Iraqi National Journal of Nursing Specialties
The Iraqi National Journal of Nursing Specialties (INJNS), formerly known as “Scientific journal of nursing”, is a peer reviewed scientific publication that publishes original research articles in variety of nursing Specialties. Such publication contributes to the extension of nursing specialties body of knowledge relative to theses specialties. The Iraqi National Journal of Nursing Specialties also features qualitative research, systematic review articles, selected case reports and other original articles of special nature. The Iraqi National Journal of Nursing Specialties (INJNS) published a half yearly open access publication with one special issue since 2008 and two supplements since 2023. The Iraqi National Journal of Nursing Specialties editorial mission is to focus on improving nursing practice, knowledge, and clients’ outcomes through scientific research. Therefore, we are pleased to welcome and encourage you to both submit your original research articles and read the published articles and share them with your fellow nurses. Online ISSN: 2958-5759 Print ISSN: 2958-5740 ISSN Portal
Work Environment during Pregnancy and Maternal Health Status: A Cross-Sectional Study
Objective(s): To determine the effects of the work environment on maternal health during pregnancy and to investigate the relationships among physical and psychosocial occupational factors, work-related risk exposures, and maternal health. Methods: A quantitative cross-sectional study was conducted from 18 December 2025 to 18 June 2026 among 150 pregnant employees in Baghdad-Rusafa. Data were collected using a socio-demographic form, the PROMIS-29 Profile v2.1, the Workplace Exclusion Scale, and a Pregnancy Risk Assessment Form. Descriptive and inferential statistics were used, including frequency, percentage, mean, standard deviation, chi-square tests, and ANOVA. Results: Psychosocial work environment factors showed significant associations between anxiety and fatigue, sleep, physical function, and pain intensity; between depression and fatigue, physical function, and pain intensity; and between workplace exclusion and fatigue, physical risk factors, and psychological and social risks. Maternal age, parity, gestational age, daily working hours, years of service, employment status, and family income were significantly associated with maternal health (p < 0.05). High exposure to biological hazards, especially toxoplasmosis (71.3%) and rubella risk (72.0%), was observed. Recommendations: Maternal health during pregnancy is affected by a multidimensional interaction between physical workplace exposures, psychosocial conditions, and occupational risk factors. Pain was the health outcome most directly related to physical work environment factors, while anxiety, fatigue, sleep disorder, and impaired social participation were strongly interconnected.
pregnancy; maternal health; workplace environment; occupational hazards; anxiety; fatigue; sleep disorder; workplace exclusion
Copyright (c) 2026 saja Ihsan Hussein , Wesam Mashaan Muttaleb https://creativecommons.org/licenses/by/4.0
Effect of Nurse-Guided Respiratory Interventions (Incentive Spirometry vs. Coughing Exercises) for Postoperative Recovery in Children following Cardiac Surgery: Randomized Controlled Trial
Objective: To evaluate and compare the effectiveness of incentive spirometry versus coughing exercises on the recovery level in children after cardiac surgery. Methods: A prospective, randomized, single-blind controlled trial posttest design was conducted among children in the intensive care unit at cardiac hospitals in Iraq between December 2025 and March 2026. A total of 105 children aged 6–18 years who underwent cardiac surgery were randomly allocated into three groups: incentive spirometry (n = 35), coughing exercises (n = 35), and control (n = 35). Interventions were initiated within 24 hours after extubation and continued for 5 days. Recovery was assessed using the QoR-15 scale. Secondary outcomes included ICU length of stay. Data were analyzed using SPSS version 27. Results: Both intervention groups showed significantly higher recovery scores compared with the control group on the first and seventh postoperative day (p < 0.001). Incentive spirometry shows greater initial improvement in the recovery level. No significant improvement was observed in the control group. Conclusion: Incentive spirometry and coughing exercises significantly enhance postoperative recovery in children after cardiac surgery compared with routine care. They are low-cost, safe, and effective, and can be integrated into routine care to improve clinical outcomes. Recommendation: The study recommended provide educational programs and practice training for nursing staff in cardiac hospitals in Iraq to improve their knowledge and skills regarding the appropriate use of the IS and coughing exercises techniques in practice.
Respiratory Therapy; Spirometry; Pediatric; Heart surgery; Postoperative Care
Copyright (c) 2026 MSc. Rusul Khalid, PhD. Zaid Ajil https://creativecommons.org/licenses/by/4.0
Infertility Status and Sociodemographic Determinants of Polycystic Ovary Syndrome: A Comparative Nursing Study in Kurdish Women
Objectives: This study aimed to compare infertility status and reproductive outcomes, along with associated sociodemographic and obstetric factors, among Kurdish women with and without PCOS in Erbil, Iraq. Methods: This descriptive-comparative study was conducted at the Maternity Teaching Hospital from July 2024 to July 2025. A total of 548 Kurdish women aged 14-49 years were enrolled, comprising 274 with clinically confirmed PCOS and 274 without PCOS or other hormonal disorders (comparison group). Data were collected via face-to-face interviews using a validated researcher-made checklist consist of sociodemographic data, obstetric history, clinical characteristics, and PCOS-specific diagnosis and treatment history. Statistical analysis was performed using SPSS version 26, employing chi-square tests, t-tests, and logistic regression. Results: A history of infertility (98.9% vs. 2.2%, p<0.001) was overwhelmingly more common in the PCOS group. The control group had higher gravidity and parity (p<0.001). Multivariate analysis identified extended family type (AOR=2.262, p<0.001), as independent risk factor for PCOS, while higher parity was protective (AOR=0.374, p<0.001). Conclusions: Women with PCOS in this sample demonstrated significantly higher infertility prevalence, with significantly poorer reproductive outcomes despite treatment. Sociodemographic factors, particularly family structure, are strongly and independently associated with PCOS.
