July 2006

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Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD): Evidence-Based Approach

Acceptance of self-treatment in Hemophilic Patient: A Training Method

A Study of Depression Prevalence of  (in) Nurses and It’s Effective Factors in Shiraz Namazi Hospital

Home Health Care Team Members

Call for a Middle East Center of Disease Control

Skilled Health Workers - A Solution to Primary Health Problems in Pakistan

The Blind School Project - An activity from School Health Program

Scleromalacia Associated with Marfan’s Syndrome

Reference values of hematological parameters of healthy Anatolian males aged 18-45 years old

Aspiration and Death from Amitraz-Xylene Poisoning

Childhood Orbital Cellulitis Complicating Sinusitis in Tafila



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A Study of Depression Prevalence in Nurses and It's Effect in Shiraz Namazi Hospital



S.Habibollah Kavari, PhD
Assistant Professor of School of Management and Medical Information Sciences, Shiraz.
University of Medical Sciences, Shiraz, Iran.



In a cross-sectional survey, depression prevalence of 130 nurses in Shiraz Namazi hospital, Iran, has been investigated by using long form test items (21 questions) of Beck depression questionnaire. Also necessary data for independent variables was collected by interview.

The findings of this study indicated that depression rates of mild, moderate and severe types were 73.1%, 21.5% and 5.4%, respectively.

In this study a statistically significant association has been found between depression and marital status (P<0.0001), level of education (P<0.005), overtime hours at work (P<0.02) and parent's death in childhood (before 11th year of age) (P<0.001).

Key Words: Depression; Nurses; Prevalence; Beck questionnaire


Depression encompasses feelings of indisposition, shortage of energy, despair, uselessness, disinterestedness and pessimism that may lead to suicide.

The prevalence of this disease in society is 9 to 20 percent, but when more exact criterion was taken into consideration for measurement of mature depression, its prevalence is 3% in men and 4 to 9% in women.(3).

Probability of suffering from depression in duration of life, for women is almost 20% and for men 10% and that only 20 to 25 percent of people have criterions of depression that have been cured. The prevalence of depression is in women twice that of men and age of beginning of depression varies from childhood until the age of retirement but in 50% of cases disease begins between the ages 20 to 50. (Average age at the beginning of this disorder is about age 40.) (3).

There is a direct relationship between onset of depression and physical stress. In a work environment physical, psychological and social stimulants can contribute to stress (4). In nurses a variety of stressors, create a state of chronic weariness and depression is the result of despair (5).

Nurses don't only assume the role of carers but are also administrators and supervisors of patients.(6). They perform the role of advisor on the subject of hygiene and are members of a group trained to be responsible for public health, disease prevention, and advocates for the full health of individuals, of families and of society (7).

Nursing is a profession where depression is apparent and documented ( 8). The abandonment of nursing as a profession and a decrease in the number of volunteers in this field has been due to different reasons, with one factor lack of job satisfaction. If expectations of a nursing career, both professional and personal are not met, discouragement and disillusionment contribute to an abandonment of the profession (9).Absenteeism due to depression also causes problems ( 10)

In our research one aim was to compare the rates of depression between our nurses and those in other societies. Research focused particularly on upper levels of stress in nurses in Iran, compared to nurses in other societies. 75.6% nurses have job stress in the little and middle categories. (11).

It is important to have a stress and depression free, nursing profession, as nurses are responsible for many services including hygiene and the guaranteeing of a healthy society. The present study was devised for with the purpose of finding the levels of depression in nurses in Shiraz Namazi hospital and the connection with some effective factors.. These factors consisted of: age, marital status, educational qualification, occupation of spouse, education of spouse, number of children, parent's death before 11th age (at childhood), absence of support by relatives in the preceding 6 months, continuous use of contraceptives in the previous three months, existence of present pregnancy, rate of over time hours worked and rate of night-shift hours.

Namazi hospital is an important center of sciences and medical technology in the south of the country that performs many services which entail heavy workloads and shortages of staff leading to fatigue and depression.


The type of study was cross-sectional. The study population consisted of: 130 nurses from Namazi hospital.

