Relationship between mental workload and musculoskeletal disorders with intention to leave service among nurses working at neonatal and pediatric departments: a cross-sectional study in Iran.

BACKGROUND: Despite the challenge of nursing shortage in the world and its subsequent impact on care quality as well as aggravation of the situation by intention to leave service, this issue has not been properly addressed, especially among neonatal and pediatric nurses. The present study aims to identify the relationship between mental workload and musculoskeletal disorders with intention to leave the service among nurses working at neonatal and pediatric departments. METHODS: This descriptive-analytical study was conducted on 145 nurses working at neonatal and pediatric departments in six hospitals in Bushehr Province using full-census method. The data were collected using national aeronautics and space administration-task load index (NASA-TLX), Cornell musculoskeletal discomfort questionnaire(CMDQ) and Mobley and Horner's voluntary turnover questionnaire. The data were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Kruskal-Wallis test, Pearson's and Spearman correlation tests and hierarchical linear regression in simultaneous model in SPSS 19.0. RESULTS: The mean score of intention to leave the service was 9.57 ± 3.20 (higher than the moderate level) and the mean mental workload was 71.65 ± 15.14 (high level). Pain in at least one of the legs (100%), back (77.3%) and knees (76.6%) was highly prevalent. However, no statistically significant correlation was found between musculoskeletal disorder categories and intention to leave the service (p > 0.05). The regression analysis results revealed among mental workload domains, only effort-induced workload was negatively and significantly correlated with intention to leave the service (p = 0.003; ß=-0.078). However, the number of night shifts per month was positively and significantly correlated with intention to leave the service (p = 0.001; ß = 0.176). CONCLUSIONS: Planning for appropriate allocation of night shifts, investigating the etiology of musculoskeletal disorders and providing solutions for reducing mental workload should be prioritized by policymakers, while maintaining pediatric nurses' motivation for making efforts.

Hospital service quality based on HEALTHQUAL model and trusting nurses at Iranian university and non-university hospitals: a comparative study.

BACKGROUND: Establishment and improvement of patients' trust in healthcare organizations like hospitals necessitate delivery of high-quality services by nurses, as the largest group of healthcare providers. The present study aimed to compare hospital service quality based on the HEALTHQUAL model and trusting nurses at university and non-university hospitals in Iran. METHODS: This comparative cross-sectional study was conducted on 990 patients admitted to university and non-university hospitals located in Bushehr Province, southern Iran, who were selected using the stratified random sampling method. The data were collected through the HEALTHQUAL questionnaire and the Trust in Nurses Scale, and then analyzed via the SPSS Statistics software (version 22) as well as the General Linear Model (GLM) univariate procedure and the Chi-square test with a significance level of 0.05. RESULTS: The study findings revealed that the mean values of real quality (perceptions) and ideal quality (expectations) were 3.89 ± 0.69 and 4.55 ± 0.47, respectively. The gap between the real and ideal quality (- 0.64) was also larger at non-university hospitals from the patients' viewpoints. Comparing various dimensions of service quality, the largest gap at university and non-university hospitals was associated with "environment" (- 0.13) and "empathy" (- 0.18), respectively. Additionally, the mean scores of the patient trust in nurses at university and non-university hospitals were 10.34 ± 5.81 and 8.71 ± 4.05, respectively, being a statistically significant difference (p <  0.001). CONCLUSION: The study results demonstrated that hospital service quality and trusting in nurses were at higher levels at the university hospital than the non-university one; however, hospital service quality was at a lower level than what the patients had expected. Accordingly, hospital managers and policy-makers were suggested to focus on patients to reduce gaps in service quality, to promote service quality, and to provide better healthcare services to patients.

The effects of an empowering self-management model on self-efficacy and sense of coherence among retired elderly with chronic diseases: a randomized controlled trial.

