The Relationship between Missed Nursing Care and Job Burnout in Intensive Care Units

The Relationship between Missed Nursing Care and Job Burnout in Intensive Care Units | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship between Missed Nursing Care and Job Burnout in Intensive Care Units Shahin Shabani, Shahnaz Salawati Ghasemi, Arian Azadnia, Neda Sheikhzakaryaee This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4595367/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Providing quality nursing care in intensive care units is a crucial and vital component of hospital services. Conversely, the stress and workload in these environments put nurses at risk of job burnout. This study aimed to examine the relationship between missed nursing care and job burnout among nurses in intensive care units. Methods This cross-sectional study was conducted using a census sampling method on 200 nurses working in the intensive care units of teaching hospitals at Kurdistan University of Medical Sciences in Iran. The data were collected using demographic information forms. The Kalisch Missed Nursing Care Questionnaire and the Maslach Burnout Inventory (MBI). Descriptive and analytical analyses were performed using SPSS software version 24. Results In this study, the mean score of missed nursing care was 35.29 ± 9.43. Additionally, a moderate level of job burnout among nurses was found with a mean score of 42.54 ± 17.22. The results indicated a significant relationship between missed nursing care and the gender and economic status of the nurses (P < 0.05). Furthermore, missed nursing care was significantly related to job burnout and its dimensions, including depersonalization and personal accomplishment (P < 0.05). Conclusion Based on these findings, to enhance the quality of healthcare services in intensive care units, measures should be taken to reduce missed nursing care and job burnout among nurses in these units. Missed Nursing Care Job Burnout Nurse Intensive Care Unit Background Recent research has shown that missed nursing care is a highly prevalent phenomenon in acute care settings ( 1 ). This issue has been recognized as a critical concept in nursing within acute care facilities worldwide ( 2 ) and is considered one of the forms of healthcare deficienciy on a global scale ( 3 ). Missed nursing care refers to the neglect of both minor and major aspects of patient care that are either forgotten or delayed ( 4 ), partially completed, or not completed at all. In another definition, it involves care that is essential and necessary for the optimal and rapid recovery of patients but is omitted or not performed ( 3 ). Moreover, missed nursing care is not only a type of nursing error that can affect patient safety but also leads to the neglect of patients' rights and jeopardizes their rehabilitation and recovery ( 4 ). Nursing care holds particular importance due to its direct impact on patient recovery and health ( 5 ). It can also serve as a benchmark for comparing performance across systems and organizations ( 6 ). Several factors, such as understaffing, poor teamwork and safety, and work-related stress, contribute to missed care ( 7 ). Emotional exhaustion among nurses is one such factor that leads to diminished care quality ( 8 ). Indeed, job burnout and occupational stress among healthcare workers are among the threats to patient safety and care quality. Job burnout among healthcare workers is an independent predictor of adverse events, healthcare-associated infections, and medical errors, and it is associated with poor patient satisfaction ( 9 ). Among the job-related consequences of burnout are withdrawal from work, absenteeism, changes in job performance, and; decreased activity and effectiveness at work for those who remain in their positions ( 10 ). Therefore, job burnout and job dissatisfaction not only lead to staff turnover but also have a detrimental impact on the quality of care ( 11 ). When a nurse experiences burnout, patients are deprived of adequate attention and care, and their individual human rights are called into question. A nurse suffering from burnout, due to depersonalization, responds negatively to care recipients ( 12 ). The evidence suggests that nurse burnout affects patient recovery more than any other factor ( 13 ). Studies indicate that 23 to 43% of intensive care unit (ICU) nurses worldwide suffer from job burnout ( 14 ), characterized by high levels of emotional exhaustion (EE) and depersonalization, and low levels of personal accomplishment (PA) ( 15 ). Providing care in the ICU requires nurses to regularly handle and manage the most critical cases ( 15 ), making ICU work more stressful for nurses and impacting the quality of care they provide ( 16 ). Recent evidence shows that insufficient, delayed, or even omitted nursing care is widespread among nurses responsible for providing care ( 6 ). In fact, the ability of nurses to provide care and fulfill their roles is greatly influenced by the work environment in which they serve ( 11 ). Several studies have shown that missed nursing care is prevalent in hospitals in the United States and Europe ( 17 , 18 ). In a study conducted in the United States, the prevalence of missed nursing care was reported to be between 10 to 27% ( 19 ). A review of related literature indicates that this issue is highly context-dependent, varying in frequency and type across different hospitals within the same country and even across different units within the same hospital ( 20 ). In Iran, the rate of missed nursing care has been reported to be greater than that in other parts of the world ( 21 ). For instance, a recent Iranian study revealed that 72.1% of nurses missed at least one nursing care activity during their last shift ( 22 ). Studies on missed nursing care highlight the greater the importance of quality nursing care and its comprehensiveness in intensive care units (ICUs) than in other departments. Therefore, assessing factors such as job burnout, which may be related to missed nursing care in ICUs, is crucial. However, there have been few studies specifically examining the relationship between missed nursing care and job burnout, and these studies have not been conducted recently, particularly in Iran, or within ICU settings. Thus, this study aimed to fill this gap by determining the relationship between missed nursing care and job burnout among nurses in intensive care units. Methods The present study was a cross-sectional study with a descriptive-analytical approach. The research population included all nurses working in the intensive care units of teaching hospitals at Kurdistan University of Medical Sciences in Iran in 2023. The research sample was selected from the research population based on inclusion criteria, which included having rotating shift duties, at least six months of clinical experience in an intensive care unit, willingness to participate in the study, and holding a bachelor's degree or higher. The sampling method used was convenience sampling. The exclusion criterion was incomplete completion of the questionnaires. The research environment for this study comprised 11 intensive care units in Kosar, Towhid, and Besat educational hospitals affiliated with Kurdistan University of Medical Sciences. To determine the sample size, a census method was used, and all nurses working in the intensive care units of these teaching hospitals in 2023 were included in the study. It is worth mentioning that the total number of nurses working in the intensive care units of Kurdistan's teaching hospitals was 253. Of these, 23 did not meet the inclusion criteria, and out of the remaining 230, 200 completed the questionnaires. In this study, the data collection tools included a demographic information form for nurses, the Kalisch Missed Nursing Care Questionnaire, and the Maslach Burnout Inventory (MBI). The demographic information form comprised questions related to age, gender, marital status, education, employment status, economic status, place of residence, place of employment, length of employment in ICUs 1 , length of employment overall, number of shifts per month, type of shift, total working hours per month, and the amount of overtime per month. In the present study, the Kalisch Missed Nursing Care Questionnaire was used to assess missed nursing care. This questionnaire was developed by Kalisch in 2006 and was psychometrically evaluated by the same researcher in 2009. It consists of 24 items, including patient movement, turning, assessment, education, discharge planning, and medication administration. Each item is rated on a four-point Likert scale ranging from 1 to 4. Higher scores on this questionnaire indicate a higher level of missed nursing care, and vice versa. The maximum score on this questionnaire is 96, and the minimum score is 24 ( 23 ). The validity of this tool in Iran was estimated by Khajavi and colleagues (2019) to be 0.91 ( 23 ). In the study by Abadi and colleagues (2021), its reliability was calculated using Cronbach's alpha, which was 0.88 ( 23 ). Notably, in the present study, to assess face validity, a questionnaire was provided to 10 faculty members who are experts in nursing care, and their feedback was incorporated into the questionnaire items. Subsequently, to assess reliability, we used Cronbach's alpha. The Maslach Burnout Inventory (MBI) was used to measure job burnout among nurses. This questionnaire consists of 22 items designed to assess three dimensions of job burnout: emotional exhaustion (9 items), depersonalization (5 items), and reduced personal accomplishment (8 items). High scores in the dimensions of emotional exhaustion and depersonalization, along with low scores in personal accomplishment, indicate a high level of job burnout. The scores for each dimension are considered separately and are not combined into a single total score. In the study by Azimi Lolaty and colleagues, the reliability coefficients for the dimensions of emotional exhaustion, depersonalization, and personal accomplishment were calculated to be 0.90, 0.79, and 0.71, respectively ( 24 ). In the study by Rasoul Aghadavoud, the Cronbach's alpha coefficient for the Maslach Burnout