Development and validation of burnout factors questionnaire in the operating room nurses.

Nurses may experience burnout more than other professions. Occupational burnout is a serious concern considering the importance of nurses' jobs in patient care. This study was carried out with the aim of designing and validating the questionnaire of burnout factors in the operating room nurses. Mixed method study was done in two qualitative and quantitative phases in 2022 on Iranian operating room nurses. In the first stage, the concept of operating room nurses' burnout was explained using interviews and literature review, and items were generated. In the second stage, the face validity, content and construct validity of the questionnaire was examined with 342 operating room nurses, and also the reliability of the questionnaire was tested using internal consistency (Cronbach's alpha) and stability (test-retest). After conducting the interview and literature review, 65 questions were extracted. Based on face validity, 4 items were modified. After content validity, 40 items remained. In construct validity, after exploratory factor analysis, 34 items with 5 dimensions were extracted. These dimensions included Organizational, Individual, Interpersonal, Occupational Nature and Managerial factors. Cronbach's alpha and intra-class correlation coefficient were equal to 0.937 and 0.946, respectively. The designed tool based on understanding the concept of burnout in operating room nurses has appropriate and acceptable validity and reliability. Therefore, it can be used to measure burnout in operating room nurses.

Relationships Between Job Satisfaction of Operating Room Nurses and Hospital's Compliance With Protective Guidelines During the Covid-19 Pandemic: A Cross-Sectional Study, Iran.

PURPOSE: The Covid-19 pandemic is considered the biggest threat to human health in the recent century. During emergency surgeries, the possibility of infection of members of the surgical team with Covid-19 increases due to the direct contact with patients. The present study has been conducted aimed to investigate the relationships between job satisfaction of operating room nurses and the hospital's compliance with protective guidelines (guidance) during Covid-19 pandemic from the perspective of operating room nurses. DESIGN: This was a descriptive and cross-sectional study conducted from September 22, 2020 to April 21, 2021. METHODS: This study was conducted on 926 nurses working in operating rooms in 15 metropolises of Iran. The sampling method in this study was multistage clustering. The questionnaire was sent to the target group through social apps (WhatsApp and Telegram). The collected data were analyzed by SPSS software version 26 using descriptive and analytical statistics. FINDINGS: The mean age and job satisfaction of the participants were 28.81 ± 5.64 years and 51.15 ± 11.45, respectively. Participants (n = 259; 27.97%) reported very good job satisfaction. Also, the mean hospital's compliance with protective guidelines during Covid-19 pandemic from the perspective of operating room nurses was 42.29 ± 7.11. The results of the present study showed a significant relationship between job satisfaction and hospital's compliance with protective guidelines during Covid-19 pandemic (P-value ≤ .001). CONCLUSIONS: Optimization of infrastructure, improvement of management decisions and increasing human resources in a crisis can affect the quality of performance and job satisfaction of operating room nurses. The researchers suggest that health system managers can contribute to the safety and efficiency of the existing human resources by taking measures to increase job satisfaction.

Factors related to good death in the Eastern Mediterranean Region: a systematic review.

Background: Considerations for palliative care and quality of death has significantly increased over the past 10 years in the Eastern Mediterranean Region (EMR). Recent trends in ageing and increasing chronic disease burden have drawn attention to the need to pay attention to the concept of good death and related factors from the perspective of the local population. Aims: To assess the factors related to good death in the EMR. Methods: We searched PubMed, Embase, Scopus, Web of Science, and ProQuest on 22 October 2021 for English language articles, with no time limit, using keywords "quality of death", "good death", "quality of dying", "good dying", "Middle Eastern", and countries in the Region. The quality of articles was evaluated using the Hawker criterion and based on the PRISMA guidelines. From the thematic analysis, the factors influencing good death were extracted. EndNote X8 software was used for data management. Results: The search yielded 55 articles, and 14 were included in the study, with a total of 3589 participants. Factors related to good death were classified into 2 main categories: patient preferences and end-of-life care. The former was divided into 4 groups: symptom management, psychological support, social support, and spiritual care. The second category included 2 subcategories: death control and patient autonomy, and end-of-life care. Conclusion: Although patients' beliefs about good death are personal, unique, and different, perception about good death in the EMR depends on the extent to which patients' preferences are met and end-of-life care is provided. More research on good death is recommended in the context of Islamic countries in EMR, and to empower patients and their families to better manage the dying process and create educational programmes.

