2024-03-29T14:36:58+04:30 http://ijn.iums.ac.ir/browse.php?mag_id=112&slc_lang=fa&sid=1
112-2998 2024-03-29 10.1002
Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Association of Death Anxiety and Quality of Life in the Caregivers of Patients with Multiple Sclerosis M Seyedoshohadaee M Bozorgi Matin H Haghani Background & Aims: Multiple sclerosis (MS) is a disease that evolves into a chronic progressive phase and leads to a loss of muscular ability following the attack of the nervous system by the immune system. MS incidence has significantly increased in Iran and the world, and its disabling and progressive nature has affected various aspects of the life of patients and their caregivers. In fact, caregivers face the process of death, pain, and fear of mortality of patients during the care process, which may affect their quality of life. Therefore, given the direct impact of the caregivers’ quality of life on patients’ quality of life, more support of caregivers is of utmost importance. Since the care of patients might cause death anxiety and decrease the quality of life of caregivers, the present study aimed to determine the relationship between death anxiety and the quality of life of caregivers of MS patients. Materials & Methods: This descriptive and correlational study was performed on caregivers of MS patients who referred to Iran MS society in 2018. In total, 200 individuals were selected by convenience sampling after determining the sample size based on 95% confidence interval, 80% test power, and 0.2 correlation coefficient between death anxiety and quality of life of MS patients. The research was approved by the ethics committee of the Iran University of Medical Sciences (IR.IUMS.REC.1397.357). Data were collected using a demographic characteristics questionnaire for caregivers of MS patients (age, gender, level of education, marital status, economic status, occupational status, relationship with the patient, duration of care, and being responsible for care alone), the 36-item short-form health survey (SF-36), and Templer’s death anxiety scale. The latter instrument encompassed 15 items and was scored in a range of 0-15. In this regard, a score higher than eight was indicative of high death anxiety in the participants, whereas scores below seven showed low death anxiety. On the other hand, SF36 had eight dimensions of general health, physical performance, role limitations due to physical issues, role limitations due to emotional reasons, physical pain, social performance, joy, and psychological health. In the mentioned questionnaire, the lowest and highest scores were zero (worst case scenario) and 100 (best case scenario), respectively. In the end, higher scores demonstrated a better quality of life. Data analysis was performed n SPSS version 16 using descriptive (frequency, frequency percentage, mean and standard deviation) and inferential (analysis of variance, independent t-test, Scheffe’s test, and Pearson’s correlation coefficient) statistics. Results: In this study, the mean age of the participants was 40.39±11.75 years. The majority of the participants were male (58.5%) and married (64.4%). In terms of relationships with patients, 40% of the subjects were spouses of the patients, and 54.5% of them took care of the patients alone. The mean duration of patient care was 8.7±5.9, and most caregivers had a diploma degree (36.2%). Regarding residential status, 58.3% of the subjects had personal homes, and 44.2% of the participants had government jobs and a moderate economic status. In addition, about half of the people (50.8%) had social security insurance, and 54.5% of caregivers took care of the patients alone. According to the results, the mean death anxiety and quality of life scores of caregivers were estimated at 5.92±3.82 and 55.42±14.82, respectively. Moreover, 143 subjects (71.5%) received a low death anxiety score (in the range of zero-seven) while 57 of them (28.5%) a high score (above eight) in this respect. In the study of caregivers' quality of life, the highest and lowest mean and standard deviation were obtained in terms of physical performance and role limitations due to emotional reasons, respectively. The results showed a moderate quality of life in caregivers, and a significant, reverse correlation between death anxiety and quality of life (r=0.42) (P<0.05). In addition, there was a significant association between death anxiety and the variables of relationship with the patient (P=0.001), duration of care (P=0.036), occupational status (P=0.021), and type of insurance (P=0.006). Furthermore, a significant relationship was found between quality of life and the variables of age (P=0.032), level of education (P<0.001), income level (P<0.001), occupational status (P<0.001) and insurance (P<0.001). Conclusion: According to the results of the study, the majority of caregivers had low death anxiety. In addition, the mean score of death anxiety was estimated at 5.92 (out of 15), which demonstrated low death anxiety in these individuals. The results were indicative of a reverse correlation between death anxiety and quality of life and its dimensions. In other words, an increase in death anxiety led to a decrease in quality of life and its dimensions. Given the significant correlation between death anxiety and quality of life, it is recommended that more support be provided by healthcare providers to eliminate problems and decrease death anxiety in caregivers, especially those taking care of MS patients. Given the progressive nature of MS and its psychological outcomes, caregivers of these patients need ongoing psychological training to help them care for patients more effectively. Therefore, it is suggested that programs be designed to help caregivers and improve their quality of life in line with focusing on themselves and their needs. It is also recommended that more attention be paid to the importance of care and caregivers in the field of nursing management and continuous nursing education. It is also important to focus on the problems and disabilities of patients and their caregivers. For further research, it is suggested that the quality of life of caregivers be compared with the quality of life of patients and death anxiety in caregivers with death anxiety in patients. Multiple Sclerosis Caregivers Quality of Life Death Anxiety 2019 11 01 1 13 http://ijn.iums.ac.ir/article-1-2998-en.pdf 10.29252/ijn.32.120.1
