Document Type : Original Article


1 Ph.D Student in Health Education and Promotion, Department of Health Education and Promotion, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

2 Professor, Occupational health Research Center, Iran University of Medical Sciences, Tehran, Iran

3 Community medicine specialist Preventive Medicine and Public Health Research Center, Psychosocial Health Research Institute, Community and Family Medicine Department, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

4 Assistant Professor, Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

5 Associate Professor, Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran


BACKGROUND: Health‑care workers are exposed to complex types of health and safety hazards. 
A high percentage of hospital staff in Iran are women, who in addition to heavy and stressful hospital 
work, also carry the burden of the family roles. It is in these circumstances that creating a supportive 
environment for women is of particular importance. Accordingly, this study is designed to determine 
the characteristics of a mental supporting work environment in the workplace from the perspective 
of female hospital staff.
MATERIALS AND METHODS: This study was performed by a qualitative method and content 
analysis approach. Sampling was purposive and 26 women working in different wards of this 
hospital were included in the study. In this study, women with maximum diversity in terms of age, 
work experience, and employment ward were selected. The main method of data collection in this 
study was a semi‑structured interview. Interview texts were extracted and divided into meaningful 
units. To validate and confirm the results plus accuracy of the research, the criterion of data validity 
or data credibility, admissibility, data accuracy, verifiability, reliability, and transferability were used.
RESULTS: Through the data analysis, 58 primary concepts with the same features were classified 
into 10 subcategories. Then, based on common features at a more abstract level, they were converted 
into four main categories including job stressors, women’s stress management, providing women’s 
psychological‑job satisfaction, and women’s work‑life balance.
CONCLUSION: Creating supportive work environments for women, especially those operating in 
workplaces such as hospitals, which brings a lot of work pressure and workload for them, can be an 
important policy for organizations and hospital work environments.