Preferred place of death and end-of-life care for adult cancer patients in Iran: A cross-sectional study.

Background: More than 50,000 deaths in terms of cancer occur annually in Iranian hospitals. Determining the preferred place of end-of-life care and death for cancer patients in Iran is a quality marker for good end-of-life care and good death. The purpose of this study was to determine the preferred place of end-of-life care and death in cancer patients. Method: In 2021, the current descriptive cross-sectional investigation was carried out. Using the convenience sample approach, patients were chosen from three Tehran referral hospitals (the capital of Iran). A researcher-made questionnaire with three parts for demographic data, clinical features, and two questions on the choice of the desired location for end-of-life care and the death of cancer patients served as the data collecting instrument. Data were analyzed using SPSS software version 18. The relationship between the two variables preferred place for end-of-life care and death and other variables was investigated using chi-square, Fisher exact test, and multiple logistic regression. Result: The mean age of patients participating in the study was 50.21 ± 13.91. Three hundred ninety (69.6%) of the patients chose home, and 170 (30.4%) patients chose the hospital as the preferred place of end-of-life care. Choosing the home as a preferred place for end-of-life care had a significant relationship with type of care (OR = .613 [95% CI: 0.383-0.982], P = .042), level of education (OR = 2.61 [95% CI: 1.29-5.24], P = 0.007), type of cancer (OR = 1.70 [1.01-2.89], P = .049), and income level (Mediate: (OR: 3.27 (1.49, 7.14), P = .003) and Low: (OR: 3.38 (1.52-7.52), P = .003). Also, 415 (75.2%) patients chose home and 137 (24.8%) patients chose hospital as their preferred place of death. Choosing the home as a preferred place of death had a significant relationship with marriage (OR = 1.62 [95% CI: 1.02-2.57], P = .039) and time to diagnostic disease less than 6 months (OR = 1.62 [95% CI: 0.265-0.765], P = .002). Conclusion: The findings of the current research indicate that the majority of cancer patients selected their homes as the preferred location for end-of-life care and final disposition. Researchers advise paying more attention to patients' wishes near the end of life in light of the findings of the current study. This will be achieved by strengthening the home care system using creating appropriate infrastructure, insurance coverage, designing executive instructions, and integration of palliative care in home care services.

Prevalence and Clinical Characteristics of Low Back Pain among Operating Room Personnel: A Cross-Sectional Study in South of Iran.

Background: Low back pain is one of the most common musculoskeletal disorders and the most common cause of activity restriction in people younger than 45 years. Nurses have a high incidence and prevalence of low back pain in terms of physical and emotional factors among healthcare workers. This study aimed to evaluate the prevalence and clinical characteristics of low back pain. Methods: This cross-sectional study was performed on 385 operating room personnel of the hospitals affiliated with Shiraz (the largest city in southern Iran) University of Medical Sciences. The data were collected via a research-made developed questionnaire. The questionnaire consisted of two parts, including the demographic information and prevalence and dimensions of low back pain. Results: The results showed that the prevalence of low back pain was 74% among operating room personnel. There was a significant relationship among low back pain, education level, and marital status (p < 0.05). Conclusion: Hospital managers should reduce the prevalence of this disorder among operating room staff by teaching preventative patient handling techniques via training courses.

Psychometric Properties of the Persian Version of Palliative Care Outcome Scale (POS) in Adult Patients With Cancer.

