bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design and validation of a self-assessment questionnaire of basic thinking skills
Authors: Vafamehr Vajiheh , Haghani Fariba , Jamshidian Sepideh 
Published: November 2024

BACKGROUND:
Since assessment of basic thinking skills is crucial in identifying an individual’s cognitive capacities and comprehending their strengths and weaknesses, developing a suitable evaluating instrument holds significant importance in scheduling the training of basic thinking skills. This study aims to develop and subsequently validate a self-assessment questionnaire of basic thinking skills for medical sciences students.

MATERIALS AND METHODS:
The present study of designing and psychometrically testing the self-assessment questionnaire of basic thinking skills among medical sciences students was conducted between 2022 and 2023 at Isfahan University. For the validity review, exploratory factor analysis (EFA) was employed. The adequacy of sample size was checked with the KMO index and Bartlett’s test of sphericity. To perform EFA, principal factor analysis with Varimax rotation was performed. To obtain evidence of reliability, the internal consistency of the questionnaire was examined using Cronbach’s alpha. The instrument stability was assessed through test-retest and intra-cluster correlation coefficient (ICC) analysis.

RESULTS:
The KMO (Keyser-Meyer-Elkin) sampling index was 780, and Bartlett’s sphericity test (BT) was also significant (P = .000). In analyzing the main components and checking the value, the first five components had an eigenvalue above one. The highest percentage of the total variance (67.64%) was explained by the first five factors, while the remaining variance (33.35%) was explained by the remaining 14 factors. Cronbach’s alpha coefficient for 19 items of the final questionnaire was 0.83. Intra-cluster correlation index (ICC) for overall self-assessment of thinking skills (ICC = 0.77), self-assessment of basic thinking skills (ICC = 0.80), self-assessment of lateral thinking (ICC = 0.78), and the necessity of teaching thinking skills (ICC = 0.74)) were all above 0.7 (P < 0.001).

DISCUSSION:
This study offers the first self-assessment questionnaire for basic thinking skills of medical sciences students which can be employed as a valid and reliable instrument for self-assessment of thinking skills and gaining insight into their training experiences. While the psychometrics of this questionnaire were based on the data from medical students, this questionnaire applies to students across various academic disciplines and is not limited to medical fields.
Identifying the factors influencing the quality of education from the perspective of nursing students: A qualitative study
Authors: Rastegarimehr Babak , Mahboubi Mohammad , Raoofi Samira , Beigi Soheila , Teymourlouy Ahmad Ahmadi 
Published: November 2024

BACKGROUND:
Nursing education in Iran suffers from challenges such as inadequate training time, non-scientific methods, lack of facilities, and so on. Nursing students can better discuss these issues and identify variables affecting their education. Thus, this study sought to uncover factors affecting education quality from nursing students’ perspectives.

MATERIALS AND METHODS:
This is a qualitative study that was conducted on nursing students in 2022. Purposive sampling chose 20 undergraduate nursing students from Abadan University of Medical Sciences, Abadan, Iran. The data was acquired using a semi-structured interview. Content analysis was performed using MAXQDA-10 software to extract relevant themes.

RESULTS:
The factors derived from content analysis were classified into two internal and external main themes and six sub-themes, including professors, students, the university/education department, hospitals, and the educational system.

CONCLUSIONS:
Analyzing the strengths and weaknesses of trainers and professors in practical programs and teaching new practical teaching methods can effectively enhance the quality of nursing education. Also, giving training and welfare equipment and necessities in educational hospitals and changing the headlines and contents of some nursing courses will improve education quality.
The relationship of social support with sexual assertiveness and marital satisfaction in Iranian women
Authors: Abdolalipour Somayeh , Feyzollahi Ayda , Laghusi Delara , Kalekhane Zahra Yousefi , Zamani-Zad Nasrin , Ahmadi Mobina , Mirghafourvand Mojgan 
Published: November 2024

BACKGROUND:
People who receive social support in their marital life have a higher chance of experiencing more marital satisfaction. Pleasant healthy sexual relations and a couple’s sexual assertiveness are of prime significance in such satisfaction. This study aimed to determine the relationship between social support and both sexual assertiveness and marital satisfaction in married women referring to health centers in Tabriz, Iran.

