Association between loneliness and cigarette smoking attitudes among university students in Iran: a cross-sectional study.

OBJECTIVES: During the last two decades, cigarette smoking witnessed a global increase in use, especially among youth. Loneliness is one of the possible psychosocial determinants of smoking. This study examined the association between loneliness and attitudes towards cigarette smoking among university students of Iran. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: This study was conducted among 538 university students, who were recruited using the cluster random sampling method. Loneliness and smoking attitudes of the samples were assessed using the revised version of the University of California Los Angeles Loneliness Scale and the Scale of Cigarette Smoking Attitude (CSA). Descriptive statistics, Pearson's correlation coefficient and multivariable regression analysis were used to analyse the data. RESULTS: From a total of 538 participants, 301 (59.9%) students were young women. The mean age of the students was 22.2±2.9 years. Only 56 (10.4%) of the students were married and 370 (87.9%) of them were lived with their families. 131 (24.3%) students experienced cigarette smoking. In terms of university-related characteristics, 205 (38.1%) of the students studied in the faculty of medicine. Also, 30% of the students had a positive or indifferent attitude towards smoking, while 26.4% of the students reported feeling lonely. The mean scores for loneliness and CSA were 41.42±11.29 and 48.64±11.2, respectively. Statistically, a significant positive correlation was found between loneliness and CSA (r=0.289; p<0.001). After controlling for potential confounders by regression analysis, loneliness scores were also positively associated with CSA scores (B: 0.14; 95% CI 0.097 to 0.18). CONCLUSIONS: According to the positive association between loneliness and students' CSA, paying more attention to the state of loneliness in college students, examining situations and reasons that increase it and identifying the interventions that might reduce it are necessary. Reducing loneliness among college students can correct their attitudes towards smoking.

The association between health literacy and pedestrian safety behavior among adults: a cross-sectional study.

INTRODUCTION: Pedestrians are considered the most vulnerable and complex road users as human behavior constitutes one of the fundamental reasons for traffic-related incidents involving pedestrians. However, the role of health literacy as a predictor of Pedestrian safety behavior remains underexplored. Therefore, the current study was designed to examine the level of health literacy and its association with the safety behavior of adult pedestrians in the city of Tabriz. METHODS: This cross-sectional analytical study was conducted among individuals aged 18 to 65 years in the metropolitan area of Tabriz from January to April 2023. Data were collected using the HELIA standard questionnaire (Health Literacy Instrument for adults), comprising 33 items across 5 domains (access, reading, understanding, appraisal, decision-making and behavior), as well as the Pedestrian Behavior Questionnaire (PBQ) consisting of 29 items. Data were analyzed using descriptive and analytical statistics (independent t-tests, ANOVA, and Pearson correlation coefficient) via SPSS-22 software. RESULTS: Based on the results, 94% (376 individuals) had excellent health literacy levels, and their safety behavior scores were at a good level. Health literacy and safety behavior were higher among the age group of 31 to 45 years, women, married individuals, those who read books, and individuals with higher education. However, safety behavior showed no significant association with education level (P > 0.05). There was a significant and positive relationship between health literacy and all its domains and pedestrian safety behavior (r = 0.369, P < 0.001). CONCLUSION: This study underscores the significant impact of health literacy on pedestrians' safety behavior. The findings reveal that higher levels of health literacy are associated with better safety behavior among individuals aged 18 to 63. Demographic factors such as age, gender, marital status, and education level also play a role in shaping both health literacy and safety behavior. By recognizing these relationships, interventions can be tailored to improve health literacy levels and promote safer pedestrian practices, ultimately contributing to a healthier and safer community in Tabriz city.

The effectiveness of couple-based interventions on the marital outcomes of women with genital and breast cancer and their partners: a systematic review and meta-analysis.

