Advances in Nursing & Midwifery

Introduction: Childbirth is one of the divine gifts for the production of the human race on earth; but one of the important factors involved in avoiding vaginal childbirth is the childbirth self-efficacy. On the other hand, many changes occur during pregnancy that lead to increased depression, anxiety, and distress. Whereas self-efficacy affects all aspects of behavior and emotional activities such as anxiety, stress, and thought patterns; therefore, this study was aimed to determine the relationship of depression, anxiety, and stress with childbirth self-efficacy in nulliparous pregnant women.

Methods: This study is a descriptive- predictor correlation study that it is done over 323 nulliparous pregnant women referring to health centers in Zahedan city in 2020-2021. Data were collected using Individual questionnaire, Lowe childbirth self-efficacy questionnaire and DASS21 scale. The data was analyzed using Spearman correlation coefficients test, Liner regressions model and Multiple regression in SPSS version 22. A statistical significance was deemed present when the P-value was less than0.05.

Results: Results of Spearman correlation coefficients test didn’t show a significant direct correlation between childbirth self-efficacy with depression, anxiety and stress (p>0.05). According to Liner regressions model, none of the variables of depression, anxiety and stress had a significant level of less than 0.05 and isn’t considered as a predictor variable of childbirth self-efficacy(p>0.05).

Conclusion: Since there is no significant relationship between depression, anxiety and stress with childbirth self-efficacy in nulliparous pregnant women, it is suggested that more studies be conducted in this field with more samples and in other societies.

Abstract
Introduction: Recent studies suggest that shift work can be associated with the incidence of metabolic syndrome. The present study was conducted in 2019 to investigate the relationship between metabolic syndrome and shift work in midwives working in hospitals affiliated to universities of medical sciences in Tehran, Iran.
Methods: The present analytical cross-sectional study recruited 216 midwives who satisfied the inclusion criteria. Questionnaires were first used to collect demographic information and job records. Waist circumference and blood pressure of the subjects were then measured. A 12-hour fasting blood test was performed to determine fasting blood sugar (FBS), triglyceride and HDL levels. The frequency of metabolic syndrome was ultimately evaluated based on the Harmonized criteria. Data were analyzed in SPSS using the Chi-square and Fisher's exact tests.
Results: The prevalence of metabolic syndrome was found to be 6.9% in the midwives using the Harmonized criteria. Although the prevalence of metabolic syndrome was higher in the night-shift workers (11.5%) compared to that in the other two groups, but the difference was not significant. Low HDL cholesterol and abdominal obesity were respectively the most frequent metabolic syndrome criteria. Significant relationships were observed between low HDL cholesterol and night shift (P<0.001), and also between abdominal obesity and rotational shift work (P<0.001).
Conclusions: According to the present findings, a higher prevalence of metabolic syndrome was observed in the night-shift workers, and rotational shift work was found to be significantly associated with two of the metabolic syndrome criteria, namely low HDL levels and abdominal obesity.

Abstract
Introduction: Providing safe care is one of the nursing goals and medication errors are considered as one of the threatening factor for patient safety. The aim of this study was to determine the nursing students’ experience of medication errors and its related factors.
Methods: This descriptive cross-sectional study was conducted on 120 nursing students, from third to eighth semester, in Kurdistan University of Medical Sciences, Iran, enrolled through the census. Data collection was performed using a three-part questionnaire including demographic features, types of medication errors and its causes. Data were analyzed through using descriptive statistics, Chi-square, Fisher's exact test, and correlation coefficient.
Results: The average number of student medication errors in the past semester was 20 (16.4%), in which 16 (13.1%) of them reported their errors. The most common types of medication errors was errors in determining the type of medication (66.4%, n=81). Also, the most common cause of medication errors in the viewpoints of nursing students were the lack of pharmacological information among students (83.1%, n=102), illegibility of drug orders (76.3%, n=93) and distraction (73.8%, n=90).
Conclusions: Based on the findings of this study, effective clinical and theoretical pharmacological educations are essential for increasing the pharmaceutical information of the students in order to reduce the amount of medication errors. It is necessary to increase the pharmacological information of nursing students by organizing various pharmacological workshops and giving time to students from training and internship to pharmaceutical conferences.

