فصلنامه مدیریت پرستاری
سال یازدهم شماره 2 (پیاپی 40، تابستان 1401)

Clinical decision making is one of the most important processes which nurses always use to care for patients. Appropriate decisions help to improve the quality of care, reduce the duration of illness and disability, reduce costs and make optimal use of resources. Therefore, the purpose of this research was to review studies conducted in the field of clinical decision making of Iranian nurses and its related factors.

The present study was a systematic review conducted in 2021. In this research, articles published in databases of Magiran, Iran doc, SID, Science Direct, Pub med, Scopus, web of science, and Google Scholar in both Persian and English without any time limit were examined. For this purpose, the keywords “clinical decision making” and “nurse” in Persian sources and “clinical decision making”, “nurse”, “Iran” and their MeSH equivalents in English articles were applied using OR and AND operators. Conducting research in Iran was the most important inclusion criterion. Accordingly, out of a total of 144 articles related to clinical decision making of nurses in Iran, 49 ones remained after applying the inclusion and exclusion criteria, and by eliminating duplicate cases, 21 articles were finally included in the study. STROBE tool was used to evaluate the quality of articles.

Out of 144 initial articles, 21 studies were analyzed. The results of the analysis of 21 articles showed that nurses' participation in clinical decision making was moderate and their decision making was intuitive analytical. Nurses with older ages, more work experiences and employed formally and contractually had better clinical decision making. There was also a statistically significant positive association between clinical decision making and the variables of self-efficacy, the thinking style and emotional intelligence.

In order to improve the quality of nursing, health system officials should pay attention to the employment and arrangement of nurses, their type of decision making, state of emotional intelligence, self-efficacy and style of thinking. In addition, nursing managers should employ nurses with older ages, and more work experiences, as well as formally employed ones for wards and posts which require more and better clinical decision making

Today, human resources are one of the most important and guiding elements in organizations. Based on mutual learning, by balancing the two types of exploratory learning and for-profit learning, a kind of balance in the acquisition and use of new knowledge and the preservation and utilization of existing knowledge is emphasized.

This research was based on quantitative studies in two stages and through three questionnaires by survey method with the participation of 288 people among managers, deputies and selected staff of the central headquarters of the Social Security Organization. To review the data, an architectural questionnaire, human resource functions were provided to selected managers, deputies and employees. Data from quantitative studies (questionnaire) were used through inferential analysis and using confirmatory factor analysis test by modeling analysis by Eviews software.

Organizational human resource management is vital to enjoy reciprocity (mutual exploitation). The fact that an organization has a knowledge-based human resource structure, by itself can not turn an organization into a mutually successful organization in both profitability and exploration. Because if the organization focuses on profitability, it is the reciprocal orientation of some human resource management measures to determine how it is compatible with the dimensions of human resources functions and ultimately mutual learning (exploration and profitability) of the organization.

The designed model and formulated hypotheses, while filling the theoretical gaps in these three research areas, also provide the basis for further research by researchers in the future.

Improving the quality of providing health services on the one hand requires the participation and inter-professional cooperation of the care and medical team, and on the other hand, empathy of the care and medical team is considered essential to the provision of quality care. But participation in care and medical team always faces challenges which it has become a serious challenge in the Covid-19 pandemic.
Goal: In this regard, the aim of this study was evaluation of effectiveness educational based on inter-professional approach on rate of empathy and inter-professional collaboration among nurses and physicians in emergency department during the Covid-19 pandemic.

The cross-sectional research was applied research and research method was quasi experimental with pretest-posttest design and control group. The statistical population of the study consisted of nurses and physicians of Bahman hospital's emergency department with at least 5 years of work experience. That 40 of them were selected by available method and randomly assigned to experimental and control groups (20 in each group). Then, two separate two-day workshops with the same conditions were held for the experimental and control groups, so that the experimental group was given inter-professional training and the control group was given single-professional training. The tool used was readiness for inter-professional learning scale (Parsell & Bligh, 1999) and scale of physician empathy-health professionals (Jefferson et al, 1987). Data were analyzed by ANCOVA in SPSS, Version 26. 

