bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between organizational commitment, working environment, and burnout in clinical nurses
Authors: Alinejad-Naeini Mona , Ghasemi Mahin , Mirzaee Mohammad Saeed , Heidari-Beni Farshad 
Published: November 2024

BACKGROUND:
Burnout is a mental condition caused by chronic emotional or psychological stress. Organizational commitment is always an important issue in the field of organizational development of clinical nurses. The study aimed to assess the association between organizational commitment, work environment, and burnout in clinical nurses.

MATERIALS AND METHODS:
This is a correlational descriptive study that was conducted from November 2021 to January 2021 on 456 clinical nurses at the Hazrat Rasul Akram University Hospital in Iran. The convenience sampling method was used. Data were collected using socio-demographic and work-related data collection sheet, the Working Environment Scale (WES-10), the Organizational Commitment Questionnaire (OCQ), and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Data were analyzed by the Statistical Package for the Social Sciences (SPSS) version 23.

RESULTS:
The overall results showed that the mean score of organizational commitment was 29.87 ± 8.19, the mean score of burnout was 91.98 ± 17.40, and the mean score of work environment satisfaction was 24.62 ± 7.53. There were negative and significant relationships between organizational commitment with burnout (r = -0.324, P < 0.001) and work environment satisfaction (r = -0.440, P < 0.001). Also, there was a positive and significant relationship between work environment satisfaction with burnout (r = 0.386, P < 0.001).

CONCLUSION:
The nursing profession is widely recognized as one of the most stressful professions, often characterized by high rates of staff turnover, absenteeism, and burnout. The result of this study highlights the importance of positive work conditions for ensuring the commitment and well-being of clinical nurses.
The effect of education on pre-operative anxiety in patients undergoing extracorporeal shock wave lithotripsy
Authors: Mahkooyeh Saeideh Azizi , Zakerimoghadam Masoomeh , Haghani Shima , Navidhamidi Mojdeh 
Published: November 2024

BACKGROUND:
The period before diagnostic and therapeutic procedures is associated with increased anxiety levels in patients due to a lack of sufficient information. This study aimed to determine the effect of education on physiological and psychological anxiety levels in patients before extracorporeal shock wave lithotripsy (ESWL).

MATERIALS AND METHODS:
This randomized clinical trial was conducted at Baharloo Hospital in Tehran on 122 patients, and the samples were selected in two stages. In the first stage, the samples were selected using convenience sampling. In the second stage, they were randomly assigned to the intervention and control groups. The data were collected using demographic information and Spielberger’s State-Trait Anxiety Inventory to measure psychological anxiety. Salivary cortisol was measured to evaluate physiological anxiety by both groups before the intervention and entering the room. The intervention group received the information before ESWL via face-to-face lectures and the broadcast of pre-recorded lecture videos. The control group received only the usual care in the ward. The data analysis was performed by SPSS version 25 using descriptive statistics that included the calculation of mean, standard deviation, and frequency distribution and inferential statistics (independent t-test, paired t-test ANOVA, and Chi-square test).

RESULTS:
There was no significant difference in demographic characteristics between the intervention and control groups (P > 0.05). A significant decrease in the mean salivary cortisol level was found in the intervention group compared with the control group (P < 0.001). The anxiety level was markedly decreased in the intervention group compared with the control group (P < 0.001).

CONCLUSION:
Adequately informing patients before ESWL could decrease patients’ physiological and psychological anxiety levels. So, people in the field of nursing education can take an important step towards using this method and reducing the anxiety of patients. The existence of such videos and holding training sessions can be a suitable solution for educating the patient.
Development, implementation and evaluation an empowerment program for adolescent girls with substance use disorders: Protocol for a mixed methods study
Authors: Ghelbash Zakiye , Alavi Mousa , Noroozi Mahnaz , Mahdavianfar Masuood 
Published: November 2024

BACKGROUND:
A tendency to high-risk behaviors, such as suicide, high-risk sexual behavior, and violence are among the important consequences of substance use in adolescent girls. Today, programs are designed with an empowerment approach, as important practical strategies for the management of issues associated with health and social welfare. Thus, in this study, we intend to design a comprehensive psychosocial empowerment program with an approach to reducing high-risk behaviors in adolescent girls with substance use disorder.

MATERIALS AND METHODS:
Using the Talbot and Verrinder model, this study will be designed in six steps. In the first step, the experiences of adolescent girls with substance use disorder as well as their psychosocial needs will be identified using a qualitative approach. Then, through a review of the literature, the needs and strategies will be completed and enriched. Thereafter, using a Delphi technique, the relevant needs and strategies identified in previous stages will be prioritized. In the second step, the program’s draft will be designed based on the results obtained from the previous step. During the third phase, the content of the program will be evaluated by a panel of experts. The fourth, fifth, and sixth steps of the model are dedicated to the implementation, monitoring, and evaluation of the program.

