1.Psychometric Properties of the Competency Inventory for Registered Nurses
ALIMA ; ; Solongo D ; Baasanjav N ; Khulan G
Mongolian Journal of Health Sciences 2026;93(3):151-156
Background:
Developing a standardized methodology and a reliable and valid assessment tool for assessing the professional competence of nurses in Mongolia is of great importance for nursing research and practice.
Aim:
To determine the psychometric properties of the Mongolian version of the Competency Inventory for Registered Nurses.
Materials and Methods:
This study was conducted using a methodological research design. The study included 550 nurses from 11 state hospitals and collected data between June and December 2024 using the Competency Inventory for Registered Nurses Scale (CIRN) developed by Ming Liu et al. (2007).
Result:
The internal reliability of the questionnaire was Cronbach’s alpha coefficient (Cronbach’s α=0.98). Content validity indices (Content Validity Index CVI) were I-CVI ≥ 0.78, S-CVI/Ave=0.98, and S-CVI/UA=0.85, indicating good content validity. Varimax factor analysis revealed factor loadings ranging from 0.380 to 0.780.
Conclusion
1. The Mongolian version of the Competency Inventory Registered Nurses demonstrated adequate internal reliability.
2. The validity of the questionnaire was confirmed to be acceptable.
2.First successful whole lung lavage for pulmonary alveolar proteinosis in Mongolia: A Case Report
Amartuvshin G ; ; Altanzul L ; Ichinnorov D ; ; Naidansuren Ts ; Solongo B ; Densenbal D ; ; Tumen-Ulzii G ; ; Allabyergyen M ; Tumurjin G ; Khaliun P ; Tamir L ; Erdenetuya E ; Byambasuren S ; Ankhzaya B ; Ganbold L ; Manaljav Ts ;
Mongolian Journal of Health Sciences 2026;93(3):212-216
Background:
Pulmonary alveolar proteinosis (PAP) is a rare lung disorder characterized by the accumulation of surfactant within the alveoli, leading to impaired gas exchange and respiratory insufficiency. Although the disease is uncommon, it significantly affects patients’ quality of life and requires specific diagnostic and therapeutic approaches. Whole lung lavage (WLL) is considered the standard treatment; however, it has not been widely implemented in Mongolia. We report the first successful case of WLL performed for PAP in Mongolia.
Case Presentation:
A 56-year-old male presented with dyspnea. Chest computed tomography demonstrated a bilateral “crazy paving” pattern. Bronchoalveolar lavage fluid was positive for periodic acid–Schiff (PAS) staining, and anti–GM-CSF antibodies were detected, confirming the diagnosis of PAP. WLL was performed under general anesthesia using a double-lumen endotracheal tube with bronchoscopic guidance. One lung was ventilated with 100% oxygen while the contralateral lung was sequentially lavaged with 800–1000 mL of warm (37°C) saline per cycle until the effluent became clear. A total of approximately 20 liters of saline was used.
Result:
The procedure was completed successfully without complications. Following treatment, the patient showed marked clinical improvement with reduced dyspnea and increased exercise tolerance. Oxygen saturation improved from 88% to 93%, and spirometric parameters (FVC, FEV₁) demonstrated improvement. Chest imaging revealed a reduction in pulmonary opacities.
Conclusion
This case demonstrates the successful implementation of whole lung lavage (WLL) in Mongolia and highlights its importance in improving the diagnostic and therapeutic capacity for rare pulmonary diseases such as pulmonary alveolar proteinosis. The procedure resulted in significant improvement in clinical, functional, and radiological parameters, consistent with findings from international studies. Early diagnosis of PAP and the adoption of standardized protocols in accordance with international guidelines are essential to optimize treatment outcomes and enhance patients’ quality of life.
3.Evaluation of nurse–patient interaction among Hemodialysis patients based on Jean Watson’s theory of human caring
Oidov V ; Khulan G ; Solongo D
Mongolian Journal of Health Sciences 2026;95(5):89-93
Background:
Nursing theories help nurses understand the values and beliefs related to human health and support them in providing effective and compassionate care to patients. Nursing theorist Jean Watson defined the relationship between nurses, patients, and their families as an interpersonal interaction, referring to it as a “transpersonal caring relationship.” Currently, there is a lack of studies based on Jean Watson’s theory that examine how nurses’ attitudes and behaviors influence the quality of life of patients undergoing hemodialysis. Therefore, this topic was selected for the present study.
Aim:
To determine how nurse–patient interaction influences patients undergoing hemodialysis based on Jean Watson’s Theory of Human Caring.
