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  • This descriptive-analytic study was conducted at two teaching and referral hospitals affiliated with Rafsanjan University of Medical Sciences (RUMS) in the southeast of Iran from March to June 2016. At the time of data collection, these hospitals were small and medium in size with 100 and 300 beds, respectively. The target population of this study included nurses working at the time of data collection (N = 364). The inclusion criteria were having Bachelor’s degrees or higher, work experience over 6 months, working in the position of a clinical nurse or a head nurse at the time of data collection and good mental and psychological conditions. Incomplete questionnaires were considered as the exclusion criteria. The sample size was calculated based on Cochran’s formula (α = 0.05, d = 0.05, Z = 1.96) by 190 individuals and, in total, 240 nurses were recruited in the study by taking into account the probability of participant loss. The studied samples were selected through stratified random sampling based on the proportion of nurses working per hospital. Finally, 10 questionnaires were excluded from the study due to their incompleteness (the response rate was 95.83%). Three questionnaires were used for data collection. The first part was a demographic questionnaire including items about age, gender, marital status, work shifts, level of education, type of employment, position and work experience. The second part included competency inventory for registered nurse (CIRN) that was introduced by Liu et al., (2009). This questionnaire evaluates the competency of nurses in various clinical positions in the form of self-evaluation or peer evaluation [22]. The Persian version of the questionnaire was also translated and validated in 2014 by Ghasemi et al., [23]. This questionnaire consisted of 55 items and 7 dimensions including clinical care (10 items), leadership (9 items), interpersonal relationships (8 items), legal-ethical practice (8 items), professional development (6 items), teaching-coaching (6 items) and research aptitude-critical thinking (8 items). The CIRN was scored using the five-point likert scale ranging from 0 to 4, with incompetency (score zero), low competency (score 1), moderate competency (score 2), high or sufficient competency (score 3) and very high competency (score 4). In this respect, the mean scores below 2, 2–3 and above 3 were considered as low competent, moderate and highly competent, respectively. The content validity index of the main questionnaire calculated by experts was 85%. In order to determine the reliability of the questionnaire, Cronbach’s alpha coefficient was used in which Cronbach’s alpha of the entire instrument was 0.90, and it was reported in the range of 71–90% for its dimensions [22]. The Content Validity Index (CVI) of the Persian version of CIRN was 94% for the entire instrument and more than 83% for all the items. Furthermore, the reliability of the questionnaire was calculated through internal consistency method, in which Cronbach’s alpha coefficient for the whole instrument was 0.97 and it was reported between 68–87% for all the dimensions of this inventory [23]. The third part was the organizational commitment questionnaire which was developed in 1990 by Allen and Meyer. Bastami et al., [15] used the Persian version of this questionnaire in 2013. This questionnaire was comprised of 24 items, in which each of the 8 items measured one dimension of the organizational commitment, i.e. affective commitment, normative commitment and continuance commitment. Responses to this questionnaire were based on a 5-point Likert scale, with strongly agree (score 5), agree (score 4), neutral (score 3), disagree (score 2) and strongly disagree (score 1). The minimum score in this questionnaire was 24 and the maximum score was 120. The scores between 90 and 120 were considered as high organizational commitment, scores between 60–90 and lower than 60 were likewise taken into account as moderate and low organizational commitment, respectively. In general, higher scores indicated the greater organizational commitment of an individual. The Ethics Committee affiliated with Kerman University of Medical Sciences approved the conductance of this study as well as the consent procedure (Medical Ethic No: ir.kmu.rec.05.1395). Thus, first, the researcher presented the letter of introduction for the required coordination with the context of the study. A cover letter explaining the purpose of the study and the procedure for the data collection was provided to the eligible participants prior to the data collection. Then verbal agreement of the participants was obtained, and they were ensured in terms of confidentiality and anonymity of the data as well as voluntary participation in the study. Informed consent was implied from returning the completed questionnaires. Descriptive statistics (percentage, mean and standard deviation) as well as analytical statistics (Mann-Whitney test, Kruskal-Wallis test and Spearman correlation coefficient) were used. The level of significance was considered by 5% and SPSS software (version 18) was employed for data analysis.
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