kufa Journal for Nursing sciences

Background: Patient safety has been identified as a global importance health care challenges. There is a rising number of patients’ mortality in hospitals each year because of gaps in patient safety. Knowledge, attitude, and practice of the nurses toward patient safety have a main impact on the delivery of safe patient care.
Objectives: To assess knowledge, attitude, and practice towards patient safety among nurses.
Methodology: A cross-sectional design was conducted on 205 nurses working in Soran City of Erbil governorate. A self-reported questionnaire toward patient safety was used between February and March 2025.
Results: The results revealed that the mean age of the nurses was 33.77 years. More than half (51.2%) of them were male. The majority (81.5%) of them were graduated from nursing institute. The majority (57.6%) of them had working experience of ≥ 6 years. The nurse’s level of good knowledge, positive attitude, and good practice towards patient safety was 62.4%, 55.6%, and 48.3% respectively. The multi-variable logistic regression analysis showed that; age, years of experience, working hours per week were factors significantly associated with knowledge towards patient safety. The significant predictors of a positive attitude are age and years of experience. Marital status, years of experience, having information about patient safety during initial education, and receiving training about patient safety were factors significantly associated with practice towards patient safety.
Conclusion: In the present study, more than half of the nurses had good knowledge and positive attitude towards patient safety, yet only 48.3% engage in good practice. It is necessary to implement patient safety education curricula and focused training sessions.

Background: Neonatal respiratory distress syndrome (RDS) continues to account for significant morbidity and mortality in the preterm infant. RDS, sometimes called hyaline membrane disease, is a syndrome due to a deficiency in production of a substance that promotes lung growth leading to structurally immature lungs in the newborn and impaired lung functions. Therefore, caring for children with respiratory distress syndrome demanding alert, skillful, and sensitive nurse.
Objectives: The study aimed to assess the scientific knowledge and practice of nurses regarding their care provided to premature infants with respiratory distress syndrome in pediatric teaching hospitals at Mosul city.
Methodology: The present study utilized a descriptive, cross-sectional design and was carried out on a sample of 120 nurses. that were selected from working in premature units and NICUs in the pediatric teaching hospitals in Mosul city from period 16th March 2025 to 25th May 2025. Data was collected using a structured interview questionnaire designed by researcher. The data was analyzed performed by Statistical Package for the Social Science (SPSS, version 25).
Results: The study findings shows that the majority of the study sample were female 80% and 20% of them were male, the study showed that majority of the study sample 68.3% at age range between 20-29 years, while 26.7% of them their age ranged between 30-39 years. The study showed 46.7% of the study sample had acceptable knowledge related to care for premature infants suffering from respiratory distress syndrome. 25% of the study sample had a poor knowledge related to care of premature infants suffering from respiratory distress syndrome.
Conclusion: The finding of the study reported that mean total knowledge score of study participants regarding the caring of the newborn with respiratory distress syndrome was 72.8%, while the level of practice in providing care of the newborn with respiratory distress syndrome was 80.4%. In additional, the research revealed significant differences in age, gender, educational level, and participants' knowledge and practice levels in caring of newborns with respiratory distress syndrome.
Recommendation: The study recommended that the nurses working in premature units and neonatal intensive care units should attend the training programs periodically to update their knowledge and skills in care of the neonates with respiratory distress syndrome.

Background: Second and third-degree burn wounds are an ideal environment for colonization by bacterial pathogens due to damage to the skin barrier, where S. aureus, Pseudomonas aeruginosa, and Acinetobacter baumannii predominate. They are characterized by high resistance to antibiotics and the ability to form biofilms, which increases infection and sepsis rates. Therefore, early diagnosis of pathogens can facilitate rapid recovery and prevent them from penetrating the body.
Objectives: This study aimed to determine the prevalence and distribution of bacterial pathogens in burn wounds at our center to inform local infection control and empiric treatment protocols.
Methodology: Cross-sectional study of 60 patients, ages ranging from 1 to 60 years, for both sexes. Swabs were processed via culture on standard and selective media, with identification via biochemical tests and VITEK-2.
Results: All patients suffered from second and third degrees of burns, and most of them were women at a rate higher than that of men. As for the age group, 21–30 had the highest percentage of burned people under study compared to the rest of the age groups. 44 bacterial isolates were identified, 29 isolates from patients with second-degree burns and 15 isolates from patients with third-degree burns, including 19 isolates of Pseudomona aeruginosa, 13 isolates of Acinetobacter baumannii, and 9 isolates of Staplylococcus aureus. At the same time, there were 3 isolates of klebsiella pneumonia bacteria.
Conclusion: Early detection prevents the progression of local wound infections to septic shock, the leading cause of death in burn units. These types of bacteria, known as hospital-acquired bacteria, possess complex defense mechanisms and are classified as multidrug-resistant. Their presence in the burn area often leads to skin graft failure, as they inhibit the growth of new cells responsible for adhesion. Furthermore, knowing this allows doctors to choose the appropriate antibiotic instead of relying on guesswork, thus reducing the exacerbation of resistance.

