Advances in Nursing & Midwifery

Abstract
Introduction: The Covid 19 pandemic has increased the stress and fear of the society. Evaluating the reflections of the pandemic on nursing students' first clinical practices are important in terms of ensuring the adaptation to the practice. The aim of this study is to determine the stress levels and coping behaviours of nursing students during the COVID-19 pandemic.
Methods: This study descriptive and correlational. The data were collected from nursing students who were started first clinical practice. This study was carried out in the nursing department of a public university, Turkey. The purposive sampling method was used in this study. The research was carried out with 203 volunteers. The Perceived Stress Scale for Nursing Students (PSSNS), the Coping Behaviours of Stress Scale for Nursing Students (CBSSNS) were used to collect the data and started first experience of clinical practice.
Results: The mean age of the students was 20.79±2.29, 79.3% were afraid of having a negative experience. The mean score of PSSNS was 58.23±22.48. The maximum stress experienced by the students was observed in the subscale “stress from taking care of patients” (16.58±6.71). The most frequently used coping behaviour was “Avoidance” (13.39±4.33).
Conclusions: It was determined that the nursing students had moderate level of stress during their first clinical practice during the pandemic period, they experienced the most stress while caring for the patient, and they used the avoidance approach the most.

Abstract
Introduction: The mental health of the nurses is of utmost importance to accomplish the ideal goals of communities in terms of reducing financial and spiritual costs. The present study aimed to investigate the relationship between subjective well-being with mindfulness and cognitive flexibility in nurses of psychiatric wards of hospitals in Ahvaz city using an artificial neural network (ANN).
Methods: This was a descriptive and correlational study. The statistical population of this study comprises all nurses of the psychiatric ward of hospitals in Ahvaz city, Iran, in 2022. Accordingly, 200 nurses were selected through convenience sampling. The research instruments included the Kentucky Inventory of Mindfulness Skills, the Subjective Well-being Scale, and the Cognitive Flexibility Inventory. The data were analyzed using descriptive and inferential statistics, Pearson correlation coefficient and simultaneous regression, and ANN.
Results: The results suggested a positive and significant relationship between mindfulness and subjective well-being, and between cognitive flexibility and subjective well-being (P<0.001). Furthermore, the subjective well-being of nurses had multiple relationships with mindfulness and cognitive flexibility (P<0.001). Following the results of the ANN, cognitive flexibility demonstrated the highest estimation in predicting subjective well-being.
Conclusions: Mindfulness and cognitive flexibility of nurses had a significant relationship with their subjective well-being. The results suggested the necessity to emphasize the appropriate methods of mindfulness and cognitive flexibility, which can be obtained by holding proper workshops and training programs.

Introduction: The world is currently facing the drug crisis as a serious threat. This study was conducted with the aim of investigating the structural modeling of the relationship between distress tolerance and quality of life based on the mediating role of religious beliefs in opioid abuse patients.
Methods: The method of this research is descriptive correlation based on the model of structural equations. The statistical population of this research included all patients suffering from opioid abuse who referred to the community center for addiction treatment in SAYEBANE ARAMESH located in RASHT city. From this community, 300 qualified volunteers entered the study by the convenience sampling method. The WHO Quality of Life-BREF (1998), Simmons and Gaher Distress Tolerance Questionnaire (2005), Allports Religious beliefs Questionnaire (1967) were used for data collection, and AMOS24 software was utilized to analyze the findings.
Results: The results showed that all the fit indexes are at an optimal level. The relationship between distress tolerance and intrinsic religious beliefs (0.32) is positive and significant (P<0.01). The relationship of this variable with extrinsic religious beliefs (-0.36) is negative and significant (P<0.01). The relationship between distress tolerance (0.19) and intrinsic religious beliefs (0.33) with quality of life is positive and significant (P<0.01). Also, the relationship between extrinsic religious beliefs and quality of life (-0.22) is negative and significant (P<0.01).
Conclusions: According to the results, intrinsic religious beliefs in opioid abuse patients, has direct impact on distress tolerance and quality of life. In fact, the higher the intrinsic religious beliefs in opioid abuse patients, ends in the higher the distress tolerance and quality of life. Also, extrinsic religious beliefs in opioid abuse patients, has inverse impact on distress tolerance and quality of life. In fact, the higher the extrinsic religious beliefs in opioid abuse patients, ends in the lowerthe distress tolerance and quality of life. Therefore, intrinsic religious beliefs as an Islamic moral variable can affect the distress tolerance and quality of life of opioid abuse patients.