Inventory was calculated to be 0.852 ( 25 ). In this study, data analysis was conducted using SPSS version 24 software. Descriptive analysis of the data was performed using frequency tests, means, and standard deviation calculations. To explore the relationships between variables, various statistical tests, including t-tests, Mann-Whitney U tests, ANOVA, and Kruskal-Wallis tests were used. Furthermore, linear regression analysis was conducted to evaluate correlations between variables. The significance level was set at 5%. Ethical Concentration: To collect the data, the researcher first obtained approval from the Research Deputy of Kurdistan University of Medical Sciences and obtained ethics committee clearance (IR.MUK.REC.1402.107). First, the proposal was reviewed and approved by the research council of the university. Subsequently, the researcher approached the authorities of the educational hospitals. We sought permission to conduct the research. After briefing the authorities and the units under study (nurses working in special care units) about the study objectives and obtaining their consent, sampling was initiated. Notably all the data obtained from the questionnaires were treated as confidential. Sampling was carried out using a census method for nurses. The questionnaires were then distributed to the study participants, who received thorough instructions on how to complete them. Adhering to ethical standards, the researcher distributed the questionnaires anonymously among the research units after providing their consent_ while providing assurance to both nurses and patients regarding the confidentiality of the collected information. Data are available in this study. Ethical considerations were followed in writing the article based on the Declaration of Helsinki. Results The results of the present study regarding 200 nurses working in the intensive care units of educational hospitals affiliated with Kurdistan University of Medical Sciences showed that the age of the studied nurses was 32.05 ± 6.09 years. The majority of the studied nurses were female (58.0%), married (54.0%), had a bachelor's degree (94.5%), were officially employed (49.0%), and had moderate economic status (65.5%), resided in urban areas (99.0%), and had a workplace at Kowsar Hospital (48.5%). Furthermore, the average length of employment for the studied nurses in the special care units was 21.5 ± 4.41 months, and the average length of service was 17.04 ± 20.13 months. Additionally, the average number of shifts worked by the studied nurses was 20.00 ± 15.52, and the average number of working hours was 187.06 ± 28.56 (Table 1 ). Table 1 Demographic Characteristics nurses employed in the intensive care department of teaching hospitals, Sanandaj, Iran (n = 200) Demographic characteristics Mean ± (SD) or Number (%) Age 32.05 ± 6.09 Gender Male 84 (42.0%) Female 116 (58.0%) Marital status Married 109 (54.5%) Single 85 (42.5%) Divorced 5 (2.5%) Widowed/ Widower 1 (0.5%) Level of education Associate's degree 1 (0.5%) Bachelor's degree 189 (94.5%) Master's degree 10 (5.0%) Employment status Employed by a company 10 (5.0%) Contractual 52 (26.0%) Fixed-term contract 35 (17.5%) Official 98 (49.0%) Service commitment period 5 (2.5%) Economic status Weak 43 (21.5%) Moderate 131 (65.5%) Good 26 (13.0%) Place of residence City 198 (99.0%) Village 2 (1.0%) Workplace hospital Kawsar Hospital 97 (48.5%) Tohid Hospital 87 (43.5%) Be'sat Hospital 16 (8.0%) Duration of employment in the intensive care unit (ICU) 5.21 ± 4.41 Duration of nurses' employment 17.04 ± 120.31 Number of nursing shifts 20.00 ± 15.52 The working hours of nurses 187.06 ± 28.56 Work shift type Fixed shift 39 (19.5%) Rotating shift 161 (80.5%) Overtime hours per month 100> 190 (95.0%) 100< 10 (5.0%) The results of the present study indicated that in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences, the average score for forgotten nursing care was 29.35 ± 43.9, the average score for emotional exhaustion of nurses was 25.14 ± 11.12, the average score for depersonalization of nurses was 9.4 ± 56.5, the average score for personal accomplishment of nurses was 19.24 ± 5.9, and the average score for nurses' occupational burnout was 54.42 ± 22.17 (Table 2 ). Table 2 The distribution of scores for Missed nursing care, Nurse Burnout, and dimensions of Nurse Burnout (n = 200) Scores Mean ± (SD) Missed nursing care 35.29 ± 9.43 Emotional Exhaustion 14.25 ± 12.11 Depersonalization 4.05 ± 5.56 Personal Accomplishment 24.19 ± 9.05 Nurse Burnout 42.54 ± 17.22 The results of the present study, based on the Mann_Whitney test, showed a significant relationship between the score of forgotten nursing care and the gender of nurses (P = 0.024), the economic status of nurses (P = 0.0001), and the hospital where nurses worked (P = 0.0001). Additionally, according to the Spearman correlation test, there was a significant correlation between the score of forgotten nursing care and the emotional exhaustion of nurses (P = 0.0001), the depersonalization score of nurses (P = 0.0001), the personal accomplishment score of nurses (P = 0.0001), and the occupational burnout score of nurses (P = 0.045) in special care units (Table 3 ). Table 3 Scores of Missed Nursing Care and its Association with Demographic Characteristics, Nurse Burnout, and its Dimensions, Sanandaj, Iran (n = 200) Missed nursing care score Demographic characteristics Mean ± (SD) or Frequency (Average Rank) Spearman’s rho P-value Scores of Missed nursing care 35.29 ± 9.43 Age 32.05 ± 6.09 − 0.032 0.654 Gender Male 84 (111.36) 0.024 Female 116 (92.63) Marital status Married 109 (109.07) 0.091 Single 85 (88.57) Divorced 5 (110.30) Widowed/ Widower 1 (131.50) Level of education Associate's degree 1 (141.50) 0.620 Bachelor's degree 189 (99.66) Master's degree 10 (112.25) Employment status Employed by a company 10 (102.70) 0.320 Contractual 52 (86.87) Fixed-term contract 35 (112.24) Official 98 (102.75) Service commitment period 5 (111.60) Economic status Weak 43 (120.74) 0.0001 Moderate 131 (107.43) Good 26 (32.10) Place of residence City 198 (101.01) 0.246 Village 2 (50.25) Workplace hospital Kawsar Hospital 97 (121.19) 0.0001 Tohid Hospital 87 (80.53) Be'sat Hospital 16 (83.69) Work shift type Fixed shift 39 (107.05) 0.430 Rotating shift 161 (98.91) Overtime hours per month 100> 190 (100.94) 0.639 100< 10 (92.15) Duration of employment in the intensive care unit (ICU) 5.21 ± 4.41 − 0.126 0.075 Duration of nurses' employment 17.04 ± 120.31 − 0.030 0.672 Number of nursing shifts 15.52 ± 20.00 0.089 0.212 The working hours of nurses 187.06 ± 28.56 0.077 0.280 Emotional Exhaustion 14.25 ± 12.11 0.380 0.0001 Depersonalization 4.05 ± 5.56 0.318 0.0001 Personal Accomplishment 24.19 ± 9.05 -0.349 0.0001 Nurse Burnout 42.54 ± 17.22 0.142 0.045 The results of the present study, based on linear regression analysis, demonstrated a significant relationship between forgotten nursing care and sex (P = 0.037) as well as economic status (P = 0.0001) (Table 4 ). Table 4 Regression Analysis of the Relationship Between Missed Nursing Care and Demographic Variables Among Researched Nurses Variable B S. E Sig Collinearity Tol VIF Intercept - 13.619 0.000 - - Age -0.040 0.186 0.740 0.292 3.421 Gender -0.148 1.339 0.037 0.854 1.171 Marital status 0.086 1.154 0.225 0.849 1.178 Education 0.024 2.799 0.731 0.898 1.113 Employment status 0.090 0.674 0.213 0.808 1.238 Economic status -0.331 1.154 0.000 0.829 1.207 Place of residence -0.004 6.298 0.957 0.949 1.053 Workplace hospital -0.133 1.122 0.080 0.738 1.354 Duration of employment in the intensive care unit (ICU) -0.069 0.221 0.505 0.392 2.550 Duration of nurses' employment 0.010 0.005 0.887 0.909 1.100 Number of nursing shifts 0.098 0.040 0.140 0.963 1.039 Work shift type -0.013 2.053 0.885 0.564 1.775 The working hours of nurses -0.107 0.026 0.171 0.969 1.437 Overtime hours per month 0.022 2.909 0.750 0.927 1.078 Discussion The present study aimed to investigate the relationship between missed nursing care and job burnout among nurses working in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences in 2023. The study was conducted on 200 nurses employed in the aforementioned hospitals. The results of the current study indicated that the mean scores of job burnout among nurses and its dimensions were moderate for emotional exhaustion, low for depersonalization, and low for personal accomplishment. The findings of the present study regarding the association between job burnout score and the study by Rastegari and Zendehdel (2023) are consistent; in this study, the overall score of job burnout among nurses was moderate ( 26 ). In terms of the dimensions of job burnout, another study by Rastegari and colleagues (2021) showed that the average scores of the emotional exhaustion and depersonalization dimensions were moderate, and that of the personal accomplishment dimension was low ( 26 ). Additionally, a study conducted by Mudallal et al. (2017) on 407 Jordanian nurses demonstrated a high level of job burnout in the emotional exhaustion and depersonalization domains and a moderate level of personal accomplishment ( 27 ). In the study by Ghazvini et al. (2023), 84% of nurses were found to experience job burnout ( 28 ). However, a systematic review and meta-analysis by Esfahani et al. (2018) reported a job burnout prevalence of 25% among Iranian nurses ( 12 ). Furthermore, a study systematic review and meta-analysis by Wu et al. (2023) on the global prevalence of job burnout symptoms among revealed an overall prevalence of 11.23%. This study included 113 studies for systematic review and 61 studies for meta-analysis, comprising 45,539 nurses from 49 countries across various specialties ( 29 ). Based on these findings, it may be concluded that the prevalence of job burnout among nurses in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences is greater than that in global statistics. Several factors may contribute to this issue, including long working hours, excessive time, insufficient staffing relative to workload, frequent fluctuations in demand and response to medical and nursing care, psychological pressures, and stress waves resulting from sudden and critical patient conditions, as well as unexpected critical events such as accidents and physical injuries. Moreover, the imbalance between workload and material and spiritual rewards is one of the factors that may contribute to nurse burnout in these environments. Therefore, managerial and executive measures to reduce workload pressure, increase staffing levels, establish rest and psychological support programs, and strengthen support systems can help improve the job burnout status of nurses in these units. Additionally, some of these differences may be attributed to environmental, cultural, and organizational factors associated with each work environment, which requires further investigation and analysis. The results of the present study indicated that the average score for missed nursing care in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences was 43.9 ± 29.35. This was in contrast to the findings of Mohammadi et al. (2023), who reported an average score of missed nursing care in COVID-19 special care units in Kurdistan of 20.24 ± 18.55, which was higher than the level observed in the current study. The higher rate of missed nursing care in Mohammadi et al.'s study may be attributed to the timing of the study during the COVID-19 pandemic and the impact of the coronavirus crisis on missed nursing care. Additionally, the results of Khajavi et al. 