The relationship between anxiety and academic identity and the motivation to study nursing and midwifery in the covid-19 pandemic: A structural model.

BACKGROUND: The coronavirus disease (COVID-19) pandemic had a great psychological effect on health service providers and students of related fields. The study aimed to investigate the relationship between COVID-19 anxiety and academic identity and the motivation to study nursing and midwifery during the COVID-19 pandemic. MATERIALS AND METHODS: In a cross-sectional study 221 nursing and midwifery students at-University of Medical Sciences in 2020 using census sampling were studied. The questionnaires were GADQ-7, the student's academic identity standard questionnaire, the coronavirus anxiety scale, and academic motivation in nursing and midwifery. Pearson's correlation coefficient, regression coefficient, and path analysis were used in statistical software AMOS (version 21) and SPSS (version 22). RESULTS: The results showed that motivation and anxiety with a significant overall effect of 0.43 and -0.36 were the main determining variables of academic identity respectively (P < 0.001). COVID-19 anxiety was recognized as responsible for 24% of the changes in motivation to study nursing (P < 0.001). CONCLUSIONS: Academic identity and motivation to study nursing and midwifery have been affected by the COVID-19 pandemic. The need for psychological attention in this situation is required for nursing and midwifery students.

Correlation between COVID-19-related health anxiety and coping styles among frontline nurses.

BACKGROUND: The long-term epidemic of COVID-19 and its recurrence has exposed frontline nurses to mental disorders such as stress and health anxiety. High levels of health anxiety associated with COVID-19 may lead to maladaptive behaviors. There is no agreement on which coping styles are most effective against stress. Therefore, more evidence is required to find better adaptive behaviors. The present study was conducted to investigate the correlation between the level of health anxiety and the type of coping strategies used by frontline nurses fighting COVID-19. METHODS: This is a cross-sectional study that was performed on a convenience sample of 386 nurses who are working in the COVID department from October to December 2020, coinciding with the outbreak of the third COVID-19 peak in Iran. Data were collected through a demographic questionnaire, the short version of the health anxiety questionnaire, and coping inventory for stressful situations. Data were analyzed using independent T-test, U-Mann-Whitney, and Kruskal-Wallis statistical tests with SPSS version 23 software. RESULTS: The mean score of nurses' health anxiety was 17.61 ± 9.26 which was more than the cut-off point for health anxiety and 59.1% of nurses had COVID-19-related health anxiety. The mean score of problem coping style (26.85 ± 5.19), was higher than emotion (18.48 ± 5.63) and avoidance (19.64 ± 5.88) coping styles and nurses mostly used problem-coping strategies to deal with anxiety caused by COVID-19. There was a positive significant correlation between the scores of health anxiety and emotion coping style (r = 0.54; P < 0.001). CONCLUSION: Based on the findings of this study, COVID-19-related health anxiety was high in front-line nurses and those with high health anxiety were more likely to use emotion-based coping strategies, which are ineffective. Therefore, considering strategies to reduce nurses' health anxiety and holding training programs on effective coping methods in epidemic conditions are recommended.

Stress coping strategies of Iranian healthcare staff during the COVID-19 pandemic: A cross-sectional study.

The COVID-19 pandemic has exposed healthcare staff to mental distress. Given the importance of applying effective strategies to cope with stress caused by COVID-19, this study aimed to assess the stress-coping strategies of Iranian healthcare providers. This cross-sectional study was performed through a web-based survey. Data collection was done online using a demographic data questionnaire and the short form of Endler and Parker's coping inventory. The mean scores of task-oriented strategies (27.06 ± 5.13) were higher than avoidance-oriented (19.42 ± 5.77) and emotion-oriented strategies (18.45 ± 5.76), and the healthcare workers mainly used task-oriented styles to cope with COVID-19-related stress. There was a significant difference between the score of task-oriented strategy in terms of age groups (P < 0.001), work experience (P = 0.018), level of education (P < 0.001), having children (P = 0.002), and type of hospital (P = 0.028). The score of task-oriented strategies was lower in employees who were in the age group of 20-30 years and had less than 10 years of work experience, and it was higher in employees who had children, worked in private hospitals, and had a master's degree or higher. The score of emotion-oriented strategies in the age group of 51-60 years was significantly lower than other age groups (P < 0.01) and was significantly higher in employees with a bachelor's degree than those with a master's degree or higher (P = 0.017). There was no significant difference between the scores of avoidance-oriented strategies and any socio-demographic variables. According to the findings of this study, young and less experienced employees were more inclined to utilize emotion-oriented coping styles. Therefore, considering appropriate training programs for these employees to apply effective coping strategies is extremely important.

