Workplace Conflicts Among Emergency Department Nurses: Instrument Development and Psychometric Properties.

BACKGROUND AND PURPOSE: Conflicts in nursing workplace are frequent and can be resolved by individuals or groups. The purpose of this study was to develop a valid and reliable measure for the Workplace Conflicts among Emergency Department Nurses (WCEDN). METHODS: A three-stage mixed methods study was conducted: (a) In-depth interviews with emergency department (ED) nurses were performed and themes were extracted from the data (b) Findings of the content analysis in combination with results of a literature review were examined, and preliminary instrument items were developed. The initial instrument comprised 50 items. (c) Content validity, face validity, content validity ratio, content validity index, and construct validity using exploratory factor analysis were performed. RESULTS: Subscales in the final instrument included Intrapersonal Conflict, Intragroup Conflict, Intergroup Conflict, and Causes of Conflict. Reliability of the instrument was .86, and the feasibility was 96.8%. CONCLUSIONS: The final 40-item WCEDN demonstrated strong psychometric properties.

Development and Psychometric Assessment of Risk Factors of Compassion Fatigue Inventory in Nurses.

BACKGROUND AND PURPOSE: Identifying the risk factors of compassion fatigue is the basic step in designing effective interventions to prevent and manage compassion fatigue. This study developed an inventory of compassion fatigue risk factors and investigated its psychometric properties. METHODS: This methodological study consisted of two phases: item pool generation through semistructured interviews with 13 nurses and reviewing of 38 related articles and the psychometric validation. RESULTS: The initial item pool contained 62 items. The psychometric properties was examined and exploratory factor analysis revealed a four-factor structure. Risk Factors of Compassion Fatigue Inventory (RFCFI) contained 20 items. The Cronbach's alpha, intra-class correlation coefficient (ICC), and standard error of measurement (SEM) were .86, 0.83, and 5.73 respectively. CONCLUSION: RFCFI is a short, self-reporting, valid, and reliable inventory for determining the risk factors of compassion fatigue in nurses and can be easily used by managers, nurses, and scholars.

Postgraduate Nursing Students' Expectations of their Supervisors in Iran: A Qualitative Study.

BACKGROUND: Exploring the expectations of postgraduate nursing students from their supervisors is required in order to meet the expectations, raise the general students' satisfaction, and enhance the students' capabilities to the highest degree possible. The present study was conducted to explore the expectations of postgraduate nursing students from their supervisors. MATERIALS AND METHODS: This qualitative study was done through semi-structured individual interviews with seven PhD students and 14 master's students in two focus groups from three universities in Tehran, Iran. The data were analyzed using the inductive approach and through conventional content analysis. RESULTS: The analysis of the data led to the extraction of five categories (support for the students, good communication skills, professional competence, guiding the students, and professionalism) within 12 subcategories. CONCLUSIONS: The results revealed that postgraduate students expect their supervisors not only to guide and support them in education and research but also have good communication skills, be professional, and value professionalism. Therefore, supervisors should try to meet these expectations and offer practical strategies for better realization of their needs.

Effect of electronic report writing on the quality of nursing report recording.

BACKGROUND AND AIM: Recording performed nursery actions is one of the main chores of nurses. The findings have shown that recorded reports are not qualitatively valid. Since electronic reports can be regarded as a base to write reports, this study aims at determining the effect of utilizing electronic nursing reports on the quality of the records. METHODS: This quasi-experimental study was conducted with the aim of applying an electronic system of nursing recording in the heart department of Shahid Rahimi Medical Center, Lorestan University of Medical Science. The samples were nursing reports on the hospitalized patients in the heart department, the basis of complete enumeration (census) during the fall of 2014. The subjects were sixteen employed nurses. To do the study, the software of nursing records was set based on the Clinical Care Classification system (CCC). The research's tool was the checklist of the Standards of Nursing Documentation. RESULTS: The findings indicated that before and after the intervention, the amount of reports' adaption with the written standards, respectively, was (21.8%) and (71.3%), and the most complete recording was medicine status (58%) and (100%). The worst complete recording before the intervention, acute changes was (99.1%) and nursing processes was (78%) and after, the medicine status, intake and output status and patient's education (100%); while the nursing report structure was regarded in all cases (100%). The results showed that there is a significant difference in the quality of reporting before and after using CCC (p<0.001). CONCLUSIONS: Since the necessary parameters for recording a standard report do exist in electronic reporting (CCC), from one point, nurses are reminded to record the necessary parts and from the other point, the system does not allow the user to shut it down unless the necessary parameters are recorded. For this reason, the quality of recorded reports with electronic reporting improves.