Copyright (c) 2026 Madiha Abbas Mohmmed, Hamdia Mirkhan Ahmed https://creativecommons.org/licenses/by/4.0
Assessment of Dietary and Fluid Adherence among ‎Hemodialysis Patients: A Cross-Sectional Study
Objective(s): To assess the level of dietary and fluid adherence among hemodialysis patients. Assessing the level of adherence provides valuable insights into patients’ behaviors and helps in identifying areas that require intervention to enhance their overall health status. Methods: A cross-sectional study was conducted over the period from November 15th to December 15th, 2025, to assess dietary and fluid adherence among hemodialysis patients. A purposive sample of (78) patients undergoing hemodialysis was selected from the dialysis unit at the Renal Disease and Transplantation Center, Al-Najaf Al-Ashraf City / Najaf Health Directorate. The validity and reliability of the questionnaire were established. Data were collected using validated dietary and fluid adherence questionnaires. Statistical analysis of data was performed using descriptive parameters through the Statistical Package for Social Sciences (SPSS) program version (26). Results: The findings demonstrated low levels of adherence among the participants. Dietary adherence was categorized as low in 78.21% of participants, whereas 21.79% exhibited moderate adherence, with a mean dietary adherence score of 0.20 ± 0.13, indicating an overall low level of adherence. Similarly, fluid adherence was categorized as low in 89.74% of participants, while 10.26% demonstrated moderate adherence, with a mean fluid adherence score of 0.20 ± 0.10, also reflecting an overall low level of adherence. Conclusion: The current study concluded that hemodialysis patients demonstrated a low level of dietary and fluid adherence. This indicates poor adherence to the recommended therapeutic regimens. Recommendations: It is recommended to strengthen patient education through continuous counseling during hemodialysis sessions, with active involvement of family members. Regular monitoring and improved communication among healthcare providers and patients are also important to support better adherence to dietary and fluid restrictions.
Fluid Adherence; Dietary Adherence; Hemodialysis
Copyright (c) 2026 zahraa Al-Najdi https://creativecommons.org/licenses/by/4.0
The role of training model in improving nurses' knowledge during blood transfusion for children
Objective(s): This study aims to determine The role of the training model in improving nurses' knowledge during blood transfusion for children . Methods: This study used a quasi-experimental pretest-posttest design was performed in the premature unit , emergency unit and hematology unit of two hospitals in Baghdad and Baqubah city, Iraq from September May 18th to 25th, october 2025. A convenience sample of 80 nurses was selected. Nurses’ knowledge were assessed before and after training using questionnaire format. The instrument's validity and reliability were confirmed by experts and interrater agreement. Data were analyzed by questionnaire, and it processed using SPSS version 22.0. Results: Demographic data were similar between groups before intervention. Comparison post intervention showed there is a statistically significant difference in the mean scores of nurses’ knowledge , indicating that there is an effect of the training model between the two periods (pre- and post-test) on nurses' knowledge at p0.05 toward the blood transfusion. Conclusion: There was a significant improvement in nurses' knowledge toward blood transfusion after the application of the training model. There were no significant association between the nurses general information and knowledge . Recommendations: The study recommends ongoing training through workshops, conferences, and establishing hospital committees to improve blood transfusion. It emphasizes developing standardized protocols and integrating the training model into nurses’ knowledge . Continuous supervision and evaluation are also suggested to identify and address knowledge shortcomings. © 2023 College of Nursing. Published by University of Baghdad.
Role , Training model, Nurses’ knowledge, children , Blood Transfusion.
Copyright (c) 2026 Huda Mohsen Hammed, Khatam Matsher Al-Musawi , Khatam Matsher Al-Musawi https://creativecommons.org/licenses/by/4.0
Effect of Stretching Exercise Applied to Legs during Hemodialysis on Fatigue and Discomfort: Randomized clinical trials
Introduction: Hemodialysis patients often experience fatigue and muscular cramps, which can lead to a decrease in patient comfort. As supplementary therapy for the management of these complications, stretching exercises and warm/cold compresses applied to the limbs during hemodialysis treatments have been suggested Aim of study: to evaluate the effectiveness of stretching exercise applied to the legs on fatigue and cramps Methodology: This multicenter investigation was conducted in four Iraqi hemodialysis facilities. Patients receiving dialysis were divided into one of three groups using a randomized, parallel-group approach. legs was preceded by nothing (control group), applying exercise, or applying a warm compress to the legs. Each patient's level of weariness and cramping was measured throughout the course of two treatment periods. The Modification of the Functional Assessment of Chronic Illness Therapy (FACIT) scale was used to measure fatigue, while the Cramp questionnaire chart was used to measure cramps. Result: 95 patients who consented to participate were included in the data analysis. When compared to pretreatment, the use of a stretching exercises were linked to lower fatigue and discomfort. When comparing the experimental group or groups to the control group, there was a statistically significant difference in fatigue and discomfort. Conclusion: As study result stretching exercise effect positively on comfort and fatigue, Intradialytic stretching exercises are simple yet effective intervention to reduce fatigue and enhance comfort during hemodialysis and is recommended, the incorporation of these exercises will significantly improve the well-being of the patients.
Stretching Exercise, Hemodialysis, Fatigue, Discomfort
Copyright (c) 2026 Maitham A. Shawwat, Rajaa Ibrahim Abed https://creativecommons.org/licenses/by/4.0
Effect of Warm Water Foot Immersion Therapy on Physiological Parameters Regulation among Febrile Children: An Evidence-Based Nursing Intervention
Objective: To evaluate the effect of warm water foot immersion therapy on selected physiological parameters among interventional group and identify the association and differences of demographic characteristics and clinical data with post-trial physiological parameters. Methods: A quasi-experimental study was conducted at the emergency department of Karbala Teaching Hospital for Children, Karbala, Iraq, from25th May 2025 to 30th September 2025. a purposive sampling involving 120 child aged between 2-7 years old allocated to either the intervention group (n=60), received warm water foot immersion therapy for 15 minutes, or the control group (n=60), received only standard treatment in the hospital. Physiological parameters were assessed before and after intervention. Data were analyzed using SPSS version 26, employing descriptive statistics and Mann-Whitney U test for group comparisons. Results: Post-intervention analysis revealed a significant reduction in body temperature (p=0.001) and significant improvement in heart rate, respiratory rate, and oxygen saturation level (p=0.001) in the intervention group compared to controls. Progressive improvements in all selected physiological parameters were observed across the one hours of evaluation. Conclusion: Warm water foot immersion (WWFI) therapy demonstrated significant beneficial effect on the body temperature, heart rate, respiratory rate, and oxygen saturation level among febrile children. Recommendations: Healthcare providers, particularly nurses should receive training on how to effectively use non- pharmacological methods like WWFI to regulate physiological parameters of febrile children Additionally the researchers recommended to educate Parents that this intervention is safe, easy, and can be applied at home.