Developing a Culture of Civility in Nursing Students.

ABSTRACT: Incivility is a significant problem in nursing education. The purpose of the study was to determine the impact of culture management on incivility in nursing students. Nursing faculty and students participated in a quasi-experimental study. The program included the formation of a committee, development of codes of conduct, giving positive scores for civil behaviors, and setting a vision. Behavioral changes were assessed before and after the intervention. There were significant differences between the two groups for perceived level and occurrence rate of incivility ( p < .05).

Psychometric evaluation of the Persian version of the Heart Disease Fact Questionnaire (HDFQ) in people with diabetes in Iran.

BACKGROUND AND AIMS: Public health and clinic-based educational strategies are desperately needed to stem the tide of death from heart disease among people with diabetes in low and middle-income countries. This study translated the Heart Disease Fact Questionnaire into Persian and evaluated its reliability and validity for use in Iran. METHODS: Using rigorous translation methods, the 25-item scale was administered to Persian speakers with diabetes. The scale was evaluated for content validity, construct validity and reliability. RESULTS: Participants were 268 patients with diabetes with mean age of 63.19 ± 16.61 years. The mean HDFQ score was 17.31 ± 5.11 (in the low range). Higher scores were associated with younger age, younger age of diabetes onset, higher education, higher employment position, family history of diabetes and hypertension, shorter diabetes duration, and adherence to home exercise regimens. Kuder-Richardson's reliability coefficient was good, i.e., 0.82. Confirmatory factor analysis showed that the factor loadings of all questions, except question number 25, were favorable, i.e., >0.3. Model fit indices were favorable: Chi-square statistic to degree of freedom ratio (χ2/df) = 1.82, Comparative fit index = 0.96, Tucker-Lewis Index = 0.96 and root mean square error = 0.06. CONCLUSION: After removing item #25, the Persian heart disease fact questionnaire has good validity and reliability and can be used to inform and evaluate clinical and public health educational programs aimed at decreasing risk for heart disease among Persian speakers with diabetes.

Psychometric evaluation of the perceived nursing student's Incivility questionnaire.

AIM: Student's uncivil behaviour is one of the most common problems in the educational setting, including nursing schools. It is essential to develop tools for measuring the uncivil behaviour of nursing students to solve this problem. Therefore, this study aimed to evaluate psychometric properties of perceived nursing student's incivility questionnaire among the Iranian community. DESIGN: In this methodological study, perceived nursing student's incivility questionnaire was completed by 360 nursing students and 121 nursing faculty members. METHODS: Sampling was done from October 2019-November 2019. Content and construct validity of the questionnaire were evaluated. Reliability was estimated using Cronbach's alpha and McDonald's omega coefficients and composite reliability. The construct validity of nursing student's perceived incivility was investigated by exploratory and confirmatory factor analyses. RESULTS: Content validity index 0.88 for the whole instrument. The three factors of violent behaviours, irresponsible behaviours and unsound behaviours explained more than 51.485% of the variance. Factor structure extracted using model fit indices (PCFI = 0.763, PNFI = 0.732, CMIN/DF = 2.501, RMSEA = 0.056, GFI = 0.941, AGFI = 0.918, CFI = 0.935) and convergent validity were also confirmed. Internal consistency and composite reliability were estimated to be more than 0.7. The results showed that Iranian perceived nursing student's incivility questionnaire is a three-dimensional construct with good validity and reliability.