MATERIALS AND METHODS:
This is a descriptive-analytical cross-sectional study on 292 women out of 22308 reproductive-age married females referring to the health centers of Tabriz in 2022. Sampling was done by cluster sampling method. Data collection instruments included a socio-personal information questionnaire, personal resource questionnaire 85 (PRQ85-Part 2) as a social support measure, Halbert index of sexual assertiveness (HISA), and enrich marital satisfaction (EMS) scale. Data were analyzed using Pearson, independent t, one-way ANOVA tests, and the general linear model.

RESULTS:
The mean (SD) of social support, marital satisfaction, and sexual assertiveness scores were 103 (19.8), 135.9 (11.8), and 52.2 (19.5), respectively. Social support had an average positive correlation with marital satisfaction (P < 0.001; r = 0.57) and a good positive correlation with sexual assertiveness (P < 0.001; r = 0.73). An adjusted general linear model showed a significant statistical relationship between social support with sexual assertiveness (B: 0.7; 95% CI: 0.6–0.8; P <0.001), and marital satisfaction, (B: 0.3; 95% CI: 0.2–0.4; P <0.001).

CONCLUSION:
An increase in social support, increases their marital satisfaction and sexual assertiveness. Focusing on social support could be an effective approach in family counseling or family education programs to improve marital satisfaction.
Assessment of the relationship between thinking styles and learning styles with academic performance in medical and nursing students of Kermanshah University of Medical Sciences
Authors: Barry Azizeh , Haji Sadra , Shahabi Maryam , Sepahi Vida , Ghasemi Mahdiyeh , Norouzi Azam , Ramezani Ghobad 
Published: November 2024

BACKGROUND:
Learning and studying approaches are among the topics of great importance in medical sciences universities. Different approaches to learning can explain why some students learn better than others. This study aims to assess the relationship between learning or thinking styles and academic performance among nursing and medical students.

MATERIALS AND METHODS:
This is a quantitative and cross-sectional study that was conducted on 364 nursing and medical students of Kermanshah University of Medical Sciences in 2022–2023. The tools used in the present study are as follows: the short version of the Approaches and Study Skills Inventory for Students, the Sternberg-Wagner Thinking Styles Inventory, the Academic Performance Index including the semester grade point average and the overall grade point average. Descriptive statistics, including mean and standard deviation were employed for data analysis. Moreover, inferential statistics such as normality or correlation coefficient, independent sample t-test, and regression analysis were used to determine the predictor coefficients.

RESULTS:
A positive and significant correlation was found between nursing and medical students’ thinking or learning styles and their academic performance (P < 0.001). In addition, the two groups showed a statistically significant difference between learning styles with respect to gender (P < 0.001) and thinking styles (P < 0.001).

CONCLUSION:
Since the strategic approach is a predictor of academic performance, identifying and determining the types of approaches adopted by students using diagnostic evaluation is a method of evaluating students’ learning styles at the beginning of the educational process so that teachers can tailor the most effective approach and instructional strategies that suit the needs of students and improve academic performance.
Efficiency and coherent development as the main concepts of health care managers' readiness in passive defense; Experiences of Iranians healthcare managers
Authors: Khayeri Fereydoon , Tabibi Seyed Jamalodin , Riahi Leila , Hajinabi Kamran 
Published: November 2024

BACKGROUND:
This study examines the elements of efficiency and coherent development in passive defense among healthcare managers for disaster management in Iran.

MATERIALS AND METHODS:
The study employs a qualitative method using conventional content analysis from 2021 to 2023. A purposive sample of 25 healthcare managers with experience in passive defense is selected. Data are collected through unstructured interviews and analyzed using conventional content analysis.

RESULT:
The participants’ experiences regarding the coherent efficiency development of passive defense are categorized into three main themes, namely, enhancing emergency knowledge empathic and responsible cohesion, management development planning and resources, and individual updating and flexibility.

