Journal of Research Development in Nursing and Midwifery

Whom can I rely on? Confronting Self-Stigma in patients undergoing methadone maintenance treatment

Pedram Abolfathpour

Letter to the Editor

Concept analysis of adherence to treatment in hemodialysis patients: Using a hybrid model

Farahnaz Mohammadi-Shahboulaghi

Background: Treatment adherence (AT) can enhance hemodialysis patients' quality of life and life expectancy. Nurses in the healthcare system can benefit from understanding this concept, its attributes, antecedents, and consequences. This study aims to clarify the concept of AT in hemodialysis patients.
Methods: A three-phase concept analysis was conducted utilizing a hybrid model. In the theoretical phase (first phase), a literature review was conducted using PubMed, Web of Science, ProQuest, EBSCO, Scopus, Google Scholar, SID, and Magiran search engines. In the fieldwork phase (second phase), semi-structured interviews were conducted with eight patients and nurses. The final analysis (third phase) combined the results from the previous phases.
Results: The characteristics of treatment adherence include being process-oriented, actively participating in therapy, being patient-centered, accepting responsibility for treatment, and being committed to the treatment process. To understand this concept, antecedents related to the patient, society, and the health care system must be considered. As a result of the emergence of this concept, patients' quality of life has been improved, and healthcare costs have been reduced.
Conclusion: This study provides insight into the characteristics of adherence to treatment and the factors that influence its proper implementation. This program will assist healthcare providers in better understanding this concept and improving their clinical practices for hemodialysis patients.

Exploration of the needs and potential spiritual capacities of mothers of premature infants hospitalized in the neonatal intensive care unit: A Qualitative Study

Narges Yaghoobi Beglar

Background: The birth of a premature baby and the long treatment process lead to conflict and inconsistency between the hope, values, and beliefs of mothers and the occurrence of spiritual distress. This study aims to explore the needs and potential spiritual capacities of mothers of premature babies admitted to the NICU.
Methods: This qualitative content analysis study included 15 mothers of premature infants hospitalized in four neonatal intensive care units in Mashhad, Iran, in 2021. The participants were selected using purposeful sampling and engaged in deep, semi-structured interviews with the FICA (faith, importance, community, address) questionnaire. The study included mothers of premature babies born between 28 and 32 weeks who were hospitalized for at least three days, did not have mental disorders, and were identified as Iranian or Muslim. The data were analyzed using the content analysis method developed by Granheim and Lundman.
Results: The data analysis revealed four main themes. The first theme referred to "potential spiritual capacities," with subthemes including belief in a divine source, belief in religious rituals, and empathetic support. The other three themes refer to spiritual needs, including “challenges of faith,” encompassing subthemes of doubts in beliefs and guilt, “need for compassionate care,” which includes subthemes related to the necessity of a deep connection between the nurse and the mother, the need for dignity in care, and finally, ‘need for value and positive expectations,’ featuring subthemes addressing the challenges of meaning of life and the need for hope, highlights the spiritual needs of mothers.
Conclusion: Many parents of premature babies share similar spiritual needs. This research provides a new perspective for understanding the spiritual needs of premature baby mothers. Nurses should assess these needs and design appropriate interventions according to their potential spiritual capacities.

Fertility intention and its sociodemographic correlations among female marriage volunteers: A province-wide cross-sectional survey in Iran

Abedin Iranpour

Background: Declining fertility rates pose significant demographic challenges globally, particularly in Europe, the Asia-Pacific region, and Iran. Female marriage volunteers, as a group capable of having children, are a key target for pronatalist policies. We aimed to identify the factors influencing fertility intention among Iranian female marriage volunteers.
Methods: We conducted a province-wide cross-sectional survey from January to April 2023. Using a convenience sampling approach and a validated questionnaire (Determinants of Childbearing Intention Questionnaire), we assessed the childbearing intention (i.e., intention to have a child during the next three years) and fertility intention (i.e., ideal number of kids) among 1,506 female marriage volunteers in Kerman, Iran. Data were collected through face-to-face interviews and the sealed ballot box method was applied to ensure the confidentiality of the participants’ information. Multivariate logistic regression was used to identify the factors associated with childbearing and fertility intentions.
Results: The majority of the female marriage volunteers (83.7%) intended to have two or more children, and 61.8% of them intended to have a child during the next three years. They believed that the most appropriate time to have a child after marriage was 2.2 (±1.8) years. Physical and mental health, with a mean of 4.37 (0.94) out of a possible score range of 0 to 5, was the most important perceived barrier to having children. The participants stated that the most appropriate ages for women and men to marry were 22.1 (3.7) and 26.2 (3.9) years, respectively. The vertical collectivism score was 3.90 (0.85) out of the maximum attainable score of 5. The working or educational situation of premarital women was a barrier against fertility intention (OR=0.82; CI95%= 0.71-0.94, p<0.001) and childbearing intention (OR=0.81; CI95%= 0.73-0.89, p<0.001).
Conclusion: Despite the decline in the total fertility rate, the tendency to have children is still promising in Iranian female marriage volunteers. Their concern about work and education was the main obstacle to their childbearing intention. This finding underlines the need to implement supportive measures for having children, as seen in the law.

