Psychological Capital of Nurses Working in Academic Medical Centers of Iran University of Medical Sciences

Nursing, the core and front line of the health system, is considered as one of the most challenging jobs due to problems such as lack of human resources, increasing demand in the clinical environment, constant changes in work schedule, client expectations, legal problems, and client mortality. Paying attention to influential factors including client health is important in creating a positive working environment and increasing the mental health of nurses. One of the issues raised recently is psychological capital, with four dimensions of self-efficacy, optimism, hope, and resilience. Psychological capital has a positive effect on work attitude and behavior and is positively related to constructive performance. In addition, psychological capital leads to better psychological health, better adaptation to stressful conditions, and increases nurseschr('39') ability to cope with the problems. Given that nurses are always exposed to physical, mental, and emotional challenges, hospital managers should provide mechanisms to reduce potential workplace risks. Recognition of preventive factors (e.g., psychological capital) is the first step towards the growth and development of effective policies in this area. Therefore, this study was conducted to determine the psychological capital of nurses working in academic medical centers of Iran University of Medical Sciences.

This descriptive study was conducted to examine the psychological capital of nurses working in academic medical centers of Iran University of Medical Sciences in 2019. The study population was all nurses working in academic medical centers affiliated to Iran University of Medical Sciences in 2019 and the sample included 305 nurses with inclusion criteria (at least 1 year of clinical experience and not facing severe crises or death of loved ones during the last 6 months) from emergency departments, pediatric ward, ICU, CCU, internal ward, psychiatric ward, Operating room, obstetrics ward, surgical ward, dialysis unit, burn unit, oncology, and etc. Sampling was performed using proportional allocation procedure and samples were selected from academic medical centers of Iran University of Medical Sciences. The Psychological Capital Questionnaire devised by Luthans was used to collect the data. The questionnaire Includes 24 items in 4 subscales of hope, self-efficacy, resilience, and optimism, and is scored based on 6-point Likert scale  ranging from 1 (strongly disagree) to 6 (strongly agree). Its score ranges from 24 to 144, with a higher score indicating a higher level of psychological capital. The Demographics Survey included information such as age, gender, marital status, employment status, education, work experience, income, employment in one or more hospitals, experience in the current ward, work experience in current hospital, job position, shift work. Sampling and collecting questionnaires took about 5 months (from October 2019 to March 2020) as the nurses were too busy. Data analysis was performed using SPSS software version 16. Descriptive statistics and inferential statistics were used to analyze the data. In the descriptive statistics part, frequency distribution tables were used to analyze the qualitative variables of the research and numerical indices of minimum, maximum, mean, and standard deviation were used to analyze the quantitative variables of the research. In inferential statistics part, Pearson correlation coefficient, independent t-test, ANOVA, and multiple linear regression model were used.

The mean age of the subjects was 34.75 with a standard deviation of 7.71 years. 86.9% of the nurses were female and 86.6% had an undergraduate degree. Most nurses were married (55.4%). The economic status of 78.7% of the nurses was average and 89.8% of them did not report any specific chronic disease. 49.8% of the nurses were employed. The morning shift accounted for 63.3% of the work shift. The majority of participants were nurses (85.2%). Most of the participating nurses were working in intensive care units (38%). The average work experience of all participants was 10.44 ± 6.96. Their average work experience in the current wards was 4.82 ± 4.41 and also the average work experience in the current hospital was 8.26 ± 6.20. The results revealed that the mean of psychological capital was 104.63 ± 15.25, and given the score range of 24-144 in the Psychological Capital Questionnaire and the mean score, it can be concluded that nurses had a high level of psychological capital.  Among the components of psychological capital, the highest mean score was related to self-efficacy of 28.29 ± 4.70 and the lowest mean score was related to resilience of 24.62 ± 4.37. Also, psychological capital had a statistically significant relationship with job position (P <0.001) and chronic disease (P = 0.050). Tukeychr('39')s multiple comparison showed that the mean score obtained for psychological capital of nurses was significantly lower than the one obtained for head nurses (P = 0.002) and supervisors (P = 0.029). It was also observed that the average score of psychological capital in nurses with chronic diseases was significantly lower than others. It should be noted that other personal and occupational variables had no statistically significant relationship with psychological capital.

According to the mean scores obtained from this study, it can be said that nurses have an almost high level of psychological capital and the highest mean score among the dimensions of psychological capital was related to self-efficacy. Regarding the correlation of research variables with demographic characteristics, the results showed that the psychological capital of nurses was less than that of head nurses and supervisors, which increases the importance of addressing psychological capital in nurses.  It is possible to provide the basis for improving their personal, professional, and caring performance by focusing on psychological capital in nurses and adopting proper planning for necessary training in this field. Considering that the resilience component of the psychological capital variable obtained the lowest average, paying attention to this component in nurses is of great importance. We can also point out the importance of these variables and their impacts on personal, occupational, and organizational areas, including personal and psychological effects and care outcomes such as improving the quality of care and organizational outcomes, which increases the importance of paying attention to it.