Copyright (c) 2026 Eitidal Nassir Hussain, Zahid Jasim Mohammed https://creativecommons.org/licenses/by/4.0
Foot Reflexology Massage Effect on Preterm Neonates` Physiological Response: A Quasi-Experimental Study
Objective(s): This study aims to determine the effects of foot reflexology on stabilizing physiological parameters (heart rate, respiratory rate and saturation of oxygen) in pre-term infants hospitalized in the Neonatal Intensive Care Unit. Methods: A quasi-experimental study was performed in the Neonatal Intensive Care Unit of Bint Al-Huda Teaching Hospital, Al-Nasiriyah city, Iraq from May 3rd to September 15th, 2025. A purposive sample of 90 preterm infants aged 30-37 weeks were allocated to group of intervention (n=45) who received foot reflexology massage, for 20 minutes per session twice daily for three days consciously, and the control group (n=45) who receive routine care only. Physiological parameters of preterm were measured before and after the intervention by a constructed format. Data were collected by direct observation, and it processed using SPSS version 26 where descriptive statistics and Mann-Whitney u test were used in the comparison of groups. Results: Demographic baseline data were similar between groups before intervention. Comparison post intervention showed significant enhancement in SpO2 (p=0.001), respiratory rate (p=0.001) of study group as compared to controls. Heart rate showed a declining trend but did not reach statistical significance (p=0.286). Progressive improvements in all measured parameters were observed across the three-day intervention period. Conclusion: Foot reflexology demonstrated significant beneficial effects on oxygen saturation and respiratory rate in preterm neonates, supporting its potential as a safe, non-invasive complementary intervention in neonatal intensive care settings. Recommendations: Using foot-reflexology as a complementary approach, especially for those experiencing respiratory oxygen desaturation. Development of parent education programs to teach safe and effective foot reflexology practice.
Foot reflexology; Preterm infant,; Physiological response
Copyright (c) 2026 Sahar Ghazi https://creativecommons.org/licenses/by/4.0
A Comparative Study of the effect of Virtual Reality and Shot Blocker Maneuver on Managing Pain, Anxiety, and Vital Signs in Patients during Bone Marrow Aspiration and Biopsy: A Factorial, Randomized Controlled Trial
Objective(s): The present study aimed to evaluate the effect of virtual reality and shot blocker on patients' pain, anxiety, and hemodynamic variables during the procedure. Methods: A randomized controlled trial included 173 patients undergoing bone marrow aspiration and biopsy. The patients were randomly allocated to three intervention groups and one control group. The pain was measured with using a visual analogue scale. Anxiety was measured with the state trait anxiety inventory subscale, and hemodynamic variables were measured by the patient monitor device. Results: The data analysis showed that the three interventions were cross-compared, highly significant differences were found in pain and anxiety scores at p-value of .001. When both virtual reality and shot blocker interventions were applied, compared to virtual reality only and shot-blocker only, the mean rank of pain and anxiety was lower. Significant differences were observed in HR, RR, SBP, and DBP across groups (all p < 0.001), while no significant difference was found in oxygen saturation (p = 0.127). Conclusion: Virtual reality and shot blocker intervention are effective in stabilizing hemodynamic variables and reducing patient pain and anxiety during bone marrow aspiration and biopsy. Recommendations: The study recommends that virtual reality and shot blocker interventions are used simultaneously for patients undergoing bone marrow aspiration and biopsy
Virtual reality; Shot blocker; Pain; Anxiety; Hemodynamic Variables; bone marrow aspiration and biopsy.
Copyright (c) 2026 Tahseen Hassan, Alaa Kadhim, Aghaie Bahman https://creativecommons.org/licenses/by/4.0
Evaluating the Association between Frailty Status and Health Outcomes among Hospitalized Older adult Patients with Cardiovascular Disease: A Prospective Study
Objective(s): This study aimed to assess frailty status and examine its association with in-hospital outcomes among patients admitted with acute cardiovascular conditions. Methods: A prospective observational cohort study was conducted in the Cardiac Care Unit of Baquba Teaching Hospital in Diyala province from December 2024 to March 2025. Frailty was assessed by the validated tool Clinical Frailty Scale (CFS). In-hospital mortality, unscheduled 30-day readmission, and length of hospital stay were the primary outcomes measured. Results: A total of 200 patients were recruited. The median age was 71 years, and (55.5%) of them were female. Of the cohort, 117 patients were considered frail, according to the CFS, giving a prevalence of (58.5%). Frailty was an independent predictor of in-hospital death, irrespective of adjusting some potential confounders (OR = 1.985, 95% CI = 1.218–3.235). Conclusion: The study revealed that frailty was prevalent in elderly patients with cardiovascular disease. Frail patients had a higher rate of in-hospital mortality compared to their counterparts. Recommendations: Based on the study result, it is vital to identify frailty status when assessing older adult patients to tailor cardiovascular treatment individually along with interventions to reduce frailty should be a primary focus in this high-risk population. Furthermore, frailty assessment could be adopted as risk stratification in the acute care setting.
Copyright (c) 2025 Noor Mubder, Mohammed Yawuz https://creativecommons.org/licenses/by/4.0
The relationship between Attachment Style and Socio-Demographic characteristics of Pediatric Emergency Department Nurses: A Cross-Sectional Survey
Objective(s): The study aimed to assess the relationship between attachment style and socio-demographical characteristics of nurses working in pediatric emergency departments. Methods: A descriptive cross-sectional survey conducted across 132 pediatric emergency nurses from three pediatric hospitals in 2024. The study utilized a tool comprised socio-demographic characteristics of pediatric emergency nurses and the 15-item Adult Attachment Scale. The Statistical Package for Social Sciences (SPSS), version 26 was used to examine the associations among the measured variables in the study. Results: There was a significant relationship between the total level of attachment style of nurses in the pediatric emergency departments and their age (P-value = 0.001), marital status (P-value = 0.020); accommodation (P-value = 0.025); nursing qualification (P-value = 0.073); and their years of experiences (P-value = 0.026). Conclusion: The findings could be the basis for emergency nurses to expand their roles in enhancing children health outcomes to improve their own abilities for adapting positive attachment style. Recommendations: The present study recommends implementing targeted attachment style training programs (e.g., workshops, Balint groups, narrative medicine) to enhance securing behaviors and compassionate care skills.
