Job satisfaction and the role of self-esteem and self-efficacy: A cross-sectional study among Iranian nurses.

AIM: This study aims to investigate the relationship between nurses' self-efficacy and self-esteem, and their job satisfaction. DESIGN: A cross-sectional study was conducted. METHODS: Employing a random sampling method that included 234 nurses from three hospitals in Iran enrolled. This study utilized the General Self-Efficacy Questionnaire, Coppersmith Self-Esteem Inventory, and Minnesota Job Satisfaction Questionnaire. Descriptive analysis, independent t-tests, Pearson correlation analyses, and linear regression were employed for data analysis. RESULTS: The mean self-efficacy score for nurses was 26.73 ± 5.62 (out of 40), while self-esteem and job satisfaction scored 37.13 ± 6.87 (out of 50) and 68.27 ± 12.65 (out of 100), respectively. Significant correlations were found between self-efficacy, self-esteem, and job satisfaction. Moreover, self-esteem and the age group >40 years were identified as important predictors of nurses' job satisfaction. This study highlights the influential role of self-esteem in determining nurses' job satisfaction.

The relationship between spirituality and aggression in the workplace during the COVID-19 pandemic: A cross-sectional study among Iranian nurses.

BACKGROUND: Aggression towards nurses in the workplace arises from various reasons, reportedly increasing during the COVID-19 pandemic. Where aggression can be maintained by spiritual well-being, as it is said that spirituality is a coping skill and psychological well-being maintainer-but there is little known, especially during the pandemic. Thus, this study explored the effect of spirituality on aggression among the nurses working in the COVID-19 wards. METHODS: This cross-sectional data from 200 nurses involved in the COVID-19 patient treatment were collected using a random sampling method from four hospitals in East Mazandaran province, Iran. Responses were collected based on socio-demographics, Buss-Perry Aggression Questionnaire, and Paloutzian & Ellison Spiritual Well-being Scale. T-test, ANOVA, Pearson correlation coefficient, and multiple linear regression were applied for data analysis. RESULTS: The mean age of nurses was 31.49±6.88 (range: 21-48) years. Nurses working in the COVID-19 wards have a mean score of spiritual health of 67.21±12.84 (out of 120), whereas 51.77±10.96 (out of 116) was for aggression. The results showed a significant negative weak correlation between aggression and spiritual health (r = -.285, p<0.01). As per regression analysis, spiritual health [ß = -.264], age [ß = -.374], and working experience [ß = 4.156] were the significant factors associated with aggression (p<0.05). CONCLUSIONS: It is evident that nurses who consider spirituality in their life actions are in a state of reduced negative emotions, such as aggression. Thus, policymakers and managers of the healthcare settings are suggested to promote spirituality among the nurses through spiritual care education, providing the ground for promoting spirituality and a positive attitude towards it.

Evaluation of patient satisfaction with nursing services before and after implementation of the Health System Transformation Plan in Iran: A cross-sectional study.

Background and Aims: How healthcare service delivery is achieved after implementing the Health System Transformation Plan (HSTP) is investigated in the present study by assessing the patients' satisfaction with nursing care services compared to before HSTP. Methods: This cross-sectional study was conducted in Iranian hospitals during two periods, that is, before (N = 300) and after (N = 279) HSTP, whereas the Patient Satisfaction Instrument was used to assess the satisfaction with nursing services. Results: About 57.7% and 4.7% of the patients were dissatisfied with nursing care services, whereas 34% and 77.4% for moderate satisfaction, and 8.3% and 17.9% for total satisfaction, before and after HSTP, respectively. The mean score of overall satisfaction was 57.33 (±11.17) and 70.84 (±11.99) before and after HSTP, respectively (p < 0.001), which represents there is an improvement in healthcare services delivery after HSTP. Although none of the sociodemographic factors were significantly associated with satisfaction, higher satisfaction was found among the coronary care unit (CCU) hospitalized patients. Conclusion: The patients' overall satisfaction with nursing care services after HSTP was increased, although higher satisfaction was observed in the patients of special wards such as CCU. Therefore, using more care facilities and equipment and engaging more skilled nursing staff in other wards is highly recommended.

Happiness and Moral Courage Among Iranian Nurses During the COVID-19 Pandemic: The Role of Workplace Social Capital.

