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Research Article | DOI: https://doi.org/10.31579/2642-9756/256
1Assistant Professor of Obstetrics & Gynecological Nursing, Faculty of Nursing, Benha University, Egypt.
2Assistant Lecturer of Maternity & Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
3Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
4Professor of Obstetrics & gynecological Nursing, Faculty of Nursing, Benha University, Egypt.
*Corresponding Author: Hanan Elzeblawy Hassan, Professor of Maternal and Newborn Health Nursing, Faculty of Nursing, Beni-Suef University, Egypt.
Citation: Ali Gaafr HA, Hend E. Saad, Hanan E. Hassan, Hassan Omran AA, (2026), Maternity Nurses’ Knowledge Regarding Nursing Care of First Stage of Normal Labor and Partogram Through Instructional Package, J. Women Health Care and Issues, 9(1); DOI:10.31579/2642-9756/256
Copyright: © 2026, Hanan Elzeblawy Hassan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received: 05 January 2026 | Accepted: 16 January 2026 | Published: 21 January 2026
Keywords: nurses’ knowledge; nursing care; first stage of normal; partogram, instructional package
Background: Normal labor is a vital physiological process necessitating ongoing evaluation and interventions. Continuous nurse education is crucial for effective maternal care, and training in obstetrical emergencies enhances outcomes for mothers and newborns.
Aim: evaluate the effect of the instructional package on maternity nurses’ knowledge regarding nursing care of first stage of normal labor and partogram.
Subjects and Methods:
Design: A quasi-experimental design with a one group pre-posttest.
Setting: The current study was conducted at labor unit at Beni-Suef University and Beni-Suef Specialist Hospitals.
Sample: A convenience sample consisting of all 50 maternity nurses.
Tools: A structured interviewing questionnaire, which includes 3 parts:
1. Discusses the training and experience of maternity nurses.
2. Evaluates their understanding of general nursing care during first stage.
3. Analyzes their knowledge of the Partogram.
Results: 56% of the studied nurses had less than 5 years of experience and 28.0% attended training courses regarding the stages of normal labor. Post-intervention assessments indicated substantial improvements in maternity nurses' knowledge of normal labor. Recognition of true labor pain increased from 8% to 70%, understanding of uterine contractions from 12% to 72%, and knowledge about nursing care during the first stage of labor rose from 24% to 88%. Correct reporting of cervical dilatation improved from 14% to 68%, while knowledge of labor progress components went from 20% to 72%. Understanding of complications addressed by the partogram increased from 22% to 74%. All changes were statistically significant (p-value 0.000).
Conclusion: Improvements in maternity nurses' knowledge of partogram and nursing care during the first stage of normal labor were noted after the intervention, with levels of knowledge correlating positively with years of nursing experience before and after the instructional package.
Recommendations: Distribute the clarified pamphlet for maternity nurses to acquire a correct knowledge regarding partogram and nursing care of first stage of labor.
The World Health Organization (WHO) defines normal labor as spontaneous, low-risk from onset through delivery, with both mother and newborn in normal status [1]. Normal delivery occurs between 37 and 42 weeks of pregnancy, usually with the baby in a vertex position [2-6]. The exact mechanisms initiating labor are unclear, although it is thought to be influenced by factors such as uterine stretch, hormonal changes including progesterone withdrawal and estrogen dominance, increased sensitivity to oxytocin, and prostaglandin release [7-11].
Theories of labor, such as the uterine stretch theory, oxytocin theory, progesterone deprivation theory, prostaglandin theory, and the aging placenta theory, aim to explain the onset of labor. The uterine stretch theory posits that as the uterus, a hollow muscular organ, stretches due to fetal growth, it will contract to expel its contents, leading to physiological changes that initiate labor [12-16].
Ongoing education and training are crucial for nurses to provide competent care to pregnant women. An instructional package on obstetrical emergencies aims to enhance management, improve unit efficiency, and outcomes for both women and newborns, supporting immediate management decisions [17-20]. Merrill’s First Principles of instruction provides a meta-model for task-centered learning with five key principles, emphasizing authentic problem engagement in nursing contexts, particularly during emergencies in normal labor [21-25].