Materials and Methods:
A cross-sectional study design was employed using a quantitative survey method. The study included 72 patients undergoing hemodialysis at Medvic Hospital. The Caring Nurse–Patient Interaction Scale (CNPI-70P), patient version, was used to assess attitudes and behaviors in nurse–patient interactions. This instrument was originally developed by Sylvie Cossette in 2005. Official permission to use the patient version of the questionnaire was obtained from the author on March 29, 2023. Data collection was conducted between December 2025 and January 2026. Statistical analysis was performed using SPSS version 25. Descriptive statistics were used to analyze subscales, independent sample t-tests were applied to compare group differences, and Pearson correlation analysis was conducted to determine relationships among variables.
Results:
The mean age of the participants was 38.8±10.5 years, with a mean age of 39.3 years for males and 38.1 years for females. The overall evaluation of nurse–patient interaction in nursing care among patients undergoing hemodialysis was at a moderate level (3.78±0.82). There was no statistically significant difference between the mean ages of the two groups (t (70) =0.494, p=0.623). The reliability of the CNPI-70 questionnaire was very high, with a Cronbach’s alpha of 0.988. Among the subscales, the highest score was observed for “meeting human needs” (M=4.16, SD=0.87), indicating that nurses most frequently supported patients in fulfilling their needs. High scores were also observed for “humanism” (M=4.02, SD=0.80) and “helping relationship” (M=4.00, SD=0.86). In contrast, the lowest score was found for “sensitivity” (M=3.39, SD=1.13), followed by “spirituality” (M=3.47, SD=0.99) and “problem-solving” (M=3.56, SD=1.07), indicating comparatively lower levels in these aspects. The mean scores of the remaining factors ranged from 3.72 to 3.95.
Conclusion
Nurse–patient interaction among patients undergoing hemodialysis was found to be at a moderate level (3.78±0.82). However, aspects related to understanding patients’ sensitivity, providing emotional support, and meeting spiritual or psychological needs were relatively lower.
4.Co-occurrence of non-communicable disease risk factors among children and adolescents
Ariunzaya P ; Uuganbayar A ; Solongo P ; Anandashiri B ; Tuyajargal B ; Batkhuu B ; Tsolmontuya A ; Usukhbayar M ; Khangai E ; Ayurzana A ; Myagmartseren D
Mongolian Journal of Health Sciences 2026;95(5):242-246
Background:
Between 2017 and 2021, the prevalence of obesity among children aged 2-19 years reached 19.7%, affecting approximately 14.7 million children, with rates of 12.7% among those aged 2-5 years and 22.2% among those aged 6-11 years. Globally, dental caries is among the most common non-communicable diseases, often leading to pain, infection, tooth loss, and reduced quality of life. In Mongolia, the prevalence of overweight and obesity among children and adolescents has increased markedly since 2010, beginning at an early age. In 2018, one in six children under five years and one in eight adolescents were overweight.
Aim:
This study aimed to assess selected non-communicable disease risk factors among children and adolescents.
Materials and Methods:
A cross-sectional study was conducted in Ulaanbaatar, Mongolia, using Family Health Centers across all nine districts. A total of 622 children aged 6–17 years were included. Anthropometric measurements (weight, height, and waist circumference) were obtained, and body mass index (BMI) was calculated. Oral health examinations were performed to determine the Decayed, Missing, and Filled Teeth (DMFT) index. Nutritional status was classified based on age and sex-specific growth charts into normal weight, overweight, and obesity categories.
Results:
Among the participants, 10.29% (n=64) were overweight and 9.97% (n=62) were obese. Overweight was more prevalent among girls, whereas obesity was relatively higher among boys (p<0.001). Regarding dental caries, 37.6% (n=234) of participants had no caries (DMFT=0), 48.1% (n=299) had mild caries (DMFT=1-2), and 14.3% had moderate to severe caries (DMFT≥3). The overall prevalence of dental caries was 62.38%, with significant variation by age group: highest in children aged 6-9 years (69.9%) and lowest in those aged 15-17 years (46.1%) (p<0.001). No statistically significant association was found between BMI categories and dental caries status. Although normal weight predominated in the DMFT=0 and DMFT=1-2 groups, logistic regression adjusted for age and sex showed no significant relationship between BMI and dental caries. However, children aged 6-9 years had a significantly higher likelihood of having dental caries compared to those aged 15-17 years (OR=0.39, 95% CI: 0.24-0.63, p<0.001).
Conclusions
1. Among the risk factors for non-communicable diseases (NCDs), overweight and obesity were highly prevalent among children, with one in every five children classified as overweight or obese. The prevalence among male children was approximately two times higher than that among female children (p<0.001). 2. The prevalence of dental caries among the study participants was 90.7%, with a mean caries intensity of 6.4, indicating high level of severity. Age-group analysis demonstrated that children aged 6–10 years exhibited the highest prevalence and severity of dental caries, with a prevalence of 93.5% and a mean caries intensity of 7.3.
