1
|
Kiratli D, Duran S. Compassion fatigue and loneliness at work in nurses - the mediating role of resilience: a cross-sectional study. J Res Nurs 2024; 29:290-302. [PMID: 39291224 PMCID: PMC11403983 DOI: 10.1177/17449871241238965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024] Open
Abstract
Background Heavy workload, job stress and lack of colleague support can lead to loneliness and burnout in nurses. Caring for a patient with constant pain can cause compassion fatigue. Loneliness at work and compassion fatigue also negatively affect the quality of patient care. Aim This study aims to determine the effect of resilience on loneliness at work and compassion fatigue in nurses. Method This is a descriptive cross-sectional study. The study was conducted with a total of 214 nurses. Results A statistically significant negative relationship was found between the level of loneliness at work and resilience, and between resilience and compassion fatigue in nurses. The mediating role of resilience was found to be significant in the effect of loneliness at work on compassion fatigue in nurses. Conclusions The results of this study suggest empowering nurses who have loneliness at work and compassion fatigue. Compassion fatigue is seen as occupational deformation. Nurses need to learn how to manage compassion fatigue, develop coping skills and receive support to ensure job satisfaction. In addition, nurse managers should create a reasonable workload for nurses. These efforts can increase the job satisfaction and patient care quality of nursing departments.
Collapse
Affiliation(s)
- Didem Kiratli
- Assistant Director of Health Care Services, Dr. Behçet Uz Children's Diseases and Surgery, Training and Research Hospital, Izmir, Türkiye
| | - Songul Duran
- Associate Professor, Izmir Demokrasi University, Health Services Vocational College, Care of Elderly Program, Izmir, Türkiye
| |
Collapse
|
2
|
McInally W, Taylor V, de Los Rios de la Serna CD, Sulosaari V, Trigoso E, Gomes SMR, Dias ARC, Piskorjanac S, Tanay MA, Hálfdánardóttir H, Dowling M. An Innovation in Cancer Nursing Education Across Europe: A Pilot Evaluation. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2024; 39:426-436. [PMID: 38592656 PMCID: PMC11219416 DOI: 10.1007/s13187-024-02424-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/10/2024]
Abstract
The European Oncology Nursing Society (EONS) is a pan-European not for profit society involving approximately 28,000 cancer nurses from 32 countries in the region. The European College of Cancer Nursing (ECCN) exists under the umbrella of EONS and was established in 2020 with a strategic priority to develop, promote and deliver educational opportunities for nurses across Europe. ECCN introduced a pilot on-line education programme for 20 nurses in January 2023. This study evaluated participating nurses' views and experience of learning on the pilot programme. The study adopted a mixed method approach guided by the four levels of the Kirkpatrick theoretical framework. A dominant focus on qualitative data was used with supplementary quantitative data. The Standards for Reporting Qualitative Research (SRQR) was followed. Eleven nurses completed the pre-pilot online questionnaire (response rate 65%) and seven (n = 7) completed the post-pilot questionnaire (41% response rate). Five (n = 5) nurses participated in two focus group interviews. Data analysis resulted in the development of four overarching themes: A wider world of cancer nursing; Shapeless mentorship; Impact on Practice; Learning online and what now? On commencement of online education programmes, nurses value a structured timetable and support from nursing management to maximise engagement with the learning materials.
Collapse
Affiliation(s)
- Wendy McInally
- School of Health, Wellbeing and Social Care, The Open University, Milton Keynes, UK.