Background: Primary caregivers or parents play critical role in managing broad group of children who require particular educational, social, and medical treatments due to physical, cognitive, and mental disabilities, which may contribute to impairment in family well-being and impairments in quality of life for both child and their family. It is common for caregivers of children with special needs to feel more psychological stress.
Objectives: The aim of the study was to assess of psychological distress among caregivers of children with special needs and find out the relationship among psychological distress and socio-demographic characteristics.
Methodology: The current study utilized a descriptive (cross-sectional) design was conducted on (111) study sample included all caregivers who attended seven institutes (Al-Amal Institute for deaf, Al-Noor Institute, Al-Raja Institute, Al-Rayahin Institute, Al-Mustakbal Institute, Al-Saada Institute for Autism, and Al-Amal Institute for Impaired hearing) from 12 November 2025 to 15 January 2026. A purposive non-probability sampling was used. Furthermore, a adopted two tools used: Kessler scale, a personal and clinical characteristics for child and personal characteristics for caregivers questionnaire sheet was added. Data were analyzed using descriptive statistics and Kruskal-Wallis H test to determine the statistical differences and relationship.
Results: The results of the study revealed the majority of caregivers of children with special needs who participated in this study have moderate level of psychological distress with mean of scores (25.64). There is a non-significant relationship between Psychological Distress for caregivers and their socio-demographic trait such as age, sex, level of education, monthly income at (P<0.05).
Conclusion: The findings of this study conclude caregiving for child with special needs stress factor in itself, regardless of the social, economic background of caregivers. Therefore, providing families with educational programs helps increasing caregivers' awareness about causes, signs and symptoms and how to relief stress by using Coping strategies.

Background: Miscarriage, also known as spontaneous abortion, is the spontaneous termination of a pregnancy before 28 weeks of gestation, or the birth of a nonviable fetus weighing 500 grams or less.
Objectives: Objectives of the study are to determine the risk factors of pregnant women and examine the relationship between variables.
Methodology: The study was carried out in Babylon Teaching Hospital for Maternity and Children and Al-Imam Al-Sadeq Teaching Hospital in Iraq. Non-probability using a purposive sample of (50) pregnant women was accomplished from 17th October /2024 to 25 March/ 2025. Data was gathered by using an instrument developed by the researchers through the interviews with the pregnant women. The statistical analysis was utilized to examine the data and obtain the findings by using the SPSS application.
Results: The study found that 44% of the participants were aged 18–27 years, and 42% had a basic elementary education. Regarding obstetric history, 52% of the women had a history of previous miscarriage, and 44% had three or more pregnancies (gravidity). Statistical analysis revealed a significant association between miscarriage risk factors and maternal age, parity, and background knowledge of antenatal care (P < 0.05). Notably, there was a highly significant association between the risk of miscarriage and the number of previous miscarriages (P = 0.004). Among maternal risk factors, increased weakness, fatigue, and physical/psychological exhaustion were identified as significant risks by 54% of the sample.
Conclusion: The study concluded that there is a significant association between the age of pregnant women and a number of labor (parity) and risk factors of miscarriage at (P value less than 0.05).
Recommendations: The study recommended educating mothers to take care during the first trimester to avoid any complications and educating families about the risk factors for miscarriage.

Background: Diarrhea is one of the most prevalent disorders, and it causes mortality due to a lack of bodily fluids, which causes severe dehydration (Kolsin et al., 2018). Viruses, bacteria, fungi and parasites infections are the major causes of diarrhea.
Objectives: This study aims to identify the infectious agents responsible for persistent diarrhea among adults A total of [265 for male , 324 for female] aged 25–60 years in hospitals across Al-Najaf.
Methodology: Microbial data were collected during September and October of 2023 to determine the prevalence of bacterial, viral, fungal, and parasitic infections associated with diarrheal cases.
Results: The findings indicate that Vibrio cholera represented the predominant bacterial infection in September, while E. coli and E. histolytica appeared more frequently among males. Limited cases of fungal and viral infections were detected, with no reported Salmonella infections. In contrast, October showed a reduction in bacterial infections and an increase in certain parasitic and fungal cases, alongside the emergence of Nile virus infections that were absent in September. These patterns highlight a noticeable seasonal variation in microbial diarrheal infections within the region.
Conclusion: Acquired bacterial pathogens, particularly Vibrio cholera and E. coli were listed as the causes of diarrhea among adults in Al-Najaf governorate during September 2023. During this period a strong statistical association (p < 0.0001) was found between female gender and cholera infection.

