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Introduction: Nurses as the main members of treatment-and-care team play an important role in improvement and promotion of health in society. Job stress is a recognized and integral part of modern nursing which has destructive effects on both nurses and patients.

Materials and Methods: The present descriptive and analytical study aims to determine the level of nurses&apos job stress in Tehran in 2004. It also tries to identify factors affecting job stress from nurses&apos point of view. A total of 111 nurses working in two educational and non-educational hospitals in Tehran were studied. The sampling was simple, i.e. the subjects volunteered to participate in the study. A questionnaire with 2 sections was developed. In the first section we asked about personal and professional characteristics and the second section was designed to evaluate job stress in following 5 categories: management, economy and welfare, mentality and social affairs, occupational health and ergonomics. There was also an open-ended question asking about nurses&apos attitude toward job stress. The questionnaire items were to be answered on a scale ranging from 0 to 4. We used descriptive statistics and Chi square statistical test to analyze the collected data.

Results: The results showed that 44.1% of samples had high levels of job stress while 54.1% suffered from medium and 1.8% from low levels of job stress. There was a significant relationship between hospital type and job stress job stress in the educational hospital was higher compared to the noneducational hospital. There was also an inverse relationship between years of experience and job stress.

Conclusion: Due to high percentage of the subjects with high to medium levels of job stress, employment of preventive and precautionary procedures regarding job stress is recommended.

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Introduction: Stress is a complex and physiologic phenomenon that sometimes can be a source of problem. If an individual could not cope with stress, it would be a threat to physical and psychological health. Inclination to cope with stress is a positive way which helps one to improve his/her health.

Materials and Methods: This research is a quasi-experimental study with the aim of determining the effect of education of methods of coping with stress on rate of stress among women working at Tehran University of Medical Sciences. After primary study, 138 cases were chosen through census sampling. The collection tool was Chaudron stress scale. The statistical tests included t test and 2. Data were analyzed by SPSS software.         

Results: The result showed that there was no significant difference between level of stress before and after education in domains of job stress (p=0.22), life health stress (p=0.53), personal life stress (p=0.44) and personality stress (p=0.1). Also the statistical result of X2 did not show significant correlation between variables such as type of school, age, duration of work, marital status, number of children, educational level and housing condition with job stress.

Conclusion: The result showed that work environment is an important source of stress for working women. It could have undesirable effects on physical and emotional health of women. It seems that short term education can not decrease the stress of women therefore it is necessary to organize different long-term education programs, consultation and other strategies to reduce stress.

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Background & Aim: Epilepsy as the most important chronic neurological disease affects on child and his/her family therefore it can lead to occur some stresses in family particularly in parents. This study has been done to determine ideas of parents with epileptic children about stressors and their coping with this agent in those who come to the optional therapeutic centers in Tehran.

Methods & Materials: This is a descriptive-analytical research which 400 parents with epileptic children were selected based on aim. The method of collecting data was by questionnaire for literate persons and by interview for illiterates whose research tool was questionnaire. The questionnaire was prepared in three parts (demographic information’s, stressors questions, and coping questions for parents with epileptic children. The data was collected in one stage and analyzed with SPSS software. To analyze the data, descriptive and inferential statistical methods (t-test, analyze variance) have been used.

Results: Statistical analysis showed that there is significant differences in stress between parents (p=0.001). The most percentage (86%) of fathers in comparison mothers (81.9%) have moderate level of stress and least percentage (5.4%) fathers and (4.4%) of mothers have low level of stress. The level of stress in parents showed significant correlation with personal variables. Most percentage (69%) of fathers and mothers (66.1%) have low-moderate level of coping and it has significant correlation with some personal variables. The analyze variance test showed that there was significant and converse relationship between stress and coping in parents with epileptic children and increasing stress lead to decrease coping. Conclusion: The results of this study have been shown that the stress in father of epileptic children is more that mothers however there is no significant differences in the level of coping.

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Background & Objective: Nursing and Midwifery students experience different and numerous sources of stress. Stress is a complex phenomenon that may be experienced by all. Nursing and midwifery students have multiple sources of stress due to their work environment. In order to reduce their stress and prevent the complications, all sources of stress should be recognized. This study was carried out to compare sources of stress between midwifery and nursing students of Tehran universities of medical sciences.

