Mosul Journal of Nursing

Background: Premature babies, those born very early, often have complicated and medical problems. Typically, complications of prematurity are varying. The premature baby has a higher risk of complications. The baby will likely need a more extended hospital stay in a special nursery unit at the hospital, depending on how much care requires. Mother is faced with numerous challenges by experiencing a premature birth; therefore, knowing about the mother's efforts and knowledge regarding premature infants. The present study was carried out to explore the mothers' knowledge regarding prematurely born infants.
Patients and methods: This survey was conducted amongst 100 mothers visiting the Al Khansa Hospital and Ibn Al-Atheer, both hospital, specialized in the maternity and pediatric. The collection of data was done for the period of 15th November 2019 until 28th February 2020. A questionnaire form consisting of multiple-choice questions about knowledge about infant premature health was distributed to the volunteer mothers. The data was compiled and analyzed statistically. A Chi-Squair was used in data analysis resulted.
Results: Inthe present study, 53% of mothers scored 50 or less (poor knowledge), showing inadequate knowledge about infant premature health. Mother’s knowledge about infant premature health showed a significant positive correlation with her education, the order of childbirth, age at childbirth, and socioeconomic status (P-value<0.001).
Conclusion: The present study concludes that mothers have inadequate knowledge of premature infant health. Factors like mother's education, birth order of the child, mother's age at childbirth, and her socioeconomic status are related to the mother's knowledge
Keywords: mother knowledge, care of the baby, premature baby

Objective:  To evaluate the effectiveness of an education program on nurses knowledge toward leukemia in Kirkuk Oncology center
Methodology: Quasi-experimental study carried out among 30 nurses at oncology center, the data collected by using questionnaire consisted of 43 items.
Results: 70% of the study group at age (20-29) years, 50% of them were males and females, Graduate Nursing Institute. They had low level of knowledge at pretest the grand mean was (1.25) and at posttest the level of knowledge improve to moderate level (1.6) after implementation of an educational program.
Conclusion: Nurses had un adequate knowledge about leukemia. Therefore it is need to identify the gap of knowledge and initiate training session to improve their information.
Recommendations: nurses had un adequate knowledge about leukemia. Therefore it is need to identify the gap of knowledge and initiate training session to improve their information.
Key words: effectiveness- education program- nurses knowledge- leukemic patients.

Background: Cytomegalovirus belongs to the Herpesviridae family of subfamily Betahrpesvirnae. CMV is one of the major causes of perinatal and congenital viral infection. Also can cause spontaneous abortion in pregnant women in the first trimester of gestation.
Objective: To identify the relationship between CMV and women’s demographic variables of age, parity, occupation, residence and socioeconomic status etc. To determine the prevalence rate of CMV in aborted women in the 1st trimester. To assess the relationship between abortion and CMV. To determine anti CMV IgM and IgG in women after abortion. To find out the consequences of risk factorsof CMV on fetus and maternal.
Methodology: A descriptive correlational design was used in this study. Data were collected from three maternity hospitals in Kirkuk city. A convenience sample of (100) aborted women in the first trimester of gestation were selected in this study, who were admitted in maternity hospitals. A questionnaire designed about assess the risk factors for cytomegalovirus and prediction the relationship between abortion and virus. Assessment tool was constructed by the researcher after extensive review of previous studies and relevant literature. The study instrument consists of two main parts; part one was Demographic data for. And the part two include (Test result and Risk factors for cytomegalovirus on pregnant women). The data were
described statistically and analyzed through the use of descriptive and inferential statistical analysis procedures
Results: The prevalence rate of CMV IgG seropositivity was reported (37%), while the prevalence rate of CMV IgM seropositive results was lower (1%). The majority of the study sample was within middle age group (26 – 36 years, live in urban areas, housewives, Barely
Sufficient economic status and Consanguineous). There is significant correlation of CMV and (abortion, stillbirths, Age at Menarche, Regularity of Menstrual Cycle, Age at Married, Interval between last pregnancy & present Pregnancy, Causes of Abortion, Number of Para,
Type of Previous Delivery to Present Delivery, IgG & IgM Test Results).
Conclusion: CMVI showed significant effects on the abortion rates among pregnant women in the first trimester of gestation. In this study the socio-economic status of the tested women has no significant effects on the rates of anti-CMV IgG and IgM seropositive results.
 Keywords: Cytomegalovirus, prevalence rate of CMV, anti-CMV IgG and IgM, risk factors of CMV