Background: COVID-19 has become a major global health problem, and healthcare professionals are facing lot of pressure and stress. Accumulated resources and energy obtained via interpersonal relationships is called social capital, which can reduce the negative effects of pressure and stress related to the workplace by impacting happiness and moral courage. This study explored the effect of workplace social capital on moral courage and happiness in nurses working in the COVID-19 wards. Methods: In this cross-sectional study, using a random sampling method, 169 nurses from three hospitals in East Mazandaran province, Iran, participated who worked in COVID-19 wards. The Onyx and Bullen Social Capital Questionnaire, the Sekerka's Moral Courage Scale, and the Oxford Happiness Inventory were used in this study. Descriptive analysis, Pearson correlation analyses, and stepwise multiple regression were performed for data analysis. Results: The mean age of nurses was 31.38 ± 6.82 years. Socio-demographic factors such as age, gender, educational level, and employment status were significant predictors of workplace social capital. Social capital was positively correlated with moral courage (r = 0.29, p < 0.01) and happiness (r = 0.32, p < 0.01). In addition, social capital explained 6.8 and 8.6% variance in predicting moral courage and happiness, respectively. Conclusions: Workplace social capital is a vital organizational phenomenon affecting nurses' moral courage and happiness, especially during the COVID-19 pandemic. Thus, hospitals should be aware of the importance of social capital; they should ensure that all the practices and policies are in place to develop and increase it.

Total delay and associated factors in pulmonary tuberculosis patients in Golestan province.

BACKGROUND: Delay in diagnosis and treatment of TB is a critical component in TB control program which thereby spreading illness in the community. Sicnce Golestan province has the high risk with high rates of tuberculosis in the country, therefore, the analysis of the factors associated with treatment delay in this province for effective interventions and proper planning is considered necessary. METHODS: 689 patients documents of TB cases in the health department of Golestan University of Medical Sciences in 2016 were enrolled in this survey. The response variable in this study was having the delay or not (via determining the 34 day as cut-off point in the interval between the date of onset of the symptoms and the date of treatment start-up). The data were analyzed using SPSS 24 software and final significant level for multivariate logistic regression model was considered 0.05. RESULTS: Median (mean) treatment delay was calculated 49(77.75) days. In the current study 60.4% of patients had total delay greater than 34 days. In final model variables such as type of PTB (OR=0.645), contact history (patients who had no contact with TB patients (OR=1.441)) and patients who their contact history were unknown (OR=1.654)) had significant relationship with delay in starting treatment after 34 days of onset of symptoms of PTB patients in Golestan (p<0.05). CONCLUSION: It should beam emphasis on increasing the community's awareness of the symptoms of tuberculosis and effective collaboration should be made between the Infectious Disease Control Center and the private and public sectors.

Survival of gastric cancer patients based on pathologic and demographic characteristics in Mazandaran between 2007 and 2013.

AIM: Survey of the survival levels of gastric cancer and its effective causes. BACKGROUND: The survival of gastric cancer because of the advances in this type of cancer cures has been increased during the last decades. METHODS: 643 patients evolved by gastric cancer referred to Imam Khomeini hospital of Sari (2007- 2013) were studied. According to this method, the numbers of 74 patients were neglected because of defective data, and the number of 569 patients went under study. The level of survival was determined by use of Kaplan Meier, so to determine the causes affecting on the patients' survival, the univariate analysis of Log-rank test was used. RESULTS: Regarding the follow up of these patients during 2013 Nov-Dec the one, 2, 3, 4 and 5 years of survival of these patients were estimated equal to 0.77, 0.65, 0.52, 0.44, 0.27 percent and the survival median equal to 19 months, so survival means equal to 24.49 months. Based on the ranked logarithm test and FDR method some variables like stage (p<0.001) Radiotherapy (p<0.005) and undergo Surgery before Adjuvant chemotherapy (p<0.001) were determined as the effective factors on the survival probability. CONCLUSION: The life length of the patients under this article in comparison with developed countries is shallow that might be because of late reference or delayed diagnosis and the shortness of cure facilities. In this way, some materials like soon diagnosis and screen methods could be effective on the increase in patients' survival.

The relationship between Aldosterone level and various LV conditions in patients with End-stage renal disease.

BACKGROUND: Aldosterone has been assumed to be implicated in left ventricular hypertrophy (LVH). Preventing the progression of LVH in the early period of end-stage renal disease (ESRD) can increase patient survival. In this study, therefore, we analyzed the relationship between aldosterone level and LVH in ESRD patients who underwent hemodialysis at Fatemeh Zahra Hospital and Imam Khomeini Hospital in Sari, Iran from 2016 to 2017. METHODS: This research is a case-control study involving 69 patients, divided into the case group (n=52, exhibiting LVH) and the control group (n=17, no ventricular hypertrophy observed in the echocardiography). The relationship between the patients' serum aldosterone levels and LVH was evaluated on the basis of relative wall thickness (RWT). RESULTS: Among the patients, 20.3% had normal cardiac conditions, 53.6% eccentric hypertrophy (EH), 4.3% exhibited concentric remodeling (CR), and 21.7% had concentric hypertrophy (CH). In other words, 24.6% of the patients belonged to the control group, and 75.4% belonged to the case group. The results indicated a significant difference (P=0.006) in average aldosterone levels between the case (165.11±80.8) and control (115.76±72.47) groups and a significant difference in aldosterone levels among the four subgroups (P=0.03), with the levels of the CH group being higher than those of the EH group. CONCLUSION: Based on the results of the study, a significant relationship exists between plasma aldosterone level and LVH in ESRD patients. Serum aldosterone level is therefore a predictor of LVH.