Activation of prior knowledge is crucial for understanding normal labor, alongside the demonstration and application of this knowledge by nurses. Simulation training is essential in preparing for labor and emergencies, as many deaths stem from management failures due to inadequate education and training. This training aims to enhance both learning effectiveness and the transfer of knowledge [26-29].
Instructional package strategies in standards-based classrooms emphasize high expectations for all students, effective time usage, various grouping methods, a safe environment, and physical organization. Key elements include addressing nurses' prior knowledge and misconceptions, utilizing multiple forms of representation, incorporating instructional technology and tools, and fostering nurses' ownership of learning. Significant learning derives from effort rather than innate ability [30].
Multiple forms of classroom representation, including pictures, words, symbols, diagrams, tables, and graphs, enable nurses to understand that different representations can convey the same concept. Instructional technology such as manipulatives, calculators, and computers is readily available and aligned with session objectives, ensuring nurses receive adequate support for effective learning [31]. Additionally, nurses take ownership of their learning, engaging in self-assessment and receiving directive feedback to improve their understanding and practice, with opportunities for revision to facilitate mastery [30].
To enhance nurses' engagement in instructional sessions, it is vital to use questions that stimulate responses and encourage participation, linking sessions to their personal labor experiences with varied materials [27]. Nurses must take responsibility for their actions towards women in labor and infants, applying critical thinking guided by clinical standards and quality improvement initiatives [32]. The use of instructional packages can improve clinical scenarios, increase safety, reduce errors, and refine nurses' clinical judgments. Ongoing learning is crucial for student nurses to stay informed about labor mechanisms, hormonal effects, normal labor signs, and care for mothers and newborns across cognitive, affective, and practical domains [33].
Aim Of the Study
The current study aimed to evaluate the effect of the instructional package on maternity nurses’ knowledge regarding nursing care of first stage of normal labor and partogram.
Research Hypothesis
Following the implementation of the instructional package, maternity nurses’ knowledge regarding nursing care of first stage of normal labor and partogram through instructional package will be improved.
Research Design:
A quasi-experimental design with a one group pre-posttest.
Settings:
Labor unit at Beni-Suef University and Beni-Suef Specialist Hospitals.
Subjects:
All maternity nurses in the labor unit during the data collection comprised 23 nurses from Beni-Suef University Hospital and 27 nurses from Beni-Suef Specialist Hospital.
Tools of data collection:
Tool I: A Structured Interviewing Questionnaire:
This tool was applied before and after the instructional package sessions to assess the effect of the instructional package on the nurses' level of knowledge. This tool was designed by a researcher after reviewing the related current and previous literature and translated to the Arabic language and included three parts as the following:
Part one:
General characteristics of the maternity nurses, which included, years of experience and any training courses regarding the stages of normal labor.
Part two:
Maternity nurses' knowledge regarding the nursing care of the first stages of normal labor. This tool was designed by a researcher after reviewing the related current and previous literature. It consisted of 15 questions to assess the maternity nurses’ general knowledge regarding the first stage of normal labor, such as the definition of normal labor, signs and symptoms of normal labor, mechanism of labor, etc.
Part three:
Maternity nurses' knowledge of partogram. It consisted of 16 questions to assess the maternity nurses’ knowledge regarding partogram such as definition of partogram, objective of partogram, component of program, etc.
Knowledge scoring system:
Each item was scored: 2 points for complete correct answers, 1 point for incomplete correct answers, and 0 points for incorrect answers or "don't know." Total scores were summed and averaged to categorize knowledge levels as Good Knowledge ≥ 75%, Average knowledge 50% to > 75%, and Poor knowledge > 50%.
Field work:
Revision of assessment tools for content validity by five experts in obstetrics and gynecological nursing highlighted their clarity and applicability, with strong internal consistency (Cronbach’s Alpha = 0.951). A pilot study with 5 nurses evaluated a structured questionnaire, leading to necessary modifications for clarity in knowledge-related questions. Conducted from October 2024 to June 2025, the research included phases of initial interviews and assessments of nurses' comprehension, practices, and attitudes towards early normal labor, utilizing a self-administered questionnaire and observational checklists. An instructional package in Arabic was developed, covering theoretical knowledge and practical skills over four weeks through lectures, discussions, and demonstrations. The evaluation phase used identical pretest tools post-intervention to assess changes in knowledge, practices, and attitudes. Ethical approvals were obtained, and data analysis was performed using SPSS with significance evaluated via chi-square tests and paired sample t-tests.
