Advances in Nursing & Midwifery

Introduction: Cultivating a patient safety culture within an organization is essential for enhancing patient safety. This culture is closely tied to nursing practices, and any lapses in care can significantly compromise the delivery of safe nursing services. As such, missed nursing care is closely associated with the broader patient safety culture. This study aims to explore the relationship between patient safety culture and missed nursing care.
Methods: This descriptive-correlational study was conducted between 2022 and 2023 with nurses at Shahid Sadoughi University of Medical Sciences. The inclusion criteria were: having a minimum of a bachelor's degree in nursing, at least six months of experience in the department, and willingness to participate. Stratified random sampling was used for participant selection. Data were collected using a demographic questionnaire, the Kalisch and Williams Missed Nursing Care Questionnaire, and the HSOPS Questionnaire. Data analysis was performed using SPSS software (version 22), with statistical methods including descriptive statistics, t-tests, one-way ANOVA, linear regression, and Pearson correlation.
Results: The study sample comprised 233 nurses, including 94 males and 139 females. The results revealed a statistically significant difference in the mean score of overall patient safety culture based on work experience (p-value < 0.001), working hours (p-value < 0.001), and work shifts (p-value < 0.001). However, no significant difference was found in the total mean score of missed nursing care across different age groups (p-value = 0.287), work experience (p-value = 0.294), and shift work (p-value = 0.059), although a significant difference was observed with weekly working hours (p-value = 0.002). These findings were further supported by univariate linear regression analysis. The Pearson correlation coefficient indicated a significant negative correlation between missed nursing care and patient safety culture.
Conclusions: This research enhances our understanding of the relationship between patient safety culture and missed care. By exploring this connection, it provides empirical evidence for improving care quality and its management, while also laying the groundwork for future research in this area.

Introduction: Marital conflict can lead to emotional detachment (emotional divorce) and hinder a woman's ability to manage her emotions effectively (emotional self-differentiation). Choice theory, with its emphasis on personal responsibility and need fulfillment, offers a potential framework for improving these outcomes. This study investigates the effectiveness of choice theory intervention on emotional divorce and emotional self-differentiation in women with marital conflict referring to the psychological centers of Isfahan.
Methods: The current study employed a quasi-experimental design with a pre-test-post-test structure and a control group. The target population encompassed all women experiencing marital conflict who sought services at Isfahan's psychological centers during the year 2023. A convenience sampling method was utilized to recruit a sample of 30 participants (15 per group) who met the study's inclusion criteria. Random assignment procedures were employed to allocate participants to either the experimental or control group. Both groups completed the Emotional Divorce Inventory and the Differentiation of Self Inventory at both the pre-test and post-test stages. The experimental group then received the choice theory intervention, delivered in eight 90-minute sessions. Data analysis was conducted using analysis of covariance (ANCOVA).
Results: The experimental group demonstrated a significant decrease in emotional divorce scores from 56.13±2.20 pre-intervention to 34.87±3.98 post-intervention. In contrast, the control group showed no significant change in emotional divorce scores. The experimental group also exhibited a significant increase in emotional self-differentiation scores from 118.40±8.11 pre-intervention to 183.80±12.39. The control group experienced a slight increase in emotional self-differentiation scores, but the change was not statistically significant. These findings suggest that the choice theory intervention is effective in reducing emotional divorce and enhancing emotional self-differentiation among women experiencing marital conflict (P<0.001).
Conclusions: These results suggest that choice theory intervention has the potential to be a valuable tool for improving emotional connection and emotional regulation in women facing marital discord.

Introduction: Triangulation is a destructive pattern of communication where a third party becomes involved in a conflict between two people, often leading to an alliance with one against the other. Mindfulness is a mental state achieved by focusing one's attention on the present moment without judgment. By examining the relationship between these two factors on divorce probability, this research aims to identify potential early warning signs and intervention strategies.
Methods: This descriptive-correlational research investigated the relationship between divorce probability, triangulation, and mindfulness among married female university students in 2023. A convenience sample of 304 participants was selected from the entire population of married female students. The research instruments included the Divorce Probability Questionnaire, Triangulation Scale, and Five Facet Mindfulness Questionnaire. SPSS-27 software was used to analyze the data collected from this study. Data were analyzed using Pearson correlation and stepwise regression to determine the associations between these variables.
Results: The findings revealed a strong positive correlation between triangulation and the probability of divorce (r = 0.41, P < 0.001). Conversely, mindfulness was negatively associated with divorce probability (r = -0.37, P < 0.001). Collectively, triangulation and mindfulness explained 45% of the variance in divorce probability among the sample of married female university students. However, triangulation was found to be a more significant predictor of divorce than mindfulness.
Conclusions: These findings suggest that addressing triangulation patterns, such as involving a third party in marital conflicts, is crucial for enhancing marital satisfaction and reducing the risk of divorce. While mindfulness may offer some protective benefits, its impact on divorce probability appears to be less significant in this context. These findings emphasize the need for targeted interventions that address triangulation and promote mindfulness to support marital well-being among Iranian female university students.

