Epidemiology of Celiac Disease in Western Iran during 2019-2021.

Celiac disease is a growing global public health concern. This epidemiological study is aimed at determining the prevalence of celiac disease in Kermanshah, Western Iran, from 2019 to 2021, as well as the frequency of gastrointestinal and nongastrointestinal manifestations associated with the disease. In this cross-sectional study, the medical records of all patients with a confirmed diagnosis of celiac disease between 2019 and 2021 were reviewed. The average population during the study period was 2,058,545. A researcher-developed checklist was used as the data collection tool, and descriptive statistics were employed for data analysis. During the study period, there were 113 patients diagnosed with celiac disease, with a mean age of 29.1 ± 16.6 years. The three-year prevalence of celiac disease was 5.49 (95% CI: 5.17-5.82) per 100,000 population. Among these patients, 70% (n = 78) was female. The most common gastrointestinal manifestations of the disease were abdominal pain (77.8%), constipation (59.3%), and diarrhea (54.9%). Iron-deficiency anemia (64.6%) and vitamin D3 deficiency (46.1%) were the most common nongastrointestinal manifestations. Growth retardation was observed in 39.0% of patients. This study demonstrated a higher prevalence of celiac disease in Kermanshah compared to global statistics. Given the association of celiac disease with other conditions such as diabetes, irritable bowel syndrome, growth retardation, and iron-deficiency anemia, healthcare providers should consider screening patients for celiac disease. Furthermore, community-based education is crucial in raising awareness about the significance of adhering to a proper diet and reducing wheat consumption.

Cancer patients' experience with implanted venous ports: A qualitative descriptive study.

AIM: The aim of this study was to explore the experiences of cancer patients regarding venous access ports. BACKGROUND: The utilization of intravenous access ports for administering chemotherapy drugs is on the rise. Understanding patients' experiences with these devices can provide valuable insights for nursing managers and nurses. METHODS: A conventional qualitative content analysis approach was employed to explore the experiences of 14 patients who had venous access ports. The participants were selected from patients admitted to the oncology ward of a hospital affiliated with Kermanshah University of Medical Sciences. A purposive sampling method was used for participant selection. Semi-structured in-depth interviews were conducted as the data collection tool. MaxQda-10 software was utilized for data management. RESULTS: The data analysis yielded three main categories and ten sub-categories. The categories consisted of positive aspects of venous access ports, negative aspects of venous access ports, and barriers to accepting venous access ports. CONCLUSIONS: The participants highlighted both the positive and negative aspects of venous access ports, while also identifying insufficient knowledge and "fear and anxiety" as barriers to accepting these devices. Providing essential training and offering psychological support to newly hospitalized cancer patients could prove beneficial in this regard.

Physicians' attitudes towards the development of the nurse prescribing role in critical care and emergency departments.

BACKGROUND: The progression of the nurse prescribing role encounters numerous challenges, with physician resistance being a significant obstacle. This study aims to assess physicians' perspectives regarding the expansion of the nurse prescribing role within critical care and emergency departments. METHODS: This cross-sectional study employed convenience sampling to enroll 193 physicians. Data collection instruments included a demographic information form and a researcher-developed questionnaire. Descriptive and inferential statistics were used to analyze the data using SPSS-22 software. RESULTS: A total of 193 physicians participated in the survey, with a mean age of 41.9 ± 10.7 years. Among physicians from various age groups, genders, educational backgrounds, and clinical experiences, more than 60% acknowledged prescribing medicine as an essential component of their professional responsibilities. However, a significant majority of physicians in these categories agreed that in emergency situations, nurses should be allowed to prescribe medication to save patients' lives. It is worth noting that, unlike specialist and fellowship physicians, a majority of general practitioners (83.3%) held the view that nurse-prescribed medications do not contribute to the professional development of nursing. The nurse prescribing role encountered several predominant obstacles, namely legal consequences (78.8%), interference of duties between physicians and nurses (74.1%), and a legal vacuum (77.2%). CONCLUSION: The majority of physicians expressed a favorable attitude towards nurse prescribing in emergency and critical care departments. To facilitate the development of the nurse prescribing role, it is essential to ensure the acquisition of scientific qualifications and implement necessary changes in nursing curricula across bachelor's, master's, and doctoral programs.