Figure (1): Illustrates that 56% of the studied nurses had less than 5 years of experience.
Figure (2): shows that 28.0% of the studied nurses attended training courses regarding the stages of normal labor.
Table (1): presents the relation between total maternity nurses’ knowledge and their years of work experience through the instructional package. It revealed that the level of knowledge was increased by increasing nurses’ years of experience in both pre- and post-instructional packages. Mean knowledge was 18.00±7.00 pre-instructional package compared to 48.00±4.58 post-instructional package among nurses whose experiences were more than 10 years.
Table (2): Shows that there were improvements in the studied maternity nurses’ knowledge regarding nursing care of the first stage of normal labor post-intervention. Regarding signs of true labor pain, 8% of them reported a correct and complete answer pre-instructional package compared to 70% post-intervention. Regarding the importance of uterine contraction, 12% of them had a correct and complete answer pre-instructional package compared to 72% post-intervention, and 24% of them reported a correct and complete answer about nursing care during the first stage of normal labor pre-intervention compared to 88% post-intervention. The table also proves that there was a highly statistically significant difference for all aspects of the studied maternity nurses’ knowledge regarding the first stage of normal labor at a p-value of 0.000 between pre- and post-intervention.
Table (3): Shows that there were improvements in the studied maternity nurses’ knowledge regarding partogram post-intervention. Regarding the normal rate of cervical dilatation, 14% of them reported the correct and complete answer pre-intervention compared to 68% post-intervention. Regarding the components of progress labor, 20% of them had correct and complete answers pre-intervention compared to 72% post-intervention, and 22% of them reported correct and complete answers about the complications that were avoided by the partogram pre-intervention compared to 74% post-instructional package. The table also proves that there were highly statistically significant differences for all aspects of the studied maternity nurses’ knowledge regarding partograms at p-value 0.000 between pre- and post-intervention.

Figure 1: percentage distribution of years of experience of the studied maternity nurses

Figure 2: percentage distribution of the studied maternity nurses’ attendance training courses regarding the stages of normal labor
| Years of work experience | Maternity nurses’ knowledge | |||||
| Preprogram | Postprogram | |||||
| ????±SD | F/t | P-Value | ????±SD | F/t | P-Value | |
| 16.82±6.05 16.47±5.82 18.00±7.00 | F= 0.087 | 0.917 | 49.53±7.35 50.31±8.87 48.00±4.58 | F= 0.133 | 0.876 |
Table 1: Relation between total maternity nurses’ knowledge and their years of work experience thorough instructional package
| First stage of normal labor items | Pre instructional package | Post-instructional package |
2 | alue | ||||||||||
| Complete correct | Incomplete correct | Incorrect/ Unknown | Complete correct | Incomplete correct | Incorrect/ Unknown | |||||||||
| No | % | No | % | o | % | No | % | o | % | o | % | |||
| 1. Concept of labor | 6 | 2.0 | 13 | 6.0 | 1 | 6.0 | 8 | 7.0 | 8 | 1.0 | 4 | 0 | 45292 | 0.00** |
| 2. Advantages of normal labor | 5 | 100 | 7 | 1.0 | 8 | 7.0 | 7 | 7.0 | 1 | 2.0 | 2 | 40 | 57670 | 0000** |