CONCLUSION:
The role of passive defense is very decisive in crisis management through the strategy of efficiency and coherent development. This strategy is implemented using the concepts of enhancing disaster knowledge, empathic and responsible cohesion, management development planning and resources, and individual updating and flexibility.
Alexithymia and attachment on mental health of people with multiple sclerosis: The mediating role of perceived social support and loneliness
Authors: Doostdari Farnaz , Kianimoghadam Amir Sam , Arzpeyma Mahyar , Fatollahzadeh Saina , Zakibakhsh Mohammadi Nassim , Masjedi-Arani Abbas , Hajmanouchehri Reza 
Published: November 2024

BACKGROUND:
Multiple sclerosis and its progressive relapsing–remitting nature for MS patients is challenging and significantly affects the mental health of people with MS. We examined the direct effects of alexithymia and attachment on mental health and the indirect effect of attachment, alexithymia, loneliness, and perceived social support on the mental health of people with MS.

MATERIALS AND METHODS:
Three hundred and forty-five diagnosed with multiple sclerosis (MS) were deemed eligible for inclusion in the study and selected through the Iranian MS Association. Measures included the Toronto Alexithymia Scale (TAS20), Attachment Style Questionnaire (ASQ), General Health Questionnaire (GHQ28), Social and Emotional Loneliness Scale for Adults (SELSA-S), and Perceived Social Support from Family and Friends Questionnaire (PSS-FA and PSS-F). The mental health of MS patients was analyzed using structural equation models (SEM), examining how alexithymia, attachment, social support, and loneliness, directly and indirectly, affect their mental health. The fit of the model to the data was analyzed using the discrepancy function divided by degrees of freedom (CMIN/DF), Normed Fit Index (NFI), Tucker–Lewis Index (TLI), Comparative Fit Index (CFI), and Root Mean Square Error of Approximation (RMSEA).

RESULTS:
The results showed that the model fit was good. Furthermore, findings indicate that 28% (R2 = 0.28) of the mental health changes are explained via study predictors. Alexithymia and attachment directly affect mental health. Attachment style indirectly affects social support and loneliness, while loneliness and family support indirectly affect the mental health of MS patients.

CONCLUSION:
The study findings provide valuable insights into the fundamental structures that influence the mental health of individuals with MS. Loneliness and social support are critical mediating factors that significantly impact the mental well-being of these patients. In the times ahead, healthcare professionals must prioritize attachment, alexithymia, social support, and loneliness in their medical and psychological interventions for individuals diagnosed with multiple sclerosis.
Differences between networks of cognitive emotion regulation strategies in medical students with and without a history of non-suicidal self-injury
Authors: Zadehparizi Reza , Kianimoghadam Amir Sam 
Published: November 2024

BACKGROUND:
Non-suicidal self-injury (NSSI) is deliberate self-harm without the intent to die. NSSI is associated with mental health issues and has a higher prevalence among medical students. Understanding the cognitive emotion regulation strategies in NSSI is important for intervention and prevention. Network analysis provides a holistic perspective on these strategies.

MATERIALS AND METHODS:
Participants were 405 individuals (68.6% female) with a mean age of 22.7 years (standard deviation: 3.97, range: 17–55 years), recruited from Tehran, Iran. Upon conducting an initial screening, it was found that 68 individuals from our sample acknowledged a prior history of NSSI.

RESULTS:
A network analysis showed that that students with a history of NSSI perceived themselves to have difficulties in putting into perspective, positive reappraisal, and self-blame. Compared to students without NSSI, those with NSSI exhibited negative associations between putting into perspective and rumination (PIP__RUM: -0.240) and positive associations between positive refocusing and catastrophizing (PR__Catast: 0.61).

CONCLUSIONS:
This study discovered notable distinctions in the cognitive processing and coping strategies of medical students with and without a history of NSSI. These findings contribute to the existing literature on the link between cognitive-emotional processes and NSSI, informing the development of interventions to decrease such behaviors.
Two distinct psychological concepts: Diabetes depression and diabetes burnout profiles
Authors: Noorian Kobra , Abdolazimi-Najaf-Abadi Azam , Taghipoor Mahboobeh , Doosti-Irani Mahboobeh , Doosti-Irani Mehri , Abdoli Samereh 
Published: November 2024

BACKGROUND:
Diabetes burnout represents a unique experience that shares some similarities with other psychological concepts. Differentiating diabetes burnout from depression symptoms is a challenging issue. This study aims to examine diabetes burnout profiles and their association with depression.

