kufa Journal for Nursing sciences

Background: Vitamin D, known for its immunoregulatory effects and antimicrobial properties, plays a crucial role in regulating inflammation and chemokine production. Zinc is influential for a healthy immune system and human health, influencing cell differentiation, proliferation, and apoptosis, which impact organism growth.
Objectives: Determine the serum zinc and vitamin D3 levels in UTI patients and controls to detect the role of Vit. D3 and Zn in UTIs, and their levels in recurrent and non-recurrent infections.
Methodology: Samples of 60 urinary tract infection patients, distributed between 30 females and 30 males, were collected from Imam Hassan Al-Mujtaba Hospital for the period from December 2022 to April 2023. After collecting venous blood samples from patients and the controls, the serum was separated to measure the concentrations of vitamin D3 and zinc. The concentration of vitamin D3 was measured using the Cobas system, while the concentration of zinc was measured using a Mindray device.
Results: UTI patients have lower serum zinc levels than the controls group, with the patient group having 83.0 mg/dL compared to the control group. Vitamin D3 was also low in the patients group compared to controls (10.50, 12.58 respectively).
Conclusion: Vitamin D3 and zinc levels can influence UTI development, with patients having lower serum vit. D3 and zinc than the controls group, indicating a potential risk of UTI.

Background: Suicide is a grave public health issue that impacts people of all ages, including children and teenagers, and represents a significant global public health concern. This study concentrates on recent advancements in our comprehension of trends and risk factors related to children and adolescent suicidal behavior. While suicide is among the leading causes of mortality in many Western countries, it was, until recently, an exceedingly rare phenomenon in Eastern countries.
Objectives: The study aims to explore on the trends in suicide attempt behaviors among children and adolescents. it was, until recently, an exceedingly rare phenomenon in Eastern countries.
Methodology: The research objectives were achieved through a descriptive-analytic study. Incidence in suicide attempt behaviors between 2015 and 2018 among children and adolescents in Al Najaf Al Ashraf were identified. The study was conducted in the Al-Najaf province from December 2nd, 2022, to April 16th, 2023. A non-probability purposive sample of 156 participants was included in the study. Data were collected from at Hakeem teaching hospital and from police center documentation in hospital between December 16th, 2022, and January 20th, 2023. The study instrument consisted of two parts: Part I included a socio-demographic characteristics sheet with three items, gender, age, and residence. Part II focused on the method of suicide attempt (poisoning, jumping from a high place, shooting, cutting of the artery, strangulation, hanging, and burning).
Results: The highest percentage of the study sample (46%) within age group (18 years) or younger, (52%) were female. Notably, suicide attempts were highest in 2017 compared to the frequencies in 2015. A significant relationship was observed between suicide attempt behaviors and gender.
Conclusion & Recommendations: Poisoning was the most common method, while the percentage of attempts involving cutting of the artery was lower. Limit access to the means of suicide, such as pesticides, drugs, and weapons. Focus on treating individuals with mental disorders, especially those struggling with depression, schizophrenia, and alcoholism. In our community, poverty, deprivation, and unemployment should be addressed as political priorities, with decision-makers actively working to strengthen the community economically and ensure equal employment opportunities.

Background: Pregnancy is one of the most important periods in the life of woman. Nutrition plays an essential role in the development of a healthy pregnancy. The importance of the taking adequate essential vitamins such as Folic acid both before and during pregnancy is emphasized for the wellbeing of a developing embryo.
Objectives: The purpose of this use study is to assess the level of pregnant woman’s Information regarding adherence of using folic acid supplementation in Rania City.
Methodology: In a descriptive cross section study, 100 women were selected. On the basis of questionnaires and interviews, data was obtained during the month of (December, 2020 to March, 2021). Data was analyzed using SPSS Version 23.
Results: The obtained information revealed that (71%) of pregnant women had intermediate level of knowledge Although excellent knowledge of folic acid was only (14%). Doctors are major sources for promoting awareness about folic acid. There is a significant relationship between the knowledge, level of education, age group, and monthly income. There were more women with high levels of knowledge among those who had lower parities, had more education, and were looking for health-related information.
Conclusion: Results acquired have shown some understanding towards the perception of folic acid among pregnancy. Therefore, it is important to increase the awareness of folic acid supplementation among women who are or planning to become pregnant.

Objectives: This is from the most important study in Iraq that investigates the psychological alienation related to problematic internet use in married female students.
Methodology: The descriptive correlational study design is carried out by questioning individuals of the research population to describe the phenomena simply in terms of its type and degree of existence. Asking study participants about their problematic internet use, level of psychological alienation and emotional divorce, and how the descriptive approach is used. Since the problem of the study is related to the present, and its study will be done through direct asking, as well as this study aims to stop at the limit of description and correlation between study variables (problematic internet use vs. level of psychological alienation and emotional divorce). This study started from 10th November 2022 to 20th December 2023. and was approved by the council of the College of Nursing before the initiation of the study and distribution of the questionnaires to be completed by the sample, the targeted setting (Kerbala University).
Results: the results show that there is a positive correlation between problematic internet use and psychological alienation. This indicates that the greater the use of the Internet, the greater the percentage of psychological alienation among the sample of women who underwent the research.
Conclusion: This study aimed to bridge this gap by providing a more comprehensive overall picture of this issue through a quantitative synthesis. more than half of students who have met to some extent of problematic internet use have an average level of psychological alienation among married female students.

