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India has approximately 23 million children without parental care, who need alternative forms of care (MOSPI, 2018). Udayan Care, an NGO, designed an innovative group care model for children and youth in need of care and protection, implementing the indigenously developed LIFE (Living in Family Environment) strategy in 17 Udayan Ghars. (Sunshine Homes). With child participation as a core pillar, Udayan Care developed a Questionnaire to Assess the Needs of Children in Care (QANCC) in 2011, which is to be filled up by children annually, as a longitudinal study. The tool is conceived to ascertain whether children in the Ghars perceived if their rights were being fulfilled and that their needs were being addressed. With "meaningful participation" of children stipulated by the United Nations Convention on the Rights of the Child (UNCRC), the objective was to develop an evidence-based tool to assess the views of children on the services meted out to them, from their standpoint, and inform actual care practices annually. The self-assessment tool consists of questions, assessing the four dimensions of basic/fundamental, emotional, educational, and interpersonal needs, on a four-point Likert rating scale. A convenient purposive sampling is done on children, aged 10 to 18 years, who receive care and protection at the Ghars, and have resided there for a minimum of 6 months. This paper has two objectives, where at one end, the deductions of the previous years' data are made (2011–12 to 2016–17) with demarcating the differences with year 2018–19 data and at the second level, there is an update on the efforts made to establish the reliability and validity of the tool and create a standardized tool that can be implemented by other child care organizations in India. The paper illustrates how listening to direct voices of children and incorporating their inputs into actual care practice, can go a long way in improving the holistic wellness of children living in an alternative care setting. The results indicate that all needs of the majority of the children in Udayan Ghars. [ABSTRACT FROM AUTHOR]

Background: Work-family enrichment refers to the extent to which experiences in one role improve the quality of life in another role, and the bidirectionality indicates that benefits derived from work can be applied to family and vice versa. Parent nurses, that is, female nurses who are raising preschool children, play a major role at work and in the family. Thus, work-family enrichment is significant for them. The Work-Family Enrichment Scale cannot be generalized to parent nurses. This study was aimed at developing and psychometrically validating a draft Work-Family Enrichment Scale for Parent Nurses. Methods: A questionnaire survey was conducted among 1,090 parent nurses who were randomly sampled from hospitals with more than 200 beds in Japan. The survey evaluated (1) a draft Work-Family Enrichment Scale for Parent Nurses, (2) the Japanese version of the Work-Family Enrichment Scale, and (3) the Positive Spillover Scale. The scales were psychometrically evaluated for internal consistency, construct validity, and criterion-related validity. Results: Data from 503 participants (age, mean ± standard deviation [range] 35.5 ± 4.96 [23–47] years) were analyzed. Results of exploratory factor analysis, the work to family enrichment direction yielded five factors for 23 items: "emotional fulfillment," "efficiency," "ability to lead," "displaying industriousness," and "self-growth." Cronbach's alpha coefficients ranged from 0.862 to 0.914. In the family-to-work enrichment direction, there were five factors for 28 items: "help-seeking," "receptiveness," "expansion of one's horizon," "efficiency," and "emotional fulfillment." Cronbach's alpha coefficients ranged from 0.790 to 0.907. Additionally, the correlation coefficients reporting criterion-related validity were 0.685 and 0.619 with regard to the Japanese version of the Work-Family Enrichment Scale and 0.596 and 0.534 with the Positive Spillover Scale for the Work-to-Family Enrichment Scale and the Family-to-Work Enrichment Scale for Parent Nurses, respectively. Conclusions: The Work-Family Enrichment Scale for Parent Nurses has adequate reliability and validity and can be used as an effective measure to assess the positive aspects of work and family roles among female parent nurses. [ABSTRACT FROM AUTHOR]

Aim: Explore the mediating role of cognitive emotion regulation strategies used by nursing students between academic anxiety and procrastination. Design: A descriptive correlational design was used. Setting: This study was carried out in the faculty of nursing at the University of Alexandria. Sample: The participants in this study were all students enrolled in emergency nursing during the second semester of the academic year 2021–2022 and a convenience sampling of 654 nursing students. The Sobel test was used as a statistical method to determine the significance of a mediation effect by assessing whether the relationship between perceived academic anxiety and procrastination was significantly reduced when cognitive emotion regulation was included, using coefficients and standard errors from regression models to calculate the test statistic. Tools: Academic Anxiety Scale, Academic Procrastination Scale, and Cognitive Emotion Regulation Questionnaire were used to collect data. Results: The study found that 46.5% of students reported high anxiety levels, with 40.1% perceiving moderate anxiety and only 11.3% experiencing low anxiety. Moreover, 80.4% of nursing students showed moderate academic procrastination. There is a positive correlation between procrastination and academic anxiety, with Adaptive and maladaptive coping strategies mediating this relationship, according to the Sobel test. Conclusion: Based on the results, it can be concluded that there is a complex causal and effect relationship between academic anxiety and procrastination. Nursing students may resort to academic procrastination as a means of coping. Therefore, reducing anxiety, correcting maladaptive behaviors, and enhancing adaptive cognitive and emotional regulation strategies could effectively reduce academic procrastination. [ABSTRACT FROM AUTHOR]

Background: Adequate eHealth literacy and health promotion behavior (HPB) are important to achieve good health-related quality of life. There is limited information on the influence of eHealth literacy and HPB on body mass index (BMI) in our setting and among public service workers. Objectives: This study assessed the eHealth literacy, HPB, and BMI of public service workers and determined the influence of eHealth literacy and HPB on BMI. Design: A descriptive cross-sectional design was adopted. Methods: A simple random sampling technique was used to select 440 public service workers from civil service of redacted. A structured questionnaire was used to collect data on socio-demographics, eHealth literacy, and HPB. Weight and height were measured and BMI was calculated. Data were analyzed using frequency, percentage, mean, standard deviation, and logistic regression analysis. The significant level was set at 0.05. Results: More than one quarter (28.2%) of respondents had low eHealth literacy, and more than one third (42.5%) had inadequate (30.0% fair and 12.5% poor) HPB. An average (50.5%) had a level of obesity that ranged from preobesity to type 2 obesity. There was a significant association between eHealth literacy and HPB with the BMI of respondents at p <.05. Conclusion: There was inadequate eHealth literacy and HPB among public service workers. An average of the workers had a level of obesity that ranged from pre-obesity to type 2 obesity. There was a significant association between eHealth literacy and BMI and also between HPB and BMI of respondents. Community health professionals should assist public service workers to develop competencies and skills useful in evaluating health information on the Internet and applying such information to make informed decisions. [ABSTRACT FROM AUTHOR]

Background: Given increases in China's aging population, the growing demand for public health services and the shortage of human resources among nurses have become more prominent. Under such a background, "Internet + Nursing Services" have received more attention. Thus, exploring the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and utilizing internet technology to increase the supply of nursing services has become a key issue. Objective: This study aimed to develop a scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" and to test the validity and reliability of the scale. Methods: A preliminary scale was developed based on a literature review, theoretical research, semistructured qualitative interviews, and two rounds of Delphi expert inquiry. A convenient sampling method was used for the questionnaire survey. A 5-point Likert scale was used to evaluate the importance of the items. The survey data of 659 clinical nurses obtained from February to March 2023 were used for item analysis, exploratory factor analysis (EFA), and reliability and validity tests of the scale. The survey data of 538 clinical nurses obtained in April 2023 were used for confirmatory factor analysis (CFA) of the final scale. Results: The final scale consists of 25 items and 4 dimensions (performance expectations, perceived risk, need for professional knowledge training, and nonprofessional knowledge training). The scale showed good structural validity and content validity: the Cronbach's α coefficient of the scale was 0.955, the split-half reliability was 0.778, the test-retest reliability was 0.944, the kaiser-meyer-olkin(KMO) value was 0.960, and the cumulative variance contribution rate of the 4 common factors was 83.147%. The scale content validity index(S-CVI) was 0.914. The confirmatory factor analysis model had favorable fit indices: χ2/df = 4.234, RMSEA = 0.078, NFI = 0.940, IFI = 0.953, TLI = 0.947, and CFI = 0.953. Conclusion: The scale for assessing the barriers to and facilitators of nurses' willingness to participate in "Internet + Nursing Services" has good reliability and validity, and provides a reference for evaluating nurses' willingness to participate in "Internet + Nursing Services". [ABSTRACT FROM AUTHOR]

