marzieh adel mehraban

Health workers during the COVID-19 pandemic had high responsibilities of prevention and treatment, which can cause anxiety in them considering the negative effects of the pandemic on mental health. This study aims to investigate the COVID-19-related anxiety level and its relationship with job burnout in health workers from Bushehr province, southern Iran.

This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022. Participants were 365 health workers from health centers affiliated to Bushehr University of Medical Sciences, who were selected by census method. The data was collected using a sociodemographic form, the Maslach Burnout Inventory, and the corona virus anxiety scale. SPSS software, version 16 was used for data analysis.

Of 365 health workers, 308 completed the questionnaires. The majority of thm were female (69.5%) and married (85.7%). Their mean age and work experience were 37.8 and 13.9 years, respectively. The anxiety in most health workers (70.8%) was mild (Mean: 12.58 ±10.81). The findings also showed that 31.8% had moderate to severe emotional exhaustion; depersonalization was mostly low (82.1%), and about half had low personal achievement (49.7%). There was a significant relationship between COVID-19-related anxiety and emotional exhaustion (r=0.667; P<0.001), depersonalization (r=0.472, P<0.001), and personal achievement (r=-0.188, P=0.001). 

There is a significant relationship between anxiety caused by COVID-19 and job burnout in health workers. Although the pandemic did not cause high anxiety among health workers in Bushehr province, it can disrupt their performance. Policymakers in Iran should pay more attention to the negative effects of pandemics on health workers.

One of the reasons for leaving the job among nurses can be the lack of career adaptability, which refers to ability to cope with changes in working conditions. This study aims to determine the relationship between career adaptability and the intention to stay in job among nurses working in critical care units of teaching hospitals in Tehran, Iran.

This is a descriptive-correlational study with a cross-sectional design that was conducted in 2022-2023 in critical care units of seven hospitals affiliated to Iran University of Medical Sciences. Participants were 220 nurses working in these units with at least 6 months of work experience, who selected by a stratified sampling method from different working shifts. Data collection was done online using a demographic form, the career adapt-abilities scale (with four dimensions of concern, control, curiosity, confidence), and an intention to stay in job questionnaire (with three dimensions of adaptation, sacrifice, communication). Descriptive statistics (Mean±SD, frequency, percentage) were used to describe the data, while Pearson’s correlation test and regression analysis were used to assess the relationships between the study variables.

The mean total score of career adaptability was 2.98±0.98 and the mean total score of intention to stay was 3.02±1. Among the dimensions of career adaptability, the highest average was related to concern (3.05±1.14) and the lowest score was related to curiosity (2.92±1.09). Among the dimensions of intention to stay, the highest score was related to sacrifice (3.06±1.09) and the lowest score was related to adaptability (2.98±1.1). A positive and significant relationship was found between career adaptability and the intention to stay in job (r=0.43, P<0.05). 

Career adaptability, especially its curiosity dimension, has a significant relationship the intention to stay in job among nurses working in critical care units. By addressing different dimensions of career adaptability in nurses, hospital managers can be able to safeguard nurse retention in hospitals and mitigate nurse turnover.

The most important factors for the development of any society are human resources. The intensive care units (ICUs) are the most important departments in the hospitals. Considering the importance of time management for patient care, lack of human resources in this profession, and the fact that nurses spend a lot of time on indirect and non-nursing works, this study aims to investigate the time and type of indirect patient care provided by nurses in the ICU of a hospital in Iran during the COVID-19 pandemic.

This is a descriptive, cross-sectional, and observational study that was conducted for 6 months. Participants were 42 nurses working in the ICU of Hafte Tir Hospital in Rey, Iran who were randomly selected from different shifts. Their activities were observed and their spent time was recorded by the researcher using the stopwatch mobile application. The data collection tool was the Persian version of the International Classification for Nursing Practice (ICNP) checklist with acceptable face and content validity according to opinions of a panel of experts (5 faculty members and 10 nurses). descriptive statistics (frequency, mean, standard deviation, minimum, and maximum) were used for data analysis by SPSS software, version 22. 