MATERIALS AND METHODS:
A cross-sectional study was conducted in Iran in 2023. Individuals with type 2 diabetes over 18 years old (N = 1300) were recruited through convenience sampling. Data collection was conducted through demographic information, Personal Health Questionnaire Depression Scale (PHQ), and Diabetes Burnout Scale (DBS). Unsupervised clustering methods were utilized to determine the optimal number of profiles.

RESULTS:
Five burnout profiles were found (fully burned-out, overextended, exhausted, on the threshold of burnout, and not-burned-out(. The mean burnout score increases as we move from the not-burned-out profile to the fully burned-out profile. The mean depression score was 7.04. Some individuals (n = 124) who were not-burned-out still experience different depression levels. As depression levels increase, burnout levels also tend to increase. It is noteworthy that while depressed individuals are also burned-out, not all individuals experiencing burnout are necessarily depressed. This is a crucial finding in distinguishing between these concepts.

CONCLUSION:
Addressing burnout based on profiles could be more effective for individuals with diabetes. It is a foundation for further exploring the development of diabetes burnout profiles over time and its relationship with diabetes management and outcomes.
Exploring the perceptions and cultural differences surrounding mindfulness among early childhood education informal caregivers: A qualitative study
Authors: Villalobos Jennifer P. , Valverde Patricia A. , Farewell Charlotte V. 
Published: November 2024

BACKGROUND:
Early childhood education (ECE) caregivers experience high levels of stress and increased physical and emotional work demands. Promoting mindfulness practices may be an acceptable and feasible strategy to bolster mental health and well-being. The present study’s goals were to explore the 1) perceptions and 2) cultural differences surrounding mindfulness practices and mental health among Spanish-speaking Hispanic (SSH), English-speaking Hispanic (ESH), and English-speaking non-Hispanic (ESNH) informal ECE caregivers.

MATERIALS AND METHODS:
Seventeen informal caregivers participated in semi-structured individual interviews between July 2021 and January 2022. Using NVivo12 software, an inductive, qualitative thematic content analysis was conducted to identify themes in the caregivers’ discourse.

RESULTS:
All three groups of caregivers expressed the desire to make time for themselves, their physical health, and their mental health when discussing self-care. However, two main barriers and challenges related to mindfulness practices reported by all three caregiver groups included lack of time and frequently feeling tired after a long day of work. Other key results and suggestions for practicing mindfulness are provided.

CONCLUSION:
The findings from this study show that mindfulness practices among informal ECE caregivers may be deemed acceptable and considered a valuable tool to support mental health in caregiver communities.
Precision medicine and patient outcomes in intensive care unit: Culture sensitivity, antibiotics, and APACHE score IV
Authors: Zubair Sidra , Jamil Subia , Fatima Sakina , Sibtain Syed T. , Raees Hira , Eraj Asma , Nawab Amber 
Published: November 2024

BACKGROUND:
In the intensive care unit (ICU), complex medical conditions require specialized care; the threat of antibiotic resistance is significant due to frequent antibiotic use. This study investigates the pivotal role of culture sensitivity testing in shaping antibiotic prescription practices and patient outcomes in ICUs.

MATERIALS AND METHODS:
By using a prospective observational-analytical design, medical data from 640 patients at a Karachi hospital for one year in 2022 were utilized. The study focused on antibiotic therapy, including empiric and targeted approaches, culture sensitivity testing, the use of the APACHE scale for mortality prediction, and changes in antibiotic regimens based on culture reports. Statistical analysis involved Fisher’s Exact and ANOVA tests.

RESULT:
The age category above 60 emerged with the highest survivorship. Contrary to expectations, age did not seem to correlate significantly with mortality rates. Staphylococcus species was the most prevalent microorganism in this study, disproportionately affecting nonsurvivors 66.7%. The clinical profile comparison between survivors and nonsurvivors offered a multifaceted perspective, with significant differences in vital parameters such as temperature, heart rate, respiratory rate, urine output, FiO2, mean arterial pH, and blood sugar levels. Survivors (44.60%) underwent complete antibiotic regimen changes, a strategy for improved patient outcomes.

