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November 2017 -
Volume 15, Issue 9

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From the Editor

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Original contribution/Clinical Investigation
Diabetes Mellitus - Knowledge, Management and Complications: Survey report from Faisalabad-Pakistan
Ijaz Anwer, Ahmad Shahzad, Kashmira Nanji, Farah Haider, Muhammad Masood Ahmad

Alanine aminotransferase indicates excess weight and dyslipidemia
Mehmet Rami Helvaci, Orhan Ayyildiz* Mustafa Cem Algin, Yusuf Aydin, Abdulrazak Abyad, Lesley Pocock

Comparative Analysis of Antimicrobial Peptides Gene Expression in Susceptible/Resistant Mice Macrophages to Leishmania major Infection

Hamid Daneshvar, Iraj Sharifi, Alireza Kyhani, Amir Tavakoli Kareshk, Arash Asadi

Does socio-economic status of the patients have effect on clinical outcomes after coronary artery bypass grafting surgery?
Forough Razmjooei, Afshin Mansourian, Saeed Kouhpyma

Comparison of the uterine artery Doppler indices during pregnancy between gestational diabetes and diabetes mellitus and healthy pregnant women
Nazanin Farshchian, Farhad Naleini, Amir Masoud Jaafarnejhad,
Parisa Bahrami Kamangar

Survey single dose Gentamicin in treatment of UTI in children with range of 1 month to 13 years old in Jahrom during 2015
Ehsan Rahmanian, Farideh Mogharab,
Vahid Mogharab

Evaluation of control of bleeding by electro cauterization of bleeding points of amplatz sheath tract after percutaneous nephrolithotomy (PCNL) in Jahrom Peymanieh hospital during year 2015-2016
Ali Reza Yousefi , Reza Inaloo

Comparison of the three-finger tracheal palpation technique with triple ID formula to determine endotracheal tube depth in children 2-8 years in 2016-2017
Anahid Maleki, Alireza Ebrahim Soltani, Alireza Takzare, Ebrahim Espahbodi,
Mehrdad Goodarzi , Roya Noori

Effect of Sevoflurane and Propofol on pulmonary arterial pressure during cardiac catheterization in children with congenital heart diseases
Faranak Behnaz, Mahshid Ghasemi , Gholamreza Mohseni, Azim Zaraki
Population and Community Studies

Prevalence and risk factors of obesity in children aged 2-12 years in the Abu Dhabi Islands
Eideh Al-Shehhi, Hessa Al-Dhefairi, Kholoud Abuasi, Noora Al Ali, Mona Al Tunaiji, Ebtihal Darwish

Study and comparison of psychological disorders in normal students and students with multiple sclerosis in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Comparative study of self-concept, physical self-concept, and time perspective between the students with multiple sclerosis and healthy students in Shahrekord
Neda Ardestani-Samani, Mohammad Rabiei, Mohammad Ghasemi-Pirbalooti, Asghar Bayati, Saeid Heidari-Soureshjani

Relationship between Coping Styles and Religious Orientation with Mental Health in the Students of the Nursing-Midwifery Faculty of Zabol
Nasim Dastras, Mohsen Heidari Mokarrar, Majid Dastras, Shirzad Arianmehr

Tuberculosis in Abadan, Iran (2012-2016): An Epidemiological Study
Ali-Asghar ValiPour, Azimeh Karimyan, Mahmood Banarimehr, Marzieh Ghassemi, Maryam Robeyhavi, Rahil Hojjati,
Parvin Gholizadeh

Family Stability and Conflict of Spiritual Beliefs and Superstitions among Yazdi People in Iran: A Qualitative Study
Zahra Pourmovahed , Seyed Saied Mazloomy Mahmoodabad ; Hassan Zareei Mahmoodabadi ; Hossein Tavangar ; Seyed Mojtaba Yassini Ardekani ; Ali Akbar Vaezi

A comparative study of the self-actualization in psychology and Islam
Simin Afrasibi, Zakieh Fattahi

The effectiveness of cognitive - behavioral therapy in reducing the post-traumatic stress symptoms in male students survivors of earthquake in the central district of Varzeghan
Sakineh Salamat, Dr.Ahad Ahangar, Robab Farajzadeh

Reviews

Effects and mechanisms of medicinal plants on stress hormone (cortisol): A systematic review
Kamal Solati, Saeid Heidari-Soureshjani, Lesley Pocock

Comparing Traditional and medical treatments for constipation : A Review Article
Mohammad Yaqub Rajput

