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Aim: This study was conducted to evaluate the knowledge levels of nurses working in children’s hospitals in Al-Hilla, Iraq, regarding pain management in children and to examine certain variables associated with knowledge levels. Method: This descriptive cross-sectional study was carried out with nurses working in pediatric units of three children’s hospitals in Al-Hilla. The study sample consisted of 255 nurses. Data were collected using the Introductory Information Form and the Nurses’ Knowledge Form on Pain Management in Children. Descriptive statistics and the chi-square test were used for data analysis. Results: The overall level of knowledge regarding pain management among nurses was found to be moderate. The lowest level of knowledge was identified in the subdimension related to nursing care for children experiencing pain. Statistically significant relationships were found between knowledge scores and educational level as well as the unit in which the nurses worked. Nurses working in pediatric emergency units, neonatal units, and pediatric intensive care units had higher knowledge scores. Conclusion: The results of the study indicate a need to improve the knowledge levels of nurses working in pediatric units regarding pain management. Strengthening structured educational programs and standard practice guidelines, particularly those focusing on nursing care and pain assessment, is recommended.

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Patient advocacy is an ethical nursing practice, but its valid and reliable measurement remains problematic. The majority of existing scales lack robust psychometric evidence in diverse clinical environments. This study aimed to develop and psychometrically validate the Nursing Advocacy Scale (NAS-4), which is a multifaceted scale to measure challenges, strategies, and influencing factors on patient advocacy. The research was cross-sectional with 148 nurses. NAS-4 was applied, and the factorial structure of the NAS-4 was examined with Exploratory Factor Analysis (EFA). Internal consistency was assessed with Cronbach's alpha, and construct validity was assessed with known-groups validity and convergent validity analysis. EFA affirmed a four-factor solution for the core advocacy construct: 'Operational & Systemic Challenges,' 'Professional & Ethical Challenges,' 'Interpersonal & Social Challenges,' and 'Advocacy Action & Competency.' The overall scale and its subscales had high internal consistency (α = 0.78 to 0.92). Descriptive analysis of the items revealed that nurses strongly agreed that factors like supply and demand (M=4.49, SD=0.71) and ensuring patient safety (M=4.61, SD=0.75) were mandatory, while fear of losing one's job (M=3.13, SD=1.30) was a neutral challenge. Construct validity was established, with the scale differentiating well between groups with experience and training. The NAS-4 is a psychometrically sound instrument with proven reliability and validity for the measurement of the multifaceted construct of nursing advocacy. It is a valuable tool for health organizations and researchers to employ in the identification of barriers, audit of advocacy competency, and the development of effective targeted interventions to facilitate nurses as patient advocates.

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Despite progress in maternal health services, rural Zambia continues to record high rates of home delivery. Birth Preparedness and Complication Readiness (BPCR) is promoted to reduce delays in accessing skilled birth care, yet limited qualitative evidence exists on how preparedness influences actual delivery-site decisions among postpartum women. This qualitative study explored the role of birth preparedness in delivery-site selection among breastfeeding women in Petauke and Lusangazi districts, Eastern Province, Zambia. A descriptive phenomenological design was employed involving semi-structured interviews with 17 breastfeeding women who delivered at health facilities and four focus group discussions with 20 women who delivered at home. Data were analyzed thematically following Braun and Clarke’s approach. Birth preparedness emerged as the strongest determinant of delivery-site choice. Women who delivered at health facilities reported deliberate preparation including saving money, arranging transport, attending antenatal care, and preparing delivery items. In contrast, home delivery was associated with financial constraints, long distances, lack of emergency transport, cultural restrictions, limited decision-making autonomy, and low perceived risk. Strengthening birth preparedness particularly financial planning, transport readiness, male involvement, and community health education has high potential to increase institutional deliveries and reduce preventable maternal and neonatal risks in rural Zambia.

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People living with mental illness are disproportionately affected by stigma in public environments and healthcare systems. Therefore, this quantitative correlational study aimed to explore the nurses’ attitudes towards people with mental illness in Oman. It also assessed the factors that influence nurses’ attitudes in providing health care in the Ministry of Health facilities. Additionally, this study examined the relationship between the demographic characteristics of nurses (age, gender, levels of education, years of nursing experience, and areas of nursing practice) and their attitudes towards people with mental illness. Methods: A total of 530 registered nurses, with a minimum of one year nursing experience, from Four governmental hospitals in Oman have participated in this study, and only 502 surveys were included in the study analysis. The participants were recruited via convenience and nonprobability sampling. The Opinions about Mental Illness Scale (OMI) and the Demographic Characteristics Questionnaire were used in the study. Results: A total of 530 registered nurses have participated in the study with a response rate of 94.7%. Demographic characteristics (age, levels of education, and years of nursing experiences) were significantly related to nurses’ attitudes towards people with mental illness. The findings of this study indicated that nurses who worked in mental health areas had more positive attitudes than nurses who worked in in other areas including medical-surgical and maternal and child health areas. Conclusion: Actions should be taken to foster positive attitudes towards people with mental illness, such as evaluating ways to do this in nursing curricula as well as incorporating programs to promote knowledge of mental health among practicing nurses, particularly general nurses.