CONCLUSIONS:
Complex antibiotic combinations were prescribed for broad clinical conditions. These insights pave the way for future research on antibiotic stewardship in ICUs, navigating more effective and targeted treatments.
Effectiveness of nurse-led progressive muscle relaxation on stress, anxiety, and depression in parents of adolescents with mental illness: A randomized controlled trial
Authors: George Sijesh , Govindan Radhakrishnan , Kommu John Vijay Sagar 
Published: November 2024

BACKGROUND:
Prevention of depression, stress, and anxiety is a serious concern of the World Health Organization and has been a research topic over the last decades. There is a close association found between children’s mental health problems and parental stress, valid for biological and foster families. Evidence suggests that parents with children with disabilities are more stressed, depressed, or anxious than parents who do not have such children. In addition, the progressive muscle relaxation technique (PMR) is the easiest to learn and administer among the relaxation methods available for lowering stress, anxiety, and depression.

MATERIALS AND METHODS:
A randomized clinical trial (RCT) was adopted with an equivalent group pre-test and post-test design. The experimental group (n = 31) received ten sessions of Jacobson PMR, and the control group (n = 30) received treatment as usual (TAU). Data analysis: The researcher used frequency, percentage, mean, standard deviation, median, and interquartile range to describe the study subjects’ demographic profile and clinical profile. Mann-Whitney U test, Kruskal-Wallis H test, and Spearman’s Rho were used to find an association between socio-demographic and clinical variables in parents’ stress, anxiety, and depression levels. Further, Spearman’s Rho was used to find a correlation between stress anxiety and depression. In addition, the Chi-square test and Fisher’s exact test were used to compare control and experimental groups with important socio-demographic and clinical variables. Further, Fridman’s analysis of variance (ANOVA) was used to assess PMR’s effectiveness on group stress, anxiety, and depression. Finally, the Mann-Whitney U test was used to compare stress, anxiety, and depression levels between groups.

RESULTS:
Analysis revealed clinically and statistically significant (P < 0.05) reductions in the stress and anxiety scores of the parents after five sessions of the PMR technique. In addition, findings reveal that there is a statistically significant reduction (P < 0.001) in depression, anxiety, and stress scores after ten sessions of the PMR program among parents of adolescents with mental illness.

CONCLUSION:
The PMR program adopted in this study was highly effective in reducing stress, anxiety, and depression among parents of adolescents with mental illness.
Opinion on agile methodology in education among the nursing students
Authors: Thiyagarajan Suseela , Saldanha Prakash R. M. , Govindan Radhakrishnan , Leena Kunnath Chacko , Prathyusha P Vasuki 
Published: November 2024

BACKGROUND:
Agile methodology (AM) is an innovative, active, project-based learning method. The scrum is a popular agile framework widely used in project management and education. This study evaluates the opinions on agile adaptation in nursing curricula among nursing students to identify how AM can be applied in higher education to facilitate learning.

MATERIALS AND METHODS:
The study employed a cross-sectional design and was conducted at two colleges affiliated with health science university, Bengaluru, India in 2021-22. A 23-item agile scrum perception tool (ASPT) was used to evaluate the opinions on AM among the nursing students after the agile training. The data were analyzed by using IBM SPSS version 28. Descriptive statistics was used to evaluate the opinion.

RESULTS:
A total of 133 students responded to the questionnaire. Nearly, 99 (74%) of the students strongly agreed the team leader’s (TL) responsibility for managing the time was good. Around 109 (82%) of the students felt that the product owner (PO)/outcome evaluator (OE) explained the course objectives well. About 107 (76%) of students strongly agreed that the learning was facilitated by AM.

CONCLUSION:
The agile scrum framework (SF) can be taught and fostered to improve collaborative learning, teamwork, leadership abilities, and educational outcomes. The policymakers should set the criteria for implementing agile in the curriculum, and nurse managers should allocate the budget for organizing the training program in the form of workshops and conferences for the nursing educators and nurses which could help to improve the self-directed learning and safe collaborative quality of patient care.