Aim: To analyze the psychometric properties of the Hospital Survey on Patient Safety Culture (HSOPS) in internal care units at a specific teaching hospital in the Czech Republic. Design: The paper has the character of a cross-sectional validation study. Methods: The study was conducted between November 2015 and January 2016. The convenience sample consisted of 207 registered nurses working in internal care units at a specific faculty hospital in the Czech Republic. Analysis of the psychometric properties of the HSOPS was conducted using Principal Component Analysis (PCA) and reliability testing. Results: Acceptable psychometric properties of the HSOPS were verified in our study. We confirmed 12 components of the HSOPS, the same number stated in the original version from the Agency for Healthcare Research and Quality (AHRQ). The reliability of the instrument was evaluated using the Cronbach alpha coefficient, and is considered acceptable. Conclusion: These findings can help healthcare institutions to raise awareness of patient safety culture and to gain a comprehensive overview of the individual dimensions of patient safety culture. In the future, the instrument could help to compare the components of patient safety culture, not only at a national but also at an international level. [ABSTRACT FROM AUTHOR]

Background: Professional nursing practice is informed by biological, social and behavioural sciences. In undergraduate pre-registration nursing programs, biological sciences typically include anatomy, physiology, microbiology, chemistry, physics and pharmacology. The current gap in the literature results in a lack of information about the content and depth of biological sciences being taught in nursing curricula. The aim of this study was to establish what priority is given to the teaching of science topics in these programs in order to inform an understanding of the relative importance placed on this subject area in contemporary nursing education. Method: This study employed a cross-sectional survey method. This paper reports on the first phase of a larger project examining science content in nursing programs. An existing questionnaire was modified and delivered online for completion by academics who teach science to nurses in these programs. This paper reports on the relative priority given by respondents to the teaching of 177 topics contained in the questionnaire. Results: Of the relatively small population of academics who teach science to nursing students, thirty (n = 30) completed the survey. Findings indicate strong support for the teaching of science in these programs, with particular priority given to the basic concepts of bioscience and gross system anatomy. Of concern, most science subject areas outside of these domains were ranked as being of moderate or low priority. Conclusion: While the small sample size limited the conclusions able to be drawn from this study, the findings supported previous studies that indicated inadequacies in the teaching of science content in nursing curricula. Nevertheless, these findings have raised questions about the current philosophy that underpins nursing education in Australia and whether existing practices are clearly focused on preparing students for the demands of contemporary nursing practice. Academics responsible for the design and implementation of nursing curricula are encouraged to review the content of current programs in light of the findings of this research. [ABSTRACT FROM AUTHOR]

Supporting early-stage nurses to adapt to the field and become proficient in nursing is important to improve the quality of patient care. This study aimed to determine the effects of the nursing work environment, nursing practice readiness, and optimism on the field adaptation of early-stage nurses. A descriptive survey was conducted among 209 early-stage nurses with ≤3 years of work experience at hospitals. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, Pearson's correlation coefficients, and regression analysis with the SPSS Program. The participating nurses' mean field adaptation score was 2.90 ± 0.40 (total score = 5) and a significant positive correlation was found between nursing work environment (r = 0.61, p < 0.001), nursing practice readiness (r = 0.41, p < 0.001), and optimism (r = 0.26, p < 0.001). The regression analysis revealed that the nursing work environment (β = 0.38, p < 0.001), job satisfaction (β = 0.33, p < 0.001), nursing practice readiness (β = 0.24, p < 0.001), and turnover intention (β = 0.17, p = 0.001) significantly affect the field adaptation of early stage nurses; the explanatory power was 56.1% (F = 27.55, p < 0.001). The results suggest that to facilitate the field adaptation of early-stage nurses, the nursing work environment, job satisfaction, and nursing practice readiness should be improved. Improvement in the nursing work environment and the development of additional training for field adaptation would enhance the ability of early-stage nurses to adapt to the field and, consequently, improve the quality of nursing care. [ABSTRACT FROM AUTHOR]

Background: Interventions within preschool settings have gained prominence due to the need to increase physical activity (PA) in early childhood. We first developed a 10-week preschool-based behaviour change intervention, guided by the UK Medical Research Council's framework for complex interventions. We then conducted a cluster feasibility randomised controlled trial (RCT) among young children. Aim: This process evaluation was embedded within the cluster feasibility RCT and aimed to assess the acceptability of the 10-week IAAH intervention among both preschool staff and parents. Methods: The study utilised a mixed method, involving post-intervention questionnaires completed by preschool staff (n = 4) and children's parents/caregivers (n = 9) and focus groups with preschool staff (n = 3) and parents/caregivers (n = 7). Quantitative data were analysed using SPSS to calculate acceptability scores, while qualitative data underwent thematic analysis using NVivo 12. Results: The intervention was well-received, with preschool staff reporting a 94.5% acceptability rate (mean score of 10.4 out of 11) and parents/caregivers indicating an 86% acceptance rate (mean score of 5.2 out of 6). Thematic analysis of focus group discussions revealed facilitators to intervention delivery, such as user-friendly materials and alignment with preschool curricula, and identified barriers, including time constraints, spatial limitations, and policy conflicts. Parental engagement was hindered by time restrictions, although the intervention materials were praised for their clarity and visual appeal. Conclusions: The findings suggest that the IAAH programme was acceptable to both preschool staff and parents. However, the identified barriers to intervention delivery and engagement should be addressed in the planning of a future cluster RCT to evaluate the efficacy of the intervention. [ABSTRACT FROM AUTHOR]

Introduction: Mental health is a serious concern among novice school nurses in Japan. Numerous novice school nurses with various health problems experience high stress levels, affecting their mental health. They may be experiencing reality shock, a known risk factor for burnout and turnover, or its factor, the "reality gap." Objective: This study aimed to examine the hypothetical model by which the reality gap affects the mental health of novice school nurses. Methods: This cross-sectional study conducted a self-administered questionnaire survey, and responses were obtained from 102 novice school nurses. A path model was created based on a hypothetical model. Results: After several revisions on the hypothesis model, a modified path model was generated (CFI =.98, TLI =.93, RMSEA =.06). The path model showed that reality gaps negatively affected work engagement, work engagement positively affected intention to stay, and intention to stay positively affected mental health. Reality gap was also directly negatively associated with mental health. Having various support networks reduced the effects of reality gaps on mental health. Additionally, social support in the workplace boosted work engagement. Conclusion: Unique from other studies, this study contributed to understanding the effects of reality gaps on mental health. School managers and administrators should establish a support system that enables school nurses to receive various supports from within and outside the school. In addition, novice school nurses should take advantage of networks and support inside and outside school to reduce reality gaps and grow as professionals. [ABSTRACT FROM AUTHOR]

(1) Background: Patient safety culture (PSC) encompasses the values, attitudes, norms, beliefs, practices, perceptions, competencies, policies, and behaviours of professionals that determine organisational commitment to quality and patient safety. Few studies use mixed methods to analyse patient safety culture, and none offer the richness of using a mixed methodology to develop their theoretical model. This study aims to identify the factors nurses believe contextualise and influence PSC in relation to existing theoretical frameworks. (2) Methods: This study employed a sequential explanatory mixed-methods design combined with the Pillar Integration Process for data integration. (3) Results: In the final data integration process, 26 factors affecting nurses' PSC were identified. Factors nurses related to PSC not being assessed with the tool used in phase 1 were notification system, flow of patients, patient involvement, resources and infrastructure, and service characteristics. (4) Conclusions: This mixed-methods study provides an opportunity to identify the weaknesses and strengths of currently developed theoretical frameworks related to PSC and offers content for its improvement. Even though multiple studies aim to assess PSC using existing quantitative method tools, the development of this study offers a glimpse of some aspects relevant to nurses' PSC not included in the theoretical framework of the said tools, such as patient involvement, the flow of patients, and service infrastructure. [ABSTRACT FROM AUTHOR]