's study in Kerman in 2017 showed an average score for missed nursing care of 41.7 ± 28.32, which was close to and consistent with the findings of the present study. This finding contrasts with a study by Hessels et al. (2015) conducted in the United States, where the prevalence of missed nursing care was reported to be between 10% and 27%. In another study by Blackman et al. (2015), the rate of missed nursing care was 34%, which is consistent with the results of the present study. However, the rate of missed nursing care in the study by Labrague et al. (2022) in the Philippines was very low at 50.0 ± 35.1. The authors predicted that the reasons for the low rate of missed care include inadequate patient surveillance as the most commonly missed nursing activity, hospital resource levels, staffing levels, and patient safety culture. The present study results revealed a significant relationship between the missed nursing care score and the gender of nurses in special care units. This finding was consistent with the study by Chegini et al. (2019). It should be noted that in the current study, the frequency of missed nursing care was greater for women than for men, while Chegini et al. reported a greater risk of missed care for men. Most of the reviewed studies did not observe a significant relationship between missed nursing care scores and sex. For instance, studies by Mohammadi et al. (2023), Abadi et al. (1400), and Labrague et al. (2022) in the Philippines did not report any significant correlation between the average score for missed nursing care and gender. However, considering the results of the present study and corroborating studies, it can be suggested that gender is an important influencing factor on missed nursing care. This finding supports the notion that women are more likely than men to forget about nursing care tasks, which may be attributed to childcare responsibilities and family issues that can influence the work behavior of female nurses. Therefore, addressing the needs of this group of caregivers is crucial. The mentioned this findings can guide policymakers in addressing the issues faced by female nurses and paying more attention to the reasons for missed nursing care for women. The current study revealed a significant relationship between the missed nursing care score and the economic status of nurses, with individuals whit better economic status having fewer instances of missed nursing care. This finding contrasts with many studies that have not assessed the impact of this factor on missed nursing care, such as those by Abadi et al. (1400), Mohammadi et al. (2023), and others. Based on this finding, it can be argued that improving the economic status of nurses may lead to a reduction in missed nursing care and ultimately improve the quality of nursing care. Therefore, policymakers and health system decision-makers need to prioritize improving the economic status of nurses. Furthermore, the study revealed a statistically significant correlation between the missed nursing care score and the level of nursing burnout in special care units. This finding is consistent with the study by White et al., which also demonstrated a significant correlation between missed nursing care and burnout, with nurses experiencing burnout being 4.97 times more likely to have missed nursing care. Additionally, Tan et al. showed that each one unit increase in burnout among nurses was associated with a 1.61 fold greater likelihood of missed nursing care. Moreover, Abdulrahim Ibrahim and El-Wekil (2021) demonstrated a positive and significant relationship between burnout dimensions and missed nursing care in Egypt. On the other hand, the growing phenomenon of burnout syndrome is accompanied by civilization changes and increasing professional demands. Work-related stress causes dissatisfaction, chronic fatigue, and emotional exhaustion. Therefore, improving management and supervision systems for nursing care to reduce missed care and consequently reduce burnout is essential. Strengthening management and supervision systems, as well as providing stress management skills training and promoting collaboration and interaction, can be effective in reducing burnout and missed nursing care. The current study revealed a significant correlation between missed nursing care scores and dimensions of job burnout, including emotional exhaustion, depersonalization, and personal accomplishment among nurses. This finding is consistent with the study by Abdulrahim Ibrahim and El-Wekil (2021) in Egypt, which also showed a significant positive relationship between dimensions of job burnout and missed nursing care. Similarly, Liu et al. (2019) also reported this association in China. Moreover, the experiences of nurses in the study by Harvey et al. (2020) indicated a relationship with jeopardizing care, professional incongruence, emotional exhaustion, and depersonalization. Therefore, considering the association between missed nursing care and depersonalization among nurses, addressing this issue requires the development of communication skills and personality enhancement among nurses. Personality development programs and psychological counseling can help improve this situation and reduce care omissions. These findings, suggest that job burnout, including emotional exhaustion, depersonalization, and personal accomplishment among nurses, may influence nurses ability to provide care, leading to a reduction in care omissions. Additionally, organizing courses and workshops to enhance personal accomplishment skills and reduce job burnout and emotional exhaustion can lead to improvements in nurses' competence and care provision. Furthermore, investigating environmental factors in special care units and creating conducive environmental conditions can help improve nurses' performance in providing care. Conclusion The findings of the present study indicate a moderate level of missed nursing care and job burnout among nurses in the special care units of teaching hospitals affiliated with Kurdistan University of Medical Sciences. Despite the passage of time and advances in hospital technology and the increase in accreditation standards in hospitals, nurses in special care units still experience job burnout and may forget to perform certain care tasks. Therefore, measures need to be taken to reduce burnout and meet the needs of nurses in these units to improve the quality of healthcare services. Furthermore, considering the significant correlation between the score of missed nursing care and job burnout and its dimensions, it is recommended that healthcare policymakers and decision-makers take action to reduce nurse burnout and ensure continuous improvement in nursing care and healthcare service quality. Continuous training on burnout reduction skills should be provided to nurses to enhance nursing care and overall service quality in healthcare. Declarations All of part is my manuscription. Conflict of interest The authors( Shahin Shabani, Shahnaz Salawati-Ghasemi, Neda Sheikhzakaryaee, Arian Azadnia) declare no conflicts of interest. Author Contribution 1. collected the data and wrote the main manuscript2. wrote the main manuscript and reviewed the manuscriped3. analyzed the data Acknowledgement AcknowledgmentsWe wish to express our heartfelt gratitude to Kurdistan University of Medical Sciences for their assistance in facilitating this study, which was built upon a student thesis. We also extend our appreciation to the diligent research team, as well as the esteemed faculty and administrators of Kowsar, Towhid, and Besat Teaching Hospitals, which are affiliated with Kurdistan University of Medical Sciences. Additionally, we are grateful to the nurses who participated in this study for their indispensable cooperation, without which this research would not have been possible. References Gurková E, Mikšová Z, Šáteková L. 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Nurses’ burnout: the influence of leader empowering behaviors, work conditions, and demographic traits. INQUIRY: J Health Care Organ Provis Financing. 2017;54:0046958017724944. Khaneghai K, Parvin A, Vaisi Raygani AA, Abdi A, Salari N, Mohammadi MM, PREDICTING JOB BURNOUT, BASED ON JOB SATISFACTION, ORGANIZATIONAL COMMITMENT, EMOTIONAL INTELLIGENCE, AND FIVE PERSONALITY TRAITS IN KERMANSHAH NURSES. Nurs Midwifery J. 2023;20(11):939–53. Woo T, Ho R, Tang A, Tam W. Global prevalence of burnout symptoms among nurses: A systematic review and meta-analysis. J Psychiatr Res. 2020;123:9–20. Mohammadi S, Valiee S, Nouri B, Fathi M. The Rate and Causes of Missed Nursing Care of COVID-19 Hospitalized Patients in Intensive Care Units: A Multicenter Cross-sectional Study. J Crit Care Nurs. 2023;16(1):16–25. Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, et al. Factors influencing why nursing care is missed. J Clin Nurs. 2015;24(1–2):47–56. Labrague LJ, de Los Santos JAA, Fronda DC. Factors associated with missed nursing care and nurse-assessed quality of care during the COVID-19 pandemic. J Nurs Manag. 2022;30(1):62–70. White EM, Aiken LH, McHugh MD. Registered Nurse Burnout, Job Dissatisfaction, and Missed Care in Nursing Homes. J Am Geriatr Soc. 2019;67(10):2065–71. Nantsupawat A, Wichaikhum OA, Abhicharttibutra K, Sadarangani T, Poghosyan L. The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic. J Clin Nurs. 2023;32(15–16):5076–83. Ibrahim IA, El-wkeel NS. Exploring the Relationships between Job Burnout, Job Satisfaction, and Missed Nursing Care Among Staff Nurses. Tanta Sci Nurs J. 2021;2(21):97–120. Piotrowska A, Lisowska A, Twardak I, Włostowska K, Uchmanowicz I, Mess E. Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses. Int J Environ Res Public Health. 2022;19(12):7180. Liu J, Zheng J, Liu K, You L. Relationship Between Work Environments, Nurse Outcomes, and Quality of Care in ICUs: Mediating Role of Nursing Care Left Undone. J Nurs Care Qual. 2019;34(3). Harvey C, Thompson S, Otis E, Willis E. Nurses’ views on workload, care rationing and work environments. J Nurs Adm Manag. 2020;28(4):912–8. Footnotes intensive care units Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4595367","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":321248044,"identity":"f8a471e6-03b8-4dcd-bbdf-fdc9fc206d53","order_by":0,"name":"Shahin Shabani","email":"","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Shahin","middleName":"","lastName":"Shabani","suffix":""},{"id":321248045,"identity":"ccf30139-6a4d-47d2-8305-f86ef80e5753","order_by":1,"name":"Shahnaz Salawati Ghasemi","email":"","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Shahnaz","middleName":"Salawati","lastName":"Ghasemi","suffix":""},{"id":321248046,"identity":"33e0e2fb-9f0b-4931-8014-208bb5320ddb","order_by":2,"name":"Arian Azadnia","email":"","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Arian","middleName":"","lastName":"Azadnia","suffix":""},{"id":321248047,"identity":"22fa256c-6858-493c-a58e-a9503dfea3e0","order_by":3,"name":"Neda Sheikhzakaryaee","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYBACgwMMDIwNIBYzA+MDIMXDR0iLBZIWZgOQFjZCWmzgWhgY2CTAJGEt7A8/zqi5l9jfznys8muOnQwbA/PDRzfwaDE7wJAsueFYceKMw2xpt2W3JQMdxmZsnINfywHJB2wJiQ2HecxuS25jBmrhYZPGp8X4AGPzzwf/EhLnH+b/Viy5rZ6wFsMDzGySG9sSEjcc5mFj/LjtMBFaDrOxWc7sSzDeeJjNWJpx23EeNmYCfjE43v74Zs+3BNl55w8//PhzW7U9P3vzw8f4tABjEAwcG0BsHiQRgsAeRDD+IFL1KBgFo2AUjCwAAND1Sqs44e/pAAAAAElFTkSuQmCC","orcid":"","institution":"Kurdistan University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Neda","middleName":"","lastName":"Sheikhzakaryaee","suffix":""}],"badges":[],"createdAt":"2024-06-17 16:29:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4595367/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4595367/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":62927879,"identity":"468c99c3-b5f5-46ef-8193-e96cd5522500","added_by":"auto","created_at":"2024-08-21 07:07:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":843773,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4595367/v1/f73d8aed-55bc-4a74-ab3b-b690bcf782c3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Relationship between Missed Nursing Care and Job Burnout in Intensive Care Units","fulltext":[{"header":"Background","content":"\u003cp\u003eRecent research has shown that missed nursing care is a highly prevalent phenomenon in acute care settings (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). This issue has been recognized as a critical concept in nursing within acute care facilities worldwide (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) and is considered one of the forms of healthcare deficienciy on a global scale (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Missed nursing care refers to the neglect of both minor and major aspects of patient care that are either forgotten or delayed (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), partially completed, or not completed at all. In another definition, it involves care that is essential and necessary for the optimal and rapid recovery of patients but is omitted or not performed (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Moreover, missed nursing care is not only a type of nursing error that can affect patient safety but also leads to the neglect of patients' rights and jeopardizes their rehabilitation and recovery (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eNursing care holds particular importance due to its direct impact on patient recovery and health (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e). It can also serve as a benchmark for comparing performance across systems and organizations (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). Several factors, such as understaffing, poor teamwork and safety, and work-related stress, contribute to missed care (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). Emotional exhaustion among nurses is one such factor that leads to diminished care quality (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e). Indeed, job burnout and occupational stress among healthcare workers are among the threats to patient safety and care quality. Job burnout among healthcare workers is an independent predictor of adverse events, healthcare-associated infections, and medical errors, and it is associated with poor patient satisfaction (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAmong the job-related consequences of burnout are withdrawal from work, absenteeism, changes in job performance, and; decreased activity and effectiveness at work for those who remain in their positions (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e). Therefore, job burnout and job dissatisfaction not only lead to staff turnover but also have a detrimental impact on the quality of care (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e). When a nurse experiences burnout, patients are deprived of adequate attention and care, and their individual human rights are called into question. A nurse suffering from burnout, due to depersonalization, responds negatively to care recipients (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). The evidence suggests that nurse burnout affects patient recovery more than any other factor (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudies indicate that 23 to 43% of intensive care unit (ICU) nurses worldwide suffer from job burnout (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e), characterized by high levels of emotional exhaustion (EE) and depersonalization, and low levels of personal accomplishment (PA) (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e). Providing care in the ICU requires nurses to regularly handle and manage the most critical cases (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e), making ICU work more stressful for nurses and impacting the quality of care they provide (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e). Recent evidence shows that insufficient, delayed, or even omitted nursing care is widespread among nurses responsible for providing care (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e). In fact, the ability of nurses to provide care and fulfill their roles is greatly influenced by the work environment in which they serve (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eSeveral studies have shown that missed nursing care is prevalent in hospitals in the United States and Europe (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e). In a study conducted in the United States, the prevalence of missed nursing care was reported to be between 10 to 27% (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e). A review of related literature indicates that this issue is highly context-dependent, varying in frequency and type across different hospitals within the same country and even across different units within the same hospital (\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). In Iran, the rate of missed nursing care has been reported to be greater than that in other parts of the world (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e). For instance, a recent Iranian study revealed that 72.1% of nurses missed at least one nursing care activity during their last shift (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eStudies on missed nursing care highlight the greater the importance of quality nursing care and its comprehensiveness in intensive care units (ICUs) than in other departments. Therefore, assessing factors such as job burnout, which may be related to missed nursing care in ICUs, is crucial. However, there have been few studies specifically examining the relationship between missed nursing care and job burnout, and these studies have not been conducted recently, particularly in Iran, or within ICU settings. Thus, this study aimed to fill this gap by determining the relationship between missed nursing care and job burnout among nurses in intensive care units.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThe present study was a cross-sectional study with a descriptive-analytical approach. The research population included all nurses working in the intensive care units of teaching hospitals at Kurdistan University of Medical Sciences in Iran in 2023. The research sample was selected from the research population based on inclusion criteria, which included having rotating shift duties, at least six months of clinical experience in an intensive care unit, willingness to participate in the study, and holding a bachelor's degree or higher. The sampling method used was convenience sampling. The exclusion criterion was incomplete completion of the questionnaires.\u003c/p\u003e \u003cp\u003e The research environment for this study comprised 11 intensive care units in Kosar, Towhid, and Besat educational hospitals affiliated with Kurdistan University of Medical Sciences. To determine the sample size, a census method was used, and all nurses working in the intensive care units of these teaching hospitals in 2023 were included in the study. It is worth mentioning that the total number of nurses working in the intensive care units of Kurdistan's teaching hospitals was 253. Of these, 23 did not meet the inclusion criteria, and out of the remaining 230, 200 completed the questionnaires.