Background and Objectives:
With laparoscopic varicocelectomy (LVV) invention, controversial ideas are developed regarding choosing the preferable method for surgical management of varicocele; accordingly, various comparative studies are required to evaluate safer and more productive technique. This study is aimed in observation of validity of both laparoscopic and inguinal open methods and their efficiency in producing fruitful male fertility progression.
Cases and methods:
This study is performed in a period of one-year (2017-2018), during which (60) cases of infertility due to varicocele pathophysiological consequences collected by simple random method. Of these (32) cases were laparoscopically managed (Group 1) and the other (28) cases managed by open inguinal method (Group 2). In these patients the basal spermatic analysis performed the parameters were below normal values.  The presences of varicoceles were proved clinically and by ultrasound Doppler studies. The varicocelectomy operations for non-fertile purposes were excluded from study. The follow up carried on two monthly intervals for next (6) months by clinical examinations, US and BSA. Statistically SPSS version package 24 is used; presented data are used.
Results:
The included ages were (24 to 43) years. In (51) cases only left side and in (9) cases were bilateral (VV). Postoperative follow up showed an acute rising of motility and quality of sperms after 4-8 weeks period among laparoscopic group and reached minimum normal level at the end of 24 weeks and 9 (28.13%) cases achieved conception in the first year. In the 
opened group the changes were slow and remained for 24 weeks to achieve wanted normal parameters and 11 (39.3%) cases achieved conception. Laparoscopic group operative duration was (42±5) minutes for unilateral and (60±8) minutes for bilateral, while in open group operation duration was (35± 5) minutes for unilateral and (50±5) minutes in bilateral. Regarding postoperative complications in laparoscopic group were; less painful, less disabling, least trauma, scars and complications.
Conclusions:
The laparoscopic varicocelectomy is promising method of treating varicocele for abnormal sperm parameters, uni or bilateral same ports approachability for especially in subclinical varicoceles.  LVV was safer than open method from various points of but longer operation duration. However open group conceptive outcomes observed more beneficial than LVV.
Key words; varicocelectomy- inguinal - Laparoscopic.  Fertility.    

Nurses have a key role in effective pain management, the nurse's accurate assessment, prompt intervention and adaptation of pain relief measures are necessary for positive patient outcomes.  This cross-sectional study carried out to highlight awareness of pain for its' importance to nurses. A convenience sample of (107) nurse selected randomly from four teaching hospitals in Nineveh Governorate through the period "December/2009-March/2010". Knowledge and Attitude Survey regarding Pain tool had been used n collecting data from the subjects which was self-administered through interview with each subject in the workplace. The main findings were; "Mean scores of correct answers= 15.65 ± 2.52, Total= 57.63, Percentage= 57.63%, Range= 40.74% - 85.19%", the workplace scores statistical significant differences with awareness as a ward or as a hospital working in. The study concluded that overall awareness was good as a total or as domains except patients' behavior domain while it recommended to include the educational curriculum by pharmacological area, patient assessment and integration of knowledge about pain into daily practice.
Keywords: Awareness, Pain, Nurse.

A descriptive analytical study was conducted through out the period between the first of November 2005 to the first of August 2006 in order to assess the practice of the nursing staff in the Pediatric Surgery Center in AL-Khansa' Teaching Hospital in Mosul. The sample of study included all the nursing staff working in the Pediatric Surgery Center (20 nurses). After directing an open-end question to (13) professionals medical staff and nurses working in the center to address the nursing activities carried out in center wards, the most common nursing activities were selected (Dressing, Intravenous infusion, placing intravenous cannula, checking axillary temperature, and intravenous drug administration). The reliability of the observational tool was determined through the application of test-retest technique and computation of Pearson Correlation Coefficient (r=0.93), the content validity of tool is determined through a panel of experts. The finding of study indicated that (95%) of nursing staff were males, and (10%)were graduates of Nursing College, while the remaining nurses graduated equally from Secondary School and Nursing Institute. The analysis of variance of study subject showed no-significant differences according to age, marital status, training session, level of education, and work in special department. When reviewing the mean of scores of the steps for all the procedures, it showed that the basic steps of each nursing procedure which may be shared among all procedures fluctuated among excellent, acceptable and weak measures with strong tendency to weakness. The study concluded that there are intense shortage in nursing staff, threatening of the feministic nursing staff, and continuous learning and training programs were not active and dependency on low nursing educational levels. The study recommended the necessity of staff to be highly qualified through activation of continuous learning and training, also the center should be provided by a sufficient number of nursing staff especially females, and the activation of nursing job description is necessary. Key word : QUALITY ، MONITORING ، PEDIATRIC ، SURGERY