The relationship between informatics competency and clinical competency in nurses working in intensive care units: A Cross-sectional Study in Northeast Iran

Shohreh Kolagari

Background: The use of information technology improves the competency of nurses at the bedside. This study was conducted to determine the relationship between informatics competency and clinical competency in nurses working in intensive care units.
Methods: In this cross-sectional study, 135 nurses employed in intensive care units affiliated with Golestan University of Medical Sciences, Iran, were included. The inclusion criteria were having at least a bachelor's degree in nursing, a minimum of six months of work experience in the ICU, and current employment in the ICU. The participants were enrolled in 2023 using a stratified sampling method with proportional allocation. Data were collected using demographic information forms, clinical competency questionnaires, and informatics competency questionnaires. Statistical inferential tests included Mann-Whitney, Kruskal-Wallis, multiple linear regression, and generalized multiple linear regression models. The significance level for all statistical tests was set at 0.05.
Results: The mean scores of the nurses' clinical competency and informatics competency were 58.41±8.80 and 45.67±18.88, respectively. There was no statistically significant correlation between these two variables (r = -0.07, p-value = 0.42). When examining the simultaneous effect of explanatory variables, only work experience in the ICU had a significant association with clinical competency (β = 0.3, P = 0.02). Moreover, informatics competency was significantly associated with gender (β = -12.93, P = 0.001) and the duration of using health information systems (β = -6.22, P = 0.008).
Conclusion: There is no significant relationship between informatics competency and clinical competency among ICU nurses. It is suggested that health system policymakers introduce the components of nurses' informatics competence and emphasize their importance in the clinical setting to improve the quality of care. In addition, nurses should be encouraged to enhance their professional skills and acquire competency in new approaches by gaining updated knowledge.

Examining religious attitudes and mental well-being in post-earthquake trauma

Şükran Başgöl

Background: Natural disasters, such as earthquakes, can traumatize survivors and affect various aspects of their lives, including mental health and quality of life. This study explores religious attitudes, mental well-being, and post-earthquake trauma among female survivors of the 2023 Kahramanmaraş earthquake in Türkiye.
Methods: This cross-sectional study was conducted from 18 May to 18 June 2023, involving 618 female survivors aged 18 and older affected by the 2023 Kahramanmaraş Earthquake. Participants voluntarily completed an online survey via social media platforms and group forums. The data were collected using a “sociodemographic form,” “The Ok-Religious Attitude Scale,” “The Warwick-Edinburgh Mental Well-being Scale,” and “Post-Earthquake Trauma Level Determination Scale.” Data analysis was conducted using SPSS 25.0. Descriptive statistics were presented using numbers, percentages, means, and standard deviations. Independent samples t-tests and one-way ANOVA were conducted to compare the means between groups. Pearson’s correlation was used to assess relationships between continuous variables, and linear regression was performed for further analysis. The significance level for all analyses was set at p < 0.05.
Results: Female survivors demonstrated strong religious beliefs, maintained good mental well-being, and reported below-average levels of post-earthquake trauma. A significant positive relationship was found between women's religious attitudes and mental well-being (r=0.57, p=0.0001). Additionally, there was a significant positive relationship between religious attitudes and trauma levels (r=0.20, p=0.0001). Furthermore, mental well-being and trauma levels were significant predictors of religious attitudes.
Conclusion: Healthcare professionals should consider the role of religious beliefs in coping with trauma and maintaining mental well-being in counseling, intervention, and support strategies.