BACKGROUND: Being elderly and retired are related phenomena that overlap in a time symmetry. The present study aimed to assess the effect of an empowering self-management model on the self-efficacy and sense of coherence (SOC) in retired elderly with chronic diseases. METHODS: A randomized controlled trial that included 60 elderly people was carried out in Bushehr (Iran) in 2016. The participants were randomly assigned to either a control group or an intervention group. Based on an empowering self-management model, the intervention group participated in a five-stage plan: 1) self-awareness of changes and understanding their personal level of performance and expectations; 2) optimal goal setting; 3) planning; 4) adjusting physical, psychological, and social structures; and 5) evaluation. Self-efficacy and SOC were measured using the questionnaires developed by Sherer and Antonovsky, respectively, before and after the intervention. The results of the observed differences between the groups were subsequently compared. Data were presented as mean±SD. RESULTS: The mean change of the self-efficacy score in the intervention and control groups was 9.48±5.32 and 1.68± 6.04, respectively, (t[56]=5.20, P<0.001). The mean change of the SOC score in the intervention and control groups was 24.17±12.05 and 0.10±13.42, respectively, (t[56]=7.18, P<0.001). CONCLUSION: The applied empowering self-management model led to an improved self-efficacy and SOC among the retired elderly with chronic diseases. This model can be used to empower the elderly to achieve comprehensibility, manageability, and meaningfulness in their lives.

Perspectives of nursing and midwifery students regarding the role of the hidden curriculum in patient education: A qualitative study.

BACKGROUND: Although education is one of the most substantial needs of patients that should be taught by nurses and midwives, it is not clearly defined through the hidden curriculum in students' teaching programs. The aim of this study was to explore the patient education through the hidden curriculum in the perspectives of nursing and midwifery students. MATERIALS AND METHODS: A qualitative, content analysis study was performed and twenty nursing and midwifery students were interviewed. Data were collected using face-to-face semi-structured interviews and analyzed using conventional content analysis approach. RESULTS: Students' perception of the hidden curriculum in patient education emerged in three main themes concerning: (1) interactions, (2) teaching and learning opportunities, and (3) reflective evaluation. CONCLUSIONS: The hidden curriculum in patient education can be transferred as interactions between professors, students, nurses, doctors, and also patients who are rooted from paying attention to the human dimension of the patient, avoiding the materialistic treatment of the patient and treating the patient with dignity. Educational policies and students' assignments should be designed based on the patient's educational goals and the goal of evaluation has to be presented to the students clearly.

Burnout and its related Demographic Factors among the Medical Staff working in Hospitals associated with Bushehr University of Medical Sciences.

OBJECTIVE: Burnout exerts a significant negative influence on job performance, especially in such difficult jobs as those to be found in the health care industry. This research aimed to evaluate the association between 3 dimensions of burnout and demographic factors among the medical staff working in all of the hospitals associated with Bushehr University of Medical Sciences, Iran. METHODS: The research detailed herein was a descriptive, analytical cross-sectional study which was conducted on 461 medical staff working in all of the hospitals associated with Bushehr University of Medical Sciences, Iran, from April 2011 to February 2012. The data were collected using a self-response method and include demographic information as well as the Maslach Burnout Inventory. In this study, samples were selected using a stratified random sampling method. The scoring of the burnout questionnaire ranged from 0 (never) to 6 (every day), with the levels of each of the 3 dimensions of burnout (as well as burnout itself) then being categorized as being low, moderate, or high. The data were analyzed using an independent t-test, a chi-square test, ANOVA, and Pearson's correlation coefficient, all in SPSS 18. RESULTS: Most people had experienced moderate levels of burnout (53.6%). With regard to the 3 domains of burnout, 46.4% of the participants had experienced moderate levels of emotional exhaustion, more than half (56.4%) had experienced low levels of depersonalization, and more than half (52.5%), high levels of a diminished sense of accomplishment. Burnout was shown to be statistically significantly associated with gender, place of residence, the condition of that residence, educational level, and being or not being local (p>0.05). CONCLUSION: The research findings showed that the rate of burnout was moderate among the medical staff working in hospitals associated with Bushehr University of Medical Sciences. Probably, burnout can be reduced in the hospitals' different staff members through better and suitable planning and through the organization of human resources.