\u003c/p\u003e \u003cp\u003eIn this study, the data collection tools included a demographic information form for nurses, the Kalisch Missed Nursing Care Questionnaire, and the Maslach Burnout Inventory (MBI). The demographic information form comprised questions related to age, gender, marital status, education, employment status, economic status, place of residence, place of employment, length of employment in ICUs\u003ca class=\"FNLink\" href=\"#Fn1\" id=\"#FNLinkFn1\"\u003e\u003csup\u003e1\u003c/sup\u003e\u003c/a\u003e, length of employment overall, number of shifts per month, type of shift, total working hours per month, and the amount of overtime per month.\u003c/p\u003e \u003cp\u003eIn the present study, the Kalisch Missed Nursing Care Questionnaire was used to assess missed nursing care. This questionnaire was developed by Kalisch in 2006 and was psychometrically evaluated by the same researcher in 2009. It consists of 24 items, including patient movement, turning, assessment, education, discharge planning, and medication administration. Each item is rated on a four-point Likert scale ranging from 1 to 4. Higher scores on this questionnaire indicate a higher level of missed nursing care, and vice versa. The maximum score on this questionnaire is 96, and the minimum score is 24 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). The validity of this tool in Iran was estimated by Khajavi and colleagues (2019) to be 0.91 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). In the study by Abadi and colleagues (2021), its reliability was calculated using Cronbach's alpha, which was 0.88 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e). Notably, in the present study, to assess face validity, a questionnaire was provided to 10 faculty members who are experts in nursing care, and their feedback was incorporated into the questionnaire items. Subsequently, to assess reliability, we used Cronbach's alpha.\u003c/p\u003e \u003cp\u003eThe Maslach Burnout Inventory (MBI) was used to measure job burnout among nurses. This questionnaire consists of 22 items designed to assess three dimensions of job burnout: emotional exhaustion (9 items), depersonalization (5 items), and reduced personal accomplishment (8 items). High scores in the dimensions of emotional exhaustion and depersonalization, along with low scores in personal accomplishment, indicate a high level of job burnout. The scores for each dimension are considered separately and are not combined into a single total score. In the study by Azimi Lolaty and colleagues, the reliability coefficients for the dimensions of emotional exhaustion, depersonalization, and personal accomplishment were calculated to be 0.90, 0.79, and 0.71, respectively (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e). In the study by Rasoul Aghadavoud, the Cronbach's alpha coefficient for the Maslach Burnout Inventory was calculated to be 0.852 (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eIn this study, data analysis was conducted using SPSS version 24 software. Descriptive analysis of the data was performed using frequency tests, means, and standard deviation calculations. To explore the relationships between variables, various statistical tests, including t-tests, Mann-Whitney U tests, ANOVA, and Kruskal-Wallis tests were used. Furthermore, linear regression analysis was conducted to evaluate correlations between variables. The significance level was set at 5%.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eEthical Concentration:\u003c/h2\u003e \u003cp\u003e To collect the data, the researcher first obtained approval from the Research Deputy of Kurdistan University of Medical Sciences and obtained ethics committee clearance (IR.MUK.REC.1402.107). First, the proposal was reviewed and approved by the research council of the university. Subsequently, the researcher approached the authorities of the educational hospitals. We sought permission to conduct the research. After briefing the authorities and the units under study (nurses working in special care units) about the study objectives and obtaining their consent, sampling was initiated. Notably all the data obtained from the questionnaires were treated as confidential. Sampling was carried out using a census method for nurses. The questionnaires were then distributed to the study participants, who received thorough instructions on how to complete them. Adhering to ethical standards, the researcher distributed the questionnaires anonymously among the research units after providing their consent_ while providing assurance to both nurses and patients regarding the confidentiality of the collected information. Data are available in this study. Ethical considerations were followed in writing the article based on the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe results of the present study regarding 200 nurses working in the intensive care units of educational hospitals affiliated with Kurdistan University of Medical Sciences showed that the age of the studied nurses was 32.05\u0026thinsp;\u0026plusmn;\u0026thinsp;6.09 years. The majority of the studied nurses were female (58.0%), married (54.0%), had a bachelor's degree (94.5%), were officially employed (49.0%), and had moderate economic status (65.5%), resided in urban areas (99.0%), and had a workplace at Kowsar Hospital (48.5%). Furthermore, the average length of employment for the studied nurses in the special care units was 21.5\u0026thinsp;\u0026plusmn;\u0026thinsp;4.41 months, and the average length of service was 17.04\u0026thinsp;\u0026plusmn;\u0026thinsp;20.13 months. Additionally, the average number of shifts worked by the studied nurses was 20.00\u0026thinsp;\u0026plusmn;\u0026thinsp;15.52, and the average number of working hours was 187.06\u0026thinsp;\u0026plusmn;\u0026thinsp;28.56 (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic Characteristics nurses employed in the intensive care department of teaching hospitals, Sanandaj, Iran (n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eDemographic characteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean \u0026plusmn; (SD) or\u003c/p\u003e \u003cp\u003eNumber (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32.05\u0026thinsp;\u003cb\u003e\u0026plusmn;\u003c/b\u003e\u0026thinsp;6.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84 (42.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e116 (58.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e109 (54.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85 (42.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed/ Widower\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAssociate's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1 (0.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBachelor's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e189 (94.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMaster's degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployed by a company\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eContractual\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52 (26.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFixed-term contract\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e35 (17.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOfficial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e98 (49.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eService commitment period\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5 (2.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eEconomic status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWeak\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43 (21.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eModerate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e131 (65.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26 (13.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e198 (99.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eVillage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2 (1.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003e\u003cb\u003eWorkplace hospital\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eKawsar Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e97 (48.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTohid Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (43.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBe'sat Hospital\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16 (8.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of employment in the intensive care unit (ICU)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.21\u0026thinsp;\u0026plusmn;\u0026thinsp;4.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of nurses' employment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.04\u0026thinsp;\u0026plusmn;\u0026thinsp;120.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of nursing shifts\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.00\u0026thinsp;\u0026plusmn;\u0026thinsp;15.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe working hours of nurses\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e187.06\u0026thinsp;\u0026plusmn;\u0026thinsp;28.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eWork shift type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFixed shift\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (19.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRotating shift\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161 (80.5%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eOvertime hours per month\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026gt;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e190 (95.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e100\u0026lt;\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (5.