Background: Although cervical cancer is preventable, it remains the most feared and second most common cancer in women worldwide, as well as the leading cause of cancer deaths in many lowand middle-income countries, including South Africa. Numerous studies conducted globally, in Africa and in South Africa revealed a knowledge gap about cervical cancer and its preventive strategies, including cervical cancer screening, among nurses and the general population. Aim: The purpose was to investigate and describe nurses' knowledge and management practices regarding cervical cancer screening in uMsunduzi Local Municipality, KwaZulu- Natal. Methods: The study was directed by a positivism paradigm. A quantitative research approach and nonexperimental descriptive design was used in this study. Probability random sampling was used, and a self-administered questionnaire was used to collect data. Eighty-three professional nurses participated in the study. Results: The study discovered that professional nurses working in selected clinics in uMsunduzi Local Municipality, KwaZulu-Natal, had a high level of knowledge about cervical cancer and its screening. Nonetheless, despite the high level of knowledge demonstrated, the level of practice remained low. Conclusion: Cervical cancer morbidity and mortality have long been a major health concern in South Africa's general population. The study found that PNs are knowledgeable about cervical cancer screening; conversely, practice was low. This paper includes recommendations for future research, nursing practice, nursing education and the Department of Health. Contribution: This study contributed vastly to the body of knowledge in managing cervical cancer screening practices, particularly in health promotion and prevention of diseases at primary care level. [ABSTRACT FROM AUTHOR]

Background: Intensive care nurses look after the most critically ill patient population with the highest mortality rate on a daily basis. Whilst research to date has highlighted and provided some insights into the current provision of end of life care, further research is much needed to improve the efficacy of nurses existing practice. Objective: To investigate the specific barriers and contextual characteristics that nurses experience within the Intensive Care Unit environment. Study Methods: The National Questionnaire of Critical Care Nurses Regarding End of Life Care was used to collect quantitative and qualitative data to answer the research questions. This study was conducted in a major intensive care unit located in a tertiary public hospital in metropolitan Western Australia. Results: The respondent rate was 67.31%. Obstacles with the highest perceived intensity score (PIS) reported by participants involved issues around the communication and practice of end of life care including family interaction. The ranges of mean scores for supportive behaviours were much higher than the ranges for obstacles. These supportive behaviours included allowing family members to have adequate time alone with the patient after death, and families being taught how to engage with the dying patient. Conclusion: The findings reflect that the most intense and frequently occurring obstacles are consistent with past research. A perceived negative end of life care experience by the nurse was found to negatively impact the nurse's psychological and physiological health. The research demonstrates the need for a stronger multidisciplinary patient centred approach. It is envisaged that the findings will support the review and development of appropriate guidelines to support nurses caring for intensive care patients in the initial and progressive phases of end of life care. What is already known about this topic? * ICU patients have the highest incidence of mortality in the acute care setting with one in four patients dying in an ICU, accounting for 15% of all hospital deaths annually. * This patient population presents nurses with a set of unique, yet significant challenges related to increased rate of mortality. * There is a significant amount of existing literature that has explored moral distress amongst nurses, particularly in relation to end of life care. What this paper adds: * This research suggests that there continues to be obstacles that impede critical care nurse's ability to facilitate EOLC in the ICU setting. * The participants of this study highlighted the need for stronger emphasis being placed on decision making processes, communication, and standardised practice. * The most supportive behaviours reported were associated with practice that could be initiated by the nurse such as, allowing family members adequate time with their loved one pre and post death, and teaching family members how to act and engage with their loved ones during this time. [ABSTRACT FROM AUTHOR]

Introduction: The effects of COVID-19 lockdowns and the discontinued face-to-face clinical practicum had negative consequences on nursing and midwifery students at many levels. The clinical learning environment includes all the training and learning experiences that nursing students undergo during their clinical practicum. Objectives: This study aimed to assess the effects of the COVID-19 lockdowns on the nursing and midwifery students' practicum training in governmental and private universities and academic faculties of nursing in Jordan. Methods: A descriptive cross-sectional study of 1025 nursing and midwifery students from academic faculties of nursing of both governmental and private Jordanian universities was conducted in September 2021. The research group from two Jordanian universities designed and validated a 13-item survey to determine and evaluate the impact of mass lockdowns on nursing and midwifery students' practicum training. The responses were assessed using descriptive and inferential analyses. Results: The findings revealed that the lockdown had a negative impact on nursing and midwifery students' self-confidence and competency in performing nursing procedures. The academic year of the students was a significant independent predictor of their self-confidence and competency levels in performing nursing procedures. Conclusion: The study concluded that nursing and midwifery students were dissatisfied with their clinical education during the COVID-19 pandemic, which led to poor self-confidence in performing nursing procedures. The study group recommended repeating the clinical practicum, incorporating extensive laboratory and hospital courses, and implementing a one-year internship for newly graduated nurses and midwives to address the training gap and enhance self-confidence in clinical procedures. [ABSTRACT FROM AUTHOR]

The state of confinement during the COVID-19 pandemic affected the quality of life of the general population. This study aims to define and contrast an explanatory model of the quality of life in adults and to analyze the relationships between these variables based on the state of confinement and sex. A total of 872 people from Chile aged between 17 and 50 (M = 21.70 years; SD= 3.272), of both sexes (60.90% male and 39.1% female) participated in this research, of whom 46.6% were not confined when tested and 53.4% were confined, analyzing the quality of life. A model of multi-group structural equations was performed, which adjusted very well (χ2 = 559.577; DF = 38; p < 0.001; IFC = 0.934; NFI = 0.916; IFI = 0.934; RMSEA = 0.061). The results show a positive and direct relationship among all the variables studied and the structural equation model proposed according to confinement and sex reveals a good fit in all the evaluation indexes. Stress and sleep, personality, and introspection were the indicators with the greatest influence in the four models, followed by the family and friends indicator with a medium correlation strength, such as the health monitoring dimension, although this was not as influential in confined individuals. The main conclusions are that the best adjustments are obtained in confined adults and females, and the data show that the psychological indicators obtained (stress and sleep, personality, and introspection) have the greatest influence on adults in the four models proposed with regard to their quality of life. [ABSTRACT FROM AUTHOR]

Objectives: Sudden infant death syndrome (SIDS) is the third most frequent cause of infant mortality in the United States (US), which kills 3500 infants a year and accounts for 8% of all infant deaths. The study aims to evaluate mothers' practices of preventing SIDS in Holy Karbala City and to find... [ABSTRACT FROM AUTHOR]

Background: Dehydration is a serious public health concern occurred due to the imbalance between water intake and loss which increased in the climate change and Egypt's hot weather, lead to the morbidity and mortality rate raise among the older persons. Aim: To evaluate the effect of nursing educational program for improving older persons' hydration status. Subjects and Method: One group pre-post intervention research design. Setting: The study conducted at the (internal medicine and urology) clinics at the Assuit University hospitals. Sample: Total number of 130 older persons was included. Study tools: Contained four tools; Tool (I): Consisted of four parts; personal data, El-Gilany scale for measurement of socioeconomic status, health condition and knowledge of older persons regarding dehydration. Tool (II): Dehydration screening. Tool (III): Hydration knowledge scale and Tool (IV): Hydration facilitators and barriers attitude. Results: Mean ± SD and (range) of participant age: 69.28±7.65 (60-91). It was found that, more than half (56.9% &53.1% respectively) of them were male and had very low socioeconomic status. There was statistically significant effect of the educational program on the older persons' dehydration status; also there was improvement of older person's hydration & dehydration knowledge and attitude of older persons about hydration facilitators and barriers after the application of the educational program. Conclusion and recommendations: These results support that the nursing educational program improved the hydration status, hydration & dehydration knowledge and attitude toward hydration facilitators and barriers among older persons. Continuous educational programs about hydration status of older persons are recommended. [ABSTRACT FROM AUTHOR]