Most of nurses (60%) were in the age group of 30-39 years and 72% of them had a work experience of 11-20 years. Most of the nurses were female (85%) and married (80%). In each shift, nurses spent an average time of 247 minutes providing indirect care. The longest time in indirect care was related to writing nursing reports (34.9 ± 10.5 min per shift) and the shortest time were related to removing personal protective equipment (6.11±3.19 min per shift), consulting with a colleague, and wearing personal protective equipment (both with 7±3.55 min per shift).

Although patients need direct care and continuous presence of the nurse more during the COVID-19 pandemic and there are advanced equipment. To provide proper nursing care, it is important to increase the number of nurses and reduce their non-nursing activities.

Background & Aims :

Risk management in academic research, courses, and degrees is crucial in universities. However, there is no evidence for risk management in most aspects of university management. This study was conducted to determine the risk management Evaluation from the Staff's Perspective of Iran University Medical Sciences In 2021.

Materials & Methods:

 This is a descriptive cross-sectional study. The research samples were 224 staff of the Iran University of Medical Sciences selected by the available sampling method. The data collection tool was a risk management questionnaire. Risk management was classified into six dimensions. The first dimension is related to the level of employees' knowledge of risk management. The second dimension of risk management status. The third dimension includes policies and procedures. The fourth dimension is related to training status. The fifth dimension was the position of risk management, and finally, the sixth one was monitoring, analysis, evaluation, and risk control. In total, the questionnaire was examined in 45 questions on a 5-point Likert scale and was classified into three levels: poor (score less than 3), moderate (score 3 to 4), and good (score more than 4). The data were analyzed using SPSS software, version 26. The numerical indices of minimum, maximum, Mean±SD for the quantitative variables of the research were used. Friedman test was used to examine the relationship between domains and independent t-test, and analysis of variance and Pearson correlation coefficient was used to investigate the relationship between individual variables and risk management.

Results:

The results showed that most employees (59.4%) were women and the majority (48.7%) were 45-36 years old. The majority of employees (72.8%) were married. Most of the participants (54.4%) worked in administrative headquarters. More than half of the employees (53.1%) had a university degree at the undergraduate level, and only 12.5% of them had completed risk management courses. The results showed that the total score of risk management was 2.44±0/82. The Friedman test result showed a statistically significant relationship between employees' knowledge of risk management and all areas of risk management (p = 0.00). Statistical tests showed that risk management had a statistically significant relationship with the variables of gender (P = 0.02), risk management (P<0.001), and education (P=0.02). The mean score was higher in men than women, and also in employees who had passed the risk management course was higher than other employees. Two-to-two Tukey comparison also showed that the average score obtained by employees with master's degree education was significantly higher than an associate degree (P=0.03). At other levels, this difference was insignificant.

The results showed that, generally, from the perspective of the Iran University of Medical Sciences staff, risk management at this university is poor. In this regard, the development of educational programs, the adoption of policies and procedures, and the establishment of monitoring programs to implement risk management should be seriously pursued at the university.

Home care service is considered as comprehensive care for children with chronic disease or COVID‑19. This study aimed to investigate the factors affecting the implementation of a home care nursing program for such children in 2019–2020.

A descriptive‑analytical study was conducted with 198 nurses working in pediatric wards of selective hospitals of Isfahan University of Medical Sciences. The data were collected through an author‑administered questionnaire with 44 questions. The questionnaire was designed in two parts. Part one involved gathering the demographic data of the participants. Facilitating and barrier factors of the implementation of the care were prioritized and examined in part two by using the Likert scale in both the individual and the organizational domains. The data were analyzed using the mean frequency and paired t test.

