Prevalence of Psychological Disorders among Health Workers During the COVID-19 Pandemic: A Systematic Review and Meta-Analysis.

Background: Repeated contact with patients with COVID-19 and working in quarantine conditions has made health workers vulnerable to psychological distress during the COVID-19 pandemic. The goal of the present systematic review and meta-analysis was to examine the prevalence of the various psychological distresses among health workers during the COVID-19 pandemic. Methods: PubMed, Scopus, Web of Science, EMBASE, and Cochrane databases were searched for access to papers examining psychological distress among healthcare workers during the COVID-19 pandemic. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). Heterogeneity among the studies was examined using the Cochran's Q test; because heterogeneity was significant, the random effects model was used to examine the prevalence of psychological distress. Results: Overall, 12 studies with a total sample size of 5265 were eligible and included in the analysis. Prevalence rates of depression, anxiety, and PTSD were 20% (95% CI: 14-27), 23% (95% CI: 18-27), and 8% (95% CI: 6-9), respectively. The highest prevalence rates of depression and anxiety were related to the SDS and the GAD-7, respectively, and the lowest prevalence rates of the two aforementioned variables were related to the DASS-21. Conclusions: The high prevalence of psychological distress among healthcare workers during the COVID-19 epidemic can have negative effects on their health and the quality of services provided. Therefore, training coping strategies for psychological distress in this pandemic seems necessary.

Development and validation of the Domestic Violence during Quarantine Scale (DVQS).

Background: Domestic violence is a common health problem that often affects women's mental health. Although domestic violence may not be reported during quarantine, it may increase due to increased restrictions. Therefore, the goal of the present study was to develop and validate the Domestic Violence during Quarantine Scale (DVQS) on a sample from Iran. Methods: Two hundred and three Iranians participated in this study and completed online questionnaires. This cross-sectional and methodological study consisted of two phases. In the first phase, item pool generation and questionnaire design was carried out through literature review. In the second phase, psychometric properties were assessed via an exploratory factors analysis (EFA). Internal consistency was examined by Cronbach's alpha coefficient and McDonalds' Omega. Results: In the EFA, three factors, including humiliation (seven items), threatening (six items), and restriction (four items) were extracted that together explained 64.4% of the variance of domestic violence during quarantine. Using Cronbach's alpha coefficient, the internal consistency of humiliation, threatening, and restriction was found to be 0.90, 0.896, and 0.76 respectively, and an alpha of 0.927 was found for the total scale. In addition, using McDonalds' Omega, internal consistencies of 0.82, 0.84, and 0.78 were found for the three factors respectively. Conclusion: The DVQS has good validity and reliability; therefore, it can be used in future studies.

Investigating the relationship between workplace stressors and caring behaviours of nursing staff in inpatient wards: A cross-sectional study.

AIM: The present study aimed to investigate the effects of various job stressors on caring behaviours of nursing staff. DESIGN: A cross-sectional nationwide study. METHODS: This cross-sectional, descriptive-correlational study was conducted on 260 nurses employed in the inpatient wards of seven teaching hospitals in Tehran, Iran during December 2019-February 2020. The participants were selected via convenience sampling. Data were collected using a demographic questionnaire, the nursing stress scale and the caring behaviours inventory. Data analysis was performed in SPSS version 20 using descriptive statistics and linear regression analysis. RESULTS: The results of regression analysis indicated that job stress is correlated with nurses' caring behaviours (ß = -.36; p = .001). Factors such as workload (ß = -.27; p = .001), uncertainty about patient treatment (ß = -.26; p = .017) and lack of emotional preparation (ß = -.20; p = .017) were the important stressors associated with nurses' caring behaviours. CONCLUSIONS: According to the results, high levels of perceived job stress due to workload, uncertainty about patient treatment and lack of emotional preparation are associated with lower levels of nurses' caring behaviours. IMPACTS: The findings of this study showed that to provide patients with optimal caring behaviours, hospital and nursing managers should design interventions to reduce nurses' job stressors, especially in terms of their interactions with their colleagues and physicians.

Frequency and determinants of domestic violence against Iranian women during the COVID-19 pandemic: a national cross-sectional survey.

INTRODUCTION: Domestic violence (social, legal, and health violence) is the most common type of violence against women. Due to factors such as the current quarantine, this type of violence has increased during the COVID-19 pandemic. The present study aimed to assess the frequency of domestic violence against women and identify the risk factor among Iranian women during the COVID-19 pandemic. METHODS: This online cross-sectional study was conducted on 203 Iranian women during May-June 2020. Data were collected using a domestic violence questionnaire, which measured three forms of violence, including physical, emotional, and sexual violence. A link of the questionnaire was distributed among anonymous subjects through social networking apps, such as WhatsApp and Telegram. The subjects were asked to complete the questionnaire based on their experiences during the COVID-19 pandemic. Data analysis was performed using descriptive statistics and a regression model. RESULTS: The descriptive results showed that the mean domestic violence against women in all the participants was 34.9 (SD: 17.28). In addition, 26.6% (n = 84), 26.1% (n = 53), and 21.2% of the subjects (n = 43) experienced high levels of physical, emotional, and sexual violence during the COVID-19 pandemic, respectively. The regression model also indicated that lower age, illiteracy/primary education, previous marriage(s), and unwanted/unwise marriage were the significant risk factors for domestic violence against women. CONCLUSION: According to the results, domestic violence against women is common among Iranian women during the COVID-19 pandemic. Therefore, strategies are urgently needed to prevent and minimize such domestic violence, and such strategies could be adopted through providing educational opportunities, raising awareness, promoting wanted/wise marriage, and providing social support and rehabilitation opportunities to vulnerable social groups, especially vulnerable women.

