Correlation between critical thinking dispositions and self-esteem in nursing students.

BACKGROUND: Critical thinking has been acknowledged as a key component of clinical decision-making and professional competency. Therefore, it is of great importance to reflect on how critical thinking is acquired and investigate its determinants, including self-esteem, in nursing education. The present study was thus to assess the correlation between critical thinking and self-esteem in nursing students. MATERIALS AND METHODS: This descriptive correlational study was fulfilled in 2019 on 276 nursing students selected via the random sampling method. For this purpose, Ricketts' Critical Thinking Disposition Questionnaire and Eysenck's Self-Esteem Scale were employed to collect the data, which were then analyzed using the SPSS Statistics (ver. 22) software along with independent-samples t-test, Pearson correlation coefficient, and one-way analysis of variance, considering the significance level of P < 0.05. RESULTS: The study findings showed a significant correlation between critical thinking and self-esteem (r = 0.529, P < 0.001) as well as self-esteem and critical thinking dispositions, that is, commitment, perfectionism, and creativity (r = 0.40, P < 0.001). Moreover, these dispositions had a significantly increasing trend during various academic years, but the difference was not significant with regard to perfectionism (P < 0.001). CONCLUSION: Given the positive correlation between self-esteem and critical thinking, commitment, perfectionism, and creativity in nursing students, it is essential to develop self-esteem skills in such students, using appropriate approaches to boost self-esteem as one of the important missions of higher education systems. As well, a lack of perfectionism during academic years confirms that it is possible that determinants other than educational environments, for example, families, are involved. Therefore, managers are suggested to hold meetings with parents and nursing students.

Effect of lullaby on volume, fat, total protein and albumin concentration of breast milk in premature infants' mothers admitted to NICU: a randomized controlled trial.

BACKGROUND: Listening to music can reduce or manage stress, fatigue, and accompanying symptoms in mothers. Music increases oxytocin secretion which affects breast milk. This study aimed to examine the effect of lullaby on volume, fat, total protein and albumin concentration of breast milk in mothers of premature infants admitted to the NICU. METHODS: This clinical trial was performed on 100 primiparous mothers whose premature infants were hospitalized in the NICU of Ayatollah Rouhani Hospital from January 2020 to December 2020. Using block randomization method, the participants were divided into three groups: control (A), playing lullaby for mother (B) and playing lullaby for a mother while holding a photo of her own baby (C). The mothers of the intervention groups listened to lullabies through headphones for 30 minutes every morning for 6 days. On the first and the sixth day of birth, the volume of breast milk (ml) and two milliliters of breast milk samples of all three groups were measured and compared in terms of fat, albumin concentration and total protein (mg/DL). ANOVA, Paired T-Test and ANCOVA model (the included variables were: basic value of dependent variable, group type, Maternal age, Birth weight, Gestational age and Maternal weight) was used for analytical statistics. RESULTS: The difference between the mean compositions of breast milk before and after the intervention in three groups of A, B and C: in terms of the breast milk volume were 66.33 ± 4.80, 71.30 ± 4.18 and 75.91 ± 6.80 ml; in terms of triglyceride level was 177.84 ± 50.57, 210.72 ± 34.55 and 224.17 ± 12.97 mg/DL, cholesterol level was 14.57 ± 3.70, 21.96 ± 3.82 and 26.26 ± 5.16 mg/DL, albumin concentration was 0.90 ± 0.30, 1.22 ± 0.19 and 1.46 ± 0.28 mg/DL and total protein level was 1.61 ± 0.61, 2.20 ± 0.57 and 2.72 ± 0.30 mg/DL. Finally, the results of ANCOVA analysis for the effects of the intervention, taking into account the baseline values, showed that the intervention was effective and had the greatest effect on cholesterol levels. CONCLUSION: In this small trial, there was a statistically significant association between trial arm and biochemical composition of breastmilk though further studies are needed to see if these changes result in meaningful clinical outcomes to the infant. TRIAL REGISTRATION: IRCT, IRCT20191114045439N1. Registered 14 January 2020- prospective, https://en.irct.ir/trial/43671.

Comparison of the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants: a randomized clinical trial.

