The design and psychometric evaluation of a COVID-19 social stigma questionnaire in nurses.

BACKGROUND: The patient's fear of social reactions, the disease stigma, and being a transmission agent is a psychological and social consequence of contracting some diseases, especially infectious ones, in any society. The present study aimed to design and psychometrically evaluate a COVID-19 social stigma questionnaire in nurses. METHODS: This mixed-method study was conducted using a sequential exploratory approach according to the Creswell method in Mazandaran Province (Iran) during 2021-22. The study was performed in three phases: (1) a qualitative phase to explain the key concept, (2) designing the scale items, and (3) an experimental phase with the scale psychometric evaluation. In the first phase, nurses' experiences regarding the concept of COVID-19 social stigma were evaluated using a qualitative method with an inductive qualitative content analysis approach. In this phase, the lived experiences of 12 nurses working at hospitals of Babol University of Medical Sciences were extracted through in-depth interviews with semi-structured questions and analyzed by conventional content analysis. The main classes are contradictory feelings, rejection, and adaptation strategies. In the second phase, the designed items were validated by determining face validity, content validity, and construct validity using exploratory factor analysis (EFA). In addition, the scale's reliability was determined through internal consistency and stability. RESULTS: Following the study's first phase, a pool of questions with 64 initial items was formed. After evaluating face and content validity, the number of items was reduced to 24 cases. An excellent total content validity (S-CVI/Ave) of 0.93 was calculated for the scale. According to EFA outputs, three factors accounted for the most variance (52.82%), and four items were excluded in this phase. The Kaiser-Meyer-Olkin (KMO) statistic and Bartlett's test of sphericity were calculated at 0.776 and P < 0.001, respectively. The results of Cronbach's alpha (0.796) and intraclass correlation (0.793) indicated the correlation and internal consistency of the scale. CONCLUSION: This scale can help healthcare managers and policymakers apply necessary protective measures by evaluating the social stigma of COVID-19 in nurses and emerging infectious diseases that may occur in the future.

Nurses' experiences of the social stigma caused by the COVID-19 pandemic: a qualitative study.

Background: One of the psychological issues that health personnel face when treating COVID-19 patients is the societal stigma. This issue has not been addressed due to the disease's devastating impact on numerous sectors of society. This study aimed to evaluate nurses' experiences of social stigma caused by the COVID-19 pandemic with a qualitative approach. Methods: Inductive qualitative content analysis was used to conduct this qualitative research. COVID ward nurses who had been subjected to social stigma were chosen as the study sample. Data were collected through semi-structured and individual interviews and were concurrently analysed using the conventional content analysis approach recommended by Graneheim and Lundman. Results: There are three categories and six sub-categories of social stigma experienced by nurses: (1) paradoxical emotions (psychological stress and positive attitude), (2) abandonment (all-round rejection and isolation) and (3) coping strategies (self-awareness over time and the influential role of the media). Conclusions: The findings of this study can help healthcare managers to improve the quality of care by enhancing understanding of the psychological needs arising from social stigma. Based on these findings, designing psychosocial interventions related to stigma can promote the mental health of this group and their families.

The effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality in pregnant women: a randomized controlled trial.

Sleep disorder is very common during pregnancy. Non-pharmacological treatments are a priority to improve the sleep pattern. This study aimed to determine the effect of cognitive-behavioral counseling with or without Citrus aurantium essential oil on sleep quality (primary outcome) and anxiety and quality of life (secondary outcomes). This randomized controlled trial was performed on 75 pregnant women in Tabriz, Iran. Participants were randomly assigned to the intervention and control groups. The first intervention group received 8 sessions of cognitive-behavioral counseling and aromatherapy with Citrus aurantium essential oil 15-20 min before bedtime. The second intervention group received cognitive-behavioral counseling and aromatherapy with placebo and the control group received only routine prenatal care. Pittsburgh Sleep Quality Index, Pregnancy-Specific Quality of life Questionnaire, and Pregnancy-Specific Anxiety Scale were completed before and after intervention. After the intervention based on ANCOVA test and by adjusting the baseline score, the mean score of anxiety in the intervention group 1 (AMD: - 4.54; 95% CI - 6.79 to - 2.28) and intervention group 2 (AMD: - 3.30; 95% CI - 5.60 to - 0.97) was significantly lower than the control group. Also, the mean score of quality of life in intervention group 1 (AMD: 2.55; 95% CI 0.45-4.65) and intervention group 2 (AMD: 2.72; 95% CI 0.60-4.83) was significantly higher than the control group, but there was no statistically significant difference between the study groups in terms of sleep quality (P > 0.05). Also, there was no statistically significant difference between the two intervention groups after the intervention in terms of anxiety (P = 0.379) and quality of life (P = 0.996). Cognitive-behavioral counseling reduced anxiety and improved quality of life. However, further trials are required to reach a definitive conclusion. Iranian Registry of Clinical Trials (IRCT): IRCT20120718010324N63. Date of registration: 4/10/2020. URL: https://en.irct.ir/user/trial/54986/view; Date of first registration: 18/10/2020.

