Iraqi National Journal of Nursing Specialties

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.

Objective(s): To assess the pregnant women's self-efficacy for maintaining weight during pregnancy.

Method(s): A descriptive study design was conducted in Mosul city for the period from July 2nd, 2022 to November 7th, 2022. A non-probability (convenience) sample was selected from (532) pregnant women who attended the primary health care centers. A questionnaire was developed through review of relevant literature, and consists of two parts namely: participant socio-demographic characteristics, and self-efficacy of pregnant women in relation to physical activity and healthy eating habits and behaviors to assess self-efficacy of pregnant women. The data was collected through the use of the study tool and the interview technique. The data was analyzed using the SPSS program, version (26), applying the descriptive approach to data analysis.

Results: The results of the study showed that (31.8%) of pregnant women were aged between (26-30) years, (84.02%) of them lived in the city, (68.80%) were housewives, more than half of pregnant women lived in their own homes (57.89%). The study also showed that more than half of pregnant women were overweight during pregnancy at a rate of (68.3%), and (44.18%) of them consumed unhealthy food.

Conclusions: The study showed that most of pregnant women suffer from overweight and obesity during pregnancy, as they do not practice daily physical activity, and follow an unhealthy food.

Recommendations: The study recommended the need to develop educational programs about the importance of exercise, healthy nutrition, and the risks of gain weight during pregnancy.

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.

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.

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.

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.

Objective(s): To assess the level of job performance among nurses exposed to workplace violence, and to examine the association between workplace violence exposure and nursing job performance in pediatric emergency departments.

Methods: A descriptive cross-sectional study was conducted to assess the job performance of nurses who were exposed to workplace violence at emergency departments. A non-probability, convenience sample was selected 72 nurses who experienced workplace violence at pediatric emergency departments in Baghdad Governorate pediatric hospitals. A Six-Dimensions Scale was used to assess job performance between nurses who experienced workplace violence, the data were collected using self-administration technique. The data analyzed by using the descriptive and inferential processes through SPSS version 26.

Results: Over half of the nursing staff (53.3%) had experienced workplace violence at emergency departments, predominantly non-physical violence (51.1%). Nurses with work violence exposure demonstrated a moderate level of job performance (80.6%; M = 105.08 ± 13.50), whereas nurses without wok violence exposure predominantly showed a good level (76.2%; M = 130.79 ± 15.43). A statistically significant difference was identified between the two groups (U = 482.5, p < 0.001).

Conclusion: Workplace violence has a significant negative influence on nursing job performance, particularly across leadership, teaching/collaboration, planning/evaluation, interpersonal relations, and professional development domains. Critical care performance remained at a good level despite WPV exposure.

Recommendations: Healthcare authorities and Ministry of Health decision-makers need to enact a Nurses Protection Law, mandate systematic reporting of workplace violence incidents, and implement rotating shift systems to mitigate workload-related vulnerability.

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.