BACKGROUND: Oral feeding problems will cause long-term hospitalization of the infant and increase the cost of hospitalization. This study aimed to compare the effect of two methods of sucking on pacifier and mother's finger on oral feeding behavior in preterm infants. METHODS: This single-blind randomized controlled clinical trial was performed in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. 150 preterm infants with the gestational age of 31 to 33 weeks were selected and were divided into three groups of 50 samples using randomized block method, including non-nutritive sucking on mother's finger (A), pacifier (B) and control (C). Infants in groups A and B were stimulated with mother's finger or pacifier three times a day for five minutes before gavage, for ten days exactly. For data collection, demographic characteristics questionnaire and preterm infant breastfeeding behavior scale were used. RESULTS: The mean score of breastfeeding behavior in preterm infants in the three groups of A,B,C was 12.34 ± 3.37, 11.00 ± 3.55, 10.40 ± 4.29 respectively, which had a significant difference between the three groups (p = 0.03). The mean rooting score between three groups of A, B, and C was 1.76 ± 0.47, 1.64 ± 0.48, and 1.40 ± 0.90 (p < 0.001) respectively. Also, the mean sucking score in groups of A, B and C was 2.52 ± 0.76, 2.28 ± 0.64 and 2.02 ± 0.74 respectively, which had a significant difference (p = 0.003), but other scales had no significant difference between the three groups (P > 0.05). The mean time to achieve independent oral feeding between the three groups of A, B, C was 22.12 ± 8.15, 22.54 ± 7.54 and 25.86 ± 7.93 days respectively (p = 0.03), and duration of hospitalization was 25.98 ± 6.78, 27.28 ± 6.20, and 29.36 ± 5.97 days (p = 0.02), which had a significant difference. But there was no significant difference between the two groups of A and B in terms of rooting, sucking, the total score of breastfeeding behavior and time of achieving independent oral feeding (P > 0.05). CONCLUSION: Considering the positive effect of these two methods, especially non-nutritive sucking on mother's finger, on increasing oral feeding behaviors, it is recommended to implement these low-cost methods for preterm infants admitted to neonatal intensive care unit. TRIAL REGISTRATION: Trial Registration: IRCT, IRCT20191116045460N1 . Registered 11 January 2020- prospective registered.

The protective role of professional self-concept and job embeddedness on nurses' burnout: structural equation modeling.

BACKGROUND: Job embeddedness and professional self-concept are among the important nursing components, the existence of which help decrease occupational burnout among nurses. This study aimed to determine the protective role of Professional Self-concept and Job embeddedness on nurses'burnout. METHODS: This descriptive, correlational study had a predictive design and was conducted on nurses working in training and healthcare centers of Babol University of Medical Sciences in 2019. In total, 308 nurses participated in this study and were selected by stratified random sampling. In addition, data were collected using demographic characteristics questionnaire, Professional Self-concept questionnaire, Job embeddedness scale and nurses' burnout questionnaire. Moreover, data analysis was performed in SPSS version 25 and Smart PLS version 3.3 using correlational statistics and structural equation modeling. RESULTS: Both the variables of professional self-concept and job embeddedness, had a significant effect on nurses' burnout at 99% confidence level (P < 0.001) and the negative beta value for these two variables shows the inverse relationship between both professional self-concept and job embeddedness with nurses' burnout. The value of the coefficient of determination for burnout indicates that both the variables of professional self-concept and job embeddedness, together explain 78% of the changes in the variable of burnout. The beta coefficient for professional self-concept (- 0.50) is higher than the same coefficient for job embeddedness (- 0.42). As a result, the role of professional self-concept in predicting burnout of clinical nurses has been more than the role of job embeddedness. The indirect effect of professional self-concept on burnout of clinical nurses mediated by job embeddedness has been equal to - 0.347. As a result, it can be said that nurses' professional self-concept has a significant effect on nurses' burnout through mediation of job embeddedness. CONCLUSION: According to the results of the study, Professional Self-concept had an effective role in nurses' burnout. In other words, the higher the Professional Self-concept of nurses, the lower their burnout. Therefore, it is suggested that effective interventional strategies be designed by nursing managers through better planning and a supportive workplace be established to improve Professional Self-concept among nurses and decrease their burnout.

The effect of inhaling mother's breast milk odor on the behavioral responses to pain caused by hepatitis B vaccine in preterm infants: a randomized clinical trial.