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Effect of the Performance of the Liaison Nurses on the Motor Complications in Stroke Patients after Discharge: A Randomized Clinical Trial S Ebrahimi Z Kalani Background & Aims: Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of long-term and serious disabilities in adults. Motor and sensory impairments due to stroke cause common complications such as bedsores, constipation, and falls. In addition, strokes, directly and indirectly, affect the outcomes of patient treatment, including the duration of stay and death. Despite the rapid prevention and diagnosis and management of stroke, patients are still at high risk for complications. Given the prevalence of stroke complications, comprehensive nursing care during four weeks after a stroker plays a significant role in the decrease of the outcomes, disabilities, and mortality caused by the disorder. One of the most important roles of a liaison nurse is improving care quality by better preparing the patient for discharge. In fact, liaison nurse nurses are those who take care of patients with strokes after a holistic assessment and the application of technical and communication skills and improve their condition for discharge and continued care. Through coordination with other healthcare team members, they ensure that all the needs of patients and their families are met. In other words, the role of the liaison nurse is to improve pre-discharge planning, establish and improve communication between hospital staff and health care providers in the community, and provide home care facilities to assist hospital staff. Therefore, this study aimed to determine the effect of the performance of liaison nurses on the motor complications caused by a stroke after discharge. Materials & Methods: This quasi-experimental research had a randomized trial design and was performed in a hospital in Shiraz, Iran in 2016-2017. In total, 80 patients were selected by purposeful convivence sampling and were randomly divided into two test (n=35) and control (n=45) groups. Patients in the test group were evaluated before discharge by the liaison nurse and care and educational program focusing on the needs of each patient was developed. During discharge, an educational booklet was given to the patients or their caretakers in the test group to prevent motor complications caused by stroke (constipation, falls, bed sores). If necessary, the liaison nurse would be present at the patient's bedside at home and would be in contact with the patients to resolve their problems. On the other hand, the subjects in the control group received routine ward care and were discharged. In this study, falls were determined based on the report of patients and their families two weeks and two months after discharge (any type of fall due to imbalance and physical weakness). In addition, bedsores were determined based on the diagnosis of the liaison nurse after examining the patients, and constipation was determined by the same expert using Rome3 criteria. Data analysis was performed in SPSS version 16 using independent t-test (to compare the mean age and criteria for stroker) and Chi-square (to compare qualitative variables). Moreover, Mann-Whitney U was used to compare the risk of bedsores and falls due to non-compliance with normal distribution, and the Chi-square test was used to compare the frequency of complications in the two groups. Results: In this study, no significant difference was observed between the two groups in terms of age (P=0.319). the two groups were homogenous in terms of other baseline conditions, including the distribution of patients in terms of gender, Braden criterion, Morse criterion, and NIHSS. According to the results, no significant difference was observed between the groups regarding the frequency of falls two weeks (P=0.060) and two months (P=0.509) after discharge. Overall, a significant difference was observed between the two groups (P=0.041). Moreover, the groups had no significant difference regarding the frequency of constipation two weeks (P=0.121) and two months (P=0.102) after discharge, but the overall difference in the frequency of constipation was significant (P<0.001). In terms of bedsores, no significant difference was observed between the two groups two weeks (P=0.861) and two months (P=0.037) after discharge and in total (P=0.068). Conclusion: In this study, no significant difference was observed in the frequency of bed sores following the intervention of a liaison nurse. One of the positive points in this study was the use of the Braden criterion to predict the risk of bedsores and plan care based on the results in the test group. The criterion evaluates sensory perception, immobility, incontinence, and nutritional status. For each of the factors, separate measures were considered by the liaison nurse in order to reduce the occurrence of further problems and patient referral due to high-grade and infectious bed sores. According to the results of the study, the intervention of the liaison nurse significantly decreased the frequency fall in the test group, compared to the control group. By assessing the risk of falls in stroke patients based on Morse criterion, the liaison nurse increased sensitivity toward the topic in the patients and their families and pointed out the causes of falls. In the control group, two patients