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Aim: The study examines the impact of the acmeological approach to postgraduate education on developing the personal component of nursesʼ professional skills. Design: An experimental study. Methods: The study involved 72 nurses in postgraduate training (average age 36.3 years old) specializing in family nursing and nurse anesthetists in anesthesiology and intensive care units, with an average working experience of 14.3 years. The following methods were used: the morphological test of life values, the “Need for achievements” inventory, and the “Motivation of professional activity” test. A Studentʼs t-test was used to compare the indicators and assess the validity of the results. The data obtained from the written survey were calculated and entered into Excel spreadsheets for further processing. Results: The use of the acmeological approach in nursesʼ professional training in advanced training courses statistically significantly (p < 0.05) contributed to an increase in the importance of spiritual and moral values. The research results revealed the increasing importance of internal motives to nursesʼ professional activity and the positive dynamics of nurses’ desire to perform Conclusion: The acmeological approach to developing professional skills in continuing education contributed to the reinforcement of important personal qualities in nurses.

Aim: The aim was to understand the lived experiences of family caregivers caring for a dying patient at home. Design: A qualitative phenomenological approach was used. Methods: Data were collected between September and December 2018. Data collection was took the form of in-depth interviews with family caregivers (n = 4), followed by the use of interpretative phenomenological analysis (IPA). Results: Five main themes were identified in terms of which family caregivers described their experience: the Role of caregiver; I’ll do everything for him / her; Support; “Time out” after death; and Benefits of care. The family caregivers had to establish their new caregiver roles, often they were the mainstay of the whole family. In the various areas of care they did everything for the dying person. They experienced pain, mental and physical burdens, and doubts, and spirituality was vital to them. It was important to experience support from different sources. After this experience, the caregivers needed time to release emotions after the death. Overall, the caregivers came to regard this experience as beneficial: revealing other priorities, increasing time spent with family, clarifying relationships, and changing attitudes and values. Conclusion: The study offers a unique insight into family caregivers’ experiences in the Czech Republic. In confirmation of previous results, experiences are generally similar for all caregivers and point to a need for significant improvement in the quality of support and assistance from health professionals and support from family members, particularly in the areas of practical demonstration of care, the expression of condolences, provision of pain medication, handling of formalities related to the death of a loved one (e.g., when arranging the death certificate and widow’s pension), and the sharing of emotions as they occur.

Aim: To assess the perceived health-related quality of life (HRQoL) in hospitalized patients with rheumatic diseases and to determine whether selected characteristics can affect their perceived quality of life. Design: A cross-sectional study. Methods: Data were collected between September 2022 and March 2023 using the standardized instrument to measure HRQoL, namely the RAND 36-Item Health Survey (SF-36). The sample consisted of 170 patients with rheumatic diseases hospitalized in a teaching hospital in the Czech Republic. Results: The average perceived HRQoL was 34.94 (SD = 17.06), indicating poor quality of life. The most highly rated subscale was ‘emotional well-being’ (56.02 ± 15.71), and the lowest rated subscale was ‘role limitations due to physical health’ (11.76 ± 28.54). The HRQoL subscales were significantly correlated with Mini-Mental State Examination (MMSE) score, self-care activities, pain severity, age of the patients, and length of hospitalization. Differences in HRQoL were identified based on education, social status, use of compensatory aids, attendance at social events, and history of falls in the past year (p < 0.05). Conclusion: The study contributes to the existing body of knowledge on the subject, but also underscores the importance of considering holistic factors when evaluating HRQoL in individuals with rheumatic diseases.

