Decreased desire to have children: A qualitative study

Objective:To explain barriers to childbearing among working women from the perspective of working women and midwives.Methods:In this study,a qualitative study of content analysis method was employed.The study was conducted from December 2021 to July 2022.The population consisted of working women and midwives.Data collection was conducted using semi-structured interviews and continued until data saturation was achieved.Through purposeful sampling,10 women and 11 midwives were selected as the sample.The data were analyzed by Graneheim and Lundman content analysis approach.For more rigorous,Nvivo 14 software was also used for data management,analysis,coding and organization of data.Results:This study included 21 women(10 women employees and 11 midwives)aged 25-43 years(for women employees)and 27-56 years(for midwives)with 1 to 34 years of job experience.In examination of participant’views about the barriers to childbearing,1124 codes were identified,of which we managed to extract six subthemes and two themes.Two themes emerged:“lack of social support and lack of family support”.Subthemes of“lack of social support”were“inadequate leave,long distance from workplace,and insufficient wages”.Subthemes of“lack of family support”were“lack of spouse support,lack of spouse's family support,and lack of their family support”.Conclusions:Different socioeconomic factors influence childbearing tendency in working women.Social and family supports play an important role in this regard.It is important to take these factors into account at the time of policymaking in the field of midwifery.

Improve nursing in evidence-based practice:How Chinese nurses'read and comprehend scientific literature

Objectives:To examine Chinese nurses'practice of reading and understanding scientific literature and elucidate the motivating and deterring factors.Methods:This is a cross-sectional study conducted between March and June 2015.A random sample of 853 full-time registered nurses from three tertiary and two secondary hospitals in China filled out a set of self-administered questionnaires,including literature habit questionnaire(41 items),the situational motivation scale and the socio-demographic and professional characteristics questionnaire(15 items).Results:Significant majority(89.2%)of the respondents reported perception of barriers to keeping up to date with literature.The language barrier was the most prominent,followed by poor presentation and readability of articles.Using simpler language when writing articles,improving ones'foreign language proficiency and getting education or training on nursing research were raised as the top facilitators.Additionally,reading and understanding literature was significantly associated with the nurses'educational background,motivation,genders and work settings.Conclusions:The survey of the current status of literature education among Chinese nurses suggests that providing protected time,training for critical thinking,and incentive mechanisms will help improve nurses'engagement in literature and create a culture of academic inquiry.

Nurses'critical thinking disposition and professional commitment:a cross-sectional study

Objective:High-quality and successful nursing care delivery in a variety of situations requires critical thinking training and professional commitment.The present study aimed to investigate critical thinking disposition,professional commitment,and the relationship between these 2 variables among nurses.Methods:As a result of stratified random sampling,201 nurses were enrolled in the present cross-sectional study.Data were gathered using a socio-demographic form,the Critical Thinking Disposition Inventory(CTDI),and the Nurses'Professional Commitment Scale(NPCS).Results:Although the critical thinking disposition scores were at a moderate level(115.70±13.55),the mean score for professional commitment was high(91.37±11.77).A positive correlation was found between critical thinking disposition and professional commitment(r=0.67,P=0.001).Conclusions:Nursing managers are urged to employ strategies to enhance nurses'critical thinking disposition and professional commitment.

Nurses'attitude toward patients'safety climate during COVID-19 pandemic:a cross-sectional study