5.Stress among university faculty members
Solongo D ; Odgerel B ; Taivanjargal G ; Ariunaa J ; Delgermaa S ; Orgilmaa R
Mongolian Journal of Health Sciences 2026;95(5):293-297
Background:
Teaching is a profession associated with high levels of stress. Research has shown that when job demands are high while organizational support is insufficient, levels of stress and burnout increase.
Aim:
Prior to conducting our study aimed at determining the stress levels among university faculty members, we performed a literature review.
Materials and Methods:
We conducted a literature search using the PubMed and Embase databases for studies published in English without restriction on publication year, including all relevant articles available up to September 2025. The search strategy included the following keywords: “stress,” “researchers,” “university professors,” “academic researchers,” “college,” “academics,” “scholars,” “teachers,” and “professors.”
Results:
We searched for English-language publications in the PubMed and Embase databases without year restrictions, including studies published up to September 2025. The search was conducted using the following mesh terms: “stress,” “researchers,” “university professors,” “academic researchers,” “college,” “academics,” “scholars,” “teachers,” and “professors.” A total of 3,961 articles were identified from the database search. After screening titles, 2,944 articles were excluded. Subsequently, 58 articles were reviewed based on their abstracts, and 12 studies that were relevant to our research objectives and questionnaire were selected for analysis.
Conclusion
This review study demonstrated that stress levels among university and college faculty members are high. Stress is associated with multiple factors, including workload, organizational support, and performance demands, leading to negative physical and psychological consequences. Therefore, it is necessary to implement systematic institutional-level interventions to support the well-being of faculty members.
6.Analysis of the reliability and validity of the competency inventory registered nurses scale
ALIMA ; ; Khulan G ; Solongo D
Mongolian Journal of Health Sciences 2025;89(5):72-78
Background:
Ensuring the quality of healthcare services relies heavily on the professional competence of nurses. This
study aimed to assess the internal consistency and construct validity of a competency assessment questionnaire developed
for nurses working in tertiary-level hospitals in Ulaanbaatar, Mongolia.
Aim:
The aim of this study is to determine the internal reliability and construct validity of the questionnaire used to assess
nurses’ competency
Materials and Methods:
A cross-sectional study design was conducted among 390 nurses employed at tertiary hospitals
in Ulaanbaatar. Data were analyzed using SPSS version 25.0. Internal reliability was evaluated using Cronbach’s alpha,
and construct validity was assessed through exploratory factor analysis (EFA).
Results:
The 55-item questionnaire demonstrated excellent internal reliability (Cronbach’s alpha=0.981). The Kaiser-Meyer-Olkin (KMO) measure was 0.972, and Bartlett’s test of sphericity was significant (p<0.001), indicating the
data were suitable for factor analysis
Conclusions
1. The internal consistency of the questionnaire showed a Cronbach’s alpha coefficient of 0.981, indicating excellent
reliability. In addition, the Cronbach’s alpha values for each of the seven subscales were all above 0.90, demonstrating
strong inter-item correlations and stability of the measurement indicators. The developed questionnaire is a highly
reliable and valid tool for assessing the competencies of nurses in Mongolia. Its strong psychometric properties
support its use in both research and professional development contexts.
2. Factor analysis was conducted using the Varimax rotation method to evaluate the construct validity of the
questionnaire. The Kaiser-Meyer-Olkin (KMO) measure was 0.972, and Bartlett’s Test of Sphericity was significant
(p<0.001), indicating that the data were suitable for factor analysis. The analysis identified seven factors, each with
a loading above 0.60, confirming the high construct validity of the measurement tool.
7.Risk Factors and Clinical Characteristics of Pulmonary Embolism Among Mongolian Patients
Javzan-Orlom D ; ; Chuluunbileg B ; Gantogtokh D ; Enkhtuguldur M ; Munkh-Erdene D ; Zolzaya B ; Enkh-Amgalan Ts ; Altankhuyag N ; Amgalandari B ; Badamsed Ts ; Tumur-Ochir Ts ; Solongo B
Mongolian Journal of Health Sciences 2025;90(6):55-62
Background:
The annual incidence of pulmonary thromboembolism is reported to be 39–115 cases per 100,000 population,
with rates of 60–120/100,000 in Western countries and 10–20/100,000 in Asian countries. In Mongolia, few studies
revealed the prevalence of risk factors and clinical manifestations of acute pulmonary embolism. Over the past 30 years,
the incidence of risk factors for non-communicable diseases, which are mainly triggered by lifestyle and social parameters,
has rose. Moreover, environmental conditions such as cold climate, hypoxia, and blood hyperviscosit may contribute
to higher incidences of acute pulmonary embolism in high-altitude regions. This condition is potentially fatal and can
become impair quality of life.
