Communication skills and mental health of nursing and midwifery students in northern Iran
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https://www.eduzhai.net International Journal of Nursing Science 2013, 3(2): 33-37 DOI: 10.5923/j.nursing.20130302.01 The Communicating Skills and Mental Health of Nursing and Midwifery Students in North of Iran Ghahraman Mahmoudi1,*, Mohammad Ali Jahani2, Maesoome h Naghavian2 1Islamic Azad University, Sari Branch ,Sari, Iran 2Babol University of M edical Science, Babol, Iran Abstract Students in any commun ity are considered to be the future workforce of that society and their co mmunication skills and mental health are the most impo rtant aspects of human health. this study is conducted to identify co mmunication skills and mental health in nursing and mid wifery students North of Iran. This is an applied research that prepared descriptive and analytical, conducted on 139 nursing and midwifery students which were chosen by cluster and stratified rando m sampling. To collect data, questionnaires were used and in order to analyze the data, the Pearson correlation, Chi square and independent t-test were used. The nurses’ communication skills was average, mid wives were high and total the communicat ion skills was at average ,but the independent t-test between the two groups on their commun ication skills showed no significant difference (P <0/ 22). the findings indicate that in all subjects, there existed a significant relationship among the communication skills and anxiety (P<0/007 and r= 0/ 237), co mmunication skills and depression level (-0/ 196)and communicat ion skills and social function disorder (0/354). Due to the average level of co mmun ication skills, it is necessary that measures be taken in their educational planning to include co mmunicat ion skills and mental health trainings for nursing and midwifery students. Keywords Mental Health, Co mmun ication, Skills, Students 1. Introduction Going to the university Lead to major changes in any person’s life, this period of life is very important . Be in such circu ms tances is oft en coup led with th e pressures and concerns and can effect on people's functioning and mental health. With regard to the importance of mental health in different st rata o f society and key ro le o f nu rs ing and midwifery students , their mental health pro motion can effect on promotion of co mmunity ‘s mental health. Because of the nature of this period , workload and financial problems for some students, study in nursing and mid wifery field, has an inverse relationship with mental health. The feeling of depression and mental stress and other adaptive and anxious disorders are major proble ms in the fie ld of the mental health of the med ical students[2,3]. Lack o f attent ion to these prob lems will lead to t he redu ct io n o f mo t ivat ion for studying in the Universities. Therefore, it is necessary for their work to have a strong spirit and good mental health. It seems that the existing problems in mental health creates difficulty in interpersonal relationships. this problem will be increasing ly crit ical in a close mutual relat ionship  in addition to, creating problems for nurses and mid wives and * Corresponding author: mahmudi.alemi@Iausari.ac.ir (Ghahraman Mahmoudi) Published online at https://www.eduzhai.net Copyright © 2013 Scientific & Academic Publishing. All Rights Reserved Lack of proper co mmunicat ion with patients, problems in mental health will affect on performance of other colleagues. In the meantime patients suffered from the extreme harm . Fro m the consequences of reduction of mental health and communicat ion skills can be noted to the reduction of concentration and attention, learning disorders, academic and functional failure, and Wasting human resources and economic capital of the country's active youth . Ult imately it will have a bad and irreversible effects on the quality of patient care and community health pro motion. In this regard, a study was done on 67 h igh school students in Izmir, Turkey In 2005 by Akai. The results of this study showed the relationship between communicat ion skills and mental health , demographic variab les in this study was not significant. But about 10 percent of students, suffered from anxiety and depression. Also, another study that was done in A merica“ by Muris & et al on 530 s tudents from different dis ciplines of humanities in 2005 with the title of “A study on the mental health and communicat ion skills . the results showed that 12 percent of students had problems such as depression and anxiety, and there was a Significant relationship between the low number of friends and reduction of communication skills, relationships and the problems of an xiety and depression. a research was done by Stevens & et al in 2006 in Boston, America on 450 cases of students under title of the assessment of mental health . result showed about 13.5% of students suffered fro m d ifficu lties such as depression and 34 Ghahraman M ahmoudi et al.: The Communicating Skills and M ental Health of Nursing and M idwifery Students in North of Iran anxiety . The study result of Noorbala & et al showed the Prevalence of mental disorders in d ifferent parts of Iran ranged fro m 9 percent to 36 percent, In this study, 3 percent of psychiatric