Aim: To discover the perceived level of nursing interruptions during care activities. The study evaluates the contributing factors of alarms, equipment failures, visitors, and telephone calls in predicting interruptions according to the site of nurses’ work. It also examines the potential association of demographic factors of nurses with interruption levels. Design: A cross-sectional study. Methods: The study included nurses working at a tertiary hospital in Amman, the capital of Jordan. Data collections were carried out between May and July 2020. The analysis was performed using 257 valid questionnaires, compromising 128 male and 129 female respondents. The study used a nursing interruptions scale and an interruptions scale related to patients and hospitals. Results: Results indicated that the participating nurses generally experienced a high level of interruptions during nursing care activities. Visitors were found to be the main predictor of nursing interruptions on the surgical / medical floor; whereas equipment failure was found to be the main predictor of nursing interruptions in intensive care units. Finally, the demographic factors of marital status and educational level were associated with interruptions. Conclusion: Visitors and equipment failures are the main predictors of interruptions during nursing care activities. Our results provide a clear explanation for organizations, nurse managers, and clinicians of the factors behind nursing interruptions.

Aim: This descriptive qualitative study provides information on research dealing with women’s opinions, experiences, and attitudes toward menopause. Design: A descriptive qualitative study. Methods: Individual semi-structured in-depth interviews were used for qualitative research into this topic. The research group consisted of 17 women aged 40 to 55 years. Thematic data analysis was used to analyze the data obtained. Results: Based on the thematic analysis, the following categories were created: 1) Association with the period of menopause; 2) Experiencing menopause; and 3) Education. The results showed that women viewed menopause as a transitional phase of life. The main symptoms included hot flashes, night sweats, disturbed sleep, mood swings, and weight gain. Prior to the study, participants were not interested in additional information on the issue. Conclusion: As estrogen levels decline later in life, women transition from the reproductive to the post-reproductive phase of their lives. For women to experience healthy menopause, they must understand the process before they begin to experience the consequences of estrogen deficiency.

Aim: To analyze the influence of sociodemographic, obstetric, childbirth, and breastfeeding variables on maternal self-efficacy in newborn care. Design: Descriptive cross-sectional study. Methods: The study was conducted in three hospital units in the Northern region of Portugal, with a non-probabilistic sample composed of 340 women recruited at postnatal wards on the day of hospital discharge. A questionnaire including the mother’s sociodemographic, obstetric, childbirth, and breastfeeding data was used. For the analysis of maternal self-efficacy in newborn care, the Scale of Perceived Parental Self-Efficacy in Child Care was used. The scale is a 20-item self-report instrument developed to identify women with low levels of self-efficacy in newborn care. Descriptive and inferential statistics were used for data analysis. Results: Significant differences concerning maternal self-efficacy in newborn care were found with regard to level of education and parity, with multiparous women and women with lower levels of education presenting higher levels of self-efficacy in newborn care. Conclusion: The analysis of these variables could be valuable in building new knowledge to support the development of an action model that would allow at-risk women to be highly confident in their parenting role.

Aim: This study was carried out to determine quality of life in patients who have had colorectal cancer surgery. Design: A sequential explanatory mixed methods design was used. Methods: The study sample consisted of 120 patients who had had colorectal cancer surgery, met the inclusion criteria for the study, and agreed to participate in the study. In-depth interviews were conducted with 20 of the patients from the study sample. The quantitative data were collected using the “Introductory information form” and the The Functional Assessment of Cancer Therapy-Colorectal Version “FACT-C scale”, while the qualitative data were collected using the “Introductory information form” and the “Semi-structured interview form”. Results: The FACT-C scale total mean score of the patients was 100.95 (± 10.07) before the surgery and 88.90 (± 10.55) after the surgery. From the in-depth interviews performed with the patients, the factors affecting the patients’ physical, mental, and social well-being after discharge from hospital were identified. Conclusion: According to the results of this research, following colorectal cancer surgery, the patients faced problems that affected their physical, mental, and social well-being, and their quality of life diminished.