Methods & Materials: This is a cross-sectional study. All senior midwifery and nursing students of Tehran and Shahid Beheshti Universities were invited to participate in the study (n=380). Data were collected using a questionnaire including demographic section (15 questions) and sources of stress of educational environment, clinical environment, and social-personal problems (54 items). Data were analyzed using SPSS and tested with chi-square test.

Results: 363 students participated in the study. Research findings showed that the followings are the most cited sources of stress among the students: ambiguous professional view, incompetent professional knowledge after graduation, caring for terminally ill patients, discordance between theory and clinical education, concerns about employment. Also results showed that there were significant differences between some sources of stress and the study programs.

Conclusion: The nursing and midwifery students had numerous sources of stress in the educational, clinical, and social-personal domains of their life that can affect their physical and psychological health and cause learning problems. Using appropriate approaches to control and manage these sources of stress are recommended

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Background & Aim: Adverse childbirth experiences as a trauma can evoke fear and post-traumatic stress disorder in some women. This study was conducted to investigate the effect of counseling on post traumatic stress disorder after a traumatic childbirth.

Methods & Materials: This research was a clinical trial which was conducted at Kamaly hospital in Karaj. Samples (300 women) who had experienced a traumatic childbirth were selected by a convenient sampling method and were randomized into an intervention (n=150) and a control (n=150) group. The intervention group received face-to-face counseling within 72 hours of birth for forty to sixty minutes in a session. The control group just received usual care after childbirth. The data collection tool was questionnaire, which was completed via interview. The measuring variables were demographic characteristic, reproductive history, maternity social support, and post-traumatic stress disorder. Data were analyzed using descriptive statistics and inferential tests (Chi-square, Fisher&aposs exact test, and generalized Fisher&aposs exact test) by SPSS v.13 software.

Results: After 4-6 weeks of follow-up there was no significant difference regarding post-traumatic stress disorder between two groups (P=0.295). At 3-month of follow-up, the intervention group reported less post-traumatic stress disorder comparing with the control group (P=0.001).

Conclusion: A midwife-led counseling plan is effective in reducing post-traumatic stress disorder during a long term.

 

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Background & Objective: Assessment of mental health is one of the most important aspects of assessing health status. Entering to the university is a challenging life event for young adults because students encounter with changes in social communication, expectations and roles. As a result, they are susceptible for experiencing stress and anxiety that could affect their functions. The aim of this study was to determine the mental health status and related stressors among Hamadan Medical Sciences University Students.

Methods & Materials: In this cross-sectional study, 180 medical sciences&apos students were selected using stratified sampling method. Data were collected using the Stressor questionnaire and the SCL90. Data were analyzed by SPSS.

Results: The study showed that 57.1 percent of the students were female. The ages ranged 18-22. Most of the students (94.8 percent) were single. Most of the students had no mental disorders (66.1%). Mild and moderate mental disorders were 29.4& and 4.4%, respectively. Mean of mental health score was 72.99 (±46.02). Mental health status was correlated with marital status, concerns about family, changes in religious activities, concerns about the future, working in the hospitals, problems with friends, sexual problems, and the number of experienced stressors (P<0.05).

Conclusion: Experiencing stressors threatens students&apos mental health status and provide a potential cause for mental disorders.

 

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Background & Aim: Childbearing is a potentially traumatic event in the lives of women and can lead to post traumatic stress disorder in some women. This study aimed to determine the prevalence and predisposing factors of post traumatic stress disorder after childbearing in women in Bushehr.

Methods & Materials: In this cross-sectional study, 400 women who attended the medical centers 6-8 weeks after delivery were recruited to the study. Participants with traumatic delivery were included in the study. They completed the posttraumatic symptoms scale-I (PSS-I), and predisposing factors questionnaire. Data were analyzed in two groups of women with the PTSD and without PTSD using Chi-square and Fisher&aposs exact test with P=0.05.

Results: The results of this study showed that 54.4% of women had experienced a traumatic delivery and one-third of the women were affected to PTSD after childbearing. There were significant differences between obstetrical factors including complications of pregnancy, wanted pregnancy, post-partum complications, interval of the last two pregnancies less than two years neonatal factors including type of feeding, issues of child care, birth weight and psychological factors including stressful life events, and maternity social support with the PTSD (P<0.05). Income had statistically significant association with the PTSD (P<0.05).