fell despite the low risk of falling according to Morse's criterion, which might be due to the insufficient knowledge of patients and their caregivers about the issue in the absence of a liaison nurse. The results were different in terms of the incidence of falls with the clinical trial of the fall prevention program with several factors that were performed at home after the rehabilitation phase of stroke patients. We found a significantly lower frequency of constipation in the test group. One of the expected results in this trial was the implementation of self-care behaviors in patients with stroke. Since sampling was carried out in a short duration and only in two internal brain and nervous systems and brain ICU sectors, it seems that the implementation of the liaison nurse plan on stroke patients to achieve more accurate results requires more time and a larger sample size. Some of the important measures to be taken by liaison nurses include special care and education of these individuals and following up patients after discharge. According to the results, the performance of liaison nurses regarding stroke patients was effective in the decrease of motor complications such as constipation and falls. However, they played no role in the decrease of bedsores in these patients. Stroke Liaison Nurses Bedsore Constipation Fall 2019 11 01 14 25 http://ijn.iums.ac.ir/article-1-3008-en.pdf 10.29252/ijn.32.120.14
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Association of Sleep Quality and Quality of Life in the Operating Room Technologists at the Teaching Hospitals Affiliated to Iran University of Medical Sciences P Rezagholy S Hannani F Nasiri Ziba NA Azad Background & Aim: Sleep is very important for the body to rest and restore its energy, and insufficient and low-quality sleep results in physical and psychological disorders over time. In addition, sleep disorders can disrupt the presentation of job responsibilities in the work environment, and a reduction in sleep quality and quantity leads to an extreme decline in professional performance. Furthermore, sleep disorders are among the most important causes of decreased life quality and well-being and memory impairment, which can be a result of high work pressure and stress. Other factors affecting life quality are demographics and job properties. Life quality is defined as each individual’s perception of their position in life according to cultural conditions and social value system. On the other hand, professional activity can have the highest effect on operating room nurses’ life quality, and a large part of professional activities are affected by stresses related to the sector, responsibilities, duties, risk conditions, intra-group professional relationships and the type of work outside the operating room. Given the importance of sleep quality and life quality in the performance of operating room technicians and the possibility of the effect of these two parameters on the care quality of this profession, the present study aimed to determine the relationship between sleep quality and life quality of operating room technicians working in training hospitals of Iran University of Medical Sciences. Materials & Methods: This was a descriptive-analytical study performed on 134 operating room technicians selected by convenience sampling. Written informed consent was obtained from the participants following explaining research objectives and methodology and they were ensured of the confidentiality terms regarding their personal information. Data were collected using a demographic characteristic questionnaire, Pittsburgh Sleep Quality Index (PSQI) and the 26-item WHOQOL-BREF. The PSQI encompasses nine items related to seven components of subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. In each scale, a person’s score is between 0 and 3, which are interpreted as follows: no sleep problem (zero scores), moderate sleep problem (one score), serious sleep problem (two scores), and very serious sleep problem (three scores). On this scale, a score above five is indicative of poor sleep quality. The life quality sleep includes an overall score and four subscales of physical health, psychological health, social relations and health of the surrounding environment. First, a raw score is obtained for each subscale, which is converted into a standard score in the range of 0-100. In this regard, a higher score shows higher life quality. In addition, data analysis was performed in SPSS version 22 using multivariate analysis and Pearson’s correlation coefficient. Results: In this study, the mean age of the subjects was 34.12 years. In terms of gender, 44.8% (n=60) of the participants were male and 55.2% (n=74) were female. In addition, 47.38% (n=64) were aged 20-30 years, whereas 27.6% (n=37) and 24.6% (n=33) were aged 30-40 years and above 40 years, respectively. The mean sleep quality of the participants was reported to be 8.58±2.9, which demonstrated the poor sleep quality of operating room technicians. In addition, the mean and standard deviation of life quality was 60.44±18.47, which showed moderate life quality of the participants. According to the results, there was a direct and significant correlation between sleep quality and life quality (P<0.05). On the other hand, there was a reverse significant correlation between the components of sleep quality (sleep duration, sleeping medication and daily function disorders) and sleep quality components (physical and psychological health) (P>0.05). There was also a reverse significant relationship between the use of sleeping medication and four components of life quality (physical, psychological, environmental and social health) (P>0.05) (Table 2). Meanwhile, there was no significant relationship between sleep quality and life quality and demographic characteristics (P>0.05). Conclusion: According to the results of the study, operating room