The Findings showed that as compared to the nurses and physicians who did not receive this program, nurses and physicians that received this program by using the inter-professional education had a significant impact leading to an increase in the empathy and inter-professional collaboration of the nurses and physicians in emergency department (FEmpathy =20. 846, FInter-professional collaboration =27.184; P<0.0001). The effect of using the inter-professional education on empathy and inter-professional collaboration was 36 and 43 percent.

Therefore, the results showed that inter-professional education lead to significant increase in empathy and inter-professional collaboration among nurses and physicians in emergency department during the Covid-19 pandemic.

According to the obtained results, improving the quality of providing health services in emergency department during the Covid-19 pandemic depends on increasing their level of empathy and inter-professional collaboration among nurses and physicians that can be achieved through inter-professional education.

During the corona pandemic, nurses endured a lot of stress and tension due to direct exposure to the threats caused by this virus. This research was carried out with the aim of determining the relationship between corona stress and anxiety with psychological well-being considering the mediating role of corona burnout in nurses.

The research method was correlation in the framework of structural equation modeling and the statistical population of the study was all the nurses from two hospitals in Isfahan city. From them 234 nurses were selected in an convenience sampling method. To measure the variables, the corona stress questionnaire, the corona anxiety questionnaire, the psychological wellbeing questionnaire and the corona burnout questionnaire  was used. Data were analyzed using Pearson’s correlation and structural equation modeling by SPSS version 26 and AMOS version 21 software.

The results indicated that there is a positive and significant relationship between corona stress and anxiety with corona burnout and a negative and significant relationship with psychological well-being (p<0.01). The results of structural equation modeling and bootstrap analysis showed that corona burnout is a complete mediating variable in the relationship between corona stress and distress with psychological well-being in nurses (p<0.05).

The results of this research revealed that the corona stress and anxiety weakens the health and psychological well-being of nurses by causing burnout. Therefore, it is necessary to help nurses to maintain their health and well-being by training stress coping strategies and anxiety management.

Marital conflict affects the mental, physical and family health of nurses. Therefore, the present study aimed to investigate the role of alexithymia, cognitive flexibility and fear of intimacy in predicting marital conflict in nurses

The present study is descriptive-correlational. The statistical population of the present study was all nurses working in the hospitals of Karaj city in 2021, which were selected by the Convenience sampling method from shahidrajaee, Imam ali and Takhtjamshid hospitals 240 people. The Psychological Flexibility Inventory (CFI), the Toronto Emotional Dysfunction Scale (TAS) and the Intimacy Fear Scale (FIS) were used to collect data. The collected data were analyzed using Pearson correlation coefficient and multivariate regression analysis in SPSS-24 software.

The results showed that there is a negative and significant relationship between problem solving processing (r = 0.732 and P = 0.001) and control perception (r = -0.616 and P = 0.001) with marital conflict. Between difficulty in identifying emotions (r = 0.593 and P = 0.001), difficulty in describing emotions (r = 0.724 and P = 0.001), objective thinking (r = 0.441 and P = 0.001) and fear of intimacy (r = 0.544 and P = 0.001) have a positive and significant relationship with marital conflict. Also, the results of multiple regression analysis revealed that 68.7% of the variance of marital conflict is explained by alexithymia, cognitive flexibility and fear of intimacy.

According to the results, to reduce nurses' marital conflict, programs can be designed to increase their cognitive flexibility and reduce alexithymia and fear of their intimacy, and implemented through online or offline workshops.

The increasing threat of the Covid-19 disease and public health emergencies around the world have led to the exacerbation of various psychological problems in vulnerable groups, including patients with diabetes; Therefore, the present study was conducted with the aim of investigating the role of psychological flexibility, difficulty in emotion regulation and intolerance of uncertainty in predicting psychological distress and obsessive - compulsive in patients with type 2 diabetes during the covid-19 epidemic.