Perspectives on HIV stigma in Asia and Middle East: Legal protections, ethical considerations, and public health solutions

Forouzan Akrami

Perspective

The perception of shared governance among nurses at Dar Al Shifa Hospital in Kuwait in 2024

Ahmad Fawzi Aldmour

Background: Shared governance empowers nurses by allowing them to participate in decision-making and be accountable for their professional practices. Involving nurses in decision-making creates a positive workplace culture. Therefore, our objective was to assess the perception of shared governance among nurses working at Dar Al Shifa Hospital in Kuwait.
Methods: The study employed a descriptive design and recruited 454 participants utilizing a convenient sampling technique. Data were collected between March 2024 and May 2024 through an online self-administered questionnaire, using the Index of Professional Nursing Governance (IPNG 3.0). The data were analyzed using descriptive statistics, ANOVA, post-hoc analysis, and the independent sample t-test.
Results: Findings showed that nurses at Dar Al Shifa Hospital perceived the first level of shared governance in their working environment (Mean±SD: 100.31±25.01). All IPNG subscales indicated shared governance levels except for the personnel and participation subscales. The results revealed no statistically significant differences between registered nurses and nurse managers regarding the level of shared governance (P = 0.231). In addition, there were no statistically significant differences between the nurses' sociodemographic data and the level of shared governance except for the years of experience in Dar Al Shifa Hospital (P = 0.044).
Conclusion: The results showed that the nurses perceived the first level of shared governance range in their working environment, indicating that decisions were made primarily by the nursing administration with some staff input. Therefore, implementing a shared governance model, continuous education, and training could improve the nurses' perception of shared governance.

Sarcopenia, functional capacity, and physical components of quality of life in older adults Mexicans: An explanatory model

Josué Arturo Medina-Fernández

Background: Sarcopenia, characterized by the progressive loss of muscle mass and strength, significantly impacts functional capacity and quality of life (QoL) in older adults. Among Mexican seniors, this condition exacerbates physical limitations, compromising daily activities and independence. The objective was to model the effect of sarcopenia on functional capacity and physical components of health-related QoL in older adults.
Methods: The study has a predictive correlational design with a sample population of 144 older adults from Coahuila, Mexico in 2024. A demographic and clinical form was applied, containing measurements of calf circumference, body mass index (BMI), grip strength with a dynamometer, gait speed and appendicular skeletal muscle mass, simple questionnaire to rapidly diagnose sarcopenia, a subscale of physical components of the SF-36, Barthel Index for Activities of Daily Living (BADL), and Lawton-Brody scale. The data were analyzed with SPSS software version 20 using central tendency and dispersion, Kolmogorov Smirnov test, Mann Whitney U test, Spearman test, and simple linear regressions. Moreover, structural equation was assessed using EQS software version 6.1.
Results: The results showed that the prevalence of sarcopenia was 44.8%, and sarcopenia significantly and negatively affected the basic activities of daily living (r=-0.46, p=0.001). In the same way, it negatively and significantly affected the instrumental activities of daily living (r=-0.41, p=0.001), meanwhile, it positively and significantly affected the physical components of quality of life (r=0.43, p=0.001).
Conclusion: Therefore, it is concluded that sarcopenia negatively influences the physical components of QoL and functional capacity.

Investigating the effect of mindfulness-based art therapy on self-efficacy of multiparous and nulliparous women: A randomized controlled trial

Zahra Rahemi

Background: Labor pain is a common concern among pregnant women, leading to fear and anxiety. Enhancing self-efficacy can play a crucial role in managing these complications. This study aims to evaluate the effect of mindfulness-based art therapy on the self-efficacy of multiparous and nulliparous women.
Methods: The present study was a randomized clinical trial with three parallel intervention arms (multiparous and nulliparous groups) and a control. The statistical population of the study included pregnant women (multiparous and nulliparous groups) referring to health centers (public and private) in Bandar Abbas city for prenatal care. A total sample size of 90 participants was determined, with 30 individuals randomly assigned to each group using a block randomization method. Participants were selected based on inclusion and exclusion criteria. Interventions were conducted in eight sessions, with 3 to 15 people in each group, in a face-to-face and coherent manner. Participants in the intervention and control groups were assessed three times: before the intervention, immediately after the intervention, and four weeks after the intervention using the Iranian Childbirth Self-Efficacy Questionnaire and the Five-Factor Mindfulness Questionnaire. The data were then analyzed using SPSS version 26 software, employing ANOVA and repeated measures tests. A significance level of less than 0.05 was considered.
Results: The mean self-efficacy scores for expectations during the active stage of labor immediately after the intervention were 162.07±11.28 (nulliparous), 163.07±12.02 (multiparous), and 145.77±27.50 (control group). Four weeks post-intervention, the scores were 162.07±11.98 (nulliparous), 163.07±12.02 (multiparous), and 145.77±27.50 (control group). The mean self-efficacy scores for expectations during the fourth stage of labor immediately after the intervention were 155.21±10.80 (nulliparous), 156.21±11.12 (multiparous), and 122.77±24.96 (control group). Four weeks after the intervention, these scores were 152.46±10.29 (nulliparous), 154.23±11.34 (multiparous), and 121.23±27.42 (control group). The mean mindfulness scores in both intervention groups (multiparous and nulliparous) were significantly higher immediately after the intervention (p=0.001) and four weeks later (p=0.001) compared to baseline.
Conclusion: The results indicated the effectiveness of mindfulness-based art therapy in enhancing self-efficacy and mindfulness among pregnant women. Thus, it is recommended that this therapeutic method be utilized to manage and reduce the fear of childbirth in pregnant women.