Effects of auricular acupressure on test anxiety in medical students: a randomized parallel-group trial.

BACKGROUND: Test anxiety is a prevalent issue among students, including those in the medical field. The present study aims to examine the impact of auricular acupressure on reducing test anxiety specifically among medical students. METHODS: In this single-blind randomized parallel-group trial, a total of 114 medical students from Kermanshah, Iran, were allocated into two groups: intervention and control. Each group consisted of 57 students. The data collection instruments included a demographic information form and the Sarason Anxiety Inventory. In the intervention group, bilateral auricular acupressure was administered on the Shen Men point for a duration of 10 min. On the other hand, the control group received bilateral auricular acupressure on the Sham point, located in the earlobe, as a placebo, also for 10 min. RESULTS: The mean test anxiety scores in the Shen Men acupressure group exhibited a significant reduction from 18.4 ± 5.3 before the intervention to 13.3 ± 4.8 after the intervention (P = 0.001). Conversely, in the Sham acupressure group, the mean test anxiety scores showed no significant change, with values of 16.36 ± 6.4 before the intervention and 16.4 ± 6.1 after the intervention (P = 0.963). Prior to the intervention, the majority of participants in both the intervention group (87.7%) and control group (86.0%) exhibited moderate to severe levels of test anxiety. Following acupressure, a significant improvement was observed in the intervention group, with 52.6% of participants experiencing a reduction to mild anxiety levels (P = 0.001); however, no notable change in anxiety levels was observed in the control group. Furthermore, a statistically significant difference in anxiety intensity after the intervention was found between the two groups (P = 0.001). CONCLUSION: Shen Men auricular acupressure demonstrates efficacy in reducing test anxiety among medical students. However, to validate its effectiveness, further research using objective measures is warranted.

Emergency care utilization and patients' outcome before and after COVID-19 national lockdown in Iran: a cross-sectional study.

INTRODUCTION: COVID-19 rapidly spread throughout the world. Stay-at-home and social distance strategies accompanied by fear of contamination with COVID-19 caused significant disruptions in daily life. The study focused on the impact of the COVID-19 pandemic on emergency visit and patients' outcome in the emergency department (ED). METHOD: Administrative and clinical data of 25-hospital EDs in Kermanshah province of Iran from February 20, 2020, to February 18, 2021, were retrospectively analyzed with the comparable periods in the previous year. The incidence rate ratio (IRR) was used to compare the differences between the pandemic and the pre-pandemic period. RESULT: The number of ED visits decreased nearly 50% after the declaration of a national lockdown. Moreover, the proportion of patients triaged in ESI 1 and 2 levels increased by 40 and 52%, respectively. The ratio of patients admitted to intensive care units and discharged against medical advice also increased significantly. CONCLUSION: Despite the number of ED visits sharply declining, the ratio of patients who came to EDs with higher acuity significantly increased. So, health authorities must sensitize the public about life-threatening signs and symptoms in such conditions.

Predictors of care burden among caregivers of patients with COVID-19.

AIM: To explore predictors of care burden among the caregivers of patients with COVID-19. DESIGN: The findings of this cross-sectional study were presented in accordance with the guidelines outlined in the Strengthening the Reporting of Observational Studies in Epidemiology statement. METHODS: The samples included 172 caregivers in Imam Reza and Farabi Hospitals, located in Kermanshah, Iran, who were enrolled in the study using convenience sampling. A demographic information form and the Caregiver Burden Inventory were administered. The data were collected between 13 May 202 and 20 August 2021. RESULTS: Of the caregivers, 62.8% (n = 108) were male and 71.5% (n = 123) were over 40 years old. Furthermore, 66.3% (n = 114) of caregivers had severe and very severe care burden, with a mean care burden of 78.9 ± 20.4 out of 120. A statistically significant difference was found between care burden and the variables of monthly income, health status, number of patients under care and residence status (p < 0.05). CONCLUSION: The caregivers experienced a high care burden, which can have harmful effects on them. Therefore, it is necessary to provide them with various forms of economic, psychological and social support.

Prevalence and reasons for self-medication for prevention of COVID-19 among the adult population in Kermanshah-Iran.

