Iraqi Nurses' Perspectives on Safety Issues in Maternity Services

Background: Studies introduce maternal and neonatal safety phenomena as important challenges to the public health, particularly in low-income countries. However, few researches are conducted on the identification of safety issues in maternity hospitals in Iraq. It was the first study on nurses’ perspectives on safety issues in Kurdistan, Iraq. Objectives: The current study aimed to describe nurses’ perspectives on what constitutes a safe maternity service in Kurdistan, Iraq. Patients and Methods: A qualitative design, based on a content analysis approach, was used. Ten Kurdish nurses who worked in the delivery room of Kurdistan, Iraq maternity hospital were recruited through purposive sampling. Semi-structured interviews were performed to collect data. All interviews were audiotaped and transcribed verbatim. Sampling continued to the level of data saturation. Data analysis was performed based on the steps suggested by Graneheim and Lundman. Results: Thematic analysis led to the identification of six main categories including stressful job, lack of schedule and job description, providing care with limited resources, professional unaccountability, regional sociopolitical factors, and inadequate training. Conclusions: Iraqi nurses identified factors such as limited health resources, lack of job description, and professional unaccountability as major safety issues in maternity services. These findings alarm the need to ensure the provision of females and neonates with appropriate care. This, however, would require coordination between Iraqi Kurdistan health authorities to provide midwifery care facilities, high-quality and relevant staff training, and an effective healthcare system in the maternity units

Development and validation of the Nursing Profession Self-Efficacy Scale

Aim: This study describes the development and validation of the Nursing Profession Self-Efficacy Scale. Background: Self-efficacy can be useful in predicting performance, job satisfaction or well-being. In the nursing field, there is a shortage of studies on self-efficacy with regard to nurses’ global confidence in coping ability across a range of everyday, challenging work situations. Methods: To define the theoretical framework of nursing professional self-efficacy, two focus groups and a literature review were performed. An empirical study was then conducted to test validity and reliability. Face and content validity, construct validity, concurrent validity, internal consistency and test–retest reliability were examined. The content validity index was evaluated by 12 experts who suggested deleting 11 redundant items. The final developed tool was tested for construct analysis using a cross-validation approach, randomly splitting the overall sample of 917 nurses in two sub-groups. Findings: The construct validity indicated two dimensions. The face and content validity were adequate. Test–retest reliability displayed a good stability, and internal consistency (Cronbach's α) was acceptable. Moreover, concurrent validity using the Generalized Self-Efficacy Scale was in line with the theoretical framework. Conclusion: The scale showed evidence of validity and reliability. The major limitation is the strong influence of the Italian context in the tool development

Evaluation of Airway Management Proficiency in Pre-Hospital Emergency Setting; a Simulation Study

Introduction: Infrequency and low exposure to critically ill patients requiring airway management will lead to reduction in the skills and performance of the Emergency Medical Technicians (EMTs) over time. The present study was conducted primarily aiming to evaluate airway management in stationary ambulance simulations and identify the factors affecting Endotracheal Intubation (ETI) success rate.Method: This is a simulation study. The study population comprised of active EMTs in prehospital emergency bases in Hamadan province. The participants were placed at the back of an ambulance to perform the airway management scenario, which had already been prepared. To investigate the factors affecting the success (≤3 attempts) or failure rate of intubation, both unadjusted and adjusted odds ratios (95% confidence intervals) for univariate and multivariate regressions were reported.Results: 184 subjects with the mean age of 33.91+6.25 years and the median work experience of 8 years were studied (54.3% with a history of training in the past year).  The median number of previous intubations performed by technicians in the last year was 7 times (IQR 4-9). The total success rate at ventilation, intubation and back-up airway were 50.67%, 53.29%, and 50.0%, respectively. Out of the total 552 attempts for ETI placement, 58.2% of the technicians were able to perform ETI within 3 attempts. Univariate analysis showed that age (OR=1.06, P=0.022), previous number of ETIs (OR=2.49, P<0.001), work experience (OR=1.13, P<0.001), and previous ETI training (OR=1.85, P=0.041) were significantly associated with ETI success rate. After adjustment, previous number of ETIs (OR=2.66, P<0.001) was the most effective factor on ETI success rate.Conclusion: Success rate in airway management, especially ETI, is low. Therefore, improvement in modifiable factors such as increasing the number of ETIs performed and gaining experience in the same conditions as pre-hospital emergency is necessary

Effects of Blended Self-Management Training on Knowledge and Self-Care Behaviors of Patients with Type 2 Diabetes: A Randomized Clinical Trial