Psychometric Testing of the Persian Version of the Perceived Perioperative Competence Scale-Revised.

The clinical competence of nursing students in operating room (OR) is an important issue in nursing education. The purpose of this study was to evaluate the psychometric properties of the Persian Perceived Perioperative Competence Scale-Revised (PPCS-R) instrument. This cross-sectional study was conducted across 12 universities in Iran. The psychometric properties and factor structure of the PPCS-R for OR students was examined. Based on the results of factor analysis, seven items were removed from the original version of the scale. The fitness indices of the Persian scale include comparative fit index (CFI) = .90, goodness-of-fit-index (GFI) = .86, adjusted goodness-of-fit index (AGFI) = .90, normed fit index (NFI) = .84, and root mean square error of approximation (RMSEA) = .04. High validity and reliability indicated the scale's value for measuring perceived perioperative competence of Iranian OR students.

Development and Psychometric Evaluation of the Nurses' Compassion Fatigue Inventory.

BACKGROUND AND PURPOSE: Many efforts have been made so far to measure compassion fatigue (CF). There is no specific, precise, and comprehensive tool for CF measurement among nurses. This study aimed at developing and evaluating the psychometric properties of the Nurses' Compassion Fatigue Inventory (NCFI). METHODS: This methodological study was made in 3 consecutive phases: the hybrid concept analysis, the item pool generation, the psychometric validation. RESULTS: The initial item pool contained 98 items. The psychometric properties were examined and exploratory factor analysis revealed a 6-factor structure. NCFI contained 35 items. The Cronbach's alpha, intra-class correlation coefficient (ICC), and standard error of measurement (SEM) were 0.940, 0.935, and 7.6, respectively. CONCLUSION: The NCFI has acceptable reliability and validity. It can be easily used by nursing researchers and managers and even hospital nurses.

Teachers' and postgraduate nursing students' experience of the educational environment in Iran: A qualitative Research.

BACKGROUND: The learning environment has a significant role in determining nursing students' academic achievements and course satisfaction. Creating a proper educational environment is therefore necessary for improving the quality of teaching and learning, and for delivering competent graduates to society. OBJECTIVE: The present study was conducted to explore teachers' and postgraduate nursing students' experience of the educational environment in Iran. METHODS: This qualitative study uses an inductive approach and conventional content analysis. Data were collected through semi-structured face-to-face interviews with seven PhD students, seven faculty members (directors) and two focus groups comprising of fourteen master's students in total, selected from three major universities in Tehran, Iran. RESULTS: Seven subcategories were extracted from the data, including the organizational context, interactive climate, teachers' competency, student appreciation, research centeredness, educational guidance and professionalism. CONCLUSION: The educational environment of postgraduate nursing programs in Iran encompasses different dimensions that can serve as both key points for educational environment evaluators and as guidelines for officials at different levels, to modify the weaknesses and improve the strengths of the system.

The relationship between organizational commitment and nursing care behavior.