AIM: To determine the prevalence of self-medication and reasons for self-medication (SM) for the prevention/treatment of COVID-19 among the adult population. DESIGN: Cross-sectional study. METHODS: This study was performed on 147 adults in Kermanshah, Iran. Data were collected by a researcher-made questionnaire and analysed by SPSS-18 software using descriptive and inferential statistics. RESULTS: The prevalence of SM in the participants was 69.4%. Vitamin D and vitamin B complex were the most commonly used drugs. The most common symptoms leading to SM were fatigue and rhinitis. Strengthening the immune system and prevention of COVID-19 (48%) were the main reasons for SM. Factors related to SM included marital status [OR = 8.04, 95% CI = (3.62, 17.83)], education [OR = 0.16, 95%CI = (0.08, 0.35)] and monthly income [OR = 0.09, 95%CI = (0.03, 0.26)]. PATIENT OR PUBLIC CONTRIBUTION: Yes.

Intention to leave the profession and related factors in nurses: A cross-sectional study in Kermanshah, Iran.

AIM: To investigate the intention to leave the profession and its related factors among nurses in Kermanshah, western Iran. DESIGN: Cross-sectional study. METHODS: A total of 377 nurses were enrolled in a stratified random sampling method. Data were collected by the Anticipated Turnover Scale and a sociodemographic information form. and analysed by descriptive and inferential statistics (logistic regression analysis). RESULTS: The results showed that 49.6% (n = 187) of nurses tended to leave the profession and the mean score of intention to leave was 36.6 ± 0.5 of 60. There were no statistically significant differences between nurses who intended to leave and those who did not in terms of age, marital status, gender, type of employment, type of shift and work experience. But a statistically significant association was found between workplace (p = 0.041, adjusted OR = 2.07) and job title (p = 0.016, adjusted OR = 0.58) and intention to leave the profession. PATIENT OR PUBLIC CONTRIBUTION: No.

Mortality rate and liver transplant in patients with mushroom poisoning: A systematic review & meta-analysis.

Background: Mushroom poisoning is raised as a poor food problem that can cause the death of patients or the need for a liver transplant. Objective: This study was conducted with the aim of assessment the mortality rate and liver transplantation in people suffering from mushroom poisoning through a systematic review and meta-analysis. Method: The study is designed and conducted based on the PRISMA statement. International databases have been checked for articles up to March 1, 2022. The results of the study are presented with the guidance of Garrard's statement. CMA software was used in meta-analysis. Results: Thirty-three articles were selected for this study. The mortality rate reported 0-40% and the results of the meta-analysis showed that the mortality rate was 2.87%. in other hand the mortality rate was 1.4% with studies that reported zero death. Overall, 16 patients had liver transplants, that only 2 died after liver transplants and 14 others survived. Conclusion: The death in patients with mushroom poisoning is significant. Patients with liver disorders and patients or kidney disorders are more likely to have a poor prognosis. Liver transplant can be lifesaving. Also, quick referral of patients in the early stages reduces the need for liver transplantation.

Violence against Emergency Nurses in Kermanshah-Iran: Prevalence and Associated Factors.

Background: Violence against emergency nurses is a global concern with undesirable physical and psychological consequences. This study was conducted to investigate the characteristics of physical and verbal violence against emergency nurses in Iran. Methods: In this cross-sectional study, 150 nurses working in seven hospitals affiliated to Kermanshah University of Medical Sciences were included in the study using the stratified random sampling method. The data collection tools included a personal information form and a researcher-made questionnaire. Violence-related characteristics were assessed using descriptive statistics. Logistic regression was used to identify factors related to physical and verbal violence. Results: The frequency rates of physical and verbal violence during the past 12 months were equal to 62% (n = 93) and 94.7% (n = 142), respectively. In both types of physical violence (49.5%, n = 46) and verbal violence (40.4%, n = 57), the nursing station was the most common place of violence. In both physical (n = 40, 43.0%) and verbal violence (n = 101, 71.1%), the most common perpetrator was the patient's family. Most physical violence (57.0%, n = 53) and verbal violence (35.2%, n = 50) occurred in the night shifts. No statistically significant relationship was found between physical and verbal violence and gender, age, marital status, type of employment, and work experience. Discussion. The results indicate the seriousness of workplace violence against nurses. It is necessary to adopt a global approach along with providing sufficient manpower and psychological empowerment of nurses. Further studies with a forward-looking approach are suggested.