School phobia is one of the most common symptoms among children in the elementary stage, which affects their psychological, social and scientific formation, as the child expresses his fear of coming to this strange environment and reflects this in a set of psychological and physical symptoms.
A descriptive study design carried out to assess school phobia among elementary school students in Nineveh Governorate during the period from September 1, 2019 to August 10, 2020. The sample of the study consisted of (806) elementary school pupils selected randomly from many elementary schools from inside and outside Mosul city which selected by stratified method. Data were gathered by a structured questionnaire based on previous studies and sources related to the research topic. It composed of two main parts; Demographic data and expected reasons or causes behind the phenomenon of the study. Its validity was checked through the opinions of (16) experts, and its reliability was measured by applying it to (50) students who were excluded from the main sample of the research, its value was (0.71). Data were collected through personal interview with each pupil in order to address the causes of the fear from the school, while the pupils’ commitment to the school and absenteeism from it was checked by reviewing each pupil’s file in the school. The interview was carried out by the researcher himself or by one of the teams of teachers assisting the researcher after their approval and engagement if the study. The study found a positive relationship between fear of school and fear from colleagues. The study concluded that there are large numbers of pupils in the schools, also in comparing with the numbers of teachers. High rate of absenteeism from the school among females. The study recommends building more schools in the governorate, establishing an educational and psychological counselling programs to deal with the phenomenon of fear, refusal and truancy from the school.  Also, the school administrations, personnel and teachers should create an appropriate school atmosphere based on dealing with pupils equally without differences, caring for them and follow up their academic levels, as well as working to control the school's surroundings and prevent any transgression and bullying among pupils and create the spirit of intimacy, love and cooperation among them.

Background: Congenital Heart Disease(CHD) is a problem of the heart's structure with its function at birth and it is the most common congenital anomaly . Etiology of congenital heart diseases are often unknown . However, many cases of CHD may result from genetic factors, environmental stimuli as well as chromosomal abnormalities  . Our study aimed to assess the degree of association of suggestive risk factors with the occurrence of congenital heart disease in infants at pediatric teaching hospitals ,in Mosul .
Materials and Methods  : A case-control prospective study  was carried out at pediatric teaching hospitals in Mosul city (Ibn Al Atheer and Al Khansaa Hospitals)on infant   ≤ 12 month of age with congenital heart diseases, who attended the pediatric cardiology units during 3 months from November 2019 to February 2020. To collect the data, a questionnaire was performed through interviews with parents of enrolled infant n= 557 (cases n= 272,controls n=285).
Results :   Residence of rural area , poverty , housewife mothers , parental low level of education ,  parental consanguinity, use of contraceptive measures, gestational diabetes, prematurity , low birth weight ,twins and caesarean section  have  significant associations with the occurrence of CHD .
Conclusions: Significant association were found between  prematurity ,low birth weight, twins, caesarian section,  positive family history for CHD, low parental education and poverty, and  the development of CHD.
Key words : Congenital heart disease, risk factors, infants, parents .

Background: Hepatitis (HBV & HCV)  a worldwide public health problem distressing millions of people annually.  Millions of people are living with viral hepatitis & other millions are at risk.  About ((1.3) million deaths annually result of acute hepatitis infection related liver cancer & cirrhosis. Therefore, the nurse's knowledge regard HBV & HCV influences the nature & quality of care that is given to the patient.
Objectives:  The study targeted to assess the nurse's knowledge regarding viral hepatitis B & C, evaluate the efficiency of information booklet on nurse's knowledge about viral hepatitis B & C & learn the connection between the scores of post  test & demographic variables selected.
Subjects & methods: A pre experimental design of the study method was adopted, one group pre & post test. The study was conducted between 70 nurses conveniently selected from pediatric hospitals in Mosul city. Content validity was determined by presenting the items to a panel of scientific experts.
Results: Pretest was conducted & the information booklet was distributed. The post test was implemented after 14 day. The data analyzed by using differential & inferential statistics. The mean score of pre-test knowledge (11.1571) the mean score of post-test knowledge (20.2857) was apparently greater than the pre-test, recommending that the information booklet was impact in increasing the knowledge of the nurse's regarding HBV & HCV. The mean enhancement in the knowledge was (9.1286) among pre-test & post-test knowledge score of the nurse's was found to be high significant. Conclusion the mean knowledge of post-test score is statistical significant higher than the mean knowledge of pre-test score so information booklet was effective.
Recommendations: The study recommends that self-learning module was highly impact in increase of nurse's knowledge about HBV & HCV in pediatric hospitals in Mosul city.
Key words: HBV & HCV, Effectiveness of  Information booklet, Nurse's knowledge.