CONCLUSION:
It is expected that in the case of its effective implementation by social welfare and health organizations, the empowerment program would have the potential to have a considerable effect on reducing or controlling high-risk behaviors in adolescent girls with substance use disorder.
Revision of institutional accreditation standards and processes in Iranian medical universities
Authors: Yousefi Alireza , Changiz Tahereh , Avizhgan Maryam , Jokar Fariba , Ehsanpour Soheyla , Yamani Nikoo 
Published: November 2024

BACKGROUND:
The institutional accreditation standards were revised after the initial round of institutional accreditation and gaining experience while scrutinizing issues and complications. This research covers the steps needed to update and then compile the new standards, making the necessary changes in regulations, self-evaluation guides, external evaluation, ethics, and the required forms.

MATERIALS AND METHODS:
This comprehensive developmental study, conducted in two main phases from 2019 to 2022 at Isfahan University of Medical Sciences, employed a variety of rigorous methods. These included a thorough literature review, analysis of previous documents, gathering of gathering experts' opinions, and consensus techniques. In the first phase, standards were revised through meticulous steps such as a literature review, expert meetings, and a survey study among managers and faculty members of medical universities. In the second phase, regulations, forms, and guidelines were compiled during experts’ meetings.

RESULTS:
In the first phase, a draft of the standards, prepared based on previous accreditation experiences, universities feedback on standards, and review of 14 accreditation institution websites, in eight domains, 23 subdomains, and 94 standards. Notably, 75 of these standards were deemed mandatory, while 19 were classified as preferred. The prepared draft of the standards was then subjected to a three-stage survey. During this process, the National Accreditation Commission proposed one modification to the regulations and four alterations to the standards, along with accompanying explanations. Afterward, during the second and third review stages involving universities and managers, 14 standards were revised, two new standards were introduced, and seven explanations were appended. The finalization of mandatory and preferred standards was contingent upon attaining a 70% consensus on their necessity and clarity. Following approval by the Secretariat of the Council for Development, these standards were formally ratified. The regulations, self-assessment guide, external evaluation guide, ethics guide, and necessary forms were prepared and approved by the National Accreditation Commission in the second phase using data from literature reviews and experiences gained from the first round of accreditation.

CONCLUSION:
This study focused on developing standards and processes commissioned by the National Accreditation Commission, which will serve as the national institutional accreditation standards for evaluating medical universities. Additionally, these standards could be used as a basis for development of accreditation standards of those universities affiliated with the Ministry of Science, Research, and Technology.
Experiences of COVID-19 survivors and their families: A qualitative study based on social cognitive theory
Authors: Sohrabivafa Malihe , Sadeghi Roya , Tedadi Yaser , Sighaldeh Shirin Shahbazi , Riahi Forough , Foroushani Abbas Rahimi , Zarei Javad 
Published: November 2024

BACKGROUND:
The COVID-19 pandemic caused social and economic damages, increased mortality rates, and psychological damages such as fear, stress, anxiety, and depression. Therefore, the present study aimed to explore the perceptions and experiences of COVID-19 survivors diagnosed with anxiety and depression, along with one of their family members in Ahvaz.

MATERIALS AND METHODS:
A qualitative study was conducted on 50 COVID-19 survivors and their family members using an in-depth interview and a purposive sampling method in 2022. On average, each interview lasted 45 minutes. For the content analysis, the content of the interviews was analyzed using MAXQDA10 software.

RESULTS:
In the present research, 188 primary codes were extracted with six categories and eight subcategories for the survivors: Patient’s knowledge and perspective regarding COVID-19, post-COVID-19 conditions, sense of capability before and after infection with COVID-19, management of COVID-19, and social support, and one main category for family members: social support.

CONCLUSION:
The experiences of COVID-19 survivors, their friends, family members, and healthcare providers significantly impact their mental health and accelerate their recovery. Therefore, it is recommended to develop an educational and preventive program using scientific and proper methods to cope with psychological challenges.
Analyzing the status of pre-hospital emergency medical services graduates in Iran during the last two decades
Authors: Miri Kheizaran , Sabbaghi Mohammadreza , Namazinia Mohammad 
Published: November 2024

BACKGROUND:
Pre-hospital emergency medical services (PHEMS) training system is an integral part of the health system of any country. Therefore, knowing the status of graduates of this field can provide a new analysis for the policymakers of the National Health System. The purpose of this study was to analyze the status of PHEMS graduates in Iran.

