Africa Journal of Nursing and Midwifery

The concept of stigma has received significant attention in recent years in the HIV/AIDS literature. Although there is some change towards the positive, AIDS still remains a significantly stigmatized condition. AIDS stigma and discrimination continue to influence people living with and affected by HIV (PLWA), as well as their health-care providers. Unless stigma is conquered, the illness will not be defeated. Due to the burden that HIV/AIDS places on people living in Africa, a five-year project entitled Perceived AIDS Stigma: A Multinational African Study was undertaken. The focus of the first phase of this project was on exploring and describing the meaning and effect of stigma on PLWA from the experiences of PLWA and the nurses involved in their care in five African countries: Lesotho, Swaziland, Malawi, South Africa and Tanzania. An exploratory descriptive qualitative research design was used to explore and describe the experience of stigma through the critical incident method. Purposive voluntary sampling was utilized. Forty-three focus group discussions were held with respondents to relate incidences which they themselves observed, as well as those that they themselves experienced in the community and in families. The transcribed data was analyzed through the technique of open coding using the NVivo 2.0 analysis package. Three types of stigma (received stigma, internal stigma and associated stigma) and several dimensions for each of these types of stigma emerged from the data. Recommendations were made to pursue these findings further.

Volunteers (n = l 999) who regarded themselves as healthy enrolled in the Prospective Urban and Rural Epidemiology (PURE-SA) study in the North West Province, of South Africa (SA) after giving signed consent. All the participants, with newly identified health problems, were immediately counselled and referred to the local health clinics or hospitals with a referral letter from the principal researcher. The aim of the research was to explore the health care seeking behaviour of the newly diagnosed HIV people, after having been referred to a health care facility a year earlier, and after having received pre- and post-test counselling. Purposive voluntary sampling was conducted. Data were collected by means of a survey, followed by an in-depth interview specifically aimed at exploring the health care seeking behaviour of HIV infected persons in the North West Province. Each researcher wrote verbatim responses of the participants as well as, demographic, descriptive and reflective field notes during and after each interview. For the quantitative data in the survey, frequency and cross tabulations were performed. The verbatim responses and field notes were analysed using the open coding technique of content analysis. Of the 1 999 participants in the PURE-SA baseline study 16.6% (332) who considered themselves to be healthy were diagnosed with HIV. Only 27.7% (n=92) of these 332 participants had actually sought medical care after post-test counselling and referral by a health professional. Three main aspects that influenced health care behaviour of the participants were: various forms of stigmatisation; aspects around the illness itself; poverty and other factors influencing access to health care services. Recommendations enhanced focus on stigma reduction, understanding of HIV, and factors to enhance access to health care facilities.

Introduction: Some authors have been able to determine that cardiovascular disease has its origins in early life stages and that the risk of suffering them is determined by the effect associated with exposure to cardiovascular risk factors over a long time, all of which produce a negative effect on the quality of life. Objective: We aimed to identify cardiovascular risk factors in schooled adolescents within public institutions of education in Villavicencio. Methods: This was a cross-sectional, prospective, observational study developed in eight high schools with children between 13 and 17 years old. A written standardised survey was applied (questionnaire type), which was auto-administered from the instrument denominated Global School-based Student Health Survey (GSHS) of the World Health Organisation (WHO). The modules were physical activity, eating behaviour, and drugs and alcohol consumption. In addition, the researchers took measures of weight, size, waist circumference, blood pressure and blood tests to measure total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides and glucose, with each student’s informed consent and that of his or her guardian. Statistics used were: average, standard deviation, interquartile ranges, proportions, Chi-square, and logistic regression. Results: A total of 1 504 students were analysed. Age and physical activity were not significantly associated with cardiovascular risk. Conclusions: The results allow us to establish that the predominant risk factors for cardiovascular disease in young adolescents between 13 and 17 years old school in high school in Villavicencio are: smoking, alcohol consumption, body mass index (BMI), and family antecedents (such as precursor pathologies and chronic renal insufficiency), the latter with a risk opportunity of 15.5 times of having cardiovascular disease in this population group.

