No Abstract No Abstract

Background & Aim: Students are the most vulnerable group for reproductive health problems due to their inclination to be engaged in risky sexual behavior. The present study sought to determine the pooled prevalence of sexual and reproductive health service utilization and its determinant factors among students in Ethiopia.
Methods & Materials: PubMed, Web of Science, Google Scholar, EMBASE, and the Ethiopian University online library were searched. The review took place between November 15, 2022, and December 15, 2022. Data were extracted using Microsoft Excel and analyzed using STATA statistical software version 14. The pooled prevalence of sexual and reproductive health service utilization was computed with 95% CI, whereas a log odds ratio was used to declare the statistical significance between associated factors and sexual and reproductive health service utilization.
Results: There were 1520 research articles retrieved, but 18 articles with 12,338 participants were met the inclusion criteria and included in this systematic review and meta-analysis. The pooled estimates of sexual and reproductive health service utilization among students was 42.606% (95% CI: 32.917%–52.295%; I2 = 88.3%). Discussion with families/friends  (OR=3.033, 95% CI=2.217-4.150, P-value<0.001, I2=75%) and knowledge  (OR=2.215, 95%CI=1.105-4.515, P-value=0.025, I2= 85%) were predictors of sexual and reproductive health service utilization among students.
Conclusion: In relation to the data from the studies under analysis, below half percent of students in Ethiopia utilized sexual and reproductive health services. Further health education and communication are crucial to improving knowledge about sexual and reproductive health services among students in Ethiopia.

Background & Aim: Healthcare workers are exposed to certain infectious diseases through needlestick injuries and exposure to blood and other bodily fluids. This study aimed to determine the prevalence of needlestick injuries and blood and other body fluids exposure among healthcare workers at Namazi Hospital in Shiraz, Iran.
Methods & Materials: This cross-sectional study was conducted on 656 Healthcare workers, including students and staff in medical, nursing, laboratory, service, and operating room groups, at the Namazi Hospital, in 2019. A questionnaire with four parts, including demographics, questions about using sharps containers, needle recapping, masks, and glasses, and the experience of sharps injuries or blood and body fluid exposure and reporting them, was distributed using the quota sampling method. To analyze the results, the T‑test and Chi-square test were performed.
Results: Nearly 75.2% of the participants always used sharps containers, and 21.7% never recapped syringes. Sharps injuries and blood and body fluid exposure occurred in 40.7% and 39.8% of the participants. Occupation (P<0.001), being a student (P: 0.048), and age (P: 0.008) were associated with sharp injuries. Occupation (P: 0.001), gender (P: 0.016), and age (P<0.001) differed in exposed and no exposed participants to blood and body fluids. The prevalence of reporting exposure was not significantly different between men and women, occupation groups, students and staff, and different ages (P> 0.05).
Conclusion: Hospital managers should provide effective educational interventions to protect against occupational hazard exposures. Also, they should provide protective equipment for Healthcare workers.

Background & Aim: Nursing staff are exposed to high levels of stress daily due to the demanding work environment. This study aimed to examine nursing staff occupational stress and coping mechanisms during the COVID-19 pandemic.‎
Methods & Materials: A cross-sectional study with a sample of 108 nursing staff was carried out. The Expanded Nursing Stress Scale (ENSS), the Brief Coping Orientation to Problems Experienced (Brief COPE) Scale, and constructed questions were used for data collection. Data were analyzed using chi-square (χ2), Pearson methods, and Multiple linear regression analysis. Statistical significance was determined at p-value ≤ 0.05.
Results:  Overall Occupational stress was assessed with a mean score of 146.8 (SD±35.3). In Brief COPE Scale higher mean was assessed for “social support - information seeking” and lower for “substance use” or “withdrawal” (p<0.001). A significant difference in response distributions was observed regarding their degree of concern or fear about COVID-19 (p<0.01). Increased levels of Overall Occupational Stress (ENSS) were associated with higher levels of BCOPE. Emotional Focus and Venting and Diffusion of Emotions (β=5.15, p=0.026), younger age of the participants (β=-5.78, p=0.033), years of working in the healthcare sector (β=14.46, p=0.004) or the highest fear/concern about being infected and infecting their patients (β=6.22, p=0.032).
Conclusion: Nursing staff experienced moderate levels of occupational stress, while challenges raised by the pandemic were handled through seeking social support, positive reframing and acceptance, taking protective measures, and turning to religion. Developing meaningful administrative and educational strategies for staff empowerment and resilience may reduce anxiety and occupational stress for nurses.