Aim: To determine the level of teamwork among nursing staff in a selected teaching hospital and identify factors that influence the level of teamwork. Design: A descriptive cross-sectional study. Methods: The sample included 292 nursing staff working in a teaching hospital in the Žilina region of Slovakia. Data collection was carried out between April and June 2022 using the Nursing Teamwork Survey (NTS). Data were analyzed using descriptive and inferential statistics. Results: The mean score for the NTS was 2.87 (SD = 0.56) demonstrating a positive perception of teamwork less than 75% of the time. The highest evaluated subscale was the shared mental model (3.23 ± 0.62). Differences were found in the evaluation of teamwork according to education, job position, working hours, total and current professional experience, intention to leave, and staffing adequacy. The correlation analysis revealed associations between teamwork and variables related to satisfaction and quality and safety evaluation. Several variables predicted the general evaluation of teamwork (p < 0.05). Conclusion: The evaluation of teamwork may point to its different perception among members of nursing teams. It may also help to identify strengths and weaknesses of nursing teams and, consequently, to implement effective techniques focused on improving teamwork and, thus, the quality of nursing care in hospitals.

Aim: To investigate the reasons for unfinished nursing care (UNC), its prevalence and patterns, and to explore its relationship to level of teamwork as perceived by Slovak postgraduate nursing students. Design: A descriptive cross-sectional study. Methods: The study was conducted between November 2022 and January 2023. Data collection was carried out using a set of questionnaires that involved the Unfinished Nursing Care Survey tool to measure UNC and the Nursing Teamwork Survey (NTS) to investigate level of teamwork. The sample consisted of 159 postgraduate nursing students from five public universities in different regions of the Slovak Republic. Results: The mean composite score of UNC was 2.41 (SD = 0.71) and for the NTS, 3.25 (SD = 0.51). An overall weak association was found between UNC and Trust (r = -0.164), Backup (r = -0.157), Shared mental model (r = -0.158), and Team leader (r = -0.187). Teamwork did not predict perceptions of UNC. Conclusion: These findings suggest that nursing students are aware of the phenomenon of UNC and reflect on reasons for its occurrence, including ineffective teamwork among nursing staff. During clinical placements, nursing students should be integrated into nursing teams and the importance of teamwork should be emphasized during nursing studies. However, there is a need for further research to better understand and address these phenomena in nursing education and practice.

Aim: The aim of the literature review was to identify evidence of the effectiveness of self-management programs in preventing progression of diabetic nephropathy. Design: A literature review. Methods: This review was conducted according to the Cochrane guidelines for systematic review research and complies with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We found seven articles from electronic databases such as Science Direct, PubMed, and CINAHL from 2011 to 2021. Three researchers independently conducted study selections, extracted data, and assessed the data quality. Results: Seven studies were included (two randomized control trials and five quasi-experimental studies). We examined studies that provided deep analysis and explanation of self-management to prevent progression of diabetic nephropathy. Conclusion: All of the studies reported that self-management programs significantly improved behaviors aimed at preventing diabetic nephropathy progression such as dietary, physical activity, medication adherence, and smoking cessation. In addition to behaviors, the program also improved renal function, metabolic markers, and blood pressure.

Aim: The study aimed to describe nurses’ roles, map their views, knowledge, and experiences, and clarify the factors influencing their work and personal life during the Covid-19 pandemic in the Czech Republic. Design: A descriptive and cross-sectional design was used for the study. Methods: A representative sociological survey was conducted. A non-standardized questionnaire was used to collect data; the primary objective was to survey nurses’ views, knowledge, and experiences gained during the Covid-19 pandemic and identify essential issues that must be addressed before the next pandemic. The questionnaire contained a total of 57 questions. The sample was constructed by quota sampling; the criteria for inclusion in the sample were the respondents’ gender, age, and region. These characteristics were established as representative. The sample consisted of 1,197 nurses. Results: The most commonly reported factor influencing the work of nurses during the Covid-19 pandemic was fear of transmitting the infection (63.6%). Fear of the unknown (59%) and increased workload (54.7%) were also frequently reported to be strong influencers. The responses of nurses were statistically significantly influenced by the type of medical facility in which they worked (p < 0.05) and where they worked during the Covid-19 pandemic (p < 0.001). Most respondents (89.6%) said Covid-19 represented increased physical and mental burdens. Almost the same proportion of respondents (88.4%) felt Covid-19 affected their social lives, and 76.7% reported that it also affected their personal lives. Conclusion: Healthcare facility management should ensure sufficient personal protective equipment (PPE) is available before pandemics and pay close attention to the needs of staff regarding psychological counselling and crisis intervention during pandemics.

