional e‑mails. Statistical analyses were carried out using Statistical Package for the Social Sciences (SPSS).

51.2% of students were satisfied with the online learning experience and reported several benefits including no need to travel (35.8%), cost savings (20.7%), and flexibility of home studying (32.3%). Technical issues related to the use of platforms or internet connection, limited interaction between students and their instructors, and lack of motivation were the major barriers to online learning. Moreover, results also showed a significant difference when comparing the attendance frequency between presential classes and online learning (i.e., before vs. during the COVID‑19 pandemic) (P < 0.001).

The experience of medical online learning was reported in our study to be associated to several advantages and disadvantages. Hence, students’ perceptions should be considered to evaluate and improve the quality of this instructional method for a successful and more active approaches implementation.

Fluoride Ion can cause remineralization of primary caries lesions in the presence of calcium and phosphate. New compounds of calcium‑containing casein phosphopeptides‑amorphous calcium phosphate (CPP‑ACP), make the remineralization more effective. This research has been done to evaluate the awareness, attitude, and performance of Isfahan general dentists regarding the prescription of new caries prevention materials containing calcium and fluoride components.

This cross‑sectional‑descriptive‑analytic study has been conducted on 152 general dentists in Isfahan ensuring confidentiality of information and obtaining informed consent. Isfahan general dental offices and clinics were selected using a simple random method. Data of this research were collected using a questionnaire from previous studies. The questions were divided into four sections, including demographic information, awareness, attitude, and performance towards products containing calcium and fluoride prescription. The significance level of P was considered 0.05. Data were analyzed using SPSS version 22, T statistical test, Pearson correlation coefficient, and one‑way analysis of variance.

The mean score for dentists awareness was 46.3 (standard deviation [SD] = 15.4), the mean score of attitude was 91.4 (SD = 26.1) and the Mean Score of performance was 54.3 (SD = 27.3) (the scores range from 0 to 100). According to the Pearson correlation coefficient, there was no significant relationship between dentists’ awareness, attitude besides performance, and their ages together with dentistry work experiences (P > 0.05).

According to the study results, dentists’ awareness of compounds containing CPP‑ACP is overall average. However, attending to their positive attitudes toward this context, providing appropriate training programs seem to stimulate them for optimum cooperation as well as using these products for patients.