Objectives: to identify the impact of using electronic games on psychological domain of adolescents quality of life and find out relationship between socio demographic variables and psychological domain
Methods: A descriptive study conducted among 300 adolescents using electronic games and the data collected by using questionnaire contain the sociodemographic characteristics and 9 items related to psychological domains.
Results: most of adolescents whom using electronic games were males and at age between (15-16) years and most of them from moderate level of socioeconomic status. They had poor level of psychological status when evaluated, the mean was (1.82).
Conclusion: increase using of video games had negative effect on quality of life (psychological domain).
Recommendation: it’s important to follow up of adolescents quality of life and encourage them to using physical activity and social relationship and decrease using the video games
Key words: Impact, Using electronic games, Psychological domain, Adolescents, Quality of life

A descriptive predictive design was used to guide this study, which mainly aims to identify students' readiness to seek mental health services (MHS).  The study was conducted at different universities across Iraq by an online survey.  The study included a convenience sample of 460 university students.  Data were collected through using a self-reported online survey for the period from October 28th, 2019 to March 30th, 2020. The study instrument includes the sociodemographic sheet and the Mental Health Belief Model Assessment, which assesses the six constructs of the HBM: Perceived Susceptibility, Perceived Severity, Perceived Benefits, Perceived Barriers, Self-Efficacy, and Fears. The study results revealed that less than a fifth reported that they experienced a mental health problem (n = 72; 15.7%). There are associations between students’ Perceived Severity of MDs, their families’ socioeconomic status, and their readiness to seek mental health services (r = .015; .008) respectively. The researchers recommend that there is a need to establish community-based health education activities that focus on raising the public’s awareness of the extreme importance of seeking mental health services. Moreover, mental health professionals in Iraq need to launch as many mental health education activities as possible to consolidate the public’s rapport and trust with them.
Keywords: Mental Disorders- Mental Health- College students- Stigma- Mental Health Beliefs-Mental health services

Background, The family, remains the primary source of care for the patient with schizophrenia, having a patient with schizophrenia in a family also affects the roles and interactions within the family.
Objectives: The objectives of the present study are to study the demographical data of the caregivers and to identify coping strategies and burden in family caregivers of schizophrenic patients as well as the effect of such a burden on the quality of health caring provided by family caregivers.
Materials and Methods: A cross-sectional, descriptive study was done on 105  family caregivers of schizophrenic patients, the study was carried out from 15^th October 2019 through 30^th  July 2020. The data were collected through the use of Caregiver Burden Scale and Coping Strategies Scale through the interview with relatives of the patient. This study was conducted in psychiatry consultant and psychiatric lounges in Ibn Sina Teaching Hospital in Mosul city.  The study Instrument consists of four parts; was the demographic data for the patient,  part two demographic data for the caregivers,  part three use the Caregiver Burden Scale, and part four use the coping scale.
Results : The mean age of the caregivers (26-36) years. Most of the caregivers were male. The economic level of caregivers did not influence the burden score. Caregivers reported their family burden the overall total score is (55), which mean a moderate to severe burden according to the caregiver burden scale(41-60), which represent (74.3%) of the caregivers.
Conclusion : The study concludedthe mean of burden was moderate to severe. There were significant differences between females and males; females had a higher subjective burden and males had a higher objective burden. No significant differences were found between participants according to their age in all burden types. 
Recommendations : The study recommended psychiatric nursing intervention should be focused on the need of the caregivers and an emphasis placed on community care for mentally ill patients as well as family intervention. Mental health professionals should increase attention to the caregivers in addition to the patients and develop more programs for families; they should be provided social support, especially by healthcare professionals, and they should also be provided psychoeducation. Further studies should examine the association between patients’ characteristics and level of burden, and to explore models of family interventions.
Key words : Caregivers Burden , Coping strategies, Schizophrenia