| 3. Factors increase chances of normal labor | 8 | 160 | 0 | 2.0 | 32 | 4.0 | 39 | 8.0 | 10 | 0.0 | 1 | .0 | 49568 | 0.00** |
| 4. Cases in which normal labor is Prohibited | 11 | 220 | 9 | 1.0 | 0 | 6.0 | 6 | 7.0 | 0 | 2.0 | 4 | .0 | 33233 | 0.00** |
| 5. signs True Labor Pain | 4 | 80 | 2 | 2.0 | 4 | 6.0 | 5 | 7.0 | 10 | 2.0 | 5 | 1.0 | 60.97 | 0.00** |
| 6. Definition of Show. | 5 | 10.0 | 15 | 3.0 | 0 | 6.0 | 7 | 7.0 | 9 | 1.0 | 4 | .0 | 45763 | 0.00** |
| 7. Definition First stage of normal Labor | 5 | 10.0 | 15 | 0.0 | 30 | 6.0 | 7 | 7.0 | 9 | 1.0 | 4 | 80 | 45.63 | 0.00** |
| 8. Physiological changes first stage of normal labor | 9 | 180 | 0 | 20 | 31 | 62.0 | 0 | 80 | 8 | 60 | 2 | 0 | 45.19 | 0.00** |
| 9. Site of True Labor Pain | 10 | 0.0 | 8 | 1.0 | 2 | 640 | 5 | 700 | 8 | 60 | 7 | 140 | 29.15 | 0.00** |
| 10. Importance of Uterine Contractions | 6 | 120 | 1 | 2.0 | 3 | 6.0 | 36 | 7.0 | 8 | 1.0 | 6 | 1.0 | 40595 | 0.00** |
| 11. Complications of the first stage of normal labor | 9 | 1.0 | 8 | 160 | 3 | 6.0 | 1 | 8.0 | 4 | 80 | 5 | 1.0 | 42445 | 0.00** |
| 12. Definition frequency of uterine Contraction | 9 | 1.0 | 8 | 1.0 | 3 | 6.0 | 7 | 740 | 7 | 140 | 6 | 120 | 35.02 | 0.00** |
| 13. Definition duration of uterine contraction | 10 | 0.0 | 2 | 4.0 | 28 | 6.0 | 44 | 8.0 | 3 | .0 | 3 | .0 | 46969 | 0.00** |
| 14. Definition of the intensity of uterine contraction. | 1 | 22.0 | 14 | 5 | 50 | 5 | 900 | 2 | 40 | 3 | 0 | 46.29 | 0.00** | |
| 15. Nursing care during first stage of normal labor | 12 | 4.0 | 7 | 4.0 | 1 | 6.0 | 4 | 8.0 | 4 | .0 | 2 | .0 | 44589 | 0.00** |
Table 2: Distribution maternity nurses’ knowledge regarding general nursing care of first stage of normal labor through pre and post- instructional package (n=50)
* A highly statistically significant difference P ≤ 0. 001
| Portogram items | Pre – instructional package | Post- instructional package |
2 |
P vae | |||||||||||
| Complete correct | Incomplete correct | Incorrect/ Unknown | Complete correct | Incomplete correct | Incorrect/ Unknown | ||||||||||
| o | % | o | % | No | % | o | % | o | % | o | % | ||||
| 1. Definition Partogram | 5 | 100 | 1 | 220 | 4 | 680 | 0 | 600 | 5 | 300 | 5 | 10.0 | 43.128 | 0.000** | |
| 2. The importance of the Partogram | 7 | 14.0 | 9 | 18.0 | 34 | 68.0 | 30 | 60.0 | 8 | 6.0 | 12 | 24.0 | 24.878 | 0.000** | |
| 3. The component of the Partogram | 12 | 24.0 | 12 | 24.0 | 26 | 52.0 | 30 | 60.0 | 10 | 20.0 | 10 | 20.0 | 15.007 | 0.000** | |
| 4. Definition Latent phase | 4 | 8.0 | 9 | 18.0 | 37 | 74.0 | 36 | 72.0 | 8 | 6.0 | 6 | 12.0 | 48.008 | 0.000** | |
| 5. Definition The active phase | 5 | 10.0 | 10 | 20.0 | 35 | 70.0 | 38 | 76.0 | 5 | 0.0 | 7 | 14.0 | 45.659 | 0.000** | |
| 6. The normal rate of the cervical dilatation | 7 | 14.0 | 11 | 22.0 | 32 | 64.0 | 34 | 68.0 | 6 | 0 | 10 | 20.0 | 30.775 | 0.000** | |
| 7. Start plotting in the Partogram | 9 | 18.0 | 10 | 20.0 | 31 | 62.0 | 32 | 64.0 | 8 | 6.0 | 10 | 20.0 | 23.881 | 0.000** | |
| 8. The components of fetal Condition | 10 | 20.0 | 8 | 16.0 | 32 | 64.0 | 31 | 62.0 | 9 | 0 | 10 | 20.0 | 22.339 | 0.000** | |
| 9. Normal fetal heart rate | 6 | 12.0 | 15 | 30.0 | 29 | 58.0 | 36 | 72.0 | 9 | 0 | 5 | 10.0 | 39.870 | 0.000** | |
| 10. The components of progress labor | 10 | 20.0 | 11 | 22.0 | 29 | 58.0 | 36 | 72.0 | 6 | 0 | 8 | 16.0 | 28.085 | 0.000** | |
| 11. The components of maternal Condition | 7 | 14.0 | 9 | 18.0 | 34 | 68.0 | 31 | 62.0 | 8 | .0 | 11 | 22.0 | 26.972 | 0.000** | |