Objective:Patient safety is a fundamental factor in improving the quality of care provided in hospitals.Therefore,it is considered a significant parameter by all healthcare organizations around the world.The present study was conducted to investigate the attitude of nurses toward the patient safety climate during the Coronavirus Disease 2019(COVID-19)pandemic in the southeast of Iran.Methods:This is a cross-sectional descriptive study.Among all the nurses working in one of the hospitals in the southeast of Iran,171 nurses participated in the study through convenience sampling methods.The survey was conducted between June 1 and July 30,2020.A 2-part questionnaire including demographic information and an assessment of nurses'attitudes toward patients'safety climate was used for data collection in 2021.The content validity of the scale is(0.77)and reliability was re-calculated and confirmed by the present study with Cronbach's alpha(α=0.9).Data were analyzed by SPSS 20(IBM Corporation,Armonk,New York,United States)using descriptive and analytical statistical tests.Results:The mean score of safety climates was 3.2±5.20(out of 5 scores).The results showed that among all dimensions of the safety climate,only the education dimension was statistically significant between males and females(P<0.001).Also,there was a significant relationship between the overall average of the safety climate and its dimensions according to the people's position only in the dimension of supervisors'attitude(P<0.01)and burnout(P<0.01).Additionally,a significant correlation between the education level and the overall score of safety climate(P<0.01),as well as the supervisor's attitude dimension(P<0.01),was observed.Conclusions:The results showed that the safety climate was at a relatively favorable level.Considering the impact of nurses'attitudes on the safety climate of patients,its improvement seems necessary.It is recommended to design training courses and educate nurses in order to promote a patients safety climate in hospitals.

Necessary prerequisites for evidence-based practice:results of investigating nurses'informatics competency and information literacy skills

This study aimed to evaluate the correlation between nursing informatics(NI)competency and information literacy skills for evidencebased practice(EBP)among intensive care nurses.This cross-sectional study was conducted on 184 nurses working in intensive care units(ICUs).The study data were collected through demographic information,Nursing Informatics Competency Assessment Tool(NICAT),and information literacy skills for EBP questionnaires.The intensive care nurses received competent and low-moderate levels for the total scores of NI competency and information literacy skills,respectively.They received a moderate score for the use of different information resources but a low score for information searching skills,different search features,and knowledge about search operators,and only 31.5%of the nurses selected the most appropriate statement.NI competency and related subscales had a significant direct bidirectional correlation with information literacy skills for EBP and its subscales(P<0.05).Nurses require a high level of NI competency and information literacy for EBP to obtain up-to-date information and provide better care and decision-making.Health planners and policymakers should develop interventions to enhance NI competency and information literacy skills among nurses and motivate them to use EBP in clinical settings.

Predictors of happiness among Iranian nurses

Objectives:This study aimed to assess happiness and its predictors among a group of Iranian hospital nurses.Methods:This cross-sectional study was done in 2016 on 620 hospital nurses who worked in five teaching hospitals affiliated to Kashan University of Medical Sciences,Kashan,Iran.Nurses were recruited through the census method.Data collection instruments were a researcher-made demographic and occupational characteristics questionnaire,the Oxford Happiness Inventory,and the Minnesota Job Satisfaction Questionnaire.Data analysis was done through stepwise multiple linear regression analysis.Results:Among 620 recruited nurses,422 returned their questionnaires completely filled.The mean of their happiness was 123.4±18.4 in the possible score range of 29-174.The significant predictors of happiness were satisfaction with mental health,monthly salary,satisfaction with salary,quality of life,current hospital ward,the length of working in the current ward,work shift,age,job satisfaction,and satisfaction with physicians'conduct and performance.These variables explained 50.3%of the total variance of happiness.Satisfaction with mental health had the greatest proportion in explaining the variance of happiness.Conclusion:Nurses in teaching hospitals in Kashan,Iran,have moderate happiness.Their happiness is affected by different factors,particularly by satisfaction with their mental health.Health policy-makers and authorities,in developing workforce-related plans and programs,need to pay special attention to nurses'happiness and its contributing factors.

Psychological capital mediates the association between nurses'practice environment and work engagement among Chinese male nurses