Background: Measuring the outcomes of palliative care plays an important role to improve the quality, efficiency, and availability of these services in patients with cancer. Using valid, reliable, and culturally appropriate tools has a considerable role to measure these outcomes. This study aimed to assess the psychometric properties of the translated version of the Palliative care Outcome Scale (POS). Methods: This methodological study was conducted in two outpatient clinics related to Shohada Tajrish and Baqiyatallah hospitals in Tehran in 2019-2020. The translation was done using the Forward-Backward approach after gaining permission from the developer. Face validity was tested with 10 patients with cancer through cognitive interviewing, as well as content validity with four experts. Construct validity was performed by (n = 203) exploratory factor analysis and confirmation (N = 150). To assess the reliability, internal consistency was assessed by using Cronbach's alpha coefficient, and relative stability was assessed using the interclass correlation coefficient (ICC). Furthermore, interpretability and ceiling and floor effects were assessed. Results: A total of 353 patients with cancer under palliative care were included in the study. Then, three psychological (30%), physical (12.25%), and social factors (12.08%) with a cumulative variance of 54.34% were extracted in exploratory factor analysis. Confirmatory factor analysis showed that the model has a good fit of information. Cronbach's alpha coefficient for scale was 0.719. Furthermore, the ICC was 0.812. The scale was interpretable, and ceiling and floor effects were 0%. Conclusion: Persian version of the POS was evaluated as a valid and reliable tool. Therefore, it can be used by the clinician to monitor the consequences of palliative care in Iranian cancer patients.

Psychometric Properties of the "Quality of Life in Life-Threatening Illness-Family Carer Version" (QOLLTI-F) in Persian-Speaking Carers of COVID-19 Patients.

Background: Measuring family caregivers' quality of life plays a significant role in improving the quality, efficiency, development, and provision of efficient services for patients with COVID-19. As a result, evaluating the quality of life requires the use of valid and reliable measures that are culturally appropriate. This study was conducted to determine the psychometric properties of the Persian version of the Quality of Life in Life-Threatening Illness-Family Carer Version (QOLLTI - F) in patients with COVID-19. Methods: This methodological study was carried out in 2021 at Baqiyatallah Hospital in Tehran. After gaining approval from the tool creator, the translation was carried out utilizing the forward-backward approach. Cognitive interviews with 10 family caregivers of COVID-19 patients were used to demonstrate face validity. Moreover, construct validity was identified by performing exploratory factor analysis (EFA) (n = 251), confirmatory factor analysis (CFA) (n = 200), and convergent validation using Zarit Burden Interview (ZBI) questionnaire. For scale reliability, internal consistency and stability were performed using Cronbach's Alpha Coefficient and test-retest, respectively. Results: 451 family caregivers of patients with COVID-19 were enrolled in this study. Three factors with a cumulative variance of 51.85% were extracted during EFA: (1) Caregiver's physical-emotional status, (2) Satisfaction with the situation, and (3) Caregiver's concerns. CFA showed that the model enjoyed a moderate to a good fit of information (RMSEA: 0.087; NFI: 0.98; CFI: 0.91; IFI: 0.91; GFI 0.89; standardized RMR: 0.070). A significant correlation was found between the Persian version of the ZBI and participants' total scores of QOLLTI - F v3 (r = -0.196, P = 0.000). Cronbach's Alpha Coefficient = 0.719 and ICC stability reliability = 0.71 of the questionnaire were confirmed. Conclusion: The Persian version of the QOLLTI - F v3 is a valid and reliable scale that can measure family caregivers' quality of life during a Life-Threatening illness in patients with COVID-19. This instrument may be utilized in clinical trials and research to enhance the quality of life for family carers in Iranian society.

Workplace discrimination and its relationship with organizational commitment among the surgical technologist: A national cross-sectional study in Iran.