Acknowledgment to Referees 2024

Leila Mahasti Jouybari

The editorial team at the Journal of Research Development in Nursing and Midwifery would like to extend our heartfelt gratitude and recognition to the reviewers who dedicated their time and expertise to review manuscripts for J Res Dev Nurs Midw in 2024. Your commitment and contributions have been invaluable in maintaining the high quality of the articles published in our journal. We sincerely appreciate all the exceptional scientists, researchers, and clinicians who have served as reviewers and have been an integral part of our community.
Editor-in-Chief
Prof. Leila M Jouybari

Akram Sanagoo
Associate Professor of Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Ali Kavosi
Instructor of Nursing Education, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Elham Adibmoghaddam
Assistant Professor of Reproductive Health, Department of Midwifery, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Elham Khoori
Associate Professor of Reproductive Health, Department of Midwifery, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Elham Lotfalinezhad
Assistant Professor of Gerontology, Department of Psychiatry and Community Health Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Farzaneh Barati
Assistant Professor of Nursing, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Fatemeh Mehravar
Assistant Professor of Epidemiology, Department of Biostatistics and Epidemiology, Faculty of Health Golestan University of Medical Sciences.
Fereshteh Araghian
Assistant Professor of Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences.
Hamideh Mancheri
Assistant Professor of Nursing Education, Department of Psychiatry and Community Health Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Katayoun Jalaliaria
Instructor of Midwifery, Department of Midwifery, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Khadijeh Yazdi
Associate Professor of Nursing, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Leila Asadi
Assistant Professor of Reproductive Health, Department of Midwifery, School of Nursing and Midwifery, Nursing and Midwifery Care Research Center, Shahid Sadoughi University of Medical Sciences.
Maryam Chehrehgosha
Instructor of Nursing,Department of Operating Room, Faculty of Allied Medical Sciences, Golestan University of Medical Sciences.
Mousa Ghelichi-Ghojogh
Assistant Professor of Epidemiology, Department of Biostatistics and Epidemiology, School of Health, Metabolic Disorders Research Center, Golestan University of Medical Sciences.
Narjes Sadat Borghei
Associate Professor of Reproductive Health, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Dr. Negarin Akbari
Department of Nursing, Faculty of Health Sciences, Fenerbahçe University, İstanbul, Turkey
Samira Foji
Assistant Professor of Nursing, Sabzevar University of Medical Sciences.
Sepipideh Mashayekh-Amiri
Assistant Professor of Midwifery Education, Department of Midwifery, Faculty of Nursing and Midwifery. Golestan University of Medical Sciences.
Shohreh Kolagari
Associate Professor of Nursing, Department of Medical Surgical Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Somayeh Ghorbani
Assistant Professor of Biostatistics, Rheumatology Research Center, Golestan University of Medical Sciences.

Tayebe Ziaei
Associate Professor of Reproductive Health, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Vida Shafipour
Associate Professor of Nursing Education, Department of Neonatal and Pediatric Nursing, School of Nursing and Midwifery, Mazandaran University of Medical Sciences.
Zahra Sabzi
Associate Professor of Nursing, Department of Reproductive Health Midwifery, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.
Zeinab Ebrahimpour
Assistant Professor of Nursing, Faculty of Nursing and Midwifery, Golestan University of Medical Sciences.