Objectives:This study aims to investigate the environmental and individual factors contributing to male nurses'psychological well-being and to explore the psychological mechanisms that may explain the links between nurses'practice environment and work engagement,thereby presenting the implications for nurse managers.Methods:A total of 161 male nurses from three tertiary first-class hospitals in Changsha City in China participated in the study.We collected the data using the Practice Environment Scale of the Nursing Work Index,the Psychological Capital Questionnaire,and the Utrecht Work Engagement Scale.Results:Scores of male nurses'practice environment(2.88±0.31),psychological capital(4.42±0.62),and work engagement(3.17±1.39)were all above the midpoint;however,the subscales"the nursing staffing and resources adequacy"(2.72±0.48),"hope"(4.33±0.72),and"dedication"(2.96±1.61)scored lowest.Nurses'practice environment and psychological capital positively predicted nurses'work engagement;psychological capital fully mediated the influence of nurses'practice environment on work engagement.Conclusions:Creating a supportive nursing practice environment can increase male nurses'work engagement by developing their psychological capital.Nurse managers can then provide reasonable workload and pathways for male nurses to achieve goals,thereby fostering their hope.

Epidemiological status of malaria in Iran,2011-2014

Objective:To determine the status and epidemiological aspects of malaria in Iran in favor of gaining a better understanding of the national control of malaria.Methods:This epidemiological study examined the status of malaria from 2011 to 2014 in Iran.Data were collected from the Ministry of Health's protocol for controlling and eliminating malaria,which is currently in use.This malaria information reporting system is automated in all Iranian provinces and cities,and all information is submitted online to the center for communicable disease control in the Ministry of Health.Information about malaria is available for researchers to evaluate.Results:The incidence rates decreased from 2011 to 2014.There were 4.76,2.12,1.80,and 1.59 per 100 000 people,respectively from 2011 to 2014.During the four-year period(2011-2014),the highest numbers of cases occurred in those aged 16-25 years,by age,and in men,by sex.Most of the cases were workers and located in rural areas.An average 52.58%of cases were Iranian.The highest incidence rates from 2011 to 2014 were located in Sistan and Baluchestan province.There were 89.94,43.9,38.3,and 30.66 per 100 000 people.The highest numbers of malaria cases were recorded in the cities Sarbaz,Nickshahr,and Chabahar in Sistan and Baluchestan province and Bandar Abbas,Bandar Jask,and Bandar Lengeh in Hormozgan province.During the four-year period,57.05%of cases were caused by imported factors.The majority of cases were related to the trophozoite lifecycle of parasites.Regarding surveillance,there was inactive care in the majority of cases.Vivax malaria was the most prevalent.Conclusions:Despite the recendy declining trend in reported cases,the expansion of local transmission,especially in areas with cross-border travel,is very worrying.Improved malaria control interventions can be effective for elimination of malaria in Iran;these can include programs to control border travel and focused interventions for high incidence areas and high-risk groups such as rural residents,men,workers,and people < 35 years old.

Progressive exhaustion:A qualitative study on the experiences of Iranian family caregivers regarding patients undergoing hemodialysis

Objective:The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers.Methods:In this qualitative study,a content analysis approach was used for data collection and analysis.Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences,Iran.Semi-structured interviews were held to collect data.Results:Four categories were developed as follows:‘care challenges’,‘psychological vulnerabilities’,‘the chronic nature of care’and“care in the shade”.The categories led to the development of the main theme of‘progressive exhaustion’experienced by the family caregivers during the provision of care to patients undergoing hemodialysis.Conclusion:Family caregivers have a significant role in the process of patient care,and this role leads them to progressive exhaustion;therefore,the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life,social welfare,and satisfaction level.

Development and psychometric evaluation of the Hospital Nurse Interpersonal Empathy Questionnaire

Objective:This study aimed to develop the Hospital Nurse Interpersonal Empathy Questionnaire(HNIEQ)and evaluate its psychometric properties.Methods:The primary version of HNIEQ was deductively developed through reviewing the literature,and then,its face and content validity were assessed.For construct validity assessment,250 hospital nurses were randomly selected from hospitals of Kashan,Iran.Their data were used for exploratory factor analysis.Internal consistency was assessed through Cronbach's α coefficient and questionnaire stability was assessed through test-retest intraclass correlation coefficient.Ceiling and floor effects were also assessed.Data analysis was done via the SPSS program(v.16.0).Results:The final version of HNIEQ contained 45 items.Exploratory factor analysis revealed a six-factor structure(empathetic and ethical attention,perspective adoption,emotional affectability,altruism,emotion identification and responsivity,and reflection forecasting)for the questionnaire which explained 52.7%of the total variance of its total score.The Cronbach's α coefficient and the intraclass correlation coefficient of HNIEQ were 0.953 and 0.972,respectively.Conclusion:HNIEQ is a valid and reliable instrument for empathy assessment among nurses.