| 12. The alert line definition | 16 | 32.0 | 12 | 24.0 | 22 | 44.0 | 31 | 62.0 | 8 | .0 | 11 | 22.0 | 9.254 | 0.010* | |
| 13. Definition The action line | 10 | 20.0 | 8 | 16.0 | 32 | 64.0 | 35 | 70.0 | 6 | 12.0 | 9 | 18.0 | 27.077 | 0.000** | |
| 14. Complications avoid with Partogram | 11 | 22.0 | 12 | 24.0 | 27 | 54.0 | 37 | 74.0 | 6 | 12.0 | 7 | 14.0 | 27.848 | 0.000** | |
| 15. Definition the fetus distress | 7 | 14.0 | 14 | 28.0 | 29 | 58.0 | 33 | 66.0 | 0 | 20.0 | 7 | 14.0 | 31.011 | 0.000** | |
| 16. Nurse role for the fetus distress | 8 | 16.0 | 10 | 20.0 | 32 | 64.0 | 37 | 74.0 | 5 | 10.0 | 8 | 16.0 | 34.756 | 0.000** | |
Table 3: Distribution maternity nurses’ knowledge regarding Partogram through pre- and post- instructional package (n=50)
* A statistically significant difference P ≤ 0.05
** A highly statistically significant difference P ≤ 0. 001
All nurses are expected to master labor standards covered in the instructional session, with support provided for those with special needs. Entry into the lesson is granted to all nurses, fostering learning opportunities. Effective wait time is utilized to encourage meaningful participation, and nurses can experience labor achievement through the application of effective effort [33].
In nursing education, comments and concerns raised by nurses are acknowledged and linked to their existing knowledge about normal labor, promoting learning. Nurses utilize their experiences to enhance their understanding, with opportunities for respectful discussion and scaffolding of learning. Misconceptions are anticipated and addressed through redirection, allowing nurses to explore and correct their own misunderstandings collaboratively [34].
The current study aimed to evaluate the effect of the instructional package on maternity nurses’ knowledge regarding partogram and nursing care of the first stage of normal labor. In relation to nurses’ knowledge about nursing care of the first stage (pre/post), the present study stated that more than three-quarters of the studied nurses had complete correct answers about the definition of labor, about signs of true labor, the definition of show, and the physiological changes of the first stage of normal labor post instructional package. This result was supported by Shokry et al. (2022) in their recent study titled “Effect of supportive measures guidelines on nurses’ practices during labor, Ain Shams, Cairo, Egypt,” which reported that the majority of the studied nurses had correct answers regarding signs of true labor, mechanism, and stages of normal labor post guidelines [35].
Moreover, the current study matched Bhullar & Kaur (2022), which studied "A pre-experimental study to assess the effectiveness of STP on knowledge regarding partographs among staff nurses in selected hospitals" and indicated that more than three-quarters of the studied nurses had improvement in knowledge after the structured teaching program [36]. That agreement is due to the presence of continuous training & the effectiveness of the instructional package. Contrariwise, this finding was disagreed with by Kaur & Saini (2020), who conducted a study entitled "Knowledge and practices regarding Partograph among staff nurses working in labor room, Amritsar, Punjab" and revealed that two-thirds of the studied nurses had correct knowledge regarding the definition of labor, physiology, and signs of labor [37].