BACKGROUND: Breast cancer and genital cancer are known as cancers that affect people's relationships with their partners. Women with such cancers are emotionally vulnerable and need more support from their partners. The present systematic review and meta-analysis evaluated the effectiveness of couple-based interventions on the marital outcomes of patients with these cancers and their intimate partners. METHODS: To perform this systematic review, Google Scholar and databases such as PubMed, Web of Science, Cochrane, Scopus, SID (Scientific Information Database), and Magiran were searched systematically. The reviewed studies included randomized controlled trials and quasiexperimental studies in which the intervention group, couple-based interventions, and the control group received routine care, general education or no intervention for cancer treatment. In this study, the included participants were patients with breast cancer or genital cancer and their intimate partners. The primary outcomes considered in this study included patients' marital adjustment, patients' marital satisfaction, patients' marital intimacy, and patients' marital relationships. The secondary outcomes were partners' marital adjustment, partners' marital satisfaction, partners' marital intimacy, and partners' marital relationships. A meta-analysis was performed with Review Manager v. 5.3 software (The Nordic Cochrane Centre, Cochrane Collaboration, 2014; Copenhagen, Denmark). The intervention impacts on continuous outcomes were measured using standardized mean differences (SMDs) with 95% confidence interval because of the use of various scales to evaluate the outcomes. The quality of evidence presented in the included studies was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. In the subgroup analysis, the studied outcomes were divided into two parts (theory-based and non-theory-based) in terms of the theoretical context of couple-based interventions. RESULTS: From a total of 138 retrieved studies, 14 trials were eligible for inclusion in the study. The results of the meta-analysis showed that the patient's marital satisfaction increased significantly with couple-based interventions (SMD 0.46, 95% confidence interval 0.07 to 0.85; 7 trials, 341 patients, very low certainty) compared to the control group, but the evidence was uncertain. However, there were no significant differences between the groups in the partner's marital satisfaction, the patient's and partner's marital adjustment, and the patient's and partner's marital intimacy. Additionally, the results of the subgroup analysis showed that the couple-based interventions significantly increased the patient's marital adjustment (SMD 1.96, 95% CI 0.87 to 3.06; 4 trials, 355 patients, very low certainty), the partner's marital adjustment (SMD 0.53, 95% CI 0.20 to 0.86; 4 trials, 347 partners, very low certainty), the patient's marital satisfaction (SMD 0.89, 95% CI 0.35 to 1.43; 2 trials, 123 patients, very low certainty), and the partner's marital satisfaction (SMD 0.57, 95% CI 0.20 to 0.94; 2 trials, 123 partners, very low certainty) compared to the control group in theory-based studies. In. However, in non-theory-based studies, the results of the meta-analysis revealed no significant differences between the intervention and control groups. CONCLUSIONS: The results of this study demonstrated the impact of couple-based interventions on the marital outcomes of patients with breast and genital cancers. Because of the very low confidence in the evidence, high-quality randomized trials with a sufficient sample size should be conducted considering the proper theoretical context.

Nurses' perceptions of patient safety competency: A cross-sectional study of relationships with occurrence and reporting of adverse events.

Although, strengthening patient safety competencies in nursing has been emphasized for enhancing quality care and patient safety. However, little is known about the association of nurses' perceptions of patient safety competency with adverse nurse outcomes in Iranian hospitals. This study aimed to measure nurses' levels of patient safety competency in the hospitals of Iran and examines the relationship between patient safety competency with the occurrence and reporting of adverse events (AEs). This cross-sectional research was applied in eight teaching hospitals in Tehran, Iran, between August and December 2021. A sample of 511 nurses was randomly selected using the table of random numbers. The validated Patient Safety Competency Self-Evaluation questionnaire was used. Furthermore, two questions were used to measure the incidence and reporting of AEs. Data analysis was performed using descriptive statistics, independent t-tests, and two binary logistic regression models through SPSS version 24.0. The mean patient safety competency score was 3.34 (SD = 0.74) out of 5.0; 41.5% of nurses rated their patient safety competency as less than 3. Among subscales, "skills of patient safety" scores were the highest, and "knowledge of patient safety" scores were the lowest. Nurses with higher Knowledge and Attitude scores were less likely to experience the occurrence of AEs (OR = 1.50 and OR = 0.58, respectively). Regarding AEs reporting, nurses with higher Skill and Attitude scores were 2.84 and 1.67 times, respectively, more likely to report AEs (OR = 2.84 and OR = 3.44, respectively). Our results provide evidence that enhancing PSC leads to reduced incidence of AEs and increased nurses' performance in reporting. Therefore, it is recommended that managers of hospitals should enhance the patient safety competency of nurses in incidents and reporting of patient safety adverse outcomes through quality expansion and training. Additionally, researchers should carry out further research to confirm the findings of the current study and identify interventions that would strengthen patient safety competencies and reduce the occurrence of AEs, and rise their reporting among nurses.

