Occupational health among Iranian nursing personnel

Background: There is increasing global evidence that today’s work environment results in a higher risk of adverse health among nursing staff than among many other professions. Since nurses constitute the largest group in the healthcare workforce and have a crucial role in providing care services, their impaired health might have an adverse effect on the quality of healthcare. The overall aim of this thesis was to explore work-related health and associated factors. A further aim was to describe the experience of managing work and family roles among Iranian nursing personnel.

Methods: The first of the four studies in this thesis used a qualitative method and the other three used a quantitative method. Study I focused on the process of managing work and family roles in the everyday life of Iranian female nurses. In Study II a questionnaire was culturally adapted and psychometrically evaluated in Persian, based on well-established instruments to measure work-related health, working conditions and family situation in the healthcare sector. This newly adapted questionnaire was then used in a cross-sectional study (Studies III-IV) among 520 nursing personnel from ten university hospitals to measure self- reported general and mental health and musculoskeletal disorders, and investigates how this was associated with organizational, physical and psychosocial working conditions and family situation.

Findings: The findings of Study I showed that nurses were striving for balance between work and family roles. In Study II the conceptual structure of the adapted questionnaire in Persian was found to be acceptable for measuring work-related health and associated factors. The results of Studies III-IV indicated an inadequate and low quality of manual patient transferring devices, as well as perceived over-exertion. The participants reported low influence at work, poor leadership and job dissatisfaction, along with inflexible work schedules. These physical, psychosocial and organizational work factors were associated with general and mental health, and with musculoskeletal disorders. However, nursing personnel perceived patient care as meaningful, and no associations between family demands and mental health were reported.

Conclusion: Iranian nurses’ attempts to balance their demanding work role and high traditional family expectations, could lead to threatened health and life dissatisfaction. Although adverse general and mental health and musculoskeletal disorders were associated with most of the working conditions; patient care was found to be meaningful, and family values were perceived as an important source of support and inspiration. Interventions such as flexible work schedules, and improvements in the physical and psychosocial work situation, along with the provision of child care and elderly care during shift work, would help nurses to play their work and family roles, which could lead to increased work efficacy and quality of healthcare.

List of scientific papers

I. Lagerström, M., Josephson, M., Arsalani, N., & Fallahi-Khoshknab, M. (2010). Striving for balance between family and work demands among Iranian nurses. Nursing Science Quarterly. 23(2), 166-172.
https://doi.org/10.1177/0894318410362543

II. Arsalani, N., Fallahi-Khoshknab, M., Ghaffari, M., Josephson, M., & Lagerström, M. (2011). Adaptation of questionnaire measuring working conditions and health problems among Iranian Nursing Personnel. Asian Nursing Research. 5(3), 177-182.
https://doi.org/10.1016/j.anr.2011.09.004

III. Arsalani, N., Fallahi-Khoshknab, M., Josephson, M., & Lagerström, M. (2012). Iranian nursing staff’s self-reported general and mental health related to working conditions and family situation. International Nursing Review. [Accepted]
https://doi.org/10.1111/j.1466-7657.2012.00987.x

IV. Arsalani, N., Fallahi-Khoshknab, M., Josephson, M., & Lagerström, M. Musculoskeletal disorders and working conditions among Iranian nursing personnel [Submitted]