Advances in Nursing & Midwifery

Abstract
Introduction: As the first step in dealing with patients referring to the emergency department, the triage process prioritizes these patients and classifies them to different levels of triage based on the severity of their clinical conditions. This prioritization is aimed at distinguishing patients whose treatment can be delayed without experiencing any complications from those who need immediate action and delay in whose treatment will cause serious complications. Therefore, this study aimed to determine the effect of the clinical audit cycle on the implementation of hospital triage in the emergency department of Golestan Hospital in Ahvaz in 2018.
Methods: This was a quasi-experimental study the population of which included all events related to the way hospital triage was implemented for patients referring to the emergency department of Golestan Hospital of Ahvaz, southwest of Iran. The research sample included 385 triage events performed for patients referring to the emergency department. A researcher-made triage questionnaire was used to check nurses' accuracy in four dimensions, namely taking history, taking vital signs, determining triage level, and frequency distribution. SPSS version 23 was used to analyze the data. A significance level of α = 0.05 was adopted for this study.
Results: Before the intervention, the mean scores of the intervention group in terms of Checklist dimensions were as follow: taking history (11.26 ± 1.89), vital signs (15.62 ± 2.21), determining triage level (23.56 ± 7.95), determining the level of required facilities (9.11 ± 3.27), and doing the general triage of patients (55.56 ± 10.17). After the intervention, the mean scores in the intervention group were as follows: taking history (12.36 ± 2.71), vital signs (16.81 ± 3.31), determining triage level (30 ± 0.051), determining the level of required facilities (11.99 ± 0.072), and doing the general triage of patients (64.73 ± 10.9), which shows the positive impact of the intervention (P < 0.001).
Conclusions: According to the findings of the present study, appropriate training in triage along with strict control and monitoring of the hospital triage implementation process and its prioritization will lead to provision of better medical services. Also, patients whose treatment can be delayed without experiencing any complications can be distinguished from those who need immediate action.

Introduction: Nurses are pivotal to the healthcare system, providing essential care to patients. However, the nursing profession is characterized by demanding workloads and significant challenges. Accordingly, this study aimed to predict life satisfaction based on clinical competence and emotional intelligence through job satisfaction in nurses working in hospitals and medical centers in Ahvaz in 2023.
Methods: The present study was correlational and of the structural equation modeling type. The study population included all nurses working in Ahvaz City hospitals during the period of April to June 2023. A convenience sample of 182 nurses was selected for participation. The research tools included the Satisfaction with Life Scale (SWLS), Minnesota Satisfaction Questionnaire (MSQ), and Competency Inventory for Registered Nurses (CIRN), and Emotional Intelligence Scale (EIS). Data were analyzed using structural equation modeling (SEM) with SPSS-25 and AMOS-24 software. All hypotheses were tested at a significance level of α = 0.05.
Results: The results showed that there was a positive and significant relationship between clinical competence and job satisfaction in nurses (P<0.001). The relationship between emotional intelligence and job satisfaction in nurses was also positive and significant (P<0.001). In addition, the relationship between job satisfaction and life satisfaction was positive and significant (P<0.001). The results suggest that job satisfaction mediates the relationship between emotional intelligence and clinical competence with life satisfaction in nurses (P<0.001).
Conclusions: The findings of this study indicate positive and significant associations between clinical competence, emotional intelligence, and life satisfaction among nurses. Moreover, job satisfaction emerged as a mediating factor, suggesting that nurses with higher levels of clinical competence and emotional intelligence report greater job satisfaction, which subsequently contributes to increased life satisfaction. These results underscore the importance of fostering both clinical skills and emotional intelligence in nurses to enhance their overall well-being and potentially optimize patient care outcomes.