Aim:
We aimed to compare risk factors and clinical characteristics based on age and sex, and to evaluate laboratory findings
and diagnostic tests among Mongolian patients diagnosed with acute pulmonary embolism.
Materials and Methods:
This retrospective research included total 232 patients meeting inclusion criteria. The information
was collected from patient histories, including general demographics, risk factors, comorbidities, symptoms, and
physical examination findings. Laboratory analyses included complete blood count, coagulation profile, and immunological
markers (D-dimer, NT-proBNP, troponin, protein C, homocysteine, and C-reactive protein), as well as selected
imaging parameters. We used Wells and Geneva scoring systems to assess probability of acute pulmonary embolism and
Pulmonary Embolism Severity Index to determine disease severity. Differences by age and sex were analyzed using independent
t-tests for continuous variables and chi-square tests for categorical variables.
Results:
Among participants with acute pulmonary embolism, the prevalence of tobacco and alcohol use was significantly
higher among males (p<0.001). Among comorbidities, arterial hypertension and other pulmonary diseases were more
common in males, whereas cardiac diseases were more frequent in females (p=0.028). Participants aged 65 years and
older showed higher rates of comorbid conditions and regular medication use (p<0.001). The most common symptoms
were dyspnea (90.9%), chest pain (74.2%), cough (70.5%), leg pain (38.9%), hemoptysis (20.7%), and cyanosis (9.3%).
According to sPESI scoring, 69.8% (n=162) were at high risk of death within 30 days, with no significant difference by
sex. However, mortality risk within 30 days was significantly higher in participants aged 65 years and above (p<0.001).
As increasing age, the neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio were elevated, indicating an acute
inflammatory response (p=0.001). Contrast-enhanced CT scans revealed that 95 participants (44.2%) had main pulmonary
artery involvement, with no significant sex difference, though involvement of the main pulmonary artery was more
frequent in those aged 65 and older.
Conclusion
Dyspnea, chest pain, and cough were the most common symptoms among patients diagnosed with acute
pulmonary embolism. The 30-day mortality risk associated with it was higher among males and increased with advancing
age.
8.Psychometric Properties of the Mongolian Version of the Competency Inventory for Registered Nurses
ALIMA ; ; Khulan G ; Solongo D
Mongolian Journal of Health Sciences 2025;90(6):78-83
Background:
The development and evaluation of nurse competency is an important research area that directly impacts
the improvement of nursing quality and the optimization of the healthcare systems.
Aim:
To determine the psychometric properties, specifically the reliability and content validity, of the Mongolian version
of the Competency Inventory for Registered Nurses.
Materials and Methods:
Research approval was obtained from the research ethics committee of the MNUMS (approval
no. 2024/3-06), and adhering to ethical principles. Copyright owners granted permission to the principal investigator (PI)
to use and translate the CIRN. Three bilingual experts were invited to be involved in the forward–backward translation
process into the Mongolian language. Instrument reliability was pilot-tested with 30 nurses, who had similar characteristics
with study sample. We collected data from 550 registered nurses, randomly selected and working in 11 reference-level
and national centers in the capital city of Ulaanbaatar, and five Regional Diagnostic and Treatment Centers (RDTCs) of
Mongolia.
Results:
The most of participants were female (96.9%); ages ranged from 20 to 63 ages with an average of 36.50. The
internal consistency reliability of the CIRN was very high and Cronbach’s alpha coefficients were 0.97 respectively. The
content validity indices (I-CVI≥0.78, S-CVI/Ave=0.98, S-CVI/UA=0.85) indicated satisfactory content validity. Factor
analysis with Varimax rotation showed factor loadings ranging from 0.380 to 0.780.
Conclusions
1. The Mongolian version of the Competency Inventory for Registered Nurses (CIRN) confirmed acceptable
internal reliability.
2. The Mongolian version of the Competency Inventory for Registered Nurses (CIRN) was confirmed
to be a valid instrument with appropriate content validity.
9.A Study on the Learning Motivation and Engagement Level of Generation Z Students
Otgontsend O ; Ganbaatar B ; Odgerel B ; Ariunaa J ; Enkhbold D ; Delgermaa S ; Orgilmaa R ; Solongo D
Mongolian Journal of Health Sciences 2025;90(6):200-204
Background:
Generation Z students, born after 1995, are characterized by their ability to multitask, low tolerance for
traditional learning methods, impatience, short attention span, and preference for working independently rather than
collaboratively. They are also considered more vulnerable to mental health challenges compared to previous generations.