The mean (SD) score of individual and organizational facilitating factors were 65.65 (16.24) and 65.98 (11.29), respectively, and the mean (SD) score of the organizational barriers was 82.04 (14.36), which was significantly higher than the mean score (SD) of the individual barriers of 57.94 (14.82) (t197 = 21.32, p < 0.05). The most important individual facilitating factor (53.82%) was “respectful communication with the family,” and the most important organizational facilitator (80.40%) was “Physicians’ support of the nurses.”

Organizational factors were the most significant barriers. Therefore, the findings of this study will help policymakers in the program implementation.

Blended learning is the thoughtful integration of online and face-to-face learning, which is widely accepted in nursing education.

Despite its importance and complicacy, few studies investigated this issue. This study aimed to extend knowledge regarding factors contributing to effective blended learning in nursing education.

Following the Attride-Stirling content analysis method, we searched PubMed, Elsevier, Emerald, Science Direct, ProQuest, and Springer databases and national databases of SID and MagIran to identify relevant studies using various combinations of online, semi-online, hybrid, and mixed keywords from 2005 to 2018.

Four main themes were identified, content, context, educational activities, and evaluation. Nine identified organizer themes were as follows: Content objectives, flexibility, control and evaluation, technological capabilities, support system, teaching activities, learning activities, performance feedback, and evaluation methods. Finally, 23 basic themes codes were obtained as factors that should be embedded in the online nursing curriculum.

Blended learning is a rational and flexible method to improve the educational performance of nursing students. However, it should be based on need assessment, appropriate planning and execution, and evaluation and feedback.

Despite the importance of integrated education in nursing, limited studies have been conducted to develop appropriate tools to assess its importance in Iran.

The present study aimed to develop a questionnaire and psychometrically assess the importance of integrated education in nursing from the perspective of faculty members.

This is a consecutive exploratory mixed study conducted in two stages. In the first stage, the concept of Intergrated training was explained via qualitative theme analysis and the relevant key themes of the identification articles were coded. Sampling was purposeful and continued until saturation. In the second (quantitative) stage, first the face and content validity was reviewed and the necessary corrections were made by 15 experts. Then, the reliability of the questionnaire was calculated using internal consistency method (Cronbachchr('39')s alpha) and the construct validity of the instrument was calculated using exploratory factor analysis.

203 items were extracted via qualitative content analysis and review of related scientific texts. After performing face and content validity (qualitative and quantitative) 162 items remained. Exploratory factor analysis led to the removal of 50 items and thus 112 items in 4 factors (dimension or scope), including educational content, educational activities, context and conditions. An evaluation was extracted which explained these 4 factors of 87.774 of the total variance. The reliability of the instrument with Cronbachchr('39')s alpha was 0.92.

The questionnaire on the feasibility of the integrated curriculum in the field of nursing with features such as reliability and validity can be easily used by faculty members and policy makers. It is suggested that other psychological features of the instrument such as convergent and divergent validity be examined in future studies

Technology has made the quality of health care evolve, and widely deployed in healthcare service systems, but the entrance of technology to a defective system would intensify the same problems and the stress resulting from its application to users, which is called "Techno-stress".

This study aimed to assess the relationship between Technology Management and Techno-stress level among nurses. Data were analyzed using mean, standard deviation, Pearson and linear regression in SPSS 16.

This survey was conducted to evaluate the frequency, intensity and levels of “Techno-stress and its dimensions” and “Technology Management by Two validated questionnaires.

The mean score of Techno-stress in the studied samples (195 registered nurses) was 51.55 ± 15.607 (highest mean score in the field of feeling pressure and the lowest mean score in the technology involving). In addition, there was a significant correlation Technology Management and the Techno-stress score (r= -0.242, p<0.001). In addition, the highest correlation between the score of the Technology Management and the feeling stress (r= 0.422, p<0.001) Implication.

Nurses experience an overall relative Techno-stress and this related to nursing how managers do about technology. Nursing managers of medical centers need to plan to eliminate the stress caused by the use of technology and better management in order to eliminate and prevent the Techno-stress.