Background: The Internet has become an essential part of modern life, used by a large number of people of all ages, especially teenagers. Therefore, the number of its users around the world is increasing daily, exposing some to its negative effects such as Internet addiction (I.A.). Internet Addiction is the frequent and reckless use of electronic devices, which may be present for a long time when engaging in non-work-related activities which can lead to physical, social, psychological, and academic problems.
Objectives: The current study was conducted to determine the I.A. level among secondary school students and determine the extent of their awareness effects of I.A.
Methodology: A cross-section descriptive study design was used through present research from the period of 10th December 2022 to 30th December 2023; the total participants were 765 secondary school students, (390) girls, and (375) boys, recruited from Ten secondary schools in the center and districts of Babylon Governorate in Iraq. The data were gathered by utilizing the structured questionnaire and the interview technique with the participants.
Results: The research finding revealed that (69.9%) of the sample recorded a high level of I.A. The majority of Internet addicts are males. Most of the study participants have a fair level of awareness about the psychosocial effects of I.A.
Conclusion: According to the research findings, secondary school students recorded a high level of I.A. with males being the majority among Internet addicts. Most participants demonstrate fair awareness of the psychosocial effects of I.A., and females show higher awareness compared to males. The Internet addiction level among the study sample is not affected by their level of awareness of its psychosocial effects.
Recommendations: The researcher recommended that cooperation between the school and parents is necessary to limit the spread of the phenomenon of Internet addiction. Also, recommend conducting similar research on a different sample using new independent variables

Background: Time management in nursing is essential for stress reduction, effective job management, and positive results for both patients and the organization.
Objectives: The aim of the study is to explore the lived experience of nurses and method use in time management strategy for dimension of time management for Intensive Care Unit nurses.
Methodology: A phenomenological study design was used, targeting ten nurses who worked in the intensive care unit were interviewed. The seven-step phenomenological by Colaizzi. .
Results: The intensive care unit nurses managed time/tasks delegated to the nursing team through the make planning to identify the objectives, goal to be realistic, goals based on the needs. Priority by move to a new task before the end of the previous task, the work more than once, lack goals, priorities, or plans daily. Goals setting, by Recognize the errors, many requests in same time, and poor performance, modify plans and good relationships with other nurses, and schedule. Time commitment, by Arrive late, leaving work, allotted time off to nurse during the official feast. Share in decision-making. Time waster, by Shortage of nurses. Ineffective delegation, Lack of motivation. no coordination between the administration and nurses disorganized work, Miscommunication, Procrastinating. The intensive care unit nurses managed time/tasks delegated to the nursing team through the make planning to identify the objectives, Goal to be realistic, Goals based on the needs. Priority by Move to a new task before the end of the previous task, the work more than once, Lack goals, priorities, or plans daily. Goals setting, by Recognize the errors, many requests in same time, and poor performance, modify plans and good relationships with other nurses, in addition, schedule. Time commitment, by Arrive late. Leaving work. Allotted time off to nurse during the official feast. share in decision making. time waster, by Shortage of nurses. Ineffective delegation, Lack of motivation. no coordination between the administration and nurses disorganized work, Miscommunication, Procrastinating.
Conclusion: Intensive care unit nurses make a time management, extend available time, and prevent time waste by maximizing available time, facilities, and opportunities. Nursing in intensive care unit make plan, priority, goalsetting, time commitment, time waster.
Nursing Implication: It challenges the idea that time management is all about the nurses. It shows how five-time management dimension plaining, goalsetting, time commitment, priority, and time waster. Time management is a relationship with care can provided by nurses. Good time management is a skill that can be honed; it is not innate. Every nurse needs to acquire the means that will allow him/her to effectively manage time.

Background: A condition known as coronary artery disease occurs when the myocardium does not receive enough blood or oxygen. It is caused by blockage of the coronary arteries and is characterized by an imbalance in the supply and demand of oxygen. Usually, it involves blood flow obstruction caused by plaques that form in the coronary artery lumen. It is the leading global cause of death.
Objectives: this study aims to measure the impact of slow deep breathing exercises using incentive spirometry on functional capacity of patients with coronary artery disease.
Methodology: Participants in this quasi-experimental research design included patients with coronary artery diseases. Patients with severe respiratory conditions, a history of coughing, difficulty breathing deeply, non-pulmonary status at first examination, and inability to complete the study were among the exclusion criteria. the participants in the study were 50 samples (25 research groups and 25 control groups), the research groups were given an incentive spirometer in addition to hands-on instruction on how to use it and collect accurate measurements. Patients were told to lie down or sit in order to breathe in and out through the tube 10 times. Patients were instructed to do this exercise three times every eight hours for a duration of three weeks.
Results: Three weeks following the intervention, a re-assessment of the functional capacity, revealed an improvement in factional capacity solely in the study groups relative to the pre-test.
Conclusion: Using an innovative spirometer, the study demonstrated the impact of various deep breaths on the functional capacity of patients with CAD. Nearly all patients demonstrated a significant short-term improvement in their functional capacity, and no significant side effects were found. Consequently, this methodology can be applied in subsequent research to examine long-term impacts for weeks or months. Because it is simple to use and the measurement is non-intrusive, this method is perfect for self-monitoring at home.

Background: Providing care for a child diagnosed with cancer presents significant emotional and psychological difficulties for parents, especially mothers.
Objectives: The study investigates association between psychological aspects and coping strategies among mothers of children with cancer.
Methodology: A Correlational study was undertaken at the Middle Euphrates Cancer Center in Al-Najaf Al Ashraf Governorate from July 31th, 2022, to September 28th, 2023. The questionnaire\'s validity was ensured through expert consultation, and its reliability was established through a preliminary pilot study. Data were collected by structured interviews using the questionnaire and subjected to thorough analysis employing both descriptive and inferential statistical methods.
Results: The findings of this study show that a significant percentage (54.9%) of mothers with children diagnosed with cancer are experiencing significant psychological distress. Moreover, a substantial number (58.8%) of these mothers are using coping strategies that are not very effective. The study also reveals a strong, negative correlation between the psychological well-being of these mothers and their coping strategies, particularly in areas such as family integration (r = -.445; p < 0.01), social support (r = -.353; p < 0.01), communication with healthcare professionals (r = -.522; p < 0.01), and overall coping (r = -.624; p < 0.01).
Conclusion: The study highlights the alarming prevalence of psychological distress among mothers with children diagnosed with cancer and underscores the ineffectiveness of many coping strategies employed by these mothers. It is recommended that healthcare professionals and support organizations prioritize the provision of tailored psychological support and social support networks to alleviate the psychological burden faced by these mothers.