Aim: To compare nurses’ and patients’ reports of missed nursing care in surgical units. Design: A cross-sectional correlational study. Methods: The sample involved 130 nurses in surgical departments, and 112 patients assigned to nurses during various shifts were included. The Slovak version of the Missed Nursing Care Survey, the MISSCARE-Patient Survey, and the Generic Short Patient Experiences Questionnaire were used to collect data. Data were analyzed using descriptive and nonparametric inductive statistics. Results: The overall mean scores of the MISSCARE versions were low, suggesting a tendency for nurses and patients to perceive missed nursing care as a rarely occurring phenomenon. Patients’ perceptions of specialist health care were positive, and only 20.7% of patients experienced any adverse events during hospitalization in surgical units. The nonsignificant relationship between nurses’ and patients’ reports of missed nursing care suggests differing perspectives on the amount and pattern of missed nursing care. A significant difference in the perception of missed nursing care in surgical wards was found among nurses but not among patients. A negative association between missed nursing care from the perspective of nurses and patients and various dimensions of patient-centered care was revealed. Conclusion: The study indicated a significant difference between nurses’ and patients’ perceptions and experiences of missed nursing care, highlighting the importance of including both perspectives.

Aim: To describe current scientific knowledge on cognitive impairment and emotional disturbances (anxiety and depression) in younger adult patients after ischemic stroke. Design: A scoping review. Methods: For the search, the following scientific databases were utilized: Web of Science, MEDLINE (Ovid), ScienceDirect (Elsevier), PsycInfo (EBSCO), Scopus (Elsevier), and ProQuest. Relevant studies were identified by searching publications from 2000 to July 2023. Results: A total of eight studies were ultimately included in the review. Cognitive impairment occurred in a range between 39.4% and 40%. This encompassed various aspects of cognitive function, such as working memory, processing speed, global cognitive function, immediate and delayed memory, attention, and executive functioning. Depression had an incidence rate ranging from 10.8% to 16.8%. Several risk factors were associated with a higher likelihood of developing generalized anxiety. These included younger age, more depressive symptoms, lower education, unemployment, a history of depression, and alcohol use. In the context of depressive symptoms, a higher risk was linked to lower education and unemployment. Conclusion: The included studies highlighted the need to assess these issues not only at the time of patient discharge but, more importantly, during the stage of further recovery. This can contribute to the creation of tailored interventions for these individuals.

Aim: The aim of the study is to identify nurse managers' competencies in Slovenia regarding various healthcare organisations, public and private healthcare sectors, and management levels, as well as the reasons for their differences. Design: The study was based on quantitative and qualitative research. Methods: An online survey was conducted among 297 nurse managers in Slovenia, and in-depth interviews with 12 nurse managers were carried out. Results: Managers who worked in nursing homes were significantly more likely to perceive themselves as being more competent in leadership (p = 0.001) and financial management (p = 0.004) than their colleagues. Managers who had higher management positions were significantly more likely to perceive themselves as being more competent in financial management than their colleagues in lower management positions (p = 0.002). Nurse managers in the private sector perceived themselves to be significantly more competent in financial management (p = 0.0001). The reasons for nurse managers' differences in proficiency levels are the degree of job security, and degree of autonomy and support in the healthcare team. Conclusion: The study identified inadequate nurse manager competencies, and reflected the needs of nurse managers for designing and providing health management programmes aimed at enhancing management capacity in the health sector in Slovenia.