Background: Health literacy concerns the capacities of people to meet the complex demands of health in modern society. In spite of the growing attention for the concept among European health policymakers, researchers and practitioners, information about the status of health literacy in Europe remains scarce. This article presents selected findings from the first European comparative survey on health literacy in populations. Methods: The European health literacy survey (HLS-EU) was conducted in eight countries: Austria, Bulgaria, Germany, Greece, Ireland, the Netherlands, Poland and Spain (n = 1000 per country, n = 8000 total sample). Data collection was based on Eurobarometer standards and the implementation of the HLS-EU-Q (questionnaire) in computer-assisted or paper-assisted personal interviews. Results: The HLS-EU-Q constructed four levels of health literacy: insufficient, problematic, sufficient and excellent. At least 1 in 10 (12%) respondents showed insufficient health literacy and almost 1 in 2 (47%) had limited (insufficient or problematic) health literacy. However, the distribution of levels differed substantially across countries (29-62%). Subgroups within the population, defined by financial deprivation, low social status, low education or old age, had higher proportions of people with limited health literacy, suggesting the presence of a social gradient which was also confirmed by raw bivariate correlations and a multi-variate linear regression model. Discussion: Limited health literacy represents an important challenge for health policies and practices across Europe, but to a different degree for different countries. The social gradient in health literacy must be taken into account when developing public health strategies to improve health equity in Europe. [ABSTRACT FROM AUTHOR]

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Background: This study aimed to examine the relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes based on Orem's Self-Care Theory. Methods: The research involved 341 patients with type 2 diabetes in Rasht, Iran, using a descriptive-analytical cross-sectional design. The data collection included questionnaires assessing Self-Care Behaviors, Self-Efficacy, and Health Deviation Self-Care Requisites based on Orem's model. Results: Demographic factors such as gender, marital status, employment, education, age, duration of disease, and oral treatment and insulin had no consistent effect on self-care behaviors. Self-efficacy was a key factor influencing Self-Care Behaviors in diabetic patients. There was a strong and direct correlation between Self-Care Behaviors and Self-Efficacy, indicating the role of individuals' confidence in managing diabetes. Health Deviation Self-Care Requisites had both positive and negative correlations with different domains of Self-Care Behaviors.The physical exercise construct of self-efficacy was the most significant predictor of Self-Care Behaviors. Conclusions: This study provides valuable insights into the complex relationship between Self-Care, Self-Efficacy, and Health Deviation Self-Care Requisites in patients with type 2 diabetes. The findings underscore the importance of addressing Self-Efficacy and specific self-care domains, such as physical activity and foot care, in diabetes management strategies. This research contributes to the existing knowledge base and may inform healthcare professionals and policymakers in developing targeted interventions to improve self-care practices in diabetic patients. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a high-risk period. Teenagers experience risky behaviors in this period, including using abusive drugs and addiction. Meanwhile, sufficient awareness helps a person to interpret and analyze health-threatening factors. This study aimed to determine the relationship between health literacy and susceptibility to addiction in adolescents living in the western part of Tehran City, Iran. Methods: This descriptive-correlational study was performed on 265 senior high school students in the western part of Tehran in 2021. The subjects were recruited by cluster random sampling. The study data were collected online using the addiction susceptibility questionnaire and health literacy measure for adolescents. The obtained data were sorted by frequency distribution, Mean±SD and analyzed utilizing the Pearson correlation coefficient, independent t-test, and analysis of variance in SPSS software, version 16. The significance level was set at 0.05. Results: Most study subjects (56.4%) were female. Their Mean±SD score of health literacy was 65.31±21.15. Among the subscales of health literacy, "calculation", with a Mean±SD score of 68.96±35.89, and "utilization", with 61.29±25.05, had the highest and lowest mean scores, respectively. The Mean±SD score of addiction susceptibility was 25.3±30.05, and among its subscales, "showing off" with a mean score of 33.09±32.64 and "family dissatisfaction" with 19.75±35.47 had the highest and lowest mean scores, respectively. Health literacy and its dimensions had a negative correlation with addiction susceptibility (P<0.001). Conclusion: According to the findings, it is recommended to use appropriate strategies to increase adolescent health literacy by health service providers, school officials, school health nurses, and teachers. The results of this study can be used as a source for further research on addiction and health literacy in adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Although different tools have been designed to measure mindfulness, none has comprehensively examined academic mindfulness. Therefore, the present study aimed to build a reliable and valid tool for academic mindfulness measurement in students. Method: The research was a descriptive-correlational study and a validation of the test. Participants included 420 students of Bu-Ali Sina University in the academic year of 2022-2023, selected by multistage cluster random sampling method and completed the Academic Mindfulness Questionnaire (AMQ-5), Fear of Self-compassion Scale, and Academic Engagement Questionnaire. Data were analyzed using exploratory and confirmatory factor analysis. Results: Examination of the data by exploratory factor analysis showed that all 20 items had acceptable factor loads and revealed five factors (self-compassion, accepting without judgment, presence in the moment, performing tasks with awareness, and listening with full attention). Moreover, according to the confirmatory factor analysis, the questionnaire had an acceptable fit (RMSEA=0.047, AGFI=0.91, NFI=0.96, CFI=0.98). The findings showed that academic mindfulness was significantly correlated with fear of self-compassion and academic engagement. Moreover, Cronbach's alpha coefficient was 0.89. Conclusion: According to the findings of the present study, it can be concluded that the academic mindfulness questionnaire has a good validity and reliability and can effectively measure academic mindfulness in the five factors mentioned. [ABSTRACT FROM AUTHOR]

Background: The first step in effectively applying novel teaching methods is identifying barriers and challenges to implementing appropriate interventions. A literature review revealed no studies exploring nursing instructors' viewpoints on the reasons for not using novel teaching methods. Purpose: The present study aimed to explore the challenges and executive barriers against using novel approaches in instructing nursing students from the perspective of nursing instructors. Methods: In this descriptive-analytical study, 163 nursing instructors from three nursing schools in Fars Province, Southwest Iran, were selected using convenience sampling. A researcher-developed questionnaire comprising 17 items scored on a five-point Likert scale was utilized to collect data. These items were categorized into three domains: challenges related to students (n=4), instructors (n=8), and structural-managerial aspects (n=5). The questionnaire's reliability coefficient was found to be 0.89 using the test-retest method. The Kolmogorov-Smirnov test was used to test the normality of variables and the independent t-test was employed to examine the relationship between genders and educational degrees across all three domains. Results: The mean scores for challenges and barriers related to the instructors, students, and structural-managerial aspects were 33.24(7.16), 16.31(3.93), and 22.14(3.64), respectively. A significant relationship between gender and educational degree was observed across all three domains (p<0.001). Conclusion: The barriers and challenges against using novel teaching methods for nursing students from the perspective of nursing instructors included challenges related to instructors, students, and structural-managerial aspects. The support and encouragement of educational institution managers in executing these methods could help promote the utilization of these techniques and improve the quality of education. [ABSTRACT FROM AUTHOR]

Aim: The study aim was to examine the relationships among workplace stress (psychological, physical, and social environments), nurses' personal characteristics, work characteristics, and safety climate in pediatric units. Methods: A descriptive correlational design was employed. In total, 138 nurses were recruited through convenience sampling from a university teaching hospital in Saudi Arabia. Of the total, 137 (99.3%) were females, 134 (97.1%) were non-Saudi, and more than half (n = 96, 69.6%) provided direct care at pediatric specialty units. Data were collected from February to May 2019 using a questionnaire that included the personal details, work conditions, surveys on an expanded nursing stress scale, and patient safety culture. Results: Average stress scores for social working environments were highest (2.98; SD = 0.76), whereas psychological and physical working environments were 2.92 (SD = 0.74) and 2.84 (SD = 0.65), respectively, and were seen as less stressful. A 37.0% of the variance in stress among pediatric nurses was explained by organizational learning, supervisor manager expectations within the patient safety aspect, and nationality. Conclusion: Study indings determined stress scores in which social and psychological work environment dimensions were higher than local and international benchmark scores, and predicted various factors of stress among nurses working in pediatric units. Implications: COVID-19 is still present, and immediate countermeasures are needed. These indings can become the guide in formulating a tailored supportive program toward the elimination of stress to provide quality and safe pediatric nursing care. [ABSTRACT FROM AUTHOR]

