Nurses' clinical competency and its correlates: before and during the COVID-19 outbreak.

BACKGROUND: Clinical competency is the ability to integrate knowledge, skills, attitudes and values into a clinical situation and it is very important in nursing education, clinical settings, nursing management, and crises. This study aimed to investigate nurses' professional competence and its correlates before and during the COVID-19 pandemic. METHODS: We conducted this cross-sectional study before and during the COVID-19 outbreak and recruited all nurses working in hospitals affiliated to Rafsanjan University of Medical Sciences, southern Iran, so we included 260 and 246 nurses in the study before and during the COVID-19 epidemic, respectively. Competency Inventory for Registered Nurses (CIRN) was used to collect data. After inputting the data into SPSS24, we analysed them using descriptive statistics, chi-square and multivariate logistic tests. A significant level of 0.05 was considered. RESULTS: The mean clinical competency scores of nurses were 156.97 ± 31.40 and 161.97 ± 31.36 before and during the COVID-19 epidemic, respectively. The total clinical competency score before the COVID-19 epidemic was not significantly different from that during the COVID-19 epidemic. Interpersonal relationships (p = 0.03) and desire for research/critical thinking (p = 0.01) were significantly lower before the COVID-19 outbreak than during the COVID-19 outbreak. Only shift type had an association with clinical competency before the COVID-19 outbreak, while work experience had an association with clinical competency during the COVID-19 epidemic. CONCLUSION: The clinical competency among nurses was moderate before and during the COVID-19 epidemic. Paying attention to the clinical competence of nurses can improve the care conditions of patients, and nursing managers should improve the clinical competence of nurses in different situations and crises. Therefore, we suggest further studies identifying factors improving the professional competency among nurses.

Is nurses' clinical competence associated with their moral identity and injury?

BACKGROUND: The enhancement of nursing care quality is closely related to the clinical competence of nurses, making it a crucial component within health systems. OBJECTIVE: The present study investigated the relationship between nurses' clinical competence, moral identity, and moral injury during the COVID-19 outbreak. RESEARCH DESIGN: This cross-sectional study was carried out among frontline nurses, using the Moral Identity Questionnaire (MIQ), the Moral Injury Symptom Scale-Healthcare Professionals version (MISS-HP), and the Competency Inventory for Registered Nurse (CIRN) as data collection tools. PARTICIPANTS: and research context: The research population for this study consisted of all frontline nurses (n = 251) employed in a hospital in southern Iran. Sampling was conducted between May 1, 2021 and September 30, 2021, during the COVID-19 outbreak. ETHICAL CONSIDERATIONS: The present study received approval from the research ethics committee of Rafsanjan University of Medical Sciences, with project No. 99267 and code of ethics ID No. IR. RUMS.REC.1399.262, dated 15.02.2021. RESULTS: According to the study findings, 42.2% of the nurses demonstrated high clinical competence, while 51.4% exhibited moderate clinical competence. The results indicated a positive correlation between moral identity and clinical competence but a negative correlation between moral injury and clinical competence. Furthermore, the variables of moral identity and moral injury were found to predict 10% of the variance in clinical competence. CONCLUSION: According to the results, moral identity and moral injury had an impact on the clinical competence of nurses. Therefore, implementing a program aimed at enhancing moral identity and providing training strategies to address moral injury during crises like the COVID-19 pandemic can lead to improvements in nurses' clinical competence and the overall quality of care they provide.

Iranian psychosocial status and its determinant factors during the prevalence of COVID-19 disease.

COVID-19 disease has quickly become a major threat and epidemic in the world. Many people are experiencing psychological disorders due to the rapid spread of the COVID-19 disease. The present study aimed to investigate the psychosocial status of the Iranian citizens during the prevalence of COVID-19. One thousand one hundred and sixteen citizens of Rafsanjan city participated in the cross-sectional study from March 15 to 30, 2020. The data were collected using demographic and COVID-19 related-items, and Health General Questionnaire (GHQ -28). The results showed that 35% of the participant had mental health problems. All participants had social functioning disorder, while 22.8% had physical symptoms, 26.8 had anxiety symptoms and sleep disorders. In addition, the risk of psychosocial disorder was higher in females, those who were living in the city, earning less than 1 million, thinking of being at risk for infection with the coronavirus, and those whose most important concern about COVID-19 was death (P < 0.05). The results of the present study showed that all participants had social dysfunction. Therefore, health-care providers are suggested to evaluate the psychosocial consequences routinely, design and implement appropriate interventions to deal with these complications.

Generalized Anxiety Disorder During the COVID-19 Outbreak in Iran: The Role of Social Dysfunction.

ABSTRACT: The COVID-19 epidemic has both physical and psychosocial consequences for the general population. The present study aimed to investigate the relationship between the prevalence of generalized anxiety disorder (GAD) and social dysfunction during the COVID-19 epidemic in Iran. This cross-sectional web-based study was conducted on 1000 Rafsanjani citizens in southeastern Iran. Data were collected by using the Generalized Anxiety Disorder-7 and the General Health Questionnaire from March 15 to March 30, 2020. The prevalence of GAD was 27.8%. The mean score of social functioning was 9.71 ± 2.66, and all participants had social dysfunction. Multivariate logistic regression test showed a significant correlation between anxiety and social functioning (confidence interval [CI], 1.16-1.30; p < 0.001), sex (CI, 1.49-3.04; p < 0.001), and concern about COVID-19 (CI, 1.38-2.73; p < 0.001). The COVID-19 epidemic had negative psychosocial consequences in the general population in Iran.

