Mosul Journal of Nursing

Background and Aim: Perception of patients’ safety cultures is fundamental in the process of improving patient care. The presence of many disciplines in healthcare organizations has necessitated the inclusion of the viewpoints of all workers from managers to technicians. The study aimed to assess the nurses’ perception about patient's safety culture.
Materials and method: cross sectional (descriptive) design was selected for this study, 125 nurses was participated in the study who work in different health departments: wards, emergency unit, intensive care units, operating room. The study was carried out from (1st November 2013 to 10th April 2014), Likert-type response scales was adopted to measure the nurses’ perception about patient safety, which consist of two parts, part one covered the demographic data for nurses (Age, Gender, educational level, years of experiences, work time and workplace). Part two; assessed the nurses’ perception, consists of four sections covered work area, supervisor relationship, communications and frequency of events reported.
Results: The findings indicated that nurses were more positive about overall perceptions of safety, teamwork within units and supervisor expectations and actions promoting, while 69.6% of event reporting, and 55.6% for communication dimensions was negatively response among nurses’ perception. Nurses’ age, educational level and workplace, were not significantly associated with their perception regarding overall perceptions of patient safety dimension, only nurses’ age was significantly associated with their perception regarding frequency of event reporting.
Conclusion: The majority of nurses hadpositive responses toward teamwork within units. While most of the sample has negative responses toward frequency of events reporting, about half of nurses has positive responses to patient safety culture toward; overall perception of safety, communications openness, non-punitive responses to errors and staffing dimensions.
Recommendation: the study recommended to encourage the reporting action, which can prevent certain errors from happening and improve patient's safety concept in nurses.

Background and aim: depression is a psychiatric illness characterized by a cluster of symptoms including prolonged depressed mood, lowered self-esteem, pessimistic thoughts, and loss of pleasure or interest in former activities for at least 2 weeks. Anxiety is an uncomfortable feeling of apprehension or dread that occurs in response to internal or external stimuli and can result in physical, emotional, cognitive, and behavioral symptoms. This study aimed to measure anxiety and depression among preoperative and post-operative patients. To signify hospitalized anxiety and depression among patients according to their gender.
Materials and method: A descriptive design was carried out from 27th, October, 2012 through 29th, March, 2013 in order to achieve the objectives of the present study. The study subjects consisted of (200) patients were chosen from the wards of al- Zahrawi teaching hospital, (100) preoperative patients and (100) post-operative patients, these patients divided to (100) male and (100) female. In the present study Hospital Anxiety and Depression Scale (HADS) was used to diagnose patients with hospitalized Depression Anxiety.
Results: the majority of the male patients had hospitalized preoperative depression, which constituted 26%, while 18% of them had hospitalized anxiety while the majority of female patients had hospitalized depression which constituted 48%, while 44% of them had hospitalized anxiety. The majority of the male patients had hospitalized post-operative depression, which constituted 40%, while 28% of them had hospitalized anxiety. The majority of the female patients had hospitalized post-operative anxiety which constituted 60%, while 52% of them had hospitalized depression.
Conclusions: The study highlighted the female show symptoms of depression and anxiety more than men before surgery. The male show symptoms of depression more than symptoms of anxiety before surgery. The female show symptoms of anxiety more than symptoms of depression after surgery. The female show symptoms of depression more than male after surgery.
Recommendations: The doctors should be providing the necessary advice to patients after surgery in terms of taking the necessary treatment and adequate care and support their psychological coping with the new situation after surgery. The study recommends good nurses transaction with patients in terms of providing crisis care to patients before the operation and give treatment and psychological support to patients to reduce the stress that occurs to have before the operation.