A review of anti-measles and anti-rubella antibodies in 15- 25 year old women in Jahrom City in 2011
Ehsan Rahmania , Farideh Mogharab, Vahid Mogharab

Review of percutaneous nephrolithotomy in children below 12 years old in Jahrom hospital, during 2010-2014
Ali Reza Yousefi , Reza Inaloo

Physical and mental health in Islam
Bahador Mehraki, Abdollah Gholami

International Health Affairs

The Challenges of Implementation of Professional Ethics Standards in Clinical Care from the viewpoint of Nursing Students and Nurses
Saeedeh Elhami, Kambiz Saberi, Maryam Ban, Sajedeh Mousaviasl, Nasim Hatefi Moadab, Marzieh Ghassemi

Cognitive Determinants of Physical Activity Intention among Iranian Nurses: An Application of Integrative Model of Behavior Prediction
Arsalan Ghaderi, Firoozeh Mostafavi, Behzad Mahaki, Abdorrahim Afkhamzadeh,
Yadolah Zarezadeh , Erfan Sadeghi

Effect of resilience-based intervention on occupational stress among nurses
Hossein Jafarizadeh, Ebrahim Zhiyani, Nader Aghakhani, Vahid Alinejad, Yaser Moradi

Education and Training

Calculation of Salaries and Benefits of Faculty Members in the Ministry of Health and Medical Education of Iran
Abdolreza Gilavand

The effect of education on self-care behaviors of gastrointestinal side effects on patients undergoing chemotherapy
Shokoh Varaei, Ehsan Abadi Pishe, Shadan Pedram Razie, Lila Nezam Abadi Farahani

Creating and Validating the Faith Inventory for Students at Islamic Azad University of Ahvaz
Solmaz Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Creating and Validating the Adjustment Inventory for the Students of Islamic Azad University of Ahvaz
Homa Choheili, Reza Pasha, Gholam Hossein Maktabi, Ehsan Moheb

Evaluating the Quality of Educational Services from the Viewpoints of Radiology Students of Ahvaz Jundishapur University of Medical Sciences
Abdolreza Gilavand, Jafar Fatahiasl

An Investigation of Psychosocial aspect of Iranian Nursing Students' Clinical Setting
Mahsa Boozaripour , Zanyar Karimi, Sima Zohari Anbohi, Amir Almasi-Hashiani, Fariba Borhani

Clinical Research and Methods

Comparison of the Antibacterial Effects of Chlorhexidine Mouth washes with Jaftex Mouth wash on Some Common Oral Microorganisms (An in Vitro Study)
Ebrahim Babadi, Zahra Bamzadeh, Fatemeh Babadi

Study of the effect of plasma jet on Fusarium isolates with ability to produce DON toxins
Elham Galin Abbasian, Mansour Bayat, Arash chaichi Nosrati, Seyed Jamal Hashemi, Mahmood Ghoranneviss

The comparison of anti-inflammatory effect in two methods of topical dexamethasone injection and topical application of ginger alcoholic extract after removing mandibular wisdom teeth
Sahar Zandi, Seyyed Muhammadreza Alavi, Kamran Mirzaie, Ramin Seyedian, Narges Aria, Saman Jokar

The effect of curcumin on growth and adherence of major microorganisms causing tooth decay
Leila Helalat, Ahmad Zarejavid, Alireza Ekrami, Mohammd Hosein Haghighizadeh, Mehdi Shiri Nasab


Middle East Quality Improvement Program
(MEQUIP QI&CPD)

Chief Editor -
Abdulrazak Abyad MD, MPH, MBA, AGSF, AFCHSE

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Lesley Pocock
medi+WORLD International
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November 2017 - Volume 15, Issue 9

Effect of resilience-based intervention on occupational stress among nurses


Hossein Jafarizadeh (1)
Ebrahim Zhiyani
(1)
Nader Aghakhani
(2)

Vahid Alinejad
(3)
Yaser Moradi (4)

(1) MSc in nursing, Patient safety research center, Urmia University of Medical Sciences, Urmia, Iran
(2) Ph.D. in nursing, assistant professor, Patient safety research center, Urmia University of Medical Sciences, Urmia, Iran
(3) Department of Biostatistics, Urmia University of Medical Sciences, Urmia, Iran
(4) Ph.D. Student in Nursing, Nursing and Midwifery school, Hamadan University of Medical Sciences, Hamadan, Iran


Corresponding author:

Yaser Moradi
Nursing and Midwifery school,
Hamadan University of Medical Sciences,
Hamadan, Iran

Email:
Yasermoradi1045@yahoo.com

Abstract

Background:
Resilience is one of the most important factors that can affect nurses’ occupational stress. The purpose of this study was to determine the effect of a resilience-based intervention on occupational stress in nurses at Tekab Shohada Hospital in 2016.