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of the present study indicated that in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences, the average score for forgotten nursing care was 29.35\u0026thinsp;\u0026plusmn;\u0026thinsp;43.9, the average score for emotional exhaustion of nurses was 25.14\u0026thinsp;\u0026plusmn;\u0026thinsp;11.12, the average score for depersonalization of nurses was 9.4\u0026thinsp;\u0026plusmn;\u0026thinsp;56.5, the average score for personal accomplishment of nurses was 19.24\u0026thinsp;\u0026plusmn;\u0026thinsp;5.9, and the average score for nurses' occupational burnout was 54.42\u0026thinsp;\u0026plusmn;\u0026thinsp;22.17 (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe distribution of scores for Missed nursing care, Nurse Burnout, and dimensions of Nurse Burnout (n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eScores\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean \u0026plusmn; (SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMissed nursing care\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e35.29\u0026thinsp;\u0026plusmn;\u0026thinsp;9.43\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmotional Exhaustion\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e14.25\u0026thinsp;\u0026plusmn;\u0026thinsp;12.11\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDepersonalization\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e4.05\u0026thinsp;\u0026plusmn;\u0026thinsp;5.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePersonal Accomplishment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e24.19\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNurse Burnout\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e \u003cp\u003e42.54\u0026thinsp;\u0026plusmn;\u0026thinsp;17.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of the present study, based on the Mann_Whitney test, showed a significant relationship between the score of forgotten nursing care and the gender of nurses (P\u0026thinsp;=\u0026thinsp;0.024), the economic status of nurses (P\u0026thinsp;=\u0026thinsp;0.0001), and the hospital where nurses worked (P\u0026thinsp;=\u0026thinsp;0.0001). Additionally, according to the Spearman correlation test, there was a significant correlation between the score of forgotten nursing care and the emotional exhaustion of nurses (P\u0026thinsp;=\u0026thinsp;0.0001), the depersonalization score of nurses (P\u0026thinsp;=\u0026thinsp;0.0001), the personal accomplishment score of nurses (P\u0026thinsp;=\u0026thinsp;0.0001), and the occupational burnout score of nurses (P\u0026thinsp;=\u0026thinsp;0.045) in special care units (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003e Scores of Missed Nursing Care and its Association with Demographic Characteristics, Nurse Burnout, and its Dimensions, Sanandaj, Iran (n\u0026thinsp;=\u0026thinsp;200)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eMissed nursing care score\u003c/p\u003e\u003cp\u003eDemographic characteristics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMean \u0026plusmn; (SD) or\u003c/p\u003e\u003cp\u003eFrequency (Average Rank)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSpearman\u0026rsquo;s rho\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eP-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003eScores of Missed nursing care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35.29\u0026thinsp;\u0026plusmn;\u0026thinsp;9.43\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e32.05\u0026thinsp;\u0026plusmn;\u0026thinsp;6.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;0.032\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.654\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e84 (111.36)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.024\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e116 (92.63)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e109 (109.07)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e0.091\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e85 (88.57)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (110.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed/ Widower\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (131.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eLevel of education\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAssociate's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1 (141.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.620\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e189 (99.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaster's degree\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (112.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployed by a company\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (102.70)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"4\" rowspan=\"5\"\u003e\u003cp\u003e0.320\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eContractual\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e52 (86.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFixed-term contract\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e35 (112.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOfficial\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e98 (102.75)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eService commitment period\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5 (111.60)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eEconomic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWeak\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43 (120.74)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e131 (107.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e26 (32.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e198 (101.01)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.246\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eVillage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2 (50.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWorkplace hospital\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eKawsar Hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e97 (121.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTohid Hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e87 (80.53)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBe'sat Hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e16 (83.69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eWork shift type\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFixed shift\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e39 (107.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.430\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRotating shift\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e161 (98.91)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eOvertime hours per month\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u0026gt;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e190 (100.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e0.639\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e100\u0026lt;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10 (92.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of employment in the intensive care unit (ICU)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e5.21\u0026thinsp;\u0026plusmn;\u0026thinsp;4.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;0.126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.075\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of nurses' employment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e17.04\u0026thinsp;\u0026plusmn;\u0026thinsp;120.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;0.030\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.672\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of nursing shifts\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e15.52\u0026thinsp;\u0026plusmn;\u0026thinsp;20.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.089\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.212\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eThe working hours of nurses\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e187.06\u0026thinsp;\u0026plusmn;\u0026thinsp;28.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.077\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.280\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmotional Exhaustion\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e14.25\u0026thinsp;\u0026plusmn;\u0026thinsp;12.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.380\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDepersonalization\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.05\u0026thinsp;\u0026plusmn;\u0026thinsp;5.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.318\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePersonal Accomplishment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e24.19\u0026thinsp;\u0026plusmn;\u0026thinsp;9.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.349\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNurse Burnout\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e42.54\u0026thinsp;\u0026plusmn;\u0026thinsp;17.