Motivation to Care: A Qualitative Study on Iranian Nurses

Psychological distress, work environment quality, and motivation levels among nurses working in Saudi Arabia

Background

A favorable clinical environment and nurse motivation are both essential for achieving high-quality patient outcomes and organizational performance in healthcare systems, which can be highly distressing for nurses. The purpose of this study was thus to determine the associations among and influences of psychological distress, work environment quality, and motivation on one another.

Methods

This was a cross-sectional, descriptive-correlational study conducted with a total sample of 204 nurses in two public tertiary hospitals. We used an online survey to collect nurses' responses, which comprised the Kessler Psychological Distress Scale-6, Brief Nurses' Practice Environment Scale, and Multidimensional Work Motivation Scale. We ran the necessary statistical analyses in SPSS version 28.

Results

We found that nurses' psychological distress, work environment quality, and motivation were moderate. A significant, positive, and moderate relationship existed between psychological distress and work environment quality, while nurses' educational level was statistically different with their motivation level. In the regression, only the nationality, current position, and work environment variables significantly influenced psychological distress. The hospital type also significantly influenced work environment quality. No variable was found to influence nurses' motivation level, though.

Conclusions

We concluded that nurses' work environment quality and motivation are interconnected with the psychological stress they experience at work. Monitoring nurses' work environment quality, motivation levels, and psychological distress is thus vital to ensure better patient care.

Breast cancer screening motivation among women: an application of self-determination theory

BACKGROUND

Breast cancer is a major health concern worldwide, especially in Vietnam. This study aimed to explore women's motivation for and factors related to breast cancer screening.

METHODS

A mixed-methods study was conducted in Danang, Vietnam, using a convergent parallel approach. This study utilized both quantitative and qualitative methods to gather the data. The quantitative approach involved surveys to assess motivation levels and related factors, including demographic information and experience with breast cancer screening. In-depth qualitative interviews were used to gain deeper insights into participants' perspectives and experiences related to breast cancer screening.

RESULTS

The average motivation score for breast cancer screening was moderate (3.55 ± 0.55). Ethnicity, regular health check-ups, family history of breast cancer, receiving information about breast cancer, and women's health issues have direct relationships with breast cancer screening motivation. According to the qualitative data, three categories emerged: intrinsic motivation, external motivation/internalization, and amotivation. The individual, and sociocultural environmental factors impacted screening motivation.

CONCLUSIONS

This study highlights the motivations behind breast cancer screening among women. Healthcare providers could use these findings to improve screening policies and guidelines and encourage more women to undergo regular screening, ultimately reducing the incidence of breast cancer in the community.

Patient satisfaction with nursing care in infertility patients: A questionnaire survey

Infertility remains a persistent global reproductive health challenge, with causative factors encompassing abnormalities in both the male and female reproductive systems. Typically, female partners seek initial consultations for infertility concerns, often within the context of routine annual well-woman check-ups. Nurses providing preventive care play a crucial role, conducting initial diagnostic assessments, and addressing certain causes of infertility. Patient satisfaction serves as a vital indicator of care quality. Identifying factors contributing to patient satisfaction with nursing services is crucial, yet research in this area has been limited. This study aimed to compare infertility patients' assessments of nurse quality and satisfaction with hospital services. The findings could offer valuable insights for healthcare providers, hospitals, and policymakers, guiding improvements in nursing care delivery and enhancing patient satisfaction in China's infertility treatment sector. By understanding patients' perspectives and experiences, healthcare providers can make necessary adjustments to improve care quality and patient outcomes. The sample included 1200 patients, and data collection utilized a self-assessment questionnaire, with percentages employed for analysis. Nurses are integral to caring for infertility patients during visits and conducting research to advance fertility care practices.

Moral distress in psychiatric nurses in Covid-19 crisis

BACKGROUND

The COVID-19 pandemic has put heavy pressure on nurses. Psychiatric nurses are also exposed to moral distress due to the special conditions of psychiatric patients and patient's lack of cooperation in observing health protocols. This study has been conducted to explore and describe factors that caused moral distress in Iranian psychiatric nurses during the COVID-19 pandemic.

METHOD

This qualitative study with a conventional content analysis approach involved 12 nurses at the Shiraz University of Medical Sciences in Iran. This study was conducted in the winter of 2021. Data collection was performed by semi-structured interviews, data analysis was performed based on the five steps of Graneheim and Lundman.

RESULTS

By continuous comparison and integration of data, 17 subcategories, 8 subcategories, and 3 categories were extracted from 252 initial codes. The causes of moral distress in psychiatric nurses during the COVID-19 pandemic were identified as emotional responses (Fear and Doubt), relational factors (Nurses' Relationship with Each Other, Nurse-physician Relationship, and Relationship whit Patients), and Institutional factors (Lack of Attention to Health Instructions, Failure to complete the treatment process for patients and Institutional Policies).

CONCLUSION

New dimensions of the causes of moral distress associated with the COVID- 19 pandemic are discovered in this study. Managers and planners should equip psychiatric hospitals with isolation facilities and Personal Protection Equipment for patients and nurses. Strengthening the ethical climate by improving communication skills and individual nursing empowerment to prevent moral distress is recommended.