Objective: This study aims to determine the effects of blended self-management training on the knowledge and self-care behaviors of patients with type 2 diabetes. Materials and methods: One hundred people with diabetes participated in this randomized clinical trial and were randomized into two groups based on the block randomization method (block size = 4). The experimental group (31 men) received a three-hour training workshop plus an education course through a designed website. The control group (32 men) received routine training, which included receiving pamphlets. Researchers used diabetes knowledge and self-care behaviors tools in both groups before and two months after the completion of the intervention. Data were analyzed using SPSS version 16 statistical software. Results: Findings showed self-care behaviors in all dimensions (p < 0.001) and knowledge (p < 0.001) in experimental group increase by blended education. Conclusions: The findings indicate that blended training is associated with positive effect on selfmanagement and diabetes knowledge for people with diabetes. So blended training program is highly recommended to improve treatment adherence, with low medical costs for patients

Blind Mothers’ Experiences of Marginalization: A Hermeneutic Phenomenological Qualitative Study

Introduction: Mothering is a precious art with many intricacies. When women experience the phenomenon of mothering, they become vulnerable, and face many challenges. It creates worst conditions, if this experience is combined with a disability such as blindness. This study aimed to determine blind mothers’ experiences of marginalization. Method: The approach used in this study was hermeneutic phenomenology. Sampling was carried out using targeted and snow balling method. Face-to-face interviews were conducted with nine congenitally blind mothers who had child under the age of 8 years old. The interviews were recorded and transcribed verbatim. Interviews continued until data saturation. van Manen method was used for all steps of the study including data collections, data analysis, and interpretation and reporting the findings. Data analysis was performed using MAXQDA software. Results: From 479 initial codes, the main theme of "hermit inevitable", and subthemes of "feelings of shame", "a sense of discrimination", and "obligation in loneliness" were emerged. Conclusion: Blind mothers’ perception of themselves was to be marginalized, and they suffered from shame feeling, discrimination, lack of support, and obligation in loneliness. Blindness affects mothering, and blind mothers are in a unique situation. Keywords: Mothers, Blindness, Hermeneutics, Qualitative research, Experienc

Predictors for nurses and midwives' readiness towards self-directed learning: An integrated review

Aim. To systematically review the existing evidence on predictors for nurses and midwives' readiness towards Self-directed Learning (SDL). Background. Increased complexities in healthcare settings demand that nurses and midwives become involved in lifelong learning by means of self-directed learning (SDL) for delivering quality healthcare. More evidence is available for the self-directed learning readiness (SDLR) of nursing and midwifery students, less is systematically derived on predictors for nurses and midwives' readiness to SDL. Design. An integrative systematic review. Methods. Systematic searches were carried out using the following five electronic databases: PubMed, Science Direct, Google Scholar, Ovid Medline and Embase. Studies published in English language from 2000 to 2017 were included. The integrative systematic review framework developed by Whittemore and Knafl (2005) was used to analyse and summarise the key themes. Results. Of 804 initial screening papers, in total of eight eligible studies (six quantitative and two qualitative) were found. Integrative analysis resulted in four themes as predictors for nurses and midwives' readiness towards SDL: 1) personal characteristics, 2) working environment, 3) online learning and SDLR, and 4) process of SDL. Review found that, although demographic characteristics of nurses and midwives do not influence their SDLR, work environment often influences their SDLR. Furthermore, nurses and midwives have a positive interest in online learning that is often used to improve their knowledge acquisition. Conclusion. The review concludes that qualified nurses and midwives have a unique SDL predictors and process; hence, a personalized SDL programme should be prescribed based on personality traits so as to achieve better SDL outcomes. Future research should address the facilitating factors for SDLR, barriers to SDLR and strategies to improve SDLR among nurses and more importantly midwives, as limited evidence is available with respect to the latter

Improve communication with deaf and hard of hearing clients during Covid-19

The article's abstract is not available.</jats:p

Digital storytelling as an innovative approach for managing the psychological challenges of diabetes

Diabetes is one of the most challenging chronic conditions, necessitating continuous and complex management efforts that impacts all aspects of an individual's life (1). Those living with diabetes often experience many social and psychological challenges alongside the disease, ultimately affecting the disease management (2). Addressing and managing these psychological challenges in individuals with diabetes are crucial for optimal disease management and the prevention of serious consequences (3). This issue necessitates the design and implementation of interventions to manage the psychological consequences of diabetes. Storytelling has emerged as a therapeutic approach utilized in social projects, health promotion, disease prevention, coping with grief, and other concerns (4). Therapeutic storytelling aims to explore the psychological problems experienced by individuals through creative narratives, using problem-solving skills, and providing narrative-based alternatives (5). Stories serve as a means of expressing viewpoints, revealing emotions, sharing experiences, and transferring information. By engaging in storytelling activities whether through oral or written narratives individuals can absorb valuable lessons, gaining insights into effective problem-solving strategies and emotional expression Storytelling serve as a means of expressing opinions, revealing emotions, sharing experiences, and transferring information (6). By engaging in storytelling activities whether through oral or written narratives individuals (7