Student nurses must be prepared professionally to provide nursing care, especially during a critical time such as COVID-19. Regardless of undergraduate nursing programmes focusing on preparedness for practice, the concept of preparedness for nursing practice is not well understood. In this descriptive quantitative study, we determined the extent of the nursing practice preparedness of graduating student nurses amid COVID-19 as perceived by these nurses and nurse educators and the possible interventions to enhance the preparedness for practice of these nurses. In the study, we used an adapted Nursing Practice Readiness Tool, employed the complete enumeration survey method and analysed through frequency, percentages and weighted means. A total of 118 student nurses and 51 nurse educators from a selected university completed the questionnaire. The data were analysed through SPSS version 25. The findings revealed that the scales, which ranked from greatest to lowest preparedness for practice, were: professionalism (4.83), communication (4.65), management of responsibilities (4.61), critical thinking (4.36), clinical knowledge (4.26), and technical skills (4.02). We concluded that the students’ performance in the nursing competency items under clinical knowledge, critical thinking, and especially technical skills, demand increased attention to be better equipped as they transition into nursing practice. Specifically, of the 36 competency items, they were least prepared in using clinical and information technologies, and performing clinical procedures. Finally, as the top intervention, we proposed the development of contingency plans for unusual situations such as a pandemic (75.74%) to enhance the student nurses’ preparedness for practice.

Nurses make up the largest group of healthcare professionals fighting Covid-19, and they frequently face patients with Covid-19 from hospitalisation to discharge. For this reason, they are exposed to several psychological pressures and occupational hazards. This study aimed to determine the relationship between death anxiety and commitment to the profession in nurses providing nursing care for patients with Covid-19 in Turkey. A correlational descriptive study was conducted with 130 nurses giving nursing care to patients with Covid-19 in a hospital in Turkey providing care to Covid-19 patients. A personal information form, the Turkish Death Anxiety Scale, and the Nursing Professional Commitment Scale were used to collect the study data. Descriptive statistical methods were used to summarise the general information. The data are expressed as “mean ± standard deviation (X ± SD)” or “frequency and percentage.” Correlations between the scales were determined using Spearman’s correlation test. The statistical significance level was accepted as p < 05. The mean score of nurses from the Turkish Death Anxiety Scale was 76.00 ± 23.44, and their mean score from the Nursing Professional Commitment Scale was 57.00 ± 14.60. No significant relationship was found between the Turkish Death Anxiety Scale and the Nursing Professional Commitment Scale scores (r = 0.085, p = .336). The findings of the study showed that nurses had a high death anxiety level, their commitment to the profession was moderate, and that no significant relationship was found between their death anxiety and commitment to the profession. Nurses should be supported by employers to enhance their professional commitment and reduce death anxiety during the Covid-19 pandemic.

To prevent the spread of Covid-19, healthcare staff require up-to-date knowledge. There is limited information about the level of knowledge, attitudes, and compliance with Covid-19 guidelines among nursing students in Iran. This study aimed to determine knowledge, attitudes, and compliance with Covid-19 guidelines and related factors among nursing students at Guilan University of Medical Sciences in the north of Iran. This cross-sectional study was conducted on 190 undergraduate nursing students. Samples were recruited by convenience sampling according to the inclusion criteria. The research instruments included demographic characteristics and knowledge, attitude, and practice towards Covid-19 questionnaires. Descriptive and inferential statistics were used to analyse the data using SPSS software version 21 with a significant level of 0.05. In this study, 131 (68.9%), 182 (95.8%), and 81 (42.6%) of the study participants had good knowledge, positive attitude, and good compliance with Covid-19 guidelines, respectively. Results showed that the mean scores of knowledge, attitude, and compliance with Covid-19 guidelines were 14.66 (SD=3.03), 30.35 (SD=4.13), and 11.05 (SD=4.00), respectively. There was a significant relationship between knowledge and some demographic characteristics (gender, job, and housing status), between attitude and gender and economic status, and between compliance and gender and academic semester (P<0.05). Managers can use the results of this research to plan and provide arrangements to improve compliance with precaution guidelines during future events similar to Covid-19.