Aim: The centralization of Finnish maternity services can mean longer journeys when women are in labor. The aim of this study was to describe women’s experiences of having an unplanned out-of-hospital delivery (OHD) and to produce a deeper understanding of how to support them when this happens. Design: Qualitative descriptive study design with narrative inquiry method. 
Methods: Individual interviews were carried out with 15 women who had an unplanned OHD and the data were analyzed using a narrative method. Results: Three narratives described the women’s experiences of an unplanned OHD with a common plot being their sense of control. In the first narrative, a sense of control was maintained; in the second, the sense of control fluctuated; and the third narrative centered on a loss of control. All the narratives were related to the women’s experiences of what was happening to their body, the people around them during delivery, and the situation after the childbirth. Conclusion: Having an unplanned OHD forced women to reconsider their preconceptions and expectations of childbirth and focus on how to handle the situation at hand. A key factor was the sense of control they felt while giving birth, which should be considered a core principle in maternity care practices, from antenatal care to delivery.

Aim: To determine the relationship between perceived satisfaction with childbirth and perceived autonomy in decision making during the childbirth process. Design: Cross-sectional study. 
Methods: The study took place within the international INTERSECT project. Data were collected in four hospitals in Slovakia. The research group consisted of 437 female respondents (average age 30.5 ± 4.8). Birth Satisfaction was measured by the Birth Satisfaction Scale – Revised (BSS-R). Level of autonomy in decision making during childbirth was measured by the Mothers’ Autonomy in Decision Making Scale (MADM). Results: Respondents who perceived a higher level of autonomy in decision making during childbirth perceived higher overall satisfaction with childbirth (p = 0.001, r = 0.416). Higher age of mothers was also associated with higher birth satisfaction (p = 0.004, r = 0.139). Almost 17% of respondents perceived their childbirth to be a traumatic event. Respondents described lower levels of satisfaction with childbirth (p = 0.001) and lower levels of autonomy in decision making during childbirth (p = 0.002) if they subjectively perceived their childbirth as traumatic. Significant associations for the BSS-R score were also demonstrated regarding parity (p = 0.001), mode of delivery (p = 0.001), and type of delivery (p = 0.001). Conclusion: The involvement of the mother in the decision-making process of her own birth is a fundamental aspect of healthcare during childbirth and overall satisfaction with the birth.

Aim: To investigate the perception of patient safety culture of nursing students on their clinical placement during the Covid-19 pandemic. Design: A cross-sectional study. Methods: Data were collected using the online form of the Hospital Survey on Patient Safety Culture for Nursing Students, between January and March 2021. The respondents were 248 nursing students from the Czech Republic. Results: Although overall level of patient safety was high in nursing students, the recommended limit of over 75% was not achieved in any dimension. Factors that influenced assessment of individual dimensions included age, student status, form of study, current clinical placement, and clinical supervision. Overall level of patient safety was found to be a predictor of the values of individual dimensions. Conclusion: The role of nursing students during the Covid-19 pandemic was invaluable. However, it is important to raise awareness about adverse events in nursing students in the Czech Republic.

Aim: To investigate how nursing students assess their competencies in patient safety in the Czech Republic. Design: A pilot study. Methods: Data collection was carried out from January to April 2023 using the Health Professional Education in Patient Safety Survey instrument through the Google Forms® platform. The sample consisted of nursing students from seven faculties in the Czech Republic (n = 145). Descriptive and inductive statistics in the statistical program SPSS 25.0 were used in data analysis. Results: Nursing students were more confident in both academic and clinical settings in the subscale of Managing safety risks (M = 3.85), and less confident in the subscale of Culture of safety (M = 3.54). Significant differences in assessment of competencies were found in three dimensions when academic and clinical settings were compared. Numerous associations were also demonstrated between patient safety dimensions and sociodemographic data, with the greatest impact on clinical factors. Conclusion: Evaluation of patient safety competencies is a key element in increasing quality and safe care in general. Integrating sociocultural aspects of patient safety into the nursing curriculum is crucial. The main focus should be on patient safety culture education.