INTRODUCTION: Nursing care encompasses physical, emotional, mental and social needs, in order to improve a patient's health and wellbeing. Caring is the central core and the essence of nursing. The important issue of care is access to proper care and increasing patients' satisfaction. Job performance of nurses is affected by many factors including organizational commitment. This study aimed to determine the relationship between organizational commitment and nurses caring behavior. METHODS: In this cross-sectional study, 322 nurses from selected Hospitals of Shahid Beheshti University of Medical Sciences in Tehran were randomly selected and enrolled in the study in 2015. The self-reported data by nurses were collected through demographic characteristics questionnaire, Meyer & Allen organizational commitment model and Caring Behavior Inventory (CBI). Data were analyzed with SPSS statistical software version 20, using t-test and ANOVA. FINDINGS: The majority of nurses (63%) were female. The mean score and standard deviation of organizational commitment and caring behavior of nurses were 74.12±9.61 and 203.1±22.46, respectively. The results showed a significantly positive correlation between organizational commitment and caring behavior (p=0.001). CONCLUSION: In this study the caring behavior of nurses with higher organizational commitment were significantly better than the others. Managers and nurse leaders should pay more attention to improve organizational commitment of nurses, in order to improve nurses' performance.

The relationship between some demographic characteristics and organizational commitment of nurses working in the Social Security Hospital of Khorramabad.

BACKGROUND: Reduction in organizational commitment of nurses results in deficiency of care services. Some demographic factors affect organizational commitment. OBJECTIVE: The present study is intended to determine the organizational commitment of nurses and its relationship with demographic characteristics. METHODS: This study was a descriptive correlation (cross-sectional) study in January and February of 2016 on 126 nurses who held Bachelor of Science (B.Sc.) or Master of Science (M.Sc.) and at least one year of work experience in the Social Security Hospital of Khorramabad, selected using the census method. Data collection tools included a demographic characteristics form and Allen and Meyer questionnaire. Data analysis was performed using SPSS 20. Independent-samples t-test and one-way ANOVA were used to determine the relationship between organizational commitment and demographic characteristics. RESULTS: The majority of nurses had moderate organizational commitment, the highest score belonging to the continuance commitment (22.33%), and the lowest score belonging to the normative commitment (19.16%). Also, there was a significant correlation between the continuance commitment and work experience (p=0.001), the staff posts (p=0.01) and shifts (p=0.04). CONCLUSION: Considering the moderate level of subjects' organizational commitment in the present study, managers should take necessary measures to increase the attachment and organizational commitment of nurses and provide the ground for improving nursing services.

Relationship between time management skills and anxiety and academic motivation of nursing students in Tehran.

INTRODUCTION: Time management skills are essential for nursing students' success, and development of clinical competence. The purpose of this study was to determine the relationship between time management skills and anxiety and academic motivation of nursing students in Tehran medical sciences universities in 2015. METHODS: This cross-sectional study was carried out on 441 nursing students in three medical universities in Tehran. Random stratified sampling was done to select the samples. Data were collected using demographic Questionnaire, Time Management Questionnaire (TMQ), Spielberger State-Trait Anxiety Inventory (STAI) and Academic Motivation Scale (AMS), which was completed t by self-report. Data were analyzed using SPSS 18 software with descriptive and analytical statistics such as ANOVA, independent t-test, Regression and Pearson Correlation Coefficient. RESULTS: Most participants had a moderate level of time Management skills (49%), State Anxiety (58%), Trait Anxiety (60%) and Academic Motivation (58%). The results also showed a statistically significant negative correlation between the students' TMQ scores and the state anxiety (r= -0.282, p< 0.001) and trait anxiety scores (r= -0.325, p<0.001). Moreover, there was a statistically significant positive correlation between the students' TMQ scores and AMS scores (r= 0.279, p< 0.001). CONCLUSION: Regarding the findings, it seems that it is necessary to plan for improving time management skills in order to enhance academic motivation and reduce anxiety rates among nursing students.

Nurses' perspective on spiritual leadership: A qualitative study based on Fry's spiritual leadership model.