The aim of this study was to assess undergraduate nursing students’ understanding of updated guidelines for the coronavirus disease (COVID-19). For the methodology, the study used a cross-sectional, descriptive, quantitative design. Three hundred undergraduate nursing students from 10 nursing schools in the West Bank, in the occupied Palestinian territories, were surveyed between April and May 2022 using a computerised survey questionnaire. The questionnaire was divided into two sections, the first comprising sociodemographic data, and the second evaluating nursing students’ knowledge. Based on the study findings, 48.3% of the nursing students had inadequate knowledge, 50.3% had satisfactory knowledge, and just 1.3% had good knowledge. Students with higher academic levels (p < 0.001); students who began clinical training in healthcare facilities (p < 0.001); and students who had one or more family members employed in the healthcare sector (p = 0.038) all showed significantly higher levels of knowledge of COVID 19 guidelines. In conclusion, nearly all elements of COVID-19, including its clinical presentation, treatment, and prevention, were poorly understood by nursing students as a whole. Evaluating nursing students’ knowledge about COVID-19 will assist policy-makers in developing appropriate techniques for moving forward with mindfulness and states of mind about COVID-19 to encourage oversight of the pandemic and increase nursing professionals’ adherence to disease anticipation and control measures.

The front line of healthcare professionals that could be at high risk for COVID-19 is nursing personnel. In Palestine, there is a lack of data on nurses’ knowledge, attitudes, and practices (KAP) regarding COVID-19 national guidelines. Undeniably, nurses’ adherence to control measures is affected by KAP. The study’s goal was to assess nurses’ KAP toward prescribed COVID-19 hospital guidelines. A cross-sectional, quantitative and descriptive design was used in this research involving a total of 340 nurses working in hospitals and health care centres in Palestine. The survey was conducted between May and July 2021 by means of a computerised survey questionnaire. Four portions of the questionnaire included sociodemographic data, nurses’ knowledge, attitudes, and practices regarding COVID-19 national guidelines. Results showed that a total of 248 (73.0%) nurses demonstrated good knowledge of COVID-19 national guidelines, 207 (61.0%) displayed positive attitudes, and 226 (66.6%) complied with prescribed COVID-19 guidelines as evidenced through observations of their daily nursing care practices. Increasing knowledge and training for improving attitudes and practices among frontline nurses is paramount for controlling the transmission of COVID-19. Nurses and other healthcare professionals who have direct or indirect contact with COVID-19 patients should be protected from infection by policies and education, which should be implemented.

The Pabon Lasso Model is often used to assess the efficiency of hospitals as the most important component of the health care system. The present study sought to evaluate and compare the efficiency of hospitals in northern Iran before and after the COVID-19 pandemic using the Pabon Lasso Model. This descriptive study was conducted in 36 public, private, and social security hospitals in northern Iran from 2019 to 2020. The hospitals were selected using the census method. The data were collected using the forms approved by the Ministry of Health and Education. The three indices of bed occupancy rate, bed turnover frequency, and the average length of stay were calculated and plotted using the Pabon Lasso graphs. The collected data were analysed using the paired samples t-test. The average bed occupancy rates in 2019 and 2020 were equal to 67.72% and 52.28%, lower than the national standard rate. Moreover, the average lengths of stay were 2.58 and 2.83 days and the bed turnover rates were 96.7 and 77.94, higher than the national standard rate. Of the total 36 hospitals in 2019, 33.3% of hospitals were in the first quarter (low efficiency), and 16.6% in the third quarter (high efficiency). Furthermore, the data for 2020 indicated that 38.8% of hospitals were in the first quarter (low efficiency), showing an increase compared to 2019 and 19.4% of hospitals were in the third quarter, indicating a decrease compared to 2019. The paired samples t-test indicated that the bed occupancy rate and bed turnover showed significant differences in 2019 and 2020 (P-value<0.05). The data confirmed that the average length of stay and bed turnover in the studied hospitals were favourable. In addition, unlike private hospitals, the number of efficient units in public hospitals decreased during the COVID-19 pandemic. Thus, hospital managers need to pay more attention to improving performance indicators and increasing productivity in these hospitals.