Background: Discrimination in healthcare centers can reduce care quality and job satisfaction, weaken the morale of the personnel and increase the cost of health care and finally lead to turnover intention. Discrimination in hospitals can affect the work outcomes and performance indicators of nurses such as their organizational commitment. Due to the vital role of surgical technologists in surgery and justice as the basis of effective performance, as well as the role of organizational commitment in care quality, the present study was conducted aimed to determine the level of workplace discrimination from viewpoint of the surgical technologists and its relationship with the organizational commitment. Methods: This cross-sectional study was conducted on 615 surgical technologists in 8 metropolises of Iran in 2022. The sampling method in this study was multi-stage. The data collection tools included three questionnaires (demographic information, workplace discrimination, and Allen and Meyer's organizational commitment). Data were collected within 2 months and analyzed by SPSS version 22. Descriptive and inferential analyzes including independent t-test and analysis of variance were used for data analysis. p-value ≥ 0.05 was considered significant. Results: The average age of the participants in the study were 29.90 ± 5.83 years with the participation of 464 women. The results of the data analysis showed an inverse and significant correlation between workplace discrimination and organizational commitment (r = -0.149, p-value < 0.001). The mean and standard deviation for workplace discrimination was 108.20 ± 11.53, which is average. Also, the mean and standard deviation for total organizational commitment was 100.56 ± 19.14, which is higher than the average. Conclusion: According to the results of this study, managers need to pay attention to reduce discrimination in the operating room and establish organizational justice, to improve the motivation of surgical technologists and the quality of their performance. It is also suggested that operating room managers and supervisors, by creating a safe, confidential, and fearless environment to encourage the personnel to express what they understand about discriminatory conditions.

Preferred Place of Death in Adult Cancer Patients: A Systematic Review and Meta-Analysis.

Background: Identifying the preferred place of death is a key indicator of the quality of death in cancer patients and one of the most important issues for health service policymakers. This study was done to determine the preferred place of death and the factors affecting it for adult patients with cancer. Methods: In this systematic review and meta-analysis study four online databases (PubMed, Scopus, web of science, ProQuest) were searched by relevant keywords. Quality assessment of papers was conducted using Newcastle-Ottawa (NOS) criterion. Odds ratios, relative risks, and 95% confidence intervals were determined for each of the factors extracted from the investigations. Results: A total of 14,920 participants of 27 studies were included into the meta-analysis. Based on the results, 55% of cancer patients with a confidence interval [95% CI (41-49)] preferred home, 17% of patients with a confidence interval [95% CI (-12%) 23)] preferred hospital and 10% of patients with confidence interval [95% CI (13-18)] preferred hospices as their favored place to die. Effective factors were also reported in the form of demographic characteristics, disease-related factors and psychosocial factors. Conclusions: This study showed that more than half of cancer patients chose home as their preferred place of death. Therefore, guided policies need to ensure that the death of the patients in the preferred place should be considered with priority. Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020218680, identifier: CRD42020218680.

Knowledge about the effects of electrosurgery smoke among operating room nurses during COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: Electrosurgery smoke is the smoke emitted from tissue cauterization when using the electrosurgery device. Accordingly, in this smoke, more than 80 harmful toxins have been discovered. In the current study, we aimed to investigate the level of knowledge reported by the operating room nurses on the effects of electrosurgery smoke during the current COVID-19 pandemic. METHODS: This descriptive, survey-based cross-sectional study was performed on 533 OR nurses in all the referring hospitals of COVID-19 infection. The required information were collected using a questionnaire regarding the knowledge on the side effects of electrosurgery smoke. The obtained data were then analyzed using t-test and ANOVA by SPSS software. RESULTS: Most of the included participants (93.6%) had a low level of awareness and only a small number of them (0.4%) had a good level of knowledge on the effects of electrosurgery smoke. As well, a significant relationship (P˂0.05) was found between the level of knowledge reported by the OR nurses and the type of hospital (educational or private). Most of the studied hospitals used no electrosurgery smoke reduction equipment during electrosurgery. CONCLUSION: The level of knowledge reported by the OR nurses was generally poor. It is recommended that managers and health officials try to increase the level of awareness of OR nurses during the COVID-19 pandemic by providing standard and protective equipment as well as holding some well-organized and related training courses.