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INTRODUCTION: Based on the Guidelines for Surgical Recommendations, the WHO has developed a 19-item operating room safety checklist to support surgical teams, ensure quality and safety, and prevent mortality and postoperative complications The checklist includes three phases (Sign In, Time Out, Sign Out), 20 items with checks to be performed during the surgery, and the corresponding boxes to be checked after the checks have been completed. It is recommended to appoint a checklist coordinator among the team members who is responsible for reviewing the checks by each member of the operating team, and only after the checks have been established. I developed the questionnaire following the WHO guidelines, specifically the "Guidelines for Surgery" document, which was drafted by the association to present the operating room checklist for patient and staff safety. Objective: The purpose of this survey is purely informative, to obtain a state-of-the-art overview and to compare it with my own work environment. Methods: Taking into account the key points highlighted by the WHO, I developed a total of eight questions. The questions addressed the importance of implementing the checklist, the checklist phases in general, the checklist coordinator, the role of the checklist coordinator, adapting the checklist to one's work environment, the sign-in phase, the time-out phase, and the sign-out phase. Results: As confirmed by the literature, the introduction of checklists and the use of clinical protocols, if used responsibly and effectively, significantly reduce clinical risks and can become an important prevention tool. Conclusions: After analyzing the responses, it can be deduced that the checklist is completed correctly, carefully, and scrupulously in most contexts. The percentage of correct answers consistently exceeds the percentage of incorrect ones. I believe the importance of the checklist as a tool for patient and healthcare worker safety is well understood. These data are

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Background: Breastfeeding is essential for promoting infant health, particularly in the first six months of life. It serves as a critical public health strategy to improve the health of both children and mothers by reducing child morbidity and mortality while lowering societal healthcare costs. Despite its importance, teenage mothers often face distinct challenges in adhering to recommended breastfeeding practices. Targeted health messages offer a promising solution, providing personalized communication that enhances breastfeeding practices and ultimately improves infant health outcomes. Method: A randomized control trial was employed across baseline, intervention, and post-intervention phases. The study targeted teenage mothers with infants less than six months who were attending public hospitals in Tharaka Nithi County. Data collection tools used were structured questionnaires and focus group discussions (FGDs). Quantitative data was analyzed using the statistical package of social sciences (SPSS) version [29]. Descriptive and inferential statistics were used, ANOVA, Chi square and regression analysis. Qualitative data was analyzed thematically and the results presented in narratives, figures, and tables to ensure clarity and comprehensiveness. Results: The study revealed significant improvements in knowledge on breastfeeding practices among teenage mothers following the targeted messages intervention. Knowledge scores increased significantly (p < 0.05) across domains related to early initiation, frequency of breastfeeding and exclusive breastfeeding. On baseline knowledge levels had a one-way Anova of F=72.34 (high) and p=000002 (small) which affirmed that intervention led to a statistically significant difference in breastfeeding practices across test faces. The results were supported by regression results that showed pretest scores to be positive predictors of posttest scores. Conclusion: Targeted health messages significantly improved Knowledge, attitudes and

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Background: The most efficient and cost-effective forms of birth control are long-acting reversible contraceptives (LARC). In spite of their effectiveness, less than 15% of women globally who are of reproductive age use LARC. In Kenya, just 18% of women who are of reproductive age are using LARC method. The frequency in Meru County (11.2%) is much lower than it is nationwide. The objective of the study was to establish health-facility factors influencing the uptake of LARC among Women of Reproductive age (WRA) receiving care at the Meru Teaching and Referral Hospital. Methods: Analytical cross-sectional survey research design was used in the study. Women of Reproductive Age receiving family planning services at Meru Teaching and Referral Hospital in Meru County were the study's target population. Ten key informants were chosen through purposive sampling, and 170 women who were of reproductive age were chosen by systematic random sampling. In order to get quantitative data for this study, the researcher utilized a semi-structured questionnaire and a key informant guide was used to gather qualitative data. The Embu Teaching and Referral Hospital served as the pretesting site for the research tools. The presentation of qualitative data involved the thematic organization and narration. Chi-square tests were utilized to examine the relationship, at a 95% confidence interval, between the uptake of LARC and variables linked to social culture, health facility-related characteristics, and knowledge level. The strength and connection of the factors that were discovered to be significant were tested using regression analysis. Results: The majority of the mothers (51.2%) were in the 20–29 age range, with a small percentage (n=5, 2.9%) being older than 40; the married women were more (n=106, 62.4%) and half of the mothers had secondary level of education (n=85, 50%) unlike that of the partner that was found to be mostly tertiary level of education (n=102, 60%). A larger proporti