Objective: Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. Methodology: This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. Results: The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5–20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. Conclusion: Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices. [ABSTRACT FROM AUTHOR]

Background. Worldwide, hospitals are required to prioritize the culture of quality in infection prevention (CQIP) for patient safety. Assessing CQIP is crucial, but there is limited research, especially regarding nurses' perceptions. Insufficient information exists due to scarcity of validated instruments in local languages to measure CQIP internationally. Purpose. This study assessed the "Leading a Culture of Quality in Infection Prevention Scale" Russian version's (LCQ-IPS-R) validity and reliability to assess the CQIP of hospitals in Kazakhstan based on nurses' perceptions. Methods. This study utilized a methodological design and analyzed data from 204 nurses at the "National Research Center for Maternal and Child Health" in Astana City, Kazakhstan. The "cultural and linguistic adaptation" process involved a "forward-backward translation" technique. Content validity and construct validity were examined. Internal consistency reliability was explored for scale reliability. Results. The scale's mean item range was from 3.56 (SD = 1.22) to 4.40 (SD = 0.85; SD = 0.92). The corrected item-total correlation ranged from 0.321 to 0.707. Six experts rated the I-CVI from 0.83 to 1.00, with an S-CVI/Ave of 0.90. The principal component analysis with Varimax rotation produced four distinct components of the LCQ-IPS-R, explaining 69.8% of the total variance. The tests of correlation between the LCQ-IPS-R's four components revealed medium to large positive associations among the components (r = 0.25–0.55, p < 0.001). The computed α for the LCQ-IPS-R was 0.909 while α values from four subscales ranged from 0.809 to 0.921. Conclusions/Implications for Practice. This study provides evidence of the LCQ-IP-R's reliability and validity in evaluating Russian-speaking nurses' perception of their hospital's CQIP. These findings open the door for further research on CQIP in healthcare settings in Kazakhstan, Central Asia, and other Russian-speaking countries. The scale provides essential baseline information to design effective interventions for achieving hospitals' infection prevention objectives. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the psychometric properties of the Persian version of the Cambodian Nursing Care Quality Scale. Design: Methodological design. Methods: This study was carried out in several steps: a forward‐backward translation was done, face and construct validity was measured using exploratory and confirmatory factor analysis and the reliability was evaluated. A convenience sampling method was employed to recruit 350 nurses from May 2021 to March 2022. Results: The exploratory factor analysis extracted six factors that explained 60.76% of the total variance. The six‐factor model is supported by confirmatory factor analysis. The Cronbach's alpha and the intra‐class correlation coefficient were 0.94 and 0.85, respectively. Patient or Public Contribution: Evaluation of the quality of care can lead to the enhancement of the quality of nursing services and patient safety. This will subsequently increase the patients' and community satisfaction. [ABSTRACT FROM AUTHOR]

Background: This study aimed to test the inter-rater reliability, construct validity, and feasibility of the modified "Which Health Approaches and Treatments Are You Using?" (WHAT) questionnaires in pediatric oncology; Methods: Parent–child dyads were invited to complete self- and proxy-report-modified WHAT, Pediatric Quality of Life Inventory, demographics, a diary of the child's recent use of CHA, and a questionnaire assessing the aspects of feasibility. Parents were asked to complete a satisfaction of their children's use of the CHA survey; Results: Twenty-four dyads completed the study. The mean weighted kappa showed strong inter-rater reliability (k = 0.77, SE = 0.056), and strong agreements between the modified WHAT and the diary (self-report [k = 0.806, SE = 0.046] and proxy-report [k = 0.894, SE = 0.057]). Significant relationships were found only between recent and non-recent CHA users in relation to the easy access to CHA (self-report [p = 0.02], proxy-report [p < 0.001]). The mean scores of the feasibility scale (out of 7.0) for the self- and proxy-report were 5.64 (SD = 0.23) and 5.81 (SD = 0.22), respectively, indicating the feasibility of the modified WHAT; Conclusions: The findings provide initial evidence of the reliability and validity of the modified WHAT and their feasibility. Further research is needed to test the theoretical relationships and further explore the validity and reliability of the modified WHAT. [ABSTRACT FROM AUTHOR]

Objectives: The mother’s knowledge and attitude about the child’s developmental norms can affect their practice and the quality of parent-child interaction. The quality of a child’s development in the early years significantly impacts their personality and future success. Therefore, this study aims to develop and investigate the psychometric characteristics of the Iranian mother’s knowledge, attitude, and practice (KAP) questionnaire about the development of communication, language, speech, and swallowing of Persian-speaking children aged 18 to 36 months and comparing them. Methods: This study was a descriptive-analytical and cross-sectional study conducted on 280 mothers with typically developed children aged 18 to 36 months from different provinces of Iran. Due to the COVID-19 pandemic with the implementation of the study, the participants were selected as available, and then the snowball completed the questionnaire in both face-to-face and online methods. To check the validity of the questionnaire, face validity was calculated using the opinion of speech therapy experts and ten mothers, and content validity was calculated using the Lawshe method. To check the reliability of the questionnaire, the test re-test method was used in a two-week interval. Results: The results indicated that this questionnaire has high validity (content validity index [CVI] >0.79) and reliability (intraclass correlation coefficient [ICC]=0.90). The multiple linear regression model showed that only the mother’s age has a significant positive relationship with knowledge ([B=0.082] P=0.04) about the development of communication, language, speech, and swallowing of children aged 18 to 36 months. Socioeconomic status and the mother’s education had no significant relationship with the mother’s KAP. Also, this study showed that the mother’s knowledge, attitude, and practice about a child’s development were high (mean=16.5), positive (mean=56.44), and good (mean=60.27). Discussion: This study showed that the designed questionnaire is a valid and reliable tool that can be used to investigate the mother’s KAP about the development of communication, language, speech, and swallowing of Persian-speaking children aged 18 to 36 months. On the other hand, speech and language pathologists can use this questionnaire in related studies and clinical evaluations to have better and more knowledge of the child’s environment and the factors affecting it in Persian-speaking society. [ABSTRACT FROM AUTHOR]

Introduction: Attention Deficit/Hyperactivity Disorder (ADHD) is a prevalent childhood disorder that affects millions of children worldwide. This neurodevelopmental disorder is characterized by symptoms such as inattention, hyperactivity, and impulsivity, which can significantly impact a child's daily functioning and academic performance. This article focuses on the effectiveness of behavioral training for mothers of boys with ADHD. The study examines how training sessions can reduce parenting stress, decrease externalizing behaviors, and improve behavioral functioning in children with ADHD. The importance of this research lies in the fact that ADHD and externalizing problems are among the most common childhood disorders, making it crucial to find effective interventions that can support both parents and children in managing these challenges. By providing evidence-based behavioral training to mothers, the study aims to enhance parental skills in dealing with ADHD symptoms and promote positive behavioral outcomes in children. Method: This study utilized a quasi-experimental design with pre-test and post-test measures and a control group. The participants were male students with ADHD (Combined type) and their mothers. The sample consisted of 30 mothers who were selected through convenience sampling and divided into experimental and control groups. Data was collected using the Children Adaptive Behavior in Home Questionnaire (1993), the Child Behavior Checklist (2001), and the SNAP-IV (1994). Both groups completed the Child Behavior Checklist and Children Adaptive Behavior in Home Questionnaire. The experimental group received nine ninety-minute sessions of parental behavior training while the control group continued with their usual routines. As for the experimental group, they were trained using Barkley's Parent Training Program (1997). Barkley's Parent Training Program is a behavioral program designed to educate parents and has been shown through empirical evidence to be effective in reducing behavior problems in children with ADHD or Oppositional Defiant Disorder (ODD). After the training, both groups completed the same questionnaires as post-tests. The obtained data was entered into SPSS-16 and analyzed using t-test and analysis of covariance. Results: The study found that Barkley's Parent Training Program was effective in reducing behavior problems in children with ADHD. Specifically, it improved their behavior at home and decreased their aggression. The program was particularly effective for children whose mothers participated in the experimental group compared to those in the control group. The results were statistically significant, with a p-value of 0.001 for improving the behavior of children at home and 0.05 for aggression reduction. Conclusion: The current study suggests that Barkley's parental training is an effective way to enhance the self-control of children with ADHD. This can be achieved by altering the way parents interact with and model behavior for their children with ADHD. As a result, it led to a decrease in behavioral issues and aggression among children with ADHD. [ABSTRACT FROM AUTHOR]

