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.

Knowledge on Newborn Life Support among the Healthcare Providers in a Tertiary Care Maternity Hospital in the Southern Province, Sri Lanka

Introduction. The newborn life support (NLS) is a set of educational guidelines established by the academies of Paediatrics that outline the proper procedures for resuscitation of a newborn. The objective of this study was to determine the knowledge on NLS among the healthcare providers (HCPs) in a tertiary care maternity hospital in the Southern Province, Sri Lanka. Methods. A hospital-based cross-sectional study was carried out among doctors, nurses, and midwives, using a self-administered questionnaire. Comparison of knowledge among different categories was made using the chi-square test. Total sample of 191 consisted of 118 (61.8%) nurses, 33 (17.3%) midwives, and 36 (18.8%) doctors. The majority of HCPs (76.7%) had good knowledge of NLS; however, following guidelines on NLS among HCPs was poor (33%). According to the category, 91% of doctors and 78% of nurses had good knowledge, whereas only 48% of midwives had good knowledge. The difference of knowledge on NLS among different categories of HCPs was statistically significant ( p < 0.001 ). Only 33% of HCPs had good knowledge of following NLS guidelines. Of them, 52% were doctors, 31% were nurses, and only 18% were midwives. The difference in adherence to NLS guidelines among different categories of HCPs was highly significant statistically ( p = 0.003 ). Conclusion. The majority of the healthcare providers had good knowledge of NLS. There was a significant difference in the level of knowledge on NLS among different categories of HCPs. Gaps in the knowledge in following guidelines of NLS were noted in the majority. Newborn resuscitation has to be included in nursing and midwifery curricula, and training on NLS is essential in the orientation programs for newly recruited HCPs in maternity hospitals.

Spatial Distribution and Determinants of Nonautonomy on Decision Regarding Contraceptive Utilization among Married Reproductive-Age Women in Ethiopia: Spatial and Bayesian Multilevel Analysis

Background. Studies conducted to date in Ethiopia did not explore the spatial distribution, individual-level, and community-level factors affecting women’s nonautonomy on decision to use contraceptives. Hence, this study aimed to assess the spatial distribution of women’s nonautonomy on decision regarding contraceptive utilization and its determinants in Ethiopia. Methods. Data were accessed from the Demographic Health Survey program official database website (https://dhsprogram.com). A weighted sample of 3,668 married reproductive-age women currently using contraceptives was included in this analysis. Bayesian multilevel logistic regression models were fitted to identify the determinants of women’s nonautonomy on contraceptive utilization. Adjusted odds ratio with 95% credible interval was used to select variables that have a significant effect on nonautonomy on contraceptive utilization. Results. A high proportion of women with nonautonomy on decision regarding contraceptive utilization was found in northern parts of Southern Nations, Nationalities, and People’s Region, Southern parts of Oromia, and Benishangul-Gumuz regions of the country. Overall, 2876 (78.40% (95% CI: 77.0%, 79.7%)) women were nonautonomous on decision regarding contraceptive utilization. In the final model, age from 35–49 (AOR (95% CI) = 0.63 (0.54, 0.72)), living in the richer households (AOR (95% CI) = 0.12 (0.03, 0.26)), being married at 18 years or above (AOR (95% CI) = 0.33 (0.19, 0.57)), and residing in an rural areas (AOR (95% CI) = 1.34 (1.01, 1.71)) and metropolitan regions (AOR (95% CI) = 0.71(0.54, 0.91)) were associated with women’s nonautonomy on decision regarding contraceptive utilization. Conclusions. In Ethiopia, the spatial distribution of women’s nonautonomy on decision about contraceptive utilization was nonrandom. More than three-fourths of married reproductive-age women in Ethiopia are nonautonomous on decision regarding contraceptive utilization. Region, residence, current age, age at marriage, and wealth index were statistically associated with women’s nonautonomy on decision regarding contraceptive utilization.

Assessment of Knowledge, Attitude, and Practice of Skilled Assistance Seeking Maternal Healthcare Services and Associated Factors among Women in West Shoa Zone, Oromia Region, Ethiopia