Copyright (c) 2025 Mazen Hassan, Ali Hussein Alek Al-Ganmi, Lin Perry https://creativecommons.org/licenses/by/4.0
Air-Lock versus Z-Track Technique for Reducing Neonatal Pain Associated with ‎Intramuscular Vitamin K Injection: A Quasi-Experimental Study
Objective(s): the study aimed to assess the effects of using the Z-track and Air-lock techniques in intramuscular injection on pain levels among neonates. Methods: A quasi-experimental study was performed on 120 term neonates selected using purposive sampling, and were divided into three groups (Air-lock, Z-track, and Control) who underwent vitamin K intramuscular injection. The control group received the injection using the routine standard practice in the neonatal unit. The Neonatal / Infant pain scale used to assess the results of the study. Statistical Package for social science SPSS was used for data analysis. Results: The results showed, the mean of pain score was lower in the Z-track technique group compared to Air-lock technique and conventional groups. The statistics showed a significant difference between the pain scores at P value= 0.000. Conclusions: The study concluded using the Z- track and Air-lock techniques are effective as non-pharmacological methods in reducing pain associated with the neonatal vitamin K injection. Recommendations: the study recommends that nurses need to use the Z- track and the Air-lock techniques in postnatal wards, as part of the standard intramuscular injection procedures for pain reduction.
Copyright (c) 2025 Haider Jumaa https://creativecommons.org/licenses/by/4.0
The Effectiveness of an Intravenous Protection Dressing in Reducing Peripheral ‎Intravenous Catheter-Related Phlebitis in Pediatric Patients
Objective(s): To assess the effectiveness of the I.V. House Ultra Dressing in reducing peripheral intravenous catheter-related phlebitis in pediatric patients, and to evaluate the correlation between pediatric sociodemographic, clinical characteristics and the protective efficacy of the dressing. Methods: A quasi-experimental, post-test-only study design was conducted in the pediatric wards of Tikrit Teaching Hospital and Balad General Hospital within the Salah Al-Din Health Department in Iraq. The study was carried out between December 1, 2024, and February 1, 2025. Using a non-probability purposive sampling method, 64 pediatric patients were recruited and divided equally into a study group (n = 32) and a control group (n = 32). The study group received the I.V. House Ultra Dressing protection device, while the control group received the standard traditional hospital dressing. Phlebitis scores were evaluated every 12 hours from the initiation of intravenous therapy until catheter removal using the Visual Infusion Phlebitis Scale VIPS. Data were analyzed via descriptive and inferential statistics using SPSS version 26. Results: The study demonstrated a statistically significant difference in phlebitis scores and clinical signs between the two groups (P = 0.000). Over a three-day observation period, highly significant differences were maintained, with the study group demonstrating a marked decrease in the incidence and severity of phlebitis compared to the control group. Recommendations: Institutional protocols should integrate specialized intravenous protection dressings, such as the I.V. House Ultra Dressing, into standard pediatric nursing care. Furthermore, structured training programs should be implemented for healthcare workers, and future research should assess nurse and parental satisfaction regarding this baseline intervention.
Copyright (c) 2025 Roaa Qaseem Mohammed , Asmahan Qasim Mohammed https://creativecommons.org/licenses/by/4.0
Effect of Play-Based Occupational Therapy on Hand Function of Children with Cerebral Palsy: A Quasi-Experimental Study
Objective(s): This study aims to improve hand function in children with cerebral palsy through using of play therapy methods: clay, beads, and sand, and find most effect method. Methods: A quasi- experimental study employed pre-test and posttest design with control group. It was conducted at the Centre of Medical Rehabilitation and Arthritis in Baghdad city, at the period November 25th, 2024, to February 13th, 2025. A non-probable sample of 64 children with cerebral palsy was selected by non-random sampling method, they were distributed into one control group and three intervention groups. Both groups continue with their routine care in the center, and only the intervention group expose to play therapy intervention. The Box and Block Test was used to assess children`s hand function before and after play intervention. The data was analyzed by using descriptive and inferential statistics by SPSS program. Results: The result showed no significant differences in the means score of hand function in the both groups before play intervention. However, after the intervention a significant difference was clear in sand and clay intervention groups. The statistics showed clay therapy was most effective at, P value ≤ 0.05. Conclusion: Nursing interventions incorporating play therapy methods are effective in improving hand function in children with CP. These methods consider child-friendly and engaging valuable methods. Recommendations: A cohort study is recommended to assess the long-term effects of play interventions. Pediatric nurses need to integrate these play-based therapies and family’s participation to enhance motor skills of hand function in children with CP.
Copyright (c) 2025 Zainab Abd al Ameer Hussein, Adraa Hussein Shawq https://creativecommons.org/licenses/by/4.0
Health Behavior and Lifestyle Interventions for Patients with Chronic Diseases: A ‎Systematic Review
Objective(s): To review and analyze the effectiveness of an instructional programs in improving healthy lifestyles among patients with chronic diseases. Methods: This systematic review synthesized data from experimental randomized controlled trials and quasi-experimental studies published between 2016 and 2024. The search encompassed major databases, including PubMed, Ovid, ScienceDirect, ProQuest, Google Scholar, and the Education Resources Information Center. Inclusion criteria prioritized studies evaluating instructional programs for lifestyle improvement in chronic disease patients. Data abstraction followed a standardized protocol focusing on intervention features and primary outcomes. Study quality was rigorously assessed using the Cochrane Risk of Bias tool for randomized controlled trials and the Greenhalgh checklist for quasi-experimental studies. Results: 15 articles met the selection criteria and were included in the review after screening 210 papers. Analysis of these articles revealed that the Healthy Living for Chronic Conditions program demonstrated the most significant improvements in promoting healthy lifestyles among patients with chronic diseases. This program's success can be attributed to its personalized approach, which included individual coaching sessions and tailored exercise plans. Conclusion: While further research is needed, existing findings suggest that the Healthy Living for Chronic Conditions program shows promise in promoting healthy lifestyles. Adapting this program to current health societies may involve integrating it within existing healthcare structures, training healthcare providers on its delivery, and ensuring accessibility for diverse populations. Recommendations: Healthcare systems should consider implementing personalized, multi-component programs based on evidence-based models, such as Healthy Living for Chronic Conditions. Further research should explore optimal adaptation strategies for diverse populations and settings, alongside rigorous cost-effectiveness analyses.