Relationship between mindfulness and maternal stress and mother - Infant bonding in neonatal intensive care unit.

BACKGROUND: Having a baby admitted to a neonatal intensive care unit (NICU) is so stressful, has a negative impact on mother well-being, and also disrupts mother-infant bonding process because the infant spend the first several weeks or months in the NICU. Previous studies have shown the positive association of the mindfulness and various health conditions. This study investigated the relationship between mothers' dispositional mindfulness and level of stress and bonding in mothers with infants in the NICU. MATERIALS AND METHODS: A cross-sectional study was performed during 2019 on 140 mothers with newborns admitted to the NICUs in two hospitals in Qom city in Iran. The self-report measures of dispositional mindfulness, Parental Stressor Scale: NICU, and the Postpartum Bonding Questionnaire were administered to mothers on the 2nd-5th day after birth. The data analysis was carried out by using a stepwise multiple regression model. RESULTS: The mean scores of mindfulness, stress, and bonding were 3.32 ± 0.52, 2.32 ± 0.77, and 0.47 ± 0.37, respectively. There was a statistically significant inverse relationship between total mindfulness score and stress (P < 0.001). Furthermore, high scores of mindfulness were associated with better bonding (P = 0.04). CONCLUSIONS: Improvement in mindfulness helps mothers to reduce stress and make better bonding with infants. It is recommended that mindfulness interventions use during pregnancy also after birth, especially for mothers that their infants admitted to in the NICUs.

Factor Analysis of Iranian Version of Nursing Students' Incivility Questionnaire.

BACKGROUND: Uncivil student behavior is one of the challenging issues in the nursing schools that disrupts the learning process and teacher-student interactions. Planning to control student's incivility requires knowing the condition using valid tools. The purpose of this study was to investigate the validity and reliability of the incivility occurrence's questionnaire among Iranian students. MATERIALS AND METHODS: This methodological study was conducted on 358 nursing students and 122 nursing faculty members. The samples were selected from the nursing students of second to fourth year from September to October 2019. McDonald's omega, Cronbach's alpha coefficients and composite reliability were calculated. Exploratory and confirmatory factor analysis were used to investigate the construct validity of tool. RESULTS: Content validity index was 0.94 for the whole instrument. In factor analysis, three factors of irresponsible, violent, and unsound behaviors were identified. These factors explained more than 50.52% of the variance. Model fit indices Parsimonious Normed Fit Index) = 0.74, Root Mean Square Error of Approximation = 0.05, Parsimonious Comparative Fit Index = 0.78, Goodness-of-Fit Index = 0.92, Comparative Fit Index ( CFI) = 0.92, Adjusted Goodness-of-Fit Index) = 0.89, CIMN=2.58) indicated the proportion of factors. Internal consistency was 0.77 to 0.89. CONCLUSIONS: This questionnaire is a three-dimensional tool with appropriate validity and reliability that can be used to evaluate occurrence rate of nursing student incivility in Iran.

The effects of teaching methods on academic motivation in nursing students: A systematic review.

Motivation is one of the key factors in educational achievement. Like any other field of study, motivation in nursing is highly critical. The instructor's knowledge about the teaching methods that are effective in academic motivation of students enables them to adopt proper measures to improve the teaching efficiency. The present paper is a systemic review of the efficiency of instructional interventions in improvement of academic motivation in nursing students. The published papers related to the study from 2000 to February 2020 were searched at different databases such as PubMed, Scopus, Web of Science, PsycInfo, and ERIC. To examine the quality of the articles, critical appraisal instrument for reports of educational interventions was used. Totally, 18 articles entered the study for structured review. The majority of the articles reported that educational interventions improved academic motivation in nursing students. The effective teaching methods described in the reviewed articles that led to an improvement in academic motivation were simulation, case-based learning, cooperative learning, learning contract, peer assessment, and self-assessment using video typing. As the findings showed, implementation of applied and participatory methods in teaching process improved the academic motivation of nursing students. Therefore, using such methods, nursing instructors can improve the academic motivation of their students.