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.045\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e \u003cp\u003eThe results of the present study, based on linear regression analysis, demonstrated a significant relationship between forgotten nursing care and sex (P\u0026thinsp;=\u0026thinsp;0.037) as well as economic status (P\u0026thinsp;=\u0026thinsp;0.0001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRegression Analysis of the Relationship Between Missed Nursing Care and Demographic Variables Among Researched Nurses\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eS. E\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSig\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eCollinearity\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eTol\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eVIF\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIntercept\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.619\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.740\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.292\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.421\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.148\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.339\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.854\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.171\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.086\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.225\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.849\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.178\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.799\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.731\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.898\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.113\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.090\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.674\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.213\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.808\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.238\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEconomic status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.331\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.829\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.207\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePlace of residence\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.957\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.949\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.053\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorkplace hospital\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.122\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.080\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.738\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of employment in the intensive care unit (ICU)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.069\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.221\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.505\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.392\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.550\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eDuration of nurses' employment\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.887\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.909\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.100\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eNumber of nursing shifts\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.098\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.040\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.140\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.963\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.039\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWork shift type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.053\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.885\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.564\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.775\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eThe working hours of nurses\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-0.107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.969\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.437\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eOvertime hours per month\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.022\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.909\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.750\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.927\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.078\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe present study aimed to investigate the relationship between missed nursing care and job burnout among nurses working in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences in 2023. The study was conducted on 200 nurses employed in the aforementioned hospitals. The results of the current study indicated that the mean scores of job burnout among nurses and its dimensions were moderate for emotional exhaustion, low for depersonalization, and low for personal accomplishment. The findings of the present study regarding the association between job burnout score and the study by Rastegari and Zendehdel (2023) are consistent; in this study, the overall score of job burnout among nurses was moderate (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In terms of the dimensions of job burnout, another study by Rastegari and colleagues (2021) showed that the average scores of the emotional exhaustion and depersonalization dimensions were moderate, and that of the personal accomplishment dimension was low (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). Additionally, a study conducted by Mudallal et al. (2017) on 407 Jordanian nurses demonstrated a high level of job burnout in the emotional exhaustion and depersonalization domains and a moderate level of personal accomplishment (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e). In the study by Ghazvini et al. (2023), 84% of nurses were found to experience job burnout (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e). However, a systematic review and meta-analysis by Esfahani et al. (2018) reported a job burnout prevalence of 25% among Iranian nurses (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e). Furthermore, a study systematic review and meta-analysis by Wu et al. (2023) on the global prevalence of job burnout symptoms among revealed an overall prevalence of 11.23%. This study included 113 studies for systematic review and 61 studies for meta-analysis, comprising 45,539 nurses from 49 countries across various specialties (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e). Based on these findings, it may be concluded that the prevalence of job burnout among nurses in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences is greater than that in global statistics. Several factors may contribute to this issue, including long working hours, excessive time, insufficient staffing relative to workload, frequent fluctuations in demand and response to medical and nursing care, psychological pressures, and stress waves resulting from sudden and critical patient conditions, as well as unexpected critical events such as accidents and physical injuries. Moreover, the imbalance between workload and material and spiritual rewards is one of the factors that may contribute to nurse burnout in these environments. Therefore, managerial and executive measures to reduce workload pressure, increase staffing levels, establish rest and psychological support programs, and strengthen support systems can help improve the job burnout status of nurses in these units. Additionally, some of these differences may be attributed to environmental, cultural, and organizational factors associated with each work environment, which requires further investigation and analysis.\u003c/p\u003e \u003cp\u003eThe results of the present study indicated that the average score for missed nursing care in the special care units of educational hospitals affiliated with Kurdistan University of Medical Sciences was 43.9\u0026thinsp;\u0026plusmn;\u0026thinsp;29.35. This was in contrast to the findings of Mohammadi et al. (2023), who reported an average score of missed nursing care in COVID-19 special care units in Kurdistan of 20.24\u0026thinsp;\u0026plusmn;\u0026thinsp;18.55, which was higher than the level observed in the current study. The higher rate of missed nursing care in Mohammadi et al.'s study may be attributed to the timing of the study during the COVID-19 pandemic and the impact of the coronavirus crisis on missed nursing care. Additionally, the results of Khajavi et al. 's study in Kerman in 2017 showed an average score for missed nursing care of 41.7\u0026thinsp;\u0026plusmn;\u0026thinsp;28.32, which was close to and consistent with the findings of the present study. This finding contrasts with a study by Hessels et al. (2015) conducted in the United States, where the prevalence of missed nursing care was reported to be between 10% and 27%. In another study by Blackman et al. (2015), the rate of missed nursing care was 34%, which is consistent with the results of the present study. However, the rate of missed nursing care in the study by Labrague et al. (2022) in the Philippines was very low at 50.0\u0026thinsp;\u0026plusmn;\u0026thinsp;35.1. The authors predicted that the reasons for the low rate of missed care include inadequate patient surveillance as the most commonly missed nursing activity, hospital resource levels, staffing levels, and patient safety culture.\u003c/p\u003e \u003cp\u003eThe present study results revealed a significant relationship between the missed nursing care score and the gender of nurses in special care units. This finding was consistent with the study by Chegini et al. (2019). It should be noted that in the current study, the frequency of missed nursing care was greater for women than for men, while Chegini et al. reported a greater risk of missed care for men. Most of the reviewed studies did not observe a significant relationship between missed nursing care scores and sex. For instance, studies by Mohammadi et al. (2023), Abadi et al. (1400), and Labrague et al. (2022) in the Philippines did not report any significant correlation between the average score for missed nursing care and gender. However, considering the results of the present study and corroborating studies, it can be suggested that gender is an important influencing factor on missed nursing care. This finding supports the notion that women are more likely than men to forget about nursing care tasks, which may be attributed to childcare responsibilities and family issues that can influence the work behavior of female nurses. Therefore, addressing the needs of this group of caregivers is crucial. The mentioned this findings can guide policymakers in addressing the issues faced by female nurses and paying more attention to the reasons for missed nursing care for women.