Comparative study of self-compassion and sense of coherence in nurses of psychiatric hospitals

Objective:Nurses,due to the nature of their job,are subjected to various forms of stress and physical and psychological injuries.Self-compassion and a sense of coherence have attracted much attention in research in recent years as having high potential for improving the health and performance of people in the workplace.The present study aimed to compare self-compassion and the sense of coherence in nurses working in psychiatric hospitals and other hospitals of Kerman University of Medical Sciences.Methods:The present study was a descriptive-comparative study of applied type conducted on 100 nurses of Shahid Beheshti Psychiatric Hospital in Kerman by the census method and 100 nurses of other hospitals of Kerman University of Medical Sciences by the stratified random sampling method.The instruments included the self-compassion questionnaire and the sense of coherence questionnaire.Data were analyzed using the Statistical Package for Social Sciences software.Results:The results of the present study showed that self-compassion and sense of coherence were higher in psychiatric nurses(39.35±7.7 and 53.02±8.01)than among other nurses(36.03±5.81 and 49.76±6.30).There was a direct and moderate relationship between a sense of coherence and self-compassion(P-value<0.005).The higher the score of compassion for oneself,the higher was the score of sense of coherence.Furthermore,the sense of coherence had a direct and weak relationship with all dimensions of self-compassion,except for the extreme imitation dimension,which showed a direct and moderate relationship to other dimensions(P-value<0.001).Conclusions:Self-compassion and a sense of coherence,as a form of self-communication,increase nurses’satisfaction and reduce nurses’job stress and,as a result,job performance is improved.

How can leadership influence the quality ofcare in a health-care organization?

Objective:This study focuses on how leadership could influence the quality of care in a health-care organization.Methods:The concept of leadership and quality are analyzed.In addition,issues concerning how leadership can influence quality of care through the effect on the organizational culture and the engagement of both nurses and patients are discussed.Results:Leadership is the pivotal factor in the improvement of quality through the effect on the organizational culture and the engagement of both nurses and patients.Conclusions:Leadership can influence the quality of care directly and indirectly.The organization and the leaders should know the importance of effective leadership to a better work environment,facilitate the implementation of the new mode of nursing,and provide best services to the patients.

Unsecured Life: The Experience of the Veteran Posttraumatic Stress Disorder Wives

Introduction: Disputativeness and incitement are one of the consequences of the posttraumatic stress disorder which causes intimacy reduction in veteran wives. This study was done with the aim of expressing the veteran posttraumatic stress disorder wives. Method: This qualitative study was done by qualitative content analysis method and 14 participants took part in this study who were all PTSD veteran wives in Golestan province in Iran. Data was gathered by semi-structured interview and by purposive sampling and was continued to the data well saturated. Data analysis was continuously done at the same time as collecting the data. Findings: The main theme and the eleven subtheme included: 1) Entanglement with wife condition: Not willing to have medicine treatment, frequent hospitalized, increasing the problems as the age goes up medicine, dependency on taking medicine, unpredictable wife behavior;2) life erosion: Living along with fear, lost life;3) stressful atmosphere in the house: Physical fight, unsecured feeling in the house, sensitive to noise;4) being worry about future: Hopelessness, spoiled life. These were the main points of this study which cause the unsecured atmosphere for the families. Conclusion: Veteran in ability in controlling their anger causes emotional problems, intimacy decreasing and marriage dissatisfaction, anxiousness and being worry about future. Social and family supports such as consulting services, informative and educational systems have an important role in wives compatibility and life promotion.