Aim: Autonomy in nursing refers to nurses’ ability to make independent decisions in providing nursing care without outside influence or control. Nurse autonomy is a key part of the provision of quality and safe care. Design: A narrative literature review was used for the study, performed according to the PRISMA ScR checklist. Methods: Relevant studies obtained from four databases were included in the narrative review. The data review was performed according to the PRISMA checklist. For data extraction and synthesis, the method of summative content analysis, in accordance with COSMIN criteria, was used. Results: The search identified four relevant studies published between 2003–2014. All instruments used in the studies were designed to measure nurse autonomy and were also used in combination with other instruments closely related to autonomy in nursing. The instruments demonstrated acceptable psychometric properties. Conclusion: Autonomy is an unexplored phenomenon in the context of the Slovak Republic and it deserves attention since nurse autonomy affects not only patients but also nurses themselves and their job satisfaction. It is important to enable nurses to participate in decision-making, planning and development of nursing as autonomous professionals.

Aim: This study aimed to evaluate nursing students’ experiences and perceptions of aggression during their clinical practice. Design: The descriptive study. Methods: This was a descriptive study comprising students in their second, third, and fourth years in the Faculty of Health Sciences during the spring term of the 2015–2016 academic year. An explanation of the aim of this study was provided to the participants, and the written approval of 213 students was obtained before the study was commenced. A Personal Information Form and the Perception of Aggression Scale were used to collect data. Descriptive statistics and the Kruskal-Wallis Test were used in data analysis. Results: The mean age of the students was 21.61 (± 6.93). Most students (98.1%) had received no training on how to interact with angry or aggressive individuals, 11.3% thought that they were unable to provide care to aggressive individuals, and 21.6% wished to receive training on interacting with such individuals. More than half of the students (54.4%) reported that they were unable to interact with angry and aggressive individuals. The mean score of the functional sub-dimension was 3.16 (± 0.59), and the mean score of the dysfunctional sub-dimension was 2.35 (± 0.49). Conclusion: Student nurses are often the target of angry and aggressive behavior during their clinical practice, are negatively mentally affected when exposed to aggression, and do not receive enough instruction in how to engage with aggressive individuals. Their negative perceptions of aggression were formed during their undergraduate education.

Aim: The study aimed to describe how undergraduate nursing students evaluated the clinical learning environment of their studies during the Covid-19 pandemic. Design: Longitudinal cohort study. Methods: The research sample of 49 full-time students who completed their first year clinical practice in the academic year of 2018/2019 was followed over three years of study. The Clinical Learning Environment, Supervision and Nurse Teacher evaluation scale (CLES+T) was used for data collection. Quantitative data were evaluated using descriptive and inductive statistics. Results: Overall, students evaluated the clinical environment throughout their studies as average. Interaction with a tutor received the lowest rating, while relationship with mentor and external factors of the clinical environment (nursing management and nursing care in the workplace) received the highest rating. Second-year students rated the practice environment most highly. Students were satisfied with individual supervision in the first two years. However, due to the Covid-19 pandemic, group supervision prevailed in the third year, resulting in reduced student satisfaction. Conclusion: Students’ perception of the clinical learning environment changed during their studies. These changes were driven by the quality of certain academic and clinical factors. The Covid-19 pandemic represented a significant impingement on the course and organization of clinical practice.

