From disobedience to struggle for adaptation: ​​nursing students' experiences of attending the clinical learning environment during Covid-19 pandemic.

BACKGROUND: The Covid-19 pandemic has affected the clinical education of nursing students all over the world. Considering the importance of clinical education and clinical learning environment (CLE) in the education of nursing students, identifying the challenges and problems faced by these students during the covid-19 pandemic helps to plan more effectively in this regard. The aim of this study was to investigate the experiences of nursing students in CLEs during the Covid-19 pandemic. METHODS: A descriptive qualitative research was conducted, which used a purposive sampling technique to recruit 15 undergraduate nursing students from Shiraz University of Medical Sciences between July 2021 and September 2022. Data were collected through in-depth semi-structured interviews. For data analysis, conventional qualitative content analysis based on Graneheim and Lundman approach was used. RESULTS: The data analysis led to emergence of two themes of "disobedience " and "struggle for adaptation". The disobedience theme consists of two categories: "objection to attend CLE" and "patient marginalization". The theme of struggle for adaptation includes two categories: "using support sources" and "applying problem-oriented strategies". CONCLUSION: At the beginning of the pandemic, the students were unfamiliar due to the disease, as well as fear of contracting themselves and infecting others, so they tried not to be in the clinical environment. However, they gradually tried to adapt to the existing conditions by applying support resources and using problem-oriented strategies. Policymakers and educational planners can use the results of this study to plan for solving the challenges of students during future pandemics and improve the condition of CLE.

Assessing the psychometric properties of persian version of Zarit Burden interview among family caregivers of patients with multiple sclerosis.

BACKGROUND: Caring for patients with multiple sclerosis (MS) imposes a great burden on caregivers and affects their lives in various aspects. This study aimed to evaluate the psychometric properties of Persian version of 22-item Zarit Burden Interview (ZBI-22) among family caregivers of patients with MS. METHODS: This methodological study was conducted in Fars province, southern of Iran. For this purpose, 120 family caregivers were recruited to participate in the study from January to March 2022. Zarit Burden Interview (ZBI) was translated into Persian through forward-backward method. Face and content validity were assessed. Construct validity was assessed using exploratory factor analyses (EFA), and its reliability was assessed by measuring internal consistency and testretest stability. RESULTS: According to face validity, the impact scores of all items were more than 1.5. Content validity ratio and content validity index values of all 22 items were 0.64-1 and 0.82-1, respectively. The scalelevel CVI/Ave was 0.97. Based on the results of factor analysis, five factors with eigenvalues more than 1 were extracted, which altogether explained 62.62% of the total variance of ZBI score. Among 22 items, one item was deleted during EFA validity assessment. Factor loading values ranged from 0.40 to 0.88. The reliability of the scale was confirmed (total Cronbach's alpha of the ZBI = 0.88). Moreover, testretest stability assessment revealed no significant difference between test and retest scores (P > 0.05). The intraclass correlation (ICC) for the ZBI and ICCs among its factors were 0.88 and 0.6-0.86, respectively. CONCLUSION: The Persian version of five-factor structure ZBI can be a valid and reliable scale, and it can be used to assess caregiver burden among family caregivers of patients with MS in Iran.

Oral health knowledge, attitude and practice among children and adolescents with type 1 diabetes.

Introduction and Objective: The prevalence of tooth decay and chronic gingivitis is higher in people with diabetes than in healthy people. The aim of this study was to evaluate the knowledge, attitude and practice (KAP) of children and adolescents with type 1 diabetes towards oral diseases. Methods: A descriptive-analytical cross-sectional study was performed on 182 patients less than 25 years of age with type 1 diabetes referred to Golestan Clinic in Ahvaz during 2015-2020. The questionnaire consisted of four sections of demographic information, different dimensions of KAP questionnaire was used to collect data about oral health. Statistical analysis was performed using SPSS software version 22 using Mann-Whitney, Kruskal-Wallis and Chi-square tests. The significance level was considered of P < 0.05. Results: The results of the present study showed that 65% of patients had a moderate and low level of knowledge and attitude. Only 13.7% of patients with diabetes reported good levels of oral health performance. Parent's level of education, patient age and urbanization significantly improved the level of KAP of children and adolescents with diabetes towards oral health (P < 0.05). The effect of knowledge on attitude and practice of individuals and also the effect of attitude on practice was positive and significant (P < 0.05). Conclusion: Considering that the KAP of 50% of patients were at low and medium levels, therefore it seems necessary to provide an appropriate solution in order to improve the level of KAP of diabetic patients in relation to oral health.