The health and wellbeing of nurses and midwives are essential to the quality of care they can provide for people and communities, affecting their compassion, professionalism and effectiveness. Ensuring that working conditions across all settings—in primary, secondary, mental health, community and social care—are supporting nurses and midwives in their work, is fundamental to ensuring the best outcomes for people who need health and care services. The coronavirus pandemic (Covid-19) has emerged as a serious health crisis of global proportion. This disease has created health emergencies, which had taken a toll on the wellbeing of many health workers. Particularly, the nursing and midwifery professions have faced numerous challenges causing ethical dilemmas in their practices and exacerbating their psychosocial wellness. In this commentary, we explore the impact of Covid-19 on the nursing and midwifery practices in South Africa.

The burden of providing care to patients during the COVID-19 pandemic escalated stress among nurses, which affected their mental health, and called for effective coping. The goal of this study was to correlate the burden of caregiving with the management of stress by nurses during the COVID-19 pandemic in the United Arab Emirates. We conducted this cross-sectional correlational study among the nurses in two hospitals in the United Arab Emirates. A non-probability voluntary sample (n = 64) was taken of nurses working in the intensive care unit (n = 41) and isolation wards (n = 24). The respondents completed two questionnaires via Google Forms, namely, the Professional Care Team Burden Scale and the 15-item Stress Management Inventory. The findings indicate that the nurses reported moderate (37.5%) to low (62.5%) levels of the burden associated with caregiving. There was a significant inverse correlation between the burden of care and three elements of the stress management inventory, namely developing resiliency (r = −.284, p = .023), short-term coping (r = −313, p = .012), and effective delegation (r = −.395, p = .001). However, there was no correlation between the burden of care and eliminating stressor elements. The findings suggest that when nurses increased their resilience, short-term coping strategies and effective delegation they tended to experience less burden of caregiving during the COVID-19 pandemic. We therefore recommend that health policymakers focus on supporting resilience, short-term coping strategies and effective delegation in the nursing work environment to reduce the burden of caregiving.

On 11 March 2020, the World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic. Knowledge about COVID-19 is an important determinant towards successful disease control. This study was designed to elucidate the knowledge, attitudes and practices (KAP) and mental health status regarding COVID-19 amongst trainees of two institutes in the state of Uttar Pradesh, India. The cross-sectional study was conducted from January to March 2021. A bilingual survey recorded the responses of 400 participants from the institutes. Variables, such as sex, age, marital status, occupation, level of education, number of family members and living place, were collected in a structured proforma. Unstandardised regression coefficients (95%) were used for evaluating the association among variables with KAP and mental health during COVID-19. The statistical significance level was determined at p<0.05.The mean correct answer score regarding knowledge about COVID-19 was 23.5 (SD=2.1), indicating an overall 87% correct rate. The mean correct answer score regarding attitude towards COVID-19was 18.4 (SD=2.3), indicating an overall 87.2% correct rate. The mean correct answer score regarding practice towards COVID-19 was 35 (SD=3.4), indicating an overall 89.7% correct rate. The mean correct answer score regarding mental health status during COVID-19 was 24 (SD=4.7), indicating an overall 80% correct rate. Thus, the results showed that being female; belonging to a higher age group; having a healthcare related occupation; being married; and having a higher level of education were significantly associated with higher KAP test scores. Furthermore, belonging to a higher age group; having a healthcare related occupation; being married; and having a higher level of education were significantly associated with poor mental health.

The preparedness of nurses in the COVID-19 pandemic is of great importance with regard to the unknown future of the pandemic and other similar ones. Identifying nurses’ problems can lead to better planning, preparation and management. In this study, we aim to explore the experiences and challenges of nursing managers’ preparedness for timing responses to the COVID-19 pandemic. We conducted the research as a qualitative content analysis in Iran in 2022. The data were collected through in-depth semi-structured individual interviews with 15 nursing managers who were selected by purposeful sampling. After transcription of the interviews, a content analysis using constant comparison was performed for data analysis based on the Graneheim and Lundman approach. The results of the study can be summarised in the following four main categories and nine subcategories: the necessity of exercises in the same environment (performing exercises to prepare for possible pandemics, experiencing scenes similar to real pandemics, creating the experience of similar environments for the preparation of nurses), educating all members involved in providing services in the COVID-19 pandemic (preparation of non-specialist workers for pandemics, training all members of the treatment and non-treatment team), management and leadership (inappropriate policymaking and unsuitable planning), and processes and structures (processes for providing services and ineffective provision of protective equipment). As we pointed out in this study, it seems that to solve some of these challenges coordination is needed outside the health sector. In addition, the establishment of the National COVID-19 Control Centre can contribute to developing necessary policies and strategies for handling the pandemic.