Aim: The study compared two instruments for detecting delirium, the Intensive Care Delirium Screening Checklist (ICDSC) and the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) as a reference method. Design: Prospective observational study. Methods: The study included 126 consecutive patients staying in the intensive care unit (ICU) for more than 24 hours. The diagnostic properties of both questionnaires and agreement between them were studied and compared. Additionally, the two tests were used to assess the relationship between selected patient parameters and the presence of delirium. Results: There was a high level of agreement between the CAM-ICU and ICDSC, as expressed by Cohen’s κ of 0.829 (95% CI: 0.821–0.838). Cronbach’s α assessing the internal consistency of a Czech version of the CAM-ICU and ICDSC was 0.903 and 0.865, respectively. The CAM-ICU had 85.5% sensitivity (95% CI: 84.6–91.8) and 94.1% specificity (95% CI: 92.4–95.5); the ICDSC (cut-off ≥ 4) had 90.6% sensitivity (95% CI: 87.0–93.5) and 89.0% specificity (95% CI: 86.8–91.0). Conclusion: Both compared diagnostic instruments, the CAM-ICU and ICDSC, appear to be adequate and usable. When compared with the CAM-ICU as a reference method, the ICDSC showed similar results and a good level of agreement.

Aim: To describe nurses’ perspectives on promoting tracheostomy self-care. There is little information on the nurses’ perspective as care providers with knowledge of clinical contexts. Design: A qualitative descriptive study was conducted. Methods: A purposeful sample of nurses was selected from eight Portuguese hospitals. Recruitment ended once data saturation was reached (n = 12). Data were collected using semi-structured interviews and analysed through content analysis. Results: The nurses described the most important aspects to promote tracheostomy self-care, namely the objectives, the contents to be addressed, the methods and resources to be used, the appropriate moment to intervene, the necessary conditions to promote self-care, the way to ensure the standardisation of interventions among nurses, and the level of tailored planned interventions. Conclusion: From the nurses’ perspective, promoting tracheostomy self-care is critical for regaining autonomy. Therefore, it is crucial to establish an intervention plan sensitive to individual needs and preferences. These results can help elucidate the aspects considered by nurses when promoting tracheostomy self-care so that more meaningful and feasible care models can be designed.

Aim: The aim of this study was to describe the three main competencies that every healthcare professional working within palliative care should have, according to the perspective of another professional body working within palliative care. Design: A descriptive qualitative study. Methods: The data were collected from physicians, registered nurses, licensed practical nurses and professional stakeholders by means of an electronic survey in 2018. The data were analyzed using content analysis. Results: The three most important competencies of every healthcare professional working within palliative care were considered to be advance care planning; symptom management; and communication and psychosocial support for patients and their significant others. Advance care planning and symptom management were the main competencies expected from physicians. Symptom management and communication, psychosocial and existential support for patients and their significant others were the main competencies expected from nurses and practical nurses. Conclusion: The findings can be utilized in the education of palliative nursing and medicine to ensure a palliative approach and symptom management in an adequate time frame as well as communication and psychosocial and existential support. The findings offer clues for understanding the roles of the multi-professional team and for competence development through multi-professional continuing education within palliative care.

Aim: Post-traumatic stress disorder refers to a person’s experience of a traumatic event. Traumatic experiences during childbirth can cause postpartum stress in some women. The present study aimed to investigate the correlation between postpartum stress disorder in different types of delivery (normal vaginal delivery and cesarean section) and maternal anxiety. Design: This was a cross-sectional study. Methods: This cross-sectional study was performed on 714 pregnant mothers selected via cluster sampling six-eight weeks after their delivery in selected health centers. The data were collected using Post-Traumatic Stress Disorder Symptom Scale I and the Spielberger State-Trait Anxiety Inventory. The data were then entered into the SPSS 20 software and were analyzed using a chi-square test. The significance level was set as p < 0.05. Results: The results showed that most of the participants in the two groups had medium to low anxiety levels, and the two groups were homogeneous in this regard. However, the mean scores of obvious anxiety (p < 0.0001) and hidden anxiety (p < 0.0001) were significantly higher in the normal vaginal delivery group compared to the cesarean section group. Moreover, post-traumatic stress score was significantly correlated to both obvious anxiety and hidden anxiety in the two study groups. Conclusion: Postpartum stress disorder had a positive relationship with obvious anxiety and hidden anxiety in both study groups. Counseling may be effective in reducing post-traumatic stress disorder in women.