fa مهارت اعلام خبر بد و عوامل مرتبط در پرستاران: یک مطالعه مقطعی تخصصي Special پژوهشي Research <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="FA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">زمینه</span></span></span></span></span></span></b><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.1pt">&nbsp;و هدف:</span></span></span></span></span></span></b>&nbsp;<span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">ارائۀ خبر بد یکی از چالش‌برانگیزترین وظایف در مراقبت سلامت است؛ به‌ویژه برای پرستارانی که نقطه تماس اصلی بیماران و خانواده‌ها هستند. باوجود اهمیت این مسئولیت، آموزش ساختاریافته و دستورالعمل‌های استاندارد برای پرستاران محدود است. این مطالعه مهارت پرستاران در ارائۀ خبر بد و عوامل مرتبط با آن را در بیمارستان‌های آموزشی دانشگاه علوم پزشکی کردستان بررسی کرد.</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">مواد و روش‌‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.15pt">:</span></span></span></span></span></b><b>&nbsp;</b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">این مطالعۀ مقطعی در سال ۱۴۰۱ انجام شد. ۱۵۰ پرستار دارای حداقل یک سال سابقۀ کار و مدرک کارشناسی یا بالاتر، با استفاده از نمونه‌گیری چندمرحله‌ای شامل نمونه‌گیری طبقه‌ای و در دسترس انتخاب شدند. داده‌ها با پرسش&rlm;نامه‌ای شامل ویژگی‌های فردی، انواع اخبار بد، مشارکت در ارائۀ خبر بد و مهارت ارائۀ خبر بد جمع‌آوری شد. روایی ابزار با نظر کارشناسان و پایایی آن با آلفای کرونباخ 0/71 تأیید شد. داده‌ها با نرم‌افزار </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">STATA</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">نسخۀ ۱۲ و آزمون‌های هم&rlm;بستگی اسپیرمن، من‌ویتنی </span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">U</span></span> <span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">و کروسکال</span></span><span lang="AR-SA" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">&ndash;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">والیس تحلیل شدند (</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P<0/05</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">).</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">یافته‌ها</span></span></span></span></span></span></b><b><span b="" lang="AR-SA" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:.2pt">:</span></span></span></span></span></b><b>&nbsp;</b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">شایع‌ترین نوع خبر بد، اعلام کد احیا (67/76</span></span><span lang="AR-SA" style="font-size:10.0pt"><span new="" roman="" style="font-family:" times="">٪</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) بود. میانگین نمرۀ مشارکت 5/85</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">17/68و میانگین نمرۀ مهارت ارائۀ خبر بد 5/10&nbsp;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span cambria="" style="font-family:">&plusmn;</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">&nbsp;54/30 بود. مهارت ارائۀ خبر بد با شیفت کاری (0/026</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، آشنایی با دستورالعمل اطلاع‌رسانی خبر بد (0/040</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، &nbsp;بخش خدمت (0/009</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">)، تعداد خبر بد (0/012</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) و نوع خبر بد (0/014</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">) ارتباط معنادار داشت. ارتباط با پست سازمانی مرزی بود (0/055</span></span><span dir="LTR" style="font-size:9.0pt"><span new="" roman="" style="font-family:" times="">P=</span></span><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">).</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:"><span style="color:#2419f7"><span style="position:relative"><span style="top:-1.0pt"><span style="letter-spacing:-.15pt">نتیجه‌گیری:</span></span></span></span></span></span></b><span lang="AR-SA" style="font-size:10.0pt"><span b="" nazanin="" style="font-family:">&nbsp;پرستاران مهارت متوسطی در ارائۀ خبر بد داشتند. اجرای برنامه‌های آموزشی ساختاریافته و کارگاه‌های مهارت ارتباطی برای بهبود شایستگی پرستاران و کیفیت مراقبت از بیماران و خانواده‌ها توصیه می‌شود.</span></span><span lang="FA" style="font-size:10.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span></span> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#2140a3"><span style="letter-spacing:.15pt">Background and Aim:</span></span></span></span></b> <span lang="EN" style="font-size:9.0pt"><span style="font-family:Optima">Delivering bad news is a challenging healthcare task, particularly for nurses who are primary points of contact for patients and families. Despite its importance, structured training and standardized guidelines for nurses remain limited. This study assessed nurses&rsquo; skills in delivering bad news and related factors in teaching hospitals affiliated with Kurdistan University of Medical Sciences, Sanandaj, Iran.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#2140a3">Materials and Methods: </span></span></span></b><span lang="EN" style="font-size:9.0pt"><span style="font-family:Optima">This cross-sectional study was conducted in 2022. A total of 150 nurses with at least one year of experience and a bachelor&rsquo;s degree or higher were selected using multistage sampling, including stratified and convenience sampling. Data were collected using a four-part questionnaire addressing demographic characteristics, types of bad news, involvement in delivery, and delivery skills. Validity was confirmed by experts, and reliability was supported by a Cronbach&rsquo;s alpha of 0.71. Data were analyzed using STATA (version 12), Spearman&rsquo;s correlation, Mann&ndash;Whitney U, and Kruskal&ndash;Wallis tests (P<0.05).</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#2140a3"><span style="letter-spacing:.15pt">Results:</span></span></span></span></b> <span lang="EN" style="font-size:9.0pt"><span style="font-family:Optima">The most common bad news was announcing a resuscitation code (76.67%). The mean participation score was 17.68&plusmn;5.85, and the mean delivery-skill score was 54.30&plusmn;5.10. Delivery skills were significantly associated with work shift (P=0.026), familiarity with bad-news disclosure guidelines (P=0.040), clinical department (P=0.009), number of bad-news events delivered (P=0.012), and type of bad news (P=0.014). The association with organizational position approached statistical significance (P=0.055).</span></span></span></span></span></span><br> <span style="font-size:12pt"><span style="unicode-bidi:embed"><span ms="" style="font-family:" trebuchet=""><span style="color:black"><b><span style="font-size:9.0pt"><span style="font-family:Optima"><span style="color:#2140a3"><span style="letter-spacing:-.1pt">Conclusion:</span></span></span></span></b> <span lang="EN" style="font-size:9.0pt"><span style="font-family:Optima">Nurses demonstrated moderate skills in delivering bad news. Structured educational programs and communication workshops are recommended to improve competence and the quality of patient and family care.</span></span><span dir="RTL" lang="AR-SA" style="font-size:9.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br> &nbsp; مهارت, اعلام خبر بد, عوامل مرتبط, پرستاران Skill, Delivering Bad News, Related Factors, Nurse 129 139 http://sjnmp.muk.ac.ir/browse.php?a_code=A-10-752-1&slc_lang=fa&sid=1 esrin lotfi اسرین لطفی asrinlotfi25@gmail.com 10031947532846008227 10031947532846008227 Yes Clinical Research Center, Health Development Research Institute, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز تحقیقات بالینی، پژوهشکده توسعه سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران Bijan Nouri بیژن نوری bijannuri@gmail.com 10031947532846008228 10031947532846008228 No Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran مرکز تحقیقات عوامل اجتماعی مؤثر بر سلامت، دانشگاه علوم پزشکی کردستان، سنندج، ایران Mohammad Fathi محمد فتحی Fathi_sanan@yahoo.com 10031947532846008229 10031947532846008229 No School of Medicine, Islamic Azad University, Sanandaj Branch, Sanandaj, Iran دانشکده پزشکی دانشگاه آزاد اسلامی واحد سنندج، سنندج، ایران