Relationship between Negative Affect and Mental Health of Nurses in Special Wards of Educational Hospitals Affiliated with Mazandaran University of Medical Sciences

Background: Negative Affect is an action occurring when an individual is involved in a mutual interaction, triggered by verbal and non-verbal power in order to make the person to comply with the orders and ultimately, it accompanies with gaining benefits. Negative Affect in workplace in recent years has drawn lots of attention because it results in serious consequences for the individuals and the goals of the organization. For this reason, Negative Affect is viewed as one of the severe forms of organizational and interpersonal misbehaviors in organizational environments. Of such Negative Affect behaviors, we can mention some passive behaviors like: negligence, intentional inattention and active behaviors such as: overt and covert threat. Negative Affect at workplace lowers the staff’s efficiency and performance in the organization since this phenomenon is associated with job dissatisfaction, anxiety, depression, burnout and reduced job commitment. Of course, being exposed to bullying is viewed as a critical source of stress. On the one hand, one of the outcomes of bullying is psychosomatic complaint originating from psychological processes of human beings. Negative Affect is also characterized as a threating factor to the nurses’ health in hospital settings. The findings of a study revealed that by strengthening resilience and hope, it’s viable to control the consequences of encountering bullying on the psychosomatic health of the nurses. As the conducted studies suggest, various factors such as: lack of understanding among fellows and manager, personality traits, major changes in practice bring about bullying. The research by Johnson et al. (2019) suggested that Negative Affect outbreak is high among nurses and as Negative Affect increases, the quality of care provided by the nurses decreases and client’s safety declines and job burnout increases. Since one of the tasks in this profession is to maximally maintain people’s health, thus the nursing staff have to be equipped with maximum level of health. In particular, due to the nature of the ward, the nursing working in special wards are more exposed to the situations like the patients on the verge of death, emergencies and unpredictable conditions, noisy monitoring equipment and conducting clinical and drug administration processes with advanced and efficient devices. Despite the studies performed about hospital workplace related Negative Affect, nothing as exclusive has been discovered so far dealing with bullying association with special wards’ nurses’ mental health. This gap emphasizes the necessity for further studying. Consequently, the current study has been designed and performed pursuing the goal to outline the relationship between Negative Affect and special wards’ nurses’ mental health in the educational hospitals affiliated with MazandaranUniversity of Medical Sciences. Method: This study is a descriptive-analytical research done as cross-sectional in 2020. The statistical community is made up of all (ICUs, CCUs and dialysis wards) nurses from five educational hospitals of Mazandaran University of Medical Sciences (Sari based Imam Khomeini, Bu Ali Sina, Heart Center, Zare and Razi). The nurses were selected through proportional and simple random methods, which overall resulted in 195 nurses. The data collection consisted of three questionnaires as the demographics, bullying and mental health. A) The demographics questionnaire including age, gender, hospital, marital status, job status and working history. B) Bullying (Negative Affect) questionnaire developed in 2001 and psychometrically assessed in Iran by Salimi et al. (2017). C) General Health Questionnaire (GHQ) was developed in 1972 and psychometrically assessed by Tehrani et al. (2011) in Iran and its reliability was reported as 0.93 using Alpha-Cronbach. The ethical considerations observed in the present research involved not requiring the name to be mentioned in the questionnaires, giving the samples information about the research objectives and the optional participation in the study. Having acquired the permit from Nasibeh School of Nursing and Midwifery and Ethics Committee of Mazandaran University of Medical Sciences, the questionnaires were distributed in Google Form in the social networks of the nurses in the study hospitals and after completing and collecting the questionnaires, the obtained data were analyzed using SPSS -21 and descriptive statistics indices (frequency distribution tables, mean and standard deviation) and and correlation coefficient (predicting the random variable in terms of another variable) was analyzed. Findings: The mean and the standard deviation of Negative Affect imposed on the CCU nurses got the max score as 62.53±14.90 and that of the ICU nurses got the min score as 55.68±15.77 and 72.6% of the participants were exposed to moderate rate of bullying. The mean and standard deviation of the mental health of the CCU nurses got the max score as 33.03 ±8.09 and that of the dialysis wards’ nurses got the min score as 29.11±2.61. Regarding the subscales of the General Health Questionnaire, the social area with a frequency of 93% was identified as the most prevalent disorder and depression with a frequency of 1.6% was detected as the least common disorder. According to the study findings, a significant positive correlation was discovered between Negative Affect and its dimensions and mental health and its dimensions (P≤0.00). Besides, in some cases, the correlation between the mental health dimensions and Negative Affect each other was achieved as poor: the correlation coefficient with social area was gained as 0.875 and with depression area as 0.225. Conclusion: The positive correlation between Negative Affect and mental health indicates that as bullying score increases, the nurses' mental health decreases. Moreover, the findings revealed that the mental health of women and single individuals is more exposed to danger. Since one of the obligations in this profession is to maintain and promote people’s health, then the nursing staff have to be at the maximum level of health so that to be less affected by the consequences of this phenomenon when facing Negative Affect. Therefore, it’s imperative for the medical health system management to develop some programs to lower Negative Affect in nurses’ workplace environment. Regarding the significant relationship existing between Negative Affect and mental health, it can be inferred that by workplace bullying increases , the individuals’ mental health gets impaired .According to the study derived findings about the mental health of women and single individuals, it’s recommended to screen the organizational Negative Affect behavior in the professional health services of the organization, or to develop on-the-job training courses or some courses during their studies at university to increase their mental health and preparedness for Negative Affect behaviors among this group of people so that to be equipped with favorable mental health when encountered with Negative Affect behaviors. Moreover, to determine the proposed approaches’ effectiveness, it’s imperative to develop and conduct an intervention study.  Of the present study limitations, we can report lack of controlling the confounding factors of Covid-19 pandemic effect on nurses’ mental health which results in being cautious about generalizing and interpreting the study findings. Therefore, it’s required to perform extensive studies about Negative Affect and mental health of the nurses in other province located hospitals and also employ other tools such as qualitative approaches like interview in order to boost the accuracy of post-Covid-19 pandemic study findings.