technicians had poor sleep quality and moderate life quality. An increase in the sleep quality of the participants led to an increase in their life quality. Therefore, given the effect of life quality and sleep quality on the health and performance of operating room technicians, officials should provide the conditions for improving these two variables by holding a workshop to offer solutions to regulate sleep patterns and increase the quality of life. Our findings could be used by healthcare managers to develop solutions to create a suitable work environment, prepare welfare and incentive facilities, and create psychological security in employees. In addition, the results of this research can be used in the field of education and design of operating room educational curriculum for teaching during the training courses of operating room students to provide solutions to regulate sleep patterns and improve quality of life. Quality of Sleep Quality of Life Operating Room Technologists 2019 11 01 26 35 http://ijn.iums.ac.ir/article-1-3010-en.pdf 10.29252/ijn.32.120.26
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Secondary Traumatic Stress and Resilience of the Nurses at the Psychiatric Centers in Tehran City, Iran E Jafar Jalal F Aziz Mohammadi N Seyyed Fatemi H Haghani Background & Aims: Secondary traumatic stress (STS) can be described as an occupational hazard for those providing care to victims of trauma. In health professions, there are times when individuals are in constant and close contact with trauma survivors and experience significant emotional disturbance, thereby becoming indirect trauma victims. Some of STS symptoms include increased negative emotions, the existence of annoying thoughts, failure to separate work from personal life, decreased frustration tolerance, increased anger, depression, disabling and selfish behaviors, fear of working with certain people, self-blame, keeping on one’s toes, decreased sense of competence at work, lack of goal, lack of enjoying the profession, decreased performance in unprofessional conditions, and loss of hope in life. Numerous factors such as environmental factors (e.g., work style, perceived organizational support, workload, client needs, and relationships with colleagues) and individual factors (e.g., level of education, level of experience, and coping styles) contribute to STSS. Nurses in psychiatric wards are faced with severe and complicated challenges in the workplace to provide mental health care. In addition, they should be aware of the risk factors and symptoms of STS. Nurses need to skillfully develop resilience in order to cope with occupational problems and ensure their mental health since resilience and the associated behaviors help overcome negative experiences and turn them into positive experiences. The present study aimed to investigate STS and resilience in the nurses at the psychiatric medical centers affiliated to Tehran University of Medical Science in 2018. Materials & Methods: This cross-sectional, descriptive study was conducted on 200 nurses working in the psychiatric medical centers affiliated to Iran University of Medical Sciences, Shahid Beheshti University of Medical Sciences, and Tehran University of Medical Sciences. In this regard, Iran Psychiatry Center included 35% of the total sample size (n=70), whereas Roozbeh Psychiatry Center, Imam Hossein Medical Center, and Rasoul Akram Medical Center encompassed 47% (n=94), 12% (n=25), and 6% (n=11) of the total sample size, respectively. Data were collected using an STS scale and resilience questionnaire. The research objectives and methods of filling the questionnaires were explained to the participants, and each questionnaire was completed within 20-30 minutes. Sampling was carried out from August to November 2018. Moreover, data analysis was performed in SPSS version 16 using descriptive statistics (mean, standard deviation, frequency, and frequency percentage), independent t-test, analysis of variance, and Mann-Whitney U in order to determine the relationship between demographic characteristics and STS and resilience. Results: In this study, most nurses (81%) were female, and the mean age of the participants was 36.69 ± 8.01 years. Moreover, more than half of the subjects (57%) were married. Regarding the level of education, most nurses (83.5%) had a BSc. In terms of employment status, 38% of the subjects had permanent employment, which had the highest frequency, compared to other levels. Furthermore, the mean work experience of nurses was 11.28 ± 7.22 years. On the other hand, the average experience of working in the ward was 4.9±4.21 years. More than half of the subjects (58.5%) were clinical nurses, and the mean working hours of nurses was 173.99 ± 28.43. Most nurses in this study (74.5%) reported moderate economic status, and three-quarters of them had liability insurance. On average, the ratio of nurse to the patient was 9.63 ± 3.03 in the morning, 11.67 ± 4.29 in the evening, and 12.25 ± 4.31 in the evening. In total, 30%, 21.5%, and 26% of the nurses reported high and severe, moderate, and mild secondary traumatic stress, respectively. Furthermore, the mean score of STS and resilience was 37.64 ± 10.03 and 69.71 ± 13.63, respectively. According to the results, there was a significant but reverse correlation between resilience and STS, meaning that those with higher STS had lower resilience (r=-0.513, P≤0.001). Conclusion: According to the results, the mean score of STS was moderate in the nurses, while the mean score of resilience was above the median of the questionnaire. According to the results, there was a significant relationship between STS and resilience of psychiatry nurses as a dimension of psychological health. In addition, there was a considerable association between psychological health and resilience. Nurses in the psychiatric ward are at greater risk of experiencing stress