BACKGROUND: Nowadays, it is generally assumed that non-pharmacologic pain relief in preterm infants is an important measure to consider. Research findings suggest that familiar odors have soothing effects for neonates. The aim of this study was to compare the effect of maternal breast milk odor (MBMO) with that of another mother's breast milk odor (BMO) on the behavioral responses to pain caused by hepatitis B (HB) vaccine injection in preterm infants. METHODS: This single-blind randomized clinical trial was performed over the period between February 2019 and March 2020 in the neonatal intensive care unit of Babol Rouhani Hospital, Iran. Ninety preterm infants, who were supposed to receive their HB vaccine, were randomly assigned into three groups: MBMO (A), another mother's BMO (B), and control with distilled water(C). Oxygen saturation (SaO2), blood pressure (BP) and heart rate (HR) were recorded for all participants through electronic monitoring. In addition, premature infant pain profiles (PIPP) were determined through video recording for all three groups during intervention. The chi-square, ANOVA and ANCOVA were used for analyzing the data, and P < 0.05 was considered significant in this study. RESULTS: No significant differences were found between the three groups in mean ± SD of HR, BP, and Sao2 before the intervention (P > 0.05). After the intervention, however, the means for heart rate in groups A, B, and C were 146 ± 14.3, 153 ± 17.5 and 155 ± 17.7, respectively (P = 0.012). Moreover, the means for PIPP scores in groups A, B and C were 6.6 ± 1.3, 10 ± 2, and 11.4 ± 1.9, respectively (P < 0.001). There was no significant difference found between groups in their means of SaO2, systolic and diastolic blood pressure after the intervention (P > 0.05). CONCLUSIONS: The results indicate that stimulation with MBMO is effective in reducing pain in preterm infants; therefore, it can be postulated that this technique can be considered in less invasive procedures such as needling. TRIAL REGISTRATION: IRCT, IRCT20190220042771N1 . Registered 18 May 2019- Retrospectively registered.

Comparing the effect of kangaroo mother care and field massage on serum bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward.

BACKGROUND: Several factors contribute to the effectiveness of phototherapy. The aim of this study was to compare the effect of kangaroo mother care (KMC) and field massage on bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward. METHODS: This double-blind clinical trial was performed on 90 term neonates aged 48 hours with hyperbilirubinemia, hospitalized in Fereydunkenar Hospital during 2018-2019. The infants were randomly divided into 3 groups of massage with phototherapy, KMC with phototherapy and control (received conventional phototherapy without KMC and massage). The massage group used field technique for three 15-minutes in 3 days and the KMC group received KMC for five 30 minutes in 3 days as well. In three groups, the serum bilirubin levels were compared at baseline, 24, 48, 72 hours after the onset and at the end of phototherapy. Moreover, the mean duration of phototherapy and hospitalization was compared during the treatment. RESULTS: Serum bilirubin levels at baseline in the control, field massage and KMC groups were (17±1.38, 17.01±1.46 and 16.97±1.27mg/dl) and at the end of phototherapy were (6.97±0.47, 5.56±0.48 and 5.91±0.52 mg/dl) respectively. There was a significant difference between the intervention and control groups (p<0.001). The mean duration of phototherapy and hospitalization had no significant difference between two intervention groups (p>0.001), but it was significantly higher in control group than intervention groups (p<0.001). CONCLUSION: The use of massage or KMC with phototherapy, compared to the phototherapy alone, can reduce the bilirubin level, phototherapy duration and hospital stay.

Experiences of Iranian Nurses on the Facilitators of Pain Management in Children: A Qualitative Study.

Background. Despite decades of research and the availability of effective analgesic approaches, many children continue to experience moderate-to-severe pain after hospitalization. Greater research efforts are needed to identify the factors that facilitate effective pain management. The aim of this study was to explore the perceptions of Iranian nurses on facilitators of pain management in children. Materials and Methods. This qualitative study collected the data profoundly through unstructured interviews with 19 nurses in Amirkola Children's Hospital in Babol and Children's Medical Center in Tehran, during 2013-2014. Purposeful sampling and analysis of the data were conducted using conventional qualitative content analysis. Results. Four themes were extracted through data analysis: mother and child participation in diagnosis and pain relief, the timely presence of medical staff and parents, proper communication, and training and supportive role of nurses. Conclusion. Mother and child participation in the report and diagnosis of pain and nonpharmacological interventions for pain by the mother, the timely presence of medical team at the patient's bedside, and proper interaction along with the training and supportive role of a nurse enhanced the optimal pain management in hospitalized children.