Spiritual well-being and moral distress among Iranian nurses.

BACKGROUND: Moral distress is increasingly recognized as a problem affecting healthcare professionals, especially nurses. If not addressed, it may create job dissatisfaction, withdrawal from the moral dimensions of patient care, or even encourage one to leave the profession. Spiritual well-being is a concept which is considered when dealing with problems and stress relating to a variety of issues. OBJECTIVE: This research aimed to examine the relationship between spiritual well-being and moral distress among a sample of Iranian nurses and also to study the determinant factors of moral distress and spiritual well-being in nurses. RESEARCH DESIGN: A cross-sectional, correlational design was employed to collect data from 193 nurses using the Spiritual Well-Being Scale and the Moral Distress Scale-Revised. ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: Mean scores of spiritual well-being and moral distress were 94.73 ± 15.89 and 109.56 ± 58.70, respectively. There was no significant correlation between spiritual well-being and moral distress (r = -.053, p = .462). Marital status and job satisfaction were found to be independent predictors of spiritual well-being. However, gender and educational levels were found to be independent predictors for moral distress. Age, working in rotation shifts, and a tendency to leave the current job also became significant after adjusting other factors for moral distress. DISCUSSION AND CONCLUSION: This study could not support the relationship between spiritual well-being and moral distress. However, the results showed that moral distress is related to many elements including individual ideals and differences as well as organizational factors. Informing nurses about moral distress and its consequences, establishing periodic consultations, and making some organizational arrangement may play an important role in the identification and management of moral distress and spiritual well-being.

Psychometric evaluation of the Moral Distress Scale-Revised among Iranian Nurses.

BACKGROUND: Experiencing moral distress is traumatic for nurses. Ignoring moral distress can lead to job dissatisfaction, improper handling in the care of patients, or even leaving the job. Thus, it is crucial to use valid and reliable instruments to measure moral distress. OBJECTIVE: The purpose of this study was to determine the reliability and the validity of the Persian version of the Moral Distress Scale-Revised among a sample of Iranian nurses. RESEARCH DESIGN: In this methodological study, 310 nurses were recruited from all hospitals affiliated with the Qazvin University of Medical Sciences from February 2014 to April 2015. Data were collected using a demographic questionnaire and the Moral Distress Scale-Revised. The construct validity of the Moral Distress Scale-Revised was evaluated using principal component analysis and confirmatory factor analysis. Internal consistency reliability was assessed with Cronbach's alpha. ETHICAL CONSIDERATIONS: This study was approved by the Regional Committee of Medical Research Ethics. The ethical principles of voluntary participation, anonymity, and confidentiality were considered. FINDINGS: The construct validity of the scale showed four factors with eigenvalues greater than one. The model had a good fit (χ2(162) = 307.561, χ2/df = 1.899, goodness-of-fit index = .904, comparative fit index = .927, incremental fit index = .929, and root mean square error of approximation (90% confidence interval) = .049 (.040-.057)) with all factor loadings greater than .5 and statistically significant. Cronbach's alpha coefficients were .853, .686, .685, and .711for the four factors. Moreover, the model structure was invariant across different income groups. DISCUSSION AND CONCLUSION: The Persian version of the Moral Distress Scale-Revised demonstrated suitable validity and reliability among nurses. The factor analysis also revealed that the Moral Distress Scale-Revised has a multidimensional structure. Regarding the proper psychometric characteristics, the validated scale can be used to further research about moral distress in this population.

Exploring the Relationship Between Spiritual Well-Being and Death Anxiety in Survivors of Acute Myocardial Infarction: Moderating Role of Sex, Marital Status and Social Support.

Previous empirical studies have shown that both spiritual well-being (SWB) and death anxiety (DA) significantly affect the mental health of patients with acute diseases. In this regard, our paper contributes to the extant literature by scrutinizing the conditional relationship between SWB and DA as well as the various mechanisms underpinning such a relationship in patients with acute myocardial infraction (AMI). A descriptive, correlational methodology was utilized. Our main sample consisted of 300 patients with acute myocardial infraction who were hospitalized in a specialized medical institution in Iran throughout a two-month period (i.e. August-October 2015). Patients completed Spiritual Well-Being Scale (SWBS) and Templer's Death Anxiety Scale (TDAS). Even though our study showed that the relationship between SWB and DA in patients with AMI is non-significant, we found that (1) single patients with higher SWB have lower DA, (2) single patients with higher SWB as well as social support have significantly lower DA, and (3) for single men/men without social support, there is a negative relationship between SWB and DA. The relationship between SWB and DA is influenced by factors such as sex, marital status and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences. Result revealed that although relationship between SWB and DA is non-significant, this is influenced by factors such as sex and social support. In addition, the specific nature of this relationship (i.e. strength and sign) is dependent upon the sociodemographic characteristics of patients as well as other contextual influences.

Factors that promote and impede other-sex friendships: a qualitative study of Iranian adolescent girls.

AIM: The aim of this study was to identify factors that promote and impede other-sex (OS) friendships in adolescent girls. METHODS: A qualitative study conducted with 20 adolescent girls recruited in public places in Tehran, Iran. Information was collected through semi-structured interviews and coded via the conventional qualitative content analysis approach. RESULTS: Four factors were identified that appeared to promote entry into OS friendships. These factors include (a) a poor understanding of perceived risks, (b) weak religious beliefs, (c) processes of identity formation, and (d) low self-esteem. In addition, six factors appeared to impede entry into these friendships: (a) self-confidence, (b) prioritizing education, (c) maintaining particular entertainment preferences, (d) awareness of prior unpleasant experiences with boys, (e) having strong religious convictions, and (f) shaming from significant others. CONCLUSION: These findings provide unique insights into the factors that stem from different levels of social complexity, which affect participation in a fundamental form of human experience.

Male Iranian adolescent's reasons for having an other-gender friend.

AIM: The aim of this study was to identify the primary reasons why male Iranian adolescents enter into other-gender friendships. METHODS: A qualitative study was conducted with a sample of 21 male adolescents recruited in public places in Tehran, Iran. Information about each boy's experiences with other-gender friends was collected via semi-structured interviews whose contents were analyzed with a conventional qualitative content analysis approach. RESULTS: Five reasons were identified for engaging in other-gender friendships: (a) for the purpose of entertainment, (b) financial benefits, (c) increased popularity with peers, (d) sensation seeking and (e) sexual experiences. CONCLUSION: This study revealed that adolescent males do not follow appropriate goals for communicating with the other-gender. In many cases, these goals could endanger their own health and the health of their other-gender friends. Future researchers must focus on identifying and understanding the factors that influence an adolescent to enter into an other-gender friendship.