because they work in direct contact with clients with mental disorders in highly stressful and difficult conditions in psychiatric hospitals. In this study, more than 50% of nurses working in psychiatric wards reported symptoms of STS. Reporting this experience of the population will help support nurses' mental health by promoting awareness and training programs. Moreover, it may prevent their turnover due to work-related stress. Suggestions for preventing and treating STS include strategies such as reducing workload, increasing staff supervision, improving staff support, increasing staff leisure and providing opportunities for nurses to receive mental health services. The resilience of nurses working in psychiatric wards can also be improved by managing their physical and mental stress and promoting their mental health. Secondary Traumatic Stress Resilience Nurses Psychiatric Ward 2019 11 01 36 49 http://ijn.iums.ac.ir/article-1-3013-en.pdf 10.29252/ijn.32.120.36
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Viewpoints of Nurses toward Prosocial Tendencies at the Teaching Hospitals Affiliated to Iran University of Medical Sciences N Taleghani M Mardani Hamooleh N Seyedfatemi H Haghani Background & Aims: Prosocial tendencies are aimed at improving the conditions of the recipient of aids, and the motivation of the individual is not to fulfill professional obligations. On the other hand, the recipient of aid is not an organization, but rather a human. Prosocial tendencies result in psychological wellbeing in individuals, so that self-esteem would become positive, life satisfaction would increase, individuals would become socially empowered, and their empathy with the other community members would extend. In fact, these tendencies lay the basis for amicable relations with others, cause empathy and compassion toward others, and enhances the support of those in need. As a result, these tendencies lead to the social flourishing of individuals and enhance their power of moral reasoning. From a deeper perspective, it could be stated that the individuals harboring these tendencies enjoy higher social trust and ultimately have favorable psychosocial health. In contrast, those without these tendencies experience greater social anxiety and emotional exhaustion and may feel unable to help and empathize with others. Prosocial tendencies promote the professional satisfaction of employees, making them content with communicating with others, which in turn leads to kindness toward others, absence of depressive symptoms, and less occupational interrelations. Therefore, it is safe to say that it is essential for nurses to benefit from prosocial tendencies, especially when they are required to provide comprehensive patient care. Nurses need these tendencies to establish valuable and ethical relations with patients and their families, which will ultimately result in their own moral transcendence. The present study aimed to assess prosocial tendencies among nurses. Materials & Methods: This cross-sectional, descriptive study was conducted on 200 nurses employed in four teaching hospitals affiliated to Iran University of Medical Sciences (IUMS) in 2019. The participants were selected via quota sampling. Data were collected using a demographic form to measure the variables of age, gender, marital status, education level, work experience, ward of employment, employment status, type of work shift, and interest in the nursing profession. The other tool was the scale of prosocial tendencies, which has been designed by Carlo et al. The content validity method was used to assess the validity of the tool. For this purpose, the Persian and English versions of the tool were provided to five nursing professors, and their corrective comments were applied. Moreover, the Cronbach's alpha coefficient was used to evaluate the reliability of the instrument, which was estimated at 0.84 for the entire tool. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test and analysis of variance), and the P-value of less than 0.05 was considered significant. The study protocol was approved by the Research Ethics Committee of IUMS. Results: The mean total score of the prosocial tendencies of the nurses was 88.9 ± 15.74. Among the prosocial tendencies, unknown dimensions (3.81 ± 0.88), critical dimension (3.72 ± 0.92), emotional dimension (3.72 ± 1.1), compliant dimension (3.68 ± 0.78), and altruistic tendencies (3.15 ± 0.82) had the highest to the lowest mean scores, respectively. Furthermore, no significant correlations were observed between the demographic characteristics of the nurses and prosocial tendencies. Conclusion: According to the results, the nurses believed that helping others was the most desirable among various prosocial tendencies as long as the recipients of aid are aware of the help. This could be attributed to the nature of the nursing profession, which is essentially a populist profession, with professionals seeking to provide services to the community members, even if they are unaware of the services. In this study, the prosocial tendencies in the altruistic dimension had the lowest mean score compared to the other dimensions. Given the importance of altruism in the nursing profession and the consequences of its lack, as well as the fact that in the present study, this prosocial tendency had the lowest status from the perspective of the nurses, related interventions are critical to promote this tendency in nurses. These interventions should be based on psychological training in this area. In the present study, no significant correlations were observed between the demographic characteristics of the nurses and their prosocial tendencies. However, further investigations are required in this regard to clarify the possible associations between the demographic characteristics of the nurses and their prosocial tendencies. In addition, nursing researchers are advised to conduct studies with a qualitative approach in order to identify prosocial tendencies and analyze the factors that facilitate and threaten these tendencies. In clinical nursing, the results of this study could help nursing managers to consider care models based on prosocial tendencies in the healthcare plans for nurses, and various dimensions of these tendencies could be the building blocks of such models. The use of non-probability sampling in this study could be considered a limitation since the nature of this method makes it difficult to generalize the findings.   Prosocial Tendencies Nurse Care Altruism 2019 11 01 50 59 http://ijn.iums.ac.ir/article-1-3015-en.pdf 10.29252/ijn.32.120.50
