Background: Despite the beneficial effects of the internet, inappropriate, and overuse of it may result in negative consequences such as internet addiction (IA). Despite the increasing uses of the internet among students and the concern about IA, the mechanism and the direction of association between IA and psychological stain is still unknown. Objectives: This study aimed to investigate the correlation between IA and psychological strain in nursing and midwifery students of Islamic Azad University, Qom Branch, in 2018. Methods: A cross-sectional study was carried out on 298 nursing and midwifery students of Islamic Azad University, Qom Branch. The students were recruited through a census method and responded to a three-part instrument. The study instrument included questions addressing the students' characteristics, the Young's IA Test, and the Osipow Psychological Strain Inventory. Data analysis was performed using descriptive and inferential statistics. Results: The mean age of the students was 21.93 ± 2.91 years. The mean IA and psychological strain were 53.12 ± 16.66 and 25.22 ± 7.33, respectively. About 50% of the students were moderately addicted to the internet, and 53% of the students showed moderate psychological strain. A direct significant correlation was found between IA and psychological strain in nursing and midwifery students (P = 0.001 and r = 0.41). IA and students' age could predict psychological strain in nursing and midwifery students (r² = 0.18). Conclusion: A majority of nursing and midwifery students showed moderate levels of IA and psychological strain, and these two variables are significantly correlated. The authorities in nursing and midwifery education should establish appropriate strategies to diminish the harmful effects of excessive internet use by the students.

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Background: Professional values are the core of developing professional identity and among the determining factors behind nurses' professional practice. Adherence to professional values seems to be affected by personality characteristics. Objectives: This study aimed to assess the relationship between personality characteristics and adherence to professional values among nursing students. Methods: This descriptive correlational study was conducted on 200 nursing students recruited from Urmia Faculty of Nursing and Midwifery, Urmia, Iran. Study data were collected using the Holland's Personality Questionnaire and the Nurses Professional Values Scale-Revised and were analyzed using the Kolmogorov–Smirnov test and the Pearson's correlation analysis. Results: Participants' closest adherence to professional values was related to the dimensions of trust (particularly the item “Maintain competency in area of practice”) and caring (particularly the item “Maintain confidentiality of patient”). Their poorest adherence was to the dimensions of professionalism (particularly the item “Participate in peer review”) and activism (particularly the item “Participate in nursing research and/or implement research findings appropriate to practice”). The social personality type had significant relationships with all dimensions of adherence to professional values, while the investigative personality type had significant relationships only with the caring (P = 0.021) and the justice (P = 0.013) dimensions. Moreover, the artistic personality type had significant relationships with the trust (P < 0.001), professionalism (P = 0.004), and caring (P = 0.001) dimensions.Conclusion: Personality characteristics have significant relationships with adherence to professional values among nursing students. Therefore, personality characteristics is suggested to be considered as a main criterion for the recruitment of new students to nursing.

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Background: Surrogates are women who bear a genetically unrelated child for another individual or couple. Experiences of surrogate mothers need further investigation. Objective: The objective of the study was to answer the questions of what were the experiences of surrogate mothers and what problems they confronted during the process of surrogacy. Methods: The present study was a qualitative content analysis. Purposive sampling was used in the study. Pregnant women with various ages and educational levels were invited for semi-structured interviews. Graneheim and Lundman's method was used for analyzing the data. Results: In this study, 15 participants were interviewed. The codes extracted from the interviews were categorized into five main themes and 13 subthemes. The main themes were: (1) desperation; (2) pain and suffering with the subthemes of physical pain, emotional suffering, suffering caused by others, and fears; (3) emotional involvement and self-alienation; (4) looking for the positive aspects of the surrogacy with subthemes of positive interpretation of the experience, and the sense of pride; (5) and supportive systems including the commissioning parents, the surrogate's family, the health system, and the community as subthemes. Financial motivations were the reason for surrogacy which made women endure many physical, psychological, and social problems. The women expressed some positive feelings about surrogacy and also mentioned several support sources. Conclusion: Surrogate mothers reported numerous physical, emotional, and social problems that require better counseling services. A supportive system, especially the health system, should provide better and more humanistic services for surrogate mothers.