Background. This study aimed to assess women’s knowledge, attitude, and practice towards skilled assistance seeking maternal healthcare services in West Shoa Zone, Oromia Region, Ethiopia. Methods. Cross-sectional survey design was conducted from 1 February to 23 March 2018 in West Shoa Zone, Oromia, Ethiopia. A simple random sampling technique was used to select the participants. The data were collected using a pretested and structured questionnaire. Data were entered using EpiData version 3.1, and descriptive analysis and bivariate and multivariate logistic regression analyses were carried out using SPSS version 20 statistical software package. Results. The study revealed that the knowledge, attitude, and practice towards skilled maternal health services were found such that 473.3 (72.4%) of the study participants had good knowledge, 180.7 (27.6%) had poor knowledge, and 400 (61.3%) had positive attitude, 254 (38.84%) had negative attitude, 460.3 (70.4%) had good practice, and 193.7 (29.6%) had poor practice towards skilled maternal health services. Factors that had a significant association with antenatal care utilization were planned pregnancy (AOR = 8.2, 95% CI = 3.39-19.78-0.87) and access to transport (AOR = 3.1, 95% CI = 1.46–6.61). Attending ANC at least once (AOR = 3.1, 95% CI = 1.13–8.41), women’s education (AOR = 3.0, 95% CI = 1.18–7.84), and unplanned pregnancy (AOR = 0.3, 95% CI = 0.21–0.75) were factors associated with skilled delivery service utilization. Attending ANC at least once (AOR = 2.1, 95% CI = 1.1–4.2), birth complications (AOR = 2.2, 95% CI = 1.35–3.66), unplanned pregnancies (AOR = 0.3, 95% CI = 0.22–0.68), and awareness about skilled obstetric care (AOR = 3.7, 95% CI = 1.68–12.79) were factors associated with postnatal care utilization. Conclusions. This study found that the knowledge, attitude, and practice of skilled maternal health services among the study participants are low, showing less than three-quarters of the total sample size. Therefore, this study implied that interventions are required to improve women’s knowledge, attitude, and practice of skilled maternal health services in the study area. Furthermore, women’s education is significantly associated with skilled delivery service utilization. Accordingly, this study recommends that improving equity among the marginalized population is needed to increase maternal health service coverage.

Nursing Students’ and Preceptors’ Experiences with Using an Assessment Tool for Feedback and Reflection in Supervision of Clinical Skills: A Qualitative Pilot Study

Background. There is a need to improve students’ learning in clinical practice. Undergraduate students need guidance when it comes to transferring knowledge from the classroom to clinical practice in community health services. Competence Development of Practical Procedures (COPPs), a simulation assessment tool, was used to explore students’ and preceptors’ experiences with feedback and reflection during the supervision of clinical skills in real practice. Method. This was a pilot study with a qualitative exploratory and descriptive research design. Four students in their first year of a bachelor’s programme in nursing and four preceptors participated. Data were collected from eight clinical skills performance assessments, audio recordings of supervision, and open-ended questionnaires. Data were systematized, categorized, and analysed using qualitative content analysis. Findings. Participants’ experiences were divided into five categories: “learning environment, an atmosphere of respect, acceptance, and encouragement,” “students’ reflections on their own personal learning,” “students’ reflections on various care situations,” and “students’ and preceptors’ assessment and feedback.” Participants found COPPs easy to use and providing structure for assessment, feedback, and reflection during supervision. Concepts related to learning clinical skills became visible for both students and preceptors and helped students assess their performance of clinical skills. Through verbalization and reflection in supervision, participants established a consensus around what students knew and what they needed to learn. Conclusions. The students and preceptors experienced the tool as a supportive structure to enhance feedback and reflection for the learning of clinical skills in municipal healthcare services. COPPs filled a gap in practice by providing a language for students and preceptors to articulate their knowledge and increasing students’ awareness of what constitutes a good performance. The tool supported the coherence of concepts, enhanced clinical reasoning, and promoted deeper thinking and reflection, and the students gained insight into their own needs related to learning clinical skills.

Nursing and Midwifery Students’ Satisfaction with Their Clinical Rotation Experience: The Role of the Clinical Learning Environment

Background. The clinical learning environment and clinical rotation experience of students are integral to nursing curriculum and are a crucial component of nursing education which helps transform theoretical knowledge to clinical practical skills. Objective. This study was aimed at assessing the role of the clinical learning environment on undergraduate nursing and midwifery students’ satisfaction with their clinical rotation experience. Method. The study employed a quantitative cross-sectional survey design. Data was collected from a sample of 240 undergraduate nursing and midwifery students of the University for Development Studies, Tamale, Ghana, using a structured questionnaire. Ethical approval was obtained from the University of Cape Coast Ethics Review Board. Descriptive analysis was displayed as frequencies and percentages. Inferentially, Fisher’s exact test, linear regression, and Spearman’s correlation tests were used to test for and quantify associations between independent and dependent variables at p ≤ 0.05 . Results. The level of students’ satisfaction with both clinical rotation experience and the clinical learning environment was high (65.6% and 63.5%, respectively). A statistically significant association of the students’ satisfaction with their clinical rotation experience was found. There was a statistically significant relationship between the clinical learning environment (χ2 (9, N = 224) = 80.665, p < 0.001 ), pedagogical atmosphere in the clinical area (rs = 0.379, p < 0.001 ), the leadership style of the ward manager (rs = 0.340, p < 0.001 ), the premises of nursing in the ward environment (rs = 0.501, p < 0.001 ), and the students’ satisfaction with their clinical rotation experience. Conclusion. These findings provide nurse educators and clinicians with meaningful understanding about areas to prioritise when planning clinical learning opportunities in such a way that skills learning and practice of nursing skills are successful and satisfactory for undergraduate student nurses and midwives.