Conclusion: Some of obstetrical, neonatal and psychological factors are associated with occurrence of the PTSD after delivery

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Background & Aim: The Non Stress Test (NST) is a main assessment tool for fetal wellbeing however, it has a high rate of false-positive results. External stimulation with halogen light has been recommended to aid in provoking fetal response, decreasing false-positive results and promoting the test. This study aimed to assess the effect of halogen light stimulation on nonreactive pattern of NST.

Methods & Materials: From 850 women who underwent NSTs, 50 women with singleton and cephalic fetuses who had nonreactive NSTs were allocated to receive halogen light stimulation through a halogen light source of 1,000,000 candle power. The light was applied to the lower abdomen above symphysis pubis over fetal head for 10 seconds. Results were compared to BPP scores as a backup test. We used mean± SD, chi-square Test and Fisher&aposs Exact Test. The >α0.05 was considered as significant level.

Results: Following stimulation, 68% of nonreactive results changed to reactive patterns. In half of the cases, first acceleration occurred in less than two minutes. Almost 90% of fetuses had reactive pattern within nine minutes.

Conclusion: Halogen light stimulation decreased the incidence of non reactive tests and testing time. Halogen light stimulation is safe and efficient in fetal well being assessment.

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Background & Aim: Moral distress, a major issue in nursing, affects nurses in all healthcare sections. The existence of such distress and its consequent job dissatisfaction may pose a threat to nurses&apos physical and mental health, as well as their quality of life and hinder their accomplishment of individual and social goals. The aim of this study was to determine the relationship between the moral distress and job satisfaction In nurses.

Methods & Materials: This cross-sectional correlational study was conducted on 210 nurses employed in the selected healthcare centers of Tehran University of Medical Sciences in 2009. Data were collected using a questionnaire consisting demographic characteristics, the Corley&aposs moral distress scale, and the Minnesota Satisfaction Questionnaire. Data were analyzed using descriptive statistics and independent t-test, analysis of variance, Wilcoxon test and Pearson&aposs correlation coefficient in the SPSS v.14.

Results: According to the findings of the study, the mean of the moral distress was 1.77 out of four and the mean of the job satisfaction score was 3.17 out of 5 indicating a moderate job satisfaction among the nurses. A significant relationship was observed between the moral distress and nurses&apos job satisfaction in the present study, indicating that by decreasing moral distress, job satisfaction increases.

Conclusion: Although numerous factors govern nurses&apos job satisfaction, the observed relationship between moral distress and job satisfaction indicates that identifying and limiting factors influencing these distresses can lead to improved job satisfaction for nurses.

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Background & Aim: Multiple structural factors preside over burn units influence nurses&apos quality of care and their activities. The complexity and multy-dimensional nature of nursing care in these units, creates many challenges. Understanding the perspectives of people&aposs involved is recommended. This study, with a theory-to-research approach, was conducted to assess the frequency of confronting intra and extra organizational factors preside over burn units, the intensity of its related pressure, and correlations among these variables from nurses&apos perspectives.

Methods & Materials: In this cross-sectional, correlational study, 98 nurses working in the Shahid Mottahari burn center were recruited by census. Data was collected using the intra and extra organizational factors instrument, provided based on the previous grounded theory study of the researchers. Intra-organizational factors questionnaire consisted of 58 Likert type statements in eight subscales and two dimensions of frequency (α=0.94) and intensity (α=0.96). Extra-organizational factors questionnaire consisted of eight Likert type statements (α=0.74). Data were analyzed using the SPSS version 14.

Results: The results revealed that the frequency of nurses&apos confrontation with factors related to environment and patients as well as its intensity were more than other factors. Moreover, the intensity of the whole factors was more than its frequency. All the extra- organizational factors were significantly correlated with all intra-organizational factors except for the "absence of employment permission" (P<0.05).

Conclusion: This study explained the importance of intra-organizational factors of a burn center in inducing stress on nurses. In addition to verification of some relationships in the previous mid-range theory, the results of this study also modified some of its aspects. Therefore it added to the existing body of knowledge about organizational factors and job stress in burn units. Moreover, it produced some evidences to use in nursing administration and service, and finally it resulted in some directions to control stress in nurses&apos job.