Concerning knowledge about partogram items during nursing care of the first stage of normal labor of the studied nurses, the present study clarified that more than three-quarters of the studied nurses had complete correct answers about the definition of partogram, the definition of the active phase, normal fetal heart rate, and components of progress of labor at the post-instructional package, and there was a highly statistically significant difference of studied maternity nurses regarding partogram through the instructional package. This result was supported by Ali et al. (2021), whose study "Effect of Educational Program about Partograph on Maternity Nurses Knowledge at Quena University Hospital—Egypt" indicated that the majority of studied nurses had correct knowledge about what a partogram is, the normal range of FHR, the time of starting the active phase, and the basic component of a partograph. At post-program education, there was a highly statistically significant difference in the post-program education [38].
Also, this result was agreed with by Lata & Verma (2025). Their study, entitled "A pre-experimental study to assess the effectiveness of a structured teaching program on knowledge and practices of partograph among staff nurses of labor rooms working in selected hospitals of Dis. Mandi (H.P), 2024-2025," revealed that there was improved knowledge of maternity nurse’s post-test and that there was statistically significant post-program [39]. Additionally, Sharma & Devi (2019), who studied "Assess knowledge and practice regarding partograph among staff nurses: a pre-experimental study," reported that there were statistically significant differences regarding knowledge of maternity nurses about the program at post-program [40].
Also, this result was agreed with Ali et al., (2021) that indicated that there was a highly statistically significant difference between the total knowledge score and the nurses' educational level in pre-intervention [38]. In addition to this, this result was matched with Ahmed et al. (2023), who studied the "Effect of Educational Program on Maternity Nurses' Knowledge and Practices Regarding Non-Invasive Fetal Well-Being Assessment Methods" and indicated that there was statistical significance between educational level and total knowledge score at the pre-educational program p-value [41]. This might be reflecting the positive effect of the instructional package on improving nurses’ knowledge regarding nursing care of the first stage of normal labor. The current study was in agreement with Kaur & Saini (2020), who conducted a study entitled “Knowledge and practices regarding Partograph among staff nurses working in labor room, Amritsar, Punjab” and revealed that there was a statistically significant difference between the studied nurses’ total knowledge and their training courses [37].
The study revealed that nurses' knowledge about partograms and first-stage labor nursing care improved after implementing an instructional package. This increase in correct knowledge and decrease in inaccuracies can be attributed to the package's teaching methods, reinforcement, and the use of educational materials such as brief, clear Arabic booklets [42-53]. These booklets support various educational forms and align with Edgar Dale’s Pyramid of Learning, showing that retention is maximized through diverse teaching approaches, including discussion [54-73].
Regarding the relation between their total knowledge and years of work experience of the studied nurses (pre and post), the present study showed that there was an improvement in nurses’ knowledge among all levels of years of experiences, however, no statistically significant difference between the studied maternity nurses’ total score of knowledge and years of experiences neither pre nor post instructional package implementation. Contrariwise, the current study disagreed with Wodaj et al. (2023), who studied "Evidence-based intrapartum care practice and associated factors among obstetric care providers working in hospitals of four Wollege Zones, Oromia, Ethiopia." Showed that there was a statistically significant difference between demographic characteristics, such as years of experience and knowledge about intrapartum care [74].
Occasionally, the present result was in agreement with Murn (2019), who conducted a study entitled “Mothering the mother: An Educational Program for Nurse-Provided Continuous Labor Support, USA” and found that there was no statistically significant difference between the studied nurses’ total knowledge and their years of experience, post educational program [75].
Based on the findings of the present study, it can be concluded that there were improvements in the studied maternity nurses’ knowledge regarding partogram and nursing care of the first stage of normal labor post-intervention. The level of knowledge was increased by increasing nurses’ years of experiences in both pre and post instructional package
Recommendation
Distribute the clarified pamphlet for maternity nurses to acquire a correct knowledge regarding partogram and nursing care of first stage of labor.
