Introduction: Cryptic pregnancy, or the delayed recognition of pregnancy until late gestation, poses unique psychological challenges for mothers due to the lack of prenatal preparation and sudden transition to motherhood. These circumstances may increase the risk of postpartum depression. Protective factors such as maternal self-efficacy and family support are believed to play an important role in reducing depressive symptoms after childbirth. Objective: The purpose of this study is (1) to analyze the relationship between maternal self-efficacy and postpartum depression among mothers with a history of cryptic pregnancy, (2) to analyze the relationship between family support and postpartum depression, and (3) to assess the extent to which maternal self-efficacy and family support predict postpartum depression levels. Materials and Methods: A cross-sectional study was conducted in Jombang Regency, East Java, Indonesia, from May to August 2025, involving 104 mothers with a history of cryptic pregnancy recruited by non-probability snowball sampling. Maternal self-efficacy was assessed using the 15-item questionnaire developed by Witungga et al. (2024; α = 0.916), family support with the 14-item questionnaire by the same authors (α = 0.836), and postpartum depression with the Edinburgh Postnatal Depression Scale (EPDS; Adli, 2022). Data were analyzed using Spearman’s rank correlation and ordinal logistic regression. Results: Most respondents had moderate self-efficacy (72.1%), fair family support (65.4%), and no signs of postpartum depression (68.3%). Spearman’s correlation showed significant negative associations between self-efficacy (ρ = –0.426, p = 0.001) and family support (ρ = –0.398, p = 0.002) with postpartum depression. Multivariate ordinal logistic regression indicated that both self-efficacy (B = –0.462, p = 0.014, OR = 0.63, 95% CI = 0.44–0.91) and family support (B = –0.518, p = 0.012, OR = 0.60, 95% CI = 0.40–0.89) were significant protective factors, jointly explaining 28.9% of variance in postpartum depression (Nagelkerke R² = 0.289). Conclusion: Maternal self-efficacy and family support are significant protective factors against postpartum depression in mothers with cryptic pregnancy. Strengthening maternal confidence and empowering family support systems are essential strategies to mitigate depressive symptoms in this vulnerable group.

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal morbidity and mortality worldwide. Effective management of PPH heavily relies on adherence to clinical guidelines. Mentorship programs aim to enhance healthcare providers' (HCPs) knowledge, skills, and guideline adherence, but their impact on guideline adherence needs evaluation. Objective: To evaluate the effect of a clinical mentorship program on HCPs' adherence to PPH clinical guidelines and patient outcomes at Muhima District Hospital (DH) and its associated health centers (HCs). Methods: A quasi-experimental design was used to compare HCPs' adherence to clinical guidelines before and after mentorship. Maternal outcomes were also analyzed in relation to guideline adherence. Standardized medical records provided data, and consecutive sampling included cases sequentially from medical registers. The Wilcoxon test was used to assess the effect of mentorship on adherence to guidelines. Multivariate regression analysis was performed to explore the relationship between mentorship, guideline adherence, and maternal outcomes. Results: The study included 384 women with PPH. Adherence to clinical guidelines before (96.4%) and after (95.8%) the mentorship program showed no significant change (P-value = 0.25). However, adherence to guidelines was significantly associated with better maternal outcomes (P-value < 0.001). Multivariate logistic regression indicated significantly lower odds of no complications in cases where guidelines were not followed. Adherence to guidelines (AOR = 0.061, 95% CI: 0.001- 0.026), prolonged labor (AOR = 187.25, 95% CI: 13.07- 2683.14), blood loss (AOR = 0.004 95% CI: 0.000 - 0.0008), and specific causes of PPH (AOR = 0.013, 95% CI: 0.000- 0.068) had significant associations with maternal outcomes. Conclusion: Adherence to clinical guidelines is critical for high-quality care and improved maternal outcomes in PPH cases. The study confirms the positive impact of guideline adherence on maternal outcomes, emphasizing the importance of promoting and strengthening adherence. While the mentorship program supported high adherence rates among HCPs, it alone may not be sufficient to ensure adherence, suggesting the influence of additional factors, such as training from other institutions.