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 The Work Engagement of Nurses and Its Correlation with Perceived Social Support Z Mehrizi A Nasiri S Irandoost Background & Aims: Work engagement refers to a positive, realized, and work-related mental state, determined by power, sacrifice, and attraction. Engaged nurses have a tendency toward providing patient-centered care, and their job productivity report and turnover are higher and lower, respectively, compared to other professions. In addition, work engagement leads to an effective connection to the job, more energy and creativity, and fewer errors and incidents in work. Improvement of work engagement in the nursing work environment requires identifying the related factors in order to strengthen or correct them if needed. One of these factors is perceived social support, which is defined as receive all kinds of help and support from formal or informal social networks. Social support is recognized as a strong facilitator of the work engagement of nurses. Accordingly, the present study aimed to determine the relationship between work engagement of nurses and their perceived social support. Materials & Methods: This descriptive, correlational, and cross-sectional study was performed in training hospitals of Birjand, Iran in 2018. In total, 120 nurses were selected by a multi-stage sampling method, and the inclusion criteria were a minimum of two years of work experience and working in the wards of Imam Reza, Vali-asr, and Razi training hospitals. On the other hand, the exclusion criterion was unwillingness to participate in the research. Data were collected using a researcher-made demographic characteristics questionnaire (age, gender, level of education, marital status, work experience, type of work shift, hospital, type of ward, employment status, and income level), Utrecht work engagement scale and Zimet’s scale of perceived social support. The Utrecht work engagement scale encompassed 17 items and three subscales of power (six items), sacrifice (five items) and attraction (six items), which were scored based on a seven-point scale (0=never to 6=always). In addition, the score range of the tool was 0-102, where higher scores were indicative of higher levels of the participants’ work engagement. On the other hand, Zimet’s scale of perceived social support was designed in 1988 and included 12 items to assess perceived social support from three aspects of family, friends, and others. The items were scored based on a five-point scale from one (not at all) to five (it is completely true). The score range of the tool was 12-60, where higher scores were indicative of a higher level of perceived social support. Data analysis was performed in SPSS version 16 using descriptive statistics, Pearson’s correlation coefficient, one-way analysis of variance, and independent t-test. Results: In this study, the mean age, mean work experience, and mean income level of the participants were 33.52 ± 6.17 years, 8.73 ± 5.58 years, and 2.41 ± 4.16 (two million and four hundred and 10 thousand) Tomans per month, respectively. In addition, the mean total work engagement and perceived social support in nurses were 62.00 ± 17.22 and 46.70 ± 8.15, respectively. According to the results, there was a positive and significant correlation between the components of power and attraction (r=0.20, P=0.02) and the total work engagement score with the component of perceived social support of family (r=0.20, P=0.02), which was statistically weak. However, a significant relationship was observed between the component of sacrifice (P=0.02) and gender. In this regard, female nurses received a higher mean. Furthermore, a significant association was found between power (P=0.03) and sacrifice (P=0.02) and the total work engagement score (P=0.02) with the hospital workplace. Conclusion: Given the total work engagement score, work engagement of nurses was at a moderate level. According to the research findings, there was a weak relationship between the family’s perceived social support and nurses' work engagement. In addition, female nurses received a higher score in terms of the sacrifice component of work engagement, compared to male nurses. By presenting the results of the present study to nursing managers and head nurses in hospitals, it is possible to raise their awareness of work engagement and related factors in nursing staff and help them to create a motivational work environment that increases the desire to work in nurses. One of the limitations of the present study was the high workload of nurses and the lack of time for filling the questionnaires. Given the importance of work engagement in the nursing profession, it is recommended that future studies be held to assess the relationship between work engagement and other variables that were not assessed in the current research. In addition, it is suggested that research be conducted on this relationship in non-training hospitals (e.g., private) as well.   Work Engagement Perceived Social Support Nurses 2019 11 01 60 70 http://ijn.iums.ac.ir/article-1-3022-en.pdf 10.29252/ijn.32.120.60