Remote ischemic preconditioning to reduce contrast-induced acute kidney injury in chronic kidney disease: a randomized controlled trial.

BACKGROUND: The impact of contrast-induced acute kidney injury (CI-AKI) on patients with chronic renal disease is well-known. Remote ischemic preconditioning (RIPC) is a non-invasive method that can reduce the risk of CI-AKI, but studies on RIPC have had different results. The aim of the present study was to assess the potential impact of RIPC on CI-AKI. METHODS: In a randomized, double blinded, controlled trial, 132 patients with chronic renal dysfunction (glomerular filtration rate < 60 mL/min/m2) who underwent coronary angiography or angioplasty received adequate hydration. RIPC was performed in 66 patients by applying an upper arm blood pressure cuff. The cuff was inflated four times for 5 min to 50 mmHg above the systolic blood pressure, followed by deflation for 5 min. In the control group, the blood pressure cuff was inflated only to 10 mmHg below the patient's diastolic blood pressure. The primary endpoint was an increase in serum cystatin C ≥ 10% from baseline to 48-72 h after exposure to the contrast. RESULTS: The primary endpoint was achieved in 48 (36.4%) patients (24 in each group). RIPC did not show any significant effect on the occurrence of the primary endpoint (P = 1). In addition, when the results were analyzed based on the Mehran risk score for subgroups of patients, RIPC did not reduce the occurrence of the primary endpoint (P = 0.97). CONCLUSIONS: In patients at moderate-to-high risk of developing CI-AKI when an adequate hydration protocol is performed, RIPC does not have an additive effect to prevent the occurrence of CI-AKI. TRIAL REGISTRATION: The clinical trial was registered on (Identification number IRCT2016050222935N2 , on December 19, 2016 as a retrospective IRCT).

The effects of health promotion model-based educational program on self-care behaviors in patients undergoing coronary artery bypass grafting in Iran.

BACKGROUND AND AIM: Post-operative self-care behaviors, have positive effects on increase in adaptability, and reduce cardiac surgery patients' disability. The present study is carried out aimed at determining the effect of education based on a health promotion model on the patients' self-care behaviors after coronary artery bypass surgery. METHODS: This is a semi-experimental study carried out in Mazandaran (Iran) in 2016. Two hundred and twenty patients who participated in the study were selected using a simple random sampling method from a population of postoperative patients, and divided into control and experimental groups (110 patients in each) using block (AABB) randomization. Self-designed self-care questionnaires based on a health promotion model were distributed among the patients once before and three months after intervention. The data were analyzed by SPSS-22, Chi-Square tests, Mann-Whitney and ANCOVA at the significance level of p<0.05. RESULTS: The average score of total self-care behaviors in cardiac surgery patients was not significant between the two groups before education (p=0.065), but after training, a significant difference was observed between the two groups (p<0.001). The analysis of ANOVA with repeated measure indicated that following the intervention, significant difference was observed between the two groups in terms of improvement of self-care behaviors after excluding the effect of pre-test and controlling demographic and health-related characteristics. CONCLUSIONS: Developing and implementing a training program based on the health promotion model can enhance self-care behaviors and reduce the number of admissions in patients after cardiac surgery.

Health-related variables and predictors of Health-promoting Lifestyle in cardiovascular disease patients.

INTRODUCTION: The principal cause for death in the world is cardiovascular disease. Poor lifestyle is a contributing element in this regard. The objective of this study was to estimate the effects of health-related variables and lifestyle variables on the results of exercise stress tests in patients with cardiovascular disease in Iran. METHODS: The study population in this case-control study was 220 patients who were candidates for exercise stress tests in Mazandaran Province (Iran) in 2015. The patients were divided randomly into two groups based on the results of their exercise stress tests, i.e., positive (110 patients) and negative (110 patients). The data collection tool was a standard questionnaire entitled "Health promotion lifestyle profile-II." The data were analyzed using mean, standard deviation, the chi-squared test, and logistic regression by SPSS version 22 software. RESULTS: The risk of a positive exercise stress test increases with age. The age group above 65 was 1.049 times more at risk of a positive exercise stress test than the age group of less than 45. The people with dyslipidemia had 1.635 times greater risk of positive exercise stress tests than the group without dyslipidemia. In addition, patients with hypertension had 1.579 times greater risk of positive exercise stress tests than the group without hypertension. The lack of individual health responsibility (Odds ratio (OR): 1.622), stress management (OR: 1.592), and physical activity (OR: 1.245) contributed more to positive exercise tests than the other risk factors. CONCLUSION: Educational interventions can improve the responsibility for health, physical activity, and stress management among people with the risk of cardiovascular disease.