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Background & Objective: Nursing students usually experience various types of stress. Lack of stress coping strategies result in more stress, incompatibility, manifestation of disorders, and mental health problems. This study carried out to assess the methods of coping with stress among nursing students.

Methods & Materials: In this cross-sectional study, 358 male and female bachelor of nursing students studying at Tehran University of Medical Sciences during the first semester of 2011-2012 were selected. Data were collected using the Coping Inventory for Stressful Situation and a demographic questionnaire. The data was analyzed using descriptive and inferential statistics in the SPSS-14.

Results: There were 66.2% female and 33.8% male students in the study. The age of the students ranged 17-29 years. Most of the students aged 20-22 years (45%), were single (90.8%), were habitants of Tehran (53.1%), had an average economic status (72.1%), and were employed (20.9%). Of all, 19.3% had experienced stressful events in the last three months. A small number of the students (4.7%) suffered from chronic diseases. The nursing students mostly used problem-oriented coping style (56%). The emotion-oriented method was used among 45.99% of the students and the avoidance-oriented style was used among 39.34% of the students. There were no statistically significant relationship between the coping styles and the demographic characteristics.

Conclusion: The problem-oriented, emotion-oriented, and avoidance-oriented styles were the most frequent styles used by the students, respectively. The mental health, particularly among nursing students who deal with patients and have important role in the health system, is important and requires special attention. The stress coping styles should be inserted in the educational curriculum of the nursing schools.

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Background & Aim: Stress is a main problem among nurses which affects their professional performance and personal life resulting in conflict between work and life. The aim of this study was to determine the effect of stress management on work-family conflicts.

Methods & Materials: In a quasi-experimental two-group study, 64 medical nurses were selected randomly to the study from Shahid lavasani hospital in Tehran. Data were gathered using a questionnaire including demographic characteristics, work-family conflict items, and nursing stress scale. Then, the experimental group participated in a 2-day stress management course. The questionnaire was completed by the participants one month later. Data were analyzed in the SPSS v.18.

Results: The mean work-family conflict score was 3.97 in the experimental group at baseline. It declined after the intervention to 3.357 (P<0.001). There was statistically significant difference between the two groups on work-family conflict after the intervention (P=0.007). There was a significant decrease in the job stress from baseline (46.52) to the post-intervention measurement (35.61) in the experimental group (P<0.001). There was a statistically significant difference between the two groups in the mean of job stress after the intervention (P=0.014).

Conclusion: Stress management education declined work-family conflict and job stress among nurses. This education should be used in nursing clinical and educational training programs.

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Background & Aim: Job stress can interfere with endocrine function and result in dysfunctional menstrual bleeding patterns. The aim of this study was to assess the relationship between job stress with menstrual bleeding pattern among midwives.

Methods & Materials: In this cross-sectional study, we recruited 150 midwives working in hospitals and health centers of Mashhad using two-stage sampling. Data were collected using a questionnaire including demographic characteristics, Karazek Job Content, a daily diary for menstrual periods to record duration and interval of periods, and the Higham Chart for recording the bleeding amount. The diary was completed for three menstrual periods. Collected data were analyzed using independent t-student, one way ANOVA, Mann-Whitney U, Chi-squared test, correlation test and linear regression in the SPSS-14.

Results: The findings showed that 21.3% of the midwives reported mild job stress, 19.3% had moderate stress and 59.3% reported severe job stress. Mean of the duration of the periods was 7.06 days, the mean interval of the periods was 27.9 days and the mean amount of bleeding was 79.72 cc. There was a significant relationship between job stress and the duration and interval of periods (P<0.001). There was not any significant relationship between job stress with the amount of bleeding.

Conclusion: Our study showed that job stress was related to menstrual bleeding patterns among midwives. It is necessary introduce strategies to decrease job stress and provide professional support for midwives.

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  Background & Aim: The effect of perceived stress on students’ health depends on their coping abilities. Resilience is a coping strategy for dealing with the stress. The aim of this study was to determine the relationship between the perceived stress with resilience in undergraduate nursing students .

  Methods & Materials: In this cross-sectional study, 309 undergraduate nursing students of Tehran University of Medical Sciences were selected during the first semester of 2012-2013 using the stratified sampling method. Data were collected using the Perceived stress scale and the Connor-Davidson Resilience Scale (CD-RISC). The data were analyzed using descriptive and inferential statistics in the SPSS-14 . 