The association of professionalism and systems thinking on patient safety competency: A structural equation model.

AIMS: The aim of this study is to identify how professionalism and systems thinking contribute to patient safety competency among Iranian nurses. BACKGROUND: Professionalism, systems thinking and patient safety competency play important roles in the quality of care. Strategies to enhance the patient safety competency of nurses must be devised by identifying the relationships between these variables. METHODS: A cross-sectional, descriptive survey study was conducted in 10 teaching hospitals in Tabriz, Iran. A total of 358 nursing staff with at least 12 months of experience in nursing were enrolled. Data were collected using the Professionalism scale, Systems Thinking Scale and Patient Safety Competency Self-Evaluation tool. Structural equation modelling analysis was performed to test the relationship between variables. RESULTS: The final model illustrated a good fit (χ2 /df = 2.329, goodness-of-fit index = 0.990, Tucker-Lewis index = 0.906 and root mean square error of approximation = 0.068). Professionalism directly influenced patient safety competency (ß = 0.59, p < 0.001) and indirectly influenced systems thinking (ß = 0.29, p < 0.001). Systems thinking directly influenced patient safety competency (ß = 0.46, p < 0.001). Results indicated that 91% of the variance in patient safety competency was explained by professionalism while 40.1% of the variance in the systems thinking was explained by professionalism. CONCLUSIONS: The professionalism and systems thinking of hospital nurses play a pivotal role as predictors in patient safety competency. Training opportunities, mentorship and nursing managers' leadership are needed to assist hospital nurses in their perceptions of professionalism and systems thinking. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing educators and managers should implement patient safety training strategies and improve the professionalism and systems thinking of hospital nurses to promote patient safety and quality care.

The Magnitude of Loneliness and Associated Risk Factors among University Students: A Cross-Sectional Study.

Objective: Nowadays, loneliness is one of the foremost common issues among university students that may negatively affect their physical and mental states and academic performance. Accordingly, this research project intended to investigate the incidence of loneliness and its related risk factors among students studying at universities of medical sciences. Method : The participants in this cross-sectional study were 538 Tabriz University of Medical Sciences students, selected using a simple random sampling method. Loneliness was measured using the UCLA Loneliness questionnaire with 20 questions. Descriptive statistics, multiple logistic regression, and Chi-square were used to identify factors affecting loneliness. Results: The results showed that the mean loneliness score and the magnitude of the students' loneliness were 41.42 and 26.4%, respectively. The magnitude of loneliness was higher among female respondents (OR = 1.86, P = 0.005), cigarette smokers (OR = 0.39, P < 0.001), freshman students (OR = 2.76, P = 0.021), sophomore students (OR = 2.36, P = 0.040), those with low financial status (OR = 1.80, P = 0.037), and those residing in dormitories (OR = 1.73, P = 0.013). Conclusion: In general, loneliness was widespread among the students. Based on the findings, the magnitude of loneliness was higher among the first-year student group, female students, students with poor economic status, and those who smoked and lived in dormitories. Therefore, this study's findings underline the significance of making students aware of loneliness, investigating the circumstances and factors that exacerbate this sensation among first-year students (mainly between 18-21 years old), and devising intervention to alleviate it.

The relationship between workplace deviant behaviors and organizational justice among nurses: A cross-sectional survey.

