نشریه پرستاری و مامایی ارومیه
سال بیست و یکم شماره 4 (پیاپی 165، تیر 1402)

Self-efficacy of correct pain management and emotional intelligence are the most responsibilities of nurses, which, if properly considered, will reduce patients' pain, better manage patients, increase the quality of patient care, quickly return of the patients to daily life, reduce the length of stay in hospital, and reduce treatment costs. Therefore, the present study was conducted to determine the self-efficacy of pain management and its relationship with emotional intelligence in the nurses.

The current cross-sectional study was fulfilled by available sampling method on 110 nurses from the internal and surgical, infectious, CCU, ICU, pediatric, and emergency departments in the morning, evening, and night shifts of Razi and Salahuddin hospitals in Baneh city, Iran. Data were collected by researcher using Demographic questionnaire, Pain Management Self-Efficacy questionnaire, and Goleman Emotional Intelligence questionnaire. The results were analyzed in SPSS version 25 software using descriptive statistics and independent t-tests, one-way analysis of variance, and Pearson's correlation coefficient. A probability of <0.05 was accepted as significant.

The study results showed that pain management self-efficacy had no significant relationship with nurses' demographic characteristics such as age, gender, marriage, education level, position, overtime, work experience, and employment status (P>0.05). However, there was a significant relationship between pain management self-efficacy and its dimensions with the variables of the service department and training workshop as well as between pain management self-efficacy and the dimension of pain assessment (P<0.05). Emotional intelligence has no significant relationship with nurses' demographic characteristics such as age, gender, marriage, education level, service department, position, overtime, work experience, employment status, and participation in educational workshops (P>0.05). Also, no significant relation was observed between pain management self-efficacy and nurses' emotional intelligence (P>0.05).

Although pain management self-efficacy was not significantly related to nurses' emotional intelligence, some demographic characteristics were significantly related. The findings show that work experiences, awareness, practical knowledge, positive attitude, and skills can increase pain management self-efficacy.

Artificial Intelligence (AI) technology's advancement has made it possible to utilize it in the nursing and midwifery fields to improve decision-making, provide better care for patients, and enhance the performance of healthcare systems. The application of artificial intelligence in these domains has gained attention as a practical and innovative approach to providing care services. However, the real-world applications of AI across all domains of both professions are limited, and new ethical challenges arise with the use of AI in healthcare. Real-world applications of AI in nursing and midwifery: AI techniques are being applied in nursing and midwifery to improve decision-making, patient care, and service delivery (1). AI can also support nurses' clinical decision-making in complex care situations or conducting tasks that are remote from direct patient interaction, such as documentation processes (2). Ethical challenges: New ethical challenges arise with the use of AI in healthcare. For example, nurses and midwives should ensure that integrating AI into the health system is introduced that is ethical and aligns with core nursing values such as compassionate care (3). Although using AI in nursing and midwifery can be an auxiliary tool for nurses and midwives, but cannot be considered as a substitute for them. Nurses and midwives play a crucial role in providing healthcare services to patients, and besides providing care to the patient, they also assist in emotional and psychological support, which contributes to improving their health. AI can be used in specific tasks such as processing disease data, diagnosing some diseases, and providing support in clinical decision-making, but it cannot replace the human role of nurses, midwives, and healthcare professionals (4, 5). The potential of AI to improve decision-making, patient care, and healthcare services in nursing and midwifery is highly valuable. Using of artificial intelligence as a novel and effective approach to providing improved care services has been significantly enhanced. However, new ethical challenges arise with the use of AI in healthcare, and there is a need for greater participation among all the stakeholders involved. Nurses and midwives should ensure that integrating AI into the health system is introduced that is ethical and aligns with core nursing values such as compassionate care. Data science models can also help improve midwives' learning competencies, push digital leaning toward personalized content, and provide an adaptive learning journey. There are several limitations of AI in nursing and midwifery care that need to be considered, including:1. Lack of human touch: Nursing and midwifery care requires a personal touch and emotional support, which AI systems cannot provide. 2. Limited interpretation of patient needs: AI systems rely on data and algorithms to generate recommendations, which may not fully capture the unique needs and preferences of individual patients 3. Limited ability to provide physical care: AI systems cannot provide physical care, such as administering medications or performing procedures, which are important aspects of nursing and midwifery care. 4. Limited ability to handle complex situations: Nursing and midwifery care often involve complex situations that require critical thinking and decision-making skills, which AI systems may not replicate. 5. Dependence on data quality: AI systems rely heavily on accurate and comprehensive data to generate recommendations. Data quality issues, such as incomplete or inaccurate data, can compromise the accuracy of AI-generated recommendations. 6. Ethical considerations: The use of AI in nursing and midwifery care raises ethical concerns related to patient privacy, data security, and the potential for AI to decide without human oversight. 7. Cost: The development and implementation of AI systems can be expensive, limiting their accessibility and adoption in certain nursing and midwifery care settings (1, 6-8). What ethical challenges arise with the use of AI in health care? Using artificial intelligence (AI) in healthcare raises several ethical challenges that must be addressed. Here are some of the ethical challenges of AI in healthcare:Impact on patient autonomy: AI in healthcare may impact patient autonomy, and patients must be involved in decision-making (7). Informed consent: The use of AI in clinical practice raises immediate challenges in integrating it into clinical practice, including how it will interface with the principles of informed consent (9). Safety and transparency: There is a need for safety and transparency in using AI in healthcare, including the need for clear guidelines and regulations (10). Data privacy: The use of AI in healthcare involves the collection of personal and sensitive data that needs to be kept secure and protected from potential cyber-attacks (11). Accountability and transparency: There is a need for accountability and transparency in the development and use of AI in healthcare, including the need for clear guidelines and regulations (12). In conclusion, the use of AI in healthcare raises several ethical challenges that need to be addressed, including informed consent, safety and transparency, data privacy, accountability and transparency, and impact on patient autonomy. It is important to develop clear guidelines and regulations to ensure that AI is developed and implemented ethically and responsibly.