Materials & Methods: This research was quasi-experimental and implemented using pre-test/ post-test design. All nurses working in Shohada Hospital in Tekab city (n=60) were the subjects of this study. Firstly, by referring to the hospital, the occupational stress questionnaire was distributed to the study subjects and a pre-test was obtained from them. In the next step, the nurses were trained in 5 sessions of 1 hour, twice a week in groups of 30 people in two shifts of morning and evening at the conference hall of the hospital. After collecting post-test data, data were analyzed using SPSS / 16 software.

Results: There was a significant difference in the level of occupational stress and its components between the pre-test and post-test of the studied subjects after the intervention (P< 0/001).

Conclusion: Holding resilience training courses can help reduce nursing job stress and help to adapt individuals to existing changes.

Key words: Resilience-based Intervention, Occupational stress, Nurse


INTRODUCTION

The phenomenon of occupational stress is one of the major problems that has been encountered by human societies over the last decades and with the gradual shift of societies towards modern life [1]. According to the National Institute of Occupational Safety and Health, a person faces a stressful job when there is no coordination between job needs and his/her abilities, and desires [2]. Job stress is a process that results from a person’s encounter with the organization and the workplace. Occupational stress is of particular concern to people with mental health problems [3, 4]. In 1992, the United Nations recognized occupational stress as the 20th Century disease, and later the World Health Organization declared it to be the most epidemic in the world [5, 6]. The International Labor Organization has estimated labor costs for countries to be 1 to 3.5 percent of GDP due to occupational stress, indicating that this is rising [7]. Also, the American Academy of Family Physicians estimates that about two-thirds of those who have been visited and evaluated at work have symptoms of stress [8], and about 30% of the workforce in developed countries is occupational stressed [9]. Of the various occupational groups, health professionals, especially those working in the hospital environment, experience higher job stress [10]. Among the healthcare professions, nursing is also recognized as one of the high-risk occupations for physical and mental illness [11]. In our country, 80% of healthcare workers are nurses. According to the Nursing Organization, 75 percent of nurses suffer from some degree of stress and physical and mental illness [12, 13]. The National Professional Safety Association in the United States has identified nursing at the top of 43 professions with a high incidence of occupational stress-related diseases and believes nursing is likely to be at the head of tensed healthcare jobs [12]. The nursing profession is inherently tense and tension affects the quality of life and health of nurses, the burden of workload, close relationship with patients, responsibility for their lives and their lives ; technological advancements and increasing care dimensions are directly related to nursing job stress [14]. Long working hours, busy work, shift work, lack of freedom to act in decision-making, lack of support from managers and colleagues are among the factors that cause occupational stress in nurses [12, 15, 16].

Regarding the problems of job stress, recent attention has also been paid to resilience in the nursing profession [17, 18]. In this connection, McGee in the theory of limited scope of resilience in nursing, and a nursing pattern [19] sees resilience as the ability to change disaster and turn it into a growing and forward-looking experience, and in his view, he considers the four infrastructure patterns to be resilient. Each of these patterns plays a role in both empowering and empowering individuals. The four patterns are readiness patterns, relational patterns, situational patterns, and philosophical patterns [19-21].

For resiliency five dimensions proposed by Gitterman include: 1- Integration with the family 2- Consistency with the social environment 3- Consistency with the physical environment 4. Integration with the inner wisdom and 5. Supporting mentality. These dimensions enable individuals to develop appropriate coping skills in challenging situations [22].

In relation to the research background, Kutluturkan and et al, showed a significant negative correlation between resiliency and burnout [23]. In their analysis, Warelow and Edward (2011) stated that nurses should increase their resilience skills in the 21st century in order to cope with their professional problems and mental health [24]. Allister and Kinnon (2013) found that resiliency is one of the important and effective factors in nursing career success and resilient capacity is required for nursing careers’ success [25]. Therefore, based on the importance of the above-mentioned cases, the present study aimed to determine the effect of resilience-based intervention on occupational stress in hospital nurses.

MATERIALS AND METHODS

Study Design and Participants
This research was quasi-experimental and was implemented using pretest-posttest design. All nurses working in Shohada Hospital in Tekab city were the subjects of this study. Sampling was complete and all 60 nurses working in Shohada Hospital in Tekab entered the study. The criteria for entry to studying were having a bachelor’s or master’s degree, a lack of a second job, having constant shifts (in the morning, evening, and evening), did not attend the taught training courses associated with resilience in the past 3 months, and the exclusion criteria were the reluctance to continue in the study, the lack of willingness to complete a questionnaire or an irregular company and absence from more than two sessions of classes. Participation in this study was also voluntary.