patients and 1.6 percent of the population over 15 years suffered fro m severe mental d isorder and needed to serious psychiatric treat , and 15.3 percent of this age group had a mild mental illness, and 36.6 percent had different emotional problems. Also, another study conducted by Noorbala & et al in 1999. the sample size of this study were more than 35 thousand people and was used from GHQ questionnaires in this study. result showed 21.5 percent of people over 15 years suffered fro m some degree of mental disorder symptoms. The result of second national survey that conducted by Mohammadi & et a l on 25 thousand people over 18 years old showed 17.1 percent of subjects had some degree of mental disorder. In the study conducted by Taleghani & et al on 485 students of Razi University accord ing to mental status , 46.4% of students were health , 35.5 were relat ively healthy and 18.1% were unhealthy. A lso, Asgharipour and Masoudi with the Examination of the mental health in students of Mashhad’s Ferdusi university with the using of GHQ questionnaire, Showed that 20.03 percent of students suffered fro m mental problems. Therefore, according to the conflict ing results from diffe rent research in the fie ld of the prevalence and incidence of mental disorders , this study was conducted to evaluate the mental health and co mmunication skills of nursing and midwifery students at the Universities of the North of the country . In addition to the drawing of the University students ‘s mental hea lth board , we hope the results of this research can help to the health and students fields planners for better planning . students of that semester . In this study, three questionnaires used as follows:1-Demographic In formation Questionnaire consisted of 18 questions, such as sex, age, marital status, educational field, economic status, the family’s p lace of residency, city name, employ ment and also education, father’s job, mother's occupation, education level of father , educational level of mother, housing status, quota of acceptance in the entrance, high school GPA, how to select field, interest in and satisfaction with course, needs to a psychiatrist, psychologist or counseling center, examined personal, fa milial, social and economic Profiles. 2- GHQ-28 Questionnaire :that is a standard questionnaire and is best known screening tool in Psychiatry and fo r the first time were drawn up by Goldberg in 1972, And widely used to evaluated mental health of the people. For grading samples use fro m the four scoring Likert method as 0-1-2-3. Therefore, each indiv idual score is between 0 and 84 and Its cut score is 23, Th is form has four scales of physical symptoms, an xiety symptoms, social functioning and depression Symptoms . 3 - co mmunication skills questionnaire ,that in a study was conducted by Nabizadeh, the reliability of this questionnaire were reported 81 percent and contains 20 questions that are graded fro m zero to 5. If the total score obtained is between zero to 40, the Co mmun icative skills of person is at low levels. If it is between forty one and sixty the person’s communicat ion skills is at intermed iate level and If it is between sixty one an one hundred, the person’s communicat ion skills is at high-level. Data entered in the software spss18 and for data analysis has been used fro m descriptive statistics[frequencies and percentages] and Inferential statistics (Pearson, chi-square [χ2] and independent t) at a significant level of p ≤ 0.05. 3. Findings 2. Methods This applied Research with the using of descriptive – analytical manner rev iewed and co mpared the mental health and communicat ion skills of 139 people of nursing and midwifery student who were studied in the universities of Gilan and Mazandaran province in north of the countries in years 2011 and 2012. The statistical population consisted of all nursing and midwifery students in public and private universities that were studying in the universities of Sari, Babol, A mol, Ramsar, Chalus, Tonekabon, Rasht , Astara, Lahijan and Rudbar cities. According to the sample size formu la, the number of samples Was estimated 139 people. W ith the Using of cluster samp ling , three Nu rsing and Midwifery Schools of, Sari, Rasht and Tonekabon , were selected Randomly as clusters . After selecting clusters , the applicant samples were selected by random stratified samp ling method. for carry out the plan, samp les selected fro m the Students of various semesters and in Proportional to the number of Fro m 139 total samples, 98/6% were female, 71/9% were single, 71/9% were Nursing student, 27/ 3% were M idwifery student, 90/6% o f participants in the study were native and 38.8% lived in Center o f Mazandaran province. In terms of interest to the field o f study, 2.2% of people had very low interest, 12.2% had lo w interest, 54.7% had high interest and 27.3% of samples had very high interest to their field (Table 1) . Table 1. Table of individuals frequency based on demographic variables Underlying variable type Female Single Nursing Nat ive High interest to the field The need for con sult ant frequency 137 100 100 100 76 69 percent 98.6 71.9 71.9 71.9 54.7 valid percent 98.6 73 72.5 92.6 56.7 the percentage of compression 98.6 100 72.5 92.6 71.6 49.6 50.4 50.4 International Journal of Nursing Science 2013, 