The method of this research is descriptive-correlation. The statistical population of this research included all patients with diabetes referred to the health centers of Kermanshah city in 1401. For this purpose, 220 of these people were selected by available sampling method and answered psychological flexibility questionnaire, emotion regulation difficulty scale, intolerance of uncertainty scale, Kessler's Psychological Distress Questionnaire Moudsley Obsessive Compulsive Inventory. After collecting the questionnaires, the collected data were analyzed using Pearson's correlation coefficient and multiple regression analysis simultaneously.

The results showed that there is a significant relationship between psychological flexibility, difficulty in emotional regulation and intolerance of uncertainty with psychological distress and obsessive - compulsive in patients with type 2 diabetes (p<0.01). The results of multiple regression analysis also revealed that 76.2% of the variance of psychological distress and 77.5% of the variance of obsessive-compulsive is explained by psychological flexibility, difficulty in regulating emotions and intolerance of uncertainty. 

According to the results, it is possible to use interventions based on psychological flexibility in the treatment of ACT, emotion regulation training and the ability to intolerance of uncertainty to reduce the psychological distress and obsessive problems of patients with type 2 diabetes.

Social citizenship behavior is one of the organization's intangible assets and includes a set of informal voluntary social behaviors that cover a wide range of social behaviors. Its mismanagement can have adverse effects on the performance of the organization and its members. The general purpose of the present study is to construct and validate the scale of social citizenship behavior that provides the implementation and operation of this tool in field studies.

The present study is applied-exploratory in terms of purpose and descriptive survey in terms of method. To conduct research, the contents and topics of social citizenship behavior were examined using the factor analysis technique and content analysis method of scientific texts, as well as the opinions of qualified thinkers and experts, and a researcher-made questionnaire of social citizenship behavior was obtained to obtain validity and reliability. Completed by experts and managers. The reliability coefficient of the test was calculated to be 0.838 using Cronbach's alpha test.

Exploratory factor analysis of social citizenship behavior items showed that about 76.654% of the desired variance can be explained by the components of this questionnaire. After one rotation of Varimax-type factors, the correlation between each item with each component was determined in the best case. Accordingly, eleven components with the highest weight were selected and extracted: Sense of social belonging, social identity, sense of social justice, participation, sense of social effectiveness, core value, sense of social security, collective affection, social cohesion, social resilience, and altruism.

According to the research findings, it can be concluded that social citizenship behavior is a multifaceted concept with many dimensions and components and cannot be studied with limited dimensions and components.

Introuduction: 

Organizational citizenship behaviors are extra-role behaviors that improve the effectiveness of the organization.The aim of this study was to investigate the effect of abusive supervision on nurses' organizational citizenship behaviors with the mediating role of emotional exhaustion, in Khorramabad Shohadaye Ashayer Hospital.

The present study is a descriptive research in the field of field studies in terms of applied purpose and in terms of data collection, the method of which was survey. The statistical population of the study was 230 nurses working in Khorramabad Shohadaye Ashayer Hospital. Based on Krejcie and Morgan table, a sample size of 140 people was selected by stratified random sampling method. To measure the variables of the research, a questionnaire was used which included three sections of abusive supervision, emotional exhaustion and organizational citizenship behaviours. The reliability of the questionnaire was confirmed using Cronbach's alpha method and its validity was confirmed using convergent validity. For data analysis, structural equation modeling and Spss and PLS software have been used.

The results show that at the 95% confidence level, abusive supervision has a negative and significant effect on nurses' organizational citizenship behaviours and emotional exhaustion has a mediating role in relation to abusive supervision and nurses' organizational citizenship behaviours.

According to the findings, it can be said that abusive supervision directly disrupts the supervisor-nurse relationship, which leads to an increase in nurses' emotional exhaustion and a decrease in the level of organizational citizenship behaviors.