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We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation, Auctores Publishing LLC, We would like to thank the editorial team for the smooth and high-quality communication leading up to the publication of our article in the Journal of Neurodegeneration and Neurorehabilitation. The reviewers have extensive knowledge in the field, and their relevant questions helped to add value to our publication. Kind regards, Dr. Ravi Shrivastava.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, Auctores Publishing LLC, USA Office: +1-(302)-520-2644. I would like to express my sincere appreciation for the efficient and professional handling of my case report by the ‘Journal of Clinical Case Reports and Studies’. The peer review process was not only fast but also highly constructive—the reviewers’ comments were clear, relevant, and greatly helped me improve the quality and clarity of my manuscript. I also received excellent support from the editorial office throughout the process. Communication was smooth and timely, and I felt well guided at every stage, from submission to publication. The overall quality and rigor of the journal are truly commendable. I am pleased to have published my work with Journal of Clinical Case Reports and Studies, and I look forward to future opportunities for collaboration. Sincerely, Aline Tollet, UCLouvain.
Dear Ms. Mayra Duenas, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. “The International Journal of Clinical Case Reports and Reviews represented the “ideal house” to share with the research community a first experience with the use of the Simeox device for speech rehabilitation. High scientific reputation and attractive website communication were first determinants for the selection of this Journal, and the following submission process exceeded expectations: fast but highly professional peer review, great support by the editorial office, elegant graphic layout. Exactly what a dynamic research team - also composed by allied professionals - needs!" From, Chiara Beccaluva, PT - Italy.
Dear Maria Emerson, Editorial Coordinator, we have deeply appreciated the professionalism demonstrated by the International Journal of Clinical Case Reports and Reviews. The reviewers have extensive knowledge of our field and have been very efficient and fast in supporting the process. I am really looking forward to further collaboration. Thanks. Best regards, Dr. Claudio Ligresti
Dear Chrystine Mejia, Editorial Coordinator, Journal of Neurodegeneration and Neurorehabilitation. “The peer review process was efficient and constructive, and the editorial office provided excellent communication and support throughout. The journal ensures scientific rigor and high editorial standards, while also offering a smooth and timely publication process. We sincerely appreciate the work of the editorial team in facilitating the dissemination of innovative approaches such as the Bonori Method.” Best regards, Dr. Matteo Bonori.
I recommend without hesitation submitting relevant papers on medical decision making to the International Journal of Clinical Case Reports and Reviews. I am very grateful to the editorial staff. Maria Emerson was a pleasure to communicate with. The time from submission to publication was an extremely short 3 weeks. The editorial staff submitted the paper to three reviewers. Two of the reviewers commented positively on the value of publishing the paper. The editorial staff quickly recognized the third reviewer’s comments as an unjust attempt to reject the paper. I revised the paper as recommended by the first two reviewers.
Dear Maria Emerson, Editorial Coordinator, Journal of Clinical Research and Reports. Thank you for publishing our case report: "Clinical Case of Effective Fetal Stem Cells Treatment in a Patient with Autism Spectrum Disorder" within the "Journal of Clinical Research and Reports" being submitted by the team of EmCell doctors from Kyiv, Ukraine. We much appreciate a professional and transparent peer-review process from Auctores. All research Doctors are so grateful to your Editorial Office and Auctores Publishing support! I amiably wish our article publication maintained a top quality of your International Scientific Journal. My best wishes for a prosperity of the Journal of Clinical Research and Reports. Hope our scientific relationship and cooperation will remain long lasting. Thank you very much indeed. Kind regards, Dr. Andriy Sinelnyk Cell Therapy Center EmCell
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. It was truly a rewarding experience to work with the journal “Clinical Cardiology and Cardiovascular Interventions”. The peer review process was insightful and encouraging, helping us refine our work to a higher standard. The editorial office offered exceptional support with prompt and thoughtful communication. I highly value the journal’s role in promoting scientific advancement and am honored to be part of it. Best regards, Meng-Jou Lee, MD, Department of Anesthesiology, National Taiwan University Hospital.