Copyright (c) 2025 Ahmed D. Salman, Zahid J. Mohammed https://creativecommons.org/licenses/by/4.0
The Association between Alarm Fatigue, and Burnout among Nurses in Critical Care Units
Objective(s): To examine the association between alarm fatigue and burnout among nurses working in adult critical care units. Methods: A descriptive-correlational study design was used targeting 377 nurses practicing in critical care units within 13 hospitals in Iraq. Data gathering extended for the period from January 6th, 2024 to March 7th 2024, by investigating sociodemographic, professional characteristics of nurses, and alarm fatigue questionnaire, and the Burnout Assessment Tool. Results: Overall, 240 out of 377 nurses in critical care units showed a moderate degree of alarm fatigue, with a percentage of 63.7%. Of equal importance, the majority of nurses suffered from high levels of burnout, with a mean score of 2.53. The Pearson correlation (r =.441 at p = 0.01) also showed a positive association between alarm fatigue and burnout among nurses in critical care units. Conclusion: This study illuminated the statistically significant positive correlations between nurse’s alarm fatigue and each dimension of burnout (exhaustion, mental distance, cognitive impairment, emotional impairment, psychological complaints, psychosomatic complaints, secondary symptoms, and overall burnout). Recommendations: The provision of training sessions on stress management, building resilience strategies, and coping techniques provide nurses with the necessary tools to more effectively navigate the challenges of their profession. Furthermore, it is crucial to replicate this study in critical care units in other governorates of Iraq to compare and improve the generalization of the findings.
Alarm fatigue, Burnout, Nurses, Critical care units, Nursing
Copyright (c) 2025 Sahar Yaqoob Yousif, Dr.Sadeq AL-Fayyadh, Richard Mottershead https://creativecommons.org/licenses/by/4.0
Perception of Patients with Heart Attacks Toward the Warning Signs: A Qualitative Study
Objective(s): To explore patients’ perceptions regarding warning signs of heart attacks. Methods: A descriptive phenomenological design explored 10 perceptions of patients with ischemic heart disease toward warning signs of heart attack by non-probability (purposive) sampling at cardiac care units at Baquba Teaching Hospital and AlKhalis General Hospital For the period from 21st of December, 2023 to 24th of February, 2024. A 7-item semi-structured interview guide was developed. Qualitative analysis (thematic analysis) was used in the data analysis. This process involved transcribing and translating quotes from Arabic to English for better comprehension. The data analysis procedure consisted of several steps, including first-cycle coding, second-cycle, and analytical notes Results: Six themes and sub-themes emerged. These themes include suspicious recognition, imagination, fear, family roles, experience (experience with heart attack and psychological experience), religious aspects, and repercussions. The themes that emerged included all aspects of the condition that the patient went through during the heart attack from a physical, psychological, and spiritual perspective, which expressed the depths of his sense and cognition. Conclusion: The level of participants' perception is closely linked to their personal experience with heart attack (Whether the sample had heart attack in the present or past). Knowledge alone cannot form perception unless it reaches the individual's psychological aspects, which are shaped through experience. Recommendations: Conducting qualitative research is recommended at a national level and to the whole community to increase the generalizability of the results.
perception; warning signs; heart attack, qualitative study, Nursing.
Copyright (c) 2024 Montadhar R Al-zuhairy, Mohammed Baqer Al- Jubouri https://creativecommons.org/licenses/by/4.0
Efficacy of Shot-Blocker in Alleviating Peripheral Intravenous Cannulation Associated Pain among Hospitalized School-Aged Children
Objective(s): Examining the effect of Shot-Blocker in reducing Peripheral Intravenous Cannulation (PIV) associated pain among school age children’s patients. Methods: This study used a prospective, comparative, randomized controlled trial design. The study involved 153 school aged children (6-12 years) who received intravenous cannulation at Emergency Departments in Wasit: Al-Azizia and Al-Numaniyah General Hospital between January 22nd, and February 21st, 2024. Patients were randomly divided into two groups: the Shot-Blocker group (n=79), and control group (n=74). The Peripheral Intravenous Cannulation process was followed by a request for the patients to rate their level of pain using the Wong–Baker Faces Pain Scale. The primary outcome was to reduce pain related to intravenous cannulation for school age children. A descriptive and inferential statistical measures were employed in the analysis of the data through the using IBM-SPSS. The group’s differences in levels of pain were measured using an independent sample t-test. Result: There are statistically significant differences in pain intensity between the Shot-Blocker, and control group (P-value=0.001*). When compared to the control group, Shot-Blocker group showed a markedly reduced pain intensity (mean difference 1.74684). In addition, there were higher pain levels noted in the control group (mean difference 8.757) compared to the Shot-Blocker group. Conclusions: The Shot-Blocker technique was efficient to reduce pain-related intravenous-cannulation. Most children using Shot-Blocker experienced less pain compared to those who did not. This suggests that innovative non-pharmacological approaches like Shot-Blocker are advantageous for pain reduction.