Background: Nurses' role is warned to view blood transfusion responsibilities, and able to identify the nursing required to care for patients receiving a blood transfusion so that they can develop their skills. The aimed of the study to assess nurses’ knowledge level procedure of blood transfusion.
Materials and method: A descriptive study approach was carried out at Al-Salam teaching hospital in Mosul city. A random sample consists of (130) nurses, the questionnaire was used for data collection, it include two parts. Part one was demographic data, and Part two including (16) questions for nurses’ knowledge of blood transfusion. Content validity was determined by presenting the items to a panel of (10) experts, and used the Coefficient Correlation for questionnaire items showed that the reliability of the questionnaire which was (r = 0.90).
Results: The study finding that there average of true answers (64%), while (36%) false answers of nurses’ knowledge of blood transfusion procedure for the patient. Also the present study indicates (65%) of nurses have good knowledge and (35%) of nurses has poor knowledge about procedure of blood transfusion.
Conclusions: The present study showed that a third of nurses’ have poor knowledge of blood transfusion, and finding a significant relationship between the nurses knowledge and level of education, also a significant relationship between the nurses’ knowledge and course trainings

Background and Aim Human patient simulators provide a very realistic situation for nursing students, centers on the opportunity for the learner to practice and learn in an environment as close to reality as possible, allows students to construct knowledge, explore assumptions, and develop psychomotor skills in a safe environment. The study aims to assess the effect of using human patient simulation on undergraduate nursing students’ skill performance and anxiety levels at the college of Nursing in Mosul University.
Method and Materials: A case control study design has been used for the 1st February 2014 till 30th of May 2014. A non-probability convenience sampling of (90) under graduate nursing students (60) females and (30) males were chosen, the study sample was divided into two groups, an experimental group of (45) nursing students with human patient simulation laboratory setting experience and control group of (45) nursing students with clinical practice setting experience. The validity of this study instruments was established through a panel of (12) experts of different specialties related to the field of the present research, Reliability of the study tools was determined through the use of split half -approach of the computation of Cronbach alpha correlation coefficients for the checklist and The Cronbach’s alpha for the questionnaire. Data collection tools include the checklist which is consisted of (25) question items that related to the physical examination for thorax and lungs and the questionnaire consisted of (15) question items respondents were asked to rate the individual items on a (5)-point scale according to their response to each item, Data were prepared and entered into a computer files; Statistical Package for the Social Science (SPSS, version 21) is used for data analysis.
Conclusions: The study result show that there is a significant effect of simulation in Students’ skills performance level while there is no effect in control group, and there is a significant relationship between students' skill performance and gender for case group, while there were no significant relationship between students' skill performance and gender for control group. The male students is more improvement than female in their skill level after simulation course. Anxiety level were higher in student who apply physical examination on a patient comparing with those students who apply physical examination on a HPS.
Recommendation: The study recommended to introduce the modern technology (HPS) in students' training process because it decrease students' anxiety level so the skill performance of students will be more confident and reduce errors when skilled nursing application and thus reflected repercussions on public health and a better way than the old classical training.

Background and objective: Validity of continuous variable test like total serum IgE is performed by constructing Receiver Operating Characteristic (ROC) curve. ROC curve is a technique for visualizing, organizing and selecting classifiers based on their performance. The study aims to determine the performance and validity of total serum IgE in various allergic diseases, age groups and gender. To select the optimal cut off value that has the best discriminative capability. To assess the sensitivity, specificity, predictive value and likelihood ratio of the selected cut-off points.
Materials and method: A diagnostic Receiver Operator Characteristic ROC curvestudy was conducted at Allergy Clinic, Al-Jamhouri Teaching Hospital in Mosul, Iraq on 751 individuals (561 patients with various allergic disorders and 190 healthy non-allergic subjects) ranged in age from 10 to 59 years. Classification of study samples into allergic or healthy groups was done by a committee panel of two qualified and expert allergiologist. A blood sample was taken for estimating total serum IgE by ELISA.
Results: The constructed ROC curve of overall sample showed that total serum IgE has moderate accuracy in allergic diseases and the AUC ± SE was 0.730±0.022 with 95% confidence interval (0.686-0.773). Urticaria ROC curve had the maximum AUC (0.742±0.030) and asthma had the minimum AUC (0.720± 0.027). The maximum AUC was detected in the age group 10-19 years and the least one was in age 50-59 years. No difference was found in the estimated AUC in both gender. The optimal cut-off point of total serum IgE was 96 IU/ml in the overall allergic patients and varies between 95 IU/ml (in urticaria) and 115 IU/ml (in rhinitis). Assessment of selected overall cutoff point of total serum IgE reveals the following: sensitivity (79.3%), specificity (61.0%), validity (74.7%), PPV (50.0%), NPV (85.7%), LH+ (2.03), LH-(0.34).
Conclusion: Total serum IgE has moderate accuracy in diagnosis of various allergic diseases. Its accuracy is much better in younger patients in comparison to elderly. A cut offpoint of total serum IgE(100±5 IU/ml) was the best classifier. Total IgE is a useful screening rather than a confirmatory test.