BACKGROUND: Spiritual leadership and spirituality in organizations have the capacity to develop individual and organizational outcomes. This concept, as a newly established paradigm, has many ambiguities and definitions highly affected by cultural contexts. OBJECTIVE: This study aimed at determining the concept of spiritual leadership from nurses' perspective and recognizing aspects of spiritual leadership model in the Iranian nurses' sociocultural context, to achieve a common and comprehensive understanding of the concept under study. METHODS: This qualitative study used a directed content analysis method. The participants of this study were 14 managers and nurses employed at different wards of hospitals affiliated to medical universities of Tehran, and were selected using purposive sampling method on the basis of inclusion criteria. The data were collected via individual, deep, and semi-structured interviews from October 2015 to March 2016. RESULTS: In this study, 14 participants were interviewed, 11 females and three males aged between 26 and 52 years old with a mean working experience of 13 years. After data analysis, 33 subcategories were distilled which fell into nine categories and three main categories including "spiritual leadership", "spiritual well-being", and "organizational consequences". The findings indicated that spiritual leadership can, through application of intrinsic motivation, help develop individual and organizational outcomes by the use of elements of extrinsic motivation in organizational learning. CONCLUSION: Nursing managers and nurses expunged upon various dimensions of spiritual leadership. The elements of extrinsic motivation and organizational learning have the potential to develop spiritual leadership. The nursing leaders can use this potential to foster the outcomes of nursing services.

EFFECT OF THERAPEUTIC TOUCH ON PAIN RELATED PARAMETERS IN PATIENTS WITH CANCER: A RANDOMIZED CLINICAL TRIAL.

INTRODUCTION: In patients with cancer, pain may influence their life style, and feeling of satisfaction and comfort, leading to fatigue, and cause impairment of their quality of life, personal relationships, sleep and daily activities. The aim of this study was to evaluate the effect of therapeutic touch (TT) on pain related parameters of in patients with cancer. METHODS: In a randomized clinical trial a total of 90 male patients referring to Specialized Oncology Hospital in Mashhad, were conveniently selected and randomly divided into three intervention, placebo, and control groups. The intervention consisted of TT in 7 sessions for a 4-week period. The data were collected using a demographic questionnaire along with the Brief Pain Inventory, which were then analyzed and compared using Kruskal-Wallis and Mann-Whitney tests. RESULTS: By comparing scores parameters of pain scales (general activity, mood, walking ability, relations with other people and sleep) in the three groups, there was no significant difference at the beginning of the first session. However, a significant difference was observed at the end of TT sessions between the three groups (p= 0.001). Furthermore, the groups were compared two-by-two by using Mann-Whitney test and Bonferroni correction, and the result indicated significant differences between the two intervention and placebo groups as well as between the two intervention and control groups. CONCLUSION: The results of the study showed that TT had a positive impact on the positive management of pain related parameters in cancer patients. Therefore, TT is suggested to be used by healthcare providers as a complementary method for managing pain and its parameters.

Effect of Therapeutic Touch in Patients with Cancer: a Literature Review.

BACKGROUND: The use of complementary and alternative medicine (CAM) techniques has been growing. The National Center for Complementary and Alternative Medicine places therapeutic touch (TT) into the category of bio field energy. This literature review is aimed at critically evaluating the data from clinical trials examining the clinical efficacy of therapeutic touch as a supportive care modality in adult patients with cancer. METHODS: Electronic databases (PubMed, Scopus, Scholar Google, and Science Direct) were searched from the year 1990 to 2015 to locate potentially relevant peer-reviewed articles using the key words therapeutic touch, touch therapy, neoplasm, cancer, and CAM. Additionally, relevant journals and references of all the located articles were manually searched for other potentially relevant studies. RESULTS: The number of 334 articles was found on the basis of the key words, of which 17 articles related to the clinical trial were examined in accordance with the objectives of the study. A total of 6 articles were in the final dataset in which several examples of the positive effects of healing touch on pain, nausea, anxiety and fatigue, and life quality and also on biochemical parameters were observed. CONCLUSION: Based on the results of this study, an affirmation can be made regarding the use of TT, as a non-invasive intervention for improving the health status in patients with cancer. Moreover, therapeutic touch was proved to be a useful strategy for adult patients with cancer.