  Results: Findings revealed that most of the students (99.3%) had a moderate or high perceived stress. There was a statistically significant relationship between the perceived stress with the resilience (P £ 0.001, r=-0.38) .

  Conclusion: The school of nursing should provide facilities and opportunities for students in their 4-year educational program to learn stress management strategies including increasing resilience ability.

  

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  Background & Aim: Mothers often feel anxious about giving care to their premature babies. This maternal stress is associated with negative attitudes and behaviors towards babies. The aim of this study was to assess the effect of Kangaroo mother care on stress among mothers with premature babies .

  Methods & Materials: This quasi-experimental study was carried out on 46 pairs of mothers and their premature babies hospitalized in the ICUs of Shahid Sadooghi and Tamin Ejtemaee hospitals. The participants were selected using convenience sampling method and were assigned into two intervention and control groups. In the intervention group, the Kangaroo mother care was provided to the babies after breastfeeding for about 30 minutes once a day for four weeks. Maternal stress was measured using the Parental Stress Scale before and immediately after the intervention. Data were analyzed using the Chi-squared test, t-test, and Mann-Whitney test . 

  Results: The mean of stress score in mothers of the intervention and control groups were 102.0 ± 17.02 and 174.52 ± 18.25, respectively (P<0.001). The stress score was significantly different before and after the intervention among mothers of the intervention group (P<0.001) .

  Conclusion: The Kangaroo mother care decreased stress score among mothers who had premature babies. The Kangaroo mother care is strongly recommended to be used by mothers with premature babies .

  

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  Background & Aim: Demographic transition and aging are global conditions result in increased risk of disability and chronic diseases such as diabetes. Considering stress as having mutual interaction with different aspects of health is vital in treatment of common disorders among older adults with diabetes. This study aimed to assess the relationship between the perceived stress with spiritual health among older adults with diabetes registered to the Association of Diabetes Prevention and Control in Babol .

  Methods & Materials: In this cross-sectional (descriptive- analytical) study, 194 older adults aged 60-75 years old were selected using convenience sampling from the Association of Diabetes Prevention and Control in Babol. Data were collected using the demographic form as well as the Perceived Stress Scale (PSS) and the Spiritual Well-being Questionnaire (SWB). The validity and reliability of the scales were confirmed previously. Data were analyzed using descriptive and inferential statistics including ANOVA, Chi-Squared tests, t-test and Pearson correlation coefficient in the SPSS-21 . 

  Results: The study findings showed that perceived stress was low in a substantial percentage of the elderly (74.2%) with the mean ± SD of 22.52±8.06. Also, the levels of spiritual health were medium to high among most participants (97.72 ± 11.51). Interestingly, there was a significant negative relationship between the perceived stress and spiritual health (r=-0.48, P<0.001) .

  Conclusion: This study elaborated the relationship between the perceived stress with spiritual health of elderly patients with diabetes. Considering the results, enhancing spiritual health as one of the health dimensions seems necessary .

  

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Background & Aim: Given the importance of mothers’ health and considering that developmental delay in children affects their mothers’ mental health this study aimed to compare stress and perceived social support in mothers of 6-18 month old children with and without developmental delay.

Methods & Materials: This cross-sectional, analytical study was performed on 610 mothers and their 6-18 month-old infants in health centers affiliated to Shahid Beheshti University of Medical Sciences. The participants were selected through the multi-stage random sampling. To collect data, the following questionnaires were used: obstetric and demographic characteristics, socio-economic status, infants’ characteristics, the Cohen perceived stress scale, perceived social support, and Ages and Stages questionnaire to determine the children’s development status. The data were analyzed by SPSS v.19 software and using descriptive statistics, Pearson correlation, chi-square, independent t-test and Man-Whitney statistical tests.

Results: The mean age of infants were 10.68±4.5 months. Independent t-test revealed a significant difference between mothers’ perceived stress (P=0.004) and social support (P=0.01) in the two groups. In addition, a relationship was observed between the mother’s social support and stress (P<0.04).