Background and aim: Diabetes mellitus is currently considered as one of the most invaders diseases. Diabetes self-care requires the patient to make many dietary and lifestyle changes. These changes called coping strategies. One of the biggest challenges for health care providers today is how to address the continued needs and demands of individuals with chronic illnesses like diabetes. The main aim of this study is to assess the knowledge and possible coping strategies that diabetic patients may have.
Materials and Method: A descriptive study was based in the present study. The data was collected from the patients who visit AL-Wafa’a Centre for Diabetes Mellitus Patients in Mosul Medical Centre from 1st Febrauary 2013 to 1st May 2013 using a structured questionnaire designed for this purpose. The sample utilized a systematic random sample to eliminate the ethical issues. A target number for the sample was 100 of patients with DM those visit AL-Wafa’a Centre for Diabetic Patients. A standard statistical package for social sciences (SPSS version 14) was used to analyze the collected data.
Results: The results show that there is a heavier distribution of respondents presented in the (46-65) age groups, representing (29 % and 36 %) of the total survey. The most of the participants were female presenting (66 %). Most of the participants have a good knowledge with DM.
Conclusions: The study concludes that diabetic patients have good knowledge about their disease, but they have less coping strategies in their awareness about daily checking their blood sugar and checking their eyesight periodically. In addition, the participants presented that there is an obvious psychological distress and low self-care which mean they have difficulty to cope with their disease.
Recommendations: Generally, this study suggests four coping skills can be taught and reinforced; these skills include social problem solving, communication skills training, including assertiveness training, cognitive behaviour modification, and conflict resolution. In addition, further studies are needed to deeply investigate the possible factors that may affect the coping strategies of patients with Diabetes Mellitus such as age and gender.

Background and objective: The protein energy malnutrition represents as a major health problem in the Iraq. It occurs particularly in weaklings and children in the first year. This study aims to identify the nurses' knowledge regarding protein energy malnutrition for children under age five years at medical pediatric wards in Baghdad city
Materials and method: A descriptive study was carried out in the pediatric ward of teaching hospitals in Baghdad City to assessment of nurses' knowledge concerning protein energy malnutrition for children under age five years from 2ed of May till 20ed of December 2016. A non- probability (purposive) sample. This sample consisted of (33) nurses. The questionnaire was constructed and provided for nurses which consists of four parts. The validity of the questionnaire tool was established through a panel of experts. The reliability of evaluating statistically, a pilot study was carried out for (6) nurses selected randomly (excluded from study results).
Results: The socio-demographic characteristic of the study presents that 84.8 % of them females, 54.5% of them Single, 39.4 % at age (26-35) years old, 75.8 % of them have (1-7) years of general experience, 39.4% graduated from Junior Nursing.
Conclusions: Majority of nurses have poor knowledge about Kwashiorkor, miasmas, and nursing management. There is significant differences between demographic characteristics such as age, level of education, and years of general employments with nurses Knowledge.
Recommendations: A extensive programs, training and workshops about protein energy malnutrition for children under age five years should be designed and implement.