Introduction: During the past 4 years Lebanon suffered from a major economic crisis and a health care system crisis after COVID pandemic. Nurses as a part of the healthcare system, had to deal with the impact of both crisis and the consequences. "In this study, job satisfaction and anxiety levels of nurses from 4 Lebanese public and private hospitals were assessed. Correlations of the job satisfaction and anxiety levels among them and with sociodemographic, professional and socio-economic ones, were evaluated. Objectives: This study helps to determine the prevalence of the psychological distress and its association with the job satisfaction among hospital nurses during economic crisis in South and Beirut hospitals. Materials and Methods: It is a cross-sectional study that aims to identify a cause-effect relation between hospital nurses Job satisfaction, level of anxiety and different sociodemographic and professional characteristics. The study was done through an online questionnaire including: an introduction to the study, an agreement of participation, the sociodemographic and professional information of the participants, the Generalized Anxiety Disorder Assessment (GAD-7) rating scale and the Nursing Workplace Satisfaction Questionnaire “NWSQ”. Results: Findings confirmed a significant relationship among salary decreasing due to economic crisis and job dissatisfaction (Spearman’s rho = 0.157; p-value =0.009); and significant relationship between lower levels of job satisfaction and higher anxiety levels of Lebanese hospital nurses (Spearman’s rho = 0.367; p-value <0.0001). Additionally, further correlations among sociodemographic and professional variables had explored. Conclusion: The study shows the correlation between the decreased nurses job satisfaction with the increased level of anxiety among nurses in Beirut and South of Lebanon hospitals, a negative correlation between salaries during the economic crisis in parallel with the average spending per month and the total job satisfaction, and a positive correlation between the job satisfaction and the anxiety levels. Also, both anxiety level and job satisfaction among nurses were subjective to the hospital locations and categories, the sociodemographic and professional characteristics and the economic crisis which has a significant impact on the nursing physiological status.

Introduction: Healthcare organisations require optimal leadership to achieve goals and deliver high-quality services. Leadership is the ability to influence employee behaviour and beliefs and is an essential element of a successful organisation. Improving job satisfaction is a key objective in addressing the challenges related to achieving and maintaining quality standards, ensuring patient satisfaction and staff retention. Similarly, transformational leadership has positive effects on nurses' job satisfaction and promotes organisational wellbeing in the workplace. Objective: The purpose of the review is to describe transformational leadership and job satisfaction in the nursing profession through a narrative revision. Materials and methods: The bibliographic research was carried out between September 2022 and March 2024 by consulting databases such as PubMed, CINAHL, and PsycInfo, with time limits of 12 years and Italian and English language filters. All items deemed relevant have been stored and managed with the Zotero IT platform. Results: 16 studies were examined: 1 comparative study, 5 descriptive correlational studies, 1 meta-analysis, 1 systematic review, 4 cross-sectional studies, 2 mixed method studies and 2 unspecified studies. The results of this study are consistent with transformational leadership theory, which highlights the leader's role in providing employees with supportive work environments that result in higher levels of job satisfaction and efficiency. Conclusions: The skills of a transformative leader, such as the ability to listen, provide support, and promote fairness and recognition, are fundamental to increasing nurses' job satisfaction and sustaining environments with a high level of quality of care. Healthcare managers must protect the quality of work undertaken by staff, implementing strategies that can improve nurses' working conditions.