Effect of rehabilitation education on pain, knee stiffness and performance difficulty in patients undergoing knee replacement surgery: A randomized clinical trial

Objective:To determine the effect of rehabilitation education on pain,knee stiffness and performance difficulty in patients undergoing knee replacement surgery.Methods:This randomized clinical trial study was performed on 96 patients undergoing knee replacement surgery,who were randomly divided into two groups:the control group and the intervention group,with 48 patients in each group.In the intervention group,the patients received educational intervention in four stages one day before surgery,24 h and 48 h later,upon discharge from the hospital.In the control group,only the routine of the hospital was performed.Questionnaires were completed before and 6 weeks after the intervention.Results:The mean scores of pain,knee stiffness and performance difficulty were significantly decreased in the intervention group(P=0.01).Compared to the control group,the intervention group had a better outcome of the illness,including pain,knee stiffness and performance difficulty(P=0.001).Conclusion:Rehabilitation education could be a suitable way to improve the surgical outcomes of patients undergoing total knee replacement.

Minimum MSE Weighted Estimator to Make Inferences for a Common Risk Ratio across Sparse Meta-Analysis Data

The paper aims to discuss three interesting issues of statistical inferences for a common risk ratio (RR) in sparse meta-analysis data. Firstly, the conventional log-risk ratio estimator encounters a number of problems when the number of events in the experimental or control group is zero in sparse data of a 2 × 2 table. The adjusted log-risk ratio estimator with the continuity correction points based upon the minimum Bayes risk with respect to the uniform prior density over (0, 1) and the Euclidean loss function is proposed. Secondly, the interest is to find the optimal weights of the pooled estimate that minimize the mean square error (MSE) of subject to the constraint on where , , . Finally, the performance of this minimum MSE weighted estimator adjusted with various values of points is investigated to compare with other popular estimators, such as the Mantel-Haenszel (MH) estimator and the weighted least squares (WLS) estimator (also equivalently known as the inverse-variance weighted estimator) in senses of point estimation and hypothesis testing via simulation studies. The results of estimation illustrate that regardless of the true values of RR, the MH estimator achieves the best performance with the smallest MSE when the study size is rather large and the sample sizes within each study are small. The MSE of WLS estimator and the proposed-weight estimator adjusted by , or , or are close together and they are the best when the sample sizes are moderate to large (and) while the study size is rather small.

Role of herbal medicines to treat the symptoms of COVID-19 disease

The need for effective therapeutic options for patients has received increasing attention in response to the prevalence of COVID 19.Although there are several options for the prevent of COVID-19,including vaccines,monoclonal antibodies,oligonucleotide-based therapies,peptides,and interferon therapies,no treatment for coronaviruses has yet been approved[1].

Nurses' lived experiences of professional autonomy in Iran

Objectives: Nurses' autonomy is a complex and multi-dimensional concept that has often been overlooked.Although many studies have addressed patients' autonomy,there has been no assessment of nurses' experience of professional autonomy.The present study aimed to assess nurses' lived experiences of professional autonomy in Shiraz,Iran.Methods: The present qualitative study was conducted in Shiraz (Iran) from January 2016 to February 2018.The target population was selected among nursing professionals employed by various hospitals affiliated to Shiraz University of Medical Sciences,Shiraz,Iran.The experiences of the participants were assessed through 14 in-depth semi-structured interviews.The response of the participants was analyzed using Van Manen's 6-step approach for interpretive phenomenology.Results: Based on the analysis of the interviews,4 themes,11 categories,and 13 sub-categories were extracted.The themes were: Advocacy for patients and nurses,independence in the workplace,Involvement in professional decision-making,and Professional accountability.Conclusion: Due to the intense interaction between nurses and patients,a better quality of care will be achieved if the professional autonomy of nurses is ensured.Healthcare authorities and hospital managers should provide the framework and permit the nurses to practically exercise full independence in the workplace.