Background: Communication challenges are one of the main contributors for medication incidents in hospitals, but health professionals' perceptions about variety of the contributing communication factors and the factors' occurrence frequencies are studied little. This cross-sectional descriptive study aimed to (1) operationalize a literature-based framework into a scale for measuring health professionals' perceptions of communication factors, which contribute to medication incidents either directly or indirectly in hospitals, (2) to measure the construct validity and internal consistency of the scale and (3) to describe the primary results of the measured weekly perceived communication challenges. Methods: The structured online questionnaire with 82 communication related items was developed based on a framework in literature. A content validity index of expert panelists' answers was used for item reduction. Data was collected between November 1st, 2019, and January 31st, 2020, by convenience sampling. The study sample (n = 303) included multiple health professional groups in diverse specialties, unit types and organizational levels in two specialized university hospital districts in Finland. Exploratory factor analysis with Maximum Likelihood method and Oblique rotation produced a six factors scale consisting of 57 items and having acceptable construct validity and internal consistency. Results: The six communication factors contributing to medication incidents concerned (1) medication prescriptions, (2) guidelines and reporting, (3) patient and family, (4) guideline implementation,5) competencies and responsibilities, and 6) attitude and atmosphere. The most frequently perceived communication challenges belonged to the Medication prescription related factor. Detailed item frequencies suggested that the most usual weekly challenges were: (1) lack or unclarity of communication about medication prescriptions, (2) missing the prescriptions which were written outside of the regular physician-ward-rounds and (3) digital software restricting information transfer. Conclusions: The scale can be used for determining the most frequent detailed communication challenges. Confirmatory factor analysis of the scale is needed with a new sample for the scale validation. The weekly perceived communication challenges suggest that interventions are needed to standardize prescribing documentation and to strengthen communication about prescriptions given outside of regular ward-rounds. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to translate and adapt the traditional Chinese Food Allergy Quality of Life‐Parental Burden Questionnaire (TC‐FAQL‐PB) into simplified Chinese language and determine the validity and reliability of the translated version. Design: A methodologic study design involving instrument translation and psychometric evaluation was used for the present study. Methods: The simplified Chinese FAQL‐PB (SC‐FAQL‐PB) was developed following Guillemin's guidelines for cross‐cultural adaptation. A convenience sample of 230 participants was recruited. The psychometric properties were examined using internal consistency, test–retest reliability, item discrimination, content validity and construct validity. Results: The values of I‐CVI ranged from 0.83 to 1.00. The CFA model revealed that the study supported the two‐factor model. The questionnaire had good internal consistency with a Cronbach's alpha coefficient of 0.946. The item‐total correlation values ranged from 0.707 to 0.866. Test–retest reliability showed that the intraclass correlation coefficient was 0.926 (95% CI, 0.830–0.968). [ABSTRACT FROM AUTHOR]

Aim: To describe the associations of psychological burnout and time factors on hospital nurses' medication errors. Design: A cross‐sectional survey design was used. Methods: A structured questionnaire pertaining to psychological burnout, time factors and medication error was administered to 200 bedside nurses working at two tertiary university hospitals in Korea. The associations between the psychological burnout, time factor and medication error were analysed with the zero‐inflated negative binomial regression for over‐dispersed and over‐abundant zeros count data. Results: Higher psychological burnout, shorter meal time during duty and longer weekly overtime were associated with an increased likelihood of medication error of nurses working in tertiary university hospitals. For medication safety, nurse managers should provide appropriate administrative support to nurses to cope with psychological burnout of nurses. Work time management should also be considered as human factors to satisfy the needs of nurses, such as securing meal times and maintaining a low level of weekly overtime. [ABSTRACT FROM AUTHOR]

Background. The high turnover rate of new nurses is significantly impacted by the transition issue. Practice readiness has been identified as a key factor in ensuring a smooth transition, but there is currently a lack of specific instruments available in China to measure it. Aims. To translate and adapt the Casey-Fink Readiness for Practice Survey and validate its psychometric properties in senior nursing students in the Chinese cultural context. Methods. The descriptive cross-sectional study design was used. The English version of the Casey-Fink Readiness for Practice Survey was translated into Chinese according to Brislin's translation guidelines. A total of 590 senior nursing students from three nursing schools in China were surveyed with the Chinese version of the Readiness for Practice Instrument. Data analyses were performed to assess the reliability and validity of the instrument. The STROBE guidelines were used as the reporting method. Results. The validated Chinese version of the Casey-Fink Readiness for Practice Survey contained 18 items in the same four dimensions as the original English version. The internal consistency was satisfactory, with Cronbach's α and composite reliability values for all four dimensions above 0.70. The final confirmatory factor analysis model also demonstrated good fit indices, with the average variance extracted values for all dimensions above 0.50. Conclusion. The validated Chinese version of the Casey-Fink Readiness for Practice Survey is a reliable and effective instrument for measuring the readiness for practice among senior nursing students in China. Implications for Nursing Management. This study presents a valuable contribution to adapting an effective and reliable tool to assess readiness for practice among Chinese senior undergraduate nursing students. This will enable the development of specific strategies based on cultural context to optimize the readiness for practice for senior nursing students and smooth the transition of new nurses in China. [ABSTRACT FROM AUTHOR]

The study compared perceived differences in Quality of Work‐Life (QoWL) among nurse clinicians and educators and coping strategies used by nurses. Design: A cross‐sectional study. Methods: From August and November 2020, the study measured the QoWL and coping strategies of 360 nurses with two scales using a multi‐stage sampling technique. The data were analysed with descriptive, Pearson correlation and multivariate linear regression analyses. Results: Quality of Work‐Life was generally low among nurses; nurse educators, however, had better QoWL than clinical nurses. Age, salary and nature of work predicted the QoWL of nurses. Work‐family segmentation, seeking assistance, open communication and recreational activities were employed by most nurses to cope with challenges. With the rate of workload and work‐related stress associated with COVID‐19, nurse leaders must advocate for evidence‐based coping strategies to deal with work and family life stress. [ABSTRACT FROM AUTHOR]

Introduction: Illness perception and self-efficacy in patients with coronary artery disease (CAD) may affect medication adherence, which is one of the most important challenges in disease management in this group of patients. Objective: The present study aimed to investigate the factors influencing medication adherence in CAD patients, especially the effect of illness perception and self-efficacy. Methods: This study was cross-sectional and conducted from April to September 2021. A total of 259 patients with confirmed CAD were selected by convenience sampling method based on inclusion criteria. Illness perception, self-efficacy, and medication adherence were investigated using Brief IPQ, SCSES, and MARS_10 questionnaires, respectively. The data were analyzed using the STATA software (version 14) and the regression path analysis method. Results: Patients had moderate illness perception and high self-efficacy, and 61.8 of them adhered to their medication regimen. Greater illness perception, better self-efficacy, and higher education had a positive effect on medication adherence, and increasing age had a negative effect on it. The final path model shows a good fit of the data in the model (χ2: 0.37, df: 274, χ2/df: 0.36, CFI: 1, IFI: 0.95, TLI: 1.07, and RMSEA: 0.00). Conclusion: The results of the present study suggest that patients' illness perception can play an important role in predicting self-efficacy in disease management and the level of medication adherence in patients with CAD. To improve self-efficacy and medication adherence, future intervention studies should focus on the patient's illness perceptions and their improvement. [ABSTRACT FROM AUTHOR]