Background: Diabetes Mellitus (DM) is a clinical syndrome characterized by hyperglycemia due to an absolute or relative deficiency of insulin.
Objectives: The study aimed to assess the knowledge on DM and its associated risk factors among type 2 diabetic patients in endocrine center in Sulaimaniyah city.
Methodology: A descriptive cross-sectional study was carried out among 308 diabetic patients by using convenient sampling. Face to face interview was used to collect data. Data were collected from October to November 2025.
Results: The high percentages of participants were age between 41-65 years old (75%), (31.8%) female, (48.7%) illiterate, (76%) married. Most of participants were unemployed 54.9%. Good knowledge about diabetes mellitus was 32.5%, and poor knowledge about diabetes mellitus was 32.5%. The correlation between socio-demographic variables and the general knowledge of diabetic mellitus among the participants revealed that gender, educational level, occupation, and place of residence were significantly correlated. Similarly, there was a highly association between patient's overall knowledge on diabetes mellitus and heredity, smoking, alcohol consumption, and monitoring the diabetes.
Conclusion: The study concluded that the need of improving patient’s awareness on diabetes mellitus in order to obtain better health outcomes. It is crucial to provide diabetic patients education, pamphlet and counseling sessions to enhance their knowledge.

Background: Poor sleep quality is a prevalent public health concern among health professions students and has been associated with adverse academic, psychological, and health outcomes. Identifying modifiable determinants of poor sleep quality is essential for developing targeted interventions in this population.
Objectives: This study aimed to determine the prevalence of poor sleep quality and examine the roles of physical activity, perceived stress, and smartphone use as determinants of poor sleep quality among undergraduate health professions students in the Kurdistan Region of Iraq.
Methodology: In this cross-sectional study, 871 undergraduate students from five health professions disciplines at two public universities in Sulaymaniyah, Iraq, participated. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Additional covariates included perceived stress (Perceived Stress Scale-10; PSS-10), physical activity (International Physical Activity Questionnaire–Short Form; IPAQ-SF), and problematic smartphone use (Smartphone Addiction Scale–Short Version; SAS-SV). Data were analyzed using multivariable binary logistic regression to estimate Adjusted Odds Ratios (AOR).
Results: Poor sleep quality was identified in 60.7% of participants (mean PSQI: 7.04 ± 3.45). After multivariable adjustment, nine predictors were independently associated with increased odds of poor sleep quality: moderate perceived stress (AOR = 6.895), high perceived stress (AOR = 6.549), obesity (AOR = 6.773), paid employment (AOR = 4.591), dormitory residency (AOR = 4.188), chronic illness (AOR = 3.855), overweight status (AOR = 3.584), pre-sleep caffeine intake (AOR = 1.677), and problematic smartphone use (AOR = 1.649). High (AOR = 0.208) and moderate (AOR = 0.439) physical activity levels and pre-sleep dairy consumption (AOR = 0.409) were independently associated with reduced odds of poor sleep quality.
Conclusion: The high prevalence of poor sleep quality among health professions students underscores the need for multi-level, evidence-based interventions targeting modifiable lifestyle and environmental factors at the university level.

Background: Family caregivers are key players in the provision of support to mentally ill patients, especially in low-resource and community-based care facilities.
Objectives: The objective of the proposed study was to investigate the experiences of family caregivers concerning persons with mental illness and their knowledge and perceptions of the caregiving role.
Methodology: The qualitative descriptive design was adopted in the form of the six phases in the thematic analysis framework by Braun and Clarke. A total of 20 family caregivers of the outpatient psychiatric clinics of Azadi Teaching Hospital were recruited using purposive sampling. The data were gathered using semi-structured face-to-face interviews in Arabic, audio-taped, transcribed in their verbatim, and English translations. The collection of data was done until saturation was reached.
Results: There were six high-level themes, including caregiver duties and stress, emotional and psychological impact, role transformation and altered family relationships, coping strategies and lack of support, knowledge and misconceptions, and resiliency and new outlook. Caregivers reported they spent many hours a day supervising, the person didn't take medication, risked their safety, became emotionally exhausted, placed financial burdens on the family and felt stigmatized. Poor mental health literacy and cultural models of explanation were affecting behaviors of seeking help and management of crisis.
Conclusion: Mental illness family care is a multidimensional and transforming experience that may be associated with a high burden and considerable resilience. It is critical to enhance family-focused psychoeducation, diminish stigma, increase access to services and enhance culturally competent support systems.