Abstract
Background: Exclusive breastfeeding (EBF) is defined as “an infant’s consumption of human milk with no supplementation of any type (no water, no nonhuman milk, and no foods) except for vitamins, minerals, and medications until six months. Mothers’ lack of knowledge and experience often results in difficulties in feeding especially when feeding the first time and it may result in the most frustrating experience for the mothers. The main aim of the study was to assess knowledge, towards breastfeeding among mothers attending Maternity Teaching Hospital in Erbil city.
Subjects and methods:  A cross-sectional design was used to achieve study objectives in Erbil Maternity Teaching Hospital in Erbil city, a non-random consecutive sampling method was adopted and the researcher was planned to involve one thousand mothers those were undergoing delivery regardless the type of delivery. 
Results: 73.7%  of mothers have Knowledge about the benefits of BF for mothers and her baby but they don’t have good information about EBF about, and 74.1% of mothers thought EBF meaning feeding baby with breast milk and water and 13.7 were EBF. Up to 62% of mothers know that first breastfeeding has to be initiated after 1 hour of child life, half of the mothers know that child needs 6 months of exclusive breastfeeding. There was a relation between mother occupation and education level.
Conclusion: Mothers have positive knowledge concerning breastfeeding initiation,  knowledge regarding the exclusivity of breastfeeding, and duration of breastfeeding. There was a significant statistical association between occupation status and educational level of mothers
Keywords: Knowledge, exclusive breastfeeding, Erbil maternity hospital

Abstract
Objective: Although sex hormones impart many effects on the cardiovascular system, few studies have analyzed the relationship between these hormones and ischemic stroke. We aimed to assess the serum levels of follicular stimulating hormone (FSH), luteinizing hormone (LH), and testosterone (Tn) among patients who had developed ischemic strokes.

Methods: This case-controlled study was conducted at the Rizgary teaching hospital, Erbil, Iraq, from December 1, 2018, to October 31, 2019. Fifty patients, who developed completed ischemic stroke were consecutively enrolled (patients’ group). This group was age-matched and gender-matched with another group of 40 healthy individuals, who had no stroke in the past. Serum levels of FSH, LH, and Tn were performed on days 1-4 of hospital admission. In both genders, these values were compared and analyzed.
Results: No statistically significant difference was found among the levels of serum FSH and Tn in both groups and genders (P-value=0.257 and P-value=0.835, respectively). Although there was no statistically significant difference among the levels of serum LH between patients and control groups in males, but there was a statistically significant difference among women (P-value=0.033) in both groups.
Conclusion: Serum LH levels among women who had developed ischemic stroke demonstrated a statistically significant difference when compared to non-stroke, age-matched and gender-matched female individuals in the control group. Whether this difference is clinically significant or not, further analytic studies are required to clarify its effect.
Key words: Ischemic stroke, FSH, LH, testosterone, sex hormones

Abstract
Background: Transient ischemic attack (TIA) is a neurological emergency. About 15-30% of strokes are preceded by TIAs. We aimed to evaluate the risk factors developing TIAs, assess all patients with diffusion weighted MRIs, and to initiate early treatment to prevent completed strokes.
Method: This cross-sectional observational study was conducted from December 1, 2018, to October 31, 2019. Eighty patients, who developed TIAs and who had attended the Rizgary Teaching Hospital’s emergency department and its neurology outpatients’ clinic at Erbil, Iraq, were enrolled consecutively. All patients underwent thorough medical and neurological examinations, the ABCD2 score was calculated in all patients, and an extensive battery of investigations, including an emergency brain CT scan and MRI with diffusion-weighted images (DWI) were done.  After securing the diagnosis of TIA, all patients were treated with antiplatelets or anticoagulants in addition to other medications, as needed.
Results: The mean age of patients was 56.63 (±SD of 11.6 years). The most common risk factor was hypertension (53.7%) followed by diabetes and smoking. The commonest presentation was acute hemiparesis followed by hemianesthesia. DWI sequences demonstrated acute ischemic infarctions in 15 (18.7%) patients.
Conclusion: TIAs targeted people younger than expected by other international studies. DWI of the brain is more sensitive than conventional brain MRI sequences in detecting the acute ischemic changes in patients with TIAs.
Keywords: TIA, stroke, ischemia, MRI, DWI

Abstract
Training programs designed to boost employees’ motivation in Kurdistan Region’s diagnostic laboratories require well-planned and appropriate structuring to strengthen employees’ professionalism in the services they provide to the customers—the patients. Currently, the services that the laboratories provide are fraught with incalculable problems that range from unmet needs and lack of organizational assessment, inadequately skilled employees, inadequate employee and patient safety measures, environmental issues, and insufficient managerial skills to inadequate technical and technological skills. The purposes of this research are; to examine public laboratories in an attempt to establish their similarities and dissimilarities in terms of the quality of the services they provide; to investigate the extent to which public sector care about training programs; to analyze how employees’ motivation vary from one laboratory to another. For the data collection, 178 useful questionnaires were collected from participants of the four provinces of the Kurdistan Region. Their responses were collated and analyzed. This study’s findings reveal that the safety training have a significant positive impact on employees’ motivation.
Keywords: Diagnostic Laboratories, Safety Training on Employees