Introduction: In recent years, with the rapid advancement of technology, tools capable of minimising discomfort for the diabetic patient are becoming increasingly popular, thereby increasing adherence to treatment. The use of technology improves glycometabolic compensation and quality of life. Objective: The aim of the present study is to verify, in the group using the Flash Glucose Monitoring system, improved diabetes management and satisfaction in insulin-treated patients. Materials and Methods: A retrospective cross-sectional study was performed through the administration of the “Diabetes Treatment Satisfaction Questionnaire”. The study was performed from January to July 2019. 82 validated questionnaires were administered in the Italian version. Participants were 47 women (39 Type 1 Diabetes Mellitus and 8 Type 2 Diabetes Mellitus) and 35 men (19 Type 1 Diabetes Mellitus and 16 Type 2 Diabetes Mellitus). Results: Results show that subjects with the Flash Glucose Monitoring system have greater satisfaction than those using the Self-Monitoring of Blood Glucose system. Patients using Flash Glucose Monitoring showed 83.9% satisfaction, while patients using Self-Monitoring of Blood Glucose showed 33.3% complete satisfaction. The average glycosylated haemoglobin of the group of subjects using Flash Glucose Monitoring was 53.2 mmol/mol, while that of subjects with self-monitoring of capillary blood glucose was 60.3 mmol/mol. Conclusions: The adoption of new technologies has benefits for the patient that positively affect quality of life. The study showed better glycometabolic compensation in the group of patients using Flash Glucose Monitoring. Diabetes carries significant costs to public health, and prevention and improvement of care could be a primary goal for the community and health systems.

Introduction: To date, Emergency Department overcrowding represents one of the most important problems regarding the organisation of emergency healthcare. See and Treat was devised in England around the 1980s to provide an effective solution to the overcrowding issue. The Emergency Nurse Practitioner indicates a faster pathway in selected patients with certain characteristics. This model translates into a reduction in waiting times while maintaining the same quality of care. Aim: To evaluate the potential benefits for patients of the implementation of the See and Treat model within the Emergency Department. Materials and Methods: Using the GIPSE system, all Emergency Department entries from 2019 have been selected. Minor codes in the triage phase have been considered, as well as those potentially falling within the See and Treat protocol. Each included case has been associated to a See and Treat diagnosis. The waiting time and the time spent in the Emergency Department were derived from the data collected. Results: 9.41% of the sample is eligible for the See and Treat method, with an average waiting time of one hour and peaks of almost 4 hours for white codes. The application of the See and Treat model to the population covered by our study would reduce the waiting times at the Emergency Department by 6.99%, reduce the simultaneous presence of users on the Emergency Department by 8.88% and reduce the stay for other minor codes by 4.38%. Discussion: The percentage of patients treatable in the See and Treat system (11%) is in line with the Tuscany trial but statistically lower than the international context (from 63% to 90%). The results obtained from this study showed the significant impact that the See and Treat model could have on reducing overcrowding, positively affecting both users and staff.

Background: Communities around the world have expressed concern about the safety and side effects of SARS-CoV-2 vaccines. The adverse effects of the Covid-19 vaccines played a critical role in public trust in the vaccines. The current study aimed to provide evidence on the side effects of the BNT163b2 mRNA COVID-19 vaccine (Pfizer-BioNTech®); ChAdOx1 nCoV-19 vaccine (AstraZeneca®); BBIBP-CorVvaccine (Sinopharm®) COVID-19 vaccines. Material and Methods: A cross-sectional study design was performed from April 26th, 2021, to June 3rd, 2021. Convenience sampling was used to select respondents; face validity was performed to the mandatory multiple-choice items questionnaire to cover the respondent’s demographic characteristics, coronavirus-19 related anamneses, and the side effect duration of coronavirus-19 vaccines, the data were analyzed by using descriptive statistics. Results: The 588 participants enrolled in the current study. ChAdOx1 nCoV-19 vaccine received 49.7%, followed by BNT163b2 mRNA COVID-19 vaccine and BBIBP-CorV (39.5% and 10.9%). The most common complaint was headache (61.2%), followed by vaccine injection site discomfort (58.8%), fatigue (49.7%), fever (48.3%), muscle discomfort (42.9%), and approximately (10.5% and 10.2%) had injection site swelling and nausea, respectively. Most of those surveyed had post-vaccine symptoms for one to two days (25.2%), (41%), and only a small percentage (3.7%) experienced them for over one month. ChAdOx1 nCoV-19 vaccine handled 53% of the side effects, followed by BNT163b2 mRNA COVID-19 vaccine (42%) and BBIBP-CorV vaccines (5%). Conclusion: Prevalence of various local and systemic vaccines side effects, such as headache, fever, and pain at the injection site, was observed. Almost all participants had mild symptoms and were well-tolerated .AstraZeneca® vaccine has the most side effects, followed by the Pfizer® vaccine, and the Sinopharm® vaccine has the least. More independent studies on vaccination safety and public awareness are critical to improving public trust in vaccines.