Introduction: Healthcare centers have been established with the aim of providing quality, safe, and effective care. In order to achieve these goals, nursing managers have the responsibility to choose a nursing care delivery model that ensures quality and minimizes the job stress of nurses. The objective of this study was to compare the impact of primary nursing and case method on job stress of nurses working in the intensive care unit (ICU).
Methods: This was a pilot quasi-experimental study which two nursing care methods, primary nursing and case method, were compared using a pretest-posttest design. The study population consisted of 25 nurses working in the ICU. The data collection tools included demographic questionnaires and an expanded version of the nursing stress scale. The collected data were analyzed using SPSS version 25 and running paired samples t-test.
Results: Based on the findings, the demographic characteristics of nurses did not show statistically significant differences between two groups (p > 0.05). The mean total score of job stress for nurses in the case method group (25.12±125.16) was significantly higher than in the primary nursing group (16.07 ± 109.04) (p = 0.009).
Conclusions: According to the findings, the provision of nursing care through the primary nursing method reduced job stress among adult nurses in the ICU. Therefore, it is recommended to give more attention to the primary nursing approach in the management planning of nursing care.

Introduction: The concept of career anchors pertains to identifying an individual's values, capabilities, interests, motivations, and needs concerning their professional trajectory. Career satisfaction and performance may be enhanced by tailoring career anchors to align with an employee's specific role. Nonetheless, there exists a paucity of studies investigating the psychometric properties of this scale within the nursing context. The present study has been conducted to address this gap.
Methods: This research involved scaling tests administered to a substantial cohort of nurses (N=470) from university hospitals in East Azerbaijan Province, Iran, in December 2021. After translating the scale, experts assessed its content validity index and ratio. Both participants and specialists evaluated face validity. Confirmatory factor analysis was employed to ascertain convergent and discriminant validity. Additionally, the maximum shared squared variance, average shared squared variance, and construct reliability were calculated using the average variance extracted. The underlying structure of the scale was assessed via exploratory factor analysis, while internal consistency was determined using Cronbach’s alpha coefficient in SPSS Version 21.
Results: The instrument's content was deemed adequate, reflecting high internal consistency and reliability. However, confirmatory factor analysis did not substantiate the existence of eight instrumental factors, while exploratory factor analysis revealed six product factors, which accounted for 62.626% of the total variance.
Conclusions: The findings of this study indicate that Schein’s career anchors scale necessitates modification to be effectively utilized for identifying the predominant career anchors of nursing professionals. Recommendations have been provided for nurses on how to adapt and implement the scale appropriately.

Introduction: In order to achieve success in the fight against the pandemic, society's perception of the pandemic and its attitudes towards its control have gained importance. It is wondered whether the level of fear experienced during the pandemic affects individuals' attitudes towards the COVID-19 vaccine. The purpose of this study is to determine the relationship between individuals' attitudes towards the COVID-19 vaccine and their level of fear.
Methods: This study utilized a descriptive and correlational design. The sample of the study consisted of 400 individuals aged 18-70 years who lived in Erzurum city center in Turkey between May 2021 and January 2023 and agreed to participate in the study. Data were collected through the Personal Information Form, the Fear of COVID-19 Scale, and the Attitudes towards the COVID-19 Vaccine Scale. Ethics committee approval was obtained for the study. Data analysis was done in a computer environment using SPSS 20 package program and parametric tests were used.
Results: It was determined that the average age of the participants was 33.87±14.93, 66.3% were female, 34.7% had a bachelor's degree or higher, 53.2% were single, 71.8% were unemployed, 57% lived with their families, 71.8% did not smoke, and 84.3% did not have a chronic disease. The Attitudes towards the COVID-19 Vaccine Scale positive attitude sub-scale mean score was 3.41±1.41 and the negative attitude sub-scale mean score was 3.28±1.15. It was determined that the total score average obtained from the Fear of COVID-19 Scale was 17.42±8.70, indicating above-average fear. A positive and moderate-level correlation was detected between the participants’ Attitudes towards the COVID-19 Vaccine Scale positive and negative attitude sub-scales and the fear of COVID-19 scores (r= 0.582, p<0.001).
Conclusions: The results obtained show that the participants' attitudes towards the COVID-19 vaccine are positive. Fear of COVID-19 positively affects attitudes towards vaccines.