MATERIALS AND METHODS:
The present survey research was conducted with the participation of 437 pre-hospital emergency medicine graduates of Iranian medical science universities in spring and summer of 2022. Sampling in this study was convenience. The documents of the National Organization of Educational Testing were used as well. The data collection tool was a researcher-made questionnaire. Statistical analyses were performed by SPSS25 software using descriptive statistics and analytical statistics.

RESULTS:
Among the graduates, the largest number (41.5%) was reported to be in the associate degree. According to the emergency system structure in Iran, graduates were employed in operational, communication, and headquarters areas, respectively, of which 76.8% were working in government centers. Most of the graduates were from the medical sciences universities of Zone 2 (35.6%) in the eastern area of Iran, while most of the workers were related to the medical sciences universities of Zone 1 (27.9%) in the capital region.

CONCLUSION:
Our findings revealed that the distribution of EMS graduates was not proportional to the distribution of the population and geographical area. Therefore, it is suggested that the policymakers of the country’s health system should make changes in the recruitment of students in each medical zone.
Design and validation of the reflection skills self-assessment questionnaire (RSSAQ)
Authors: Hamedfar Hadi , Barzegar Mohammad , Ranjbar Fatemeh , Ghaffarifar Saeideh 
Published: November 2024

BACKGROUND:
Reflection is one of the main components of the medical sciences curriculum. It is one of the learner-centered educational strategies, leading to deep learning, and is necessary to attain professional capabilities. A pertinent challenge is how to assess reflection. This study was conducted to design and assess psychometric characteristics of medical sciences students’ reflection skills self-assessment questionnaire (RSSAQ) in Persian.

MATERIALS AND METHODS:
This is a methodological explorative study conducted at our University of Medical Sciences. First, an item pool was collected from both the literature review (previously designed questionnaires and existent models of reflection) and experts’ and researchers’ perspectives. Then the initial version of the questionnaire was presented to 19 experts and 50 students to assess the face and content validity. To assess the reliability, 48 students filled out the questionnaire twice at a one-week interval. To assess the construct validity, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were done. For doing so, 151 students filled out the questionnaire. The data was analyzed using IBM SPSS (Statistical Package for the Social Sciences) Statistics for Windows version 16 and Analysis of Moment Structures (AMOS).

RESULTS:
The content validity index (CVI), content validity ratio (CVR), and impact score (IS) for the questionnaire came out to be 0.91, 0.75, and 4.68, respectively. Regarding the reliability, Cronbach’s alpha and intraclass correlation coefficient (ICC) were, respectively, 0.75 and 0.8 (with a 95 percent confidence interval). Regarding the construct validity, three factors were extracted, labeled as “readiness to reflect” (RTR), “reflection in action” (RIA), and “reflection on action” (ROA). It became clear that this questionnaire can predict 36.8 percent of variations in reflective behavior or process in students. CFA determined that there is a positive and significant correlation between RIA and ROA factors. However, the RTR factor has a negative correlation with the other factors and vice versa.

CONCLUSION:
The questionnaire designed in this study for reflection self-assessment had acceptable psychometric characteristics and can be applied in curriculum planning, educational evaluations, and designing educational interventions.
Investigating the effect of yoga-based educational interventions on the volume and composition of breast milk in premature infant’s mothers admitted to neonatal intensive care unit: A randomized controlled trial
Authors: Karimi Fatemeh , Aziznejadroshan Parvin , Akbarian Rad Zahra , Nikbakht Hossein-Ali , Qujeq Durdi 
Published: November 2024

Background:
This study examined the effects of yoga-based educational interventions on the volume and composition of breast milk in premature infants’ mothers admitted to the neonatal intensive care unit (NICU).

Materials and Methods:
A randomized controlled trial was conducted on 78 primiparous mothers whose premature infants were less than 34 weeks and were hospitalized in the NICU of Ayatollah Rouhani Hospital from February 2021 to November 2022. Mothers were assigned to a control group and an experimental group, that is, yoga, using the block randomization method. Mothers in the experimental group performed yoga for 30 minutes under the supervision of a yoga therapist every morning for six consecutive days. The volume of the mother’s milk was measured using an electric pump, while its composition was assessed using a spectrophotometer according to the instructions of the Pars Azmoun Standard Kit.

Results:
The results of the analysis on the remaining 76 samples showed a difference in the means of the volume of breast milk after the intervention with 11.39 and 33.84 ml for the control and yoga group, respectively.there was a significant difference between the amount of breast milk in the control and yoga groups (P < 0.001). Also, the average difference in the amount of breast milk compounds was not significantly different in any of the cases.

Conclusions:
The yoga technique is effective in increasing the volume of breast milk in mothers with premature infants. Therefore, it is recommended to increase the volume of breast milk in the NICU.
Effectiveness cognitive emotion regulation strategies to reduce social anxiety and improve social self-efficacy
Authors: Gazo Ahmad M. , Mahasneh Ahmad M. 
Published: November 2024

BACKGROUND:
This study aimed to investigate the effectiveness of a training program based on cognitive emotion regulation strategies to reduce social anxiety and improve social self-efficacy among Hashemite University students.