Abstract
Introduction: One of the ways to improve the quality of life of patients with thalassemia major is to empower patients through education to deal with the effects and complications of illness and control disease and life further. This study aimed to determine the impact of E-learning intervention on self-care behaviors in patients with thalassemia major.
Methods: The present study is a quasi-experimental study of clinical trial type. The effect of e-learning on the lifestyle of eligible adolescents with thalassemia major of both sexes referred to Razi, and Bu Ali Sina Hospitals was investigated. Samples were divided into two groups control (N=25) and intervention (N=25). The control group received routine training from the relevant centers or health care staff, and the intervention group received e-learning and regular exercise. Data were collected through valid and reliable questionnaires, including two main parts. The first part contains demographic information. The second part of the questionnaire was a standard health-promoting behaviors questionnaire that assesses the lifestyle of adolescents in three dimensions nutrition, physical activity, and stress management. Finally, data were analyzed using SPSS version 22, and P-value less than 0/05 was considered significant.
Results: Obtained results demonstrated a significant difference in the quality of nutrition in adolescents with thalassemia before e-learning intervention between intervention and control groups (P< 0.05). Moreover, after the intervention, there was a significant difference in the stress management of the intervention and control groups, and the scores of the intervention group increased significantly (P< 0.05). The findings also indicated that physical health was also considerably increased in adolescents with thalassemia after intervention by e-learning compared to the control group (P< 0.05).
Conclusions: It can be concluded that e-learning has a significant effect on patients' quality of life with thalassemia in three dimensions: nutrition, physical and mental health. The results of this study can serve as a guideline for designing appropriate educational programs for thalassemia patients.

Introduction: Nursing research has dramatic effects on nursing practice. Studying the history of nursing research can provide valuable information about past challenges and future prospects. This study aimed to explore the history of nursing research methodology in Iran.
Methods: This was a mixed methods study. In the quantitative part, articles published by nurses in the last four decades were reviewed using a checklist. In the qualitative part, several Iranian nursing doyens and experts were recruited through purposeful and snowball sampling and interviewed through semi-structured interviews. The main focus of the interviews was on the history of nursing research methodology in Iran. Qualitative data were analyzed through conventional content analysis. Finally, the findings of the two parts were merged.
Results: The number of nursing articles and journals increased from 39 and one in the 1980s to respectively 461 and thirty in the 2010s. Articles published in the 1980s and the 1990s were mainly related to descriptive researches (91.9% and 88.4%, respectively), while articles in the 2000s were mainly related to quasi-experimental researches (42.8%) and articles in the 2000s were mainly related to quasi-experimental and experimental researches. Qualitative researches become common in the 2010s. The results of the qualitative part were presented based on three era.
Conclusions: Nursing research in Iran has had significant improvements in the last three era. Yet, nurses need to make more serious attempts to provide conclusive evidence for nursing practice, improve the Iranians’ health status, and promote the position of nursing in Iran and the position of Iranian nursing in the world.

Introduction: The increasing global rates of adolescent morbidity and mortality highlights problems such as suicide during puberty. Adolescent suicide prevention along with adolescent health in general comprise a priority on the global agenda. Since suicide is associated with several behavioral symptoms, the present study seeks to present a narrative review of suicide risk factors among adolescents.
Methods: The present review study was conducted between January 2000 and November 2017 by navigating the Science Direct, Scopus, Web of Science, Cochrane, PsycINFO, Google Scholar and PubMed databases to find relevant articles containing the keywords “suicide” and “adolescent.” Of the 49,450 articles obtained from this search, 85 relevant articles were selected for review.
Results: According to the findings of the present study, suicide risk factors can be classified into three categories: Social and community risk factors, relationship risk factors and individual risk factors. Some studies examined several risk factors at the same time and all the studies investigated individual risk factors.
Conclusions: A large number of suicides are committed in association with behavioral symptoms and many have intersectionality. Recognizing these factors may contribute to suicide prevention and mediation. Adolescent-friendly services provided in accordance with the distinct culture of each society are considered an effective measure for suicide prevention.