Background: Diabetes contributes to the development of multiple chronic conditions including cardiovascular disease, stroke, blindness, kidney disease, and lower-limb amputations. Currently, it is known that the Appalachian Region is an area of significant disparity in the occurrence of Diabetes. Persons with Diabetes can develop high levels of cognitive stress related to the experience of living with Diabetes. Method: This paper presents the results of a descriptive study guided by the Transactional Model of Stress and Coping (TMSC), aiming to enhance understanding of the relationships among diabetes-related distress, appraisal, and self-management in a sample of 102 adults who were living rurally in Appalachia. Findings: The majority of the study sample were low-income, obese, and had mean A1C levels above the goal for adequate diabetes control. Over one-third of the sample had a high likelihood or possibility of limited health literacy. Participants reported adhering to medication on over 6 days of the week but adhering to diet and exercise on fewer days per week. Overall, the sample had a lower level of distress related to the diagnosis of diabetes. Participants perceived diabetes as more of a challenge than a threat, harm, or benign stressor. Diabetes related distress was inversely correlated to challenge appraisals and benign appraisals, but positively correlated to threat and harm appraisals. Anxiety and depression were significantly positively related to diabetes related distress, threat appraisals, and harm appraisals and significantly negatively correlated with challenge and benign appraisals. Conclusions: Recommendations for future research include the development and testing of targeted interventions that address the study findings including health literacy level, challenge appraisals, and the interrelationships of psychological and physical health variables. Knowing that diabetes is appraised as a challenge enhances the likelihood that it may be amenable to intervention. The interrelatedness of anxiety and depression to self-management further informs future intervention design. [ABSTRACT FROM AUTHOR]

Background: Understanding nursing students' knowledge about and attitudes toward older adults' using context-specific survey instruments can help to identify and design effective learning and teaching materials to improve the care for persons 60 years and above. However, there are no validated instruments to examine nursing students' knowledge and attitudes toward the care for older adults in the African context. The study aimed to evaluate the items on the Knowledge about Older Patients Quiz and Kogan's Attitudes towards Old People Scale suitable for the African context. Methods: A cross-sectional study was conducted using second-and third-year nursing students from two public Nursing Training Institutions in Ghana. Using Sahin's rule of sample size estimate of at least 150 participants for unidimensional dichotomous scales, 170 nursing students were recruited to participate after an information session in their classrooms. Data were collected from December 2019—March 2020 using the Knowledge about Older Patients Quiz and Kogan's Attitudes Towards Old People Scale. Item response theory was employed to evaluate the Knowledge about Older Patients Quiz difficulty level and discrimination indices. Corrected item-to-total correlation analysis was conducted for Kogan's Attitudes towards Old People Scale. The internal consistency for both scales was examined. Results: Of the 170 participants, 169 returned completed surveys. The mean age of participants was 21 years (SD = 3.7), and (54%) were female. Of the 30-items of the Knowledge about Older Patients Quiz, seven items were very difficult for most students to choose the correct response, and one was easy, as most of the students chose the correct response. Although 22 items demonstrated appropriate difficulty level, discrimination indices were used to select the final 15- items that discriminated moderately between upper and lower 25% performing students. The Kuder-Richardson-20 reliability was. 0.30, which was low. Considering Kogan's Attitudes towards Old People scale, 10-items were removed following negative and low corrected item-to-total correlation and a high Alpha coefficient if items were deleted. The final 22-items had a Cronbach alpha coefficient of 0.65, which was moderately satisfactory. Conclusion: Evaluation of the scales demonstrated essential content validity and moderate internal consistency for the context of our study. Further research should focus on ongoing context-specific refinement of the survey instruments to measure nursing students' knowledge about and attitudes toward caring for older adults in the African context. [ABSTRACT FROM AUTHOR]

Aim: To investigate the perception of undergraduate nursing students in different countries in the Middle East about caring. Design: A cross‐sectional, descriptive, comparative design. Methods: A total of 1,582 nursing students from six different countries in the Middle East completed the Caring Dimensions Inventory. Results: The total mean score of caring was 138.8 (± 15.8), indicating a high level of caring. The highest mean score was for nursing students from Egypt (M = 145.37 ± 15.97), whereas the lowest was for nursing students from Palestine (M = 135.36 ± 13.48). The caring perception was more significant for female students than male students, and no significant correlation was found between students' ages and caring scores. Conclusions: The high level of caring among nursing students reflects the involvement of caring behaviour in the nursing curricula, which motivates nursing schools to continue stressing the importance of caring and to enhance this behaviour among their graduates. Patient or Public Contribution: Improving the students' caring competencies as recommended by the study will influence the caregiving quality in the future that will be reflected in nurse–patient caring relationships and raise the patients' and public satisfaction with nursing care. [ABSTRACT FROM AUTHOR]

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Mindfulness research and clinical programs are widespread, and it is important that mindfulness-based interventions are delivered with fidelity, or as intended, across settings. The MBI:TAC is a comprehensive system for assessing teacher competence, yet it can be complex to implement. A standardized, simple fidelity/engagement tool to address treatment delivery is needed. Objective: We describe the development, evaluation, and outcomes of a brief, practical tool for assessing fidelity and engagement in online mindfulness-based programs. The tool contains questions about session elements such as meditation guidance and group discussion, and questions about participant engagement and technology-based barriers to engagement. Methods: The fidelity rating tool was developed and tested in OPTIMUM, Optimizing Pain Treatment in Medical settings Using Mindfulness. The OPTIMUM study is a 3-site pragmatic randomized trial of group medical visits and adapted mindfulness-based stress reduction for primary care patients with chronic low back pain, delivered online. Two trained study personnel independently rated 26 recorded OPTIMUM sessions to determine inter-rater reliability of the Concise Fidelity for Mindfulness-Based Interventions (CoFi-MBI) tool. Trained raters also completed the CoFi-MBI for 105 sessions. Raters provided qualitative data via optional open text fields within the tool. Results: Inter-rater agreement was 77-100% for presence of key session components, and 69-88% for Likert ratings of participant engagement and challenges related to technology, with discrepancies only occurring within 2 categories: 'very much' and 'quite a bit'. Key session components occurred as intended in 94-100% of the 105 sessions, and participant engagement was rated as 'very much' or 'quite a bit' in 95% of the sessions. Qualitative analysis of rater comments revealed themes related to engagement challenges and technology failures. Conclusion: The CoFi-MBI provides a practical way to assess basic adherence to online delivery of mindfulness session elements, participant engagement, and extent of technology obstacles. Optional text can guide strategies to improve engagement and reduce technology barriers. [ABSTRACT FROM AUTHOR]

Fear of infection has been sparked by the advent of the novel coronavirus disease (COVID-19). Insomnia in college students, especially its correlations and predictions with mental diseases, remains a research concern. Aim: To estimate the prevalence of fear related to COVID-19, depression, anxiety, and insomnia among female nursing college students throughout the pandemic and to determine the predictors of insomnia. Methods: A web-based cross-sectional descriptive study used 145 female nursing college students. Results: Students reported fear related to COVID-19, depression, and anxiety at rates of 79.3%, 30.2%, and 35.2%, respectively. Insomnia disturbed 24.7% of students. Anxiety predicted worsening insomnia in the student (AOR = 1.08, 95% CI: 0.92–0.97, p < 0.001). Fear related to COVID-19 was also a predictor (AOR = 0.96, 95% CI: 1.07–1.21, p < 0.05). Additionally, when depression severity declined, the chance of insomnia improved (AOR = 0.87, 95% CI: 0.85–0.91, p < 0.001). Insomnia was more common in chronically unwell students (AOR = 1.50, 95% CI = 1.01–2.24, p < 0.05). Conclusion: During the COVID-19 pandemic, university students' mental health should be monitored, and all essential safeguards should be taken, including resource allocation, awareness raising efforts, and the building of a mental health counseling facility. [ABSTRACT FROM AUTHOR]