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Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 The Psychometric Properties of the Persian Version of the Schizophrenia Caregiver Quality of Life Questionnaire S Mokhtari SA Haghayegh Background & Aims: Schizophrenia is a severe psychological disorder that adversely affects the life quality of patients and their caregivers. In addition, life quality is a multidimensional and important index in determining the impact of the disease on the patient (18) and is assessed from two objective and mental aspects. It is the family of these patients who always incur the burden of support and care. Not only families must provide preliminary care (personal care and financial support) for patients, but also, they should adjust to the symptoms of the disease and accept and manage them. the Schizophrenia Caregiver Quality of Life Questionnaire encompasses significant experiences of Schizophrenia caregivers and is completely different from the conventional general quality of life questionnaires. The present study aimed to evaluate the psychometric properties of the Farsi version of the schizophrenia caregiver quality of life questionnaire (S-CGQoL). Materials & Methods: This psychological study was conducted on all the caregivers of schizophrenia patients in Isfahan, Iran in 2018. Caregivers of schizophrenia patients were selected via continuous sampling from three mental hospitals and three nursery centers during three months and were asked to fill the S-CGQoL by Richieri et al., which was translated in the present study, and the World Health Organization Quality of Life Questionnaire (WHOQOL) (Skevington et al.). The items of this tool are scored based on a five-point Likert scale from never (score=1), to rarely (score=2), sometimes (score=3), often (score=4) and always (score=5). The S-CGQoL includes 25 items and evaluates seven dimensions of psychological and physical well-being (five items), psychological burden and daily life (seven items), relationships with spouse (three items), relationships with the psychiatric team (three items), relationships with family (two items), relationships with friends (two items) and material burden (three items). The total score is obtained from the sum of these questions, and higher scores in this questionnaire mean a higher quality of life. The tool was translated into Farsi by the translation-retranslation method. In addition, the retest reliability of the instrument was assessed by asking 40 previous participants to refill the questionnaires after two weeks. Overall, 13 out of 40 individuals returned questionnaires and 27 tools were excluded due to being incomplete. The inclusion criteria were: 1) having a family member diagnosed with schizophrenia based on DSM.5, 2) being the main caregiver of a person with schizophrenia based on interviews and being the closest relative of the patient, and 3) giving full consent to participate in the research. On the other hand, the exclusion criterion was incomplete questionnaires. Reliability was assessed by the Cronbach’s alpha method and split-half test. Following that, 200 questionnaires were distributed, 155 of which were returned. Data analysis was performed in SPSS version 24 and Amos version 21 using psychometric indexes such as confirmatory factor analysis (CFA), correlation coefficient and Cronbach’s alpha. Results: The results of the CFA indicated significant correlations between the factorial load of all the items in the S-CGQoL with the related factor (P<0. 05) with relatively appropriate efficiency indices. Moreover, the results of internal reliability indicated the Cronbach’s alpha range of 0. 54-0. 92 in various sub-indices of the questionnaire. The results of the retest reliability showed that Pearson’s correlation coefficients for all the sub-indices of the S-CGQoL were significant in the two performed stages (P<0. 05), with the overall correlation coefficient of 0.96. In addition, the results of concurrent validity of the sub-indices of the SCGQoL with WHOQOL with the correlation-coefficient was significant (P<0.05) with a correlation coefficient of -0.56, which means that there was a strong and reverse correlation between the two instruments. According to the retest correlation coefficient results, there was a significant correlation between the scores of the first and second implementations of the S-CGQoL (P<0.01). Furthermore, the reliability of the entire S-CGQoL was approved at a Cronbach’s alpha of 0.92 and split-half of 0.78.  Conclusion: According to the results, the Farsi version of the S-CGQoL had proper validity and reliability and could be used for the caregivers of patients with schizophrenia in the healthcare centers in Iran. Based on our findings, the overall score of the instrument with subscales of psychological and physical well-being, psychological burden and daily life, relationships with spouse, relationships with the psychiatric team, relationships with family, relationships with friends, and material burden had a favorable fit, and the questions were able to properly fit the factors related to themselves. According to the CFA and internal consistency of the S-CGQoL, the Farsi version of the instrument had construct validity and significant fit. It is suggested that the retest reliability of the tool be assessed at intervals longer than two weeks. Questionnaire Quality of Life Caregivers Schizophrenia Reliability Validity 2019 11 01 71 86 http://ijn.iums.ac.ir/article-1-3030-en.pdf 10.29252/ijn.32.120.71
112-3031 2024-03-29 10.1002
