RESUMO
BACKGROUND: Nurses in their workplace, for a variety of reasons, always face moral distress that is an underlying issue in the nursing profession, which can lead to problems such as reduced quality and quantity of care and sleep disorder. Besides, given the increased privatization of hospitals, this study aimed to explore the association between nurses' moral distress and sleep quality and its comparison among nurses in private and public hospitals. MATERIALS AND METHODS: This was a descriptive-analytical study involving 150 nurses working in Ilam Province hospitals. Sampling conducted using a multistage random sampling method. Data were collected through the questionnaire of sociodemographic characteristics, the Corley's Moral Distress Scale, and the Pittsburgh Sleep Quality Index. Data were analyzed using SPSS software version 22. Descriptive statistics such as frequency, mean, ANOVA, independent t-test, multiple linear regression, and Pearson correlation coefficient at the significant level of P < 0.05 were calculated. RESULTS: The analysis revealed that moral distress was positively associated with sleep quality. Furthermore, the scores of nurses' moral distress and sleep quality were different in private and public hospitals, so that the level of moral distress in the public hospital and sleep quality in the private hospital was higher and lower, respectively, but the difference was not statistically significant. Moreover, sleep quality, and the type of employment was the most important predicting variables of moral stress (B = 1.86) and sleep quality (B = 2.39), respectively. CONCLUSION: According to the study results, a positive and significant association was found between moral distress and nurses' sleep quality. It is recommended that appropriate strategies and training program be formulated by the health-care system to increase nurses' ability to combat moral distress adverse effects.
RESUMO
BACKGROUND: The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate. OBJECTIVES: This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students. DESIGN: This study used an experimental three-group pre- and post-test design. SETTINGS: The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran. PARTICIPANTS: A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34). METHODS: To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL). RESULTS: Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006). CONCLUSIONS: Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.