Background: Voluntary termination of pregnancy (VTP) is influenced by ethical convictions, religious orientations and knowledge of the law. The latter is essential for students to be improved in University curricula, in order to develop attitudes among future nurses and midwives with the objective to reduce stigma and reluctance in providing VTP. Previous research has shown that nursing and midwifery students’ attitudes and knowledge can be improved. Aim: The aim of this study is to describe literature regarding knowledge and perception about abortion and voluntary termination of pregnancy in several countries of the world among nurses, midwives and university students. Methods: This is a scoping review of the literature conducted by following the recommendations of the PRISMA-ScR Statement. The authors selected studies in MEDLINE, Scopus, CINAHL, PsycINFO, Academic Search Index, Science Citation Index and ERIC, published in English and Italian in the last decade. Quality assessment was performed using the Jadad scale. Results: Initially, 434 studies were selected. A total of 11 articles met the inclusion criteria. The articles included in the scoping review deal with the issue of abortion from different perspectives. From the analysis it emerged that the barriers for VTP are the lack or inadequate knowledge of the legislation and of the practical / technical phases of the procedure. Conclusions: Health professionals and students have different perspectives and attitudes toward VTP. Nurses and midwives have inadequate knowledge of procedures and legislation. Therefore, it is recommended to implement university curricula on the topic.

Introduction: Sleep quality disorders may cause a decrease in concentration and work performance of individual. It is also believed that nurses with work shifts as health workers may run into sleep quality disorders. Several researches have shown the relationship between sleep quality and the work performance of nurses in shifts duty. This study aimed to determine the relationship of sleep quality and vigilance of nurses in shifts duty in Raden Mattaher hospital Jambi. Methods: A cross sectional study was performed recruiting 97 nurses working shifts in 3 inpatients wards of the Raden Mattaher Hospital Jambi. Socio-demographic details and data nurses alertness were collected using ad hoc questionnaires, data sleep quality were collected using the Pittsburgh Sleep Quality Index. Relationships among sleep patterns and alertness variables were investigated. Data were analyzed by univariate and chi-square test (CI 95%). Statistical analysis was performed using the SPSS version 16.0. Results: Results showed an average of 29.4 years of age. Respondents were mostly female, married with working time &lt;5 years. The results of the bivariate analysis show there was not relationship between sleep quality and vigilance of nurses who undergoing shifts in Raden Mattaher hospital Jambi with p-value 0.35. Conclusion: There was not a relationship between sleep quality and vigilance among nurses undergoing a shift in patients’ rooms.

Background. The misconception of nutritional principles causes dietary oversight, resulting in an excess or deficit of energy and specific nutrients essential for the proper course of pregnancy and a child's healthy growth. This review aims to evaluate the effectiveness of nutrition education in improving knowledge and dietary change conducted in pregnant women. Methods. This review study complies with the 2009 PRISMA guidelines. The studies included in this review are mainly studies with experimental designs. Databases used in searching relevant literatures such as PubMed, ScienceDirect, Willey online Library, Web of Science, Cochrane, and Proquest that were published from 2010 to 2021, full text, English version, experimental studies. Two review authors conducted studies screening based on the eligibility criteria, and extracted important points in the studies included. Quality of the studies included were assessed using EPHPP. Results. A total of 10 studies were identified in this review. Six studies in the high quality, and four studies in moderate quality. Overall outcomes of the studies included are Knowledge, Attitude, practice, dietary practice, awareness, hemoglobin blood level, and Gestational Weight Gain (GWG). Conclusion. Nutrition education in many methods has a power to improve knowledge, and dietary change of pregnant women. It implies the need for future large high quality trials using a standardized approach to measuring and reporting similar findings across studies. Keywords : Pregnancy, Pregnant women, Education, Nutrition