Information was gathered by a questionnaire consisting of two original parts, and included gathering of social and occupational information. A test of 21 questions, by Beck, was completed first, by the nurses., Beck test appoints different rates of depression from mild till severe. The maximum grade in the test is 63.This test is independent from culture and isn't specific to any class or economic or educational levels.

For analyzing, information was used from statistical tests analyzing variance and T test, in SPSS software.


In this study, 130 nurses were interviewed and 73.1% of subjects had mild depression, 21.5% had moderate depression and 5.4% had severe depression. (Table 1).

Table 1- Distribution of proportional abundance of intensity of depression in Namazi hospital nurses



Intensity of depression













The depression prevalence according to independent variables of marital status and parent's death before 11th age (at childhood) has been shown in Table 2.

The maximum prevalence of severe depression was observed in widowed persons and a group that had lost their parents before 11th year of age.


Statistical specification of depression according to independent variables has been shown in Table 3. Between age, occupation of spouse, education of spouse, number of children, absence of relatives in last 6 months, continuous using of contraception in last three months, existence of present pregnancy and rate of night-shift hours (hour per week) there wasn't any meaningful connection with the state of depression.

Between depression prevalence with marital status (P<0.0001), educational qualification (P<0.006), parent's death before 11th year of age (P<0.001) and rate of over time hours per week (P<0.02) there was a meaningful connection.

Table 2 - Distribution of depression intensity according to different variables, before recent 6 months






Independent variables
Marital status


married /
before 11th age




Table 3 - statistical specifications of depression privilege according to independent variables in Namazi hospital nurses

P<0.0001 marital status
9.37 11.2 40 Single
8.82 11.27 77 Married
9.46 25.67 6 Divorced
8.49 26.14 7 Widow
P<0.006   educational document
11.39 17.54 26  
9.21 11.51 104 parent's death before 11th age
P<0.001 9.97 23.56 16 Yes
9.98 11.19 114 No
P<0.02   rate of over times hours (hour per week)


72 Hours per week
12.33 18.5 22 0 - zero
8.69 10.95 20 lower than 14
6.80 9.79 14 lower than 14



The findings of this study showed that 21.5% people studied have moderate depression, and 5.4% have severe depression.

Therefore it can be said that in total 26.9% have notable depression.

In this study the connection between depression prevalence and marital status was meaningful (P<0.0001). Divorced and widowed people were more depressed than single and married persons.

In this concern we can say that social support among family relations and matrimony have an inverse relationship with creation of stress and physical illness(12) and in subjects without support, there are increased rates of occupational stress. (13) Married nurses experienced less occupational depression due to support from family. (14). In the research 41% of nurses studied supported themselves 18% had a spouse and family (11) 37.5% divorced and widowed persons were inclined to change their profession, while this was 27.7% in married persons.

In this study the inclination to change employment was an issue for nurses(15) and with attention to family and lack of formal support (16) divorced and widowed persons had enjoyed less social support from family memebers, than married and single subjects.

In this study there was a meaningful and inverse relationship between intensity of depression and level of education (P<0.005). When nurses do not have sufficient clinical information or training, this causes lack of confidence (17) and we can conclude that with increasing of levels of education and clinical information income will increase and depression decrease.

The correlation between depression prevalence an parent's death before 11th age was seen as a meaningful connection (P<0.001).Persons who had lost parents before 11th year of age, have been deprived of important support in early years, and have undergone hardships in formative years and this problem has culminated in the appearance of the disorder.

In our research on overtime hours per week and the intensity of depression there was a meaningful connection (P<0.02) between the probability of increased work hours leading to increased income for nurses and in relation to occupational stress connected with the rate of income of nurses (17) which decreases depression.

Existence of social supports is very important in the workplace because there is an inverse relationship between support by head nurses and colleagues with occupational stress of nurses (14).

Head nurses and supervisors are the frontline people best able to show attention, supporting and cooperation (17). In our research only 45% of nurses mentioned receiving support from these personnel. (11). Head nurses especially should pay more attention to young nurses requiring support because with maturity such problems decrease with an increase in support. (12).


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