Copyright of Investigacion en Enfermeria: Imagen y Desarrollo is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Based on the latest estimates of the United Nations Program on HIV/AIDS (UNAIDS), acquired immunodeficiency syndrome (AIDS) is now a public health challenge in Iran, and in 2018, 61,000 people were living with human immunodeficiency virus (HIV), of which 45,000 (75%) were men. This study aimed to evaluate effect of educational intervention based on theory of planned behavior (TPB) on HIV/AIDS preventive behaviors among male barbers. Material and methods: The current quasi-experimental study was conducted in 2019 among 120 male barbers, who were selected using stratified sampling method. Data were collected using a valid and reliable questionnaire based on TPB at baseline and post-intervention. Intervention was designed and performed according to TPB. Data were analyzed with SPSS version 20 using descriptive and inferential methods. Results: Mean age of barbers was 30.41 ± 8.43 years. At baseline, mean scores of TPB constructs were not significantly different between intervention and control groups (p > 0.05). However, in post-intervention phase, there was a significant difference between two investigated groups in mean scores of TPB constructs (p < 0.05). Conclusions: Findings of the current study showed that educational intervention based on TPB can enhance knowledge level, perceived behavioral control, and attitude and creation of appropriate subjective norms for formation of behavioral intention and promoting AIDS preventive behavior among barbers. [ABSTRACT FROM AUTHOR]

Background: Participation in peer social groups could be used in health promotion programs for the elderly. The current study investigates the effectiveness of participation in a peer social support network intervention on the self-management of the elderly with type 2 diabetes. Methods: This research is a quasi-experimental study with a pre-test-pos-ttest design with a control group conducted in 2019. Two health centers were selected as research settings from a single district in Qom Province, Iran. From each center, 46 subjects were randomly selected. Subjects in the intervention group participated in a peer social support network for 3 months (12 sessions), and the control group received only usual care. The outcome variable was self-management. The components of this variable include the level of hemoglobin A1C (HbA1C), diabetes distress (measured with Diabetes Distress Scale), awareness (measured with Davoodi's knowledge of diabetes questionnaire), attitude (measured with diabetes attitude scale [DAS-3]), self-efficacy (measured with diabetes empowerment scale, [DES-28]), weight and blood pressure. Subjects were evaluated at baseline and at a 6-month follow-up. The obtained data were analyzed using t-test, Chi-Square, and Fisher test in SPSS software, version 22. The significance level was set at less than 0.5. Results: The change in mean HbA1C of the intervention and control groups at baseline and 6-month follow-up was -0.7 and 0.1, respectively, which was significant (P=0.0001). Moreover, the difference in changes in the mean values of diabetes distress (P=0.008), selfefficacy (P=0.0001), and attitude (P=0.0001) were significant. No significant changes were found in knowledge, weight, systolic and diastolic blood pressure (P>0.05). Conclusion: The formation of social support groups may help control blood sugar in the elderly with type 2 diabetes. Seemingly, social groups can mainly impact through psychological factors such as distress control, attitude improvement, and self-efficacy enhancement. [ABSTRACT FROM AUTHOR]

Background: In the recent era, nursing needs employees with moral intelligence, cultural competence, and self-compassion skills more than ever. This study aimed to determine the predictors of moral intelligence and its relationship with self-compassion and cultural competence in nursing students. Methods: This cross-sectional and multi-center descriptive study was conducted in 2022. With convenience sampling, 250 nursing students from three Iranian universities participated in this study. Data gathering included the Moral Intelligence Questionnaire, Self-Compassion Scale (short form), and Cultural Competency Questionnaire. The data were analyzed using descriptive statistics, the correlation between variables, and hierarchical regression. Results: The results showed that nursing students had good moral intelligence (72.63 ± 11.38), moderate self-compassion (37.19 ± 5.02), and poor cultural competence (50.06 ± 13.15). No statistically significant relationship was observed between self-compassion and cultural competence (r = 0.11, p = 0.07). Moral intelligence with marital status (r = 0.16, p = 0.01), academic year (r = 0.14, p = 0.03) and self-compassion (r = 0.33, p < 0.001) had a significant relationship in such a way that these variables explained 15% of moral intelligence and self-compassion had the highest impact (p < 0.001). Conclusion: Considering the moderate level of self-compassion and the poor level of cultural competence reported in the undergraduate nursing students, and also that self-compassion was known to be a predictive factor for moral intelligence, planners and educators must pay more attention to promoting self-compassion and cultural competency in the curriculum and conduct studies to find ways to improve them. [ABSTRACT FROM AUTHOR]

The World Health Organization warns about the threat of the COVID-19 sixth wave. Our aim was to propose the first validated Romanian questionnaire to assess people's level of education and attitudes towards general measures to protect against COVID-19 infection. Our study was conducted on a sample of 194 people. The first version of the questionnaire consisted of 40 items. Items that did not meet psychometric criteria were removed. Latent components/factors were identified through exploratory factorial analysis (EFA). The Cronbach's alpha coefficient was used to assess internal fidelity. The EFA identified three factors. Factor 1 was named "Compliance with protective measures", factor 2 was "Attitudes toward vaccination" and factor 3 was "Attitudes regarding potential COVID-19 therapies". The final version of the questionnaire consists of 16 items. The test's final score predicted the presence of vaccination with an accuracy of 0.773. The questionnaire score, the diagnosis of diabetes, the advice provided by healthcare workers and the medical profession proved to be significant predictors of vaccination. The implementation of our questionnaire within national programs could identify populational areas that need specific interventions to reach vaccination targets and prevent a full-blown sixth wave of the COVID-19 pandemic in Romania. [ABSTRACT FROM AUTHOR]

Family Centered Care (FCC) in Neonatal Intensive Care Units (NICUs) included family involvement in the care process of newborns and infants. Staff perceptions of FCC may influence clinical practice and management strategies in NICUs, with an impact on quality and humanization of the care. The Family-Centred Care Questionnaire-Revised (FCCQ-R) was adapted for the NICU setting, therefore the FCCQ-R@it-NICU was developed and used for the present study in 32 Italian NICUs. We calculated internal consistency using Cronbach's alpha correlation between Current and Necessary dimensions of the scale using the Pearson correlation coefficient. Furthermore, we investigated which characteristics could influence staff perceptions of FCC in NICUs. 921 NICU professionals participated in the study. The FCCQ-R@it-NICU revealed good internal consistency (0.96) and good correlation between dimensions (p < 0.05). Statistical and significant differences in Current and Necessary dimensions were found and some demographic characteristics were found predictable on FCC practice. The FCCQ-R@it-NICU is a valid tool to investigate staff perceptions about FCC in NICU settings. Profession, education level and work experience seem to positively influence the perception of what is required for FCC practice within NICUs. [ABSTRACT FROM AUTHOR]

Purpose: Students have important talents whose flourishing is a necessary and basic condition for the success and development of today's societies. The purpose of this study is to investigate the effectiveness of Pilates training on cognitive function, mental wellbeing, and students' hope for education. Methods: This study is a randomized clinical trial. A total of 30 male students in the sixth grade of elementary school, aged =11 years, were initially allocated to either a pilates group (n=15, who underwent a 16 week Pilates exercise program) or to a control group (n=15, who did not receive any intervention). The data collection tools were the mini-mental state examination (MMSE), the questionnaire of academic hope by Campbell and Cowen (2001), and the short form of mental wellbeing questionnaire by Ryff and Singer (2006). We performed the analysis of covariance for data analysis using SPSS software, version 21 at a significant level of 0.05. Results: Results of the analysis of covariance showed between-group differences for cognitive function (F1, 27=3.8, P=0.01), mental wellbeing (F1, 27=232.46, P=0.001), and hope for education (F1, 27=29.26, P=0.001). Therefore, Pilates training increased cognitive function, mental wellbeing, and hope for education in students. Conclusion: Pilates training significantly increases cognitive function, mental wellbeing, and hope for students' education. Therefore, it is suggested to use Pilates training for school students. [ABSTRACT FROM AUTHOR]