| | - Vanessa Taylor
- School of Health and Human Sciences, University of Huddersfield, England, UK
| | | | - Virpi Sulosaari
- Health and Well-Being, Turku University of Applied Sciences, Turku, Finland
| | | | | | - Ana Rita Cesario Dias
- Faculty of Dental Medicine, Health Centro Hospitalar E Universitário de Lisboa Central, Lisbon, Portugal
| | | | - Mary Anne Tanay
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | | | - Maura Dowling
- School of Nursing and Midwifery, University of Galway, Galway, Ireland
| |
Collapse
|
3
|
Soheili M, Jokar F, Eghbali-Babadi M, Taleghani F. Development and psychometric evaluation of a tool to assess oncology nurses' occupational health needs. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:146. [PMID: 38784271 PMCID: PMC11114573 DOI: 10.4103/jehp.jehp_471_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/25/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Oncology nurses are confronted with various occupational hazards; consequently, it is of great importance to identify and measure their occupational health needs. Due to the fact that standard tools are not available to assess these needs, this study was conducted to develop a tool for assessing oncology nurses' occupational health needs. MATERIALS AND METHODS This study consisted of two phases from 2020 to 2021. The first phase was item generation and tool design. The initial development of the item pool was based on the result of the qualitative study and literature search. The second phase was item reduction and psychometric evaluation of the formulated tool including, face, content, and construct validity and reliability. Construct validity was assessed using exploratory factor analysis and convergent validity with the participation of 300 oncology nurses. The reliability of the tool was assessed using internal consistency (Cronbach's alpha) and test-retest (intra-cluster correlation coefficient). RESULTS The mean content validity index (CVI) of the tool was 0.95. The results of exploratory factor analysis showed that this tool consisted of 69 items and four factors, explaining 65.88% of the variance. The results of the convergent validity assessment showed a significant positive correlation between the mean scores of occupational health needs and occupational stress (P < 0.0001 and r = 0.40). Cronbach's alpha coefficient (0.98) and tool stability (0.98) confirmed the appropriate reliability of the tool. CONCLUSION The developed tool is recommended as a valid and reliable tool for assessing oncology nurses' occupational health needs that can be used both in practice and in future studies.
Collapse
Affiliation(s)
- Mozhgan Soheili
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Jokar
- Department of Medical Education, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
4
|
Wood RE, Bleich M, Chung J, Elswick RK, Nease E, Sargent L, Kinser PA. A mixed-methods exploration of nurse loneliness and burnout during COVID-19. Appl Nurs Res 2023; 73:151716. [PMID: 37722784 DOI: 10.1016/j.apnr.2023.151716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/23/2023] [Accepted: 07/23/2023] [Indexed: 09/20/2023]
Abstract
AIM This study investigated the phenomenon of nurse loneliness as a potential contributor to burnout. BACKGROUND Nurse wellbeing is critical for safe and efficient healthcare delivery. However, evidence indicates nurses' wellbeing is at risk. The levels of burnout, the most commonly measured symptom of suboptimal wellbeing, are rising and may relate to a largely unexplored phenomenon: loneliness. METHODS A mixed-methods approach was used to investigate burnout and loneliness in direct-care nurses in four diverse hospitals in the midwestern and southeastern United States. Burnout and loneliness were measured, prevalence was estimated, and correlation was examined. Interpretive descriptive inquiry and analysis was used to develop a richer understanding of nurse loneliness in the context of burnout. While this study did not explicitly explore the impact of the global pandemic, data was collected in late 2021 and early 2022, during the Delta variant wave. RESULTS In the study population (n = 117), rates of burnout are high and positively correlate with loneliness. Qualitative interviews (n = 11) revealed that nurses feel unseen, emotionally detached from their work, and dehumanized. However, social connection with peers is protective and nurses still report a strong sense of devotion to the profession and solidarity with peers. CONCLUSIONS This study offers insight into nurse loneliness, highlighting the importance of social connectedness to improve nurse wellbeing.