Background: Vital signs are a reliable way to assess the essential physiological processes of a living being. The reason they are called "vital" is that figuring out how valuable and important they are is a crucial first step in any clinical evaluation. One of the first clinical evaluations is looking at the patient's vital signs. Following orientation, education and training are two crucial components of nursing staff advancement.
Objectives: the current study aims to evaluate effectiveness of short training program on nurse’s knowledge and practice regarding vital signs measurement.
Methodology: A quasi-experiment, a type of research approach, was employed. The subjects of this study were thirty nurses who worked directly with patients at the Heevi Teaching Hospital and were selected at random. Three instruments were used to collect the data: a questionnaire, sociodemographic information, and the nurses' proficiency in taking vital signs.
Results: The current study found that nurses' overall mean acquaintance and competence degrees increased with a statistically significant difference 30 days following the program's deployment. The nurses' performance and comprehension both significantly improved once the vital signs measuring nursing instruction was put into practice.
Conclusion: Nurses' expertise and proficiency in measurement of vital signs were lacking. Nurses may be able to improve their knowledge and skills after taking part in an instructional program on vital signs measurement.

Background: Uncontrolled hypertension affects millions of people worldwide, whether they live in developed or developing countries. According to the WHO, there are around 1.13 billion people in the globe who suffer from hypertension. Every year, almost seven million individuals die as a result of hypertension.
Objectives: The aim of this study is to evaluate quality of life in hypertension patients treated in al-Najaf teaching hospitals.
Methodology: Descriptive design cross-sectional study was used in the study. The population of the study consists of hypertension patients who are followed up in the Teaching Hospitals in Al-Najaf Al-Ashraf Province/Iraq. The sample of the study consisted of 120 patients who applied to the hospitals on February 1, 2022 and May 1, 2022 and met the research criteria. Study data were collected with Quality Of Life, the Socio demographic data form.
Results: The results of study showed that 35% of the patients were between the ages of 46-55 and 62.5% were female. It is seen that 25% of the evaluated patients are illiterate and 22.5% are high school graduates. 59.2% of the patients resided in the city and 73.3% of them had hypertension between 1-10 years. It was observed that the quality of life increased as the age of the patients increased and the highest quality of life was statistically higher in the 66-75 age range (p<0,05). It has been determined that the quality of life of individuals who do not work and who have a disease year of 21-30 years is high (p<0,05).
Conclusion: The median quality of life of patients differs radically by demographic factors like age, level of education, occupation, and length of disease. Patient awareness is significantly related to demographic variables such as age, education, occupation, and duration of disease.
Recommendations: The study recommended to Encourage patients to regular monitoring of blood pressure. And Educated them about anxiety and depression management to enhance their psychological status.

Background: Ischemic heart disease and myocardial infarction are the most common causes of death in the world, and nurses play a key role in the management of these patients. Adequate attitude of health care workers towards the management of patients with acute myocardial infarction using thrombolytic agents is very important and this issue is part of patients' rights.
Objectives: The present study was conducted with the aim of study investigate the attitude of nurses and doctors regarding the management of patients with acute myocardial infarction using thrombolytic agents in the teaching hospitals of Babylon, Iraq in 2022.
Methodology: In this comparative study, 103 nurses and 13 doctors were selected in 2022 by available sampling method the type of sample was purposive and was conducted on nurses and doctors working in cardiac and coronary resuscitation units in Babylon Specialized Hospitals. Information was collected using two questionnaires including demographic questionnaire and attitude measurement questionnaire the attitudes questionnaire contained parts that included nurses and doctors, and a section specific to nurses only.
Results: Among the studied nurses, the largest number were university nurses (36.9% bachelor, 8.7% master). (89.3%) of the nurses had work experience in the coronary care department and (73.8%) of them were currently working in the coronary care department. (78.6%) worked in the morning shift. (76.7%) of the nurses did not have a history of passing the training course in the coronary care department. (54.4%) of the nurses have a diploma and only (2.9%) of them have completed an academic course. The score of doctor’s attitude about the management of patients with acute myocardial infarction using thrombolytic agents was in the range of 68 to 98 with a mean and standard deviation of 83.62 ± 9.62. Based on the results of the independent t-test, there was no significant difference between nurses and doctors regarding the management of patients with acute myocardial infarction using thrombolytic agents (p=0.210).
Conclusion: The study concludes that both nurses and doctors in Babylon Teaching Hospitals show a positive attitude towards managing acute myocardial infarction patients using thrombolytic agents. Despite variations in experience and training, both groups are prepared to provide effective care for these patients. The findings suggest a readiness within the medical staff to handle cases of AMI with thrombolytic therapy, highlighting the importance of continued education and training in coronary care management.