\u003c/p\u003e \u003cp\u003eThe current study revealed a significant relationship between the missed nursing care score and the economic status of nurses, with individuals whit better economic status having fewer instances of missed nursing care. This finding contrasts with many studies that have not assessed the impact of this factor on missed nursing care, such as those by Abadi et al. (1400), Mohammadi et al. (2023), and others. Based on this finding, it can be argued that improving the economic status of nurses may lead to a reduction in missed nursing care and ultimately improve the quality of nursing care. Therefore, policymakers and health system decision-makers need to prioritize improving the economic status of nurses.\u003c/p\u003e \u003cp\u003eFurthermore, the study revealed a statistically significant correlation between the missed nursing care score and the level of nursing burnout in special care units. This finding is consistent with the study by White et al., which also demonstrated a significant correlation between missed nursing care and burnout, with nurses experiencing burnout being 4.97 times more likely to have missed nursing care. Additionally, Tan et al. showed that each one unit increase in burnout among nurses was associated with a 1.61 fold greater likelihood of missed nursing care. Moreover, Abdulrahim Ibrahim and El-Wekil (2021) demonstrated a positive and significant relationship between burnout dimensions and missed nursing care in Egypt. On the other hand, the growing phenomenon of burnout syndrome is accompanied by civilization changes and increasing professional demands. Work-related stress causes dissatisfaction, chronic fatigue, and emotional exhaustion. Therefore, improving management and supervision systems for nursing care to reduce missed care and consequently reduce burnout is essential. Strengthening management and supervision systems, as well as providing stress management skills training and promoting collaboration and interaction, can be effective in reducing burnout and missed nursing care.\u003c/p\u003e \u003cp\u003eThe current study revealed a significant correlation between missed nursing care scores and dimensions of job burnout, including emotional exhaustion, depersonalization, and personal accomplishment among nurses. This finding is consistent with the study by Abdulrahim Ibrahim and El-Wekil (2021) in Egypt, which also showed a significant positive relationship between dimensions of job burnout and missed nursing care. Similarly, Liu et al. (2019) also reported this association in China. Moreover, the experiences of nurses in the study by Harvey et al. (2020) indicated a relationship with jeopardizing care, professional incongruence, emotional exhaustion, and depersonalization.\u003c/p\u003e \u003cp\u003eTherefore, considering the association between missed nursing care and depersonalization among nurses, addressing this issue requires the development of communication skills and personality enhancement among nurses. Personality development programs and psychological counseling can help improve this situation and reduce care omissions.\u003c/p\u003e \u003cp\u003eThese findings, suggest that job burnout, including emotional exhaustion, depersonalization, and personal accomplishment among nurses, may influence nurses ability to provide care, leading to a reduction in care omissions. Additionally, organizing courses and workshops to enhance personal accomplishment skills and reduce job burnout and emotional exhaustion can lead to improvements in nurses' competence and care provision. Furthermore, investigating environmental factors in special care units and creating conducive environmental conditions can help improve nurses' performance in providing care.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe findings of the present study indicate a moderate level of missed nursing care and job burnout among nurses in the special care units of teaching hospitals affiliated with Kurdistan University of Medical Sciences. Despite the passage of time and advances in hospital technology and the increase in accreditation standards in hospitals, nurses in special care units still experience job burnout and may forget to perform certain care tasks. Therefore, measures need to be taken to reduce burnout and meet the needs of nurses in these units to improve the quality of healthcare services. Furthermore, considering the significant correlation between the score of missed nursing care and job burnout and its dimensions, it is recommended that healthcare policymakers and decision-makers take action to reduce nurse burnout and ensure continuous improvement in nursing care and healthcare service quality. Continuous training on burnout reduction skills should be provided to nurses to enhance nursing care and overall service quality in healthcare.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eAll of part is my manuscription.\u003c/p\u003e\n\u003ch2\u003eConflict of interest\u003c/h2\u003e \u003cp\u003eThe authors( Shahin Shabani, Shahnaz Salawati-Ghasemi, Neda Sheikhzakaryaee, Arian Azadnia) declare no conflicts of interest.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003e1. collected the data and wrote the main manuscript2. wrote the main manuscript and reviewed the manuscriped3. analyzed the data\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eAcknowledgmentsWe wish to express our heartfelt gratitude to Kurdistan University of Medical Sciences for their assistance in facilitating this study, which was built upon a student thesis. We also extend our appreciation to the diligent research team, as well as the esteemed faculty and administrators of Kowsar, Towhid, and Besat Teaching Hospitals, which are affiliated with Kurdistan University of Medical Sciences. Additionally, we are grateful to the nurses who participated in this study for their indispensable cooperation, without which this research would not have been possible.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eGurkov\u0026aacute; E, Mikšov\u0026aacute; Z, Š\u0026aacute;tekov\u0026aacute; L. Missed nursing care in hospital environments during the COVID-19 pandemic. Int Nurs Rev. 2022;69(2):175\u0026ndash;84.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEbadi J, Najafi E, Aghamohammadi V, Saeeidi S, Nasiri K. Missed Nursing Care and Its Related Factors in Ardabil and Khalkhal Educational and Medical Centers in 2020. 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The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic. J Clin Nurs. 2023;32(15\u0026ndash;16):5076\u0026ndash;83.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eIbrahim IA, El-wkeel NS. Exploring the Relationships between Job Burnout, Job Satisfaction, and Missed Nursing Care Among Staff Nurses. Tanta Sci Nurs J. 2021;2(21):97\u0026ndash;120.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePiotrowska A, Lisowska A, Twardak I, Włostowska K, Uchmanowicz I, Mess E. Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses. Int J Environ Res Public Health. 2022;19(12):7180.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLiu J, Zheng J, Liu K, You L. Relationship Between Work Environments, Nurse Outcomes, and Quality of Care in ICUs: Mediating Role of Nursing Care Left Undone. J Nurs Care Qual. 2019;34(3).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarvey C, Thompson S, Otis E, Willis E. Nurses\u0026rsquo; views on workload, care rationing and work environments. J Nurs Adm Manag. 2020;28(4):912\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Footnotes","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e intensive care units\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Missed Nursing Care, Job Burnout, Nurse, Intensive Care Unit","lastPublishedDoi":"10.21203/rs.3.rs-4595367/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4595367/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eProviding quality nursing care in intensive care units is a crucial and vital component of hospital services. Conversely, the stress and workload in these environments put nurses at risk of job burnout. This study aimed to examine the relationship between missed nursing care and job burnout among nurses in intensive care units.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThis cross-sectional study was conducted using a census sampling method on 200 nurses working in the intensive care units of teaching hospitals at Kurdistan University of Medical Sciences in Iran. The data were collected using demographic information forms. The Kalisch Missed Nursing Care Questionnaire and the Maslach Burnout Inventory (MBI). Descriptive and analytical analyses were performed using SPSS software version 24.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eIn this study, the mean score of missed nursing care was 35.29\u0026thinsp;\u0026plusmn;\u0026thinsp;9.43. Additionally, a moderate level of job burnout among nurses was found with a mean score of 42.54\u0026thinsp;\u0026plusmn;\u0026thinsp;17.22. The results indicated a significant relationship between missed nursing care and the gender and economic status of the nurses (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Furthermore, missed nursing care was significantly related to job burnout and its dimensions, including depersonalization and personal accomplishment (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eBased on these findings, to enhance the quality of healthcare services in intensive care units, measures should be taken to reduce missed nursing care and job burnout among nurses in these units.\u003c/p\u003e","manuscriptTitle":"The Relationship between Missed Nursing Care and Job Burnout in Intensive Care Units","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-17 08:27:55","doi":"10.21203/rs.3.rs-4595367/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"cb707a33-3d01-45f8-adc6-9d0eea332d64","owner":[],"postedDate":"July 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-08-21T06:59:28+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-17 08:27:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4595367","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4595367","identity":"rs-4595367","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}