Risk management is a useful tool for improving the quality of therapeutic services in hospitals. The aim of present study was to determine psychometric features of hospital risk management questionnaire.

In present descriptive-analytic study, 112 nurses working in educating hospitals of Ilam city were chosen by random sampling(2016 Des till 2017Mar). For data gathering, the 45-item hospital risk management questionnaire was used. The reliability and validity were measured by Cronbach alpha coefficient and exploratory factor analysis respectively. The scree plot was applied for determining the number of factors. Adequate number of samples for factor analysis was determined by Kaiser-Meyer-Olkin index and Bartlet test( P Value <0.001) we use the SPSS V19 Software.

Factor analysis revealed that the questionnaire comprised of 7 independent factors including the first (variance of 51.443), the second (variance of 8.926), the third factor (variance of 6.452), the fourth factor (variance of 3.999), the fifth factor (variance of 3.124), the sixth factor (variance of 2.840), and the seventh factor (variance of 2.459). The alpha Cronbach coefficient was acquired 0.809% for the dimensions. The KMO index of 0.76 ( P Value <0.001indicated adequate number of the sample.

From nurses’ perspective, the hospital risk management questionnaire can be recruited as a reliable and valid tool and can be considered as a practical guideline for measuring and assessing risk management.

The growing trend of obesity is a major concern for the World Health Organization, and in addition to causing physical problems, it is usually associated with some behavioral and psychological problems, including psychological areas related to sexual behavior; so, the aim of this study was to evaluate the effectiveness of Mindfulness-Based Cognitive Therapy on Body Image and Sexual Function of Women with Obesity.

This research was semi-experimental (pre-test-post-test with a control group and a one-month follow-up). The statistical population included all obese women in Isfahan city in 2019. Using available sampling method, 30 obese women were selected and randomly assigned to two experimental and control groups (15 people in each group). The experimental group received a course of cognitive therapy based on mindfulness in 8 sessions of 90 minutes, while the control group did not receive any special training. Subjects of both groups were measured in the pre-test and post-test with Fisher's body image and female sexual Function questionnaires by Rosen et al. Data analysis was done using mixed analysis of variance and Benferroni post hoc test using SPSS-22 software.

There was a significant difference between the mean post-test scores of the intervention group and the control group, so that cognitive therapy based on mindfulness significantly improved the body image and sexual performance of obese women in the intervention group (P<0.05). Also, this difference has been maintained in the one-month follow-up phase.

Based on the results of the present study, it can be said that cognitive therapy based on mindfulness can be used as a suitable treatment method to improve the body image and sexual performance of obese women in counseling centers and psychological services.

Health is an essential part of human capabilities, which is needed for progress, and for this purpose, different countries are using their health systems to provide health and respond to people's expectations in all fields related to the provision of health and medical services. Health policy is considered as one of the dimensions of social policy that governments pay attention to in order to achieve social justice. This article, while paying attention to the goals of the second step of the Islamic revolution in relation to the realization of social justice, the role of the principle of sustainability in health policy-making has been examined through the evaluation of the experience of the health transformation plan.

This study was conducted with a qualitative approach. The data has been collected through interviews with policy makers, review of policy documents and analysis of other countries' experiences, and has been analyzed using the framework analysis method.

In the aspect of health financing, paying attention to the balance of resources and costs is considered as a vital factor in achieving sustainability, the consequences of which will be justice in the distribution of resources among health service providers and creating justice in people's access and benefit from health and treatment services. Based on this, sustainability in health policy is considered as a driving force to achieve the goals of the second step of the Islamic Revolution in the dimension of social justice.

In order to realize all-round justice in the second step of the Islamic revolution and considering that sustainability is considered as one of the prerequisites and infrastructure for the realization of social justice, governments are obliged to design, formulate and implement health policies in a way that ensures sustainability in the health system. become a country.