Student's perceptions of using scenario-based education to improve civility: A mixed method study.

INTRODUCTION: Academic incivility is one of the major concerns among nursing student that disrupts the learning process and influences the quality of nursing care. Investigating a useful strategy can be a crucial action in reducing the problem. The purpose of this study was to evaluate the nursing student's perceptions of using scenario-based education to improve civility. METHODS: An explanatory mixed method approach was employed. Nursing students who were studying in the second and third years participated in research (N=81). Eight sessions were designed for discussion regarding the scenarios that were directed by a faculty leader. Changes in the students' perception were evaluated four weeks after the sessions by a questionnaire. Data were analyzed using paired t-test and calculation of mean scores. Ten focus groups were conducted and content analysis identifed two themes and four subthemes. Both the qualitative and quantitative data were analysed separately and the findings were merged in the discussion. RESULTS: There was a significant difference between the student's perceptions for the perceived level and occurrence rate of incivility before and after the intervention (p<0.05). The major themes found included awareness of the importance of incivility and capability to change uncivil behavior. The results from the mixed method study showed that the program increased awareness and capability to change uncivil behaviors. CONCLUSION: This research provided an extended understanding of the outcomes of the scenario- based education on nursing student's perceived behaviors and strengthened their beliefs and capabilities about civil behaviors. It can be applied as an effective strategy to raise the perception of the program value and use.

The Effects of Group Discussion and Self-Learning on Nursing Students' Civility.

BACKGROUND: Uncivil behavior is a widespread problem among nursing students. Using a proper strategy can help teachers to reduce incivility, and its negative outcomes. The aim of this research was to compare the effects of group discussion, and self-learning on perceived level and rate of incivility in nursing students. MATERIALS AND METHODS: A two group quasi-experimental design was used to perform the present study. The course was approved by ten members of the nursing faculty for teaching in January 2018. There are about 82 bachelor degree nursing students participated in a course that was designed to teach civility as a course syllabus. Subjects were randomly allocated to discussion group (41 students), and self-learning group (41 students). Incivility in Nursing Education-Revised Questionnaire (INE-R) was used to measure perceived level and occurrence rate of incivility in nursing students. In discussion group, eight sessions were conducted to teach course contents and each session lasted one hour. Self-learning group studied a booklet about civility. Paired and independent t-test was used to compare pretest and posttest mean scores. RESULTS: Both groups indicated an improvement in perceived level of incivility. The mean score for occurrence rate of incivility in the discussion group was significantly higher than in the self-learning group (t80 = 4.63, p < 0.001). There were significant differences between two groups for perceived level (t80 = 2.81, p = 0.02) and rate of incivility (t80 = 3.01, p = 0.01). CONCLUSIONS: Using course syllabus to educate nursing students can lead to reducing perceived level of incivility and providing active discussion is an appropriate strategy for promoting academic civility.

Diffusion of advanced medical imaging technology, CT, and MRI scanners, in Iran: A qualitative study of determinants.

BACKGROUND: Low-income and middle-income countries have a lot of problems in providing the financial, human, and capital resources for advanced medical imaging technologies (AMITs). Proper distribution of such expensive equipment might increase access to these services and enhance the quality and efficiency of health care. The present study aimed to identify the factors affecting the diffusion of AMITs including CT and MRI in Iran. METHODS: This is a qualitative research conducted in 2017. A number of purposively chosen policy makers and managers from Ministry of Health, medical universities, hospitals, health insurance, and vendor companies were approached for face-to-face and semistructured interviews. Data analysis was done using thematic analysis method. RESULTS: Three categories of influential factors were identified, including contextual, stakeholder related, and situational factors. With regards to the stakeholders, the ministry and physicians played the most important role in the diffusion process of the AMITs. Health insurance organizations and vendor companies played a minor role in distribution of the equipment. Application of political pressure by the authorities on the Ministry of Health to issue licenses for the acquisition of AMITs was taken as the most important factor and the greatest challenge in the diffusion of devices. CONCLUSION: The results sought to assist health system authorities to manage diffusion of AMITs effectively and assign an equitable access to the expensive resources. The diffusion management together with utilization management could largely improve efficiency and cost containment. Medical technology diffusion management de facto needs policy instruments in both supply and demand sides.