Dear Editorial Team, Journal-Clinical Cardiology and Cardiovascular Interventions, “Publishing my article with Clinical Cardiology and Cardiovascular Interventions has been a highly positive experience. The peer-review process was rigorous yet supportive, offering valuable feedback that strengthened my work. The editorial team demonstrated exceptional professionalism, prompt communication, and a genuine commitment to maintaining the highest scientific standards. I am very pleased with the publication quality and proud to be associated with such a reputable journal.” Warm regards, Dr. Mahmoud Kamal Moustafa Ahmed
Dear Maria Emerson, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews’, I appreciate the opportunity to publish my article with your journal. The editorial office provided clear communication during the submission and review process, and I found the overall experience professional and constructive. Best regards, Elena Salvatore.
Dear Mayra Duenas, Editorial Coordinator of ‘International Journal of Clinical Case Reports and Reviews Herewith I confirm an optimal peer review process and a great support of the editorial office of the present journal
Dear Editorial Team, Clinical Cardiology and Cardiovascular Interventions. I am really grateful for the peers review; their feedback gave me the opportunity to reflect on the message and impact of my work and to ameliorate the article. The editors did a great job in addition by encouraging me to continue with the process of publishing.
Dear Cecilia Lilly, Editorial Coordinator, Endocrinology and Disorders, Thank you so much for your quick response regarding reviewing and all process till publishing our manuscript entitled: Prevalence of Pre-Diabetes and its Associated Risk Factors Among Nile College Students, Sudan. Best regards, Dr Mamoun Magzoub.
International Journal of Clinical Case Reports and Reviews is a high quality journal that has a clear and concise submission process. The peer review process was comprehensive and constructive. Support from the editorial office was excellent, since the administrative staff were responsive. The journal provides a fast and timely publication timeline.
Dear Maria Emerson, Editorial Coordinator of International Journal of Clinical Case Reports and Reviews, What distinguishes International Journal of Clinical Case Report and Review is not only the scientific rigor of its publications, but the intellectual climate in which research is evaluated. The submission process is refreshingly free of unnecessary formal barriers and bureaucratic rituals that often complicate academic publishing without adding real value. The peer-review system is demanding yet constructive, guided by genuine scientific dialogue rather than hierarchical or authoritarian attitudes. Reviewers act as collaborators in improving the manuscript, not as gatekeepers imposing arbitrary standards. This journal offers a rare balance: high methodological standards combined with a respectful, transparent, and supportive editorial approach. In an era where publishing can feel more burdensome than research itself, this platform restores the original purpose of peer review — to refine ideas, not to obstruct them Prof. Perlat Kapisyzi, FCCP PULMONOLOGIST AND THORACIC IMAGING.
Dear Grace Pierce, International Journal of Clinical Case Reports and Reviews I appreciate the opportunity to review for Auctore Journal, as the overall editorial process was smooth, transparent and professionally managed. This journal maintains high scientific standards and ensures timely communications with authors, which is truly commendable. I would like to express my special thanks to editor Grace Pierce for his constant guidance, promt responses, and supportive coordination throughout the review process. I am also greatful to Eleanor Bailey from the finance department for her clear communication and efficient handling of all administrative matters. Overall, my experience with Auctore Journal has been highly positive and rewarding. Best regards, Sabita sinha
Dear Mayra Duenas, Editorial Coordinator of the journal IJCCR, I write here a little on my experience as an author submitting to the International Journal of Clinical Case Reports and Reviews (IJCCR). This was my first submission to IJCCR and my manuscript was inherently an outsider’s effort. It attempted to broadly identify and then make some sense of life’s under-appreciated mysteries. I initially had responded to a request for possible submissions. I then contacted IJCCR with a tentative topic for a manuscript. They quickly got back with an approval for the submission, but with a particular requirement that it be medically relevant. I then put together a manuscript and submitted it. After the usual back-and-forth over forms and formality, the manuscript was sent off for reviews. Within 2 weeks I got back 4 reviews which were both helpful and also surprising. Surprising in that the topic was somewhat foreign to medical literature. My subsequent updates in response to the reviewer comments went smoothly and in short order I had a series of proofs to evaluate. All in all, the whole publication process seemed outstanding. It was both helpful in terms of the paper’s content and also in terms of its efficient and friendly communications. Thank you all very much. Sincerely, Ted Christopher, Rochester, NY.