Copyright (c) 2025 Salsabeel A. Naser, Dr. Sadeq AL-Fayyadh https://creativecommons.org/licenses/by/4.0
A Randomized Controlled Trial to Investigate the Effect of ‎Relaxation Technique on Sleep Quality of Hemodialysis Patients
Objective(s): To examine the effect of a relaxation technique on the sleep quality of patients undergoing hemodialysis and to find out relationship between effect of a relaxation technique and demographic variables. Methods: A randomized clinical trial was carried out between February 22, 2023 and May 1, 2024. The study was conducted at two hemodialysis centers situated in Al-Nasiriyah City: Al-Hussein Teaching Hospital and Al-Nasiriyah Teaching Hospital. Following the determination of the sample size, a total of 154 patients were chosen and separated into two groups: 77 patients allocated to the experimental group and 77 patients assigned to the control group. In the experimental group, Benson relaxation technique was used, and the sleep quality was assessed using Pittsburgh Sleep Quality Index. The SPSS 26.0 was used to analyze the data. Descriptive and inferential statistics (frequency, percentage, mean score, data was analyzed using paired-samples T-test and independent t-test. Results: The data analysis showed that all 154 patients had poor sleep quality in the pre-test for all two groups. The post-test findings demonstrated a substantial improvement in sleep quality for the study group who used the relaxation approach, with an average score of 2.774±23.731. Conclusion: A statistically significant disparity was observed regarding sleep quality among hemodialysis patients from the experimental group before to and after the implementation of a relaxing strategy. The research showcased that the use of Benson's relaxation method resulted in a substantial improvement in the sleep quality of patients undergoing hemodialysis. Recommendations: The findings recommend the use of the relaxation technique in trial to all patients who undergo hemodialysis to generalize the findings of experiment to hemodialysis units in hospitals.
Copyright (c) 2025 Amer Muhasin Nasir, Dr. Alaa Jawad Kadhim, DR. Aghaie Bahman https://creativecommons.org/licenses/by/4.0
The Effect of Vibration Maneuver on Pain Relief during Cannulation Insertion for Cancer Patients: A Randomized Controlled Trial
Objective(s): To measure the effect of using vibration maneuver on the level of pain during intravenous cannulation. Methods: A randomized controlled trial was carried out in the oncology unit of AL- Al-Haboubi Teaching Hospital in Thi-Qar governorate from November 22nd, 2023 to June 5th, 2024. After the sample was selected among patients, 105 patients were divided into two groups, 50 in the control group and 55 in the experimental. In the experimental group, a vibrating device was used, and the pain was assessed using a visual analogue scale of a 10-cm line. The researcher used two white envelopes inside which there was a colored card to facilitate the random selection and a self-report method was used for data collection. Results: The results of the statistical analysis showed highly significant differences between the two groups in pain intensity during cannulation in the post-test. The control group recorded a high average pain intensity of (M+SD 76.54+20.427), While the experimental group showed a significant decrease in pain intensity with an average (M+SD 27.25+22.788). These results indicate that the intervention based on applying vibration technology contributed effectively to reducing the level of pain, as the difference between the two groups was highly statistically significant (p=0.001). Conclusion: The study concluded that vibration maneuver had a positive relationship and highly effective in reducing pain for intravenous cannulation. Recommendations: The study recommended that the vibration experience be applied to patients during cannulation insertion in adult segments.
Copyright (c) 2025 Alaa Kareem Azeez; Alaa Jawad Kadhim, Hadi Ahmadi Chenari https://creativecommons.org/licenses/by/4.0
The Effect of Cooling Face Therapy on Recovery from Pain for Patients after Rhinoplasty: A Randomized Controlled Clinical Trial
Objective(s): The present study aimed to test the effect of cooling face therapy on recovery from pain for patients after rhinoplasty. Methods: a randomized clinical trial was conducted in AL-Kindi teaching hospital and AL-Wasiti teaching hospital from 22 November ,2023 to 5 June, 2024. After the sample was selected, 53 patients were divided into two groups, an experimental group with 26 patients, and a control group with 27 patients. To achieve the purpose of study in the experimental group, a cold gel mask. pain was assessed using a Numerical Pain Scale, the interview method was chosen for data collection. Results: The data analysis showed all patients had pain in the pre-test, while the results showed that the average pain scale post-test for the intervention group with the cold gel mask was 50% with no pain, while in the traditional care group the pain intensity was 37% with moderate pain. so, there was a highly significant difference in pain levels between the experimental and control groups at p-value < .001). Conclusion: It is concluded from the results of the study that applying a cold gel mask is effective in reducing pain after rhinoplasty compared to traditional ice compresses. Recommendations: The study recommends the use of a cold gel mask after rhinoplasty to reduce pain after rhinoplasty.
Rhinoplasty, Cooling face therapy, Pain, Nursing.
Copyright (c) 2024 Maisam Saadoun Hamidi, Alaa Jawad Kadhim, Aghaie Bahman https://creativecommons.org/licenses/by/4.0
Knowledge and Attitudes of Seniors about Diabetes Mellitus
Objective(s): To evaluate the knowledge and attitude towards diabetes and their association with age, marital status, education level, and monthly income among seniors with diabetes mellitus. Methods: A cross- sectional descriptive study was carried out among 69 seniors with diabetes mellitus who were attending the Center for Endocrinology and Diabetes in AL-Muthanna Governorate. Data were collected using two scales; one for knowledge (DKN) and the other for attitudes through self-reporting. Data were analysed using IBM-SPSS. Results: The study indicated that the knowledge of senior patients was very poor in all items of the DKN scale and, only 6 (8.7%) had acceptable knowledge, while 63 (91.3%) of them lack information about diabetes mellitus type2. As well as, their attitude was negative in most items of attitude scale, with a mean total of 2.43 ± 0.584. In addition, there is a statistically significant association between patients’ knowledge and monthly income at the level of 0.05. Conclusion: The seniors had a poor knowledge with negative attitudes toward diabetes. Recommendations: Significant efforts are required to enhance seniors' understanding and attitudes toward effectively managing their health and illnesses
Knowledge, Attitudes, Self-care, Seniors, Diabetes Mellitus, Nursing.