Barriers, Facilitators, Process and Sources of Evidence for Evidence-Based Management among Health Care Managers: A Qualitative Systematic Review.

BACKGROUND: Evidence-based management (EBMgt) improves managerial decisions as a bridge from theory to practice. For reason that it has a critical impact on organization performance. The purpose of this study was to identify factors affecting EBMgt among managers. METHODS: The following electronic databases were used: PubMed, Web of Science, Cochrane, ProQuest, Embase and Scopus. In addition, we searched Google Scholar, Emerald, Academy of Management (AOM), and the website for the Center for Evidence-Based Management (CEBMa) for articles related to EBMgt. We used data sources published up to September 2017, without language restriction. We appraised the methodological quality of studies using the checklists of SRQR and MMAT. The synthesis involved interpretative analysis based on the principles of meta-synthesis. RESULTS: Of 26,011 identified studies, 26 met the full inclusion criteria. Of the 26 studies assessed, the frequency of qualitative studies and mixed-methods were 20 and 6, respectively, and the quality of 3 studies was weak. A total of 23 studies from 7 countries were included: Canada (n=8), USA (n=6), Australia (n=4), UK (n=3), Iran (n=1, Brazil (n=1); none were from Africa. Meta-synthesis findings of 23 studies identified four main factors: facilitators (5 main themes), barriers (5 main themes), sources of evidence (4 main themes), and the process of decision making in EBMgt (1 main theme). CONCLUSIONS: EBMgt is crucial to improve the quality of management decisions, and hence, to improve service delivery, effectiveness and efficiency. Furthermore, to increase the benefit and utilization of EBMgt, training organizations and research institutes must more actively involve managers in setting research plans.

Validity and Reliability of Persian Version of HIV/AIDS Related Stigma Scale for People Living With HIV/AIDS in Iran.

OBJECTIVE: To assess the perceived HIV/AIDS related stigma a comprehensive and well developed stigma instrument is necessary. This study aimed to assess validity and reliability of the Persian version of HIV/AIDS related stigma scale which was developed by Kang et al for people living with HIV/AIDS in Iran. MATERIALS AND METHODS: Thescale was forward translatedby two bilingual academic members then both translations were discussed by expert team. Back-translation was done by two other bilingual translators then we carried out discussion with both of them. To evaluate understandability the scale was administered to 10 Persons Living with HIV/AIDS (PLWHA). Final Persian version was administered to 80 PLWHA in Qom, Iran in 2014. Test-retest reliability was assessed in a sample of 20 PLWHA after a week by intra-class correlation coefficient (ICC). RESULTS: Cronbach's alpha coefficient for overall scale was 0.85. Also Cronbach's alpha coefficients for the five subscales were as follows: social rejection (9 items, α = 0.84), negative self-worth (4 items, α = 0.70), perceived interpersonal insecurity (2 items, α = 0.57), financial insecurity (3 items, α = 0.70), discretionary disclosure (2 items, α = 0.83). Test-retest reliability was also approved with ICC = 0.78. Correlation between items and their hypothesized subscale is greater than 0.5. Correlation between an item and its own subscale was significantly higher than its correlation with other subscales. CONCLUSION: This study demonstrate that the Persian version of HIV/AIDS related stigma scale is valid and reliable to assess HIV/AIDS related stigma perceived by people living whit HIV/AIDS in Iran.