Collapse
Affiliation(s)
- Rachel E Wood
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States.
| | - Michael Bleich
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States
| | - Jane Chung
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States
| | - R K Elswick
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States
| | - Elizabeth Nease
- Bon Secours Mercy Health System, 1701 Mercy Health Place, Cincinnati, OH 45237, United States
| | - Lana Sargent
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States
| | - Patricia A Kinser
- Virginia Commonwealth University School of Nursing, Box 980567, 1100 East Leigh Street, Richmond, VA 23298-0567, United States
| |
Collapse
|
5
|
Banayat AC, Challinor J, Sniderman E. An Expert Evaluation of Oncology Website Resources for Use in Pediatric Oncology Clinical Nursing Education in Low-Resource Settings. JOURNAL OF PEDIATRIC HEMATOLOGY/ONCOLOGY NURSING 2023; 40:325-337. [PMID: 37926987 DOI: 10.1177/27527530231190370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Abstract
Background: Online healthcare information is often used by pediatric oncology nurse educators in low- and middle-income countries (LMICs) for teaching clinical nurses as part of their initial orientation or continuing education. Access to peer-reviewed nursing journals via paid subscriptions or sub-specialty nursing textbooks in these settings is rare. This project identified and evaluated websites appropriate for pediatric oncology nurse educators in LMICs for teaching staff nurses, and for clinical staff nurses engaging in self-directed learning. Method: A strategic Google search for childhood cancer websites and an appropriate scoring tool was conducted. The Currency, Relevance, Authority, Accuracy, and Purpose Test, along with a previously published scoring rubric that was further adapted by the authors for pediatric oncology were used. Pediatric content, language options, and reading levels were appraised. Results: Of 86 identified websites, 51 met the inclusion criteria for evaluation. Websites were classified as highly recommended (n = 36), recommended (n = 12), or not recommended (n = 3) based on scores (range 14-30; maximum possible score = 30). Half offered content in multiple languages. Most websites were 9-10th-grade reading level. Discussion: Childhood cancer information appropriate for clinical nurse orientation and self-directed learning by LMIC nurses is available on free websites. Some information (diagnosis, chemotherapy, psychosocial support) is repeated across websites, while some is lacking (pediatric cancer genetics and health equity disparities). Reading levels are higher than recommended for health literacy. The reviewed websites were rarely peer-reviewed, inconsistently updated, and generally self-regulated. However, 48 websites on childhood cancer were deemed appropriate pediatric oncology clinical nursing education resources.
Collapse
Affiliation(s)
- Aprille C Banayat
- College of Nursing, University of the Philippines Manila, Quezon City, Philippines
| | - Julia Challinor
- University of California San Francisco, San Francisco, CA, USA
| | - Elizabeth Sniderman
- Northern Alberta Children's Cancer Program, Stollery Children's Hospital, Edmonton, AB, Canada
| |
Collapse
|
6
|
Wainwright M, Zahroh RI, Tunçalp Ö, Booth A, Bohren MA, Noyes J, Cheng W, Munthe-Kaas H, Lewin S. The use of GRADE-CERQual in qualitative evidence synthesis: an evaluation of fidelity and reporting. Health Res Policy Syst 2023; 21:77. [PMID: 37491226 PMCID: PMC10369711 DOI: 10.1186/s12961-023-00999-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 05/12/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) is a methodological approach to systematically and transparently assess how much confidence decision makers can place in individual review findings from qualitative evidence syntheses. The number of reviews applying GRADE-CERQual is rapidly expanding in guideline and other decision-making contexts. The objectives of this evaluation were, firstly, to describe the uptake of GRADE-CERQual in qualitative evidence synthesis by review authors and, secondly, to assess both reporting of and fidelity to the approach. METHODS The evaluation had two parts. Part 1 was a citation analysis and descriptive overview of the literature citing GRADE-CERQual. Authors worked together to code and chart the citations, first by title and abstract and second by full text. Part 2 was an assessment and analysis of fidelity to, and reporting of, the GRADE-CERQual approach in included reviews. We developed fidelity and reporting questions and answers based on the most recent guidance for GRADE-CERQual and then used NVivo12 to document assessments in a spreadsheet and code full-text PDF articles for any concerns that had been identified. Our assessments were exported to Excel and we applied count formulae to explore patterns in the data. We employed a qualitative content analysis approach in NVivo12 to sub-coding all the data illustrating concerns for each reporting and fidelity criteria. RESULTS 233 studies have applied the GRADE-CERQual approach, with most (n = 225, 96.5%) in the field of health research. Many studies (n = 97/233, 41.6%) were excluded from full fidelity and reporting assessment because they demonstrated a serious misapplication of GRADE-CERQual, for example interpreting it as a quality appraisal tool for primary studies or reviews. For the remaining studies that applied GRADE-CERQual to assess confidence in review findings, the main areas of reporting concern involved terminology, labelling and completeness. Fidelity concerns were identified in more than half of all studies assessed. CONCLUSIONS GRADE-CERQual is being used widely within qualitative evidence syntheses and there are common reporting and fidelity issues. Most of these are avoidable and we highlight these as gaps in knowledge and guidance for applying the GRADE-CERQual approach.