The outbreak of the novel coronavirus disease (COVID-19) in 2019 was met with various responses globally in an effort to reduce its spread. Despite these efforts, however, low- and middle-income countries like Indonesia are still being confronted with challenges, especially the healthcare providers who are frontline workers in the struggle. The current study aimed to explore the support expected by and provided to Indonesian midwives and pregnant women during the COVID-19 pandemic. The research method used was a descriptive-interpretative qualitative research design. The data was collected through conducting in-depth interviews with 24 midwives who were purposively sampled and evenly recruited across all regions and all areas of midwifery practice in Indonesia. The recorded interviews were coded and themes were identified, after which a thematic analysis was done. Two main themes emerged and nine sub-themes were identified from the main themes. The study findings offered new insights into the individual and collective experiences of midwives from various regions in Indonesia. They had to adjust by leveraging the internet and mobile telephones in order to continue delivering standard care to pregnant women amid the pandemic. In addition, the midwives saw the need to provide food and financial support to pregnant women. However, despite the end of the pandemic being in sight in September 2022, there is a need to continue to support midwives and pregnant women in the disruption caused by the pandemic. Government agencies and non-governmental organisations (NGOs) should plan interventions targeted at providing specific support to midwives and pregnant women.

The level of knowledge people have about Covid-19 can affect their anxiety and worry about this disease. The present study was conducted to assess the relationship between knowledge and anxiety about Covid-19 in nurses at Guilan University of Medical Sciences, north of Iran. This cross-sectional study was conducted on 270 nurses working in selected hospitals of Guilan University of Medical Sciences in northern Iran using a questionnaire that included demographic characteristics, knowledge (21 questions), and anxiety about Covid-19 (18 questions with two components of physical and mental). The data were analysed in SPSS ver. 21 using descriptive and analytical statistics. The mean score of knowledge of subjects about Covid-19 was 18.65±1.5 (range: 0–21); the mean score of physical symptoms of anxiety was 3.31±4.77 (range: 0–27); and the mean score of mental symptoms was 10.77±5.61 (range: 0–27). The mean of general anxiety about Covid-19 was 14.08±9.54 (range: 0–54) and most participants had sufficient knowledge and mild anxiety about Covid-19. In the present study, there was no significant relationship between the level of knowledge and the level of anxiety about Covid-19. It was found in the present study that nurses were well aware of Covid-19 and mildly anxious about it, but there were mental anxiety symptoms present. It is more critical than ever to engage nurses in educational and practical programmes provided by disparate institutions, primarily educational departments of hospitals, in different domains of mental health.

Healthcare workers have been under tremendous psychosocial strain since the advent of the COVID-19 pandemic, particularly those on the frontlines such as nurses. This is especially true in low- and middle-income countries such as South Africa, where lack of resources and support exacerbate challenges. Five focus group discussions were conducted with frontline nurses at primary, secondary, and tertiary healthcare institutions in Cape Town, South Africa. Participants reported significant stress emanating from all spheres of their life, with the acute stressors of their work having largely adverse consequences on their lives in their homes and communities. A lack of organisational support was evident, with participants highlighting various ways in which the psychosocial strain they were under may be alleviated. Healthcare facilities should investigate both individual and organisational interventions aimed at better supporting their invaluable frontline teams. These include tailored psychological support services, sufficient time for rest, adequate staffing and medical supplies, effective leadership, COVID-19 specific training, and the promotion of teamwork. However, facilities should also extend their concern to the families of staff by reducing potential risk of exposure through a variety of measures including providing transport and voluntary isolation accommodation. Such interventions are important not only for the healthcare workers and their families, but also for the smooth functioning of healthcare institutions as the pandemic draws on into an uncertain future.