Background: Vaginal discharge is a common problem among many women and causes unpleasant odor and discomfort. Therefore, the study was conducted on a group of these women to find out the microbial content causing this problem and to conduct a drug sensitivity test.
Objectives: The purpose of this study is to find out the microbial content causing this problem and to conduct a drug sensitivity test.
Methodology: Specimens were collected from 92 non-pregnant women, aged (20-60) years, from the city of AL-Najaf in Iraq. 78 (84.78%).
Results: Samples were positive, and the largest percentage of microbial content was for fungi represented by yeasts of Candida spp. in the rate of 54%. C. albicans was the most prevalent kind by 15%. The remainder is made up of non-Candida albicans kinds. Which is C. glabrata, C. Ciferrii, C. Guilliermondii, C. Tropicals, C. krusi . This was followed by gram-positive bacteria at a rate of 28%, This percentage was distributed between Streptococcus pyogenes by 15% and the rest for other types of bacteria Staphylococcus spp. While Gram-negative bacteria accounted for the least percentage of the total positive specimens, at 18%, distributed between Klebsiella spp.13% and E. coli, 5%. As for the drug sensitivity test, C. glabrate, C. ciferrii and C. Krusi showed resistance to fluconazole (MIC= 8) and were sensitive to Voriconazole. Both Gram-positive and Gram-negative bacteria showed various drug sensitivity.
Conclusion: This study showed that there are two main causes of vaginal infections: first: an overgrowth of Candida yeasts, and second: some types of bacteria, which are similar to those that cause urinary tract infections, as these bacteria are transmitted between the vagina and the urinary canal due to the closeness of the two areas to each other in women.

Background: Vaginal discharge is a common problem among many women and causes unpleasant odor and discomfort. Therefore, the study was conducted on a group of these women to find out the microbial content causing this problem and to conduct a drug sensitivity test.
Objectives: The purpose of this study is to find out the microbial content causing this problem and to conduct a drug sensitivity test.
Methodology: Specimens were collected from 92 non-pregnant women, aged (20-60) years, from the city of AL-Najaf in Iraq. 78 (84.78%).
Results: Samples were positive, and the largest percentage of microbial content was for fungi represented by yeasts of Candida spp. in the rate of 54%. C. albicans was the most prevalent kind by 15%. The remainder is made up of non-Candida albicans kinds. Which is C. glabrata, C. Ciferrii, C. Guilliermondii, C. Tropicals, C. krusi . This was followed by gram-positive bacteria at a rate of 28%, This percentage was distributed between Streptococcus pyogenes by 15% and the rest for other types of bacteria Staphylococcus spp. While Gram-negative bacteria accounted for the least percentage of the total positive specimens, at 18%, distributed between Klebsiella spp.13% and E. coli, 5%. As for the drug sensitivity test, C. glabrate, C. ciferrii and C. Krusi showed resistance to fluconazole (MIC= 8) and were sensitive to Voriconazole. Both Gram-positive and Gram-negative bacteria showed various drug sensitivity.
Conclusion: This study showed that there are two main causes of vaginal infections: first: an overgrowth of Candida yeasts, and second: some types of bacteria, which are similar to those that cause urinary tract infections, as these bacteria are transmitted between the vagina and the urinary canal due to the closeness of the two areas to each other in women.

Background: Nurses' COVID-19 knowledge in primary health care is vital for managing the pandemic, including prevention, detection, and patient education. As we know, the danger of Covid-19 is not limited to workers in health centers only, but it may develop and spread to all members of society due to the lack of knowledge of health workers about methods of prevention and protection from this disease.
Objectives: This study assesses nurses' COVID-19 knowledge at primary healthcare centers to control the spread of the virus.
Methodology: A descriptive study was conducted on the knowledge of nurses about COVID-19 at PHCs in Al-Najaf city. The study spanned from March to the end of July 2023. A total of 122 samples were collected from nine PHCs in AL-Najaf quarters. using a two-part questionnaire. The first part consisted of demographic information (6 items), and the second part involved scale questions to assess nurses' knowledge (35 items).
Results: The study revealed that more than half of the nurses possess moderate knowledge (53.28%), while less than half demonstrated good knowledge (40.72%). It was found that demographic information does not correlate with nurses' knowledge of COVID-19., with the exception of variations across primary healthcare centers.
Conclusion: The majority of nurses working in health centers have a moderate level of knowledge about COVID-19.

Background: Helicobacter pylori is a gram-negative bacterium that causes gastritis and peptic ulcer disease (PUD) and it is the most common cause of infectious gastritis. Helicobacter pylori is an infection that is typically acquired during childhood. It is widely accepted that the infection may occur early in life and may persist for decades before causing diseases.
Objectives: The study aim was to assess the prevalence of Helicobacter pylori infection in Kurdistan pediatric hospital at Sulaimani city-Kurdistan Region /Iraq.
Methodology: This scientific investigation is a cross-sectional, descriptive, and analytical study based on a prospective collection of data carried out from May to August 2023. Recruitment was probabilistic; A questionnaire sheet was prepared and used to collect personal. Information by a face-to-face interview for each study subject.
Results: Across sectional study included 219 samples, 111 boys and 108 girls, aged 1 to 15 years were evaluated. The mean age of enrolled children was 5.48 years. Stool samples were positive for H pylori in 97 (44.3%) children. There was a significant correlation between a positive H pylori status and a family who shared cutlery (P value = 0.01). The current study shows that no significant association was found between the prevalence of H pylori infection and individuals' ages, gender or socioeconomic levels and the child’s parents' education level.
Conclusion: Hp infection is common among children aged 1 to 5 years in Kurdistan Region. Often asymptomatic, it is facilitated and exacerbated by unsanitary conditions and low-level education.