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Background: Children's sleep problems can negatively affect their daily functioning at home and school, their behaviors, and their health status. Education through short message service (SMS) is among the techniques with potential positive effects. However, no study is available on the effects of SMS-based sleep education on sleep among children. Objectives: This study aimed to examine the effects of SMS-based education for mothers on sleep duration among their 7–12-year-old children who had sleep inadequacy. Methods: This randomized controlled trial was conducted on 206 elementary students and their mothers. Students with sleep inadequacy who were selected from thirteen elementary schools in Tabriz, Iran, were randomly allocated to a control (n = 103) and an intervention (n = 103) group. In the intervention group, students' mothers were provided with sleep education through thirty nightly messages sent at 20:00 for 1 month. Mothers in both groups completed the 2-week sleep record before, 1 week, and 3 months after the intervention. The data were analyzed using the independent samples t- and the Chi-square tests, the repeated-measures analysis of variance, and the analysis of covariance. Results: The mean of sleep duration in the intervention group significantly increased from 533.28 ± 29.35 min at baseline to 551.26 ± 37.93 at the first posttest and 568.25 ± 35.44 at the second posttest (P < 0.05). In the control group, the mean of sleep duration significantly increased from 523.13 ± 33.69 min at the pretest to 539.98 ± 49.03 at the first posttest (P < 0.05) and insignificantly decreased to 528.96 ± 52.20 at the second posttest (P > 0.05). Between-group difference respecting the mean of sleep duration was statistically significant only at the second posttest (P < 0.001). Conclusion: SMS-based sleep education for mothers is effective in significantly increasing sleep duration among school-aged children.

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Background: Nurses' lack of knowledge about domestic elder abuse and their limited ability to recognize it can result in negative consequences. Education has the potential to improve nurses' ability to recognize elder abuse. Yet, there is no conclusive result about its effectiveness. Objectives: The main objective of the present study was to assess the effects of education on nurses' ability to recognize elder abuse. Methods: This randomized controlled trial was conducted in two public hospitals in Ramsar and Tonekabon, Iran. Participants were 120 nurses who were randomly recruited and allocated to an intervention (n = 60) and a control (n = 60) group. The study intervention was an educational program implemented in two successive 2-h sessions in 1 day. Data were collected using a demographic questionnaire and The Nurses' Recognition of Elder Abuse by Family Caregiver Questionnaire. The possible total score of the latter questionnaire was 67–335. The data were analyzed using the Chi-square, the Fisher's exact, and the paired- and the independent-samples t-tests as well as the one-way and the repeated-measures analyses of variance. Results: The mean score of elder abuse recognition ability significantly increased in the intervention group (P < 0.001), while it did not significantly change in the control group (P = 0.85). Participants had a good ability to recognize physical elder abuse and limited ability to recognize sexual abuse. Conclusion: In-service education about elder abuse for nurses not only improves their elder abuse recognition ability but also can help them take appropriate measures for its management.

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Background: Hospital discharge and transfer of a preterm infant from hospital to home are usually stressful for parents. Objectives: This study evaluated the effects of a neonatal critical care nurse companionship with parents during hospital–home transfer of preterm infants on mothers' mood status. Methods: This randomized clinical trial was conducted on 64 mothers of preterm infants discharged from the neonatal intensive care unit of a teaching hospital in Isfahan, Iran. Participants were randomly and equally allocated to an intervention and a control group. Each mother in the intervention group was accompanied by a nurse immediately from hospital discharge up to 3 h afterward. The nurse also supported the mother during the first 3–4 postdischarge days. Mothers' mood status was assessed using the 21-item Depression, Anxiety, and Stress Scale both groups 3–4 days before hospital discharge and 72 h after hospital discharge. Data were analyzed through the Chi-square, the paired-sample t, and the independent-sample t-tests. Results: The pretest mean scores of depression, anxiety, and stress, respectively, were 4.71 ± 4.43, 6.51 ± 4.04, and 9.17 ± 5.40 in the intervention group and 4.91 ± 2.59, 6.59 ± 2.92, and 8.77 ± 3.58 in the control group. The between-group differences respecting the mean scores of depression, anxiety, and stress were not statistically significant (P > 0.05). These mean scores significantly decreased in the intervention group after the intervention (P < 0.05) while did not significantly change in the control group (P > 0.05). Conclusion: Nurse companionship with parents during the transfer of preterm infants to home improves mothers' mood status.