Background: Nurses serve at the frontline during disease outbreaks. While measures have been adopted to control the rapid spread of the Covid-19 pandemic, little is known about the level of compliance of nurses to standard precaution practices during the early phase of the pandemic. Objective: This study aimed to assess compliance with standard precaution practices (SPPs) among 713 nurses in Nigerian hospitals during the early phase of the pandemic. Method: The study adopted a descriptive cross-sectional design using an anonymous online questionnaire to elicit data from respondents. Data were analysed with the Statistical Package for the Social Sciences, version 25. Chi-square test and multiple regression analyses were also conducted where appropriate. Results: Findings from this study indicated that 448 (62.8%) of the respondents had good knowledge of Covid-19 and 265 (37.2%) had poor knowledge. Also, 529 (74.2%) had good compliance with the practice of standard precautions, and 184 (25.8%) showed non-compliance. A significant association was found between the age of nurses (χ2=14.034 p=0.015), years of experience (χ2=8. 636 p =0.035) and their overall compliance with the practice of standard precautions. Conclusion: During the early phase of the Covid-19 pandemic in Nigeria, although over an average of the nurses had good knowledge of the disease, over one-third had poor knowledge, and one-quarter showed poor compliance with standard precautions. Interventions to improve the knowledge and compliance of health workers during the early phase of disease outbreaks are hereby advocated, as 21.3% had no previous training on Covid-19.

Background: Nurses are effective in changing the negative perceptions of society about the profession. Hence, it is important to determine the professional image levels of nurses and to determine their ideas for strengthening their professional image levels. Purpose: This study was carried out to determine the professional image levels of nurses and their ideas for strengthening their professional image during the Covid 19 period. Methods: A descriptive and cross-sectional study was conducted online. In the study, the snowball sampling method was used, and a total of 305 nurses participated between August 2020 and May 2021. Results: The study found that 67.8% of nurses were not satisfied with the view of society on the current nursing image, and 76.3% of nurses themselves were not satisfied with the current image of nursing. Suggestions to strengthen the image of nursing were: raising the education level (28.0%), the society, government, and administrators should value nursing (19%), and improving the salary and working conditions (17.8%). Regarding the relationship between ideas to strengthen nurses’ professional image and their professional image education subdimension scores, it was observed that the scores of those who suggested increasing nurses’ level of education were significantly higher than those who suggested improving their salaries and working conditions (p=0.016). Conclusion: In our study, it was determined that the image levels of nurses had increased compared to the pre-pandemic period. It was determined that nurses prioritised raising the education level in order to strengthen their image level.

The advent of COVID-19 has significantly affected healthcare workers’ mental health. This study was conducted to investigate the perceived stress and its relationship with psychological distress among nurses who took care of patients with the COVID-19 disease. This cross-sectional study was performed on 180 nurses in Ardabil province in 2020. Data were collected online through two standard questionnaires, making use of the Cohen Perceived Stress Scale and the Kessler Psychological Distress Scale (K10). Then, data were analysed based on descriptive and analytical statistics using SPSS software version 19 as well as independent t-tests, Spearman’s correlation coefficient, and multiple linear regression tests. The results of the Spearman’s correlation test indicated that there was a significantly positive correlation (rho = 0.79) between perceived stress and psychological distress (P <0.001). After adjusting the effects of other variables using a multiple linear regression test, the beta correlation coefficient was calculated, and the obtained value of 0.766 was regarded as statistically significant (P <0.001). Moreover, 63.9% of the nurses experienced moderate perceived stress, and 72.6% experienced severe mental disorders. The results of this study demonstrate that high perceived stress is considered as a strong predictor of psychological distress, and also the majority of the nurses working in frontline wards have experienced severe psychological distress. Therefore, it is recommended to take into account the workplace stress and prepare the ground (e.g., through preparing education, identifying at-risk individuals, as well as providing psychotherapy services and social support) to reduce the stress and promote the nurses’ mental health.