Explanation of the internet addiction model based on academic performance, academic experience, and clinical self-efficacy in nursing students: A path analysis.

BACKGROUND: Internet addiction is a common disorder in nursing students, and this calls for a deeper investigation into this phenomenon and its dimensions. The aim of this study was to explain the internet addiction model based on academic performance, academic experience, and clinical self-efficacy in nursing students. MATERIALS AND METHODS: This study is a correlational and path analysis study that was conducted on 340 nursing students. Data collection tools included Yang's internet addiction questionnaire and self-efficacy in clinical performance scale. In this study, the academic grade point average was the measure of academic performance and the academic term was the measure of academic performance. Data were analyzed using SPSS-16 and AMOS-22 software, descriptive and analytical statistics, and structural equations. RESULTS: There was a significant negative correlation between clinical self-efficacy (r = -0.950, P ≤ 0.01), academic experience (r = -0.872, P ≤ 0.01), and academic performance (r = -0.654, P ≤ 0.01) with internet addiction. A negative and significant relationship was found between the internet addiction and variables of clinical self-efficacy (total effect = -0.743, P < 0.001). Model fit indices were good and acceptable. CONCLUSIONS: There was a negative and significant relationship between the variables of clinical self-efficacy, academic experience and academic performance, and the internet addiction. Meanwhile, the academic experience had a negative and significant effect on the internet addiction. This finding highlights the need to implement advisory and psychological interventions to reduce internet addiction, especially in students with less academic experiences.

Demographic, clinical, and laboratory findings of mushroom-poisoned patients in Kermanshah province, west of Iran.

BACKGROUND: Mushroom poisoning can cause gastrointestinal, renal, and hepatic symptoms and even death. This descriptive study examined the demographic, clinical, and laboratory findings of patients with fungal poisoning, a type of fungus causing the poisoning, and the incidence and mortality rates of fungal poisoning in Kermanshah province, western Iran, from 2014 to 2018. METHODS: The medical records of 193 patients with mushroom poisoning from 2014 to 2018 were evaluated. The liver and kidney function tests, electrolytes, abdominal and pelvic ultrasound, chest x-ray, coagulation tests, and coagulation factors (fibrinogen, prothrombin) were assessed. Data were collected from the medical records of patients admitted to the Poisoning Center of Imam Khomeini Hospital in Kermanshah, Iran using a researcher-made checklist. Data were analyzed by SPSS (version 16) using descriptive statistics, including mean, standard deviation, and frequency distribution tables. Trend analysis for proportion was done by chi-square statistics in STATA-14 software (ptrend command). RESULTS: Of cases, |51.3% were male, 92.6% were city dwellers, 38.3% were aged 21-40 years, and 92.5% were poisoned during the spring. The fungus that caused poisoning was Amanita virosa. The gastrointestinal, nervous, and visual systems were the most common systems involved. The most common gastrointestinal symptoms included nausea and vomiting (72.0%) and abdominal pain (71.0%). Vertigo (11.9%) and headache (9.3%) were the most common neurological symptoms. The most common visual manifestation was blurred vision (7.8%). Of cases, 23.7% had metabolic acidosis. The increased alkaline phosphatase level was the most common liver disorder in 98.7% of the cases. Increased blood urea nitrogen and creatinine levels were also reported in 21.0% and 17.7% of the cases, respectively. The serum lactic dehydrogenase and creatine phosphokinase levels also increased in 99.3% and 30.2% of the patients, respectively. The mortality rate was 1.6% (n = 3). CONCLUSION: The fungal poisoning diagnosis should always be considered in young patients referred to the emergency department with gastrointestinal complaints, a history of consuming wild self-picked mushrooms, and high liver and kidney test values. Since most fungal poisonings occur in the spring, it is necessary to inform the community of the dangers of consuming self-picked wild mushrooms, especially in this season.

Care burden and associated factors in caregivers of children with cancer.