Effective healthcare team among healthcare providers is important to improve the quality of services and to provide safe and effective care. The purpose of this study was to evaluate the of healthcare team work and its related factors in operating room

Methods and Materials:

 The current study is a descriptive-analytic study and the study population consisted of 217 healthcare providers who work in operating rooms of nine educational hospitals in Isfahan, Iran. For gathering data in this study, two assessment tools including a researcher designed questionnaire and a Team Assessment Questionnaire (TAQ) had been used. Finally, healthcare providers were divided into five groups according to the scoring system.

From 217 samples, 132 were female and 85 were male. The mean of age were 34.9 respectively. The mean score of the teamwork in this study was 194.67 ± 2.05; which according to the scoring system of questionnaire it was considered strong for this study.

Healthcare providers in the operating rooms mostly had a strong or relatively strong teamwork score. But the difference between the various groups inside operating room team represents different perception about the healthcare team behaviors. The results of this study also indicated that the advancement of technology, learning new methods and rewards system are factors influencing the teamwork in the operating room

Despite advances in diabetes treatment, the rate of readmission is still relatively high among these patients, especially in older population. Various factors may predict readmission in these patients; hence, the aim of this study was to assess the role of psychosocial factors in predicting readmission among diabetic elderly hospitalized in selected hospitals of Isfahan.
In this cross‑sectional study conducted from January to September 2016, 150 diabetic elderly hospitalized in selected hospitals affiliated with Isfahan University of medical sciences were chosen using a convenient sampling method. The initial information was collected by a three‑part questionnaire consisting of (a) demographic characteristics, (b) 21‑item depression, anxiety, and stress scale (DASS‑21), and (c) multidimensional scale of perceived social support (MSPSS). Further information about readmission was gathered 3 months after completing the questionnaires through a phone call follow‑up. Descriptive and inferential statistics (discriminant function analysis test) were used to analyze the data.
During 3 months after discharge, 44% of hospitalized diabetic elderly were readmitted. Analytical model predicted the readmission status of 109 individuals (of total 150 persons) in the studied units (success rate of 72.2%). Among predicting factors, depression and social support had the most and the least important roles in predicting readmission rate, respectively.
Interventions to improve mental status (i.e., decreasing levels of depression, anxiety, and stress) and develop social support are suggested to reduce the risk of readmission among diabetic elderly patients. Nevertheless, future studies are needed to verify the value of such interventions.

Currently, researchers seek to identify factors related to length of hospital stay in elderly in order to reduce burden on the health system. The importance of either physiological or psychological factors in determining health outcomes has been well stablished; however, the possible contribution of psychosocial factors particularly in elderly patients with diabetes is also of special importance. This study aimed to know what psychosocial variables predicts length of hospital stay in elderly patients with diabetes.
This was a cross-sectional, correlational study conducted on 150 elderly patients from July-October 2015. Convenient sampling method was used to recruit the subjects. The data was collected by a three-part questionnaire consisted of demographic and health related characteristics, 21-item depression anxiety stress scale (DASS-21) and multidimensional scale of perceived social support (MSPSS).
The mean ± standard deviation of length of hospital stay was 15.6 ± 7.7 days. Findings from multiple regression analysis showed that the models of predicting length of hospital stay in subgroups of both women (P = 0.001, F6,77 = 4.45) and men (P = 0.03, F6,71 = 2.43) were significant. The entered variables in subgroups of women and men accounted for 27% and 18% of total variance (R2) of the length of hospital stay, respectively. None of the psychosocial variables in women significantly predicted the lengths of hospital stay. However, one out of three predicting psychosocial variables (i.e. stress) in men significantly predicted the length of hospital stay (β = 0.39, t = 2.1, P = 0.04).
The results emphasized the importance of promoting social support of elderly patients with diabetes, particularly in patients who are women, have higher levels of stress, have higher period of disease and a history of hospitalization in the past 6 months in order to lower length of hospital stay and finally promote health status in elderly patients with diabetes. Further studies regarding the effect of each of these factors on health condition of elderly with diabetes are recommended.