Background: Adolescents with good eating habits are more likely than those with bad eating habits to learn normally and do better academically. Dietary habits refer to the long-term dietary patterns that an individual forms and maintains in his daily life.
Objectives: The study aims to assess influence of dietary habits of adolescent girls on nutritional status and identify if their association between pattern of dietary habits and nutritional status among female adolescents.
Methodology: A cross-sectional study was conducted with 400 students from middle and secondary schools in Karbala City, Iraq. Data were collected from December 2o, 2023 to February 4, 2024, Data collection was performed using self-report instrument and it is organized into three sections, include, dietary habits, nutritional status and sociodemographic data. Data were analyzed utilizing descriptive and inferential statistics.
Results: That 61% of female adolescents have normal weight and 20.2% of female adolescents have underweight but 12% of them have overweight. Exhibits that female adolescent having moderate dietary habits as reported among 73% of them (M±SD= 11.96 ± 1.81.
Conclusion: The eating habits of adolescent’s girls do not affect the nutritional status, and most of them have healthy eating habits, while about one fifth of them have unhealthy eating habits, and more than a third of them had an abnormal body mass. Which indicates the importance of involving them in healthy awareness programs about healthy nutrition and ways to maintain a normal level of body mass.

Background: Diabetes is the most common disease caused by carbohydrate metabolism disorder that causes damage to many organs including kidney, eyes and heart. Increasing the knowledge and attitude of nurses can reduce the chronic complications of the disease.
Objectives: the present research was conducted with the aim of determining the knowledge and attitude of nurses regarding hypoglycemia of diabetic patients admitted to Marjan teaching hospital in the year.
Methodology: In this cross-sectional descriptive study, 172 nurses working in Marjan teaching hospital in Babylon city were selected by available purposive sampling method. Information was collected using three parts of questionnaire, including first part of demographic data, and tow part about knowledge assessment, and last part of questionnaire to assess nurses' attitudes regarding hypoglycemia in diabetic patients.
Results: results of the study showed that among 172 participating nurses, the majority were women (55.8%), with the largest number falling into the age group of 20-29 years. Regarding knowledge assessment, nurses scored an average of 57.47 out of a total possible score ranging from 41 to 70, indicating a moderate level of knowledge about hypoglycemia in diabetic patients. Specifically, nurses in this department scored an average of 59.86% of knowledge points related to hypoglycemia. The average score among nurses regarding hypoglycemia in diabetic patients was 17.41 out of a possible range of 9 to 24, suggesting a generally positive attitude towards managing hypoglycemic episodes in diabetic patients.
Conclusion: The study highlights the importance of improving nurses' knowledge and attitudes regarding hypoglycemia in diabetic patients. While most nurses showed moderate knowledge levels, there's room for enhancement, especially in managing hypoglycemic episodes effectively. Although nurses generally displayed a positive attitude, continuous education could bolster their confidence and skills in diabetic care, potentially reducing chronic complications.

Background: Intramuscular injection is a typical nursing procedure in clinical settings. Injections into the muscle can cause pain and suffering in patients, even with their therapeutic benefits, because of the emphasis on quality in health care, it is becoming increasingly important to reduce injection-related pain in nursing care.
Objectives: The aim of this study was to determine how utilizing lidocaine spray changed the level of pain caused by intramuscular injections.
Methodology: This is a randomized controlled experiment, the data was gathered using a socio-demographic questionnaire and the visual analog scale between December 28th, 2023 and February 14th, 2024. The study included 100 participants, with 50 assigned to the study group and the other 50 to the control group. The statistical tests were conducted utilizing the SPSS software for Microsoft Windows, specifically version, with a level of significance of 5% (p value < 0.05).
Results: The average pain scores for the control group (4.46 ± 2.022) and the experimental group (1.27 ± 1.340) and there was a statistically significant variation between them (P<0.001).
The obtained t-value of 7.985 was associated with a p-value of 0.000, indicating positives effect of reducing pain. The lidocaine group compared to the control group (mean difference of-2.74000, p < .000).
Conclusion: The study found that using lidocaine spray during intramuscular injections in adults reduced the severity of pain. A simple linear regression test indicated that body max index (BMI) significantly predicted pain levels among the study group (β = 0.113; p =.028).

Background: Losing blood in the labour’s 3rd stage is the primary factor that impacts maternal health. Immediate breastfeeding could be considered a saving factor in the life of mothers. Since it could naturally spread the oxytocin to stimulate the uterine contraction, dislodging the placenta by such contractions would be easier, reducing bleeding in the labour’s 3rd stage.
Objectives: To determine the relationship of breastfeeding early initiation on the extent of vaginal bleeding in the labour's 3rd stage.
Methodology: A quasi-experimental study was conducted at the Maternity Teaching Hospital in Sulaimaniyah/ Iraq. Participants were Three hundred pregnant women in 3rd stage of labour in the labour ward who were divided equally into an experimental group that applied early initiation of breastfeeding and a control group that followed routine hospital care and was under investigation for more than five months from 26th February 2020 to 30th July 2021. The probability simple randomization technique was used to ensure that all participants had an equal chance of being selected to participate in the study by the record sheet of structured observation, in which the measure of vaginal bleeding of women in 2 groups was assessed. Descriptive and inferential statistics were used for data analysis.
Results: Based on the vaginal bleeding measure in the groups of control and experimental, it is revealed that the extent of vaginal bleeding in the control group was significantly higher than in the experimental group.
Conclusion: Breastfeeding immediately following birth is beneficial for reducing the measure of vaginal blood loss.