BACKGROUND: Evidence suggests that many parents who care for their children with cancer are affected by the care burden due to the chronic nature of the disease. The aim of this study was to determine the burden of care level and its related factors in the caregivers of children with cancer. METHOD: A total of 270 caregivers of children with cancer were included in this cross-sectional study by convenience sampling method. Data collection tools were a personal information form and the Novak & Guest's Caregiver Burden Inventory. Data were analyzed by descriptive and inferential statistics (chi-square and univariate linear regression model). RESULTS: The mean ages of caregivers and patients were 35.7 ± 7.0 and 3.1 ± 1.6 years, respectively. The mean care burden was 68.4 ± 1.5 out of 120. About 50 and 36% of caregivers had moderate and severe care burden, respectively. CONCLUSION: Caregivers had moderate to high care burden. A number of factors associated with care burden were identified. Health authorities need to take family-centered measures to reduce the burden of caregivers.

Explaining the experiences of nurses regarding strategies to prevent missed nursing care: A qualitative study.

AIM: To describe the experiences of nurses regarding strategies to prevent missed nursing care. BACKGROUND: One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the health care policymakers. METHOD: In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In-depth semi-structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management. RESULTS: The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses," "manpower supply," "supervision," "specializing the activities," "providing resources and facilities," "encouraging teamwork," and "resolving dissatisfaction." The main theme was "missed nursing care prevention strategies." CONCLUSION: The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses "empowerment, increasing nurses" job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care.

The Reasons for Self-Medication from the Perspective of Iranian Nursing Students: A Qualitative Study.

Background: The prevalence of self-medication has increased dramatically worldwide. This study was conducted to determine the reasons for self-medication from the perspective of Iranian nursing students. Methods: This qualitative study was conducted using the content analysis method. Fifteen nursing students were selected by the purposeful sampling method. Data were collected by in-depth semistructured interviews. Qualitative content analysis method was used for data analysis. The MAXQDA software was used for data management. Results: Data saturation was achieved with fifteen interviews with nine women and six men, with a mean age of 26.5 ± 4.8 years. The reasons for self-medication were explained in five categories and fifteen subcategories. Some of the reasons for self-medication were having medication information, having previous experience, easy access to medicine, lack of enough time, access to medical staff, cost of a doctor's visit, inadequate respect for patient privacy, pharmaceutical advertising in the media, and information explosion. Discussion. Several factors are involved in self-medication. Given the dangers of self-medication, health policymakers must adopt strict policies for pharmacies that sell drugs without a prescription. Furthermore, it is helpful to run training courses on self-medication risks for students.

The Relationship of Internet Abusive Use with Academic Burnout and Academic Performance in Nursing Students.

Materials and Methods: A total of 184 nursing students were recruited by simple random sampling. Data collection tools included a demographic information form, the Internet Abusive Use Questionnaire and Maslach Burnout Inventory-Student Survey. Data were analyzed by the SPSS-18 software using descriptive and inferential statistics. Results: The abusive use of the Internet in nursing students was lower than the average level. There was a positive correlation between Internet abusive use and academic burnout (r = 0.305, p < 0.001), but there was a negative correlation between Internet abusive use and academic performance (r = -0.478, p < 0.001). The results of multiple regression analysis showed that Internet abusive use could predict the variance of academic burnout and academic performance. Conclusions: Internet abusive use was correlated with increased academic burnout and decreased academic performance in nursing students. Educational interventions are required to increase students' awareness of the consequences of Internet abusive use.

Quality of life and related factors in caregivers of children with cancer in Iran.

PURPOSE: The aim of this study was to determine the quality of life and its related factors in the caregivers of children with cancer. METHODS: This cross-sectional study assessed the quality of life of 270 caregivers of children with cancer in Iran. Data collection tools were a personal information form and the Caregiver Quality of Life Index-Cancer. Data were analyzed by SPSS-18 software using descriptive and inferential statistics (independent t-test, analysis of variance, and linear regression model). RESULTS: The mean score of quality of life was 78.3 ± 1.6 out of 140. Variables that were significantly associated with quality of life included age (p = .031), gender (p = .021), education (p = .048), occupation (p = .011), economic status (p = .038), average caring time (p = .021), and age of the child (p = .011). CONCLUSION: The caregivers of children with cancer did not have a good quality of life. Healthcare providers need to provide comprehensive educational, emotional, social, and economic support to the caregivers of patients with cancer.