Abstract
Introduction: The prevalence of the COVID-19 virus has been very high, so that in a short period of time, due to its contagiousness, it has infected a large number of people around the world. Pregnant women are more sensitive to infectious diseases than the general population and are especially at risk of respiratory diseases and severe pneumonia. Considering the importance of mother and fetus management, assessment and management of pregnant women infected with COVID-19, the present study was conducted with the aim of investigating the clinical and laboratory status of pregnant women infected with SARS‐CoV‐2 referring to Imam Hassan and Bentolhoda hospital in Bojnurd.
Methods: In this cross-sectional study, pregnant women with COVID-19 referred to Imam Hassan and Bentolhoda Hospital in Bojnurd between March 2020 and the beginning of Desember 2021 were studied. In order to collect information, an information form containing demographic and obstetric characteristics, evaluation of symptoms (fever, cough, abdominal pain, bloody secretions, rupture of fetal membranes in term pregnancy, chest tightness, asthma, fatigue, loss of appetite, headache, nausea and vomiting), laboratory status and outcomes pregnancy and childbirth was used. Statistical analysis was done with SPSS 24 software.
Results: The age range of the studied women was 15-48 years and the average gestational age was 26.21±9.4 weeks. The type of delivery in 46.2% was normal vaginal delivery, 53.8% was cesarean section. LBW, admission to NICU, need for resuscitation, meconium-stained AF were 5.71%, 4.76%, 3.80%, 0.95%, respectively. The average number of referrals to the hospital due to COVID-19 in the studied women was 1.6 ± 1.1 times, the average number of days in the hospital was 5.1 ± 3.1 days, and the average number of days in the intensive care unit was 4.08±2.1 days. The most common clinical symptoms in the studied women were related to cough (76.19), dyspnea (72.38), fever (56.19), and myalgia (33.33).
Conclusions: Based on the results obtained from this study, clinical symptoms and laboratory results in pregnant women with COVID-19 are similar to infected adults. Common symptoms of COVID-19 disease in pregnant women included fever, cough, and myalgia.

Abstract
Introduction: Major β-Thalassemia is one of the most common hereditary anemias in the world and is a health problem associated with the absence or reduction of globin chain production. Self-efficacy helps adolescents with chronic illness to strength their ability to handle the routine tasks and to achieve treatment goals. Because of the importance Major β-Thalassemia in adolescents and its effects on their quality of life, we decided to do this study with the aim of “Determining self-efficacy and its related factors in adolescents Major β-Thalassemia referring to selected hospital in Tehran”.
Methods: The present study used a descriptive comparative cross-sectional design on 100 adolescents with Major β-Thalassemia referring to Shohadaye Tajrish hospital in Tehran in 2022. We used a census design to collect data in a fixed duration and in three work shifts in the morning, evening and night in the relevant units. The data collection tools included of demographic and Self-Efficacy Questionnaire for Children (SEQ-C). The collected data were analysed by SPSS Software version 20 via statistical tests included of Pearson or Spearman coefficient, t test and ANOVA test.
Results: The average age of the participant adolescents were 15.40 ± 2.22. The results of the study showed that the mean score of academic, social and emotional self-efficacy were 26.17±3.91, 24.83±5.33 and 24.49±4.75 respectively. The score of self-efficacy of the participants were approximately in the average range in the three dimensions of the SEQ-C. However, the score of academic self-efficacy was slightly higher than the average range. There are not any significant relationships between the demographic variables and any dimensions of self-efficacy (P-value>0.05). However, the results of T-Test showed significant relationships between the social self-efficacy score and positive history of splenectomy (P-value=0.018).
Conclusions: Based on the results of the study, the self-efficacy score of participants in this study were approximately in the average range, therefore, these results showed that, health staffs such as nurses should promote the self-efficacy of adolescents with Major β-Thalassemia through health education.

Introduction: Lack of adherence to the nursing code of ethics in neonatal wards is usually an issue in hospitals. The present study explored neonatal nurses’ adherence to the nursing code of ethics in the neonatal ward, using the Neonatal Nurses' Ethical Performance Self-Report Questionnaire and the Neonatal Nurses' Ethical Performance Observation Checklist.
Methods: In this descriptive study, 132 Nurses from 5 neonatal wards from two pediatric hospitals in Tehran were recruited by census sampling.
Results: The results showed that the mean score of the self-report questionnaire (86.12+10.34) and observational checklist (80.98+10.34) was within the desired performance range. The domain of improving the quality of care had the highest score (94.25+3.40) in the self-report questionnaire, and the domain of justice had the highest score (95.00+0) in the observational checklist. The domain of respect for autonomy had the lowest mean score in the self-report questionnaire (64.31+22.22) and the observational checklist (67.50+6.19). There was no significant relationship between the ethical performance score reported by nurses and nurses' demographic variables (P>0.05), and the specific condition of the neonates affected the ethical performance of nurses in neonates' demographic variables (P-value =0.002).
Conclusions: The finding showed that, overall, the performance of neonatal nurses regarding ethical codes is desirable.