MATERIALS AND METHOD:
The study sample comprised 57 students randomly divided into two groups: The experimental group consisted of 28 students, and the control group consisted of 29 students. The experimental group was exposed to the training program consisting of 18 sessions, while the control group did not receive any experimental treatment. The students in both experimental and control groups completed the social anxiety scale and social self-efficacy scales before and after the training program.

RESULTS:
The study found differences in the mean score of the experimental group on the post-test of the social anxiety level in favor of the experimental group and in the mean score of the experimental group on the post-test of the social self-efficacy scale in favor of the experimental group.

CONCLUSION:
The training program based on cognitive emotion regulation strategies is very effective in reducing the social anxiety and improving social self-efficacy.
Difference in the epidemiological and clinical profiles of mortality between the first and second waves of COVID-19 pandemic in a tertiary care hospital of Andaman and Nicobar Islands
Authors: Roy Avijit , Jahnavi G. , Peter Shirley , Dakuya Tapash K. , Venugopal Vinayagamoorthy , Bhattacharya Sudip , Biswas Bijit 
Published: November 2024

BACKGROUND:
The Andaman and Nicobar Islands reported the first coronavirus disease 2019 (COVID-19) case on March 26, 2020. This study aimed to describe the epidemiological and clinical profiles of COVID-19 mortality that occurred during the first and second waves of COVID-19 pandemic and to compare the differences between them.

MATERIALS AND METHODS:
This was a retrospective cohort study carried out among COVID-19 patients admitted at GB Pant Hospital, Port Blair. Socio-demographic and clinical details were retrieved from the case records using structured proforma. Comparison of the study variables between the first and second waves was done by using Chi-square test using SPSS version 20.

RESULTS:
The first wave had total cases of 4994 and 62 deaths, and the second wave had 2734 cases and 67 deaths. The case fatality among COVID-19 cases during the first and second waves of the pandemic was 1.24% and 2.45%, respectively. There was no significant age and gender difference of patients between the two waves. Those who had co-morbidities during the first wave were 52 (83.8%), and those who had co-morbidities during the second wave were 45 (67.2%). The median duration of hospital stay in days during the first and second waves of the pandemic was 4 and 6 days, respectively.

CONCLUSION:
There was no significant difference in the age and gender distribution between the two waves; however, those who died during the second wave had a significantly higher percentage of co-morbidities. Therefore, health policy makers should develop a targeted approach to provide appropriate education, support, and awareness of patients with underlying diseases and allocate health care resources accordingly.
Protocol of randomized controlled trial to evaluate the effect of moderate exercise training on the functional capacity of patients with an implantable cardioverter defibrillator in a tertiary care center in South India
Authors: Paramasivan Selvakumar , Ramamoorthy Lakshmi , Selvaraj Raja 
Published: November 2024

BACKGROUND:
Cardiac rehabilitation programs are planned to reduce the physiological and psychological stress of Cardiovascular Disease, decrease the risk of mortality secondary to CVD, improve cardiovascular function, and help patients to achieve their highest quality of life. However, data on the safety and efficacy of exercise training (ET) in patients with implantable cardioverter defibrillators (ICDs) is sparse. Exercise interventions in those with an ICD have not been extensively studied.

MATERIALS AND METHODS:
A randomized controlled trial will be conducted to determine the effects of moderate ET on the functional capacity of patients with an Implantable cardioverter defibrillator with age group of >18 years, NYHA with grade II and III, EF ≤50%, No evidence of ICD discharge for past 3 months with minimum post-ICD implantation period of a minimum of 3 months. This study includes a total of 70 patients. Random allocation will be used to randomize participants into two groups (35 in each). Home-based walking exercises in the form of aerobic walking will be advised to patients with ICD. They will be advised to walk within the target heart rate for 1 to 24 weeks, which is divided into two components. Initial components included 1–8 weeks of exercise as an Aerobic conditioning component, which includes 1 hour/day x 5 days/week, followed by 9 to 24 weeks as an Aerobic maintenance component, which includes 30 minutes/day x 5 days/week. Adherence to the home walking program with the pulse, spo2, and BP will be tracked using a smartwatch, home exercise log book, and telephone follow-up (if less than 35km – monthly home visit will be done). Functional capacity will be assessed using a 6-minute walk test at baseline and at 6-month intervals.

CONCLUSION:
This study will identify the safety and efficacy of ET among patients with ICD, which will contribute to the important evidence base for cardiac rehabilitation among this group of patients.