Explaining the consequences of missed nursing care from the perspective of nurses: a qualitative descriptive study in Iran.

BACKGROUND: Missed nursing care is a global challenge that can have many consequences. Knowing the experiences of clinical nurses can be helpful. Therefore, this study was conducted to explain the experiences of Iranian nurses regarding the consequences of missed nursing care. METHODS: This qualitative descriptive study was conducted with a content analysis approach. Sampling was done by the purposeful sampling method and continued until data saturation. Data were collected by in-depth semi-structured interviews. Data were analyzed using qualitative content analysis and Graneheim and Lundman's method. MAXQDA version 10 software was used for data management. RESULTS: The participants included 14 nurses with a mean age of 38.7 ± 7.7 years. The data were classified into three categories: patient-related outcomes, nurse-related outcomes, and organization-related outcomes. These categories included nine subcategories entitled "moral distress", "job dissatisfaction", " decreased quality of nursing care "," patient dissatisfaction ","adverse events"," absenteeism ","intention to leave and subsequent turnover", "decreased hospital credit", and "increased hospital costs". CONCLUSION: Missed nursing care can have adverse consequences for the patients, nurses, and organizations. Therefore, it is necessary to adopt management strategies such as providing sufficient manpower and increasing nurses' job satisfaction to reduce the amount of missed nursing care. Further studies are needed to explain the predictors of the missed nursing care consequences.

Explaining the experience of nurses on missed nursing care: A qualitative descriptive study in Iran.

BACKGROUND: Missed nursing care is a new concept that refers to the care that has been omitted or delayed. Due to the importance of the perceived experiences of nurses, this study was conducted to explain the experiences of Iranian nurses regarding the types of and reasons for missed nursing care. METHODS: In this qualitative descriptive study, face-to-face and semi-structured interviews were used to collect data. The participants were selected by purposive sampling method. The extracted codes were organized into twelve subcategories and consolidated into six categories. MAXQDA (Version 10) software was used for data management. RESULTS: The participants included 14 nurses with a mean age of 38.7 ± 7.7 years. The types of missed nursing care were expressed in the form of three categories, including "failure to pay attention to all patient needs", "non-observance of hygienic principles", and "non-observance of patient-related safety standards". The reasons for missed nursing care were also explained in three categories, including "nurse-related reasons", "facility-related reasons", and "management-related reasons". The subcategories related to these categories included nursing shortage, nurses' dissatisfaction, lack of teamwork spirit, inadequate clinical competence, personal problems, lack of facilities and equipment, old and defective equipment, and inefficient management. CONCLUSION: Missed nursing care has many types and causes. This problem can be reduced by taking measures such as empowering nurses, regulating the selection of nursing managers, providing sufficient manpower, providing resources and facilities, eliminating the causes of nurses' dissatisfaction, and encouraging team spirit. Future studies are suggested to investigate the effect of intervention measures on the frequency of missed nursing care.

Assessment of Knowledge, Attitude, and Practice of Iranian Nurses towards Toothbrush Maintenance and Use.

BACKGROUND: Since nurses are considered a role model in society, they should have sufficient knowledge, attitude, and practice in the field of oral hygiene. This study was aimed to assess the nurses' knowledge, practice, and attitude towards toothbrush maintenance and use. METHODS: In this cross-sectional study, 325 nurses working in hospitals affiliated to Kermanshah University of Medical Sciences were randomly recruited. Data collection tools included a demographic information form and a researcher-made questionnaire on knowledge, attitude, and practice regarding toothbrush maintenance and use. Data were analyzed by SPSS software using descriptive and inferential statistics (Mann-Whitney U and Kruskal-Wallis H). RESULTS: The mean scores of nurses' knowledge, attitude, and practice were 59.2 ± 16.4, 64.2 ± 20.6, and 51.4 ± 17.0 out of 100, respectively. There was no statistically significant relation between nurses' knowledge, attitude, and practice and their gender, age, level of education, and work experience. CONCLUSIONS: Nurses had moderate knowledge, attitude, and practice regarding toothbrush maintenance and use, which is not very desirable given their role model. Therefore, training courses are recommended to be held to increase the nurses' knowledge, attitude, and practice regarding toothbrush maintenance and use.