  1. Ghaffari M, Alinaghizadeh H, Ghalichi L, Pournik O, Vingard E. 
    Assessment of the psychosocial work environment among health 
    care workers and its association with work and socioeconomic 
    status. Arch Neurosci 2017;4:e13576.
    2. Hansen N, Sverke M, Näswall K. Predicting nurse burnout 
    from demands and resources in three acute care hospitals under 
    different forms of ownership: A cross‑sectional questionnaire 
    survey. Int J Nurs Stud 2009;46:95‑106.
    3. Marchand A, Durand P, Haines V 3rd, Harvey S. The multilevel 
    determinants of workers’ mental health: Results from the SALVEO 
    study. Soc Psychiatry Psychiatr Epidemiol 2015;50:445‑59.
    4. Harvey SB, Modini M, Joyce S, Milligan‑Saville JS, Tan L, 
    Mykletun A, et al. Can work make you mentally ill? A systematic 
    meta‑review of work‑related risk factors for common mental 
    health problems. Occup Environ Med 2017;74:301‑10.
    5. Tsang SS, Chen TY, Wang SF, Tai HL. Nursing work stress: The 
    impacts of social network structure and organizational citizenship 
    behavior. J Nurs Res 2012;20:9‑18.
    6. Fatehi F, Mohammadi M, Karimian M, Azmoon M, Gharibi F, 
    Shahabi H. The Relationship between Job Stress and Self‑Efficacy 
    and Public Health of Nurses and Midwives in the Besat Hospital; 
    7. Ghanjal A, Motaghi M, Sedigh N. Comparison of distribution 
    of physically induced joints pain in military and non‑military 
    patients. J Mil Med 2008;9:283‑7.
    8. Tsai YC, Liu CH. Factors and symptoms associated with work 
    stress and health‑promoting lifestyles among hospital staff: 
    A pilot study in Taiwan. BMC Health Serv Res 2012;12:199.
    9. LebniJY, Azar FE, SharmaM, Zangeneh A, Kianipour N, Azizi SA,
    et al. Factors Affecting Occupational Hazards among Operating 
    Room Personnel at Hospitals Affiliated in Western Iran: A CrossSectional Study. Journal of Public Health, 2021. 29(5): p. 1225-1232.
    10. Keshavarz Z, Simbar M, Ramezankhani A, Pourreza A, Alavi 
    Majd H. The priorities of policy making for health promotion 
    behaviors of female workers: A sequential mixed method study 
    Health care 2016;10:36‑50.
    11. Premji S. Building Healthy and Equitable Workplaces for Women 
    and Men: AResource for Employers and Workers Representatives. 
    Protecting Workers’ Health Series No. 11. Geneva: World Health 
    Organization; 2011.
    12. Rindner L, Nordeman L, Strömme G, Svenningsson I, Premberg Å, 
    Hange D, et al. Prognostic factors for future mental, physical 
    and urogenital health and work ability in women, 45‑55 years: 
    A six‑year prospective longitudinal cohort study. BMC Womens 
    Health 2020;20:171.
    13. Lebni JY, Toghroli R, Abbas J, Kianipour N, NeJhaddadgar N, 
    Salahshoor MR, et al. Nurses’ work‑related quality of life and its 
    influencing demographic factors at a public hospital in western 
    Iran: A cross‑sectional study. Int Q Community Health Educ 
    14. Pandey M. Impact of work‑life balance on job satisfaction of 
    women doctors. Probl Perspect Manage 2016;14:319‑24.
    15. Gharibi M, Sanagouymoharer G, Yaghoubinia F. The relationship 
    between quality of life with marital satisfaction in nurses in social 
    security hospital in Zahedan. Glob J Health Sci 2015;8:178‑84.
    16. Irfan U, Sheikh S, Faisal M. frequency of depression due to stress 
    in female nurses. Khyber Med Univ J 2010;2:10‑4.
    17. Derakhshan S, Rahimi Pordanjani T, Amani M. The relationships 
    between work‑ family conflict and marital adjustment in married 
    female nurses: The moderating role of social support. Q Horizon 
    Med Sci 2019;25:50‑6.
    18. Selvarajan TT, Singh B, Cloninger PA. Role of personality and 
    affect on the social support and work family conflict relationship. 
    J Vocat Behav 2016;94:39‑56.
    19. Guay S, Goncalves J, Jarvis J. Verbal violence in the workplace 
    according to victims’ sex – A systematic review of the literature. 
    Aggress Violent Behav 2014;19:572‑8.
    20. Bender KA, Donohue SM, Heywood JS. Job satisfaction and 
    gender segregation. Oxford Econ Pap 2005;57:479‑96.
  2. 21. Kravits K, McAllister‑BlackR, Grant M, Kirk C. Self‑care strategies 
    for nurses: A psycho‑educational intervention for stress reduction 
    and the prevention of burnout. Appl Nurs Res 2010;23:130‑8.
    22. Yoosefi Lebni J, Ziapour A, Qorbani M, Baygi F, Mirzaei A, 
    Safari O, et al. The consequences of regular methamphetamine 
    use in Tehran: Qualitative content analysis. Subst Abuse Treat 
    Prev Policy 2020;15:33.
    23. Graneheim UH, Lundman B. Qualitative content analysis in 
    nursing research: Concepts, procedures and measures to achieve 
    trustworthiness. Nurse Educ Today 2004;24:105‑12.
    24. Chowdhury IA. Issue of quality in a qualitative research: An 
    overview. Innov Issues Approaches Soc Sci 2015;8:142‑62.
    25. Chou LP, Li CY, Hu SC. Job stress and burnout in hospital 
    employees: Comparisons of different medical professions in a 
    regional hospital in Taiwan. BMJ Open 2014;4:e004185.
    26. Jonsson A, Segesten K, Mattsson B. Post‑traumatic stress among 
    Swedish ambulance personnel. Emerg Med J 2003;20:79‑84.
    27. Faremi FA, Olatubi MI, Adeniyi KG, Salau OR. Assessment of 
    occupational related stress among nurses in two selected hospitals 
    in a city southwestern Nigeria. Int J Afr Nurs Sci 2019;10:68‑73.
    28. Adib‑Hajbaghery M, Khamechian M, Alavi NM. Nurses’ 
    perception of occupational stress and its influencing factors: 
    A qualitative study. Iran J Nurs Midwifery Res 2012;17:352‑9.
    29. Mahmoodi GH, Rouhy GH, Mojerlu M, Sheikh H, Rahmany H. 