Iran Journal of Nursing IJN 2008-5931 2008-5931 10.52547/ijn 2019 32 120 Hospital Anxiety and Depression in the Elderly with Chronic Heart Failure P Farokhnezhad Afshar F Bastani H Haghani O Valipour Background & Aims: Chronic heart failure (CHF) is one of the most common physical problems in the elderly that causes numerous disabilities. In addition, it is the main reason for elderlies’ referral to medical centers. Overall, experiencing CHF and its complications, as well as entering the medical environment can exacerbate psychological pressure on patients, including depression and anxiety, thereby increasing heart rate and decreasing patients’ desire to continue the treatment. In fact, this is one of the unfavorable consequences of hospitalization. Moreover, depression and anxiety are the most common complications of cardiac diseases, especially in the elderly hospitalized in coronary care units (CCUs), which threaten the lives of these individuals. Since patients are considered the customers of the health system, and assessing their views is an important factor for improving their psychological and physical health, attention to their psychological and physical needs can increase their satisfaction and decrease issues such as depression and anxiety during their hospitalization. Ultimately, this technique can result in faster recovery of patients and shorter hospitalization period. This study aimed to determine hospital depression and anxiety in the elderly with CHF hospitalized in Firoozabadi Hospital during 2018-2019. Materials & Methods: This cross-sectional study was performed on 250 elderlies with CHF hospitalized in Firoozabadi Hospital. The research population included all elderlies with CHF in various cardiac wards (CCU1, CCU2, Post CCU), and the participants were selected by a continuous sampling method among those who met the inclusion criteria. Data were collected using a demographic characteristics questionnaire (age, gender, marital status, occupational status, level of education, insurance status, history of hospitalization, accompanying diseases, smoking, and family history of cardiac diseases), abbreviated mental test, and hospital anxiety and depression scale. The research tools were completed during 15 to 20-minute in-person interviews with the researcher. Sampling started February 19th, 2018, and ended on June 20th, 2019 after four months. Data analysis was performed in SPSS version 16 using descriptive statistics, such as setting frequency distribution tables, estimating numerical indicators, and inferential statistics, independent t-test, and analysis of variance. Notably, a P-value of below 0.05 was considered statistically significant. Results: In this study, the participants were in the age range of 60-74 years, having the highest frequency (64.8%) among the elderly. According to the world health organization’s classification, this group of elderlies is considered young old. Overall, 52% of the participants were male and the rest (48%) were female. More than half of the elderly were married and in terms of educational status, only 33.6% of the subjects were illiterate while the rest were literate and educated. Regarding the occupational status, only 4.4% of the elderly were unemployed, and more than half of them received a retirement salary. In addition, 78.8% of the participants had health insurance. According to the results of the anxiety and depression scale, the mean score of anxiety in the elderly was 1.52 with a standard deviation of 1.14 and the mean score of depression was 2.18 with a standard deviation of 1.51. It is notable that anxiety and depression were below eight in all participants. Findings on numerical indicators of anxiety and depression in the elderly with CHF showed a significant relationship between anxiety (P=0.024) and depression (P=0.027) and only the variable of gender, in a way that anxiety and depression were significantly higher in female elderlies, compared to male elderlies. Conclusion: According to the results of the present study, none of the participants had an extreme and abnormal level of hospital anxiety and depression. In addition, the elderly with CHF had a low level of hospital anxiety and depression. This can be due to the educational and academic nature of the hospital in question and launching the process of clinical governance and accreditation and improving the quality of services and care to patients. Clinical governance is an inclusive and powerful mechanism used to ensure adherence to the highest levels of standards for providing medical services with the least complications and unfavorable consequences. The evaluation and treatment of anxiety and depression in patients are crucial since their frequency in cardiac patients is relatively high and they can have negative impacts on the functional status, quality of life, length of hospital stay, and even treatment outcome of these individuals during hospitalization. In general, serious and acute diseases lead to the sudden and unalarmed hospitalization of individuals in intensive care units. In this regard, some of the patients, who fail to comply with the situation, experience psychological damages, including hospital anxiety and depression. Since the provision of care with proper quality in the field of nursing is a priority in the healthcare system, attention to and evaluation of mood and psychological disorders in different groups of patients admitted to a hospital or training center, which is associated with several factors, is of paramount importance. Desirable outcomes can be achieved such as promoting the health and recovery of elderly patients and their participation in the treatment process, especially in elderly women, by decreasing hospital anxiety and depression and increasing satisfaction and quality of care. Given the fact that even low levels of depression and anxiety in the elderlies can disrupt the interaction and participation between the elderly patient and caregivers, data and information based on scientific evidence can be used in the development of planning to create elderly-friendly hospitals for care managers and policy makers in order to improve the quality of standard nursing care. Anxiety Depression Heart Failure 2019 11 01 87 97 http://ijn.iums.ac.ir/article-1-3031-en.pdf 10.29252/ijn.32.120.87