3(2): 33-37 35 Table 2. Determining the mental health based on GHQ subscale test in Nursing and midwives student Midwifery Nursing Field Subscales Physical signs of GHQ Anxiety GHQ Impairment in social functioning Depression GHQ Physical signs of GHQ Anxiety GHQ Impairment in social functioning Depression GHQ The sample size 95 95 91 95 33 37 36 38 The mean 6.0316 7.1368 8.8791 4.5368 5.0303 6.7568 9.1389 2.8684 SD 3.66540 4.53265 4.79545 5.23859 3.19653 4.06479 3.68125 3.28939 Table 3. determining and comparing the communication skills of nursing and midwifery groups with the using of independent t-test Variable type, Sam ples Co mmun icat io n skills Fiel d Nursing Midwifery Sample size 100 38 mean 59.93 63.47 standard deviation [SD] 16.12 11.95 Independent T-t est 1.231 Degrees of significanc freedom e level 136 0.22 According to the cut line score of somat ic sy mptoms Subscale of the general health exa m, Two study groups have shown no signs of pathology In this subscale[mean scores of nurses was 6/03, mean scores of midwives was 5/03]. In the anxiety subscale, the nursing students group with an average score of 13/ 7 Showed Mild signs of the some problems associated with an xiety and tension, But there was not this problem in the Midwives group with the average score of 75/ 6. In the social function Impairment subscale, Midwives group with a mean score of 9/ 14 had mild sympto ms in coping with professional demands and problems of everyday life. Also, there were his problem For nurses group with a mean score of 8/88.W ith regard to the mean scores of the depression subscale (mean score of nurses 4/53, mean scores for Mid wives 2/ 86) this two groups have shown no sign of morb id (Tab le 2) The findings of this study showed that according to the cutting line of the GHQ test All subjects had some health problems , So in this study the overall prevalence of mental disorders calculated 25.71 percent. According to the mean scores, the results of this study showed the communication skills of nurses was in average level [the mean scores 59.93] But with respect to the mean scores (63.47) the communicat ion skills of midwives Group was in high level and also with regard to the overall mean of the two groups, communicat ion skills in all of the subjects was in average level. Our find ings also showed that the Commun ication skills of midwifery group was h igher than the communication skills of nursing but independent T-test Showed no statistical significant difference between Nurses group and midwives group in terms of commun ication skills (Table 3) (P<0.22, df= 136, t= 1.23) . Findings revealed that In two groups of nursing and midwifery students, there was a significant difference Between the underlying variables of need to Consultation and general health test subscales , In other words, There was a significant difference between the need for psychologist and consultant with the physical symptoms (p<0.00, df=1, f=13.735), Impairment in social functioning (P< 0.018, df=1, f = 5.76), an xiety (P<0.00, df=1, f=33.59), and depression subscales (P<0.001,df=1,f=11.54). A lso there was no significant relat ionship between other underlying variables and communication skills such as field and communication skills(p<0.023,df=1,f=2.44)and between marital status and Co mmunicat ion skill. However, findings showed there were Significant relat ionship between communication skills and anxiety variables (p<0.007, r=-0.237) between Co mmunicat ion skills and level of depression variables (-0.196) and between Co mmun ication skills and Impairment in social functioning variables (0.345) in all subjects. 4. Discussion Based on this study results, the prevalence of Physical disorder, an xiety, depression and social functioning disorder was 5.77% , 4.6% , 8.95% , 4.06% respectively ,and the rate of overall d isorder was reported 25.71 percent . The results showed the communication skills of nurses was in the average level and the communication skills of midwives was in high level and also the commun ication skills of all subjects was in average leve l . But the differences between independent groups test showed there was no significant d ifference between nurses group and mid wives group in terms of communicat ion skills. also, our findings showed there was significant relationship between communicat ion skills and anxiety variables, between communication skills and depression level variables, and between commun ication skills and Impairment in social functioning variables in all subjects . 36 Ghahraman M ahmoudi et al.: The Communicating Skills and M ental Health of Nursing and M idwifery Students in North of Iran Accordingly, the overall prevalence rate of mental disorders was 25.71 percent . In this field , the studies conducted by Shariaaty & et al , and Ben itez showed the prevalence of psychiatric d isorders among college students was 42.6 and 41 percent respectively that their findings was inconsistent with this study[16,8 ]. Perhaps the cause of these differences be related to the characteristics of research samples, the change in research environment and the use of GHQ28 questionnaire instead of GHQ12 questionnaire in this study. Araujo conducted a study and used the SRQ-20 questionnaire. He evaluate the relat ionship between occupation and psychological needs of nurses