Background: Back discomfort can be quite unpleasant, but it is seldom serious. Back pain may afflict anybody, regardless of age, although it is more frequent in persons who are 35 to 55 years old.
Objectives: The aims of this study are to analyze the knowledge and compliance of back pain patients with their condition, as well as to determine the link between patient knowledge and various socio-demographic characteristics such as age and gender in Kirkuk city.
Methodology: descriptive research with a quantitative design was conducted for back pain patients at Azadi Teaching Hospital (rehabilitation unit) in Kirkuk from Jun 2, 2023 to February 6, 2024. A non-probability (purposive) test of (100) grown-up patients with back torment were conceded to the Azadi Instructing Healing center (restoration unit) in Kirkuk. The created survey was built for the reason of the think about and comprised of four parts: the primary portion included (6) things of statistic information, the moment portion contained (5) things of patients' restorative dates, the third portion contained (40) questions evaluating the information of back torment patients, and the fourth portion contained (10) questions around back torment compliance. Information were assembled through interviews. They were inspected utilizing clear measurable examination (recurrence and rate) and inferential measurable information investigation (chi-square T-test and ANOVA) with the factual bundle for social science (SPSS) adaptation (22).
Results: The study's findings revealed that the majority of back pain patients (32%) were between the ages of 35 and 44, with a female to male ratio of 57.0 percent for females and 43.5 percent for men.
Conclusion: The study find that back pain patients had insufficient knowledge about (general information, causes of back pain, signs and symptoms), as well as enough compliance with the item.

Background: Pediatric basic life support (BLS) involves administering cardiopulmonary resuscitation (CPR) to children experiencing cardiac arrest without the use of equipment, relying on bag-mask ventilation or barrier devices until advanced life support (ALS) is available.
Objectives: The purpose of this study was to determine the effect of simulation-based education on nurses’ knowledge in Pediatric Basic Life Support (PBLS).
Methodology: A quasi-experimental pretest-posttest study was carried out with 50 nurses from the pediatric wards of two general hospitals in Al-Najaf City, Iraq, from September 16, 2023, to January 20, 2024. The study subject was a convenience sample of 50 nurses was randomly assigned to two groups of 25, to be treated as intervention or control groups. The intervention group received simulation-based educational program while the control group received no intervention. Descriptive and inferential statistics were calculated. While data collection tools were a structured self-administered questionnaire with two parts related to socio-demographic characteristics and nurses' knowledge of paediatric basic life support. The education passed through 3 phases e, pre-test, implementation and post-test phase.
Results: The study's findings showed that the implementation of a simulation education program led to an improvement in the knowledge of the study group.
Conclusion: The study concluded that simulation based education improved nurses' knowledge related pediatric basic life support and the study provides aline to enhance the simulation integration as active education strategies to develop nurses' knowledge in applying clinical skills.
Recommendations: Further studies are recommended to evaluate the impact of simulation on nurses' education outcomes, providing more evidence that simulation would be beneficial for nurses' improvement. The researcher also suggests encouraging nurses to improve their knowledge and performances through increased participation in Basic Life Support (BLS) and Cardiopulmonary Resuscitation (CPR) courses, at least every six months.

Background: Hemodialysis is a treatment for end-stage renal disease (ESRD) in which a machine filters waste and excess fluids from the blood for patients whose kidneys can no longer perform this function on their own. The health status of a hemodialysis patient can vary depending on several factors, including the underlying cause of their kidney disease, their overall health and medical history, the effectiveness of their dialysis treatments, and their adherence to their treatment plan.
Objectives: This study aimed to assess health status of hemodialysis patients with end stage kidney disease in Kirkuk city: 2023-2024.
Methodology: cross–sectional study design conducted from 10 February 2023 to 22 May 2024. This study was conducted at Kirkuk City Hospitals. A purposive sample (non-probability) consisting of 100 patients under hemodialysis at Kirkuk city hospitals. Data were collected using an interview-structured questionnaire. The structured questionnaire consisted of three main domain includes demographic data, medical data and health status domain which includes (independency, daily physical activity, psychosocial, and life adaptation. A three-point Likert scale was employed, with (3) representing always, (2) some times and (1) for never. Mean of score categorized as low significant less than 1.8, moderate significant: 1.8 to 2.39 and high significant between 2.4 to 3. The data were prepared, organized and entered into the computer file; Statistical Package for Social Science (SPSS) (23 version).The significance level for statistical analysis was set at p<0.05. The descriptive data analysis (frequencies, percentages) and inferential statics by use Anova and T test was used for categorical variables.
Results: The results shows the male more than female and constitute 60 (60.0%), most of "Age Groups", between (50-59) years and constitute 35.0% in the dialysis patients.
Conclusion: Health status of patients with hemodialysis patients different according to independency, daily physical activities, psycho- social aspects, and adaptation of life., mean score for hemodialysis patients were high and moderate in most items, Health status of hemodialysis patients were poor, Socio-demographic characteristics of hemodialysis patients age, gender, marital status and occupation has significant effect on health status at p<0.05.
Recommendations: Constructing an educational program for hemodialysis patients regarding to improve general health status, an appropriate body weight, encourage the regular physical activity to improve patient’s life adaptation, psycho-social support, home and community support in collaboration with Health Governorate, Medical college and Nursing college.