Performance appraisal is an essential component of health care organizations for the improvement in quality of patients’ care. Awareness of managers’ and employees’ perception of performance appraisal can lead to improved performance appraisal quality. The purpose of this study was to compare the perception of performance appraisal among managers and nursing staff of hospitals affiliated to Isfahan University of Medical Sciences, Isfahan, Iran.
This descriptive‑analytical and cross‑sectional study was conducted among 75 managers and 313 nurses in 2014. The participants were selected through a two‑stage quota‑random sampling. Data were collected using two researcher‑made questionnaires (nursing managers and nurses’ questionnaires). Data were analyzed using descriptive and statistical tests using the Software Package for the Social Sciences software.
The mean score of managers’ and nurses’ perception of the current performance appraisal was 56.8 (14.2) and 51.4 (14.5), respectively. A significant difference was observed between managers’ and nurses’ perception of performance appraisal (P = 0.004). The participants’ perception was examined in terms of performance appraisal method, the consequences of performance appraisal, and the necessity of performance appraisal. In general, perception of managers was more positive than employees.
The evaluation of the perception of nurses revealed deficiencies in the process of performance appraisal. Moreover, managers had a more positive perception than employees toward the current pattern of performance appraisal. The results of this study can be effective on the decisions of authorities in this field.

Enabling nursing students in clinical skills such as management is only possible through creating enough opportunities for obtaining and practicing such skills in a clinical environment. Therefore, given the importance of this issue and lack of information and backgrounds on the subject, this study aimed to evaluate management internship of nursing students through both qualitative and quantitative methods. This concurrent mixed methods study was conducted in nursing faculty of Isfahan University of Medical Sciences in 2011 and data were gathered in two phases, qualitative and quantitative. 80 nursing students were selected in the quantitative phase (65 females and 15 males) who completed a management internship evaluation questionnaire whose validity had been verified earlier (r=0.8). At the same time, data about internship procedures were collected for the qualitative phase by interviewing 18 nursing students. Quantitative and qualitative data were analyzed by descriptive methods and qualitative content analysis respectively. Findings of the quantitative phase showed that students became mostly proficient in routine activities such as writing a daily report and delivery and change in wards while had little proficiency in special and non-routine activities such as applying for monthly necessary equipment and participating in staff on-the-job training. In the qualitative phase, 48 conceptual codes were extracted. These experiences were classified into two categories of learning experiences and internship problems. Learning experiences were classified into five subcategories: organization, coordination, control, assessment and planning, and recording and reporting. Internship problems were classified into three subcategories: instructor-related problems, nature of internship training, and the internship environment. The results demonstrated that although students mostly became proficient in routine activities, they had never experienced some of these activities. This study also showed that there are barriers to implementation of such internships in terms of the nature, instructor, and environment which will have impacts on achieving internship objectives.

The medical waste productions increases in the recent decades because of hospitals development, health care equipment's promotion, and applying syringe. These residue's unsuitable waste disposal is the important threat for the environment health. Nurse's Performance in hospitals, which is important in medical waste disposal, is an issue that needs to be investigated. This is a descriptive- applied across correlation study was performed on 320 cases of surgical nursing staff in hospitals in Isfahan in 2012. The data were collected by researcher-made questionnaire. questionnaire which included two parts; the first part contains demographic characters of the cases and the second part contains some questions about waste disposal. Questionnaire’s content and face validity were confirmed by 10 academic members, and reliability were examined in pilot study (chronbach alpha= 0/7). Data were analyzed in SPSS software (16) by using independent t-test, Pearson correlation, one-way ANOVA analysis. The research data showed no significant relation in the different nurse's operation in separating hospital waste (T test p=0.1). Also, there was no significant difference among separating condition in different shifts (ANNOVA p=0/85). In separating hospital waste, the average was 74.04, and variance was 20.39 and in collecting the average was 80.04 and variance was 13.73. The coefficient is showing no significant relation between the age and job records, but the relation between education hours and separation degree was significant. In the controlling part of the supervisor's management on evacuating residues, the scores are 74.4 for separation part, packing (73.2), collecting (78.8), transporting (95) which are showing the upper than average level in all parts. Performance status score of nurses in the separation and collection of relevant test under section there was no significant difference between men and women. Also the separation of state and collect the relevant test between male and female nurses working in different shifts, age and years of work and study, there was no significant association.However, the separation and collection of the hours of training, there was a significant relationship between staff nurses Scores on the regulatory status of Supervisors resolution, packing, collection, transportation represents the average is higher than average (50%) and the shipping was 95. Based on the findings and results of studies on the training of nurses in the management of medical wastes require special training program annually And create a framework that can be used for this training as teamwork, face-to-face, video, announcements, brochures, pamphlets and training groups is in the hospital.