in a public hospital in Bra zil . his study’s result showed the prevalence of psychological proble ms was 33.3 percent , which this rate ranged fro m 20 percent among nurses wo men to 36.6% among nursing students which these amounts is slightly more than findings of this study . This difference could be related to different tools and research environment , and it could be due to this fact that stressful events in life can affect on job perfo rmance as well as the cultural specific ity. On the other hand, Rafati & et al with the using of the GHQ-28 questionnaire reported the mental health disorder in Nursing Students of Shiraz’s Nursing school was 24.8 percent , that the findings of this study was almost consistent with the present study . Perhaps the reason for this case is the use of a same tool, the cultural property and the role of dormitory and family separation in growth of psychological stress. In some studies that conducted in several Medical Science universities of our country were obtained the same result. in some universit ies, the prevalence of mental disorders reported below 30 percent and in others above 30 percent. of course in this study, due to the lack of clinical interviews with subjects, accurate detect of mental disorder diagnosis was not possible, so the results only showed signs of mental disorder[6, 16, 17] . The results showed the communication skills of nurses was in the average level and the commun ication skills of midwives was in high level and also the communication skills of the all subjects was in average level. But the differences between independent groups test showed no significant difference between nurses group and midwives group in terms of co mmunicat ion skills . In this regard, the research results of Chan& et al (2003) with the title of "Commun ication skills of health workers and its progress " revealed the Co mmunication skills of studied sample was in average level. A study with the title of " Your knowledge about the basic skills of students» that was conducted by Ingham (2003 ) showed “Less than 50 percent of students in school are familiar with basic skills”. the result o f that study was not consistent with the present study. In a study done by Hemmaty & et al in the Faculty of nursing and midwifery of Uro miyeh University, the communicat ion skills in both groups was in moderate level , but the differences between independent groups test showed no significant difference between nurses group and midwives group in terms of co mmunication skills . the result of described study was coordinated with the present study. Study Results of Mo'laee & et al On co mmun ication skills of the students of Medical Sciences in Ardabil University revealed the communication skills of most male and female students from different fields, was in average level. this study’s findings were consistent with the present study. Perhaps higher communication skills in midwifery students be due to their higher skills in education and their better Professional independence in the future. Another study was conducted by Maurice et al on 530 students from different disciplines of human ities in 2005 with the title of “A study on the mental health and communicat ion skills in the United States”. The results of this study showed 12% of students had some difficu lties such as depression and anxiety, and there was a significant relationship between small nu mber of friends with reduction of relations and communication skills and the problems of anxiety and depression[18,20]. A lso the study’s findings showed that in all subjects there was a significant relationship between Co mmunicat ion skills and an xiety, and between the level of depression and social function variab les . In this regard , The results of Akai’s study that was done on 67 high school students in Izmir, Turkey showed the relationship between co mmunication skills and mental health and demographic variables was not significant (p=0.86). But about 10% o f school children suffer fro m anxiety and depression , that the results of this study were not consistent with the present study. It seems that the existing problems in mental health creates difficulty in interpersonal relationships , this problem will be increasingly critical in a close mutual relat ionship . depression mood causes to reduce of energy, lack of p leasure feeling fro m life activ ities and the loss of the person's personal and social performance . the consequences of these cases can be seen in everyday life. The ability for correct co mmunicate In different groups of med ical students due to It’s impact on their perfo rmance has major importance . 5. Conclusions Due to the relatively high prevalence of mental d isorder among the nursing and midwifery students , and having the average level of commun ication skills It is necessary until some Strategy be adopted in Educational planning for mentioned students should be noted to Commun ication skills training, mental health And improving the quality level of Professional and caring in the Nursing and Midwifery. ACKNOWLEDGEMENTS Special thanks to the all students participating in this study, Assistance of respected Officials of the unit of the Universities in the approval of this plan with the number of 52081860502002. 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