Depression, anxiety, and stress among Iranian nurses in COVID-19 care wards

Background

Nurses are at the frontline of care provision to patients with coronavirus disease 2019 (COVID-19). The high communicability of COVID-19, high levels of stress associated with the disease, and challenges of care provision to afflicted patients faced nurses in Iran with problems such as depression, anxiety, and stress. The aim of the study was to assess depression, anxiety, and stress among Iranian nurses who provided care to patients with COVID-19.

Methods

This cross-sectional descriptive-analytical study was conducted in 2020–2021. Participants were 468 nurses purposively selected from university hospitals in Iran. They completed two online instruments, namely a demographic questionnaire and the 21-item Depression Anxiety Stress Scale. Data were analyzed using the SPSS software (v. 23.0).

Results

Most participants were female (75.9%) and married (73.4%) and held bachelor’s degree (88%). The means of participants’ age and work experience were 33.59 ± 6.40 years and 10.26 ± 6.61 years, respectively. The mean scores and the prevalence rates of depression, anxiety, and stress were 13.56 ± 5.37 and 74.1%, 13.21 ± 4.90 and 89.7%, and 15.13 ± 4.76 and 54.9%, respectively. The prevalence rates of moderate to severe depression, anxiety, and stress were 43.7%, 73%, and 24%, respectively. The mean scores of participants’ depression, anxiety, and stress had significant relationship with their employment status (p < 0.05). Besides, the mean scores of their anxiety had significant relationship with their educational level, employment status, and work shift (p < 0.05).

Conclusion

Most nurses who provide care to patients with COVID-19 suffer from depression, anxiety, and stress. Psychological support services may be needed for nurses in order to protect and promote their mental health.

The Influence of Workplace Factors on the Nursing Work Environment: A Study Before and After COVID-19

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has impacted the world and healthcare settings, particularly regarding onerous job responsibilities and changes in work culture for nurses. Nurses, known to provide skilled, compassionate, and humanitarian care to patients and families, require continual assistance and organization. Nurses must work in a good environment that encourages them to achieve their highest levels of performance and productivity to offer high-quality and safe care. Commitment to a nursing career necessitates professional dedication especially during times of crisis, as is in the case of the COVID-19 pandemic.

Objectives: The study looked at the elements that influenced nursing work culture at Sultan bin Abdul Aziz Humanitarian City (SBAHC) Riyadh, Saudi Arabia during the COVID-19 epidemic. Leadership, satisfaction, teamwork, nurse behaviour in practice, and professional commitment were among these elements. The factors are interrelated together and help in shaping the nursing work culture considering the COVID-19 scenario.

Methods: A hospital-based cross-sectional study was conducted from January 2020 to December 2020, covering a period before the outbreak of COVID-19 and a period after. The study, conducted at SBAHC, Riyadh, Saudi Arabia, followed a quantitative, positivist approach undertaken in two phases utilizing an analytical survey design before and after the COVID-19 pandemic. An initial electronic survey was distributed to 439 nurses at SBAHC nursing units. Three hundred twenty-two nurses participated in the first survey and the second survey responses after COVID-19 were 205 nurses.

Results: There was a significant difference between the two groups in their responses (p<0.05). In all five scales used, the score of mean declined in the ‘after' group, clearly showing the effect of all the five elements that influence nursing work culture due to the COVID-19 pandemic.

Conclusion: The study concluded that the workplace factors influencing the nursing work environment were greatly affected due to the COVID-19 outbreak in Saudi Arabia. The findings of this study should be considered by nurse managers and leaders when drafting the policies and programs to reduce the negative impact of COVID-19 on nurse retention. It should also provide baseline information that will allow health authorities to prioritize training programs that will support nurses during difficult times.

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.

Can passive pedaling improve sexual function in patients under hemodialysis? A randomized clinical trial

To investigate the effect of passive pedaling with mini bike on sexual function in patients under hemodialysis. This study was a randomized clinical trial. Thirty-seven patients undergoing hemodialysis were assigned to the intervention (n = 20) and control (n = 17) groups by the stratified block randomization method. The intervention group exercised with a mini bike that was automatic and tuned for patients during the first 2 h of dialysis, twice a week for 20 min each time, for 3 months. The International Index of Erectile Function and Female Sexual Function Index were used to assess the sexual function in the first, second, and third months during the intervention and one month after the intervention. A higher score indicates a better sexual function. Repeated measure ANOVA, Chi-square and Fisher exact tests, independent t, and Mann-Whitney U tests were used for data analysis. The SPSS software version 22 was used for data analysis. Sexual function scores of the intervention group were 35.9 at the beginning of the study, 34.1 in the first month, 37.4 in the second month, 34.8 in the third month, and 31.7 one month after the study. There was no significant difference in the scores of sexual function in the intervention group during the study. The mean scores of sexual function in the control group were 34.5, 34.4, 34.9, 33.8, and 33.9 at the beginning of the study, in the first month, in the second month, in the third month, and one month after the study, respectively (p > 0.05). There was no significant difference between the two groups in terms of sexual function scores during and after the intervention (p > 0.05). Passive pedaling with mini-bike had no effect on sexual function of hemodialysis patients.