Coping strategies and depression during the COVID-19 pandemic in pregnant women: a cross sectional study.

BACKGROUND: Pregnant women are vulnerable to psychological problems depending on the adaptive capacities of their personality and coping strategies. This study aimed to investigate the association between coping strategies of pregnant women during the COVID-19 pandemic and depression. METHODS: This web-based cross-sectional study was conducted in 2021 on 318 pregnant women in Amol, Iran. Data collection was performed via questionnaires (Brief cope, Edinburgh Postnatal Depression Scale, CDA, and Demographic questionnaire). The questionnaires were completed through the WhatsApp and Telegram applications. Data were analyzed using the hierarchical regression analysis and SPSS software (v. 21) at the significance level of 0.05. RESULTS: About 40% of participants had depression. The most prevalent coping strategy used by pregnant women was the avoidance strategy. Hierarchical regression revealed that the coping strategy of avoidance was a significant predictor of depression (ß = 0.226, p = 0.046) after controlling background characteristics. CONCLUSIONS: The findings of this study suggest that avoidance style associated with depression in pregnant women. Therefore, obtaining further knowledge about impacts of coping strategies on pregnant women seems to be essential.

Nurses' experiences of the causes of their lack of interest in working in psychiatric wards: a qualitative study.

BACKGROUND: The shortage of psychiatric nurses is a major healthcare challenge. Lack of interest (LOI) contributes to the shortage of psychiatric nurses. Nonetheless, there are limited studies in this area. The present study was conducted to explore nurses' experiences of the causes of their LOI in working in psychiatric wards. METHODS: This qualitative study was conducted in 2016-2019 using the content analysis approach. Participants were 27 nurses purposively recruited with maximum variation from the psychiatric wards of three referral hospitals in Iran. Data were collected via unstructured interviews and were concurrently analyzed using the conventional content analysis approach recommended by Graneheim and Lundman. RESULTS: The causes of participants' LOI in working in psychiatric wards were grouped into three main categories, namely inadequate professional skills for psychiatric care practice, negative public attitude towards psychiatric nurses, and concerns over patients. CONCLUSION: This study suggests that the causes of nurses' LOI in working in psychiatric wards are not only personal, but also social and organizational. Findings help managers and authorities develop strategies to increase psychiatric nurses' interest in working in psychiatric wards through improving their work conditions and professional knowledge and skills.

Experiences of Nursing Students in the Care for Patients Diagnosed With COVID-19: A Qualitative Study.

The present study examined the experiences of nursing students in the care of patients diagnosed with coronavirus disease 2019 (COVID-19). This qualitative study was performed based on inductive qualitative content analysis in 2020. The samples were 10 nursing students who were selected purposively from the emergency and intensive care unit wards of hospitals affiliated with Mazandaran University of Medical Sciences in Iran. Data were collected through semistructured and individual interviews and analyzed simultaneously and continuously by Granheim and Landman inductive qualitative content analysis. Experiences of nursing students in the care for patients with COVID-19 include 3 main categories and 7 subcategories: (a) psychological stress (fear of ward and patients and mental conflict), (b) social isolation (rejection by the family and friends, isolation, and concealment of the workplace), and (c) coping strategies as an adaption strategy (a positive impact of spirituality and an effective role of increasing information). According to the findings of this study, the education system and university administrators can help reduce psychological stress and improve the quality of care in nursing students.

The Iranian Psychiatric Nurses' Perception of Transition in Psychiatric Wards: A Qualitative Study.

BACKGROUND: Transition means moving from one period to another and it is usually associated with significant changes in objectives, roles, and responsibilities. Considering the challenges of the psychiatric ward, psychiatric nurses experience numerous problems, especially at the early stages of their job engagement. This study aimed to examine the perception of the Iranian psychiatric nurses in psychiatric wards and their transition period. MATERIALS AND METHODS: The study was designed as a qualitative content analysis study in three referral hospitals in Mazandaran and Tehran, Iran 2016. Participants included 18 nurses who had experienced transition at the psychiatric ward and had at least 3 months job experience in three referral hospitals of Iran and were selected purposefully. Data were collected using unstructured interviews and analyzed using the inductive approach and conventional content analysis. To ensure the trustworthiness of the data, Guba and Lincoln's criteria were used. RESULTS: The major themes of transition among the nurses of psychiatric wards included "inadequate preparation," "mental stress," "self-awareness and capabilities," and "the effective role of nurses' full support in adjustment." CONCLUSIONS: The findings revealed that nurses did not have a decent transition. In this regard, educational systems must provide training courses to prepare nurses to support them in their arrival stage and to facilitate their transition. The findings of this study can help mentally prepare nurses for their preparation to perform their role and improve the quality of care.