Background & Aim: This research was conducted to determine the effect of a pain management program based on the Critical Care Pain Observation Tool (CPOT) on the pain intensity and adjusting the dosage of analgesics in mechanically ventilated patients hospitalized in intensive care units.
Methods & Materials: This randomized controlled clinical trial was conducted during 2019-2022 on 70 mechanically ventilated patients admitted to ICUs of the Imam Reza Hospital, Mashhad, Iran. In the intervention group, patients' pain intensity was measured during endotracheal suctioning using CPOT. Then the dosage of analgesics was adjusted based on the assessed pain level. The pain level was evaluated in the control group according to the department's routine. Data were analyzed using two-way repeated measures analysis of variance (RMANOVA).
Results: CPOT and BPS showed a strong correlation (r>0.9, Pvalue<0.001) between the two pain intensity instruments. Based on the results of RMANOVA, a significant trend of pain intensity measures was observed during all three suctions (measurement effect P<0.05), which was different between the two groups (interaction effect P<0.05). The Sidak post hoc test results showed a significant difference in pain intensity measures between the intervention and control groups during all three suctions and 5 and 15 minutes after suctions (all P-values<0.05). Also, significant intervention effects were observed regarding the amount of analgesics prescribed in terms of total fentanyl blouse, total infused Fentanyl, and total Fentanyl (all P-values<0.05).
Conclusion: Using CPOT is a positive step in the evaluation and control of dosage adjustment of analgesic medications for patients with mechanical ventilation.

Background & Aim: Hungary started to administer several COVID-19 vaccines; however, attitudes toward COVID-19 and vaccination are still poorly understood. This study aimed to explore how the attitudes toward COVID-19 disease are associated with the attitudes toward COVID-19 vaccination in Hungary and compare the attitudes of health and non-health workers toward COVID-19 disease and vaccination in Hungary.
Methods & Materials: Using a descriptive, cross-sectional design, we recruited a sample of 1820 persons through an electronic survey. In addition to the sociodemographic questions, the attitudes towards COVID-19 disease and vaccination were assessed through self-developed, literature-based questionnaires. Principal component analysis, Spearman's correlation, linear regression, and the Mann-Whitney test were used in the data analysis.
Results: The mean age for the study participants (n=1735) was 43.8 ± 6.2 years, and females were the majority (84.6%). Overall, participants showed good attitudes toward COVID-19 disease (mean score= 3.48, SD= 0.43) as compared to their attitudes toward COVID-19 vaccination (Mean score= 2.67, SD=  0.44). A positive correlation was found between the attitudes toward COVID-19 disease and attitudes toward vaccination in Hungary (r= 0.247, p< 0.01). Nurses and other health workers showed more positive attitudes toward COVID-19 vaccination than non-health workers.
Conclusion: Hungarian decision-makers should intervene to improve the public's willingness to be vaccinated against COVID-19 or future pandemics. Health workers' knowledge and positive attitudes should be utilized in the media to encourage the general population to be vaccinated. The suggested questionnaires need to be validated for future pandemics' use.

Background & Aim: Turnover intention can predict the actual turnover behavior of nurses. Previous studies identified a variety of factors influencing nurses' turnover intention. However, few studies investigate nursing students' career turnover intention. This study aimed to examine turnover intention and associated factors among nursing students in Central Vietnam.
Methods & Materials: A cross-sectional study was implemented among 425 nursing students recruited through a multistage sampling technique from April to May 2022. Data were collected using a questionnaire including demographic characteristics, fear of COVID-19, perceived academic stress, and turnover intention. Descriptive statistics were used to describe demographic characteristics and study variables. Independent t-test, one-way analysis of variance, and Pearson's correlation coefficients were computed to examine the association between variables.
Results: Approximately one-third (32.5%) of the respondents will look for jobs without patient contact, 32.2% would not study nursing if given a choice, and 31.1% often think of not staying in the nursing profession. The sum scores of turnover intention ranged from 3 to 15 with a mean of 9.19 (SD= 2.49). The turnover intention was associated with the year of study, the reason to study nursing, and preparation for nursing school (p<.05). Perceived academic stress had a moderate correlation with turnover intention (r= -.325, p<.05). In contrast, the association between fear of COVID-19 and turnover intention was not significant.
Conclusion: A considerable number of nursing students had turnover intention upon graduation. Factors affecting turnover intention should be considered to retain students in educational programs and avoid a future nursing shortage.