Psychosocial status during the prevalence of COVID-19 disease: the comparison between healthcare workers and general population.

The prevalence of COVID-19 disease continues to be a significant psychosocial status among health care workers (HCWs) and the general population worldwide. This cross sectional study aimed to compare the psychosocial status between healthcare workers and general population during the prevalence of COVID-19 disease in southeast Iran. Totally 415 health care workers of a medical service center for COVID-19 patients and 1023 people of general population participated in the study. An online socio-demographic characteristics questionnaire, General Health Questionnaire (GHQ -28), and Generalized Anxiety Disorder 7-item (GAD-7) were utilized to evaluate psychosocial status. According to GHQ, the psychological disorders of the HCWs were significantly higher than that of the general population (P < 0.001). According to GAD-7, no significant difference was found between general population and HCWs. Multivariate logistic analysis showed no difference between general population and HCWs in the psychological disorder. Although HCWs suffered from psychological disorders more than general population, nearly one third to half of the participants in both groups had psychosocial disorders.

A preliminary validation of the impact on participation and autonomy questionnaire in an Iranian sample of patients with type 2 diabetes.

BACKGROUND: This study aimed to determine the face, convergent validity, internal consistency, and stability reliability of the impact on participation and autonomy-Persian version (IPA-p) scale for using among Iranian patients with type 2 diabetes. MATERIALS AND METHODS: Trained experts interviewed 227 type 2 diabetes patients who were registered in out-patient Diabetes Clinic of Ali-Ibn Abi-Talib Hospital, (Rafsanjan, Southeast Iran from May 2018 to February 2019) and their relatives to assess the face and convergent validity, internal consistency, and stability reliability of the IPA-p scale. A checklist was used to collect demographic information and also to record expert's̛̛̛̛̛̛ points of view about the scale to assess face validity. Internal consistency was measured using Cronbach's alpha, and stability was assessed using interclass correlation coefficients (ICCs). Test-retest method was used to detect the reliability of the questionnaire. Respondents completed the IPA-p scale on the two occasions with an interval of 30-45 days. RESULTS: In relation to convergent validity, the confirmatory model showed an acceptable fit and the scale had a highly convergent validity. Exploratory factor analysis showed that the IPA-p scale has a ten-factor structure that explained 77.42% of the variance. Cronbach's alpha between the mean IPA-p scores achieved on the two occasions ranged from 0.65 to 0.92. Test-retest ICCs for the ten domains were between 0.64 and 0.81. CONCLUSIONS: The IPA-p questionnaire can be a relatively valid and reliable instrument for assessing self-reported participation among Iranian type 2 diabetes patients. However, some improvement is needed to make it fully suitable for using among Persian-language diabetic patients.

The Relationship Between Nurse's Professional Quality of Life, Mindfulness, and Hardiness: A Cross-Sectional Study During the COVID-19 Outbreak.

Background: In the pandemic of Coronavirus Disease 2019 (COVID-19) disease, various factors, such as workplace factors, and psychological variables, can affect the occupational status of nurses. This study aimed to assess the relationship between nurses' professional quality of life, mindfulness, and hardiness during the outbreak of COVID-19. Methods: This cross-sectional study included 239 nurses from two medical centers in Rafsanjan, Iran. Quota sampling was performed from August to November 2020. A demographic form, the Professional Quality of Life Scale (ProQOL), the Freiburg Mindfulness Questionnaire-Short Form (FMI-SF), and the Occupational Hardiness Questionnaire (OHQ) were used to collect data. Results: The mean age of the participants was 33.20 ± 6.85 years. The majority of the participants were female, married, and employed. Compassion Satisfaction (CS), Secondary Traumatic Stress (STS), and Burnout (BO) were all moderate among nurses. Hardiness was the best predictor of compassion satisfaction. Mindfulness was the best predictor of both secondary traumatic stress and burnout. Psychological hardiness and mindfulness had the greatest impact on nurses' quality of professional life during the COVID-19 pandemic. Conclusion: Caring for COVID-19 patients may lead to BO, CF, and STS; identifying predictors of these can inform the development of interventions to mitigate or minimize BO, CF, and STS in nurses caring for these patients. Furthermore, in order to improve nurses' quality of professional life, psychological hardiness, and mindfulness, necessary psychological programs and interventions should be designed and implemented.

The relationship between frontline nurses' psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease.

AIM: The present study aimed to investigate the association between frontline nurse's psychosocial status, satisfaction with life and resilience during the prevalence of COVID-19 disease. DESIGN: A cross-sectional study. METHODS: 185 frontline nurses taking care of the COVID-19 patients participated in the study from March to April 2020. The data were collected using demographic questionnaire, General Health Questionnaire (GHQ-28), Generalized Anxiety Disorder 7-item (GAD-7), Impact of Event Scale-Revised (IES-R), Satisfaction with Life Scale (SWLS) and Connor-Davidson Resilience Scale (CD-RISC). RESULTS: The results showed that not being at risk of coronavirus infection, poor/no satisfaction with life and non-resilience were significantly associated with higher psychological disorders. The coronavirus disease has significant consequences for the mental health of nurses. The factors affecting the mental health of nurses should be considered to support nurses in crises such as coronavirus. Provision of effective psychological interventions for nurses can be one of the effective solutions.