Copyright (c) 2024 Mohammed K. Mezher ‎, Ala’a Hassan Mirza Hussain https://creativecommons.org/licenses/by/4.0
Enhancing Nurses' Knowledge-related Prevention of Sudden Infant Death Syndrome
Objective(s): to enhance nurses' knowledge-related preventing sudden infant death syndrome by applying a nursing program based on updated recommendations of American Academy of Pediatric for a Safe Infant Sleeping Environment (2022). Methods: A quasi-experimental study with two study groups (pre-test, post-test I, and post-test II) carried out at Children's Welfare Teaching Hospitals and The Central Teaching Hospital of Pediatrics in Baghdad City from September 14th, 2023 to February 21th, 2024. The study recruited fifty nurses, divided into two groups equally. The study used the validated Knowledge test instrument with (10) items (multiple choices). An Educational program is built according to American Academy of Pediatric update guidelines for sudden infant death syndrome. Version 26.0 of the Statistical Package of Social Sciences (SPSS) was used to analyze the research's data. Results: The study results indicate that the majority of nurses had a poor level of knowledge (M=0.38) prior to the application of the program, while the post-test showed a good level of knowledge during posttest 1 (M=0.80) and posttest 2 (M=0.69) among nurses in the study group. Compared with the control group, nurses showed fair knowledge during the pretest (M = 0.45), posttest I (M = 0.37), and posttest II (M = 0.38), regarding the prevention of sudden infant death syndrome. Conclusion: This study suggest that the nursing educational program yields tangible positive outcomes on improving nurses' knowledge-related prevention of sudden infant death syndrome. Recommendations: The Iraqi Ministry of Health might benefit from adapting this guide on the prevention of sudden infant death syndrome as a training program for nurses to improve their knowledge of the prevention of sudden infant death syndrome and to conduct further studies on a large sample of nurses in order to disseminate better and apply evidence-based practice.
Nurses, Knowledge, Prevention, Sudden Infant Death Syndrome
Copyright (c) 2024 Safa A. Mohammed, Afifa R. Aziz https://creativecommons.org/licenses/by/4.0
Factors Influencing Caring Ability of Family Caregivers of Children with Cancer
Objective(s): This study aimed to investigate factors influencing the caring ability of family caregivers of children with cancer based on caregiver sex, level of education, kinship to the child, and the child's sex. Methods: A descriptive study was conducted on 200 family caregivers of children with cancer, selected through non-probability (purposive) sampling technique in the Hematology and Oncology Center at Welfare Teaching Hospital from January 2nd, 2024, to March 27th, 2024. Data were collected using “the Caring Ability of Family Caregivers of Patients with Cancer Scale (CAFCPCS). Through a self-report method. Data were analysis using SPSS (version 24), employing descriptive and inferential statistics. Results: The study showed that there are several factors that affected the caring ability of family caregivers to their children with cancer, including the child’s kinship (p = .037), education level (p = .000), and monthly income (p = .003). Additionally, a significant correlation between the sex of caregivers and effective role play (p = .022), negative correlation between the education level of caregivers and the total score of caregiving abilities (p = .006). Conclusion: The study concludes that familial relationship, education level, and income significantly affect caregivers' abilities in caring for children with cancer. The sex of caregivers plays a role in their interactions with children with cancer, with mothers having greater knowledge and broader experience in caregiving. Recommendations: This study recommends that the Ministry of Health should encourage continuous family support, provide educational programs, and financial assistance to improve the abilities of family caregivers in dealing with their children with cancer. Mothers should be supported through women's workshops, and fathers' participation should be encouraged through specialized training programs.
Copyright (c) 2025 Hanan Hafedh Owed, Widad K. Mohammed https://creativecommons.org/licenses/by/4.0
Effect of Aromatherapy on Nausea and Vomiting of Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial
Objective(s): The aim of this study is to determine the effectiveness of aromatherapy in reducing nausea and vomiting in adult patients receiving chemotherapy. Methods: A randomized controlled trial was conducted on 66 patients with cancer undergoing chemotherapy at the Oncology Centre in Al-Kut City, Iraq, from November 7th, 2023, to June 13th, 2024. Patients were selected conveniently and randomly based on the inclusion criteria, and they were randomly assigned into two groups: the inhalation aromatherapy group and the control group. The first group inhaled peppermint oil for 20 minutes, while the control group did not receive any intervention and underwent only routine treatment. The Rhodes Index Scale was used to assess nausea and vomiting. Used SPSS version 26 to analyze the data, applying both descriptive and inferential analysis, and a one-way ANOVA test was used to determine the statistically significant difference between the two trial groups. Results: The findings revealed that there was a significant difference in the severity of nausea and vomiting in the aromatherapy groups compared to the control group, according to the mean of the aromatherapy group, which was 12.63, with a P value of 0.001. Conclusion: The Aromatherapy was found to be effective in reducing nausea and vomiting levels when compared to the control group. Therefore, inhalation of aromatherapy is recommended as an effective non pharmacological intervention to reduce nausea and vomiting related to chemotherapy. Recommendations: The study recommends healthcare professionals, particularly nurses to utilize nonpharmacological techniques such as aromatherapy that have been validated as effective more often for alleviating nausea and vomiting caused by chemotherapy.
Aromatherapy; Nausea and vomiting; Cancer patient, Chemotherapy, RTC, Nursing.
Copyright (c) 2024 karrar Hassan Abd Al-Sada, Rajaa Ibrahim Abed https://creativecommons.org/licenses/by/4.0
The Prevalence of Smoking Traditional Cigarettes, Hookah and Electronic Cigarettes among Palestinian University Students
Objective(s): To assess the prevalence of smoking cigarette and e-cigarette among Palestinian university students and to investigate personal characteristics, associated with cigarette and e-cigarette smoking. Methods: A cross-sectional survey using self-structured questionnaire administered among 470 students from Palestinian universities in three cities: Ramallah, Nablus and Hebron, between February, 2023 to May, 2023. The questionnaire included 31 questions related to the frequency and habits of smoking traditional cigarettes, hookah and e-cigarettes. Results: The study involving 401 students with an overall response rate 85% with a mean age of 20.5 and revealed demographic patterns in smoking habits. Gender significantly correlated with smoking, with 80.1% of males and 44.2% of females being smokers. Traditional smoking was higher in males (66.4%), married individuals (53.7%), and those with higher income (> 5000 NIS, 57.1%). Other factors, such as age, social status, residency, type of college, and academic level, showed no significant correlation with smoking E-cigarettes and hookah usage. The highest prevalence was hookah smoking (41.96%), traditional (31,16%) and lowest E- cigarette (26,88%). Conclusion: Males exhibit higher rates than female, especially in traditional smoking. E-cigarettes were popular due to their ease of use and unique flavors. Urgent action is needed, focusing on awareness campaigns about health risks and exploring associated factors for targeted interventions. Recommendations: An increase the level of awareness should be enhanced among university students in Palestine about the harmful consequences of different types of smoking on the overall health.