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Background: In Saudi Arabia, rates and duration of breastfeeding are progressively declining. Objective: The objective of this study was to examine and describe the relationship between breastfeeding knowledge, attitudes, exposure, and intention of university female students in Saudi Arabia. Methods: This cross-sectional survey recruited 124 students who completed a self-reported questionnaire. The questionnaire included breastfeeding knowledge, attitude and exposure scales, and a breastfeeding intention scale. Descriptive and inferential statistics were used to analyze the data. Results: Participants had good breastfeeding knowledge (mean score of 9.51 ± 2.63) and positive attitudes (mean score of 42.0 ± 1.8). However, they had some misconceptions about eating certain foods during breastfeeding and that breastfeeding is painful. A significant relationship was found between breastfeeding knowledge and attitude (r = 0.896,P <0.01), breastfeeding knowledge and exposure (r = 0.191,P <0.01), breastfeeding knowledge and intention to breastfeed (Phi coefficient=0.179, P = 0.033), and breastfeeding attitudes and intention to breastfeed (Phi coefficient=0.177, P = 0.030). Participants' knowledge (OR=3.280;P <0.001) and attitude (OR=1.930;P <0.001) were identified as factors independently and positively associated with future breastfeeding intention. Conclusion: The study identified specific gaps in knowledge and attitudes that pertain mainly to breastfeeding in public and perceptions that breastfeeding is painful, formula feeding gives more freedom to the mother, and that dietary restrictions by the mother during breastfeeding are needed. These gaps should be addressed in future breastfeeding promotion.

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Background: Human immunodeficiency virus (HIV)/AIDS is a disease that is stigmatized as a result of its origin and outcome. HIV stigma may occur in the form of prejudice, stereotyping, and discrimination, collectively called HIV stigma mechanism. While studies have shown that student nurses are among persons who stigmatize, little is known about the role of their personal dispositions in the stigma process. Objective: This study aimed to examine the role of personal dispositions on their HIV stigma mechanism against HIV-infected persons. Methods: We employed a cross-sectional descriptive design involving 395 students across Osun State, Nigeria, using a modified Health Care Provider HIV/AIDS Stigma Scale instrument. Four personal dispositions (age, study level, HIV knowledge, and perception) serving as the independent variable, were of interest as well as the HIV stigma mechanism (prejudice, stereotyping, and discrimination) serving as the dependent variable in this study. Data were analyzed using mean and multiple linear regression analysis. Results: The mean scores of the categorical variables of knowledge about AIDS and perception of HIV-infected persons, measured on scales of 0–9 and 0–15, revealed moderate knowledge about HIV (5.90 ± 1.26) and negative perception (10.61 ± 2.47). For the dependent variables, the mean scores were 17.97 ± 4.07 for prejudice, 13.84 ± 3.34 for stereotyping, and 10.47 ± 3.22 for discrimination, which indicated that student nurses stigmatized HIV-infected patients. However, the core finding of this study revealed that, of all the predictors of HIV stigma mechanism, perception was the most significant. Conclusions: Personal dispositions are contributory factors to the enactment of HIV stigma mechanism. Future planning for intervention studies to reduce HIV stigma among health profession students should take cognizance of this.

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