Communication between infertile women and nurses: facilitators, barriers and requirements for improving

Nurses working in infertility clinics need to know effective ways of communicating with infertile women to help them experience their treatment period comfortably. However, they can face various stressors which can reduce the motivation. Therefore, the aim of this study was to evaluate communication between nurses in infertility clinics and infertile women from the perspective of both groups. The qualitative study was conducted in an InVitroFertilization clinic, in Turkey with five nurses and seven female patients. Data obtained from semi-structured interviews were thematically analyzed. Three main themes were identified: facilitators of communication (verbal and nonverbal facilitator), barriers to communication (related to nurses and women), and requirements for improving communication. Factors such as appropriate tone of voice, smiling, provide eye-to-eye contact are expressed by women and/or nurses as facilitators. The high tone of voice, yelling, etc. for women, stress and the low education level of women for nurses were barriers. The requirements expressed by women were nurses receiving training to improve their communication skills, and not having prejudice, while requirements for nurses were enough time, women being sincere, taking psychological support. This paper may provide nurses recognize facilitators and barriers to effective communication with women and include in their care plans.

Exploring a Nursing Home-Specific, Interdisciplinary, Function-Focused, Communicative Framework Based on Situation, Background, Assessment, and Recommendation

BACKGROUND

Improved methods of communication are needed among professionals in related fields to address the increasing complexity of clinical situations and various levels of functioning experienced by older adults who live in nursing homes.

PURPOSE

The purpose of this study was to explore function-focused clinical communication among nurses and providers based on the Situation, Background, Assessment, Recommendation (SBAR) approach toward interdisciplinary collaboration to maintain function among nursing home residents and to identify the characteristics of SBAR flows in nursing homes.

METHODS

Detailed interviews with 28 interdisciplinary professionals working in four nursing homes were conducted. Directed qualitative content analysis was used to identify the internal attributes of SBAR-based communication. Case analysis was conducted to identify SBAR flows.

RESULTS

Four themes emerged as key factors for function-focused interdisciplinary staff communication in nursing homes. Effective nursing care to maintain function among nursing home residents requires accurate awareness of abnormal circumstances. Knowledge of assessment and resident background are needed to address situations requiring intervention and identify the problems underlying a resident's current state. The optimal therapeutic environment is created by sharing roles and tasks among practitioners through referrals.Twelve generalized situations requiring function-focused communication (i.e., dislocation of body line because of joint contracture, change in walking, difficulty of moving because of pain, difficulty in eating, fever, change in sleep pattern, change in excretion pattern, change in weight, change in condition, change in problematic behavior, decrease in cognitive function, and change in relationships) and the related nurse-centered SBAR pathways were identified.

CONCLUSIONS/IMPLICATIONS FOR PRACTICE

These results represent a first prototype for developing practical communication guidelines for nursing-home-specific function-focused care and provide new insights into the interdisciplinary approach.

Genetics education program to help public health nurses improve their knowledge and enhance communities' genetic literacy: a pilot study

BACKGROUND

As human genetics knowledge develops, public genetic literacy needs to be increased, though the educational capacity for this purpose has not yet been fully developed. Under this circumstance, the daily work of public health nurses can be viewed as an opportunity to enhance public genetic literacy. However, in Japan, there is not only a lack of public knowledge of human genomics but also a lack of public health nurses' recognition about genomic literacy. A short-term education program was implemented as a pilot study. This study aimed to examine the effectiveness of the program to support public health nurses' activity aimed at promoting health services-related genetic literacy.

METHODS

The genetics education program was implemented in December 2019, in Kagoshima, Japan. Twenty-three public health nurses cooperated with the research. The program was composed of a case study on consultation, a lecture on hereditary diseases, and a discussion on the role of public health nurses. Familial hypercholesterolemia was used as the topic of the case study. We evaluated scores for cognition, affect, and psychomotor characteristics related to their learning goals before and after the program using Wilcoxon signed-rank tests. Answers in the consultation were qualitatively analyzed.

RESULTS

The mean cognitive score, capturing provision of explanations of hereditary disease, was 6.3 before the program but increased significantly to 9.3 after the program (p < 0.001). For the affective score, the goal of which was deepening interest in human genetics, the mean score increased significantly from 8.5 before to 11.0 after (p < 0.001). For the psychomotor score, addressing the need for genetic consultation, the mean score increased significantly from 4.4 before to 8.1 after (p < 0.001). Prominent themes extracted from descriptions on the worksheet post training included, "providing advice and accurate information on genetic disorders" and "referral to a specialized organization."

CONCLUSIONS

Our findings indicated that this education program helps public health nurses be positively involved in human genetic disorders. Thus, they may connect to their local community to provide accurate genetics knowledge and advice for health management and promoting genetic literacy.