Aim:
To assess the level of academic engagement among Generation Z students studying in the School of Nursing.
Materials and Methods:
This descriptive, cross-sectional quantitative study was conducted from February 1 to April
1, 2025. A total of 420 students majoring in nursing, midwifery, physical therapy, occupational therapy, and traditional
medicine nursing at the School of Nursing, Mongolian National University of Medical Sciences, participated in the study.
The Student Course Engagement Questionnaire (Handelsman, 2005) was used to evaluate students’ engagement levels.
The reliability of the questionnaire was confirmed with a Cronbach’s α of 0.955. Statistical analysis was performed using
SPSS version 25, and results were considered statistically significant at p<0.05.
Results:
Among the 420 participants, 91.9% were female and 8.1% were male. By major, 57.1% studied nursing, 22.6%
midwifery, 8.8% physical therapy, and the remainder were from other disciplines. Student engagement was analyzed
across three domains: academic involvement, personal responsibility and effort, and learning attitude and motivation.
Pearson correlation analysis revealed strong positive correlations between academic involvement and personal responsibility/
effort (r=0.828), learning attitude and motivation (r=0.825), and between responsibility/effort and learning attitude/
motivation (r=0.903) (p<0.01). Age showed a weak positive correlation with year of study (r=0.381), while major and
year of study had a weak negative correlation (r= -0.146) (p<0.01). Year of study and learning motivation also showed a
weak negative correlation (r=-0.107, p<0.05).
Conclusion
The learning motivation and class engagement of Generation Z nursing students were found to be strongly
correlated with their sense of responsibility, effort, and learning attitude (r=0.82–0.90, p<0.01). Most students demonstrated
consistent participation and motivation to learn, showed less interest in traditional teaching approaches, and preferred
practical training.
10.The significance of exhaled nitric oxide in the diagnosis of asthma
Densenbal D ; Solongo B ; Ankhbold G ; Amarsanaa O ; Battsengel Ts ; Zesemdorj O ; Janchivdorj Z ; Ankhil L ; Tseepil E ; Odonchimeg B ; Sarantuya J ; Ichinnorov D
Mongolian Journal of Health Sciences 2025;86(2):14-18
Background:
Asthma is a chronic inflammatory disease characterized by bronchoconstriction and breathing difficulties,
which can be triggered by both allergic and non-allergic mechanisms. In allergic asthma, a hyperreactivity reaction
occurs, leading to an increase in fractional exhaled nitric oxide (FeNO) levels. Therefore, FeNO is used to differentiate
allergic and non-allergic types of asthma. In recent years, studies have been conducted to assess FeNO as an indicator of
treatment effectiveness and symptom control. Our goal is to introduce FeNO measurement in Mongolia for the first time
and utilize it for asthma diagnosis and treatment outcome evaluation.
Aim:
Study of FeNO levels in Asthma Diagnosis in Relation to Laboratory Findings and Lung Function
Materials and Methods:
This study included a total of 70 adult patients (18 years and older) with asthma who visited the
Outpatient Clinic of Mongolia-Japan Hospital and Shargaljuut Spa Clinic from May to December 2024. Based on their
allergic history, total IgE levels, and peripheral blood eosinophil count, participants were classified into allergic (>5%)
and non-allergic (<5%) asthma. The study aimed to determine the diagnostic specificity and sensitivity of FeNO levels.
Asthma control levels were assessed using the Asthma Control Test (ACT), lung function was evaluated using spirometry,
and exercise capacity was measured with the 6-minute walk test.
Results:
In a single measurement, there were no differences between the allergic and non-allergic groups in parameters
other than total IgE, peripheral blood eosinophil count, and FeNO levels. For diagnosing the allergic form of asthma, at
a FeNO level of 25 ppb, sensitivity (Se) was 0.68, specificity (Sp) was 0.30 (p=0.008); at 40 ppb, Se was 0.77, Sp was
0.31 (p=0.001); and at 50 ppb, Se was 0.74, Sp was 0.33 (p=0.001). Lung function and exercise capacity were similar in
both asthma groups.
Conclusion
The sensitivity of FeNO in distinguishing between allergic and non-allergic forms of asthma is 67-81%, and
its sensitivity tends to increase as the FeNO level rises. By distinguishing the allergic type in which inhaled corticosteroids
are more effective, the outcome of asthma treatment can be predicted in advance based on the FeNO level.
Result Analysis
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