Description of socioeconomic and demographic profile of young women vulnerable to infection by human papillomavirus and risk behavior in a school in Rio de Janeiro

Background: HPV is one of the main sexually transmitted diseases, especially among the female population. This is an important etiologic agent for the development of cervical intraepithelial lesions and cervical cancer. It is considered a public health problem, since young women are the most vulnerable group to this virus. Therefore, it is important that the socioeconomic and demographic profile of these women and their risk behaviors are known, so that it is possible to contribute in reducing infection occurrences in the studied population. Objectives: To describe the socioeconomic and demographic characteristics and investigate the behavioral sexual-affective aspects of risk of adolescents and young students from Rio de Janeiro/Brazil when tackling HPV infection. Methods: A group composed by 128 individuals susceptible to HPV—classified as adolescent women and young women who are students at a high school in one unity of the municipality of Rio de Janeiro. The studied period was from May to November. A quantitative descriptive approach was used, in which data were highlighted in variables, divided into economic, demographic and behavioral characteristics. Data were entered into an Excel spreadsheet and organized by descriptive statistics performed by simple frequency (%). Results: The age range of the young women who have the possibility of being infected with HPV was from 15 to 25. The focused family income among these young women was up to 2 minimum wages. The risk behavior detected in 37.5% of adolescent women and in 43.8% of young women is that these women never used condoms in sexual intercourse. Conclusion: The research showed that the studied women are vulnerable due to risk behavior practices that may lead to the virus acquisition. More focuses on educational actions of preventive measures regarding HPV infection should be emphasized, favoring a lower incidence of human papillomavirus infection and cervical cancer.

Effects of physical activity by the teach-back educational method on the physical ability and quality of life in hemodialysis patients:a clinical trial

Objective:To determine the effect of physical activity by using the teach-back educational method on hemodialysis patients’quality of life(QOL)and physical ability.Methods:This is a single-blind clinical trial study involving a control group.A total of 90 patients who admitted to the dialysis centers of Beheshti and Besat hospitals in Hamadan were selected using a convenience sampling method and were randomly assigned to intervention(n=45)and control(n=45)groups.Data were collected using a demographic information checklist,a kidney disease QOL questionnaire,and a 6-minute-walk distance(6MWD)checklist.The patients’QOL questionnaire was completed,and the 6MWD was recorded before and at the end of the 2nd,4th,6th,8th,and 12th weeks of the intervention.In the intervention group,the patients were taught to perform physical activities with Pilates stretches in different resistances using the teach-back educational method during dialysis sessions for 12 weeks.Data were analyzed by using the independent t-test and chi-square test using SPSS-22 software.Results:Before the intervention,no differences were observed between the experimental and control groups in terms of demographic characteristics,QOL,and physical ability(P>0.05).The physical ability and QOL levels of patients exercising in the test group were higher than those in the control group after the intervention(P<0.05).Based on the results,the 2 groups significantly differed with regard to the scores of various dimensions of QOL and physical ability after the intervention(P<0.05).Conclusions:Physical activity by using the teach-back method can effectively increase physical ability and improve QOL of hemodialysis patients.Therefore,the recommendations and inclusion of exercise in the dialysis care plan can effectively promote patients’health.

Frequency of fall-related injuries of female patients referred to the trauma center in the city of Kashan from years 2005 to 2008

Objective： Falls are one of the life events leading to injury and in serious cases cause high morbidity and mortality. This research was conducted to determine the fall incidence among female population of Kashan city from the years 2005 to 2008. Methods： This was a retrospective research using existing data from the data bank of trauma center of Kashan University of Medical Sciences. Records of all the female patients treated at local hospitals with complete hospitalisation kept at the center were examined for 4 con- secutive years from 2005 to 2008. Results： A total of 2 094 female patients＇ records were examined. A significantly higher incidence of injuy occurred in 2008 compared to 2005 （P〈0.0001）. In addition, the highest frequency of injury occurred in age group above 65 years （31.9%） and in group with elementary education level （42.8%）. Conclusion： The results showed that fall incidences occurred in the old age group above 65 years. Fall injuries at this age may cause disability. Therefore, preventive measures should be taken, such as increasing the awareness of the aging population about the seriousness of fall incidence and encouraging the aged individuals to get involved in fitness program to remain physical fit and healthy.