Collapse
Affiliation(s)
- Megan Wainwright
- Department of Anthropology, Faculty of Social Sciences and Health, Durham University, South Road, Durham, United Kingdom
| | - Rana Islamiah Zahroh
- Gender and Women’s Health Unit, School of Population and Global Health, Centre for Health Equity, The University of Melbourne, Carlton, VIC Australia
| | - Özge Tunçalp
- UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | - Andrew Booth
- Faculty of Medicine, Dentistry and Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, United Kingdom
| | - Meghan A. Bohren
- Gender and Women’s Health Unit, School of Population and Global Health, Centre for Health Equity, The University of Melbourne, Carlton, VIC Australia
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, Wales United Kingdom
| | - Weilong Cheng
- Melbourne School of Population and Global Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Carlton, VIC Australia
| | - Heather Munthe-Kaas
- The Centre for Epidemic Interventions Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Simon Lewin
- Division of Health Services and Centre for Epidemic Interventions Research (CEIR), Norwegian Institute of Public Health, Oslo, Norway
- Health Systems Research Unit, South African Medical Research Council, Cape Town, South Africa
- Department of Health Sciences Ålesund, Norwegian University of Science and Technology (NTNU), Ålesund, Norway
| |
Collapse
|
7
|
Rodrigues ECG, Neris RR, Nascimento LC, de Oliveira-Cardoso ÉA, Dos Santos MA. Body image experience of women with breast cancer: A meta-synthesis. Scand J Caring Sci 2023; 37:20-36. [PMID: 35781312 DOI: 10.1111/scs.13102] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/16/2022] [Accepted: 06/11/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Body image is a multidimensional concept that involves the mental image of the human body and the feeling of being oneself throughout existence. Treatment for breast cancer causes several bodily changes that affect women's body image. AIMS This meta-synthesis aims to synthesise and interpret primary qualitative studies on the experience of body image in women undergoing treatment for breast cancer. METHODS A qualitative meta-synthesis was conducted employing systematic searches in six databases (PubMed, CINAHL, SCOPUS, Web of Science, PsycINFO, and LILACS). Data analysis was performed according to thematic synthesis. RESULTS Forty studies were included. Five descriptive themes were identified: (1) actively saying goodbye to body image; (2) the rupture of body image; (3) the sacrifice of body image in exchange for life; (4) body image as a vehicle for social expression; and (5) resignation of the alterated body image. These themes were understood through one analytical theme: Half-woman: body image of the woman with breast cancer. CONCLUSION The experience of body image in the context of breast cancer is a dynamic phenomenon, which involves dismissal, rupture, and resignation and occurs mediated by interpersonal contact.