Background: Laparoscopic cholecystectomy is widely recognized as the preferred method for treating gallstone disease. However, like any surgical procedure involving anesthesia, it carries the risk of postoperative complications, including common side effects such as vomiting and nausea. As a result, acupressure treatments targeting the pericardium 6 (P6) point have gained attention in alleviating nausea and vomiting. This non-invasive massage technique has been emphasized by the World Health Organization (WHO) due to its significance.
Objectives: The main purpose of this study is to assess the impact of acupressure treatment at the wristband point (P6) on nausea and vomiting experienced by patients undergoing laparoscopic cholecystectomy.
Methodology: A quasi-experimental study was conducted at Safer Al Imam Al Hussein Surgical Hospital in Karbala Holy City. Sixty patients undergoing laparoscopic cholecystectomy were divided into two groups: 30 patients in the intervention group received acupressure techniques using an elastic wristband postoperatively, which was removed after six hours, while 30 patients in the control group received routine conventional care. Descriptive analysis (e.g., frequency, percentage, and mean score) and inferential analysis (e.g., one-way ANOVA test, independent sample t-test) were employed to examine and measure the study outcomes. A p-value of <0.05 was considered statistically significant.
Results: The mean score for nausea and vomiting in the intervention group decreased significantly from 1.97 ± 0.183 before the intervention to 1.13 ± 0.354 after implementing the intervention (p-value = 0.000). In contrast, the control group did not experience any improvement in their symptoms, with their condition worsening significantly.
Conclusion: Patients experiencing nausea and vomiting after laparoscopic cholecystectomy surgery may benefit from the non-invasive treatment of wristband acupressure.

Background: Congenital heart disease (CHD) encompasses heart or blood vessel abnormalities arising during fetal development, affecting around 9 per 1,000 live births annually, totaling approximately 1.35 million infants. CHD is clinically classified as either cyanotic or acyanotic and often coincides with malnutrition and failure to thrive. Infants with CHD are at an increased risk of developing or pharyngeal dysphagia, characterized by difficulties in swallowing. Pediatric nurses play a crucial role in monitoring CHD, including respiratory rates and overall health, with particular attention to assessing nasal flaring for signs of respiratory distress as chest retractions and cyanosis.
Objectives: Study aims to Assess variations in respiratory rate across different feeding methods and their impact on neonates with CHD at various time intervals.
Methodology: A prospective observational study was carried out at the neonatal unit of Karbala Teaching Hospital for Children in Iraq. Fifty neonates, aged less than 28 days and diagnosed with CHD, were purposively recruited for the study. Inclusion criteria targeted neonates who were undergoing enteral feeding.
Results: Analysis of records from 50 neonates revealed significant variations in respiratory rate across distinct feeding periods (p=0.027). and unveils noteworthy variations in nasal flaring throughout distinct feeding periods (p=0.001). And no significant differences in chest retraction across distinct feeding periods (p=1.000), no significant differences between breastfeeding, bottle-feeding and tube-feeding across time intervals of neonates feeding.
Conclusion: Respiratory rate demonstrates significant variations across feeding periods. There are no significant differences in respiratory rates before-after feeding among breastfeeding, bottle-feeding, and tube-feeding.

Background: Ulcerative colitis a lifelong inflammatory illness is marked by persistent inflammation of the mucosal surface that begins in the rectum and spreads toward the influence of a portion or the entire colon, the disease has different periods from severity or exacerbation to remission.
Objectives: The aim of this study was to explore risk factors of patients with Ulcerative Colitis.
Methodology: A descriptive cross-sectional study was conducted using a purposive sample of 105 patients diagnosed with ulcerative colitis attending to specialized hospital for gastroenterology and hepatology at Al-Najaf Al-Ashraf city. Study extend period from September 1,2023 to June 1, 2024. This study used self-administrated questionnaires adopted from the previous studies consist of two-part demographic and clinical forms items. Data collected were analyzed using SPSS version 25.0.
Results: The findings of the current study involved that the highest percentage of the patients are those at young ages, female patients, graduated from college, married, live in urban, unemployed, and financially secured. According to the participants’ clinical data, the results showed that the highest percentage of the patients are those with some factors that may have direct influence on disease prognosis. For example, duration of the disease, family history of ulcerative colitis, chronic disease, with sleeping patterns as well as medication adherence and others.
Conclusion: Ulcerative colitis (UC) disease commonly found in individuals within the age group (18 – 36) years old.
Recommendations: The study recommended that nurses need to be more aware in performing nursing care for patients within age group (18 - 36) years old in terms of assessing clinical features of ulcerative colitis. Nurses who recognize the risk factors of ulcerative colitis may intervene and manage patient’s condition effectively. More researches are needed to address specific risk factors and find solution to avoid it if possible.

Background: Medical Laboratory staff are exposed to a wide range of hazards associated with the materials they employ and the methods they use in their work. The occupational hazards include chemical, physical, biological, psychosocial, and ergonomics hazards.
Objectives: To assess the laboratory staff level of awareness of the anticipated occupational hazards.
Methodology: A descriptive- cross-sectional study was conducted using a self-administered questionnaire. The Study participants consist of Medical Laboratory staff who works in public hospitals. The current Study includes 350 staff who responded to the questionnaire, with a response rate of 100%. and the method used by the researcher was the probability sampling technique (Stratified Random sampling).
Results: The obtained findings show that (0.0%) of the staff have poor awareness Occupational hazards, (46.6 %) with moderate awareness, (53.4 %) of them have good levels according to the total assessment of awareness.
Conclusion: The medical laboratory staff is well-versed in the hazards associated with their jobs at the laboratory. There are a number of issues that make it difficult for upper management to increase workplace safety. Nonetheless, more might be done to guarantee hospital staff members have a safer place to work.