Copyright (c) 2026 Dr. Rebhi Bsharat, Nurse Hadeel, Neda Kayeed, Sonia , Hamed,, Noor Allawi https://creativecommons.org/licenses/by/4.0
Nurses’ Practices in Ensuring Child Safety in Hemodialysis Centers
Objective(s): This study’s objective is to evaluate nurses’ practice of patients' safety in pediatric hemodialysis centers and find which sociodemographic data are affecting on their practices. Methods: A descriptive study has been applied to 48 nurses working at the hemodialysis centers at two Teaching Hospital in Salah Al-Din Governorate. The study was conducted on September 1st, 2023, to March 5th, 2024, utilizing non-probable sampling technique.A valid observational checklist by CDC used, consists of eight nursing responsibilities to evaluate nurses-based practice for patients` safety. The checklist was filled using a trichotomous scale with three evaluations: never (1 – 1.66), sometimes (1.67–2.33), and always (2.34–3). Data was entered and analyzed by SPSS program version 24. Results: Most participants nurses were female, the majority of them were between the ages of 25 and 30 years with 70.8%. Their work experience was about 1-3 years in nursing and the hemodialysis department with 45 % of total nurses. The findings of the current study revealed that nurses had a moderate practice of children safety with an overall mean score of (1.8762). The study showed that there was a statistical relationship between the nurses' practicesand their nursing qualification. Conclusion: The study concluded nurses` practices for keeping children safety were inadequate. This inadequate level may lead to medical errors, complication, and financial burden for the family and health institutes. Recommendation: It is recommended that the hospitals implement specialized training programs relevant to patients' safety to enhance nurses’ awareness of children safety and improve quality of nursing care for pediatric patients.
Pediatric hemodialysis, Nurses' practice, Children safety, Quality improvement
Copyright (c) 2024 Ammar A. Fadhil, Zaid W. Ajil https://creativecommons.org/licenses/by/4.0
Barriers of Delivering Nursing Care to Children at Intensive Care Units: A Mixed Method Study
Objective(s): To determine barriers for delivering nursing care for children at Intensive Care Units. Methods: A mixed method research, employing (convergent parallel design) was used in this study. A non-probability (purposive) sampling of 60 nurses were employed, 15 of them were included in the qualitative part of the study. The data were collected from three different intensive care units from January 3rd to February 20th, 2024, using the performance obstacles assessment questionnaire for the quantitative part of the study. An official permission to use the study questionnaire was obtained from the corresponding author. A semi-structured interview technique was used to collect the data. It took about 45-60 minutes for each participant to complete interview and record their responses. Quantitative data analysis has been established by using SPSS version 23, and the qualitative data analysis have been established based on thematic analysis. Results: Quantitative results presented barriers including all domains (environmental barriers, organization barriers, technological barriers, task barriers, and family barriers) in which the mean of all domains was 2.61 and higher. In addition, qualitative results showed that nurses who work at children intensive care unit were faced by several barriers during care delivery for children such as environmental barrier, technological barrier, task barrier, organizational barrier, and family barrier. Conclusions: Pediatric nurses were confronting barriers during delivering care to children due to lack of family awareness about care, lack of appropriate resources and devices, nursing shortage, and absence of clear protocol. Recommendations: Efforts should be prioritized toward finding solutions for all the barriers faced by pediatric nurses to ensure better quality of healthcare services.
barriers, pediatric nurses, children, intensive care unit, mixed method study، Nursing.
Copyright (c) 2024 Sura Saleem Dhamin, Serwan Jafar Bakey https://creativecommons.org/licenses/by/4.0
Effectiveness of an Educational Program on Collegians’ Perception of Healthy Dietary Patterns
Objective(s): To determine the effectiveness of the educational program on university collegians’ perceptions of healthy dietary patterns, and to determine the relationship between these perceptions and students’ socio-demographic characteristics such as age, sex, marital status, monthly family income, place of residence, and level of education. Methods: A quasi-experimental investigation was performed on students in the University of Mosul to assess the dietary pattern from November 9th of 2022 up to January 2nd of 2023. Non-probability sampling for a sample of (60) students divided into two groups, (study and control groups). Determine the validity of the questionnaire content by presenting it to the experts and using the half-division technique and calculating the Pearson correlation coefficient to determine its validity. A questionnaire has been constructed through extensive review of related literatures to accomplish the study's aims and objectives. Results: The results of data showed that all (60) students in the study sample did not have an adequate level of perception of healthy dietary pattern in pre-test, 12.53 (±3.72). while the results of the post-test after implementing the program results showed that there is an improvement in their perceptions of the healthy dietary pattern in the study group only, 19.43 (±3.98). Conclusion: The study showed that there was an improvement in perceptions of a healthy lifestyle related to dietary pattern in study group compared to those in the control group. Recommendations: The study recommended the need to develop educational programs, lectures, courses and seminars on the benefits of a healthy dietary pattern that university students must follow to increase their perceptions that lead to changing their lifestyle and getting rid of wrong behaviors and habits.
Effectiveness, educational program, dietary pattern, university students، Nursing.
Copyright (c) 2024 Ayed A. Mustafa, Hala S. Abdel Wahed https://creativecommons.org/licenses/by/4.0
Assessment of Challenges Encountering Nurses in Delivering Care to Patients with Cerebrovascular Accident
Objective(s): The aim of the study is to assess the challenges encountered by nurses in delivering care for patients with cerebrovascular accidents in the neurological departments. Methods: A descriptive study conducted purposely on 80 nurses working in the neurological departments in Baquba Teaching Hospital from January 9th to February 20th, 2023. Data analysis encompassed the application of both descriptive and inferential statistics. Result: Nuero-specialized nurses faced many challenges namely: workload and role conflict, psychological load, inadequate resources, and feeling of increased responsibilities. The study also found a significant relationship between challenging workloads and nurse’s workplaces, and their level of education. Conclusions: Nurses encounter challenges psychological load, inadequate resources, and increased responsibilities that hinder the delivery of nursing care for cerebrovascular accidents patients. Recommendations: This study recommends that healthcare organizations prioritize workload management strategies, supply the important resources, provide psychological support for nurses, offer education and training programs, and conduct further research about nursing challenges in different healthcare settings.
Assessment, cerebrovascular accidents, nursing care, nursing challenges
Copyright (c) 2023 firas khader https://creativecommons.org/licenses/by/4.0