Instruments
In this study, the occupational stress questionnaire of the British Occupational Safety and Health Organization was used. The questionnaire was compiled by the British Health and Safety Executive Agency (HSE) and was reviewed by free translation and its validity and reliability. The occupational stress questionnaire is designed to measure work-related stresses and has 35 items with seven subscales of Demands, Control, Managers’ support, Peer support, Relationships, Role, and Change. In this scale, high scores indicate low occupational stress [26]. In this study, Cronbach’s alpha coefficient for the total job stress scale 89.9 and each of dimensions of demand, control, support of authorities, support of colleagues, communication, role and changes 0/77, 0/70, 0/69, 0/77, 0/81, 0/70, 0/72 were obtained respectively.

Procedures
Following the informed consent, patients were assured of the secrecy and confidentiality of their information. Then, occupational stress questionnaire was distributed in the group and a pretest was obtained from them. In the next step, the nurses were trained in 5 sessions of 1 hour, twice a week in groups of 30 people in two shifts of morning and evening at the conference hall of the hospital. The number of meetings held for all nurses was equal. Methods of training in interventional phase included lectures, discussion and participation of nurses in role play, group training and pamphlet presentations.

Ethical Considerations
The present study was approved by the Ethics Committee of Urmia University of Medical Sciences. Informed consent was obtained from all participants. Participants were briefed on the objectives and methods of the study and ensured about the voluntary nature of participation in, and withdrawal from, the study as well as the confidentiality of their data.

Data Analysis
SPSS 16 was utilized to analyze the data. Further to descriptive statistics, first, Kolmogorov-Smirnov test was used to assure the normal distribution of variables (Table 1), and then paired t-test, was utilized to study the mean of scores within groups. Normally distributed data were presented as the mean ± standard deviation (SD). The significance of data was set at a p-value of 0.05.


FINDINGS

28.3% of the study subjects were male and 71.3% female. The mean scores of occupational stress in men and women were 123.29 ± 15.11 and 171.05 ± 19.97 respectively and there was no statistically significant difference in terms of the level of occupational stress between both groups (P=0. 33).

Based on the results of the paired t-test, there was a statistically significant difference in the level of occupational stress and its components between the pre-test and post-test of the studied subjects after the intervention. (Table 2)



DISCUSSION

The results of this study showed that the mean score of occupational stress in the group before and after intervention based on resilience is different. As a result, there is a significant difference in the amount of occupational stress in the two periods before and after the resilience training within the group. The results of this study were consistent with the results of studies by Kutluturkan et al, Warelow et al, McAllister et al and Shakernia et al [21, 23-25, 27]. In his analysis of results, Warelow et al stated that nurses in the 21st Century should increase their resilience skills in order to cope with their professional problems and improve their mental health because resilience and resilient behaviors potentially help people. To overcome negative experiences and turn these experiences into positive experiences [24].

In the present study, there was a significant difference between the mean demands scores of the samples before and after the intervention. Job pressure is desirable for a person who is in balance between the demand to be met and his ability to perform that balance. As economists say, prices fluctuate if demand or supply is not consistent [29].

The results of this study showed that the mean scores of Peer support and authorities are different before and after the intervention based on resilience. In explaining the hypothesis, it should be said that an individual can achieve resilience who is in an amicable environment and does an altruistic affair [28].

The results showed that the mean scores of the control subscale were varied before and after intervention based on resiliency. Having a program and a goal for life can predict the future and determine the path. It also reduces the number of failures due to planning, which as a results of these items, resilience will be increase [28].

The results of this study showed that the mean scores on the subscale of the relationship before and after the intervention based on resilience are different. As a result, there was a significant difference in the rate of communication between the two periods of before and after the resilience training, within the group. Among important factors that cause stress can be cited disturbing relationships between colleagues, distress, insecurity and unhealthy competition [12, 30, 31].

The results showed that the mean scores of the role subscale were varied before and after intervention based on resilience. Therefore there was a significant difference in the rate of role between the two periods of before and after the resilience training within the group. In explaining this hypothesis, life is somewhat boring without coping with difficulties and without the need to develop capabilities. One needs to make maximum use of the situation in which he or she is located, and in this regard, it is necessary to balance his/her abilities and