Development and validation of a theory-based multimedia application for educating Persian patients on hemodialysis.

Although patients on hemodialysis require effective education for self-care, several issues associated with the process raise barriers that make learning difficult. Computer-based education can reduce these problems and improve the quality of education. This study aims to develop and validate a theory-based multimedia application to educate Persian patients on hemodialysis. The study consisted of five phases: (1) content development, (2) prototype development 1, (3) evaluation by users, (4) evaluation by a multidisciplinary group of experts, and (5) prototype development 2. Data were collected through interviews and literature review with open-ended questions and two survey forms that consisted of a five-level scale. In the Results section, patient needs on hemodialysis self-care and related content were categorized into seven sections, including kidney function and failure, hemodialysis, vascular access, nutrition, medication, physical activity, and living with hemodialysis. The application designed includes seven modules consisting of user-controlled small multimedia units. During navigation through this application, the users were provided step-by-step information on self-care. Favorable scores were obtained from evaluations by users and experts. The researchers concluded that this application can facilitate hemodialysis education and learning process for the patients by focusing on their self-care needs using the multimedia design principles.

The effect of Creating Opportunities for Parent Empowerment program on maternal stress, anxiety, and participation in NICU wards in Iran.

BACKGROUND: The purpose of this study was to perform the Creating Opportunities for Parent Empowerment (COPE) program for Iranian mothers and evaluate its effectiveness on stress, anxiety, and participation of mothers who have premature infants hospitalized in neonatal intensive care units (NICUs). MATERIALS AND METHODS: A randomized clinical trial was conducted with 90 mothers of premature infants hospitalized in the educational neonatal NICUs of state hospitals affiliated to Isfahan University of Medical Sciences. For measuring the variables, State-Trait Anxiety Inventory, the Parental Stressor Scale: Neonatal Intensive Care, and The Index of Parental Participation/Hospitalized Infant were used. Intervention group received two phases of COPE program. This program consisted of information and behavioral activities about the characteristics of premature infants. Sessions' interval was from 2 to 4 days. Stress and anxiety were measured three times (before each phase and 2-4 days after the second phase). Mothers' participation was evaluated 2-4 days after the second phase. The t-test, χ(2), Mann-Whitney U test, and repeated measurement test were used for data analysis. RESULTS: Mothers in the intervention group reported significantly less anxiety and less stress in the NICU after performing each phase of the COPE program (P < 0.001), whereas at this time, the level of stress in the comparison group increased. Also, COPE mothers participated in their infants' care rather than the mothers in the comparison group (P < 0.001). CONCLUSION: COPE program was effective for Iranian mothers. This study shows that irrespective of any culture, giving early and comprehensible educational-behavioral information may have positive effect on maternal psychological condition and maternal-infant interaction.

Quality of life in ostomy patients: a qualitative study.

PURPOSE: Therapeutic procedures may not only treat disease but also affect patient quality of life. Therefore, quality of life should be measured in order to assess the impact of disease and therapeutic procedures. To identify clients' problems, it is necessary to assess several dimensions of quality of life, including physical, spiritual, economic, and social aspects. In this regard, we conducted a qualitative study to explore quality of life and its dimensions in ostomy patients referred to the Iranian Ostomy Association. METHODS: Fourteen patients were interviewed about their quality of life dimensions by purposeful sampling. Data were gathered by semistructured interviews and analyzed using the content analysis method. RESULTS: Nine main themes emerged using this approach, including physical problems related to colostomy, impact of colostomy on psychological functioning, social and family relationships, travel, nutrition, physical activity, and sexual function, as well as religious and economic issues. CONCLUSION: The findings of the study identified a number of challenges in quality of life for patients with ostomy. The results can be used by health care providers to create a supportive environment that promotes better quality of life for their ostomy patients.