Background: The uncertainty brought about by the novel coronavirus (Covid-19) disease threatens the mental well-being of pregnant women with stress and anxiety. Further, pregnancy is a period of mixed feelings, aggravated by hormonal imbalances. This study aimed to describe pregnant women’s prenatal anxiety, perceived stress, and coping behaviour. Method: The study (N=384) utilised a cross-sessional design. Respondents were recruited by consecutive sampling. Through online mode, a structured proforma was used to collect demographics. The “Beck Anxiety Inventory Scale” was used to measure the prenatal anxiety level. Perceived stress was examined by administering the “Perceived Stress Scale,” and the “Brief Cope Scale” was used to assess the coping behaviour among participants. The data were analysed to determine the level of Covid-19-related anxiety, perceived stress, and coping behaviour adopted by the participants. This was done by using SPSS software, IBM SPSS 20, and p<0.05level of significance. Results: The majority of pregnant women, 210(55%), showed moderate anxiety. Their anxieties were related to Covid-19. The commonly found anxiety symptoms among pregnant women in this study were wobbliness in the legs, a feeling of hotness, numbness or tingling, faint or light-headedness, and hot or cold sweats. There was a moderate positive correlation (r=0.566, significant at p<0.001) between perceived stress and prenatal anxiety. The Coefficient of Determination showed that 32% of prenatal anxiety was accounted for by the perceived stress of the mother. The mean perceived stress score was 16.88+6.218, with a range of 9, and the mean coping behaviour score was 57.99+20, with a range of 20. The degree of correlation between perceived stress and coping behaviour had a moderate positive correlation (r=0.444, significant at p<0.001level). Conclusions: The study demonstrated increased anxiety and perceived stress that was related to Covid-19 amongst pregnant women.

Nurses often experience ethical dilemmas in decision-making while providing nursing care to clients, especially COVID-19 patients. This study aimed to identify an ethical decision-making model used by hospital nurses in East Nusa Tenggara (ENT) Province, Indonesia, in providing nursing care to COVID-19 patients. This article is based on a research and development cross-sectional study. The population comprised 330 hospital nurses who provided nursing care to COVID-19 patients in ENT. The sample was derived via two-stage cluster sampling and consisted of 175 respondents. The research was conducted from January to June 2022. The independent variables were consequences of actions, deontological ethics, intuition, and the stigma towards COVID-19 patients. Furthermore, the sub-variables of deontological ethics were generosity, justice, autonomy, honesty, and obedience. Meanwhile, the dependent variable was ethical decision-making. Data was collected using questionnaires as instruments. The authors analyed the data partially with chi-square and simultaneously with multiple logistic regression tests. There were correlations between the consequences of action and ethical decision-making (p=0.003). In addition, there were correlations between generosity, justice, autonomy, honesty, and obedience and ethical decision-making (p=0.001). Furthermore, there was a correlation between intuition and ethical decision-making (p=0.0001). Moreover, there was a correlation between the stigma towards COVID-19 patients and ethical decision-making (p=0.0001). Multiple logistic linear test results showed that the significant variables in the ethical decision-making model were generosity (p=0.0001), autonomy (p=0.0001), justice (p=0.001), and honesty (p=0.0001). In conclusion, generosity, autonomy, justice, and honesty have a 40% influence on ethical decision-making by hospital nurses in East Nusa Tenggara in providing nursing care to COVID-19 patients.

Due to the novel Coronavirus disease (COVID-19), which was declared a global pandemic on 11 March 2020, there was limited antenatal care service information available in Indonesia. This study aimed to analyse pregnant women’s knowledge of and motivation for prenatal visits, and their satisfaction with the COVID-19 Maternal-Child Health Education Universitas Brawijaya (COVIMEDUB) website. The study respondents were divided into two groups and the study was conducted from June to November 2021. The respondents were pregnant women who were capable of operating a smartphone and who received offline antenatal care at the Public Health Centre (PHC) in Singosari, Malang Regency, Indonesia. The intervention group were given access to the COVIMEDUB website. Data collection used pre- and post-test questionnaires. Moreover, the data analysis used the paired t-test, the Wilcoxon signed-rank test and the independent t-test. The results revealed that the group using the website had the highest average score for knowledge and motivation (3.13 ± 1.65 and 3.93 ± 3.31), and there were significant differences between knowledge and motivation (p-value 0.000 and 0.002). Furthermore, the highest average score for website satisfaction was achieved for being capable of assisting mothers in obtaining the information they require (4.27 ± 0.51). In conclusion, the use of the website significantly enhanced pregnant women’s knowledge of and motivation for antenatal visits. Therefore, it is necessary to improve healthcare provider’s ability to provide variations of educational media, mainly based on technology.