Background & Aim: Schizophrenia significantly burdens family members when a member of their family is afflicted with this condition. Family caregivers play a pivotal role in providing care and support to individuals experiencing schizophrenia within the community. Therefore, an in-depth study of family caregivers' experiences is crucial for developing effective care quality improvement programs. This study aimed at exploring family caregivers' experiences of the barriers to caregiving to patients with schizophrenia.
Methods & Materials: This study was conducted in 2021–2022 through in-depth semi-structured. The duration of the interviews varied in length from 45 to 90 minutes. Interviews were conducted with sixteen family caregivers of patients with schizophrenia. The conventional content analysis proposed by Graneheim and Lundman was used for data analysis.
Results: The findings can be classified into three primary categories. The category "Inefficiency of Support Resources" encompasses the subcategories of "Inadequate Support by Family Members," "Inadequate Support by the Healthcare System," and "Financial Predicament." The category "Limited Public Knowledge about Psychiatric Disorders" includes the subcategories of "Social Stigmatization" and "Being Social Rejection." Lastly, the category "destructive nature of schizophrenia" encompasses the subcategories of "Gradual Loss of Abilities" and "Gradual Patient Passivity."
Conclusion: Family caregivers encounter various barriers in providing patient care. Thus, they require support from the treatment team and family members, as well as financial and the development of rehabilitation programs. Additionally, involving caregivers in the patient's treatment plan and planning programs to reduce the stigma associated with caregivers is crucial.

Background & Aim: Older adults with chronic diseases are usually required to manage multiple medications and complex medication regimens. Medication adherence is crucial in older adults which is increasingly being recognized due to its potential to impact healthcare utilization and treatment efficacy. The current study aimed to assess medication adherence and its influencing factors in community-dwelling older adults with chronic illnesses in rural areas. ‎
Methods & Materials: A cross-sectional study design was used to achieve the study aim. The study sample was composed of 310 older patients from a rural area in Sharkia Governorate, Egypt. Medication adherence was assessed by the Arabic version of the General Medication Adherence Scale. Association between medication adherence and older patients' characteristics was identified through the Chi-square test, Pearson's correlation coefficient, and Logistic regression.
Results: Among 310 older patients, 84.8% of them were non-adherent to their medications. Significant relationships were found between medication adherence and age, gender, educational level, marital status, and monthly income. Aging less than 70 years, female gender, sufficient income, fewer illnesses, and medication number were significant predictors for medication adherence.
Conclusion: The current study findings revealed that most rural older adults with chronic illnesses were non-adherent to their medications, with many influencing factors such as age, gender, educational level, monthly income, and illnesses and medication number. So, the study recommends the importance of developing strategies to improve medication adherence in community-dwelling older adults in rural areas.

Background & Aim: Establishing strategies to enhance evidence-based practice (EBP) requires a reliable instrument for assessing EBP competency. This study focused on translating and validating the Evidence-Based Practice Competency Questionnaire for Registered Nurses (EBP-COQ Prof©) in the Vietnamese context.
Methods & Materials: Through a methodological approach, this study performed cross-cultural adaptation and psychometric validation. The study involved 372 nurses selected through convenience sampling. Content validity was established using the Content Validity Index for Items (I-CVI) and the Content Validity Index for Scales (S-CVI). Construct validity was assessed via exploratory (EFA) and confirmatory factor analysis (CFA). Reliability was determined using Cronbach's alpha and the intra-class correlation coefficient (ICC). Criterion validity was examined by comparing EBP-COQ Prof© competency between nurses with and without prior EBP education.
Results: The Vietnamese version of EBP-COQ Prof© maintained consistency with the original version following cross-cultural adaptation. Content validity was confirmed with I-CVI> 0.78 and S-CVI/AVE= 0.97. EFA and CFA revealed consistent components with the original version: attitude (8 items), knowledge (11 items), skills (6 items), and utilization (10 items). Cronbach's alpha values were high: attitudes (0.965), knowledge (0.962), skills (0.909), and utilization (0.926). ICC values were also significant: attitudes (0.754), knowledge (0.895), skills (0.823), and utilization (0.966). Nurses with prior EBP education demonstrated higher EBP-COQ Prof© competency.
Conclusion: The translated and validated EBP-COQ Prof© provides a robust tool for assessing EBP competency among Vietnamese nurses. Its reliability, validity, and sensitivity to educational effects underscore its potential for promoting EBP in nursing.