    Relationship between nursing burnout, physical environment 
    and profesinal equipments. J Gorgan Univ Med Sci 2006;8:40‑6.
    30. Srinivasan K, Samuel D. Psychological problem factors faced 
    by staff nurses working in hospitals. IOSR J Humanit Soc Sci 
    31. Akbari M, Bagheri A, Fathollahi A, Darvish M. Job satisfaction 
    among nurses in Iran: Does gender matter? J Multidiscip Healthc 
    32. Alavi Arjmand N, Kashaninia Z, Hosseini MA, Rezasoltani P. 
    Effect of stress management on job stress and work‑family conflict 
    among nurses. J Hayat 2013;18:81‑91.
    33. Moosavi TS, Rahmani R, Sirati NM, Abbas ZZ. Influence Factors 
    in Job Satisfaction of Nurses in the Selected Military and Civil 
    Hospital in Tehran; 2013.
    34. Eid Mt. Highlighting The Main Factors of Job Satisfaction Among 
    Jordanian Hospital Employees. Journal of Applied Quantitative 
    Methods. 2016 Mar 1;11(1).
    35. Jackson, Annette J., "Nurse Faculty Job Satisfaction: Development 
    and Evaluation of the Nurse Educator Satisfaction Index" 
    (2016). Doctorate of Nursing Science Dissertations. 3. https://
    36. Park MS, Jeoung Y, Lee HK, Sok SR. Relationships among 
    communication competence, self‑efficacy, and job satisfaction in 
    Korean nurses working in the emergency medical center setting. 
    J Nurs Res 2015;23:101‑8.
    37. Moradi M, Khatooni M, Jahani HH, Zeighami R, Sheikh 
    M. Relationship between professional commitment and job 
    satisfaction in Qazvin’s pubic educational hospital nurses. Iranian 
    Journal of Nursing 2013:55-78.
    38. Amiri A, Setoodeh G, Sajjadi SF. The effect of educational stress 
    management on job stress of operating room nurses at hospitals 
    affiliated to Shiraz University of Medical Sciences during year 
    2016: A randomized controlled clinical trial. Womens Health Bull 
    39. HosseiniZ, Moeini B, Hazavehei S, AghamollaiT, MoghimbeigiA. 
    Effect of educational stress management, based on Precede model, 
    on job stress of nurses. Hormozgan Med J 2011;15:200‑8.
    40. Seyyed Moharrami I, Pashib M, Tatari M, Mohammadi S. The 
    Efficiency of Stress Management Group therapy in job stress 
    and self‑efficacy of nurses. J Torbat Heydariyeh Univ Med Sci 
    41. Chu AH, Koh D, Moy FM, Müller‑Riemenschneider F. Do 
    workplace physical activity interventions improve mental health 
    outcomes? Occup Med (Lond) 2014;64:235‑45.
    42. Freitas AR, Carneseca EC, Paiva CE, Paiva BS. Impact of a physical 
    activity program on the anxiety, depression, occupational stress 
    and burnout syndrome of nursing professionals. Rev Lat Am 
    Enfermagem 2014;22:332‑6.
    43. Alavi S, Ahmadi MA, Zar A. Association beween physical 
    activity and social health and spiritual intelligence among nurses. 
    Community Health 2018;5:2018.
    44. Tofighi A, Babaei S, Dastah S. The relationship between physical 
    activity and mental health among nurses of Urmia hospitals. Nurs 
    Midwifery J 2014;12:72‑8.
    45. Al‑Ahmadi H. Factors affecting performance of hospital nurses 
    in Riyadh Region, Saudi Arabia. Int J Health Care Qual Assur 
    46. Ullström S, Andreen Sachs M, Hansson J, Ovretveit J, 
    Brommels M. Suffering in silence: A qualitative study of second 
    victims of adverse events. BMJ Qual Saf 2014;23:325‑31.
    47. Schelbred AB, NordR. Nurses’ experiences of drug administration 
    errors. J Adv Nurs 2007;60:317‑24.
    48. Salimi S, Rahimi J, Bayazidi S. Nurses'experiences Regarding Error 
    Reporting Process: Findings of a Qualitative Study. Nursing and 
    Midwifery Journal. 2013 Sep 10;11(6).
    49. Wolf ZR, Hughes RG. Error reporting and disclosure. Patient 
    safety and quality: An evidence-based handbook for nurses. 2008 
    50. Tabatabaee SS, Kalhor R, Nejatzadegan Z, Kohpeima Jahromi V, 
    Sharifi T. Barriers to medication error reporting from nurses’ 
    perspective: Aprivate hospital survey. Int J Hosp Res 2014;3:97‑102.
    51. Faghihi M, Farshad A, Abhari MB, Azadi N, Mansourian M. 
    The components of workplace violence against nurses from 
    the perspective of women working in a hospital in Tehran: 
    A qualitative study. BMC Womens Health 2021;21:209.
    52. Baby M, Glue P, Carlyle D. ‘Violence is not part of our job’: 
    A thematic analysis of psychiatric mental health nurses’ 
    experiences of patient assaults from a New Zealand perspective. 
    Issues Ment Health Nurs 2014;35:647‑55.
    53. Christie W. Perceptions of managerial support after workplace 
    violence. Nurs Manag (Harrow) 2015;22:32‑6.
    54. Mohajeran B, Derakhshanfard S, Sayah G, Behbodiyan A. Barriers 
    to the female nurses’ progression to management positions in the 
    hospital “case study: Imam Khomeini hospital of Ardabil”. Iran 
    J Nurs 2017;30:68‑77.
    55. Namdari S, Nasiri A, Nakhaee S, Taheri F. Exploring the effects of 
    nurses’ family‑work conflict on patient care quality: A qualitative 
    study. Mod Care J 2019;16:e86130.
    56. Polat Ş, Kutlu L, Ay F, Erkan HA, Doğrusöz LA. The relationship 
    between work-family conflict, organizational silence and 
    social support in nurses at a university hospital. Journal 
    of Psychiatric Nursing/Psikiyatri Hemsireleri Dernegi. 2018 Oct 
    57. Wong SC, Ko A. Exploratory study of understanding hotel 
    employees’ perception on work‑life balance issues. Int J Hosp 
    Manag 2009;28:195‑203.
    58. Kamrani MA, Amiri AN, Alavi SH, Hamidizadeh A. Factors 
    Affecting Work-Life Balance of Nurses in Hospitals Affiliated to 
    Jiroft University of Medical Sciences in 1396. Journal of Nursing 
    Education (JNE). 2018 Oct;7(4)