Collapse
Affiliation(s)
| | - Rhyquelle Rhibna Neris
- College of Nursing at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | | | | | - Manoel Antônio Dos Santos
- Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| |
Collapse
|
8
|
Saifan AR, Al Zoubi AM, Alrimawi I, Al-Yateem N, Abdelkader R, Assaf EA. Occupational stress and turnover intention: A qualitative study reporting the experiences of nurses working in oncology settings in Jordan. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2135069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | | | - Intima Alrimawi
- School of Nursing, Georgetown University, Washington, DC, USA
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Charles Sturt University, New South Wales, Australia
| | - Raghad Abdelkader
- Nursing Department, Applied Science Private University, Amman, Jordan
| | - Enas A. Assaf
- Nursing Department, Applied Science Private University, Amman, Jordan
| |
Collapse
|
9
|
Kim SJ, Jung KI. The Influences of Professional Self-Concept, Job Stress, and Coworker Support on Burnout in Oncology Unit Nurses. ASIAN ONCOLOGY NURSING 2022. [DOI: 10.5388/aon.2022.22.2.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- So Jeong Kim
- Advanced Oncology Certified Nurse (AOCN), Gospel Hospital, Kosin University, Busan, Korea
| | - Kwuy Im Jung
- Associate Professor, College of Nursing, Kosin University, Busan, Korea
| |
Collapse
|
10
|
Phillips CS, Becker H, Gonzalez E. Psychosocial Well-Being: An Exploratory Cross-Sectional Evaluation of Loneliness, Anxiety, Depression, Self-Compassion, and Professional Quality of Life in Oncology Nurses. Clin J Oncol Nurs 2021; 25:530-538. [PMID: 34533521 DOI: 10.1188/21.cjon.530-538] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND In addition to heavy workloads, oncology nurses are confronted with emotionally demanding caregiving moments with little training or institutional support for coping and emotional well-being. OBJECTIVES The aim of this study was to explore the associations and potential predictors among self-compassion, loneliness, anxiety, depression, and professional quality of life in oncology nurses. METHODS Participants were recruited throughout central Texas. Descriptive statistics, bivariate correlations, and multivariate regression analyses were conducted on survey data. FINDINGS Burnout and compassion satisfaction were strongly related to loneliness, self-compassion, and depression. Compassion fatigue was most highly related to anxiety and depression. Loneliness made the strongest unique contribution to burnout and compassion satisfaction, and depression was the only statistically significant predictor of compassion fatigue.
Collapse
|
11
|
Soheili M, Taleghani F, Jokar F, Eghbali-Babadi M, Sharifi M. Occupational stressors in oncology nurses: A qualitative descriptive study. J Clin Nurs 2021; 30:3171-3181. [PMID: 33960034 DOI: 10.1111/jocn.15816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 03/31/2021] [Accepted: 04/06/2021] [Indexed: 11/28/2022]
Abstract
AIM AND OBJECTIVES The present study aims at exploring oncology nurses' perceptions regarding work-related stressors. BACKGROUND Oncology nurses work in an environment with a high degree of stress, which can negatively affect their health. There is limited research on work-related stressors from the oncology nurses' perspective. DESIGN Qualitative descriptive study. METHODS Fifty-two oncology nurses were selected purposefully from eight cancer treatment centres in different cities of Iran. Data were collected through semi-structured interviews and analysed using conventional content analysis. The COREQ checklist was used to document the report of the study. RESULTS The extracted contents were classified into four main categories. The first category involved personal ability with two subcategories (person-job fit and psychological competencies). The second category included physical environment arrangements with two subcategories (physical working conditions and equipment and facilities). The third category involved psychosocial safety in the workplace with four subcategories (creating a safe work environment, overcoming the challenges of providing care to cancer patients, work/life balance and social recognition of the nursing status). The fourth category holds an organisational context with four subcategories (organisational support, interpersonal relations, justice at work and human resources). CONCLUSION It is necessary to find measures attenuating work-related stresses in oncology nurses. These measures should be in line with developing personal abilities in nurses and creating a safe environment in terms of optimising physical, psychosocial and organisational conditions. It is also important to develop programmes protecting the oncology nurses' occupational health. RELEVANCE TO CLINICAL PRACTICE The results of this study can help improve nursing work conditions, attenuate work-related stresses in nurses and introduce efficient interventions reducing occupational stressors.
Collapse
Affiliation(s)
- Mozhgan Soheili
- Department of Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Taleghani
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariba Jokar
- Medical Education department, Medical Education Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Eghbali-Babadi
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehran Sharifi
- Department of Internal Medicine, School of Medicine, Cancer Prevention Research Center, Seyyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
12
|
|