Resilience of the nurses in stressful work environments may have positive organizational effects. According to studies, employees' perception of organizational justice affects their professional commitment and resilience. This study aimed to investigate the relationship of organizational justice with professional commitment and resilience of nurses working in Medical-Educational Centers of Hamedan University of Medical Sciences in 2020-2021.

This descriptive-analytical study was conducted on 260 nurses working in in Medical-Educational Centers of Hamedan University of Medical Sciences. Sampling was done by stratified random sampling method. The research was performed using a demographic questionnaire, Niehoff and Morman Organizational Justice Questionnaire, Jafaraghaei Professional Commitment Questionnaire, and Connor and Davidson Resilience Questionnaire. Data was analyzed in SPSS v24 software using Pearson correlation and regression tests.

Perceived organizational justice was at an average level (2.94 ± 0.78), professional commitment was at a high level (2.80 ± 0.64), and resilience was at an average level (2.65 ± 0.61).Results showed that there was a statistically significant relationship between organizational justice and professional commitment (P=0.013, r=0.154) and professional commitment and resilience (P<0.001, r=0.607), but organizational justice and resilience (P=0.616, r=0.031) were not significantly related. Organizational justice and professional commitment together explain 0.379 of the variance of resilience.

Nurses' perception of organizational justice can increase their professional commitment, and higher professional commitment can increase their level of resilience. Therefore, hospital managers and administrators can increase the level of resilience in nurses by planning to improve the level of organizational justice and professional commitment of nurses.

Patients with spinal cord injury are prone to depression due to low quality of life and dependence on others to perform daily activities. Various studies conducted in Iran to estimate the prevalence of depression in these patients have reported different results. The present study was conducted to estimate the prevalence of depression in spinal cord injury patients in Iran.

Magiran, SID, PubMed, Scopus, and ISI databases were searched until January 2022 with keywords depression, spinal cord injury, and synonyms. All observational studies published in Persian and English that reported the prevalence or frequency of depression were included in the analysis. Data were analyzed with random effects model and meta-regression. Heterogeneity was evaluated with Cochran's Q test and I2 statistic.

 Seven studies with a sample size of 1517 people were included in the analysis. The overall prevalence of depression was 43% (95% confidence interval: 30-57). Based on the meta-regression analysis, there was no relationship between the prevalence of depression, the year of publication of the articles, and the sample size. Publication bias was not significant (p=0.0505).

 Nearly half of spinal cord injury patients in Iran suffer from depression. Considering that depression can make them prone to suicidal thoughts and other mental problems and reduce their quality of life and adherence to treatment, it seems necessary to identify people at risk to provide more health care.

 Women of reproductive age, especially after giving birth, are prone to overweight. Excess weight in the postpartum period is a problem for public health. آealth promotion is a process that enables people to have control over their health and mostly emphasis on disease prevention and self-care abilities. Considering that women are at the center of family health and are the main model of teaching and promoting a healthy lifestyle to the next generation, this study aimed to determine the health-promoting behaviors in postpartum women with High Body Mass Index in Urmia City, Iran.

 In this cross-sectional study, 104 women who gave birth with a high body mass index, who were covered by health centers, were selected by available sampling method. The data collection tool was Standard Walker's Health Promotion Lifestyle Questionnaire, completed by self-report via WhatsApp. The data were then analyzed with SPSS-16 software, using descriptive and inferential statistics.

 The mean age of the participants in the above study was 27.07±5.96 years and their average BMI was 27.82±1.6 years. The total score of health-promoting behaviors was 110.42±10.66, which was at the desired level. The highest mean score was related to interpersonal relations subscale (20.42±2.75) and the lowest mean score was for physical activity subscale (15.01±2.25).

 In the current study, even though women's health-promoting behaviors are desirable, there is a need to promote health-promoting behaviors, especially in the field of eating habits and physical activity. Health education with various methods is a suitable tool to motivate and correct incorrect lifestyles. As a result, appropriate interventions to encourage health-promoting behaviors should be designed and implemented.