Conclusion: The results showed that mothers of children with developmental delays have more stress and lower perceived social support than mothers of normal children. Therefore, it is recommended to perform developmental screening for further examination and the reduction of mothers’ stress, as well as to provide appropriate social support.

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Background & Aim: Although mechanical ventilation is a life-saving intervention for many infants with respiratory distress syndrome, it carries potential complications. One of these complications is prolonged duration of mechanical ventilation. More than 15 days of mechanical ventilation is associated with increased risk of cerebral palsy and attention deficit hyperactivity disorder among extremely low birth weight infants. The current study aimed to determine the relationships between the length of mechanical ventilation and its related factors in neonates with respiratory distress syndrome.

Methods & Materials: In this analytical study, a convenience sample of 60 premature infants of 33 weeks’ gestation or less with respiratory distress syndrome was recruited from three hospitals (Mahdieh, Mofid, and Imam Hossein) affiliated to Shahid Beheshti University of Medical Sciences in 2014-2015. Then, factors related to the length of mechanical ventilation such as sex, type of birth, birth weight, gestational age, Apgar score at the first minute, Apgar score at the fifth minute were assessed. The data were analyzed using descriptive statistics, Pearson correlation, independent t-test, and multiple regression analysis on SPSS software v.20.

Results: The mean gestational age was 30.62±1.8 weeks and the mean weight of infants was 1510.33±390.940 grams. The mean length of mechanical ventilation was 3.58±2.97 days. There  were not any correlations between sex, type of birth and the length of mechanical ventilation (P>0.05). Gestational age and weight were significantly correlated to the length of mechanical ventilation (P<0.001). But in adjusted analysis using multiple regression, only gestational age remained a significant factor related to the length of mechanical ventilation (P<0.05).

Conclusion: The results of the current study revealed that among the studied factors, only gestational age was a factor affecting the length of mechanical ventilation.

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Background & Aim: Post-traumatic stress disorder is one of the psychiatric disorders and exposure to trauma is a key factor in its development. This disorder affects important aspects of a person’s life such as professional quality of life. The aim of this study is to determine the relationship between post-traumatic stress symptoms and professional quality of life among psychiatric nurses.

Methods & Materials: In this descriptive analytical study, 160 nurses in psychiatric wards affiliated to Kerman University of Medical Sciences, were selected using census sampling in 2013. Data were collected using questionnaires including professional and demographic characteristics, the Weathers’ PTSD checklist (PCL-C) and Hudnall Stamm’s Professional Quality of Life (PQOL). Data were analyzed by the SPSS software v.20 using the Pearson correlation coefficient, independent t-test, one-way ANOVA and linear regression.

Results: There was a significant correlation between PTSD score and professional quality of life scores in psychiatric nurses (r=0.32, P<0.001). Also, PTSD was positively correlated with burnout (r=0.36, P<0.001) and secondary traumatic stress (r=0.61, P<0.001), and conversely correlated with compassion satisfaction (r=-0.29, P<0.001). After removing the effects of age, work experience, previous experience of traumatic events, the correlation between two main research variables was significant as well (P<0.001).

Conclusion: Post-traumatic stress has a correlation with professional quality of life in psychiatric nurses. Therefore, factors related to PTSD are suggested to be identified and prevented.

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Background & Aim: Infant hospitalization in the intensive care unit is stressful for parents so that it affects their parental role. Nurses, due to their special situation, can play an important role in reducing parental stress. This study aimed to determine the effect of parental role training by a nurse on stress in the parents of hospitalized newborns in a neonatal intensive care unit.
Methods & Materials: A quasi-experimental study (IRCT201605131788N17) was conducted on 72 parents (36 couples in the intervention group, 36 couples in the control group) of hospitalized newborns in the neonatal intensive care unit of Ali-Asghar hospital in 2016. The intervention group received the parental role training based on their needs. Their stress level was compared with the control group using the Parental Stress Scale. Data were analyzed by descriptive statistics, chi-square test, paired t-test, independent t-test and Fisher's exact test using the SPSS software v.16.
Results: Before the education, there was no significant difference in the stress level between the two groups (P>0.05). After the education program, the stress level in the intervention group fell on the tenth day compared to the control group (P<0.001).
Conclusion: Training parents based on their educational needs reduces their stress. By reducing stress and improving the role of parents, it can be assured that the newborn is provided with the quality care at the time of admission.