In recent decades, health care systems has greatly influenced by the technology development. The technology is helpful to enhance quality of care, reduce costs and improve patient care if appropriate training be applied for technology users. Technology user’s training has been studied in some quantitative studies; however, a few investigators have studied the challenges which nurses’ experienced in this regard.. This qualitative study conducted to explain how nurses explain and perceive challenges in technology user’s training.. This qualitative study was conducted in 2012 by using the content analysis technique in which data were collected through interview. Twenty-four nurses who were occupied in hospitals affiliated to Isfahan University of Medical Sciences were selected by using purposive sampling and in-deep semi-structured interviews (focus-groups and individual interviews) were done. The content of data was analyzed by the Zhang and Wildmouth’s method.. Initial concepts evolved after content analyzing and five main categories were emerged. Theses categories were “Everything and everyone teach” technology users but there are “No effective training”, “Uninformed resources”, and managers always “Rely on trial and error” and there are some “Learning Barriers”.. The result of this study outlined important concerns of nurses regarding biomedical technology user training, and determined the need for further education to modernized healthcare system for promoting and expanding patient care..

Over the years, the concept technology has modified, especially from the viewpoint of the development of scientific knowledge as well as the philosophical and artistic aspects. However, the concept of technology in nursing are still poorly understood. Only small qualitative studies, especially in Iran, have investigated this phenomenon and they just are about information technology. The aim of this study is to gain a better understanding of the concept of technology in the view of Iranian nurses. This study was qualitative explorative study which was done with a purposeful sampling of 23 nurses (staffs, supervisors and chief nurse managers) working in Isfahan hospitals. Unstructured interviews were including 13 individual interviews and 2 focused‑group interviews. In addition to this, filed notes and memos were used in data collection. After this data transcribing was done and then conventional content analysis was used for data coding and classification. The results showed that there are various definitions for technology among nurses. In the view of nurses, technology means using new equipment, computers, information technology, etc). Data analysis revealed that nurses understand technology up to three main concepts: Change, Equipment and Knowledge. In deep overview on categories, we found that the most important concept about technology in nursing perspective is equipment. Therefore, it is necessary to develop deep understanding about the possible concepts technology among nurses. We suppose that technology concepts must be defined separately in all disciplines.

Working in managerial posts, nurses need to know the management concepts and skills such as changemanagement. This knowledge can improve the quality of patients care. This research was a study on the change conceptby describing the nursing managers'' experiences as an agent for change. It was a qualitative research based on phenomenology. Data were collected from matron nurse managers workingin the hospitals of the Isfahan University of Medical Sciences. Sampling method was purposive and continued untildata saturation. The number of participants was 13. Data were collected by open interviews and the analysis of data wasbased on the Colaizzi''s method. The findings consist of 220 concepts classified in five main concepts including prospect, outcome, variables,stimulator, and acceptation. The findings showed that most nurse managers have some experiences of change state as a change agent.Since hospitals and health centers are in direct contact with people of all social groups and their activities benefit thepublic, nurses should pay more attention to health care development and change.