Introduction: Midwives play a crucial role in promoting maternal and neonatal health, making it essential to evaluate their effectiveness in childbirth counseling. This study aims to assess the competency of midwives in providing childbirth counseling at comprehensive health centers in Qazvin city, Iran.
Methods: A cross-sectional study was conducted in 2022 utilizing a census sampling method, encompassing all 88 midwives in Qazvin city, Iran. The study utilized a demographic questionnaire and Midwifery Professional Competency Standard Tool for Childbirth Counseling, consisting of 46 questions across five areas: professional/ethical counseling, comprehensive care, interpersonal relations, organization and coordination, and personal/professional development. Data were analyzed using SPSS v23 software.
Results: The mean age of participants was 37.420±7.729 years. The competency scores ranged from 137 to 230, with a mean of 200.750±13.461. The results revealed that 88.7% of the participants were accountable for their professional performance in professional-ethical competency. The mean scores for midwifery professional competencies in ethical/professional, comprehensive care, interpersonal relationships, organization-coordination, and personal/professional development were 61.318±5.029, 39.818±3.459, 34.715±3.099, 39.386±3.448, and 25.511±2.617, respectively.
Conclusions: Midwives working in comprehensive health centers in Qazvin city exhibit strong competency in childbirth counseling, reinforcing their essential role in maternal healthcare.

Abstract
Introduction: Childbirth is an experience that remains in the mind for years and can
have many short-term and long-term consequences for women’s health and
reproductive attitudes. The present study was conducted to assess the relationship
between childbirth experience and childbearing attitude.
Methods: A search was carried out in PubMed, Web of Science, Scopus, and search
engine: Google Scholar using MeSH terms and their proper combinations via Boolean
operators "AND" and "OR" operators according to each database over the years 2000
to 2022. We included published papers provided that they fulfilled all of the following
criteria: Observational study (cross-sectional, case-control, and cohort), English
language, investigating the relationship between pregnancy experience
(positive/negative) and childbearing attitude (using questionnaires), and the
participants being of reproductive age. The meta-analysis results were reported as
odds ratio (OR) with a 95% confidence interval (CI). The I2 index and Cochran's Q
test were used to assess the heterogeneity of the studies. The quality of the included
studies was evaluated using the Newcastle-Ottawa Scale (NOS). Egger's and Begg's
tests were performed to evaluate publication bias, and the leave-one-out approach was
used for sensitivity analysis. R package Meta was used for the meta-analysis.
Results: A total of 13,057 articles entered the screening and selection phase, and after
implementing the main steps of the systematic review, six articles were ultimately
accepted for the final review based on the eligibility criteria. The results of the metaanalysis
of four studies with a high level of methodological quality demonstrated that
people with negative or traumatic experiences in a previous pregnancy had 15% less
positive attitude toward childbearing (OR=0.85; 95% CI: 0.50 to 1.45; I2=93%;
Chi2=44.06, df=3, p < 0.01). Publication bias had no effect on the results obtained,
and there was no significant bias in the publication of the results.
Conclusions: Given the association observed in the current study, the mother's
negative childbirth experience can play a deterrent role in her future fertility-related
decisions. In their plans to promote high-quality caregiving, healthcare providers
should also focus on this component to improve women's childbirth experiences.

Abstract
Introduction: Marital conflict often disrupts relational dynamics and hinders
forgiveness, impacting the overall well-being of couples. This study aimed to
comparatively evaluate the effectiveness of Emotionally Focused Couple Therapy
(EFCT) and Solution-Focused Couple Therapy (SFCT) in improving relational
dynamics and fostering forgiveness within couples experiencing marital conflict.
Methods: This study adopted a quasi-experimental framework, implementing a
pretest-posttest control group design, to investigate the efficacy of two therapeutic
interventions. The study population comprised couples experiencing marital discord
who sought assistance from family counseling centers in Ahvaz City during 2024. A
total of 45 participants were selected via convenience sampling and subsequently
assigned randomly to one of three groups: two experimental groups, receiving either
EFCT or SFCT, and a control group. Both experimental interventions consisted of
eight 90-minute sessions. Data were analyzed using analysis of covariance
(ANCOVA) conducted within the SPSS version 26 statistical software.
Results: The study's results demonstrated that both EFCT and SFCT significantly
improved relational dynamics and forgiveness in couples experiencing marital conflict,
as shown by post-intervention assessments when compared to the control group
(P<0.01). Notably, a direct comparison of the two therapies revealed a significant
disparity in their impact on forgiveness, with EFCT exhibiting a substantially greater
effect (P<0.05). Conversely, the two interventions did not differ significantly in their
ability to enhance relational dynamics.
Conclusions: This study confirms that both EFCT and SFCT are effective in
improving marital relationships, but EFCT demonstrates a significantly stronger
impact on fostering forgiveness. While both therapies enhance relational dynamics
equally, EFCT appears to be particularly beneficial for addressing past relational
wounds through facilitating forgiveness.