Students’ Perspectives on Learning Practical Nursing Skills: A Focus Group Study in Norway

Practical nursing skills are complex and involve technical, theoretical, and practical aspects, caring perspectives adjusted to both patient and circumstances, as well as ethical and moral considerations. Patients’ length of stay in hospitals is decreasing, and more advanced patient treatment is conducted in primary healthcare settings. Hence, education and nursing skills need adjustment in line with the rapidly evolving field of practice. Studies emphasize a need to uncover whether the technical aspect of nursing skills, in general, is challenging in students’ learning. The aim of this study was to explore students’ perspectives on practical nursing skills and how they can best learn these. Three focus group interviews were conducted with registered nurse students and intellectual disability nurse students in their last semester (n = 11). Conventional, inductive content analysis in line with recommendations from Hsieh and Shannon was used to analyze the data. Two main categories with subcategories were identified: (1) the content of practical skills, with subcategories (a) human-to-human relations, (b) organizational competence, and (c) technical mastering and (2) building competence, with subcategories (a) need for supervision, (b) planning the learning situations, and (c) relevance for practice. Students experienced that practical skills did not only include technical aspects but also the ability to establish a relationship to the patient and to organize their working day. Supervising was assumed as essential both when training in the simulation center and in clinical placement, as well as planning of the training, respectively. Students experienced that some skills learned in the university college were less relevant in clinical practice and that certain skills were difficult to perform in practice due to the type of clinical placement. Hence, there is a need to review the approach to and content of practical nursing skills’ learning in healthcare undergraduate programs, to prepare students for clinical practice, and to ensure that they build the competence needed in healthcare services.

The Influence of Person-Environment Fit on the Turnover Intention of Nurses in Jordan: The Moderating Effect of Psychological Empowerment

There is an acute shortage of nurses worldwide, including in Jordan. The nursing shortage is considered to be a crucial and complex challenge across healthcare systems and has stretched to a warning threshold. High turnover among nurses in Jordan is an enduring problem and is believed to be the foremost cause of the nurse shortage. The purpose of this study was to investigate the multidimensional impact of the person-environment (P-E) fit on the job satisfaction (JS) and turnover intention (TI) of registered nurses. The moderating effect of psychological empowerment (PE) on the relationship between JS and TI was also investigated. Based on a quantitative research design, data were collected purposively from 383 registered nurses working at private Jordanian hospitals through self-administered structured questionnaires. Statistical Package for Social Sciences (SPSS) 25 and Smart Partial Least Squares (PLS) 3.2.8 were used to analyze the statistical data. The results showed that there is a significant relationship between person-job fit (P-J fit), person-supervisor fit (P-S fit), and JS. However, this study found an insignificant relationship between person-organization fit (P-O fit) and JS. Moreover, PE was also significantly moderate between JS and TI of nurses. This study offers an important policy intervention that helps healthcare organizations to understand the enduring issue of nurse turnover. Additionally, policy recommendations to mitigate nurse turnover in Jordan are outlined.

A Multisite Study on Knowledge, Perceived Motivators, and Perceived Inhibitors to Precepting Nursing Students within the Clinical Environment in Ghana

Background. Preceptorship constitutes an important component of the educational process of training nursing students. The purpose of this study was to assess the knowledge, perceived motivators, and perceived inhibitors to precepting nursing students at the clinical placement sites in the Cape Coast Metropolis of the Central Region of Ghana. Methods. A descriptive cross-sectional study was conducted among 442 nurses and midwives aged 27–56 years with at least three years of work experience. Data were collected with a questionnaire and analyzed using frequency counts, percentages, exploratory factor analysis, and point biserial correlation. Results. The results indicate that the participants had a high knowledge of preceptorship of up to 91.2% (n = 404). A significant proportion of up to 88.2% (n = 390) had an intention to precept nursing students in the near future. The three important perceived motivational factors to precepting nursing students were the learning and professional needs of students, helping students to develop skills, and experience and formal recognition of the role of preceptorship. The main perceived inhibitors to engage in a preceptorship role were lack of preparation for the role, lack of support from faculty and nurse managers, and additional work burden. The results further indicate a significant strong positive correlation between experience and professional recognition of preceptorship and the intention to precept nursing students in the near future (r = 0.99, p = 0.037 ). Conclusions. The nurses and midwives who participated in the study are knowledgeable about preceptorship and have the intention to precept nursing students. Having enough experience on the job and being formally recognized as a preceptor may motivate these professionals to precept nursing students. However, there are critical perceived barriers that need to be addressed, to enable more nurses and midwives with the desire to precept students to engage in the preceptorship role.

Depression and Anxiety among Patients with Type II Diabetes Mellitus in Chitwan Medical College Teaching Hospital, Nepal

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.