Does heavy mental workload affect moral sensitivity among critical care unit nursing professionals? a cross-sectional study.

BACKGROUND: Moral sensitivity creates the basic attitude in providing effective ethical care to patients. Heavy mental workload is a major concern of critical care nursing professionals, which could adversely affect nursing staff and patients. The present study aimed to investigate the effects of mental workload and some demographic variables on the moral sensitivity of critical care nursing professionals. METHODS: This cross-sectional, descriptive-correlational study was performed on 181 nursing professionals working in the critical care units of Shahid Rajaei Cardiovascular Medical and Research Center in Tehran, Iran. Data were collected using a demographic questionnaire, the moral sensitivity questionnaire, and the NASA-task load index to assess mental workload. Data analysis was performed in SPSS version 22 using descriptive statistics, independent t-test, Pearson's correlation-coefficient, and regression analysis. RESULTS: The results of regression analysis yielded no statistical significant relationship between heavy mental workload and moral sensitivity of the critical care nursing professionals, while clinical experience had a positive, significant association with moral sensitivity. CONCLUSIONS: Although care nursing professionals experience a heavy mental workload in critical care units, it does not decrease their moral sensitivity. In addition, experienced nurses have higher moral sensitivity and lower mental workload. Therefore, it seems that nursing managers should pay special attention to the importance of employing experienced nurses along with younger nurses.

Relationship between quality of work-life, resilience and burnout among nursing professionals during COVID-19 pandemic in Iran: A cross-sectional study.

Background: The COVID-19 pandemic and the increased workload and stress associated with the disease prevalence have posed a high risk of burnout to nurses. The effects of the workplace and environmental factors on resilience and burnout among nursing professionals have not been investigated in Iran. Objective: Present study aimed to assess a model linking quality of work-life to the resilience and various dimensions of burnout among Iranian nursing professionals based on the health service workplace environmental resilience model. Methods: This was a cross-sectional study performed on 202 Iranian nurses employed in three educational hospitals. Maslach burnout inventory, Brooks' quality of nursing work-life survey, and an abbreviated version of the Connor-Davidson resilience scale were used to collect data. The correlation between the study variables was assessed by conducting path analysis in AMOS 22. Results: The final model demonstrated adequate fit. The quality of working life indirectly affected burnout via a direct impact on nursing professionals' resilience (p <0.001, ß = 0.39). In addition, resilience had negative, significant effects on all the dimensions of job burnout. The quality of work-life also had negative and significant effects on emotional exhaustion (p <0.001, ß = -0.38) and reduced personal accomplishment (p <0.001, ß = - 0.38). Conclusion: Resilience and quality of work-life are protective variables against burnout in nursing professionals. Nursing managers can increase resilience and decrease burnout among nursing professionals by adopting policies that can improve the quality of work life.

Investigating the relationship between organizational justice, job satisfaction, and intention to leave the nursing profession: A cross-sectional study.

AIMS: This study aims to test a hypothetical model linking various dimensions of organizational justice to the job satisfaction and nurses' intention to leave the profession based on the theoretical assumptions of the Alexander model of voluntary turnover. DESIGN: A cross-sectional survey. METHODS: This study was conducted on 317 inpatient ward nurses of six teaching hospitals in Tehran, Iran during 1 September 2017-14 November 2018. Clinical nurses were recruited by a multistage random sampling. Data were collected using structured questionnaires of organizational justice, job satisfaction, and nurses' intention to leave. Data were analysed by structural equation modelling using Amos 22 statistical program. RESULTS: The structural equation model demonstrated adequate fit and the hypothesized correlations were partially supported. The findings suggested that the distributive justice (p < .001; ß = 0.24) and interactional justice (p < .001; ß = 0.44) could indirectly affect the nurses' intention to leave the nursing profession via the direct impact on job satisfaction, while job satisfaction had a significant, negative effect on the nurses' intention to leave (p < .001; ß = -0.71). CONCLUSIONS: According to the results, the model fit was acceptable, suggesting the validity of the final model. Furthermore, distributive and interactional justice could reduce the intention to leave the nursing profession by influencing the job satisfaction of the clinical nurses. IMPACT: This was one of the first studies to determine the aspects of justice that must be further emphasized by healthcare managers to increase the job satisfaction of nurses and their retention in healthcare systems. The findings indicated that fair interactions have a greater impact on job satisfaction and retention of nurses than procedural and distributive justice. The results of this study provide valuable references for nursing managers to increase the job satisfaction of nurses and their retention in healthcare settings.

Exploring fair decision-making rules in nursing: A qualitative study.

BACKGROUND: The decision-making process should be done according to a set of rules and principles so as to be fairly understood. OBJECTIVES: The aim of this study was to identify the basic principles and rules used by nurses to understand justice in nurse managers' decision-making processes based on a procedural justice model. Research design and participants: This research was a qualitative study based on directed content analysis, which was performed on a group of 15 nurses working in different hospitals in Tehran, Iran. An in-depth semi-structured interview was used as the method of data collection for this study. Ethical consideration: This research has been approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences. The respondents were informed about the aim of the study, about voluntary participation, anonymity and confidentiality. FINDINGS: The results of this study showed that in order to understand procedural justice, nurses use several rules, including: duties organization, managerial support, consistency, bias-suppression, accuracy, correctability, representativeness, and ethicality. CONCLUSION: Nursing leaders must consider the importance of justice rules as one of many strategies to ensure the nurses' perception of fairness in decision-making processes.