Background: Evidence-based nursing practice (EBNP) has become one of the most effective methods for improving patient outcomes and the quality of care as well as delivering cost-efficient health care. Nurses' perspectives are critical to the successful adoption of evidence -based practice. While positive views regarding EBP serve as a foundation for developing appropriate nursing approaches to improve patient care, there is a noticeable gap between belief in evidence-based practice advantages and actual implementation.
Objectives: To assess nurses’ perception toward the application of an evidence-based practice approach.
Methodology: A non-probability/ convenience sampling, Data were collected through self-administered questionnaire technique for data collection, which is constructed through the extensive review of the related literature that consisted of two assessment parts first one consist of demographic data, and the second part of the assessment tool is concerned with assessing the nurse's perception scale which include three parts, the first part contains (4) statement, the second part contains (3) statement and the last part contains (2) statement developed by Majid et al (2011). The reliability of the instrument was the Cronbach alpha of perception section was between 0.68 to 0.95, and the face validity of the study instruments was determined by a panel of (12) experts in the Nursing and Medicine fields, and science of psychology, All the experts agreed that the instrument is valid with some suggested modifications. Data were analyzed through the application of frequency, percentage and the inferential statistical analysis approach is used to test the study null hypotheses within a confidence interval equal to 0.95 (Chi-square which is used to determine the association between nurses' perception and demographic data). Such analyses are computed by using the SPSS program version 24.
Results: The findings indicate that the total assessment of perception about application of evidence-based practice approach about (39.54%) of the nurses have poor perception of evidence-based practice, (51.23 %) of them have moderate perception; while (9.32 %) of them have good levels according to the total assessment of perception about evidence-based practice.
Conclusion: According to the study results and discussion half of nurses have good perception toward application of evidence based practice approach when assessed by the statistical analysis.

Background: Nurses, as key personnel in healthcare delivery, play a critical role in the provision and coordination of care, prevention of adverse events, and optimization of health service productivity and patient outcomes. Self-efficacy is the belief, and confidence individuals feel in their ability to perform a particular task or action. Increased self-efficacy is the desired outcome of a self-management program. Several articles used Albert Bandura’s concept of self-efficacy.
Objectives: To assess the self-efficacy and wellbeing of nurses. To find out relationship between self-efficacy and wellbeing of nurses. To find out relationship between self-efficacy and wellbeing with socio-demographic characteristics of nurse.
Methodology: A descriptive, correlational study design. The study sample composed of 380 nurses who works in Al-Najaf Al-Ashraf hospitals and primary health care center. self-report questionnaire. The instrument used in this study different scales, self-efficacy scale consists of general and social=23item, and 5-well-being scale. Some nurses’ sociodemographic information was included as a separated part. The study was carried out from November 1st, 2023 up to 1 st of April 2024.
Results: The majority of study sample (67.4%) are female, (60.8%) were with age less than 27 years old. (84.5%) of nurses are from urban residency. (46.3%) of them held diploma certificate, (89.5%) of nurses do not smoke, and not suffer from physical and mental illnesses. In addition, the overall assessment of nurses' well-being is normal.
Conclusion: The majority of study sample were female (67.4); all the self-efficacy domains were high, and majority of nurses well-being are normal. The study shows that non-significant relationship between self-efficacy & wellbeing.
Recommendations: 1) Adding a curriculum that explains self-efficacy and its importance in performing tasks in daily life. 2) Conducting educational courses for nursing students on the importance of health-promoting behavior and its impact on self-efficacy.

Background: Nursing competencies significantly impact the quality of nursing care. This care can be improved by maintaining nursing proficiency via a competency-based nursing educational program.
Objectives: To determine the effectiveness of the competency-based educational program on quality of care.
Methodology: The quasi-experimental design (pre-posttest) was used in the current study to achieve the early stated objectives. The study was carried out from the period of 4th September 2023 to 3rd April 2024. A (Purposive Sample) consisted of 80 nurses. Data collected through using of a well-designed questionnaire consists of two parts: I: socio-demographic characteristics: Which consisted of (8) items. II: The Quality Nursing Care Scale (QNCS-M) which consisted of (36) items.
Results: The results of the present study indicate that there is a significant difference in the pre- and post-test periods regarding quality of care with the quality of care with the final mean of the nurses’ overall quality of care for the study group in the posttest (mean = 2.56) compared to (mean = 1.54) in the pretest for the same group.
Conclusion: The results of the data analysis show that the competency education program for nurses was implemented and that the evaluation of the program in two phases (pretest and posttest), it had a positive impact on the quality of care provided by the study group.
Recommendations: periodic assessment of the healthcare provider's abilities to provide, in addition to appropriate support and motivation to encourage healthcare providers to engage in activities that improve the quality of care from persons in authority.

Background: A common problem in hemodialysis patients, fatigue is a personal perception of extreme tiredness that impairs their quality of life, physical and mental abilities, activity levels, and performance.
Objectives: This comprehensive study aims to assess the impact of fatigue on health-related quality of life in hemodialysis patients.
Methodology: A descriptive A-non-probability (purposive sample) of (205) male and female hemodialysis patients in AL-Diwaniyah City with end-stage renal disease and undergoing hemodialysis. Most patients were diagnosed with ESRD > one year ago, including those who have been on a maintenance hemodialysis programmer for more than a year. A validated and comprehensive health-related quality of life questionnaire (SF-36) tailored for individuals undergoing hemodialysis was utilized to assess fatigue and health-related quality of life among hepatitis and non-hepatitis patients undergoing hemodialysis. The study was conducted at hemodialysis centers, ensuring representation from different geographic regions and patient populations.
Results: A total of 205 hemodialysis patients participated in the study. The results revealed that most participants had moderate fatigue (88 (42.9%), mild fatigue (61 (29.8%), and severe fatigue (56 (27.3%). The patient's overall health-related quality of life was found to be low, with a mean score of 19.82.
Conclusion: Fatigue is a prevalent symptom in hemodialysis patients, affecting their ability to engage in routine activities and self-care, negatively impacting self-confidence and health-related quality of life. Addressing fatigue is crucial for improving physical well-being and mental health.
Recommendation: To reduce fatigue, the researcher suggested Regular physical activity, personalized nutrition, emotional support, adequate rest and sleep, monitoring medication side effects, and exploring alternative therapies can help patients manage tiredness and improve overall well-being, especially in ESRD patients.