Due to the chronic nature of the disease, patients with heart failure suffer from impaired self-care and complications of the disease, including frequent hospitalizations. Meanwhile, the use of new educational methods, such as virtual and feedback-based education, is considered as one of the effective methods in educating patients. Therefore, the present study was conducted with the aim of determining and comparing the effect of self-care training using virtual training and virtual and feedback training on self-care behaviors of patients with heart failure.

The present study was semi-experimental. Ninety patients suffering from heart failure referred to Seyed al-Shohadah Medical Education Center in Urmia in 2020-2021 were selected using the convenience sampling method. Then, the patients were divided by randomized complete blocking method into three groups of feedback training, virtual training, and control groups. In the feedback training group, training was conducted individually and during one month, two sessions of 45-60 minutes per week, face-to-face, lecture, and with feedback at the end of each session for each patient. In the virtual training group, educational content was sent daily for three months in the form of text and images a total of 90 messages and images of educational content in WhatsApp software. The control group received routine care. The research tools included the demographic information form and the European questionnaire of self-care behavior in heart failure patients. Analysis was done by paired t-test as well as ANOVA and chi-square tests in SPSS software version 22.

Before the intervention, there was no statistically significant difference between the three groups in terms of demographic variables and self-care behaviors (p>0.05).The mean score of self-care behavior for control, feedback, and virtual training groups after the intervention was 31.73 ± 5.66, 41.93 ± 4.44, and 36.5 ± 072, respectively. ANOVA test showed that this difference was statistically significant (P=0.0001). Tukey's test showed that feedback training was more effective than virtual training in improving patients' self-care (p<0.05). Also, the results of the paired t-test showed that in the feedback group, there was a statistically significant difference between mean self-care score before (30.8 ± 4.99) and after (41.93 ± 4.44) the intervention (P=0.0001). In the virtual training group, the self-care score before and after the intervention was 31.03 ± 4.99 and 36 ± 5.07, respectively, and this difference was statistically significant (P=0.0001).

The results showed that self-care training by means of virtual training and feedback has a positive effect on the self-care behaviors of congestive heart failure patients. Also, the results showed that although both types of training were effective, feedback training was more effective than virtual training in promoting and self-care of patients. Considering the effect of these two training methods on the self-care of congestive heart failure patients and their simplicity and ease, it is recommended to use these two methods in the training of these patients.

Considering the importance of sexual knowledge and attitude in marital life, a study was conducted to measure sex knowledge and attitude of adolescent girls on the verge of marriage and its relationship with demographic variables.

In this descriptive cross-sectional study, 130 adolescent girls were randomly selected among those who referred to the family health center of Hamedan city from November 2019 to March 2020 and filled out the Sex Knowledge and Attitude Scale (SKAS) and demographic questionnaires. One-way analysis of variance, independent t-test, and Pearson correlation coefficient were used to analyze the relationships between variables. All the tests were done using SPSS 23 software and the confidence level of 0.95 was considered in all the analyses.

Internet was the main source of sexual information in 53.2% of the girls. The average score of knowledge and sexual attitude of girls was 34.62 and 23.56, respectively. The score of sexual knowledge in 21.5% and sexual attitude in 81% of girls was lower than average (30). There was no correlation between knowledge and sexual attitude of the girls, but there was a direct and significant linear relationship of age with knowledge score (P=0.022) and with sexual attitude (P˂0.001). There was a statistically significant relationship of internet access with the mean score of sexual knowledge (P˂0.001) and with sexual attitude (P=0.003). There was a statistically significant relationship between the mean score of sexual attitude and the education level of girls (P=0.004) and the education level of their husbands (P=0.028). There was no relationship between the knowledge and sexual attitude of girls with the place of residence in the city and village and the number of their siblings and their husbands.

More than two-thirds of girls had sexual knowledge scores more than medium, but sexual attitude scores less than medium. There were relationships between sexual knowledge and attitude and age, as well as between the sexual attitude and their education and education level of their husbands.

  Increasing abuse of pregnant women has caused health researchers and policymakers to promote respectful pregnancy care during pregnancy, delivery, and after birth. The present study was conducted with the aim of investigating the effect of implementation of respecting pregnant women training workshop on knowledge and performance of midwives.

In this semi-experimental research with pre- and post-intervention design, a training workshop on respecting the pregnant mother was held for 25 midwives of Imam Khomeini Hospital in Sardasht in 2021. The tool used in the research was a researcher-made questionnaire about the knowledge and performance of midwives in the field of respecting the pregnant mother. The pre-test before the workshop and the post-test two weeks after the end of the workshop were administered to the participating midwives. An educational workshop was held for midwives in the form of scenarios, speeches, and role playing. Data were analyzed using paired t-test in SPSS v.16 software at a significance level of less than 0.05.

The mean and standard deviation of midwives' performance score before the intervention was 124.42±22.517 and after the intervention was 167.29±7.981. The mean and standard deviation of the midwives' knowledge score before the intervention was 14.38±2.039 and after the intervention was 24.17±1.239. The findings showed that the mean score of knowledge and performance of midwives before and after the workshop had significant statistical differences (p<0.0001).

Conducting a training workshop for midwives can be a suitable method to improve the knowledge and performance of midwives in the field of respecting pregnant mothers, and as a result, improving respectful pregnancy care.