AIM: This study aimed to determine the correlations between workplace deviant behaviors (WDBs) and the levels of the perceived organizational justice among Iranian nurses. DESIGN: This was a cross-sectional quantitative research. METHODS: The present research was conducted on 424 nurses selected by a convenience sampling method in 2019 (May-August) in Tabriz, Iran. A self-administered questionnaire, including demographic information, organizational justice, and WDBs, was used for data collection. The data were analyzed using descriptive analysis, the Pearson correlation coefficient, and multiple linear regression analysis. RESULTS: Based on the findings, nurses had a moderate level of perception of organizational justice while having a low level of perception regarding the occurrence of WDBs. A significantly reverse correlation was found between perceived organizational justice and WDBs (r = -.295, p <.001). Eventually, the findings of multiple linear regression analysis indicated that the level of perceived organizational justice could significantly predict WDBs (the coefficient of determination, R2 = 0.111). CONCLUSION: The study findings confirmed the hypothesis that an improvement in the levels of organizational justice was related to a decrease in the occurrence of WDBs. Therefore, hospitals and nursing managers are suggested to build and maintain a supportive and healthy work environment to enhance the levels of perceived organizational justice and to minimize the incidence of WDBs. They should also address reward systems, organizational policies and procedures, interpersonal justice, and shared decision-making in this respect.

The association between cigarette smoking attitudes and social capital among Iranian health and medical students: a cross-sectional study.

BACKGROUND: Smoking remains a leading public health challenge globally. As a psychosocial determinant of health, social capital can influence health attitudes and behaviors, and thus it may have the capacity to reduce smoking rates. The aim of this research was to examine the association between social capital and attitudes towards smoking among university students. METHODS: This cross-sectional study was conducted among 538 health and medical students, recruited using the proportionate sampling method. Participants' social capital and attitudes toward smoking were assessed using the social capital questionnaire (SCQ) and the scale of cigarette smoking attitude (CSA). Data were analyzed using descriptive statistics, Pearson correlation coefficient, and the multiple regression analysis. RESULTS: About one in four health and medical students reported smoking, either currently or in the past, and 30% had either positive or indifferent attitudes towards smoking. The mean scores of the SCQ and the CSA were 105.1 ± 19.7 and 48.6 ± 11.2, respectively. There was a statistically significant negative association between the SCQ and the CSA scores (r = - 0.24; p < 0.001). In the regression analysis, the SCQ scores were also negatively and statistically significantly associated with the CSA scores, after controlling potential confounders (B: -0.09; 95% CI: - 0.13 to - 0.004). CONCLUSIONS: As future healthcare providers, who are expected to take the primary role in reducing smoking rates in the community, health and medical students should be supported to develop appropriate attitudes towards smoking. Promoting positive social capital among university students has the capacity to improve their attitudes towards smoking. Possessing negative attitudes towards smoking should hopefully reduce smoking behaviors among future health professionals and improve their participation in anti-smoking campaigns.

Nurses' perception of teamwork and its relationship with the occurrence and reporting of adverse events: A questionnaire survey in teaching hospitals.

AIMS: To identify the levels of teamwork and its relationship with the occurrence and reporting of adverse events among Iranian nurses. BACKGROUND: Strengthening teamwork is emphasized worldwide for enhancing quality care and patient safety. METHODS: This study applied a cross-sectional survey design. A total of 327 Iranian nurses from eight teaching hospitals participated in a self-administered survey using simple random sampling. The Teamwork Perceptions Questionnaire was used to measure the teamwork. The frequency of occurrence and reporting of adverse events were measured with two questions. Data were analysed using descriptive analyses, independent t tests and logistic regression analysis. RESULTS: The mean teamwork score was 3.81 out of 5. Among the nurses, 48.0% had experienced adverse events in the past 6 months and 79.8% reported having an appropriate performance in adverse events reporting. Teamwork was significantly associated with lower occurrences of adverse events and better adverse events reporting. Specifically, nurses with higher situation monitoring (odds ratio (OR) = 0.47), mutual support (OR = 3.18) and team leadership (OR = 2.09) scores were more likely to report adverse events. Nurses with higher situation monitoring scores were less likely to experience the occurrence of adverse events (OR = 0.38). CONCLUSIONS: Nurses' perception of teamwork was moderate to high. Teamwork was associated with the occurrence and reporting of adverse events. Further study is needed to identify the effects of teamwork training on the learning outcomes, including teamwork, occurrence and the reporting of adverse events among nurses. IMPLICATIOS FOR NURSING MANAGEMENT: Nursing managers should consider multiple educational strategies including structured teamwork training to improve staff nurses' teamwork competency. Administrative initiatives and quality improvement projects are needed to increase nurses' performance in the reporting of adverse events through an accreditation process.